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BACKGROUND Pediatric obstructive sleep apnea (OSA) poses a significant health concern, affecting the well-being and quality of life of affected children. This study focuses on the translation, adaptation, and validation of the OSA-18 questionnaire for Arabic-speaking pediatric patients, aiming to contribute to the understanding of OSA and its implications on the quality of life in this population. METHODS A study was conducted at Jordan University Hospital, involving 186 Arabic-speaking pediatric patients with suspected OSA. The OSA-18 questionnaire was translated and culturally adapted following the World Health Organization guidelines. Overnight polysomnography was conducted to assess OSA severity. Internal consistency, construct validity, convergent validity, and predictive/discriminant validity were analyzed. RESULTS The study sample (68.8% of males, median age: 10.87) showed a median Apnea–Hypopnea Index (AHI) of 7.0, OSA-18 score of 46.5, and Pediatric Sleep Questionnaire (PSQ) score of 7.0. Internal consistency of OSA-18 was acceptable, except for the “physical symptoms” domain. Exploratory and confirmatory factor analyses revealed five factors corresponding to different OSA-18 domains. Convergent validity was supported by significant correlations between OSA-18 and PSQ scores. However, no correlation was found between OSA-18 scores and AHI. OSA severity was associated with higher PSQ scores but not with AHI. CONCLUSION This study provides valuable insights into pediatric OSA in Arabic-speaking children. While the translation and validation of the OSA-18 questionnaire demonstrated acceptable reliability and convergent validity, the lack of correlation between OSA-18 scores and AHI raises questions about the survey’s ability to capture the full impact of OSA objectively. Future research should focus on developing more reliable diagnostic tools, especially in resource-limited settings.

One of the frequently used forms of discourse in the Holy Quran is storytelling. The Quranic stories are a rich treasure trove of faith-based, ethical, and behavioral teachings, which are vividly portrayed to provide models for others to emulate. In a civilization-building rereading of the stories of the prophets in the Quran, the first step is to identify the recurring themes in God's narrative of the teachings and actions of the prophets. Approaches to thematic analysis in literary sciences, such as narratology, offer scientifically valid and reliable tools that can assist in this process. Accordingly, this article adopts a descriptive-analytical method and uses the motif element from narratology to reinterpret part of the story of Prophet Ibrahim (AS) in the Holy Quran. The findings of this study reveal motifs such as the establishment of a rational civilization-building mindset through the motif of debate, the affirmation of effort and struggle in the expansion of the civilizational mission through the motif of trial, and the concern for the continuation of civilization in future generations through the motif of prayer for offspring in the story of Ibrahim (AS).

Objective: To explore sexual reproduction-related awareness and knowledge, information-seeking behavior, and related information resources needed among Saudi female students. Study Design: Descriptive cross-sectional study. Place and Duration of Study: The study was conducted in King Faisal University, Al Ahsa Saudi Arabia from 1 September 2023 to 20 November 2023. Materials and Methods: A questionnaire-based cross-sectional study was conducted at King Faisal University Saudi Arabia. A sample of 328 preparatory-year female students was evaluated on reproductive health awareness through a randomized sampling method. Data was cleaned in Excel and Analyzed in IBM SPSS 29. Results: The study involved 328 female students and highlights significant findings in reproductive health awareness. Notably, 26.2% (85) experienced irregular menstrual cycles, 99.1% (325) used sanitary pads, and 78.4% (257) and 41.2% (135) discussed their first period, primarily with mothers. TV (17.1%) and news (16.2%) were the primary sources of reproductive health information while 93.9% (307) had contraceptive knowledge, and 84.5% (277) understood reasons for use. Challenges in obtaining information included uncertainty (30.6%) and shame (29.1%). Preferences included information on reproductive/sexual health (21.1%) and sexual/premarital preparation classes (18.3%). The educational status of fathers significantly correlated with sexual and reproductive health awareness and knowledge (p=0.040). Conclusion: The study revealed gaps in female preparatory year students' awareness of reproductive health. It underscores the importance of enhancing the accessibility of reproductive health knowledge resources and improving communication channels with parents to attain first-hand appropriate knowledge of reproductive health.

Abstract Introduction Regarding a potential relationship between diabetes and the prognostic significance of hyperglycemia in patients presenting with acute myocardial infarction (AMI), there is still debate. Therefore, we aimed in this study to demonstrate the effect of hyperglycemia on different outcomes in AMI patients, whether they are diabetic or not. Methods We searched PubMed, Web of Science, and Scopus using the following search strategy: “Diabetes” or “Diabetic” AND “Acute myocardial infarction” OR “AMI” AND “hyperglycemia” OR “glucose level” to find eligible articles that needed to go through the screening process for inclusion in our study. We conducted a meta-analysis of 19 included studies from Japan, Germany, China, the United Kingdom, and others using Review Manager version 5.4 software, pooling the mean difference in continuous variables, the number and total of dichotomous variables to measure the odds ratio (OR), and the generic inverse variance of OR or hazard ratio (HR) as reported in the included studies. Results The mean age of the participants ranged from 56.3 to 72.3 years old. The difference in blood glucose levels between diabetes and non-diabetes patients was found to be statistically significant, with an SMD of 1.39 (95%CI: 1.12, 1.66, p

Background Fungal rhinosinusitis is subdivided into two subtypes, invasive and noninvasive variants, with allergic fungal rhinosinusitis (AFRS) being the most prevalent noninvasive variant. The most common clinical features of AFRS are nasal polyposis, rhinorrhea, facial pressure, and periorbital edema.Objective This study aimed to report a rare clinical presentation and serious complications of AFRS.Method and result The patient was presented to the Otorhinolaryngology Department of Qatif Central Hospital, Eastern Region, Saudi Arabia. We reported a rare presentation of a patient diagnosed with untreated AFRS complicated by basilar artery thrombosis. The patient was urgently managed with endoscopic sinus surgery, postoperative antifungal, and local nasal steroids.Conclusion Allergic fungal rhinosinusitis is a chronic disorder associated with significant morbidity that requires early diagnosis and management. The treatment protocol was based on surgical debridement of the paranasal sinuses from the fungal material and postoperative steroid therapy. Allergic fungal sinusitis with granuloma was more aggressive and needed to be treated cautiously by adding antifungal treatments.

The ability to locate and identify problems in power transmission lines is the most crucial component of power system engineering since it ensures the stable and efficient operation of electrical grids. to minimize downtime, prevent cascading failures, and maintain the power system's stability. problem localization helps identify the precise location of the problem and speeds up the process of restoring the power supply while minimizing the impact on consumers. This paper presents a measurement-based automatic fault localization and detection (ANFIS) technique for transmission lines. High-speed processing of real-time error localization and detection is made possible by the design and implementation of ANFIS. It is suggested that ANFIS for digital distance protection systems be able to discover issues in addition to detecting them. When a transmission experiences a three-phase malfunction Thus, the suggested method can precisely pinpoint the impacted stages. ANFIS has been trained and tested using many kinds of field data. The field data are collected by simulating faults in the Simulink Matlab model depicting the transmission line at various sites between Misan – Kut station 400 Kv along 200 Km using computer software based on Matlab. Phase current and voltage measurements are utilized as ANFIS inputs and are available at the busses. Regarding the kind and detection of defects, The output will demonstrate fault and location identification with an extremely low error percentage through simulated processes; the results also demonstrate that the approach's selectivity and speed are quite dependable and provide adequate performance for applications involving transmission and distribution monitoring; and security. The study emphasizes the criticality of promptly and precisely locating faults in power transmission lines to preserve the stability and security of the power system.

