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Abstract In this study, we aimed to follow up on the surprising increase in the incidence of orbital subperiosteal abscesses (SPA) reported in the Iranian pediatric population in the post-COVID era. Pediatric patients (≤ 18 years old) diagnosed with orbital SPA following acute sinusitis who were hospitalized between October 1st, 2023, and March 31st, 2024 in Farabi Eye Hospital, Tehran, Iran, were included. Demographic, clinical, microbiologic, and radiological characteristics of patients were reviewed. During the 6-month study period, 39 patients were admitted to our tertiary referral hospital. The average age of patients was 7.29 ± 4.13 years and 30 patients (76.92%) were male. The ethmoid sinus was involved in 100% of patients, and SPA involvement was in the medial wall in 27 patients (69.23%). The mean volume of SPA was 1.45 ± 1.77 cm3. Nineteen patients (48.72%) underwent surgical interventions, however, 20 patients (51.28%) received only medical treatment. The best corrected visual acuity of patients increased from 0.63 (0.20 LogMAR) on the first day of admission to 0.84 (0.07 LogMAR) according to the Snellen chart in the first month after treatment. It seems that the outbreak of orbital SPA in the Iranian children population in the post-COVID era is an increasing trend.

In reaction to the expanding predominance of diabetes mellitus, curcumin nanoparticles stacked on carboxymethyl cellulose (CMC) composite were effectively synthesized, characterized, and examined utilizing UV/Vis and FTIR spectroscopy combined with transmission electron microscopy (TEM). The bioactivity of curcumin (Cur), carboxymethyl cellulose (CMC), and curcumin nanoparticles stacked with carboxymethyl cellulose (CUR-CMC) was tried through atomic docking approval as an α-amylase and α-glucosidase inhibitor. The conclusion illustrated that the curcumin-supported CMC is more potent than CUR itself self the validation presented is compared with acarbose as a reference molecule and then CUR-CMC can presented as promising in curing hyperglycemia by decreasing the absorption of glucose.

Previous reports showed that prolonged operative time increases the risk of surgical site infection rates, prolonged hospital stays, and potentially higher rates of revision surgeries. In the context of rhinoplasty, the type of nasal deformity may complicate the surgical procedure and increase the operative time. We aimed to investigate the association between the type of nasal deformity and operative time in rhinoplasty patients. This retrospective chart review studies 349 patients who underwent primary and secondary rhinoplasty procedures due to various nasal deformities in King Saud University-Medical City. The primary outcome of the present study was the association between operative time, defined as the time from the initial incision to the completion of skin closure, and the type of nasal deformity. The association between the type of deformity and operative time was assessed using one-way ANOVA and Bonferroni post hoc analysis. There was a statistically significant association between the type of nasal deformity and operative time (p < 0.001). Patients with dorsal, alar base, and tip deformities had significantly longer operative times than patients with isolated dorsal deformities (208.01 ± 57.73 min) (p < 0.001). The analysis also showed that the presence of crooked nose deformities (p < 0.001), an inverted V deformity (p = 0.01), internal nasal valve collapse (p = 0.025), axis deviation (p = 0.003), over-projection, and under-projection significantly increased surgical duration. The complexity of nasal deformities significantly impacts the operative time in rhinoplasty surgeries; more complex deformities that require extensive surgical procedures are associated with a longer operative time. Further research is warranted to corroborate these findings and investigate other potential influencing factors.

Abstract Purpose The Moraxella species is a very uncommon pathogen that leads to microbial keratitis (MK). This study aimed to evaluate the clinical features, predisposing factors, and outcomes of Moraxella keratitis in patients of a tertiary eye hospital. Methods This retrospective study was conducted from 2015 to 2022, on patients who were admitted with the diagnosis of Moraxella keratitis confirmed by positive culture in a referral eye hospital. Demographics, predisposing factors, best-corrected visual acuity (BCVA), and prognosis were assessed. Results A total of 106 individuals diagnosed with Moraxella keratitis, were analyzed. The mean age was 54.42 ± 19.43 years. The mean baseline BCVA of the patients was 2.28 ± 0.6 LogMAR, while this amount reached 1.49 ± 0.81 in the 6-month follow-up (P-value = 0.02). The mean BCVA in the six-month follow-up of the patients who needed surgical interventions was significantly lower than the patients who received only medical treatment (2.15 ± 0.65 vs. 1.29 ± 0.75 LogMAR, P-value = 0.02). Patients with diabetes and those without diabetes did not substantially vary in the prevalence of corneal perforation (P-value = 0.515). Three predisposing factors including corneal perforation (odds ratio = 19.27, P-value = 0.001), hypertension (HTN) (odds ratio = 3.62, P-value = 0.03), and older age (odds ratio = 1.03, P-value = 0.008) were significantly associated with more need for surgical interventions. Conclusion In this cohort, poor prognosis necessitating surgical interventions in Moraxella keratitis was found to be associated with corneal perforation, HTN, and older age.

Abstract Introduction This study investigated the possible relationship between the Apo lipoprotein A1 /high-density lipoprotein cholesterol (ApoA1/HDL-C) ratio and coronary artery disease (CAD) in patients with type 2 diabetes (T2D). Methods This was a matched case-control study of 482 patients with T2D in two groups of CAD and (n = 241) non-CAD (n = 241). The patients were classified into four quartiles according to the ApoA1/HDL-C ratio, and multivariate logistic regression analysis was performed to assess the relationship between ApoA1/HDL-C and CAD. ROC analysis was also conducted. Results This study showed that the ApoA1/HDL-C ratio has an independent association with CAD in individuals with T2D. The CAD group exhibited a significantly higher ApoA1/HDL-C ratio than those without CAD (p-value = 0.004). Moreover, the risk of CAD increased significantly across the ApoA1/HDL-C ratio quartiles, with the highest odds in the fourth quartile. The second quartile showed an odds ratio (OR) of 2.03 (p-value = 0.048) compared to the first. Moving to the third quartile, the OR increased to 2.23 (p-value = 0.023). The highest OR was noted in the fourth, reaching 3.41 (p-value = 0.001). Employing a cut-off value of 2.66 and an area under the curve (AUC) of 0.885, the ApoA1/HDL-C ratio predicts CAD among patients with T2D with a sensitivity of 75% and a specificity of 91% (p-value

Teachers' professional learning plays an important role in their attempt to change their teaching practices; however, few studies have been conducted on how teachers prepare themselves for the vast initiatives in ameliorating students' outcomes. This study aimed to explore EFL teachers’ perceptions toward their professional learning practices and their professional developmental orientations that contribute to the process of their professional learning. To this end, 30 Iranian EFL teachers selected through purposive sampling participated in this qualitative phenomenological study. The data was collected through semi-structured interviews, focus group interviews, and narrative inquiries to ensure the trustworthiness criteria of the data. The thematic analysis of the data revealed three themes of professional development programs, collaborative learning and experience-based learning. The result showed that only a few teachers were satisfied with the school-based professional learning programs, indicating that revision in the educational system was required to develop teachers’ professional learning. Meanwhile, effective learning occurred through collaboration among the teachers and the mutual learning between teachers and students, hence, leading to participative decision-making and teachers' reflective practice. Overall, participants mentioned students' outcomes as a key level of teachers' professional learning. This study has important implications for policymakers, school administrators, and teacher educators.

Background: Accurate methods are needed to evaluate the anatomy of the internal nasal valve (INV), yet there is currently no ideal measurement technique. Our systematic review aims to establish a comprehensive INV assessment tool, compare different INV diagnostic tools, and establish the most ideal measurement technique for the evaluation of the INV. Methods: A systematic review and meta-analysis were conducted following the PRISMA guidelines, and the study was recorded in PROSPERO under reference number CRD42023407950. A systematic search was performed in PubMed, MEDLINE, The Cochrane Library (Cochrane Databases of Systematic Reviews), and the Cochrane Register of Controlled Trials (CENTRAL) for studies assessing INV that were conducted between 1996 and 2023. Result: Of the 421 total database searches, 23 studies were found, covering a total of 974 patients (6 studies assessed the accuracy of different diagnostic methods, with 2 of these studies comparing two different diagnostic modalities, and 17 studies measured INV angle). Based on the STROBE tool for quality appraisal the mean score was 16.92 ± ± 2.29, indicating a moderate quality. When comparing INV angle values from preoperative and postoperative records as obtained from CT readings, results showed no significant differences between the pre- and postoperative values (MD = -1.8, 95% CI, -4.8 to 1.2, p = .227). Conclusion: Acoustic rhinometry has the highest accuracy, followed by rhinomanometry then CT scan then endoscopy. Meta-analysis showed no significant differences between the pre- and postoperative values and a significant heterogeneity in the reported INV angle values across studies.

