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Abstract Background The transition to college life is a highly demanding period for all students, especially when enrolling into an academically-challenging field as that of medicine. First-generation medical students represent an overlooked demographic and are thought to be more vulnerable to the stressors of college. This study’s aim is to explore the differences between first and continuing-generation medical students in Egypt regarding their academic performance, extracurricular training opportunities and future expectations. Methods Two identical 24-item online questionnaires, in English and Arabic were distributed with five main themes: general demographics, academic performance, extracurricular training opportunities (outpatient clinics, hospitals and operating rooms), future expectations and if participants have relatives in the medical field. Results Responses from 1652 eligible respondents from all 36 medical universities in Egypt were received. Continuing-generation medical students achieved a higher cumulative grade, with 46.1% getting an “Excellent” grade compared to only 38.4% in the first-generation. The gap between the two groups was best noted in Year 1 (p-value

Spontaneous stress fracture of the scapular spine associated with rotator cuff tendinopathy is a rare complication in an elderly patient. Rotator cuff tendinopathy is a common condition characterized by degeneration and inflammation of the rotator cuff tendons. On the other hand, stress fractures are small cracks or breaks in bones that occur in response to repetitive or excessive mechanical loading. We present a rare case of a 79-year-old female patient complaining of persistent right shoulder pain that was unresponsive to medication which worsened in the last week and associated with a limited range of motion and inability to raise her arms above her head. Imaging studies revealed a nondisplaced fracture involving the mid-aspect of the scapular spine with surrounding callus formation and adjacent reactive changes. Stress fractures are often observed in weight-bearing bones, but they can also occur in non-weight bearing bones like the scapular spine. The association between rotator cuff tendinopathy and stress fractures of the scapular spine is uncommon and not well-documented in the literature. The biomechanics of the shoulder joint and altered force transmission due to rotator cuff pathology may contribute to the development of stress fractures. This case highlights the need to consider uncommon complications, such as stress fractures, in patients with shoulder pain. A comprehensive approach and early recognition of rare complications can guide appropriate diagnostic and treatment strategies to prevent potential complications and optimize patient outcomes.

Canagliflozin was assessed for its anti-inflammatory and antioxidant effects as an anti-aging drug in animal models. 50 Swiss albino male mice were divided into five groups; all groups received their intervention using gastric gavage; group 1 received normal saline for 14 weeks; group 2 received induction by D-galactose 200 mg/kg/day for seven weeks; and group 3 to 5 received the same induction for seven weeks, followed by another seven weeks of investigated drugs; group 3 received Vitamin C (100 mg/kg/day); group 4 received canagliflozin (3 mg/kg/day); and group 5 received canagliflozin (1 mg/kg/day). At the end of 14 weeks, all animals were euthanasiad, and heart and skin tissue were harvested for further analysis. Canagliflozin at both 1 and 3 mg/kg was successful in reducing the levels of inflammatory mediators (TNF-alpha and IL6), reducing levels of MDA, increasing the levels of SOD, and increasing the levels of collagen-1 and elastin in skin tissue. Additionally, 3 mg/kg Canagliflozin showed a better effect compared to 1 mg/kg regarding its effect on IL6, SOD, and elastin. Histopathologically, treatment with both doses of Canagliflozin attenuates abnormalities induced by D-galactose (bizarre, irregular, and hyperchromatic nuclei). Canagliflozin exhibits potent antioxidant and anti-inflammatory effects in living organisms, effectively prevents cardiac and skin damage generated by D-galactose, and possibly reduces aging.

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

Abstract The aim of this paper is to explore whether and how urban road transport (URT) development affects haze pollution. One of the innovations of this paper is that URT development is measured by road accessibility with novel digital elevation model datasets, which have been used by few scholars. The endogenous problem caused by revere causality issue in the relationship between URT development and haze pollution is also considered. Based on the panel data of prefecture-level cities of Yangtze River Delta (YRD) region in China from 2011 to 2018, this paper uses long-lagged values of URT development as the instrumental variable, employing the two-stage least squares (2SLS) method. The study shows that URT development leads to an increase of haze pollution. Moreover, mechanism tests based on moderating and mediating models support the finding that decreasing haze pollution resulted from better connection effects, while rising agglomeration effects tend to bring about increasing haze pollution, and the latter effect is larger in magnitude than the former. Current URT development may have long-term negative consequences for livability of YRD cities, and urban decision makers should reconsider the effectiveness of the current road transport investment and construction.

Abstract In the field of power systems, the optimization challenge of combined heat and power units economic dispatch (CHPUED) holds immense importance. This study presents an improved Aquila optimization technique (IAQT) that effectively tackles the CHPUED. The primary objective of the enhanced IAQT model is to minimize the overall cost of power generation in CHP systems while satisfying demand and operational constraints. However, to achieve more accurate cost estimations and avoid suboptimal solutions, it is crucial to consider transmission losses in the optimization model. By incorporating transmission losses, the IAQT algorithm can allocate power generation resources more effectively, leading to improved system efficiency and reduced operational costs. The proposed IAQT algorithm addresses the limitations of the standard AQT and introduces novel features to enhance its search capabilities. One key limitation of the standard AQT is its heavy reliance on the best solution found during optimization. To overcome this drawback, the enhanced IAQT model eliminates the dependency on the best solution and enables a more thorough exploration of the search space. Moreover, the algorithm incorporates specific limitations and constraints for each dimension of the newly generated solutions, ensuring their feasibility and validity. The standard AQT and proposed IAQT are tested on CEC 20 benchmark functions. Moreover, the proposed approach is extensively evaluated through experimentation and testing on various scenarios, including 7–48-unit and large 96-unit systems with/without losses. Furthermore, the overall costs for the 7 unit-system are considered including the reserve constraint. The results exhibit the remarkable performance and efficiency of the enhanced IAQT model, outperforming the standard version and several previously reported results. This validation underscores the significant contribution of the study in addressing the CHPUED and highlights its potential for real-world applications.

Recently, researchers are facing great challenges to form the homogeneous solutions of various liquids at biomedical and industrial levels. Such homogeneous solutions can be controlled through stratification phenomenon directly which is ignored by the researchers in the existing literature specifically quadratic stratification and melting heat mechanism which is valid only for higher temperature processes. Thus, to form the homogeneous and stable liquid solutions for various industrial processes, we investigate the melting heat phenomenon in quadratic stratified Jeffery Nano fluid flow deformed due to linearly stretching sheet along with stagnation point. Inclined constant magnetic field is implemented on the fluid through an arbitrary angel. Characteristics of heat and transportations are disclosed through viscous dissipation, Brownian motion and thermphoresis. Temperature and concentration of the surrounding fluids are assumed higher than the stretching surface. The resultant governing equations are reduced to ordinary differential equations through proper transformations. Convergent analytical series solutions are computed via homotopic approach. Impact of various emerging parameters on temperature, velocity and concentration fields are illustrated and discussed comprehensively. Sherwood and Nusselt numbers and drag force are scrutinized mathematically, physically and graphically. It is analyzed from the study that (i) dominant melting reduces the temperature field (ii) higher thermal and solutal stratification decay the temperature and concentration fields respectively (iii) higher thermophoresis enhances the temperature field. Further, it is concluded that stable and homogeneous solutions may be made by increasing melting and reducing stratification phenomena. This study will help us to provide actual amount of heat for heating processes in industries and biomedicine which is the basic requirement for excellent quality of products.