Background and purpose: Activated textiles have created a new field of application apart from standard textile applications. Novel, functions, for example, antimicrobial properties have been enhanced in textiles. New textile application fields have been recognized for particular areas of healthcare as well as industry, sportswear, and, home textiles. Advances in the field of antibacterial textiles have fascinated enhancing attention because those are a means to solve serious health challenges such as bacterial overgrowth. A lot of research has been done in the field of adding synthetic and toxic materials to fabrics, such as nanosilver triclosan or other metals and organic materials to produce antimicrobial fabrics. These fabrics kill bacteria by binding to intracellular proteins and inactivating these proteins. Also, by using these chemicals, the content of heavy metals in these textiles can be increased. The application of heavy metals in antimicrobial textiles is limited by many environmental tags and standards. Therefore, it is recommended to use natural antimicrobial agents, such as nisin and chitosan to produce environmentally friendly and safe antimicrobial fabrics. Nowadays finishing process with the natural antibacterial agents that protect the environment and human health is gaining importance. Therefore, this study aims to produce fabric coated with chitosan and nisin and to investigate its antimicrobial properties. Materials and methods: In this research, chitosan was used to bind nisin to the surface of polypropylene span band non-woven fabric. The fabric samples were coated with a solution containing chitosan and nisin using a pad-dry-cure method. The appearance, color, and softness of the coated fabrics were compared to the uncoated fabric. The nisin and chitosan binding properties on the fabric were explored by using the Fourier-transform infrared (FTIR (technique. The diffusion method in agar and the standard method (ASTME2149-01) were used to check the antimicrobial properties of fabric samples. The antibacterial effectiveness of fabric samples was tested against common bacteria such as Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus, Bacillus cereus, Listeria monocytogenes, and Enterococcus faecalis. After ten washing cycles, the durability of the antimicrobial properties of these fabrics was checked by the method mentioned above. Also, the toxicity of this fabric on fibroblast cells was determined using the MTT colorimetry method after seven days. Results: Fabrics coated with chitosan and nisin do not differ much from the control sample in terms of appearance and softness. The changes observed in the FTIR spectrum, such as the appearance of new absorption peaks and additional peaks associated with peptide bonds, confirm the successful incorporation of nisin and chitosan into the fabric. Antibacterial results have shown that nisin improved the antibacterial effect of coated fabrics versus B. cereus, S. aureus, and P. aeruginosa. The antimicrobial properties of the fabric coated with chitosan-nisin were maintained at some of the efficacy after washing against B. cereus, S. aureus, E. faecalis, L. monocytogenes, E. coli, and P. aeruginosa respectively. Also, the chitosan-nisin coating showed that it did not cause significant toxicity in fibroblast cells even after one week. Conclusion: However, the results showed that the chitosan/nisin coating might be used for medical textiles and antibacterial textiles. It also offers an innovative solution to protect human health and the environment.

Introduction: Carpal Tunnel Syndrome (CTS) presents with symptoms like numbness, tingling, and weakness along the median nerve pathway. Risk factors include prolonged wrist positions, repetitive muscle contractions, and exposure to vibrations. Aim: To determine the prevalence of CTS among healthcare practitioners at vaccine facilities in Saudi Arabia. Materials and Methods: A cross-sectional study on a total of 150 healthcare practitioners (aged 25-30 years) working in vaccination centres in Riyadh, Saudi Arabia were recruited. The study was conducted from November 2021 to March 2022. The authors collected demographic data, Body Mass Index (BMI) and work shift information, and administered two validated questionnaires, the Boston Carpal Tunnel Syndrome Questionnaire (BCTSQ) and the Duruoz Hand Index (DHI). CTS symptoms were diagnosed using Phalen’s and Arm Raising Test (ART). Results: Of the 150 practitioners (aged 25-45 years), predominantly in the 25-30 age group, n=65 (44.0%) tested positive on the Phalen’s test, and n=65 (43.5%) on the ART. Females had higher BCTSQ scores, while DHI scores were similar across genders. Spearman's correlation analysis showed positive correlations between BCTSQ and DHI, and a moderate negative correlation between ART and DHI. Logistic regression analysed factors affecting the likelihood of CTS diagnosed by ART and Phalen’s Test. Higher BCTSQ and DHI scores increased the likelihood of CTS (ART: BCTSQ OR=0.843, DHI OR=1.064; Phalen’s Test: BCTSQ OR=0.830, DHI OR=1.069). Conclusion: During the Coronavirus Disease-2019 (COVID-19) pandemic, the prevalence of CTS among healthcare practitioners at vaccine centres in Riyadh, Saudi Arabia reached up to 43-44%. The present study highlights that day shift workers face a higher risk of CTS compared to night shift workers, likely due to heavier daytime workloads. This underscores the need for ergonomic interventions and workload management, especially during high-demand periods like the vaccination campaign, to safeguard healthcare workers’ health and productivity.

IntroductionIt is desirable to rehabilitate desert ecosystems with a selection of native plant species that render ecosystem services and yield natural products for creating a high-value industry, e.g., pharmaceuticals or cosmetics. However, plant growth under arid and hyper-arid conditions, such as in the Arabian Peninsula, is constrained by heat, freshwater scarcity, and alkaline sandy soils with low nutrient and water holding capacity. Therefore, it is imperative to develop nature-based sustainable technologies to improve arid soil conditions, as well as increase irrigation and nutrient-use eficiency.MethodsHere, we report on a study evaluating the effects of two complementary soil amendment technologies, namely Superhydrophobic sand (SHS) mulch and engineered biochar (EB) on the growth of Moringa oleifera plants. Effects of SHS (1cm-thick), EB (2% w/w), and SHS+EB treatments were tracked in greenhouse plants under normal (N, 100% field capacity) and reduced (R, 50% of N) irrigation scenarios for over 150 days, where EB treatments were pre-loaded with nutrients and remaining treatments received traditional NPK fertilizer.ResultsSignificant benefits of the SHS, EB, and SHS+EB treatments were found in terms of increased plant height, trunk diameter, leaf area, leaf chlorophyll content index, stomatal conductance, and shoot and root biomass in comparison with the controls. Evaporation water savings due to SHS mulching significantly enhanced transpiration under N and R scenarios. Similarly, EB and SHS+EB treated plants experienced higher transpiration than in the control plants under N and R conditions (p< 0.05). In response to water stress due to excessive evaporation, metabolomics analysis showed a higher accumulation of amino acids in control plants than other treatments under both irrigation regimes. Meanwhile, a higher abundance of sugars (i.e., D-Mannose, D-Fructose, glucose) and organic acid (i.e., malic acid) was observed in SHS and EB-treatments for Variable Importance in Projection (VIP) scores >1.0 (i.e., the scores considered of significance in contributing to the differences between treatment groups).DiscussionThe results show the synergistic benefits of SHS and EB technologies for addressing the challenges of water scarcity and nutrient limitation in arid regions, which couldcontribute to the success and sustainability of agriculture and greening efforts in such regions.

Irritable bowel syndrome (IBS) is a highly prevalent gastrointestinal disorder characterized by abdominal pain with diarrhea and/or constipation. The morbidity records reveal large differences per 1000 patients per year, the incidence varies from 4-13 % and the prevalence from 6-20 % and that the syndrome is more prevalence among women than among men, it is occurs mainly between the ages of 15 and 65 and often causes long- term complications. Its about 15-20% in women the etiology of IBS has not been definitively established. It was originally thought to be a psychosomatic disorder, but more recent studies have identified chronic immune activation. The impact of IBS upon humans is tremendous. Chronic and recurring symptoms of IBS can disrupt personal and professional activities, upset emotional well-being and limit individual potential. It is imperative that the best ways to manage and treat this syndrome are made available to patients so they can enjoy a normal and healthy life. Descriptive analytical design of the study starting from July 8th 2008 to the April 29th 2009 in order to identify the impact of IBS upon Health Related Quality of Life at females. The present study was carried out in the Gastroenterology and Liver Disease Hospital (G&LDH) in Baghdad. A non- probability (purposive) sample of 100 adults females who have IBS. The questionnaire was composed of two parts and introductory page that invite the subjects to participate in the study. Part I: Socio- Demographic Information Sheet Part II: Used Short-form 36 Items version II, (Standard Version of WHO for quality of life) which included: (Health status, Physical function, Role physical, Role emotion, Social function, Bodily Pain, Vitality, Mental health, and General health). The findings of (100) IBS females of present study Indicated that the (30%) at 28-37 years old, (54%) continuous married , most of them (61%) were government employee, Majority of sample ( 42%) were college graduate, half of the sample were high level income, and the females complain from alternate between constipation and diarrhea were 47%. The total means of role physical and role emotion were lower than total means for other domains of Health Related Quality of life. A negative impact of IBS on Health Related Quality of life in females at 28-37years, widow were lowered quality of life, the IBS were negative impact on government employed females.