BackgroundRecently, the use of telemedicine technology has increased due to the Covid-19 pandemic. Cardiovascular diseases management is one of the areas that has benefited from using this technology. This study aimed to identify the applications of telemedicine for cardiovascular diseases management during the Covid-19 pandemic.MethodsThis scoping study was conducted in 2023. Various databases, including PubMed, Web of Science, Scopus, the Cochrane Library, Ovid, CINAHL, ProQuest, and IEEE Xplore along with Google Scholar were searched and all related quantitative, qualitative, and mixed-method studies published in English between 2020 and 2022 were included. Finally, the required data were extracted, and the findings were reported narratively.ResultsA total of 17 articles were included in this study. The results showed that teleconsultation via telephone and videoconferencing were the most common used technologies. Telemedicine helped to improve clinical impacts such as patient health status and quality of care, and reduced hospitalizations and re-admission rates compared to in-person visits. The non-clinical impact included reducing waiting time, in-person visits, and healthcare costs during the Covid-19 pandemic.ConclusionThe Covid-19 pandemic has led to an increased use of telemedicine technology, especially for patients with cardiovascular diseases. As teleconsultation and telemonitoring are useful for cardiovascular diseases management and regular examinations, future research should investigate how these technologies can be improved and used for a wider population.

Background: Today, self-efficacy beliefs and vitality are extensively foregrounded. Studies show that to change behavior and cognition, it is imperative to strengthen individuals’ psychological relationships with their thoughts and feelings by enabling them to select appropriate alternatives from various choices and not perform actions to avoid bothersome thoughts, feelings, memories, or desires. Thus, can Acceptance and Commitment Therapy (ACT), with its six principles of diffusion, acceptance, contact with the present moment, the observing self, values, and committed action lead to self-efficient beliefs and academic vitality? Aims: The present study aimed to investigate the effectiveness of ACT on students’ self-efficacy beliefs and academic vitality. Methods: This research was a quasi-experimental study with a pretest-posttest control group design. The statistical population included all grade 2 high school students in district 3 of Tehran during the 2020-2021 academic year. Thirty students were selected by mixed (simple and convenience) sampling and assigned into experimental and control groups. Sherer’s (1980) self-efficacy scale and Martin and March’s (2006) academic vitality questionnaire were used for data collection, and Multivariate Analysis of Covariance (MANCOVA) was employed for data analysis. Results: The results showed that ACT improved students’ self-efficacy beliefs and academic vitality in the posttest (p

Background: It is very important to pay attention to the development of children in different social dimensions and to take preventive measures against the occurrence of behavioral problems at an early age. Therefore, it will be helpful to identify targeted and effective intervention programs in this field. So far, various methods have been used to reduce children's behavioral problems, However, there is a research gap regarding the comparison of the effectiveness of the social skills training package based on puppet show and Walker's social skills training program on children's behavioral problems. Aims: The present study was conducted with the aim of comparing the effectiveness of social skills training based on puppet shows and Walker's social skills training program on preschool children's behavioral problems. Methods: The current research design was a semi-experimental type of pre-test, post-test with control group. The statistical population of the research included all preschool children in Kerman city, from among them a sample of 60 people was selected as available and they were placed in two experimental groups and one control group. One of the experimental groups of training through the social skills training package based on puppet shows (10 sessions) and the other experimental group underwent 11 sessions of training through Walker's training program (1983). The data collection tool was Gresham & Elliot (1990) Social Skills Rating System. The research data was analyzed by univariate and multivariate covariance analysis using SPSS-24 software. Results: The results of covariance analysis in the present study showed that both intervention methods were effective in reducing behavioral problems. However, the effectiveness of social skills training based on puppet shows in internalizing and hyperactivity problems was higher than Walker's method (P< 0.05). Conclusion: According to the obtained results, it seems that the use of intervention methods based on puppet shows are more effective in improving the behavioral problems of preschool children than purely mental methods, Therefore, preschool teachers and child psychologists can use the mentioned method to reduce children's behavioral problems.

Background & Aim: Self-efficacy disruption poses a significant challenge for patients with a stoma, affecting their ability to engage in community life and carry out daily activities. Utilizing remote training methods for patients presents an opportunity to maximize the use of these resources. This study aims to determine the effect of a telenursing-based training program on the self-efficacy of patients with a stoma. Methods & Materials: This quasi-experimental study involved a convenient sample of 80 patients with a stoma in Zahedan in 2023, who were randomly assigned to two groups: intervention and control, each comprising 40 participants. The intervention group received the telenursing-based program application. Self-efficacy was assessed using the self-efficacy of stoma patients questionnaire before the intervention, as well as one and three months after the intervention. Data were analyzed using Chi-square test and a two-way repeated measures analysis of variance through SPSS software version 26. Results: The intervention group exhibited a mean (SD) age of 42.84±12.98 years, while the control group had a mean (SD) age of 46.26±11.89 years (P=0.320). The self-efficacy total scores in the intervention group showed values of 69.75±8.05 before the intervention, 77.28±7.57 at one month, and 92.72±6.43 at three months post-intervention, suggesting a significant effect of the telenursing-based training on self-efficacy levels (P

Abstract Environmental concerns have pushed toward electrified technologies for off‐road vehicle actuations that can lower greenhouse gas emissions and reduce energy consumption. Replacing a central diesel engine with a dedicated electric machine (EM) as a prime mover for the hydraulic supply offers several opportunities for so‐called ePumps (aka electric‐driven pumps) to maximize energy efficiency and limit the usage of electric materials. This paper discusses the impact of different choices for the ePumps architecture (i.e., fixed vs. variable displacement pump; variable speed vs. fixed speed electrical machine), and on their main design parameters in terms of size and efficiency. Although the procedure followed in the study could be extended to different types of electric and hydraulic units, the paper particularly considers ePumps based on permanent magnet synchronous machines combined with axial piston machines. The importance of properly considering the ePump drive cycle and its cooling requirements is taken into account while addressing energy efficiency, mass, and overall compactness of the solution. The results show that an ePump based on a variable displacement pump, when compared to fixed displacement ePumps, reduces the electrical machine size both in volume and mass up to 40%, when the high‐pressure demand is not combined with high flow rate demand, thus decreasing the cost of the EM. In all drive cycles, the variable speed EM–fixed displacement pump architecture has a higher efficiency, ranging from 1% to 5%, compared to the case of fixed speed EM–variable displacement pump. Finally, the paper compares the advantages and shortcomings of each ePump architecture presented, based on representative drive cycles.

Abstract Background Familial calcific band-shaped keratopathy (BSK) is a very rare disease, with no underlying cause. There is no underlying disease in this form of the disease. This article introduces a family with seven children, three of whom were diagnosed with familial primary calcific BSK. One of them developed a systemic disease 38 years after ocular manifestation. Case presentation In this case report, three Iranian siblings from a family with familial calcific band-shaped keratopathy (BSK) are introduced. Systemic and ocular examinations performed on these patients indicated the occurrence of chronic kidney disease in the older child, a 41-year-old woman, 38 years after ocular manifestation. The examinations conducted on the other two siblings revealed no pathological findings. The 41-year-old sister and 37-year-old brother underwent unilateral deep anterior lamellar keratoplasty (DALK), while the 33-year-old sister underwent bilateral superficial keratectomy (SK). Conclusion Considering the late onset of systemic disease in one of the siblings diagnosed with familial calcific band-shaped keratopathy (BSK), it is crucial to emphasize the necessity of long-term follow-up for these patients and their families.