Jeune syndrome, a rare autosomal recessive disorder, is characterized by skeletal abnormalities, particularly a narrow, bell-shaped chest, leading to severe respiratory distress in newborns. This case report details a full-term female neonate presenting with significant respiratory challenges, typical skeletal features, and early-onset renal dysfunction. Despite normal initial imaging, persistent renal abnormalities were observed, underscoring the need for early diagnosis, vigilant monitoring, and a multidisciplinary management approach to optimize outcomes for patients with Jeune syndrome.

Small cell carcinomas are very aggressive malignancies that are most often linked with lung cancer, although they may also develop in the pancreas, colon, rectum, skin, and cervix. SCC of the pancreas accounts for about 1% of these neoplasms. An 88-year-old male with several comorbidities who presented with significant weight loss was diagnosed with metastatic pancreatic neuroendocrine carcinoma after complaining of persistent epistaxis and back pain. This case underscores the significance of using atypical tumor markers, such as thyroid transcription factor 1, to diagnose small-cell pancreatic cancer. It also emphasizes the importance of a multidisciplinary, patient-centered approach to managing these aggressive tumors.

This research examines United Arab Emirates (UAE) university students’ electronic sports habits and motivations using the theory of uses and rewards and the motivation scale for sports consumption (MSSC). A deliberate sample of 172 participants was surveyed using an electronic questionnaire to give their perspectives on various electronic sports-related topics. Most respondents considered e-sports a serious sport and valued it as a social practice. They practiced e-sports for two to four hours daily, preferring multiplayer games, confirming the collective tendency. Live-streaming services have helped electronic sports to become mainstream. Considering the UAE’s enthusiasm, most respondents played e-sports professionally. Finally, indirect realization, aesthetics, and escapism motivated e-sports players. These findings shed light on the perspectives and experiences of UAE residents who participate in electronic sports and may be used to guide efforts to legitimize and mainstream the activity.

Background: Pre-diabetes, characterized by elevated glycemic indices, poses a high risk of diabetes development, and is increasingly linked to non-specific low back pain. While mechanisms remain incompletely understood, metabolic, inflammatory, and neurological factors are implicated. Dietary interventions, including low-glycemic and anti-inflammatory diets, alongside weight management, may improve outcomes in this population. Objectives: In this non-randomized controlled trial, we aim to evaluate the influence of decreasing HbA1c levels on reducing chronic non-specific low back pain in pre-diabetic, non-obese individuals, as well as emphasizing the importance of such a study in supporting the literature. Methods: A non-randomized controlled single-blind clinical trial was conducted among 82 participants with chronic non-specific low back pain and pre-diabetes at an outpatient clinic in Baghdad from the 30th of January to the 22nd of September. The intervention methods aimed at reducing HbA1c levels to assess the reduction impact on alleviating chronic non-specific low back pain included dietary adjustments, sleep optimization, and correction of vitamins and minerals deficiencies. The follow-up process was conducted individually for each participant, with a monthly assessment over a period of six months. Results: At 12 weeks a significant decrease in chronic non-specific low back pain severity was observed in patients with lower HbA1C levels yielding a P -value of .021. Similarly, at 24 weeks there was a decline in the number of patients who reported chronic non-specific low back pain, and the association to lower HbA1C levels was significant with a p -value of .005. Conclusion: This study suggests the presence of a statistically significant association between reduction of HbA1C levels and ensuing improvement in chronic non-specific low back pain symptoms in non-obese prediabetic patients.

Tuberculosis (TB), caused by Mycobacterium tuberculosis , is a leading infectious disease with varied manifestations. We report a rare presentation of gastric TB in a 50-year-old immunocompetent woman from the Middle East with no prior medical history. The patient presented with persistent epigastric pain, weight loss, nausea, and vomiting over a 2-month duration. Imaging studies and an infectious disease panel were inconclusive. However, upper endoscopy revealed a subepithelial lesion at the pylorus, with biopsies demonstrating caseating granuloma and multinucleated giant cells. A QuantiFERON test was subsequently positive for TB. The patient was successfully treated with standard TB quadruple therapy, resulting in significant improvement in symptoms during follow-up. This case underscores the importance of considering extrapulmonary TB in immunocompetent patients with atypical gastrointestinal symptoms and highlights the efficacy of prompt antitubercular therapy.

Abstract Background and Aim The role of Resmetirom in non‐alcoholic steatohepatitis (NASH) represents a promising therapeutic approach in addressing the growing global burden of liver disease. With NASH emerging as a leading cause of liver‐related morbidity and mortality worldwide, there is an urgent need for effective treatments. Resmetirom, a selective thyroid hormone receptor‐β agonist, offers potential benefits in improving liver histology and metabolic parameters in patients with NASH. This review examines the current evidence surrounding Resmetirom's role in NASH management. Methods A systematic review and meta‐analysis was done by searching in Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, MEDLINE (including MEDLINE InProcess) (OvidSP), Web of Science, Embase (OvidSP), and Scopus databases. ROB2 Cochrane tool was used for assessing risk of bias in randomized controlled trials (RCTs). In the analysis, we used RevMan Cochrane software. Results The study showed that patients who were treated with Resmetirom had significantly lower low‐density lipoprotein‐cholesterol (LDL‐C) levels (mean difference [MD] −10.45; 95% confidence interval [CI] −15.86 to −5.83; P

Objectives: Type 2 diabetes mellitus (T2DM) is a persistent metabolic illness causing elevated glucose levels due to insulin resistance. Social media has been found to positively impact diabetes management by boosting motivation, adherence, emotional support, and sharing evidence-based information, thereby enhancing patients’ glycemic control efforts and achieving HbA1c targets. Primarily to examine the influence of social media within a random sample Iraqi population of T2DM patients on the control of diabetes, as measured by HbA1c levels. Methods: A multicentric cross-sectional study involves patients diagnosed with T2DM recruited between December 30, 2019 and November 8, 2023. Patients diagnosed with T2DM, who visited the outpatient clinic at least twice during the study period, were included. The sample size comprised 2921 patients. Various social media platforms available including, Facebook, WhatsApp, Instagram, Telegram, X (formerly known as Twitter), and Viber, were reported. Results: The study involves 2921 participants with a mean age of 53.3 years, 56% of them successfully reached their HbA1c target within a mean of 18.17 months. A significant correlation was found between achieving the target and using social media ( P = .0001), with a shorter average duration among social media users compared to non-users. A family history of diabetes also significantly correlated with achieving the desired outcome, suggesting a probable positive correlation ( P = .019). Conclusion: The study reveals a significant association between social media usage and glycemic control, introducing the importance of technology-based interventions in enhancing diabetes self-management, highlighting the relationships between social media engagement and HbA1c target achievement.