Even though death due to COVID-19 is no longer a public health emergency, less virulent but highly transmissible forms of SARS-CoV-2 continue to spread in many countries leading to outbreaks and rise in hospitalizations in the affected regions. Lessons learned during the pandemic must be put into action to protect the world's population from another catastrophe like COVID-19. Novel approaches that were developed for tracking the spread of SARS-CoV-2 included analysis of wastewater, air samples, and various environmental surfaces. We conducted a study in Kuwait during the peak of COVID-19 pandemic to examine if SARS-CoV-2 could be detected in swabs taken from frequently touched environmental surfaces. We selected 12 Cooperative Society Stores—two from each governorate of Kuwait—for collection of surface samples. The Cooperative Society Stores are widely distributed across the whole country and cater to daily household needs including groceries and other essential items. These stores operated even during the “lockdown” imposed at the height of the pandemic. We collected swabs from high-touch surfaces including the handles of the shopping carts and freezers, the elevators, the keypads of the point-of-service terminals of cash counters, and the automated teller machines. All the surfaces tested showed a variable presence of SARS-CoV-2 by reverse transcriptase quantitative PCR, showing the validity of the proof-of-concept study. Monitoring of the presence of SARS-CoV-2 by surface sampling thus offers a cheap but effective means of environmental surveillance for coronaviruses. We therefore strongly recommend the addition of surface environmental sampling as a strategy for pandemic preparedness everywhere.

ObjectiveThis study evaluates the impact of physiotherapy interventions on health outcomes and explores the correlation between physiotherapy session characteristics and improvements in health among older individuals.MethodsIn a cross-sectional design, 384 older adults with chronic conditions such as arthritis, osteoporosis, Chronic Obstructive Pulmonary Disease (COPD), diabetes, and hypertension were recruited.ResultsThe proportion of arthritis (39.1%) and hypertension (45.8%) was notably high. Participants receiving physiotherapy showed significant improvements in pain levels (mean reduction from 5.09 to 2.95), mobility scores (improvement from 3.0 to 3.96), and functional independence. A positive correlation was identified between the frequency of physiotherapy sessions and pain reduction (r = 0.26, p = 0.035), and a stronger correlation between session duration and both pain reduction (r = 0.38, p = 0.002) and mobility improvement (r = 0.43, p = 0.001). High satisfaction rates with physiotherapy were reported, and age was found to be a significant negative predictor of health outcomes (Coef. = −0.3402, p = 0.0009).ConclusionPhysiotherapy interventions significantly improve health outcomes in older adults with chronic diseases.

Abstract Background Medications are commonly used for symptom control in cancer patients at the end of life. This study aimed to evaluate medication utilization among home care palliative patients with cancer at the end of life and assess the appropriateness of these medications. Method This retrospective observational study included adult cancer patients who received home care in 2020. Medications taken during the last month of the patient’s life were reviewed and classified into three major categories: potentially avoidable, defined as medications that usually have no place at the end of life because the time to benefit is shorter than life expectancy; medications of uncertain appropriateness, defined as medications that need case-by-case evaluation because they could have a role at the end of life; and potentially appropriate, defined as medications that provide symptomatic relief. Results In our study, we enrolled 353 patients, and 2707 medications were analyzed for appropriateness. Among those, 1712 (63.2%) were classified as potentially appropriate, 755 (27.9%) as potentially avoidable, and 240 (8.9%) as medications with uncertain appropriateness. The most common potentially avoidable medications were medications for peptic ulcers and gastroesophageal reflux disease (30.5%), vitamins (14.6%), beta-blockers (9.8%), anticoagulants (7.9%), oral antidiabetics (5.4%) and insulin products (5.3%). Among the potentially appropriate medications, opioid analgesics were the most frequently utilized medications (19.5%), followed by laxatives (19%), nonopioid analgesics (14.4%), gamma-aminobutyric acid analog analgesics (7.7%) and systemic corticosteroids (6%). Conclusion In home care cancer patients, approximately one-third of prescribed medications were considered potentially avoidable. Future measures to optimize medication use in this patient population are essential.

Mycobacterium riyadhense is an emerging slowly growing species that belongs to the group of nontuberculous mycobacteria (NTM) with approximately 20 cases reported worldwide. We highlight the first case of pulmonary infection by Mycobacterium riyadhense in United Arab Emirates (UAE). A 44-year-old female presented with chronic productive cough; a bronchial breathing pattern was appreciated on auscultation of her right upper lung. She was treated multiple times with allergic medications and antibiotics. Thorough investigations revealed Mycobacterium riyadhense and antitubercular drugs were started, eventually she was cured, however she had multiple relapses later. This case report holds a significant potential to make considerable contribution to the diagnosis of NTM, primarily because it presents the first documented case in UAE, as well as insights on how to address possible similar cases in the future.

يهدف هذا البحث إلى توضيح العلاقة بين رأس المال الفكري و الأداء التنظيمي من خلال إيضاح تأثير رأس المال الفكري بأبعاده (رأس المال البشري, , رأس المال الهيكلي, رأس المال العلائقي) على الأداء التنظيمي لمنظمات الصناعات الغذائية العاملة في محافظة دمشق. اعتمدت الباحثة على المنهج الوصفي باعتباره يصف الموضوع المدروس كما هو في الحقيقة, وذلك من خلال توزيع 75 استبانة على عينة عشوائية من العاملين الإداريين في منظمات الصناعات الغذائية العاملة في محافظة دمشق ، وكان عدد الاستبيانات الصالحة للتحليل الاحصائي (61) بنسبة (81%). وكان من أهم النتائج التي تم الوصول إليها: يوجد أثر إيجابي لأبعاد رأس المال الفكري على الأداء التنظيمي لمنظمات الصناعات الغذائية محل الدراسة حيث كان أكثر الأبعاد تأثيراً هو رأس المال البشري يليه رأس المال الهيكلي ثم رأس المال العلائقي . ومن أهم مقترحات هذه الدراسة: ضرورة تبني منظمات الصناعات الغذائية في محافظة دمشق استراتيجية لإعادة هندسة الموارد البشرية من خلال تطوير فلسلفة العمل, والمحافظة على الموارد والكفاءات البشرية من خلال توفير الحوافز المادية والمعنوية لتحسين الأداء, إضافة لإعادة النظر في تصميم الهيكل التنظيمي لهذه المنظمات بما يتلاءم وعصر المعرفة وبما يحقق كفاءة وفعالية الأداء.

Nanobiocatalysts (NBCs), which merge enzymes with nanomaterials, provide a potent method for improving enzyme durability, efficiency, and recyclability. This review highlights the use of eco-friendly synthesis methods to create sustainable nanomaterials for enzyme transport. We investigate different methods of immobilization, such as adsorption, ionic and covalent bonding, entrapment, and cross-linking, examining their pros and cons. The decreased environmental impact of green-synthesized nanomaterials from plants, bacteria, and fungi is emphasized. The review exhibits the various uses of NBCs in food industry, biofuel production, and bioremediation, showing how they can enhance effectiveness and eco-friendliness. Furthermore, we explore the potential impact of NBCs in biomedicine. In general, green nanobiocatalysts are a notable progression in enzyme technology, leading to environmentally-friendly and effective biocatalytic methods that have important impacts on industrial and biomedical fields.

Background: Clinical, radiological, and laboratory findings characteristic of the coronavirus disease 2019 (COVID-19) infection have already been investigated and identified; however, data on pregnant women infected with COVID-19 are limited. This study aims to examine the clinical, radiological, and laboratory characteristics of pregnant women compared to non-pregnant women with COVID-19 disease. Method: This hospital-based retrospective age-matched case-control study included two groups, pregnant and non-pregnant women, each consisting of 51 patients hospitalized with COVID-19 in Bushehr, Iran. Demographic, clinical, and laboratory information was extracted from medical records using a predefined checklist. Results: Except for cough, there were no statistically significant differences in clinical signs and symptoms between pregnant and non-pregnant women. Although hemoglobin oxygen saturations are statistically significant among the two groups, this difference is not clinically significant (95% vs 93%). There were no statistically significant differences between pregnant and non-pregnant women in the pattern of pulmonary involvement in chest CT findings. Laboratory factors such as serum hemoglobin, red blood cell count, absolute lymphocyte count, prothrombin time and partial thromboplastin time, serum creatinine, serum potassium, and lactate dehydrogenase had statistically significant differences between the two groups. However, these differences were not clinically significant. Conclusion: In a few aspects, the clinical characteristics and laboratory test results of COVID-19 in pregnant patients seem to be distinctive from their nonpregnant controls. We believe our findings can guide the prenatal and postnatal considerations for COVID-19 pregnant patients.