Introduction: Spatial ability and response inhibition skills are essential for cognition, learning, and success in both school and life. Aim: The aim of this research was to examine the effectiveness of a cognitive-emotional empowerment educational package on the spatial ability and response inhibition of female students. Method: A semi-experimental design with pre-test, post-test, and follow-up was employed, including a control group. The population consisted of all sixth-grade female students in Tehran during the academic year 1400-1401. A sample of 30 individuals was selected, and they were assigned to control and experimental groups. The experimental group received a cognitive-emotional empowerment educational package for 12 sessions of 45 minutes each week, while the control group did not receive any intervention. Research tools included forward matrices (Raven, 1956) and go/no-go test (Gordon and Karamaza, 1982). The research data were analyzed using SPSS version 24 and repeated measures analysis of variance. Results: Data analysis revealed a significant difference in the mean scores of spatial ability and response inhibition between the experimental and control groups in pre-test and post- test stages (p < 0.05). The effect size of cognitive-emotional empowerment on spatial ability and response inhibition was estimated at 0.133 and 0.139, respectively. Conclusion: Based on the results, the cognitive-emotional empowerment educational package led to an improvement in the spatial ability and response inhibition of students. Therefore, it is recommended to use this intervention as an educational method to enhance the spatial ability and response inhibition of children

Abstract Deep neural networks (DNNs) have demonstrated higher performance results when compared to traditional approaches for implementing robust myoelectric control (MEC) systems. However, the delay induced by optimising a MEC remains a concern for real-time applications. As a result, an optimised DNN architecture based on fine-tuned hyperparameters is required. This study investigates the optimal configuration of convolutional neural network (CNN)-based MEC by proposing an effective data segmentation technique and a generalised set of hyperparameters. Firstly, two segmentation strategies (disjoint and overlap) and various segment and overlap sizes were studied to optimise segmentation parameters. Secondly, to address the challenge of optimising the hyperparameters of a DNN-based MEC system, the problem has been abstracted as an optimisation problem, and Bayesian optimisation has been used to solve it. From 20 healthy people, ten surface electromyography (sEMG) grasping movements abstracted from daily life were chosen as the target gesture set. With an ideal segment size of 200 ms and an overlap size of 80%, the results show that the overlap segmentation technique outperforms the disjoint segmentation technique (p-value

Abstract The role of N6-methyladenosine (m6A) modification of host mRNA during bacterial infection is unclear. Here, we show that Helicobacter pylori infection upregulates host m6A methylases and increases m6A levels in gastric epithelial cells. Reducing m6A methylase activity via hemizygotic deletion of methylase-encoding gene Mettl3 in mice, or via small interfering RNAs targeting m6A methylases, enhances H. pylori colonization. We identify LOX-1 mRNA as a key m6A-regulated target during H. pylori infection. m6A modification destabilizes LOX-1 mRNA and reduces LOX-1 protein levels. LOX-1 acts as a membrane receptor for H. pylori catalase and contributes to bacterial adhesion. Pharmacological inhibition of LOX-1, or genetic ablation of Lox-1, reduces H. pylori colonization. Moreover, deletion of the bacterial catalase gene decreases adhesion of H. pylori to human gastric sections. Our results indicate that m6A modification of host LOX-1 mRNA contributes to protection against H. pylori infection by downregulating LOX-1 and thus reducing H. pylori adhesion.

Background: Considering the importance of academic performance during adolescence, one of the most important variables in this regard is Goal orientation. Based on the etiology of students' low academic performance, there are several interventions to be effective on psychological well-being; However, no study has investigated the impact of cognitive, metacognitive, and emotional regulation strategies on goal orietation. Aims: The present study was conducted with the aim of comparing the effectiveness of teaching cognitive, metacognitive and emotion regulation strategies on the goal orientation of male students with low academic performance in the second year of high school. Methods: This research was semi-experimental research with a pre-test-post-test design and a control group in terms of implementation. The statistical population consisted of all male students with low academic performance in the second year of high school in Tabriz city in 1400-1401. To select the research sample, 15 people were selected for each group in the form of purposeful sampling and randomly assigned to three experimental groups and one control group (60 people). The tools used in the research were the revised goal orientation questionnaire along with the implementation protocol of cognitive, metacognitive and emotion regulation strategies interventions. Results: Based on the results of multivariate covariance analysis, the effect of all three interventions of cognitive strategies, metacognitive strategies and emotion regulation on all goal orientation subscales was confirmed (p

Introduction: Training in a certain skill not only culminates in better motor performance but also leads to neural adjustments and regulations in different brain regions. Aim: The present study aimed to psychologically assess event-related motor potential in motor-related cortical regions during simple and complicated tasks. Method: The current research was of a semi-experimental type with a single-phase post-test design without a control group. The participants of the present study consisted of all 20-32-year-old right-handed male table tennis players in Tehran, in 2019. A total of 8 samples were selected via convenience sampling. Data were collected at the National Brain Mapping Laboratory. Annett Hand Preference Questionnaire (1970), Ocular Dominance Testing Card (1910), the Newgy Robo Pong Model 2050 Digital Table Tennis Robot, and the Specific Test for Table Tennis Stroke (2016) were used to record speed from Radar gun, and cameras and judges’ scoring were also used to measure accuracy. Moreover, the two-way analysis of variance (ANOVA) statistical test was employed to assess the differences in two levels of task complexity in SPSS software version 24. Results: The results showed that the motor potential in the primary motor cortex region had a greater range in the simple task than in the complicated task (P=0.012); however, the premotor (P=0.008) and the posterior parietal cortical regions (P=0.026) of the complicated task had larger ranges than the simple task. Conclusion: According to the results of this study, the motor potential range is dependent on the task complexity level. Therefore, it is suggested that tasks with different complexity levels be taken into account in investigating event-dependent potentials.

The maintenance of DNA sequence integrity is critical to avoid accumulation of cancer-causing mutations. Inactivation of DNA Mismatch Repair (MMR) genes (e.g., MLH1 and MSH2) is common among many cancers, including colorectal cancer (CRC) and is the driver of classic microsatellite instability (MSI) in tumors. Somatic MSH3 alterations have been linked to a specific form of MSI called elevated microsatellite alterations at selected tetranucleotide repeats (EMAST) that is associated with patient poor prognosis and elevated among African American (AA) rectal cancer patients. Genetic variants of MSH3 and their pathogenicity vary among different populations, such as among AA, which are not well-represented in publicly available databases. Targeted exome sequencing of MSH3 among AA CRC samples followed by computational bioinformatic pipeline and molecular dynamic simulation analysis approach confirmed six identified MSH3 variants (c.G1237A, c.C2759T, c.G1397A, c.G2926A, c.C3028T, c.G3241A) that corresponded to MSH3 amino-acid changes (p.E413K; p.S466N; p.S920F; p.E976K; p.H1010Y; p.E1081K). All identified MSH3 variants were non-synonymous, novel, pathogenic, and show loss or gain of hydrogen bonding, ionic bonding, hydrophobic bonding, and disulfide bonding and have a deleterious effect on the structure of MSH3 protein. Some variants were located within the ATPase site of MSH3, affecting ATP hydrolysis that is critical for MSH3′s function. Other variants were in the MSH3-MSH2 interacting domain, important for MSH3’s binding to MSH2. Overall, our data suggest that these variants among AA CRC patients affect the function of MSH3 making them pathogenic and likely contributing to the development or advancement of CRC among AA. Further clarifying functional studies will be necessary to fully understand the impact of these variants on MSH3 function and CRC development in AA patients.

Background Patient safety learning systems play a critical role in supporting safety culture in healthcare organisations. A lack of explicit standards leads to inconsistent implementation across organisations, causing uncertainty about their roles and impact. Organisations can address inconsistent implementation by using a self-assessment tool based on agreed-on best practices. Therefore, we aimed to create a survey instrument to assess an organisation’s approach to learning from safety events.Methods The foundation for this work was a recent systematic review that defined features associated with the performance of a safety learning system. We organised features into themes and rephrased them into questions (items). Face validity was checked, which included independent pre-testing to ensure comprehensibility and parsimony. It also included clinical sensibility testing in which a representative sample of leaders in quality at a large teaching hospital (The Ottawa Hospital) answered two questions to judge each item for clarity and necessity. If more than 20% of respondents judged a question unclear or unnecessary, we modified or removed that question accordingly. Finally, we checked the internal consistency of the questionnaire using Cronbach’s alpha.Results We initially developed a 47-item questionnaire based on a prior systematic review. Pre-testing resulted in the modification of 15 of the questions, 2 were removed and 2 questions were added to ensure comprehensiveness and relevance. Face validity was assessed through yes/no responses, with over 80% of respondents confirming the clarity and 85% the necessity of each question, leading to the retention of all 47 questions. Data collected from the five-point responses (strongly disagree to strongly agree) for each question were used to assess the questionnaire’s internal consistency. The Cronbach’s alpha was 0.94, indicating a high internal consistency.Conclusion This self-assessment questionnaire is evidence-based and on preliminary testing is deemed valid, comprehensible and reliable. Future work should assess the range of survey responses in a large sample of respondents from different hospitals.