Cabazitaxel, a second-generation taxane chemotherapy agent, has demonstrated efficacy in treating metastatic castration-resistant prostate cancer (mCRPC) in patients who have previously received docetaxel-based therapy. By targeting microtubule dynamics, cabazitaxel inhibits cancer cell division and induces apoptosis, thereby extending survival and delaying disease progression in this challenging patient population. A systematic review and meta-analysis were done by searching the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, MEDLINE (including MEDLINE InProcess; OvidSP), Web of Science, Embase (OvidSP), and Scopus databases. ROB2 Cochrane tools assessment for RCTs. In the analysis, we used RevMan Cochrane software. Our research reveals significantly improved outcomes in terms of patient survival rates, both progression-free survival (PFS) and overall survival (OS), for cabazitaxel over comparative treatment (PFS HR 0.77 [0.61, 0.97]) (OS HR 0.79 [0.70, 0.88]). The treatment response rates were also favorable for cabazitaxel, reported as PSA Reduction Response of more than 50% (PRR) (odds ratio (OR) = 1.59 [0.56, 4.52]) and tumor response rate (TRR) (OR = 2.34 [1.28, 4.28]). Cabazitaxel was associated with significantly more incidence of adverse events. The risk ratio (RR) for serious adverse events was 1.64 [1.14, 2.35] for cabazitaxel compared to the current regimen. A systematic review and meta-analysis were done by searching in the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, MEDLINE (including MEDLINE InProcess; OvidSP), Web of Science, Embase (OvidSP), and Scopus databases. ROB2 Cochrane tools assessment for RCTs. In the analysis, we used RevMan Cochrane software.

Objectives An abscess is a localized collection of pus contained within a fibrous capsule. In this study, we aimed to determine the demographic pattern, common anatomical sites, risk factors, and the microbial profile of abscesses in different body sites among children. Methods We conducted a prospective study in our pediatric surgical department among children with abscesses in different body sites between January 2019 and December 2022. Results During the study period, 85 children were included. The participant age range was 0 to 14 years old, and 66% of participants were boys. The most common anatomical sites where abscesses formed were the pelvis (n = 29, 34%), abdomen (n = 22, 26%), neck (n = 14, 16%), and extremities (n = 12, 14%). Risk factors of abscesses in different body sites included cannulation, lymphadenitis, mastitis, perforated appendix, and perianal fistula. We observed that 74% of abscesses were of a polymicrobial nature. Conclusion The most common anatomical sites for abscesses in children included the pelvis, abdomen, neck, and extremities. Most abscesses in these sites were polymicrobial in nature.

Abstract Objectives The objective of this in vitro study was to evaluate the effects of different preparation designs on the mean colour change (ΔE*), marginal adaptation, fracture resistance, and fracture types of maxillary and mandibular premolar endocrowns (ECs). Methodology A total of 40 extracted maxillary and mandibular premolars were treated endodontically, and each type was subdivided according to the remaining axial height (remaining walls on all surfaces; 2–4 mm) and 2 mm inside the pulp chamber. Specimens were immersed in coffee for 14 days, ΔE* was determined, marginal adaptation was observed, fracture forces test was conducted, and the samples were examined visually at 10× magnification to evaluate failure type and identify fracture origin. The data were entered and analyzed using Statistical Package for Social Sciences, and significance between and within groups was evaluated through ANOVA. The p-value ≤ 0.05 was considered statistically significant. Results The ΔE* values of the maxillary premolar with 2 mm axial height were the highest (6.8 ± 0.89 units), whereas the lowest value was observed in the mandibular premolar with 4 mm axial height (2.9 ± 0.53 units). Significant differences (p

Voiding dysfunction and non-obstructive urinary retention are common conditions with debilitating patient symptoms. Treatment of these conditions can be challenging with limited conservative options available. Sacral Neuromodulation is a minimally invasive treatment which has been demonstrated to deliver good success rates in this patient population. It provides patients with a trial period to establish the likelihood of treatment success prior to implantation of a full system and can be reversed should the need arise.This review looks at the potential mechanisms of action of Sacral Neuromodulation in patients with voiding dysfunction or non-obstructive urinary retention, along with the literature evaluating success rates both in the short and long term. It aims to examine any possible predictive factors that may play a role in guiding patient selection and improving patient counselling. It also addresses gaps in the literature and areas where further research is needed.

Mesh is a synthetic material used to treat stress urinary incontinence (SUI) and pelvic organ prolapse (POP) in women. There have been several reports by patients of complications around the world and some countries have suspended the use of vaginally inserted mesh for the treatment of SUI and POP due to complications. The aim of this document is to address the types of mesh procedures performed and provide terminology for mesh removal which can be easily understood by health-care providers and patients/consumers, avoiding miscommunication which has been highlighted in the Cumberlege report in the United Kingdom.

This paper proposes a novel quaternion-based approach for tracking the translation (position and linear velocity) and rotation (attitude and angular velocity) trajectories of underactuated Unmanned Aerial Vehicles (UAVs). Quadrotor UAVs are challenging regarding accuracy, singularity, and uncertainties issues. Controllers designed based on unit-quaternion are singularity-free for attitude representation compared to other methods (e.g., Euler angles), which fail to represent the vehicle's attitude at multiple orientations. Quaternion-based Adaptive Backstepping Control (ABC) and Adaptive Fast Terminal Sliding Mode Control (AFTSMC) are proposed to address a set of challenging problems. A quaternion-based ABC, a superior recursive approach, is proposed to generate the necessary thrust handling unknown uncertainties and UAV translation trajectory tracking. Next, a quaternion-based AFTSMC is developed to overcome parametric uncertainties, avoid singularity, and ensure fast convergence in a finite time. Moreover, the proposed AFTSMC is able to significantly minimize control signal chattering, which is the main reason for actuator failure and provide smooth and accurate rotational control input. To ensure the robustness of the proposed approach, the designed control algorithms have been validated considering unknown time-variant parametric uncertainties and significant initialization errors. The proposed techniques have been compared to state-of-the-art control technique.