Purpose. This study examines the causal relationship between total expenditures and food availability and identifies their shocks in food availability in Saudi Arabia. Methodology / approach. The study uses a multivariate modeling technique of the Vector Autoregression (VAR) and its environment, the Granger Causality Test, Forecast Error Variance Decomposition (FEVD), and Impulse Response Function (IRF) for the observation period of 2000–2020 in Saudi Arabia. Results. The results of the Granger causality show that investment expenditure has a significant impact on food availability in Saudi Arabia. However, consumption and government expenditures do affect food availability in Saudi Arabia, but have an indirect effect. The Impulse Response Functions show that the shocks of the selected variables require a long period to reach the long-run equilibrium level and the greatest response of the food availability variable is explained by its own shock and investment expenditure shocks. Originality / scientific novelty. The novelty of this study is related to the investigation of a new model and focus on a new perspective. While traditional food security research has mostly concentrated on agricultural production, availability, and accessibility of food, as well as nutrition and health outcomes factors, this research conveys a new dimension by highlighting the link between total expenditure and food security. Their contribution expands the scope of food security research and highlights the impact of recognising the role of total expenditure in implementing and supporting food security at the household level. Practical value / implications. It is important to design strategies and develop a budgeting plan to allocate a reasonable portion of total consumption and government expenditures on food items. Adding, regularly reviewing, and adapting the budgeting plan based on new challenges, and evolving priorities are essential to address the dynamic nature of food security.

A new framework in the form of Polarimetric Synthetic Aperture Radar (PolSAR) image classification, where deep Convolutional Neural Networks (CNNs) were integrated with the traditional Machine Learning (ML) techniques under a Temporal Convolutional Network (TCN) architecture, was introduced in the paper. The main aim behind this new approach is to overcome the severe limitations inherent in both deep CNN and conventional ML approaches. The application of the sliding-window strategy eliminates the necessity of requiring extensive feature extraction procedures while reducing computational complexity simultaneously. Experiments on four benchmark PolSAR datasets for C-Band, L-Band, AIRSAR, and RADARSAT-2 data attest to the framework's remarkable classification accuracies in the range of 94.55% to 99.39%. This integrated framework is thus a significant advancement in PolSAR image analysis in offering an efficient methodology that combines the strengths of deep CNNs and traditional ML, by mitigating their respective limitations. It also combines the sliding-window technique with the architecture of TCN and then yields excellent classification accuracy with no much additional computational overhead. The results obtained thus indicate a good chance of revolutionizing the state of the art in PolSAR image classification, providing crucial efficiency improvements and making applications in environmental applications stronger, across almost all kinds of fields.

Background Type 2 diabetes mellitus (T2DM) is a prevalent metabolic disorder with systemic implications, potentially affecting musculoskeletal health. This study aimed to assess shoulder muscle strength and joint repositioning accuracy in individuals with T2DM, exploring potential correlations and shedding light on the musculoskeletal consequences of the condition. The objectives were two-fold: (1) to assess and compare shoulder strength and joint repositioning accuracy between individuals with T2DM and asymptomatic counterparts, and (2) to examine the correlation between shoulder strength and joint repositioning accuracy in individuals with T2DM. Methods A cross-sectional study enrolled 172 participants using the convenience sampling method, including 86 individuals with T2DM and an age-matched asymptomatic group (n = 86). Shoulder strength was assessed using a handheld dynamometer, while joint repositioning accuracy was evaluated with an electronic digital inclinometer. Results Individuals with T2DM exhibited reduced shoulder muscle strength compared to asymptomatic individuals (p

BackgroundObesity is reaching epidemic proportions with 51% of the population expected to be obese by 2030. Recently, polyphenols have been highlighted as an effective approach to managing obesity and associated risks. Polyphenols are a large class of bioactive plant compounds classified into two major categories: flavonoids which are distinguished by the fundamental C6-C3-C6 skeleton and non-flavonoids.ObjectiveThis systematic review evaluated the effect of different polyphenol sources in overweight and obese people with and without type 2 diabetes. The primary outcome was lipid profile and the secondary outcomes were blood glucose, HbA1c (%), HOMA-IR, weight, and body mass index.MethodA search was undertaken in PubMed, Web of Science, Medline, and Wiley for randomized control trials that assessed different sources of polyphenols in overweight and obese people with or without type 2 diabetes. The quality of the included studies was assessed using the National Heart, Lung, and Blood Institute Quality Assessment Tool.ResultThe search yielded 935 studies, of which six randomized control trials met the inclusion criteria. Five studies found no significant difference in lipid profile between the control and intervention groups in triglycerides, total cholesterol, LDL cholesterol, and HDL cholesterol. However, one study showed significant differences in triglycerides (p = 0.04) and HDL cholesterol (p = 0.05) between the two groups with no significant difference in total cholesterol and LDL cholesterol. There were no significant changes in blood glucose observed in the included studies, with only two studies reporting a significant difference in A1c between the groups. Four studies found no difference in HOMA-IR, while one study showed a significant decrease in HOMA-IR in the intervention group compared to the control group. Three studies reported no difference in BMI or weight between the two groups.ConclusionThe data associated with the specific health benefits of polyphenols and their sources in people with overweight, obese, and type 2 diabetes are still limited, so further research is required to support their use and prove their benefits.

Abstract Introduction The introduction of clacitonin gene-related peptide (CGRP) monoclonal antibodies (mAbs) has revolutionized the treatment of migraines. In clinical practice gepants might be considered as a valid option to treat acute attacks in patients with migraine who are treated with mAbs. However, the safety and tolerability of such a combination is not well addressed in the real-world setting. We designed this study to evaluate the safety and tolerability of combining CGRP mAbs with gepants in the management of migraines. Methods This was a retrospective, real-world, exploratory study. The participants included within the study were adult (≥ 18 years) patients diagnosed with migraine. Screening for patients who were treated with at least one GCRP mAbs was done. Data was collected from one site, the American Center for Psychiatry and Neurology, Abu Dhabi UAE. A total of 516 patients taking CGRP mAbs were identified. Extracted data from patients’ electronic medical records included patient demographics, migraine characteristics, prescribed treatments, and adverse events (AEs). The tolerability and safety of the combination therapy was evaluated on the basis of documented AEs. Results Among the identified 516 patients, 234 were administered gepants in addition to the CRGP mAb (215, rimegepant; 19, ubrogepant). Eleven of the 234 patients switched from rimegepant to urogepant as a result of lack of efficacy; one patient switched from urogepant to zolmitriptan because of the lack of insurance coverage of the former medication. Among all the patients included in this study, three AEs were documented. These AEs were generally mild and transient and hence did not lead to discontinuation of treatment. Moreover, 42 of the 234 (17.9%) patients were switched from one class of CGRP mAbs to another at least once while continuing treatment with the assigned gepants. Conclusion The findings of this study demonstrate that combining CGRP mAbs with gepants is a safe and well-tolerated treatment approach for migraine. Future studies are warranted to further validate these findings and explore long-term outcomes.