An 8-year-old male patient was presented with a chief complaint of visual perception of a spherical object located in the visual field of his right eye. According to the patient’s prior medical records, they exhibited a sole incident of minor visual impairment in the right eye, characterized by blurred vision (best-corrected visual acuity: 8/10), which first manifested during preschool assessments at the age of 5 years. During the fundoscopic examination of the patient, a pigmented, lobulated, and mobile vitreous cyst was observed in the right eye, whereas the examination of the patient’s left eye revealed no abnormalities. A video of a smartphone slit-lamp imaging was also captured to facilitate subsequent examinations and patient follow-up.

Purpose: To report a 3-month-old boy with rapid progressive orbital intraosseous hemangioma which was treated with excisional biopsy and orbital rim reconstruction. Observation: A 3-month-old boy was referred with the aggressive growth of a mass on the right orbital region. The mass was noted to develop over 4 weeks. On presentation this firm nontender orbital mass measuring 5 × 5cm mimicked a more ominous malignancy. The spiral computed tomography scan showed a destructive mass with protrusion superiorly and inferiorly toward the orbital cavity and anterior cranial fossa. The patient underwent gross tumor resection and reconstruction of the orbital rim. Histology findings revealed an intraosseous hemangioma. There was no evidence of recurrence after 1-year follow-up. Conclusion and Importance: Due to rapid progression, the patient's age, and lesion size, this case is unique. There were additional challenges regarding complete resection, intra-cranial extension, and significant blood loss in an infant. Therefore, in the face of rapidly progressing orbital tumors in infants, despite the very low prevalence of intraosseous hemangioma, this diagnosis should be considered.

Inflammatory bowel disease (IBD) is a chronic inflammatory illness of the gastrointestinal tract (GI), characterized by recurrent episodes of inflammation and tissue destruction. It affects an increasing number of individuals worldwide who suffer from Crohn’s disease (CD) or ulcerative colitis (UC). Despite substantial advances in understanding the underlying causes of IBD, the available treatments remain restricted and are sometimes accompanied by severe consequences. Consequently, there is an urgent need to study alternate therapeutic options. This review assesses the present drugs, identifies their limitations, and proposes the use of saffron, a natural plant with great therapeutic potential based on preclinical and clinical investigations. Saffron has gained attention for its potential therapeutic benefits in treating various ailments due to its established bioactive compounds possessing antioxidant and anti-inflammatory properties. This review covers how saffron impacts the levels of calprotectin, an inflammatory marker, for various inflammatory responses in multiple diseases including IBD. Data from clinical trials were assessed to determine the efficacy and safety of using saffron to counter inflammation in multiple diseases. Studies have shown that saffron may protect against inflammatory bowel disease (IBD) through several mechanisms by inhibiting pro-inflammatory cytokines (TNF-α, IL-1β, and IL-6), reducing oxidative stress through antioxidant effects, enhancing mucosal barrier function by upregulating tight junction proteins, and modulating the gut microbiota composition to promote beneficial bacteria while suppressing pathogenic ones; these combined actions contribute to its therapeutic potential in managing and alleviating the symptoms of IBD. This will enable future research endeavors and expedite the translation of saffron-based interventions into clinical practice as a valuable adjunctive therapy or a potential alternative to conventional treatments, thereby enhancing the quality of life for individuals suffering from inflammatory diseases including IBD.

Background: Academic performance is considered as an indicator for evaluating the success of the education system. One of the influential variables in academic performance during adolescence is psychological well-being. According to the etiology of low academic performance in students, this field has shortcomings. Research shows that interventions in this field require attention to growth-oriented issues such as cognitive-oriented and emotion-oriented interventions in the form of education. All kinds of interventions in this field claim to be effective, but the present study seeks to compare the effectiveness of teaching cognitive, metacognitive and emotion regulation strategies on the psychological well-being of Secondary School Students male with low academic performance. Aims: The present study was conducted with the aim of comparing the effectiveness of teaching cognitive, metacognitive and emotion regulation strategies on the psychological well-being Secondary School Students male with low academic performance Methods: The research design was a semi-experimental type of pre-test, post-test with control group. The statistical population of the research included all male students of the Secondary School Students male in Tabriz city with low academic performance in the academic year of 2021-2022. select the statistical sample of the research, 60 people were selected in the form of purposeful sampling (based on the research entry criteria) and randomly divided into three experimental groups (cognitive strategies, metacognitive strategies and emotion regulation intervention) and a control group (15 people in each group) were placed. In order to collect information, Ryff Scales of Psychological Well-Being Scale-Short Form (RSPWB-SF), cognit0ive and metacognitive strategies training protocols (Seif, 2016) and emotion regulation intervention (Gross & Thompson, 2007) were used. Univariate and multivariate analysis of covariance, Benferroni post hoc test and SPSS27 software were used for data analysis. Results: Based on the results of multivariate covariance analysis, the effect of all three interventions of cognitive strategies, metacognitive strategies and emotion regulation on the total score of psychological well-being was confirmed (P

Nermin E Eleraky,1 Mahmoud El-Badry,1 Mahmoud M Omar,2,3 Wesam M El-Koussi,4 Noha G Mohamed,5 Mohamed A Abdel-Lateef,6 Abeer S Hassan7 1Department of Pharmaceutics, Faculty of Pharmacy, Assiut University, Assiut, Egypt; 2Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Deraya University, Minia, Egypt; 3Department of Pharmaceutics and Clinical Pharmacy, Faculty of Pharmacy, Sohag University, Sohag, Egypt; 4Department of Pharmaceutical Analytical Chemistry, Faculty of Pharmacy, Sohag University, Sohag, Egypt; 5Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Sphinx University, Assiut, Egypt; 6Department of Pharmaceutical Analytical Chemistry, Faculty of Pharmacy, Al-Azhar University, Assiut Branch, Assiut, Egypt; 7Department of Pharmaceutics, Faculty of Pharmacy, South Valley University, Qena, EgyptCorrespondence: Nermin E Eleraky, Department of Pharmaceutics, Faculty of Pharmacy, Assiut University, Assiut, 71526, Egypt, Tel +20 1014017239, Fax +20 (088-002) 2345631, Email Nermineleraky@pharm.aun.edu.egPurpose: Immunomodulatory and broad-spectrum antiviral activities have motivated the evaluation of curcumin for Coronavirus infection 2019 (COVID-19) management. Inadequate bioavailability is the main impediment to the therapeutic effects of oral Cur. This study aimed to develop an optimal curcumin transferosome-loaded thermosensitive in situ gel to improve its delivery to the lungs.Methods: Transferosomes were developed by using 33 screening layouts. The phospholipid concentration as well as the concentration and type of surfactant were considered independent variables. The entrapment efficiency (EE%), size, surface charge, and polydispersity index (PDI) were regarded as dependent factors. A cold technique was employed to develop thermosensitive in-situ gels. Optimized transferosomes were loaded onto the selected gels. The produced gel was assessed based on shape attributes, ex vivo permeability enhancement, and the safety of the nasal mucosa. The in vitro cytotoxicity, antiviral cytopathic effect, and plaque assay (CV/CPE/Plaque activity), and in vivo performance were evaluated after intranasal administration in experimental rabbits.Results: The optimized preparation displayed a particle size of 664.3 ± 69.3 nm, EE% of 82.8 ± 0.02%, ZP of − 11.23 ± 2.5 mV, and PDI of 0.6 ± 0.03. The in vitro curcumin release from the optimized transferosomal gel was markedly improved compared with that of the free drug-loaded gel. An ex vivo permeation study revealed a significant improvement (2.58-fold) in drug permeability across nasal tissues of sheep. Histopathological screening confirmed the safety of these preparations. This formulation showed high antiviral activity against SARS-CoV-2 at reduced concentrations. High relative bioavailability (226.45%) was attained after the formula intranasally administered to rabbits compared to the free drug in-situ gel. The curcumin transferosome gel displayed a relatively high lung accumulation after intranasal administration.Conclusion: This study provides a promising formulation for the antiviral treatment of COVID-19 patients, which can be evaluated further in preclinical and clinical studies.Graphical Abstract: Keywords: transferosomes, curcumin, in situ gels, coronavirus 2, SARS-CoV-2, intranasal delivery