Objective:: To review and summarize the peer-reviewed literature for Surgical Training and Research in Mesh Complications. Methods:: An international author team reviewed available published literature. Results:: This paper reviews the current training situation and recognizes there are no fellowships globally which specifically train in mesh removal/ complications. The UK has recently launched a mesh complications training pathway pilot. New Zealand has recently implemented a credentialing framework for pelvic floor procedures including mesh removal and undertaken national credentialing of surgeons. A proposed training pathway is outlined including training sequence, the training setting, and a modular pathway of training.The authors acknowledge that there is very limited research and evidence for management of mesh complications. Several important research questions are suggested for future research. Future projects for collaborative research are proposed including registries, and development of improved patient education materials for pelvic floor conditions to improve shared decision making.

Joshua T Myers, Jacques Van Dam, Mir Imran, Mir Hashim, Arvinder K Dhalla Rani Therapeutics, San Jose, CA, USACorrespondence: Joshua T Myers, Rani Therapeutics, 2051 Ringwood Ave, San Jose, CA, 95131, USA, Tel +1 408-457-3700, Email joshua.myers@ranitherapeutics.comBackground: Rani Therapeutics is developing a robotic pill (RP), an oral drug delivery platform called RaniPill™ that can deliver a number of biotherapeutics with high bioavailability; eliminating the need for injections. While patients in general prefer oral to injectable therapies, preference for a more frequent oral regimen compared to a less frequent injectable regimen is unknown. Two marketing surveys were conducted to gather data on preference for oral versus injectable therapies. A clinical study gathered data on participant preference for oral pills vs injections before and after swallowing a Mock-RP capsule.Methods: A total of 1689 adults taking injections (mean duration 3– 7 years) to treat endocrine or inflammatory conditions were anonymously surveyed online for their preference to administer/prescribe medications orally via the RP. In the clinical study, 150 participants currently taking injections for chronic conditions evaluated the swallowability of a Mock-RP and completed a questionnaire regarding their preferences.Results: Majority of respondents surveyed stated they would be willing to convert to an oral alternative over their current parenteral therapy regardless of drug or disease. In the clinical study, all participants were able to swallow the Mock-RP and 91% indicated their preference for the oral route versus their current parenteral route of drug administration. Survey respondents and those in the clinical study using frequent injections were more willing to select a once-daily capsule compared to those injecting infrequently. Even study participants who inject infrequently (≥monthly: 80%) would prefer a once-daily pill over their injection regimen.Conclusion: Patients taking injections and prescribing physicians strongly prefer oral dosing to parenteral administration of biologics even if dosing frequency with the oral option, such as the RP, is increased.Keywords: oral drug delivery, biotherapeutic, robotic pill, once-daily pill, swallowability

Abstract Transposable elements (TEs) are DNA sequences that can move or replicate within a genome, and their study has become increasingly important in understanding genome evolution and function. The Tridactylidae family, including Xya riparia (pygmy mole cricket), harbors a variety of transposable elements (TEs) that have been insufficiently investigated. Further research is required to fully understand their diversity and evolutionary characteristics. Hence, we conducted a comprehensive repeatome analysis of X. riparia species using the chromosome-level assembled genome. The study aimed to comprehensively analyze the abundance, distribution, and age of transposable elements (TEs) in the genome. The results indicated that the genome was 1.67 Gb, with 731.63 Mb of repetitive sequences, comprising 27% of Class II (443.25 Mb), 16% of Class I (268.45 Mb), and 1% of unknown TEs (19.92 Mb). The study found that DNA transposons dominate the genome, accounting for approximately 60% of the total repeat size, with retrotransposons and unknown elements accounting for 37% and 3% of the genome, respectively. The members of the Gypsy superfamily were the most abundant amongst retrotransposons, accounting for 63% of them. The transposable superfamilies (LTR/Gypsy, DNA/nMITE, DNA/hAT, and DNA/Helitron) collectively constituted almost 70% of the total repeat size of all six chromosomes. The study further unveiled a significant linear correlation (Pearson correlation: r = 0.99, p-value = 0.00003) between the size of the chromosomes and the repetitive sequences. The average age of DNA transposon and retrotransposon insertions ranges from 25 My (million years) to 5 My. The satellitome analysis discovered 13 satellite DNA families that comprise about 0.15% of the entire genome. In addition, the transcriptional analysis of TEs found that DNA transposons were more transcriptionally active than retrotransposons. Overall, the study suggests that the genome of X. riparia is complex, characterized by a substantial portion of repetitive elements. These findings not only enhance our understanding of TE evolution within the Tridactylidae family but also provide a foundation for future investigations into the genomic intricacies of related species.

Wooden breast is one of the myopathies that affected broilers and caused economic loss, but the causes are still unknown. This experiment aimed to investigate the effect of a high percentage of soybean oil in inducing this abnormality. Thirty chicks were fed into basal ratio as a control group and basal ratio with soybean oil 5.20% as the treatment group for 35 days. The histopathological examination of the Pectoralis muscle of broiler rearing for 12 days was represented by abnormal myofiber architecture, edema, and increased endomysium formation at percentages 40% and

Abstract Pediatric cardiomyopathies are mostly attributed to variants in sarcomere-related genes. Unfortunately, the genetic architecture of pediatric cardiomyopathies has never been previously studied in Jordan. We sought to uncover the genetic landscape of 14 patients from nine families with several subtypes of pediatric cardiomyopathies in Jordan using Exome sequencing (ES). Our investigation identified pathogenic and likely pathogenic variants in seven out of nine families (77.8%), clustering in sarcomere-related genes. Surprisingly, phenocopies of sarcomere-related hypertrophic cardiomyopathies were evident in probands with glycogen storage disorder and mitochondrial-related disease. Our study underscored the significance of streamlining ES or expanding cardiomyopathy-related gene panels to identify plausible phenocopies of sarcomere-related cardiomyopathies. Our findings also pointed out the need for genetic testing in patients with cardiomyopathy and their at-risk family members. This can potentially lead to better management strategies, enabling early interventions, and ultimately enhancing their prognosis. Finally, our findings provide an initial contribution to the currently absent knowledge about the molecular underpinnings of cardiomyopathies in Jordan.