Calcitonin gene-related peptide monoclonal antibodies (CGRP mAbs) have shown promising effectiveness in migraine management compared to other preventative treatment options. Many questions remain regarding switching between antibody classes as a treatment option in patients with migraine headaches. This preliminary retrospective real-world study explored the treatment response of patients who switched between CGRP mAb classes due to lack of efficacy or poor tolerability. A total of 53 patients with migraine headache switched between three of the CGRP mAbs types due to lack of efficacy of the original prescribed CGRP mAbs, specifically eptinezumab, erenumab, and galcanezumab. Fremanezumab was not included due to unavailability in the UAE. Galcanezumab and eptinezumab target the CGRP ligand (CGRP/L), while erenumab targets CGRP receptors (CGRP/R). The analysis of efficacy demonstrated that some improvements were seen in both class switch cohorts (CGRP/R to CGRP/L and CGRP/L to CGRP/R). The safety of switching between CGRP classes was well observed, as any adverse events presented before the class switch did not lead to the discontinuation of treatment following the later switch. The findings of this study suggest that switching between different classes of CGRP mAbs is a potentially safe and clinically viable practice that may have some applications for those experiencing side effects on their current CGRP mAb or those witnessing suboptimal response.

Smart agriculture holds a transformative potential, driven by cutting-edge technologies, in revolutionizing the global food production sector and enhancing food safety measures. This is achieved by leveraging the capabilities of smart maps, artificial intelligence, and agricultural data analytics. Hence, farmers can benefit from it as it allows them to streamline resource utilization. This, in turn, leads to reduced inputs of fertilizers, labor, seeds, and water, while simultaneously amplifying crops. Therefore, this paper introduces a comprehensive system for advancing smart map agriculture, comprising five pivotal stages designed to yield accurate and meaningful results. Notable progress is achieved through meticulous data acquisition by employing the rice seedling and WeedNet datasets, coupled with feature extraction utilizing the MobileNet architecture. The classification stage is critical for distinguishing between rice and land in the first dataset and between crops and weeds in the second one. It further enhances the system’s efficacy. Additionally, segmentation using K-means clustering to detect rice or crop is employed. Notably, the current approach exhibits promising performance levels. It results in 99.7%, 100%, 99.4%, and 99.72% for accuracy, precision, recall, and F1_score, respectively, in the rice seedling dataset, as well as achieving 98.72%, 97.3%, 100%, and 98.63% in the WeedNet dataset. The primary contribution of this study lies in the integration of MobileNet and SVM architectures for feature extraction and classification in the agriculture field. It also presents the innovative use of K-means clustering for segmenting agricultural fields.

Abstract Abdominal aortic aneurysms (AAAs) are prevalent with aging, and AAA rupture is associated with increased mortality. There is currently no effective medical therapy to prevent AAA rupture. The monocyte chemoattractant protein (MCP-1)/C–C chemokine receptor type 2 (CCR2) axis critically regulates AAA inflammation, matrix-metalloproteinase (MMP) production, and extracellular matrix (ECM) stability. We therefore hypothesized that a diet intervention that can modulate CCR2 axis may therapeutically impact AAA risk of rupture. Since ketone bodies (KBs) can trigger repair mechanisms in response to inflammation, we evaluated whether systemic ketosis in vivo could reduce CCR2 and AAA progression. Male Sprague–Dawley rats underwent surgical AAA formation using porcine pancreatic elastase and received daily β-aminopropionitrile to promote AAA rupture. Rats with AAAs received either a standard diet, ketogenic diet (KD), or exogenous KBs (EKB). Rats receiving KD and EKB reached a state of ketosis and had significant reduction in AAA expansion and incidence of rupture. Ketosis also led to significantly reduced aortic CCR2 content, improved MMP balance, and reduced ECM degradation. Consistent with these findings, we also observed that Ccr2−/− mice have significantly reduced AAA expansion and rupture. In summary, this study demonstrates that CCR2 is essential for AAA expansion, and that its modulation with ketosis can reduce AAA pathology. This provides an impetus for future clinical studies that will evaluate the impact of ketosis on human AAA disease.

This study aimed to assess and evaluate the canal shaping ability of two different Ni-Ti rotary systems, Vortex Blue (VB) and TruNatomy (TN), using micro-computed tomography in extracted premolars. A total of 20 extracted bifurcated maxillary first premolars with two separate canals were randomly divided into two groups and prepared with either VB 35/0.04 (Dentsply Maillefer, Ballaigues, Switzerland) or TN Medium 36/0.03 (Dentsply Sirona). Pre- and post-instrumentation micro-CT scans were analyzed to measure the following parameters: percentage of untouched canal surface area, changes in canal surface area, changes in canal volume, structural model index (SMI), changes in canal angulation, changes in dentin thickness, transportation, and centering ability. Statistical analysis was performed with a significance level set at p-value < 0.05. Both VB and TN files showed a significant increase in the basic canal geometry parameters including canal surface area and canal volume. Both file systems showed no significant changes in SMI or dentin thickness after canal instrumentation (p > 0.05). Some degree of canal transportation and a similar centering ability ratio with no significant difference were observed in both file systems (p > 0.05). TN files showed less pre-cervical dentin removal when compared to VB files. A significant difference was found in the TN group regarding the dentin removal between coronal and apical thirds (p = 0.03). Both VB and TN files produced comparable root canal preparation with no considerable shaping mishaps and errors. Both files showed minimum canal transportation and minimum straightening of the canal curvature. TN files removed less pre-cervical dentin than apical dentin.

Background and Objective: The aim of this study was to evaluate cardiorespiratory fitness (CRF) measures, maximal oxygen consumption (VO2 max), and minute ventilation/carbon dioxide production (VE/VCO2 slope and others) among the T2DM population based on glycated haemoglobin (HBA1c). Material and Methods: The present study comprised a cross-sectional design, with two groups, based on HbA1c values (≤7 and ≥7.1). Laboratory samples were taken to evaluate glycated haemoglobin and fasting blood glucose (FBS). Cardiopulmonary exercise testing was performed to calculate various fitness-related parameters. Data analysis: An independent t-test was used to analyse the outcomes in the two groups. p < 0.05 was considered significant. Linear regression was used to examine the influence of predictor variables on dependent variables. Results: A total of 70 patients agreed to participate in the study, with 19 females and 51 males. The mean (standard deviation) BMI (body mass index) of all participants was 29.7(5.2), the mean (SD) weight was 84.4 (18.9) kg, and the mean height was 167.4 (23) cm. The average age of the individuals was 52 ± 8 years. The independent t-test revealed a significant difference between the two groups in terms of CRF measures. Conclusions: The current research identified the presence of poor glycaemic control and cardiorespiratory fitness measures among the Brazilian population with T2DM. HBA1c, duration of diabetes, age, and BMI can be employed to predict the ventilatory threshold (VT) and VO2 max.

BackgroundThe primary objective is to evaluate the safety and effectiveness of Stryker second generation Target® Nano Coils in the treatment of ruptured and unruptured small (

عند وجود عطل فإن الحماية تتحسس للعطل فإذا تم إرسال أمر الفصل بشكل لحظي من الممكن أن يفصل خط النقل بدون وجود عطل يستدعي الفصل، ومن الماحية الأخرى إعطاء مهلة زمنية غير مدروسة قد يؤدي إلى استمرار العطل فترة طويلة كافية لإلحاق الضرر بالتجهيزات، لذلك لابد من التحديد الدقيق لقيمة تيار العطل الواجب اكتشافه من قبل الحماية بالإضافة إلى الاختيار المناسب للتأخر الزمني تبعا لنوع العطل، كل هذه التساؤلات كانت السبب في توجهنا لاختيار المنطق الضبابي في التحكم بهذه الحماية لدراسة أثر هذا التحكم على أداء الحماية حيث تقترح بعض المراجع وجود تأخير زمني بين 0 و 4.5 ثانية حسب نوع العطل.