The purpose of the current research endeavor was to examine the efficacy of mindfulness skills training in enhancing the social competence and alexitimia of children who exhibit symptoms consistent with anxiety disorder. With experimental and control groups, a three-stage design (pre-test, post-test, and follow-up) and a two-month follow-up period, the research methodology was semi-experimental. The study’s statistical population comprised Tehran-based children in the fourth and fifth grades of primary education during the academic year 2020-2021 who exhibited symptoms consistent with anxiety disorders. A purposive sampling method was employed to select 36 children (21 girls and 15 boys) who exhibited symptoms of anxiety disorder. These children were then randomly assigned to either the experimental or control groups. Ten and a half-hours of mindfulness skills training were allocated to the students in the experimental group. The present investigation employed the Children’s Anxiety Scale (CAS), the Alexitimia Questionnaire (IQ), and the Social Competence Scale (SCS). The data were subjected to analysis using mixed ANOVA in the SPSS-23 software. Children exhibiting symptoms of anxiety disorder benefit significantly from mindfulness skills training in terms of social competence (p

A girl of 8 years old was referred to our clinic with a history of penetrating injury to her left eye 6 years ago with light perception vision and a large traumatic macular hole in her right eye. Her right eye’s vision was 4/10 when she first visited our clinic. Considering the patient’s one-eye status, her parents’ reluctance to undergo surgery, and the possibility of spontaneous closure of traumatic macular holes, it was determined to observe the patient and evaluate her visual acuity and macular hole condition. In 2 years, the final best corrected visual acuity was 8/10 in the right eye, with infratemporal eccentric fixation in visuoscopy. In addition to evaluating and reporting this case as a traumatic macular hole, we will discuss the role of nonsurgical treatment and the possibility of good visual acuity with eccentric fixation in a child with large traumatic macular hole.

Abstract Background Styloid process (SP) is a cylindrical bony projection that originates from the inferior part of the petrous temporal bone just anteriorly to the stylomastoid foramen. Several nerves, muscles, and ligaments are related closely to the (SP). It is considered elongated when the measurement exceeds 30 mm. The overall prevalence of the styloid process is between 3.3% to 84.4%. The elongation of the styloid process (ESP) is associated with the manifestation of Eagle’s Syndrome (ES) which is characterized by various types of pain in the head and neck region such as headache, tinnitus, otalgia, and trigeminal neuralgia. Eagle’s syndrome occurs in 4–10.3% of individuals with an elongated styloid process (ESP). The objective of the study is to determine the prevalence of (ESP) in the patients who were treated in the Dental Hospital University of Barcelona (HOUB), to review the literature to spot the light on the different demographic data worldwide. Methods The archived panoramic image in the University of Barcelona dental Hospital were consecutively retrieved to investigate the prevalence of (ESP). Of all digital panoramic radiographs (OPG), 400 met the inclusion criteria and were furtherly analyzed. The results are correlated with the participant’s gender, age, and occurrence. Age is subcategorized into three groups. A chi-square test is used to measure the significant differences and the P-value is set at

Background: Today, the usage of artificial intelligence systems and computational intelligence is increasing. This study aimed to determine the fuzzy system algorithms to model and predict the amount of air pollution based on the measured data in subway stations. Methods: In this study, first, the effective variables on the concentration of particulate matter were determined in metro stations. Then, PM2.5, PM10, and total size particle (TSP) concentrations were measured. Finally, the particles’ concentration was modeled using fuzzy systems, including the fuzzy inference system (FIS) and adaptive neuro-fuzzy inference system (ANFIS). Results: It was revealed that FIS with modes gradient segmentation (FIS-GS) could predict 76% and ANFIS-FCM with modes of clustering and post-diffusion training algorithm (CPDTA) could predict 85% of PM2.5, PM10, and TSP particle concentrations. Conclusion: According to the results, among the models studied in this work, ANFIS-FCM-CPDTA, due to its better ability to extract knowledge and ambiguous rules of the fuzzy system, was considered a suitable model.

Maisa A Wahab,1 Alshaymaa M Alhabibi,2 Ahmed Khairy Sakr,1 Mohamed Yahia Zakaria,3 Ola I Saleh,4 Inass Hassan Ahmad,5 Eman Kamel Abdelrahman,6 Randa Sabour Elshahat Taha,4 Fayka Karem Abdel Azeem Ahmed,4 Bothayna Ismail,2 Lamiaa Hosney Azel,5 Asmaa S Hassan,2 Hanaa Mohammed Eid El Sayed,7 Sammar Ahmed Kasim,7 Safaa Abdelfattah Elsharkawy8 1Department of Vascular Surgery, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt; 2Department of Clinical Pathology, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt; 3Department of Vascular and Endovascular Surgery, Faculty of Medicine for Boys, Al-Azhar University, Cairo, Egypt; 4Department of Radio-Diagnosis, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt; 5Department of Endocrinology, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt; 6Department of Internal Medicine, Faculty of Medicine, Port Said University, Port Said, Egypt; 7Department of Internal Medicine, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt; 8Department of Community Medicine and Occupational Health, Faculty of Medicine for Girls, Al-Azhar University, Cairo, EgyptCorrespondence: Alshaymaa M Alhabibi, Tel +201002894075, Email alshaymaa.alhabibi@yahoo.comBackground: One of the major issues affecting global health is Diabetes mellitus (DM), not only in terms of the disease itself but also its complications. Macrovascular complications are both common and serious, affecting many patients. This study aimed to assess fasting C-peptide levels and correlate them with the severity of the peripheral arterial disease complicating type 2 DM (T2DM).Patients and Methods: This study included 200 participants who were categorized into two groups: Group I (n=100, patients with T2DM complicated by femoropopliteal arterial atherosclerosis) and Group II (n=100, healthy age- and sex-matched individuals serving as controls). Fasting C-peptide levels were estimated using an immunochemiluminometric assay.Results: Fasting C-peptide levels were significantly higher in Group I than in the control group. Fasting C-peptide levels were positively correlated with the severity of atherosclerosis. In addition, the receiver operating characteristic (ROC) curve analysis revealed that fasting C-peptide levels served as a specific and sensitive marker for detecting the severity of this disease.Conclusion: Fasting C-peptide levels can be used as a sensitive and specific indicator of the severity of femoropopliteal arteriosclerosis that complicates T2DM.Keywords: diabetes mellitus, femoropopliteal arteriosclerosis, fasting C-peptide

Despite the existence of effective drugs used to treat inflammatory bowel disease (IBD), many patients fail to respond or lose response over time. Further, many drugs can carry serious adverse effects, including increased risk of infections and malignancies. Saffron (Crocus sativus) has been reported to have anti-inflammatory properties. Its protective role in IBD and how the microbiome and metabolome play a role has not been explored extensively. We aimed to establish whether saffron treatment modulates the host microbiome and metabolic profile in experimental colitis. Colitis was induced in C57BL/6 mice with 3% DSS and treated with either saffron in a dose of 20 mg/kg body weight or vehicle through daily gavage. On day 10, stool pellets from mice were collected and analyzed to assess saffron’s effect on fecal microbiota and metabolites through 16S rRNA sequencing and untargeted primary metabolite analysis. Saffron treatment maintained gut microbiota homeostasis by counter-selecting pro-inflammatory bacteria and maintained Firmicutes/Bacteroides ratio, which was otherwise disturbed by DSS treatment. Several metabolites (uric acid, cholesterol, 2 hydroxyglutaric acid, allantoic acid, 2 hydroxyhexanoic acid) were altered significantly with saffron treatment in DSS-treated mice, and this might play a role in mediating saffron’s colitis-mitigating effects. These data demonstrate saffron’s therapeutic potential, and its protective role is modulated by gut microbiota, potentially acting through changes in metabolites.