Nutritional disorders are problems in the poultry industry. This experiment aimed to study the effect of high doses of soy oil and lysine (Lys) on the liver and Pectoralis muscle (PM) in broiler during the starter period and apply I See Inside (ISI) and semiquantitative methodology, determined the correlation between pathological lesions in both organs and regression assessment for the effects of myopathies on the liver. Forty broilers were divided into T1, receiving basal diet T2 and T3, high additive oil and lysine 4.56 and 1.66% respectively, and T4, which received both high additives; the trial continued for 12 days. The total ISI index for histopathological lesions in the liver and PM was 74 and 41, respectively, represented by vascular, degeneration alteration, and necrosis; ISI assessment revealed highly significant lesions in the liver of all groups in comparison with T1, significance endomias tissue formation in T4 at 4.00, splitting PM fiber in both T3 and T4 1.60, the intermittent muscle fiber of the broiler at same treatments was 1.00, furthermore semi-quantitative analysis investigated significant correlation between infiltration of inflammatory cells with highly significant congestion correlation with necrosis in the liver. In contrast, in the muscle, the necrosis is significantly correlated with hemorrhage in the liver; the regression plot analysis also determined the R2 value for microscopic lesions in the muscle, which affected hepatic tissue. This study concludes that ISI with semi-quantitively analysis is a sound methodology for determining the significant deleterious effects of high doses of oil and lysine in broil ration.

Abstract Nanoparticles (NPs) formulation in biopolymers is an attractive process for the researcher to decrease the disadvantages of NPs application alone. Bimetallic NPs are a promising formula of two NPs that usually act as synergetic phenomena. Zinc oxide and gold NPs (ZnO@AuNPs) biosynthesis as a bimetallic was prepared via the eco-friendly manner currently. Carboxymethylcellulose (CMC) was employed for the formulation of ZnO@AuNPs as a nanocomposite via a green method. Physicochemical and topographical characterization was assigned to ZnO@AuNPs and nanocomposite features. The nanostructure of bimetallic NPs and nanocomposite were affirmed with sizes around 15 and 25 nm, respectively. Indeed, the DLS measurements affirmed the more reasonable size and stability of the prepared samples as 27 and 93 nm for bimetallic NPs and nanocomposite, respectively. The inhibitory potential of nanocomposite was more than ZnO@AuNPs against Staphylococcus aureus, Escherichia coli, Salmonella typhi, Enterococcus faecalis, Mucor albicans, Aspergillus flavus, and Mucor circinelloid. ZnO@AuNPs and nanocomposite exhibited antioxidant activity via DPPH with IC50 of 71.38 and 32.4 µg/mL, correspondingly. Excellent anti-diabetic potential of nanocomposite with IC50 of 7.4 µg/mL, and ZnO@AuNPs with IC50 of 9.7 µg/mL was reported compared with the standard acarbose with the IC50 of 50.93 µg/mL for amylase inhibition (%). Photocatalytic degradation of RR195 and RB dyes was performed by ZnO@AuNPs and nanocomposite, where maximum degradation was 85.7 ± 1.53 and 88.7 ± 0.58%, respectively using ZnO@AuNPs, 90.3 ± 0.28 and 91.8 ± 0.27%, respectively using nanocomposite at 100 min. Graphical Abstract

Identification of photovoltaic (PV) module characteristics in solar systems is a vital task, nowadays, for optimal PV power estimation. In this paper, this challenge task has been studied using a novel advanced Kepler optimization algorithm (KOA). The standard version of KOA is adopted and assessed for getting the nine parameters of the PV triple diode model (3DM) considering three different practical PV modules. Kepler's principles of planetary motion are used by KOA to forecast the location and velocity of planets at any particular moment. However, the success rate of the KOA is not compatible, and its efficiency needs to be enhanced. As a result, an Improved KOA (IKOA) is created by incorporating an advanced mechanism of Local Escaping Operator (LEO), resulting in improved process of searching with evading local optima. This mechanism means that the exploitation approach will activate with around half of the solutions for every iteration starting at the initial phase of the iteration journey. The suggested IKOA besides the standard KOA are developed for predicting PV parameters for three distinct PV modules which are Photowatt PWP201, R.T.C France and STM6-40/36. The results corresponding to the latest algorithms are also compared with the proposed IKOA about different published works. The simulation findings reveal that the suggested IKOA exhibits notable average improvement rates for the three modules of 62.27 %, 55.1 %, and 32.12 %, respectively. Furthermore, the suggested IKOA asserts significant superiority and robustness over previously reported results.

Abstract High altitude platform station (HAPS) is one of the promising solutions to many of the developing and less developed countries. To a great extent, HAPS is relatively cost‐effective and can be easily moved on demand while observing the required quality of service. For tropical countries, rain attenuation is the main factor that affects HAPS performance. This study investigated HAPS performance in Tanzania under heavy rain conditions. Rain rate, rain attenuation, and carrier‐to‐noise ratio were used to quantify the system's performance. In this study, the rain rate exceeds by 0.01% (R0.01) of an average, was obtained using the Chebil model. Based on Tanzania Meteorological Agency data, the R0.01 registered a high amount of rainfall for the five selected regions: Dar es Salaam, Kagera, Tanga, Unguja, and Pemba. By using ITU‐R model, rain attenuation for the downlink was predicted, assuming horizontal polarisation, for 31.0–31.3 GHz. Finally, the HAPS link budget was analysed with a platform altitude of 22 km at frequency of 31.0–31.3 GHz for different elevation angles. Results showed that the performance of the system was promising in the given rainfall scenarios.

Heat-mass transfer in a liquid flow over a stretching surface at a stagnation regime is significant in optimal manufacturing and quality assurance depending on the rheological behavior of viscoelastic fluids in process machinery. Stretching sheet flow at a stagnation point is a standard procedure used in the metallurgical industries for manufacturing of different equipment and cooling systems. Due to its various applications in industrial operations, the current study aims to explore the heat-mass transfer of buoyancy-driven flow of cross liquid over a stretching sheet at a stagnation point. The heat and mass transfer under the framework of Dufour and Soret effects, radiant heat, and chemical reactions are assessed. Furthermore, the analysis also takes into account the linear and nonlinear convection-diffusion phenomena. The model findings are obtained by merging the Bvp4c in MATLAB using a local similarity technique up to the fourth truncation threshold. The findings illustrate that the action of magnetic field can be used to control the flow across the sheet. Temperature increases with thermal radiation, Biot number and Dufour number. The action of buoyancy ratio parameter result in improvement in fluid flow. With increasing trend of magnetic and Weissenberg number, the flow field and skin friction coefficient drops.

The goal of this work is to provide a novel mathematical model that explains how certain physical variables propagate (acoustic-thermal-mechanical diffusive) as waves in a photoexcited non-Gaussian laser pulse semiconductor medium. Under the impact of acoustic pressure, the isotropic and homogeneous semiconductor medium is discussed concerning the fundamental equations according to charge carrier recombination processes with optoelectronic properties. Given the impact that relaxation times have on the governing equations. Laplace transforms were utilized in a one-dimensional (1D) context to examine essential non-dimensional properties such as displacement, stress components, carrier density, temperature, and acoustic pressure in order to mathematically answer the required problem. By imposing specific initial and boundary conditions, inverse Laplace transformations were employed to generate precise solutions for the numerical modeling of different physical quantities depicted graphically. The graphical representation of wave propagation data was followed by a theoretical analysis and interpretation, emphasizing the influence of other factors (such as heat rise time, relaxation times, and laser pulse effects) on the observed occurrences.