Background Recent randomized clinical trials have demonstrated that endovascular therapy for basilar artery occlusion is safe and potentially effective, predominantly in the non‐White population. The aim of this study was to identify predictors of good functional outcome in posterior circulation strokes in US population after mechanical thrombectomy from the TRACK (Trevo Stent‐Retriever Acute Stroke) and the NASA (North American Solitaire Stent Retriever Acute Stroke) registries from North America. Methods Patient‐level data from the TRACK and NASA registries were pooled, and patients with posterior circulation stroke were included in this analysis. Patients were dichotomized into those with 90‐day good functional outcome (modified Rankin scale [mRS] score 0–2) and poor functional outcome (mRS score ≥3). Baseline and procedural data were compared between the 2 cohorts. Multivariate logistic regression was performed to identify predictors of functional outcome. P

Background: While most COVID-19 cases have uncomplicated infection, a small proportion has the potential to develop life-threatening disease, as such development of a prediction tool using patients baseline characteristics at the time of diagnosis should aid in early identification of high-risk groups and devise pertinent management. Hence, we set up this retrospective study to determine preadmission triaging tool to predict the development of severe COVID-19 in the Kingdom of Bahrain Materials and methods: A retrospective study was conducted from 1 September 2020 to 30 November 2020 with enrolment of all SARS-CoV-2 PCR-confirmed persons aged ≥ 14 years who attended Al-Shamil Field Hospital (SFH) in the Kingdom of Bahrain for triaging and assessment with recording of the following parameters: systolic blood pressure, heart rate, respiratory rate, temperature, the alert, verbal, pain, unresponsive neurological score, age, oxygen saturation, comorbidities, Body Mass Index (BMI), duration of symptoms and living with immunocompromised populations to develop our local adjusted MEWS as predictor for ICU admission & for consideration of suitable isolation at home.Follow up data of all patients was obtained from the electronic medical records system including CXR findings, treatments/medications received, need of oxygen supplements /intubation, needs of ICU care, and the outcome (death /discharged alive)IBM SPSS statistic version 21 program was used for data analysis. Results: Our study showed that using the locally developed adjusted MEWS score, there was an significant association between high value of this adjusted MEWS score and abnormal radiographic finding (49.7 % Vs. 17 % for patients with high score Vs. those with low score respectively). Out of the 181 patients with high scores on adjusted MEWS; 38.7 % required oxygen via nasal cannula, 14.4 % required face mask and 8.3 % non-rebreather mask; this proportion was significantly higher than their counterpart patients who score low on adjusted MEWS (20.9 %, 7.7 %, 4.8 %respectively) with statistically significance difference between the two groups (p value of 0.00, 0.00,.004 respectively)Requirement of ICU admission was significantly higher among patients with high score in comparison to those with low score (14.4 % vs. 3 %) with significant p value (0.00)But higher score value was not associated significantly with increase mortality rate among COVID patients. Conclusion: Development of our new Adjusted MEWS score system by adding the additional elements of age, oxygen saturation, comorbidities, Body Mass Index (BMI) and duration of symptoms found to be very useful predictor tool for preadmission triaging of COVID patients based on their risk assessment to help clinician to decide on the appropriate placement to different level of isolation facilities.

Abstract. Hydroxyapatite (HA) scaffold is commonly used in the applications of bone tissue engineering due to its bioactivity and equivalent chemical composition to the inorganic constituents of human bone. The present study focused on the fabrication of porous 3D hydroxyapatite scaffold which was modified by polymer coating as a successful strategy to improve the mechanical properties. A 3D porous hydroxyapatite scaffolds were fabricated by gel-casting method by using freshly extracted egg yolk (EY) with (50 and 60)wt% of HA powder. To enhance the mechanical properties, composite PVA/ HA scaffolds were produced by using dip coating in Polyvinyl alcohol (PVA). Fourier transform infrared spectroscopy (FTIR) was used to recognize the functional group associated with the hydroxyapatite scaffolds before and after PVA coating. The physical (density and porosity) and mechanical (compressive strength and elastic modulus) properties were investigated before and after coating. SEM was used to inspect the surface morphology and pore modification of the scaffolds. Wettability was determined by using a water contact angle to analyze the scaffold hydrophobicity. Surface roughness was studied by atomic force microscopy (AFM). It was revealed that the scaffold porosity decreased with increase solid loading of HA powder in the gel and after PVA coating. The findings showed that PVA coating improved mechanical strength of scaffold to be double by covering the small pores and filling microcracks sited on the scaffold strut surfaces, inducing a crack bridging mechanism. The scaffolds’ strength was in the range of trabecular bone strength. This indicates non-load bearing applications.

Cytokine-induced neutrophil chemoattractant 1 (CINC-1), a cluster of differentiation 95 (CD95), fractalkine, and T-cell immunoglobulin and mucin domain 1 (TIM-1) are circulating proteins known to be involved in inflammation. While their roles have been studied in neurological conditions and cardiovascular diseases, their potential as peripheral artery disease (PAD) biomarkers remain unexplored. We conducted a cross-sectional diagnostic study using data from 476 recruited patients (164 without PAD and 312 with PAD). Plasma levels of CINC-1, CD95, fractalkine, and TIM-1 were measured at baseline. A PAD diagnosis was established at recruitment based on clinical exams and investigations, defined as an ankle-brachial index < 0.9 or toe-brachial index < 0.67 with absent/diminished pedal pulses. Using 10-fold cross-validation, we trained a random forest algorithm, incorporating clinical characteristics and biomarkers that showed differential expression in PAD versus non-PAD patients to predict a PAD diagnosis. Among the proteins tested, CINC-1, CD95, and fractalkine were elevated in PAD vs. non-PAD patients, forming a 3-biomarker panel. Our predictive model achieved an AUROC of 0.85 for a PAD diagnosis using clinical features and this 3-biomarker panel. By combining the clinical characteristics with these biomarkers, we developed an accurate predictive model for a PAD diagnosis. This algorithm can assist in PAD screening, risk stratification, and guiding clinical decisions regarding further vascular assessment, referrals, and medical/surgical management to potentially improve patient outcomes.

Primary Epstein–Barr virus (EBV) infection which can manifest as infectious mononucleosis (IM) is commonly acquired during childhood. EBV primarily invades B cells leading to a lytic reaction; the control of the infection is handled by natural killer and T cells in immunocompetent individuals. The infection has a wide spectrum of clinical findings and can lead to serious complications in patients with certain underlying immunological dysfunctions. We retrospectively investigated peripheral white blood cell populations’ surface marker characteristics in IM using a comprehensive flow cytometry marker panel. Twenty-one cases of IM and seventeen EBV-seropositive cases without IM serving as controls were included. We observed novel alterations in lymphocyte, neutrophil, and monocyte populations. In addition to increased activated cytotoxic T cells and low B cells, we demonstrated high T-large granular lymphocyte (T-LGL) populations in IM cases. Furthermore, despite T cells’ increased HLA-DR expression, another activation marker, CD11b, was lower in T-LGL populations. Monocytes showed increased CD16 expression; CD64 was higher in neutrophils. Our findings point to monocyte and neutrophil activation which may account for acute clinical features and may contribute to the understanding of IM immunobiology. Furthermore, they may serve as a useful tool in investigating inherited and post-transplant conditions characterized by deficiencies in controlling EBV infection.

Abstract When monitoring manufacturing processes, managing an attribute quality characteristic is easier and faster than a variable quality characteristic. Yet, the economic-statistical design of attribute control charts has attracted much less attention than variable control charts in the literature. This study develops an algorithm for optimizing the economic-statistical performance of the np chart for monitoring defectives, based on Duncan’s economic model. This algorithm has the merit of the economic model to minimize expected total cost, and the benefit of the statistical design to enhance the effectiveness of detecting increasing shifts in defectives. The effectiveness of the developed np chart is investigated under different operational scenarios. The results affirm a considerable superiority of the proposed np chart over the traditional np chart. Real-life data are used to demonstrate the applicability of the proposed np scheme, in comparison to the traditional np chart.

Human voices are unique, and for this reason, speakers can be identified by their voices. This shows that speech sounds contain speaker-specific information that can be reflected in the acoustic properties of speech signals. There are many individuals around the world who speak two or more languages, adding a fascinating dimension of variability to language perception and production. However, it remains unclear whether bilinguals alter their voice when switching between languages. A holistic view of bilingualism suggests that bilinguals are an integrated whole that cannot be separated into distinct parts; instead, they possess their own specific linguistic configuration (Grosjean, 1989). Moreover, languages differ in their segment inventories, rules of segmental combinations, as well as spectral and rhythmic characteristics of speech. Speaking styles can also contribute to within-speaker variability in acoustic parameters. Despite these factors, little is known about the influence of language and speaking style on within- and between-speaker vocal variability. This study aims to investigate how acoustic features, specifically long-term F0 and long-term formant frequencies (F1-F4), contribute to speaker individuality in Persian-English bilingual speakers and to what extent these features can discriminate between bilingual speakers.