Retinoblastoma is the most common primary malignant ocular malignancy in children. The management and treatment of retinoblastoma is a very complex process and requires attention to different aspects, such as the stage of the disease based on the International classification of retinoblastoma (ICRB) or International intraocular retinoblastoma classification (IIRC), the genetic status of the tumor and mutations, psycho-social factors of the family and society, cultural beliefs, and available economic resources. From the identification of this malignancy until the beginning of the 20th century (before the introduction of radiation therapy as one of the treatment options), enucleation was the only treatment option for this disease. In addition to not controlling metastatic and extensive features of the disease and increasing the chance of death in these cases, enucleation causes many adverse psychological and aesthetic complications in patients, and especially children, who are the main population affected by this disease. Tremendous progress has been made since the 20th century to identify and invent new methods to preserve the eyes and less invasive treatments (globe salvage treatments), and the set of efforts led to the inventing of new treatment methods such as radiation therapy, systemic chemotherapy, local treatments such as cryotherapy and thermotherapy, intra-arterial chemotherapy and intraocular chemotherapy. In summary, the set of treatments from the beginning until now has gone towards increasing survival, reducing the rate of enucleation and providing more targeted and less invasive treatments. Despite these advances, early diagnosis is the most important prerequisite for better outcomes. However, early detection is influenced by socioeconomic factors and is a major challenge, especially in low- and middle-income countries. In fact, the provision of advanced medical care in high-income areas has provided excellent survival, globe, and vision-saving rates. Unfortunately, these results do not hold true for medical systems in low- and middle-income areas, leading to poor patient outcomes. In this article, we briefly introduce various retinoblastoma treatment methods from the beginning of detection until now, and we assess the evolution of the treatment of this disease from the beginning until now, which has reduced the need for enucleation as a treatment for this disease.

Background and Objective: The trend of developments in the health system and medical education and other related sciences, including environmental health, is a global challenge. In this research educational content of environmental health and its revision were studied from the point of view of students and graduates. Materials and Methods: The present study was a cross-sectional descriptive study. In this research, through two checklists, the opinions of environmental health students and graduates regarding the necessity of revising the educational content of the field according to the requirements of the time and considering the future situation were investigated with the participation of 441 people. Data analysis was performed using SPSS-22 software. Results: According to the results, 73.7 percent of participants believed that the educational content of environmental health in Iran has fundamental differences from developed countries. 81.7 percent believed that the educational content provided to environmental health students is not proportional to their duties. Meantime, 91.4 percent of the graduates of environmental health believe that the expected capabilities included in the educational curricula of different degrees of environmental health should be revised. 88.4 percent believed that it is necessary to revise the educational content of this field considering the "change in executive and practical functions of environmental health during the past years". Conclusion: The overwhelming majority of graduates of the field emphasized the need to revise the educational content of the environmental health field, taking into account the requirements of the time. It is necessary to redefine the field of environmental health in the country according to the changing situation and the emergence of new indicators.

Background. Used oil is a problematic waste containing hazardous and toxic components. This study aimed to investigate the quantity of used oil produced by motor vehicles in Iran and offer management solutions based on health and environmental principles. Methods. First, the conversion ratio of motor oil into used oil was determined. The mass balance method and the conversion ratio were used to estimate the used oil produced in the past 14 years. The amount of used oil produced over the following 15 years was also predicted using an artificial neural network. The current status of used oil management in Iran was assessed through checklists, observations, field visits, and interviews. Finally, an appropriate management solution was provided for it. Results. According to the results, 151.2 to 315.2 kilotons (kt) of used oil were produced annually in Iran between 2003 to 2017, and it would reach 250 kt by 2031 according to prediction. In Iran, approximately 77% of the used oil was collected and recycled, about 5% was used in construction, and the rest was disposed and managed without following the scientific principles. Conclusion. The lack of principled management of used oil may have had a significant adverse impact on the environment. Taking into account the fact that about 55% of used oil was produced by vehicles, and assuming that the remaining 45% of used oil was produced by other sources, it was concluded that the overall percentage of used oil production in Iran was probably two-fold approximately. Therefore, it was recommended that the current situation and its principled management should be minitored.

Background: The aim of this study was to compile and validate the social skills training (SST) package based on puppet shows and determine its effectiveness on the behavioral problems of preschoolers. Methods: 40 preschool children were selected using available sampling method to evaluate the effectiveness of the compiled package on behavioral problems of preschool children (puppet shows, all components of preschool social skills) using a semi-experimental method with a pretest-posttest design. Then the intervention and the control group were selected. The opinions of the experts were collected by the Delphi method. The research population at this stage was all the specialists in the field of SST of children whom 10 were selected using purposive sampling method. The validity was confirmed using content validity index (CVI). Data of the behavioral problems subscale were collected using the Social Skills Rating System (SSRS), and analyzed using one-way analysis of covariance. Results: The findings showed that the effect of the SST package based on puppet show in the intervention group was statistically significant (F=47.28, P

Objectives: Balance impairment is among the main complications of stroke. The gravity-based subjective vertical (SV) is considered an important reference for upright posture and navigation affected by stroke. The correlation between injury location and pathological perception of verticality remains controversial. This study aimed to evaluate the cortico-cortical network of vertical perception among patients with the right hemisphere stroke and abnormal visual-vertical perception compared with healthy individuals. Materials and methods: This observational cross-sectional study included 40 patients with the right hemisphere stroke and 35 healthy participants. All patients had abnormal visual-vertical perception. The EEG connectivity analysis was conducted through the exact low-resolution brain electromagnetic tomography analysis (eLORETA). Results: Stroke survivors manifested a power spectral density that reduced within the beta-2 frequency band in the left hemisphere and increased within the beta-3 frequency band in the right hemisphere compared with controls (p

BACKGROUND: Patients with irritable bowel syndrome (IBS) are prone to certain physical and mental problems. This study was conducted with the aim to determine the effectiveness of biofeedback on the severity of IBS symptoms and mind rumination in people with IBS. METHODS: The present research was conducted with a pretest-posttest design, a control group, and one-month budget follow-up. The population of this study included all people with IBS who were referred to specialized gastrointestinal clinics in Tehran, Iran, in 2019. Considering the inclusion and exclusion criteria, 30 volunteers were selected and 15 of them were randomly placed in experimental group 1 (biofeedback) and 15 in the control group. A standardized questionnaire for assessing the severity of IBS symptoms and a rumination questionnaire were used in the pretest, posttest, and follow-up stages. In this study, participants in the experimental group received 8 sessions of biofeedback or biofeedback relaxation. For data analysis, SPSS software was used. RESULTS: Intervention in the biofeedback group reduced the severity of IBS symptoms and rumination in patients with IBS and this improvement continued until the follow-up stage (P < 0.05). CONCLUSION: To better and more effectively improve patients with IBS, psychological therapies are required. These therapies require the cooperation of gastroenterologists, psychologists, and psychiatrists.

Background and Objective: One of the main ways of transmitting diseases is drinking water, so the safety of drinking water is an important issue for consumers, water suppliers, operators, and health officials. This study was conducted to identify and semi-quantitative evaluation and prioritization of risks in the drinking water supply system of Bostan Abad city. Materials and Methods: In order to evaluate and document the key elements of WSP and identify the steps that need improvement, the quality assurance tool of the water safety plan (WSP-QA TOOL software) was used, and then based on the guide of the water safety plan from the WHO and the International Association Water safety, WSP team formed. Then the water supply system of Bostan Abad city from the farthest point of the basin to the last consumption point was inspected and described. Results: The results showed that the highest number of risks are in the water supply sources, distribution network, and point of consumption, respectively. Also, the most vulnerable part of the system was identified as the disinfection unit and storage tanks due to biological and chemical contamination caused by equipment failure and improper preparation of chlorine solution. Conclusion: In summary, it can be said that carrying out the necessary reforms can play an effective role in reducing the risk potential in times of crisis, which should be given serious attention by water industry officials.