Abstract Introduction Donohue syndrome (DS), also referred to as leprechaunism, is a remarkably uncommon autosomal recessive disorder that primarily affects the endocrine system. Its incidence rate is exceedingly low, with only 1 case reported per 4 million live births. The syndrome is distinguished by a series of characteristic clinical features. Case presentation We present a case of a twenty-month-old male with DS who experienced a range of dysmorphic and clinical features with the involvement of multiple systems. These features include skin hyperpigmentation, hypertrichosis, distinct facial features, abdominal distension, and microcephaly, with the involvement of the endocrine, renal, respiratory, and cardiac systems. Conclusion The primary features of DS involve severe insulin resistance and growth abnormalities, the association with pulmonary hypertension (PHTN) has not been reported before. This finding adds more complexity to the condition. To the best of the author’s knowledge, this is the first report for a patient with DS who has PHTN. Further investigation is required since the mechanisms behind the development of PHTN in DS are not entirely understood. Shedding light on this association will contribute to better management strategies and outcomes for affected patients.

Abstract Objective The objective of this study is to describe a standardised technique of full TOT removal with groin dissection and to report clinical improvement, satisfaction, safety and long‐term functional, quality of life (QoL) and sexual QoL outcomes. Materials and methods A retrospective review enrolling all women who had full TOT removal, in a tertiary referral centre from May 2017 to November 2020. Functional outcomes, satisfaction and QoL were assessed using a bespoke composite questionnaire (UDI‐6, EQ‐5D‐5L and ICIQ‐S) with additional questions on sexual QoL. Secondary outcomes were post‐operative recurrent stress urinary incontinence (SUI) and complication rate according to the Clavien‐Dindo classification. Results Full TOT removal using a vaginal approach and bilateral groin/para‐labial incisions was performed in 67 patients. Chronic pelvic pain was the main indication for mesh removal (51% of cases, n = 34). QoL questionnaires were answered by 43 patients. The satisfaction rate was high 86% (n = 37), and 81% (n = 35) of the patients considered the surgery successful. Seventy per cent (n = 30) of patients returned to having a sexual life after surgery. Recurrent SUI was reported in 32% (n = 14) of cases. The complication rate was 10% (7/67), all of them Clavien–Dindo ≤2. Conclusion Despite a high rate of postoperative bothersome SUI, full TOT removal with bilateral groin dissection improves pain and QoL. It is associated with a high overall satisfaction rate and an acceptable rate of complications.

Neurogenic lower urinary tract dysfunction (NLUTD) encompasses a broad spectrum of neurological conditions affecting the lower urinary tract. Managing NLUTD requires a tailored approach focused on preserving kidney function and enhancing patients’ quality of life. Clinical guidelines provide valuable guidance for healthcare professionals, but discrepancies in recommendations arise among other factors due to limited high-quality clinical evidence. Prominent guidelines from organisations like the International Consultation of Incontinence, the European Association of Urology, the American Urological Association, and the National Institute for Health and Care Excellence offer varying recommendations for NLUTD management. This study reviews and summarizes the recommendations for conservative, pharmacological, and surgical management options across these guidelines.

Background:: Sacrohysteropexy and sacrocolpopexy are established treatments of uterine or vaginal vault prolapse respectively and involve insertion of mesh abdominally, often using permanent sutures and fixation devices. Complications following these procedures may be serious, and there is lack of evidence about long-term functional outcomes in terms of pain, dyspareunia and development of lower urinary tract and bowel symptoms. Objective:: A non-systematic review of the available literature was performed and recommendations on assessment and management were developed by expert consensus. Conclusion:: The current evidence is limited in quantity and quality, and recommendations on assessment management of mesh-related complications were made by experts in the field. Assessment and treatment of complications following abdominally placed mesh for pelvic organ prolapse will often require a multidisciplinary approach. Assessment may require EUA, and/or cystourethroscopy, sigmoidoscopy, and laparoscopy. MRI is the most useful imaging modality. Surgery to remove mesh carries a risk of urinary tract and bowel injury, as well as development of recurrent pelvic organ prolapse. A joint decision between the surgeon and the patient should be made before embarking on a partial removal of mesh; removal of all the mesh may be a better option albeit with higher risk of surgical complications. Complete removal of mesh and tacks or sutures from the sacral attachment may not be possible and is associated with risk of major haemorrhage.

Complications can result from the use of mesh to treat female stress urinary incontinence or pelvic organ prolapse. While some of these complications are also common to non-mesh-based procedures, the risk of vaginal exposure of mesh, or mesh extrusion into other pelvic organs are unique complications that must be considered when using mesh. Chronic pain after mesh-based procedures can be a difficult complication to manage and may occur. Patients with stress incontinence or prolapse that are considering surgical treatment should be counseled on the potential complications and the likelihood of them occurring. Although there has been focus on the development, introduction and regulation of mesh, the diagnostic clinical decision-making process has not been put under scrutiny, and likely significantly impacts patient outcomes. There is a need to develop patient reported outcome measures for mesh procedures, and further work is needed to create a standardized way to measure and communicate different types of mesh-related complications. Future research to focus on the diagnostic clinical decision making process is recommended, including education on the ‘whole journey’ of the patient during the perioperative pathway.

This work presents a semi-supervised multilayer neural network (MLNN) with an Autoencoder to develop a classification model for recognizing hand gestures from electromyographic (EMG) signals. Using a Myo armband equipped with eight non-invasive surface-mounted biosensors, raw surface EMG (sEMG) sensor data were captured corresponding to five hand gestures: Fist, Open hand, Wave in, Wave out, and Double tap. The sensor collected data underwent preprocessing, feature extraction, label assignment, and dataset organization for classification tasks. The model implementation, validation, and testing demonstrated its efficacy after incorporating synthetic sEMG data generated by an Autoencoder. In comparison to the state-of-the-art techniques from the literature, the proposed model exhibited strong performance, achieving accuracy of 99.68%, 100%, and 99.26% during training, validation, and testing, respectively. Comparatively, the proposed MLNN with Autoencoder model outperformed a K-Nearest Neighbors model established for comparative evaluation.