The present study introduces and examines the characteristics of different types of Left Dislocation constructions in Persian language. Left Dislocation (LD) is a construction in which an element instead of being in its original position of sentence is located at the beginning of the clause and a resumptive element takes its canonical place. This study, which is based on the criteria introduced by Cinqué (1990) and Westbury (2016) to identify and determine the types of LD, shows that the Persian language has two types of such construction: Hanging Topic Left Dislocation (HTLD) and Clitic Left Dislocation (CLLD). In order to prove the existence of these two types of LD in Persian language, this research studies the structural differences of these two constructions from two aspects: syntactic connectivity and distributional constraints governing them. This study shows that in Persian there are more distributional constraints on HTDL than CLLD. On the other hand, there is less syntactic connectivity between the initial element and the continuation of the clause in HTLD compared with CLLD

Abstract Objective The objective of the study is to evaluate the skeletal, dentoalveolar and soft tissue changes before and after treatment with Alt-RAMEC protocol and protraction headgear in comparison to the controls. Material and methods A quasi experimental study was conducted in the orthodontic department on 60 patients of cleft lip and palate. These patients were divided into two groups. Group I was the Alt-RAMEC group that underwent Alt-RAMEC protocol followed by facemask therapy while group II was the control group that underwent RME and facemask therapy. Total treatment time in both the groups was approximately 6 to 7 months. Mean and standard deviation was calculated for all the quantitative variables. Pre and post treatment changes between treatment and control groups were made using paired t-test. Intergroup comparison between treatment and control group was analyzed using independent t-test. Significance for all tests was predetermined at a P-value of ≤ 0.05. Results The Alt-RAMEC group showed significant forward movement of maxilla and improvement in the maxillary base. A remarkable improvement in SNA was seen. The overall outcome was better maxillo-mandibular relationship as shown by positive ANB values and angle of convexity. More effect on maxilla and least effect on mandible was notified with Alt-RAMEC protocol and facemask therapy. Improvement in transverse relationship was also evident in the Alt-RAMEC group. Conclusion Alt-RAMEC protocol in combination with protraction headgear is a better alternative to treat cleft lip and palate patients in comparison to the conventional protocol.

Integrative approaches in primary care emphasize the collaboration between various health professions to improve patient outcomes and enhance the quality of care. Dentistry, nursing, and pharmacy play crucial roles in this model by addressing the diverse health needs of patients through a holistic lens. For instance, dental care is not just about oral health; it is closely linked to systemic health conditions such as diabetes and cardiovascular diseases. By incorporating dental professionals into primary care teams, patients receive comprehensive screenings and preventive care that addresses both oral and overall health. Similarly, nursing professionals, with their extensive training in patient care and health education, serve as vital advocates for patient-centered approaches, ensuring that patients receive holistic and coordinated care across multiple domains. Pharmaceutical care also significantly contributes to integrative approaches in primary care by managing medication therapy and promoting safe and effective use of pharmaceuticals. Pharmacists can conduct medication reviews, provide patients with education on drug interactions, and support chronic disease management, thereby ensuring that patients' medication regimens are optimized. This collaborative effort leads to improved adherence to treatment plans and promotes better health outcomes. By fostering strong interprofessional relationships, dentistry, nursing, and pharmacy can create a robust primary care environment where patient care is comprehensive, preventive, and tailored to meet the individual needs of each patient.

In this study, choline chloride/urea was used as a green deep eutectic solvent in the three-component reaction of hydrazine/phenylhydrazine, malononitrile, and aromatic aldehydes for synthesizing pyrazole derivatives, and in the four-component reaction of methyl/ethyl acetoacetate, hydrazine/phenylhydrazine, malononitrile, and aromatic aldehydes for synthesizing pyrano[2,3-c]pyrazole derivatives. Elemental analysis, 1H, and 13C NMR spectroscopy were used to confirm the structure of the synthesized pyrazole and pyrano[2,3-c] pyrazole derivatives. The antimicrobial effects of the synthesized pyrazole and pyrano[2,3-c] pyrazole derivatives were investigated. In antimicrobial tests, instructions from clinical and laboratory standards institutes were used. Antimicrobial study was done on pathogenic gram-positive and gram-negative species, and specialized aquatic strains and fungal species. Using choline chloride/urea, novel pyrazole derivatives and pyrano[2,3-c]pyrazole derivatives were synthesized, and other derivatives were synthesized with higher efficiency in less time than some previously reported methods. MIC (minimum inhibitory concentration) and MBC (minimum bactericidal concentration) obtained for derivatives were higher than some antibiotic drugs. Synthesis and reports of new derivatives of pyrazole and pyrano[2,3-c]pyrazole, and investigation and reports of their antimicrobial properties on gram-positive, gram-negative, and specialized aquatic and fungal species are among the novel and important findings of this study.

BackgroundPrimary liver cancer is the third leading cause of cancer deaths worldwide and has one of the worst 5-year survival rates. This study examines US primary liver cancer incidence and incidence-based mortality trends over four decades.Research design and methodsThe SEER-9 registry was used to study primary liver cancer cases from 1978 to 2018. The incidence and mortality rates were calculated based on gender, age, race, and stage of diagnosis. Joinpoint regression software was used to calculate the annual percent change.ResultsThe overall incidence rate of primary liver cancer from 1978 to 2018 increased by 2.71%/year (pConclusionWhile the overall primary liver cancer incidence and incidence-based mortality have been increasing over the last four decades, there was an observed decline in incidence and incidence-based mortality in recent years, especially among at-risk subgroups.

The characteristics of injectable hydrogels make them a prime contender for various biomedical applications. Hyaluronic acid is an essential component of the matrix surrounding the cells; moreover, hyaluronic acid’s structural and biochemical characteristics entice researchers to develop injectable hydrogels for various applications. However, due to its poor mechanical properties, several strategies are used to produce injectable hyaluronic acid hydrogel. This review summarizes published studies on the production of injectable hydrogels based on hyaluronic acid polysaccharide polymers and the biomedical field’s applications for these hydrogel systems. Hyaluronic acid-based hydrogels are divided into two categories based on their injectability mechanisms: in situ-forming​ injectable hydrogels and shear-thinning injectable hydrogels. Many crosslinking methods are used to create injectable hydrogels; chemical crosslinking techniques are the most frequently investigated technique. Hybrid injectable hydrogel systems are widely investigated by blending hyaluronic acid with other polymers or nanoparticulate systems. Injectable hyaluronic acid hydrogels were thoroughly investigated and proven to demonstrate potential in various medical fields, including delivering drugs and cells, tissue repair, and wound dressings.

The objectives of this study are to compare hip muscle strength, hip joint proprioception, and functional balance between individuals with unilateral hip OA and asymptomatic individuals and to examine the relationships among these variables in the hip OA population. In a prospective cross-sectional study, 122 participants (unilateral Hip OA: n = 56, asymptomatic: n = 56) were assessed at the CAMS/KKU musculoskeletal Physical Therapy laboratory. Ethical standards were upheld throughout the research, with informed consent obtained. Hip muscle strength was measured using a hand-held dynamometer, hip joint proprioception with a digital inclinometer, and functional balance using the Berg Balance Scale (BBS) and Timed Up and Go (TUG) test. Hip OA individuals exhibited significantly lower muscle strength and proprioceptive accuracy, and poorer functional balance than controls (p < 0.003). Correlation analyses revealed a positive correlation between muscle strength and BBS scores (r = 0.38 to 0.42) and a negative correlation with TUG test times (r = -0.36 to -0.41). Hip joint reposition sense (JRS) in flexion showed a negative correlation with balance (r = -0.46), while JRS in abduction was positively correlated (r = 0.46). The study highlights the clinical importance of muscle strength and proprioception in functional balance among individuals with unilateral hip OA. The results support the incorporation of muscle strengthening and proprioceptive training in interventions to improve balance and mobility in this population.