Abstract Background Metabolic-associated fatty liver disease (MAFLD), one of the most common liver diseases, is detected in patients with concomitant hepatic steatosis and Type 2 Diabetes (T2D). We looked into the relationship between Fibrosis-4 (FIB-4) index and coronary artery diseases (CAD) in patients with MAFLD, to further look into the efficiency of FIB-4 in screening for CAD among patients with MAFLD. Method In this study, we included 1664 patients with MAFLD (T2D, who also had hepatic steatosis) during 2012–2022 and divided them into 2 groups; CAD and non-CAD. Demographic, Anthropometric indices, liver function tests, lipid profile and FIB-4 index of all patients were evaluated and compared. Result Among the 1644 patients (all have MAFLD), 364(21.4%) had CAD. Patients with MAFLD and CAD were more probable to be hypertensive, have longer duration of diabetes and be older (with p-values

Abeer S Hassan,1 Amal Hofni,2 Mohammed AS Abourehab,3 Iman AM Abdel-Rahman4 1Department of Pharmaceutics, Faculty of Pharmacy, South Valley University, Qena, Egypt; 2Department of Pharmacology and Toxicology, Faculty of Pharmacy, South Valley University, Qena, Egypt; 3Department of Pharmaceutics and Industrial Pharmacy, College of Pharmacy, Minia University, Minia, Egypt; 4Department of Pharmacognosy, Faculty of Pharmacy, South Valley University, Qena, EgyptCorrespondence: Abeer S Hassan, Department of Pharmaceutics, Faculty of Pharmacy, South Valley University, Qena, Egypt, Tel +201012060262, Email abeer.saad@svu.edu.egIntroduction: Ginger extract (GE) has sparked great interest due to its numerous biological benefits. However, it suffers from limited skin permeability, which challenges its transdermal application. The target of the current work was to develop transethosomes as a potential nanovehicle to achieve enhanced transdermal delivery of GE through the skin.Methods: GE–loaded transethosomes were prepared by cold injection using different edge activators. The fabricated nanovesicles were evaluated for particle size, ζ-potential, encapsulation efficiency, and in vitro drug release. The selected formulation was then laden into the hydrogel system and evaluated for ex vivo permeability and in vivo anti-inflammatory activity in a carrageenan-induced rat-paw edema model.Results: The selected formulation comprised of sodium deoxycholate exhibited particle size of 188.3± 7.66 nm, ζ-potential of − 38.6± 0.08 mV, and encapsulation efficiency of 91.0%± 0.24%. The developed transethosomal hydrogel containing hydroxypropyl methylcellulose was homogeneous, pseudoplastic, and demonstrated sustained drug release. Furthermore, it exhibited improved flux (12.61± 0.45 μg.cm2/second), apparent skin permeability (2.43± 0.008× 10− 6 cm/second), and skin deposition compared to free GE hydrogel. In vivo testing and histopathological examination revealed that the GE transethosomal hydrogel exhibited significant inhibition of edema swelling compared to free GE hydrogel and ketoprofen gel. The animals that were treated with ginger transethosome hydrogel showed a significant decrement in reactive oxygen species and prostaglandin E2 compared to untreated animals.Conclusion: Transethosomes might be a promising new vehicle for GE for effective skin permeation and anti-inflammation. To the best of our knowledge, this work is the first utilization of transethosomes laden into hydrogel as a novel transdermal delivery system of GE.Graphical Abstract: Keywords: nanovesicles, transethosomes, ginger, ex vivo permeation, transdermal delivery, inflammation

Alshaymaa M Alhabibi,1 Asmaa S Hassan,1 Nashwa Mohamed Abd Elbaky,1 Hoda Asaad Eid,2 Mohie Aldeen Abd Alzaher Khalifa,3 Maisa A Wahab,4 Azza Ali Althoqapy,5 Aml E Abdou,5 Doaa Mohammed Zakaria,6 Eman Mostafa Nassef,6 Sammar Ahmed Kasim,6 Ola I Saleh,7 Asmaa Abdelghany Elsheikh,8 Mahmoud Lotfy,9 Alaa Sayed10 1Departments of Clinical Pathology, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt; 2Chest Disease, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt; 3Department of Chest Disease, General Organization for Teaching Hospitals and institutes, Cairo, Egypt; 4Vascular Surgery, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt; 5Medical Microbiology and Immunology Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt; 6Internal Medicine, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt; 7Radio-Diagnosis, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt; 8Community and Occupational Medicine, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt; 9Molecular Biology Department, Genetic Engineering & Biotechnology Research Institute, University of Sadat City, Sadat City, Minufiya, Egypt; 10Hormones Department, Medical Research and Clinical Studies Institute, National Research Centre, Cairo, EgyptCorrespondence: Alshaymaa M Alhabibi, Tel +201002894075, Email alshaymaa.alhabibi@yahoo.comBackground: Toll-like receptors (TLRs) play an important role in activation of innate and adaptive immune responses.Aim: We aimed to detect the association between TLR2 rs5743708 G>A and TLR9 rs5743836 C>T variants and COVID-19 disease susceptibility, severity, and thrombosis by using neutrophil extracellular traps (NETs).Subjects and Methods: We included 100 adult COVID-19 patients as well as 100 age- and gender-matched normal controls. Participants were genotyped for TLR2 rs5743708 and TLR9 rs5743836. Citrullinated Histone (H3) was detected as an indicator of NETs.Results: The mutant (G/A and C/C) genotypes and (A and C) alleles of TLR2 rs5743708 and TLR9 rs5743836, respectively, have been significantly related to a higher risk of COVID-19 infection, representing a significant risk factor for the severity of COVID-19. There was no significant association between the two variants and citrullinated histone (H3).Conclusion: TLR2 rs5743708 and TLR9 rs5743836 variants have been significantly related to a higher risk and severity of COVID-19 infection but had no effect on thrombus formation.Keywords: coronavirus disease 2019, single-nucleotide polymorphism, toll-like receptor, high resolution-CT, susceptibility, severity

Panoramic radiography (OPG) evaluates mandibular third molar impaction (MTMI). This systematic review aimed to investigate the diagnostic accuracy of OPG in detecting bone loss distal to the lower second molars. The associated bone loss with different impaction positions and the most prevalent positions of MTMI were investigated as secondary outcomes. In January 2023, PubMed, Scopus, and Cochrane were searched to identify studies published between January 2012 and January 2023. Two examiners blindly selected the eligible studies for data extraction and quality assessment. Of 427 studies, 8 were suitable for data extraction. All studies reported bone loss distal to the second molar using OPG, ranging from 4.9 to 62.9%. The most frequent position of MTMI is mesioangular. The distal bone loss in the vertical and horizontal positions is statistically significant compared to typically positioned third molars and those that are fully erupted or impacted, but in a normal orientation (p-value 0.005 and 0.02, respectively). Bone loss was not statistically significant in the mesioangular position compared to other impacted positions (p-value 0.14). The risk of bias ranges between 66 and 88%. Despite its limitations, OPG is still considered a valuable tool to assess bone loss distal to the lower second molar in cases of an impacted mandibular third molar.

Scene recognition is the task of identifying the environment shown in an image. Spectral filter array cameras allow for fast capture of multispectral images. Scene recognition in multispectral images is usually performed after demosaicing the raw image. Along with adding latency, this makes the classification algorithm limited by the artifacts produced by the demosaicing process. This work explores scene recognition performed on raw spectral filter array images using convolutional neural networks. For this purpose, a new raw image dataset is collected for scene recognition with a spectral filter array camera. The classification is performed using a model constructed based on the pretrained Places-CNN. This model utilizes all nine channels of spectral information in the images. A label mapping scheme is also applied to classify the new dataset. Experiments are conducted with different pre-processing steps applied on the raw images and the results are compared. Higher-resolution images are found to perform better even if they contain mosaic patterns.

Background: The mandibular third molar is the most frequently impacted tooth. An impacted mandibular third molar (IMTM) can have negative consequences on the adjacent mandibular second molar (MSM), such as bone loss. An IMTM can be identified using orthopantomography (OPG). Our objective is to compare changes in bone level distal to the mandibular second molar (MSM) in patients with an extracted IMTM versus non-extracted IMTM using OPG. Methods: In this retrospective case–control study, 160 orthopantomograms (OPGs) of 80 patients who attended Dental Hospital of the University of Barcelona (HOUB) were randomly selected. Participants were stratified into a study group and control group. Results: Males and females experienced bone gain in the study group and bone loss in the control group. However, the difference in bone-level change was not statistically significant regarding gender in the study group. Within the study group, the age group of 29–39 years demonstrated significant (p-value = 0.042) bone gain after extraction compared to other age groups. However, the control group demonstrated bone loss in all age groups in which the difference is not statistically significant (p-value 0.794). Conclusions: Bone improvements distal to the MSM were observed after the extraction of an IMTM compared to when an IMTM was not extracted.