This paper introduces a novel approach to image denoising that leverages the advantages of Generative Adversarial Networks (GANs). Specifically, we propose a model that combines elements of the Pix2Pix model and the Wasserstein GAN (WGAN) with Gradient Penalty (WGAN-GP). This hybrid framework seeks to capitalize on the denoising capabilities of conditional GANs, as demonstrated in the Pix2Pix model, while mitigating the need for an exhaustive search for optimal hyperparameters that could potentially ruin the stability of the learning process. In the proposed method, the GAN’s generator is employed to produce denoised images, harnessing the power of a conditional GAN for noise reduction. Simultaneously, the implementation of the Lipschitz continuity constraint during updates, as featured in WGAN-GP, aids in reducing susceptibility to mode collapse. This innovative design allows the proposed model to benefit from the strong points of both Pix2Pix and WGAN-GP, generating superior denoising results while ensuring training stability. Drawing on previous work on image-to-image translation and GAN stabilization techniques, the proposed research highlights the potential of GANs as a general-purpose solution for denoising. The paper details the development and testing of this model, showcasing its effectiveness through numerical experiments. The dataset was created by adding synthetic noise to clean images. Numerical results based on real-world dataset validation underscore the efficacy of this approach in image-denoising tasks, exhibiting significant enhancements over traditional techniques. Notably, the proposed model demonstrates strong generalization capabilities, performing effectively even when trained with synthetic noise.

Background:The periapical area of a tooth was diagnosed using radiography; many types of risk factors can affect the health of the apical area which is the stress during life.Objective:To analyze the prevalence of academic-environmental stress and apical periodontitis in non-endodontic teeth of dental students using cone-beam computed tomography (CBCT) X-ray, and to demonstrate the association between stress and the prevalence of apical periodontitis.Materials and Methods:Cross-sectional study was done on the 103 recruited dental students aged 22–24 years during the final examination year of study in dentistry college. The academic-environmental stress scale was used to measure the level of stress in each student. The CBCT X-ray was taken for each student. The apical area was measured only for non-root canal-treated teeth using the CBCT periapical radiography index. Chi-square (χ2) test was used to show the percentages of stress and the relationship between apical periodontitis and stress in students.Results:53 students (51.5%) had a stressed state, whereas 50 students (48.5%) had a non-stressful state. The prevalence of apical periodontitis was greater among stressed than that of non-stressed students in non-endodontic teeth. Statistically, there was a significant relationship between academic-environmental stress and apical periodontitis in non-endodontic teeth.Conclusion:There was a negative effect of examination stress on the apical healthy of teeth that can be increased with the presence of any additional factors such as problems of life.

Abstract Background Substantial weight loss in people living with type 2 diabetes (T2D) can reduce the need for glucose-lowering medications while concurrently lowering glycemia below the diagnostic threshold for the disease. Furthermore, weight-loss interventions have also been demonstrated to improve aspects of underlying T2D pathophysiology related to ectopic fat in the liver and pancreatic beta-cell function. As such, the purpose of this secondary analysis was to explore the extent to which a low-carbohydrate and energy-restricted (LCER) diet intervention improves markers of beta-cell stress/function, liver fat accumulation, and metabolic related liver function in people with type 2 diabetes. Methods We conducted secondary analyses of blood samples from a larger pragmatic community-based parallel-group randomized controlled trial involving a 12-week pharmacist implemented LCER diet (Pharm-TCR:

Desta Hashim,1,2 Shemsu Umer,2 Ariaya Hymete,3 Yalemtsehay Mekonnen4 1Department of Pharmacology, School of Pharmacy, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia; 2Department of Pharmacology and Clinical Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia; 3Department of Pharmaceutical Chemistry and Pharmacognosy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia; 4Department of Zoological Sciences, College of Natural and Computational Sciences, Addis Ababa University, Addis Ababa, EthiopiaCorrespondence: Shemsu Umer, Email shemsu.umer@aau.edu.etBackground: Malaria is causing high mortality and morbidity due to Plasmodium’s resistance to currently available anti-malarial drugs and mosquito’s resistance to insecticides. Thus, there is a critical need to search for novel anti-malarial drugs from natural sources. Therefore, this study investigated in vivo antimalarial activities of two Ethiopian medicinal plants, Croton dichogamus Pax and Ehretia cymosa Thonn, in Plasmodium berghei infected Swiss albino mice.Methods: Soxhlet extraction method using 80% methanol as a solvent was used to prepare crude extracts of the two plants. Acute oral toxicity and 4-day suppressive in vivo antimalarial activity tests were performed on healthy female mice and P. berghei infected male mice, respectively. Antimalarial activity of the crude extracts at doses of 100, 200, and 400 mg/kg and the standard drug, chloroquine were used to assesse in Plasmodium berghei infected Swiss albino mice. Parasitemia level, packed cell volume, body weight, and rectal temperature of the mice were determined before infection (day 0) and after treatment (day 4). Survival time was determined by recording the date on which the mice died, considering the date of infection as day 0. The recorded data were analyzed using ANOVA and SPSS version 24.Results: The result of the acute toxicity study revealed that the crude extracts were non-toxic at doses up to 2 g/kg. The extract of E. cymosa suppressed parasitemia level by 66.28, 63.44 and 63.14% at 400, 200, and 100mg/kg, levels while C. dichogamus extract suppressed parasitemia level by 45.29% at a dose of 400mg/kg. The remaining two dose levels of C.dichogamus extract suppressed parasitemia level by < 30%.Conclusion: C. dichogamus and E. cymosa showed anti-plasmodial activities. E. cymosa exhibited a more pronounced anti-plasmodial effect than C. dichogamus. The activities of both plants observed in this study support their traditional use as antimalarial drugs. Further studies on these plants using solvent fractions are required to identify their active ingredients.Keywords: malaria, antiplasmodium, croton dichogamus, ehretia cymosa, P.berghei

There is growing interested in the role of psychological resilience in shaping adolescent students’ delinquent behaviours in secondary schools. In this article, using locus of control theory, we examine the role of psychological resilience in terms of hardiness, resourcefulness, and optimism in minimizing the occurrence of cyber delinquent behaviours of secondary school students in Saudi Arabia. We introduce optimism and resourcefulness as protective factors critical for adolescents engaging in cyber delinquent behaviour and conceptualize them as characteristics of individuals with an internal locus of control. This study examines the multiple mediation effects of optimism and resourcefulness in the relationship between hardiness and cyber delinquent behaviours. The structural equation modelling results confirm eight hypotheses and that optimism and resourcefulness mediate the relationship between hardiness and cyber delinquent behaviours. These findings demonstrate the multiple mediation effects of optimism and resourcefulness and the important role of hardiness, resourcefulness, and optimism in predicting cyber delinquent behaviour. We draw implications for theory, secondary schools, and policymakers.