BackgroundThe working environment of healthcare institution during pandemic puts all hospital employees at high-risk of being exposed to contagious infections. An individual’s behavior and response are largely determined by their level of knowledge, attitudes and practices (KAP) toward a disease. Therefore, the present study aimed to evaluate and assess the KAP toward COVID-19 among hospital employees working in various positions and to identify the sociodemographic determinants associated with the level of KAP.MethodsA cross-sectional survey was conducted from July 1 to July 15, 2020 in Almoosa Specialist Hospital, Alhasa, Eastern Province, Saudi Arabia in which 221 hospital employees with varied job titles participated. The data for demographics and history of COVID-19 exposure, KAP related to COVID-19 spread and prevention were collected online using a web-based platform (Survey Monkey). Student’s t-test/One-way ANOVA were used to compare total mean and standard deviation of KAP scores with demographic profiles and history of exposure.Results89.1% employees knew that COVID-19 virus is mostly transmitted from human-to-human, and 76.0% employees acknowledged droplet transmission. 64.7% employees preferred to take a sick person with unconfirmed COVID-19 to a health facility. Physicians had higher knowledge scores for COVID-19 infection and non-medical employees had the lowest scores (7.47 ± 1.23 and 6.47 ± 1.44, respectively). Nurses had the highest practice scores and non-medical employees lowest practice score (6.16 ± 0.74 and 5.37 ± 1.14, respectively). Attitude scores were similar among all the employees. All employees reported an increase in hand-washing frequency and physical contact avoidance.ConclusionThe study results revealed socio-demographic factors; level of education, nationality, and field of service are associated with COVID-19 KAP. The study highlights that there is a gap in the level of knowledge about COVID-19, especially among nonmedical employees. Targeted interventional programs need to be planned and implemented to improve COVID-19 awareness among non-medical employees.

Background: Professionalism is a multidimensional and evolving structure with has socio-cultural information that affects patient satisfaction, and health care outcomes. An important part of nurses' professional behavior is formed during their student years and through education and learning. The aim of this study was assessing the professionalism in internship nursing student. Methods: This cross-sectional study was conducted in Shiraz University of Medical Sciences. The data collection instrument was a nursing professionalism questionnaire that was completed by 2 instructors for 70 final-year nursing students in the internship. Method of sampling used non-probability convenience sampling. The data were analyzed using SPSS, version 16, for Windows (SPSS Inc., Chicago, IL, USA). Descriptive statistics (mean and percentage) were used to describe demographic characteristics and mean scores of professionalisms and its dimensions. Histograms and the bias-kurtosis and Shapiro–Wilk test were used to evaluate the normality. Comparisons between the two groups were made by independent samples t-test. To compare more groups, the Kruskal–Walli’s test was used. Result: The findings of this study show that the mean score of professionalism was 75.26(±10.5), the highest mean was related to the dimension of behavior based on professional values and norms (80.36 ± 9.93) and the lowest mean was related to the dimension of professional interactions (75.00 ± 13.72). Students with perfect regular participation in their internship had a significantly higher professionalism score than other students (P-value = .0001). There was no significant relationship between students' gender and score professionalism (P

Ten-eleven translocation 2 ( TET2 ) plays a pivotal role in epigenetic regulation, cell differentiation, and the inflammatory response. It also mediates the transcriptional regulation for inflammatory cytokines, particularly interleukin-6. While loss-of-function mutation in TET2 has been associated with hematological malignancies, it has been increasingly recognized to cause atherosclerotic disease. The increased atherogenicity is thought to be the result of increased production of pro-inflammatory interleukin-1β cytokines following activation of NLRP3 inflammasomes. We present a unique case of recurrent atherothrombosis in an elderly man who was diagnosed with chronic myelomonocytic leukemia in the setting of TET2 mutation.

Molecular motor can be defined as the collection of a separate number of molecular features (that is, a supramolecular structure) which has been developed to carry out a function through the mechanical movements of its components, which occurs when it is appropriately stimulated externally. Therefore, molecular motors include a part with a motor, which is a tool with the power of turning energy to mechanical work. Molecular motors and machines operate by means of nuclear rearrangements, which like their macroscopic peers, and are described by the type of energy input provided to make them function, the way in which their operation can be observed, the potential to renew the operation at will, i.e., setting up of a cyclic process, the time scale needed to complete a cycle of operation, and the performed function. Due to progresses made in several branches of chemistry, it has become possible to design and construct basic prototypes of artificial molecular motors and machines so that we can better understand the mechanisms by which molecular motors of the biological world operate. The expansion of the concept of motors to the molecular level has received great importance not only in the whole research areas but also in the advancement of nanoscience and the development of nanotechnology. Today, molecular motors are one of the common areas of research between biotechnology and nanoscience. These devices are nanoscale motors that have the ability to perform mechanical movements in exchange for a suitable external stimulus. This stimulation can be caused by a chemical reaction, environmental changes, or light exposure. To date, a large number of high-efficiency natural molecular motors have been identified that can be imitated to develop a wide range of synthetic molecular motors. Although the net weight of Nano motors is in the range of molecular units, these nanoscale structures are capable of generating force at very small levels of Pico and fete newton, and with their self-assembly ability can produce large forces (such as those produced in human muscle). These motors obtain their energy through chemical or optical excitation and convert it into mechanical work. Also, the amount of productive force and its efficiency were examined. Molecular motors are known for having a vast variety of types. One of the best possible classifications is based on the origin of the motors. Therefore, molecular motors can be divided into natural and artificial. Natural molecular motors are protein-based, and the fuel they need is supplied by ATP. The synthetic type is either based on DNA molecules or based on chemical (inorganic) compounds. DNA-based synthetic molecular motors derive their energy from DNA. In contrast, the energy of chemical molecular motors can be supplied by various methods such as optical excitation and electrochemical reaction. In this paper, the general introduction of molecular motors and their operating mechanism, as well as the types of molecular motors and electronic and non-electronic applications of molecular motors will be discussed.

AbstractIntroduction Hip fractures have several adverse effects on patients’ morbidity and mortality. Postoperative Acute kidney injury (AKI) is one of the complications that have a significant impact on the patient’s overall prognosis. We aimed to identify AKI risk after hip fracture surgery and the preoperative and intraoperative risk factors.Methodology We conducted a retrospective cohort study in a tertiary care hospital on adult patients who underwent surgery for hip fractures between January 2015 and August 2021. All clinical data were reviewed.Result A total of 611 patients were included (age = 76.44 ± 9.69 years). 126 (20.6%) of them developed AKI postoperatively. In multilinear logistic regression analysis, factors associated with postoperative AKI included eGFR [odds ratio (OR): 0.98; 95% confidence interval (CI): 0.97–0.99 with a p value .01], spinal anesthesia [OR: 1.78; 95% CI: 1.1–2.9 with a p value .01], and partial hip replacement (PHR) type of surgery [OR: 0.56; 95% CI: 0.32–0.96 with a p value .036]. The development of postoperative AKI was the strongest factor that increase mortality of the patients as the (HR = 2.42, CI 95% [1.57–3.74]; p value

Introduction: This research aims to develop and test the adolescents' self-esteem causal model based on the parent-child relationship and basic psychological needs with the mediating role of self-concept.Method: The descriptive-correlation research was of the structural equation type. The statistical population consisted of all the second-year high school students of Meibod City in 2019-2020, and 461 people from the target population were selected as the sample size using the available sampling method and participated in the research virtually. The data was collected using Coopersmith's self-esteem, parent-child relationship by Fine et al., Rogers`s basic psychological needs and self-concept questionnaires. Finally, the data of 398 participants, which were analyzable, was collected in order to investigate the research hypotheses using the structural equation modeling method and SPSS25 and AMOS24 software.Results: The results of structural equation modeling confirmed the fit of the hypothetical research model. Also, the results obtained from the path coefficients in the structural model showed that the parent-child relationship and basic psychological needs have a positive and significant effect, and self-concept has a negative and significant effect on the self-esteem of adolescents. In addition, self-concept mediates the relationship between the parent-child relationship and basic psychological needs with self-esteem in adolescents. The variables of the parent-child relationship, basic psychological needs, and self-concept explain a total of 62% of the variance of self-esteem in adolescents.Discussion and Conclusion: Therefore, considering the role of improving the parent-child relationship, and satisfying the basic psychological needs and self-concept in the formation of self-esteem of adolescents, it is necessary to inform parents and adolescents about the characteristics of adolescence and its effects in the later stages of life.