As the global population raises, developing countries seem to have issues with the productivity of the construction projects due to high demand. Therefore, this paper aims to examine the effect of extrinsic diversity aspects impacting the construction worker efficiency. The data collection was made by a questionnaire sent to construction stakeholders working in the Punjab region of Pakistan. A comparison was drawn based on varied employee characteristics i.e., experiences and ages. It was found that old workers were negatively impacted by the distant location of the construction site. The young employees were most inclined towards holidays when working away from home. The access to basic amenities during a construction project was regarded as a major setback for the workers' productivity. Experienced workers preferred working within the vicinity and easy access to their houses. Based on the ethnicity factor while selecting the workforce, newcomers faced hurdles while entering the construction sector.

Zaki F Aref,1 Shamardan Ezz Eldin S Bazeed,2 Mohammed H Hassan,3 Abeer S Hassan,4 Ali A Ghweil,2 Mennatallah Ali Abdelrhman Sayed,5 Alaa Rashad,6 Haggagy Mansour,6 Aida A Abdelmaksoud1 1ENT Department, Faculty of Medicine, South Valley University, Qena, Egypt; 2Tropical Medicine and Gastroenterology Department, Faculty of Medicine, South Valley University, Qena, Egypt; 3Department of Medical Biochemistry, Faculty of Medicine, South Valley University, Qena, Egypt; 4Department of Pharmaceutics, Faculty of Pharmacy, South Valley University, Qena, Egypt; 5King Salman International University, El Tor, Egypt; 6Department of Chest Diseases and Tuberculosis, Faculty of Medicine, South Valley University, Qena, EgyptCorrespondence: Mohammed H Hassan, Department of Medical Biochemistry, Faculty of Medicine, South Valley University, Qena, Egypt, Tel +20 1098473605, Email Mohammedhosnyhassaan@yahoo.com; mohammedhosnyhassaan@med.svu.edu.egPurpose: Anosmia or hyposmia, with or without taste changes, are common symptoms that occur in SARS-CoV-2 infection and frequently persist as post-COVID-19 manifestations. This is the first trial to assess the potential value of using local ivermectin in the form of a mucoadhesive nanosuspension nasal spray to treat post-COVID-19 anosmia.Methods: It is a controlled, randomized trial. Participants were recruited from South Valley University Hospitals in Qena, Upper Egypt, from the ENT and Chest Diseases Departments and outpatient clinics. Patients with persistent post COVID-19 anosmia were randomly divided into two groups, the first group “ivermectin group” included 49 patients treated by ivermectin nanosuspension mucoadhesive nasal spray (two puffs per day). The second group included 47 patients “placebo group” who received saline nasal spray. Follow- up of anosmia [using Visual analogue scale (VAS)] in all patients for three months or appearance of any drug related side effects was done.Results: The mean duration of pre-treatment post COVID-19 anosmia was 19.5± 5.8 days in the ivermectin group and 19.1± 5.9 days in the placebo group,p˃0.05. Regarding the median duration of anosmia recovery, the ivermectin group recovered from post COVID-19 anosmia in 13 days compared to 50 days in the placebo group, p˂ 0.001. Following the first week of ivermectin nanosuspension mucoadhesive nasal spray therapy, the ivermectin group had a significantly higher percentage of anosmia recovery (59.2%) than the placebo group (27.7%), p˂ 0.01, with no significant differences in recovery rates between the two groups at 1, 2, and 3 months of follow up, p˃0.05.Conclusion: In the small number of patients treated, local Ivermectin exhibited no side effects. In persistent post-COVID-19 anosmia, it could be used for one week at the most as the treatment was extended to one, two and three months, with no difference in recovery compared to the placebo treatment.Trial Registration No: NCT04951362.Keywords: post-COVID-19 anosmia, ivermectin, nanosuspension mucoadhesive nasal spray

Abstract Background Lumboperitoneal (LP) shunting is an effective treatment option aiming at cerebrospinal fluid diversion in cases of idiopathic intracranial hypertension. Confirming the distal end position, on the other hand, could be technically difficult, especially in obese people. With minimal invasive procedures, laparoscopic-assisted placement of the peritoneal side of the LP shunt became a valid treatment option. In this study, we aim to evaluate the operation duration, possible complications, and patient outcomes after the placement of a peritoneal catheter using the laparoscopically assisted technique. Methods A retrospective analysis of clinical, preoperative, and postoperative data for 18 patients diagnosed with idiopathic intracranial hypertension and undergoing LP shunt surgery using the laparoscopic-assisted technique for intraperitoneal catheter placement between 2019 and 2021 was performed. Results The average operating time was 93.89 min, and the average hospital stay was 2.3 days. There was no mortality among cases treated with the described technique, and no intraoperative complication occurred. Seven patients (38.9%) had LP shunt failure, with a median duration to failure of 212 days; three cases for slippage, two cases had over drainage, one case had peritoneal adhesions around the shunt tip, and one case had Arnold Chiari malformation. Conclusions The laparoscopic assisted technique is safe and feasible. It allowed a direct vision of the shunt tip position within the peritoneal cavity which helped in confirming position and assessing function, resulting in a superior option over classic surgical options. Short hospital stay, minimal postoperative pain, and low failure rates are the main advantages of described technique.

AbstractEarthquake risk in urban areas has recently taken quite a lot of attention. Risk is a cross-cutting combination of vulnerability and hazard. Abbottabad district, a rapidly growing district, is an earthquake-prone area in the north of Pakistan. In 2005, the region suffered enormous casualties due to a significant earthquake (Mw = 7.6). The various regional behaviours, including social, physical, and economic behaviours, are causing a vulnerable situation. At the same time, the high seismicity has the potential to invite earthquake hazard, thus ensuing a possible risk situation in the region. Consequently, this study proposes an integrated approach involving an artificial neural network (ANN), convolutional neural network (CNN), and analytic network process (ANP) to carry out the seismic risk analysis of the Abbottabad district. The proposed two integrated frameworks are ANP-ANN and ANP-CNN. This kind of methodology has not been applied before in this area. The geographic information system is used to formulate a broad range of contributing factors depicting the hazard and vulnerability of the area and potentially contributing to the seismic risk. A total of 16 contributing factors are chosen for this study. The selected factors are weighed using the ANP, and training and testing databases are generated to train and test the models, thus producing the area’s earthquake risk maps (ERMs). As per the ERMs, the northwestern regions and the borderline regions from the southeast, covering an area of 30%, possess a greater earthquake risk. The rest of the 70% of the area has less risk exposure. The AUC values of ANN and CNN are found to be 0.843 and 0.878, respectively, exhibiting a good performance by the models. The study paves the way for the concerned authorities to match and redefine their policies for developing, expanding, and managing the region’s structural, health care, and disaster management facilities.

Background and Purpose: Critical thinking is a topic that lurks behind most of the questions that are raised about higher education and professional development, Therefore, it is necessary that it should be nurtured during education and the space to acquire it in the educational system should be given attention, so that the graduates, in addition to specialized knowledge, also acquire the ability to reproduce and improve science. The purpose of this study is to investigate the views and experiences of Iranian experts about the influential components in increasing the tendency to critical thinking in higher education students. Research method: The present research has examined and formulated the conceptual framework of tendency to critical thinking in post-graduate students. The type of research is fundamental-theoretical with a qualitative approach. The statistical population of the research is experts in various fields, who are active in the field of critical thinking. The purposeful selection of these experts was done by snowball method, eleven people were selected and interviewed. To collect data, a semi-structured and open-ended interview was used about the factors affecting the tendency to think critically. The interviews were mostly verbal (except for one case where they answered in writing). Done. Findings: The data analysis showed that among the primary indicators obtained from the research background (emotional regulation, boldness level, moral intelligence, and wisdom), two indicators of moral intelligence and wisdom were not approved by the experts, and among the approved variables, and they were given the highest priority. The variable of emotional regulation has. Conclusion: Four variables of questioning spirit, communication skills, boldness and emotional regulation were extracted from the text of the interviews and added to the conceptual framework.