Abstract Introduction There were no previous studies discussing the comparison of the complications among traumatic brain injury (TBI) cases during weekdays and weekends. The current study aims to retrospectively compare the TBI outcome of geriatric patients on weekdays versus weekends in the neurosurgery department in a tertiary hospital in Oman. Methods This is a retrospective study, from December 2015 to December 2019. Medical records of 670 patients above 65 years and admitted to the neurosurgery ward were reviewed. From that, only 45 patients over 65 years, diagnosed with TBI and managed surgically were included. Results The study included 28 patients admitted during weekdays and 17 patients admitted during weekends. Nevertheless, the highest number of admissions was during Friday. The male-to-female ratio was 3.6:1 during weekdays and 3.2:1 during weekends. The average length of stay (LOS) was 12.4 days among patients operated on weekdays compared to 36.5 days on weekends. For average ICU stay, it was 3.9 days during weekdays compared to 32.2 during weekends (p = 0.011). Complications were found to be more common among patients admitted on weekends (p = 0.015). Conclusion Significant differences between weekdays and weekends were found. So, more trauma imaging facilities and neurosurgeons need to be available during the weekends.

Background: Antimicrobial resistance is associated with increasing mortality rates and the emergence of multidrug-resistant (MDR) organisms. There is scarcity of data on the short-term impact of Antimicrobial Stewardship Programs (ASP) on antibiotic usage, clinical outcome and MDR organisms’ pattern following the COVID-19 pandemic. This study evaluated the short-term effects of ASP on antibiotic usage, clinical outcomes and MDR organisms’ pattern in the post COVID-19 era. Methods: Conducted at a tertiary academic health center, this observational study involved adult patients (≥18 years) in the general medical unit, treated with oral or intravenous antibiotics from May 1, 2021, to April 30, 2022. The applied ASP strategy was a prospective audit and feedback where a weekly meeting was held to discuss the antimicrobial therapy of admitted patient, after which recommendations were made regarding antimicrobial use. Results: The study included 301 patients with 166 (55.1%) pre-ASP and 135 (44.9%) post-ASP. The median (IQR) age was 69 (55−77) years with 56.1% were female. Antibiotic usage dropped by 25.2% post-ASP. The length of hospital stay (LOS) was longer post-ASP (7 days vs. 7.9 days, p = 0.001), with MDR infections being a significant predictor (OR: 0.486, p

Lichen planus (LP) is a chronic, immune-mediated mucocutaneous disorder increasingly becoming common in the general population with female predominance. Clinically, there are different forms of lichen planus with the presence of the main characteristic feature of Wickham striae. Literature, to date, is abundant with various scoring systems of oral lichen planus, and among them, the most commonly followed scoring system was the one proposed by the Thongprasom system because of its simplicity and ease of application.AimThe aim of the present study is to critically review all the disease scoring systems on oral lichen planus (OLP) that have been reported in the literature during the past decades. A systematic literature search was performed using PUBMED, MEDLINE, EMBASE, and COCHRANE Library with language restriction to English. The search was carried out incorporating the published literature from 1980 to 2020 using the MeSH (medical subject heading) terms. A literature search was done using keywords: Staging, Grading, Oral lichen planus, Diagnostic, and Therapeutic. Out of 25 publications, related to search strategy, 22 full articles, which were related to the disease scoring system for oral lichen planus, were acquired for further inspection. Out of the 22 articles, 15 articles met the inclusion criteria. The data was collected and a brief summary of the studies regarding the different disease scoring systems for oral lichen planus was explained. Taking into consideration, the parameters were not included in the previous disease scoring system. A new proposal encompassing a scoring system for oral lichen planus considering the missing parameters along with an amalgamation of histopathological criteria of dysplasia is presented. It also proposes to grade and stage the lesions and recommend appropriate therapy for each of such lesions.

IntroductionIn the current climate of heightened terrorist activity, the deliberate release or threat of biological agents like viruses, bacteria, fungi, or their toxins to induce sickness or death among civilians has become a genuine possibility. The most crucial action during a bioterrorist strike is early warning. The possibility of such an occurrence in dental setting is underestimated. Methods and MaterialsSeventy five graduate students participated in the research. In a survey on zoonotic diseases, participants were asked whether they were familiar with the transmission from person to person, if the diseases caused significant morbidity and mortality, whether they were simple to produce and disseminate, and whether they posed a high risk of infection. ResultsGraph Prism was used to examine the data. A single proportion test was used to determine the “Aware Not Aware” group. The first 10 questions assessed dentists objective knowledge of bioterrorism. The importance of the last six questions was determined by their analysis of dentists’ preparedness and desire to respond to a bioterrorism associated occurrence via perceived knowledge. ConclusionGiven the real danger they may face, dentists needed to be vigilant regarding the prevention, detection, and treatment of zoonotic illnesses transmitted in their offices or as a vector while being commended for their courage in the face of adversity.

Background: There is a lack of randomised controlled trials (RCTs) investigating the role of hand hygiene in preventing and containing acute respiratory infections (ARIs) in mass gatherings. In this pilot RCT, we assessed the feasibility of establishing a large-scale trial to explore the relationship between practising hand hygiene and rates of ARI in Umrah pilgrimage amidst the COVID-19 pandemic. Methods: A parallel RCT was conducted in hotels in Makkah, Saudi Arabia, between April and July 2021. Domestic adult pilgrims who consented to participate were randomised 1:1 to the intervention group who received alcohol-based hand rub (ABHR) and instructions, or to the control group who did not receive ABHR or instructions but were free to use their own supplies. Pilgrims in both groups were then followed up for seven days for ARI symptoms. The primary outcome was the difference in the proportions of syndromic ARIs among pilgrims between the randomised groups. Results: A total of 507 (control: intervention = 267: 240) participants aged between 18 and 75 (median 34) years were randomised; 61 participants were lost to follow-up or withdrew leaving 446 participants (control: intervention = 237:209) for the primary outcome analysis; of whom 10 (2.2 %) had developed at least one respiratory symptom, three (0.7 %) had ‘possible ILI’ and two (0.4 %) had ‘possible COVID-19′. The analysis of the primary outcome found no evidence of difference in the proportions of ARIs between the randomised groups (odds ratio 1.1 [0.3–4.0] for intervention relative to control). Conclusion: This pilot trial suggests that conducting a future definitive RCT to assess the role of hand hygiene in the prevention of ARIs is feasible in Umrah setting amidst such a pandemic; however, outcomes from this trial are inconclusive, and such a study would need to be very large given the low rates of outcomes observed here. Trial registration: This trial was registered in the Australian New Zealand Clinical Trials Registry (ANZCTR) (ACTRN12622001287729), the full protocol can be accessed there.