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The Nekor Watershed, situated in the northwest corner of Africa, experiences significant climatic variability, posing challenges for water management. This study assesses hydrological drought in the Nekor Watershed from 1945 to 2016 and analyzes its socio-economic impacts on agriculture and population distribution. The purpose of this research is to understand the extent and trends of hydrological drought in the Nekor Watershed and its socio-economic consequences, particularly on agriculture and population dynamics. The study employs the Standardized Runoff Efficiency Index (SDI), drought duration, severity (S), magnitude (M), and relative frequency (RF) metrics, along with the Mann-Kendall trend test and Sen's Slope analysis to evaluate hydrological drought. It integrates statistically representative data on cereal crop yields, livestock populations, and results from the General Population and Housing Census to understand the socio-economic impacts. Analysis reveals substantial climatic variability with pronounced dry and wet periods. Notably, the autumn season exhibits a weak positive trend in hydrological drought, indicating a slight increase in severity over the years. Conversely, the spring season shows a negative trend in hydrological drought, indicating a decrease in severity over the years, especially in the month of May. A broader trend towards increasing hydrological drought emerges, particularly since the 1980s. These dry decades pose significant challenges for the region's socio-economic sectors, including agriculture and population distribution. The study is limited by the availability and quality of historical hydrological and socio-economic data, which may affect the precision of trend analyses and impact assessments. Future research could benefit from more granular and continuous data sets. Understanding the trends and impacts of hydrological drought in the Nekor Watershed provides critical insights for water management policies and strategies, helping to mitigate socio-economic risks associated with drought. This study is novel in its comprehensive analysis of long-term hydrological drought trends in the Nekor Watershed and their socio-economic impacts. The integration of diverse data sets and advanced statistical methods enhances the robustness of the findings, contributing significantly to the scientific understanding of drought dynamics in this region.

Groundwater analysis across the Oum Rbia watershed is currently hampered by technical constraints and high costs. This research aims to produce comprehensive groundwater quality maps throughout the basin's aquifers by integrating the Water Quality Index (WQI) and Microbiological Quality Index (MQI) with GIS-Pro for a spatiotemporal assessment of water quality. Twenty physicochemical parameters, including pH, temperature, conductivity, total dissolved solids, permanganate index, ammonium (NH₄⁺), major cations (Na⁺, K⁺, Ca²⁺, Mg²⁺, Mn²⁺), major anions (Cl⁻, HCO₃⁻, NO₂⁻, NO₃⁻, CO₃²⁻, SO₄²⁻), total hardness (TH), total alkalinity (TAC), and total iron (FeT) concentration were analyzed. Additionally, the microbiological parameters such as the fecal streptococci, fecal coliforms, and total coliforms were investigated. Fieldwork spanning twelve campaigns across 2021 and 2022 seasons involved sample collection at fifty four locations distributed throughout the watershed's six aquifers. The comprehensive database facilitated the calculation of both MQI and WQI. Kriging interpolation was utilized to create spatial estimates of these indices beyond the sampling points, enabling the generation of maps that visualize water quality across the study area. The WQI indicated that groundwater in most of the studied basin is of excellent quality, though water quality deteriorates in areas receiving wastewater discharge from urban, industrial, and agricultural activities. The MQI results revealed significant pathogenic germ contamination across a substantial portion of the watershed, intensifying during the summer due to factors such as temperature, river flow, human activities, and seasonal pollution sources. These maps enhance the understanding of water table information for non-experts and aid decision-makers in identifying critical areas and developing effective management strategies. However, complexities in water quality and training data influence the accuracy of ArcGIS-Pro predictions, potentially overlooking key factors if the data is insufficient.

Posteromedial dislocation of the elbow is a rare entity even exceptional if associated with a lateral condylar fracture. Very few isolated cases are reported in the English literature. We report an additional case of a 14-year-old child admitted for elbow trauma during scholar sport and presented a posteromedial elbow dislocation associated with a fracture of the lateral humeral condyle. The surgical treatment was made by using 3 cortical screws. The results were satisfying including range motion and he has resumed sports activities at 5 months. Elbow dislocation is a rare affection in children. It represents 3% to 6% of elbow injuries. The association of posteromedial elbow dislocation with a Milch type I is remarkably rare. We review the mechanism, classifications, and therapeutic modalities of this injury. Elbow dislocations associated with a lateral condylar fracture are exceptional and need an early reduction followed by an anatomical internal fixation to ensure articular congruity.

Cardiac amyloidosis is indeed a condition characterized by the deposition of amyloid proteins in the myocardium, leading to thickening and stiffening of the heart muscle. These abnormal protein deposits can interfere with the heart's normal functioning and may pose diagnostic challenges due to its varied clinical presentation and resemblance to other heart condition. Here, we present a case of 55-year-old female patient of uncontrolled hypertensions for 15 years. About 15 years ago, she presented with chest pain and was diagnosed with cardiomyopathy (CM) characterized by low left ventricle (LV) function of unknown cause. Despite being on antihypertensive treatment, the patient continued to experience chest heaviness with persistent elevate blood pressure. An echocardiogram revealed increased LV septal wall thickness, valvular thickening, and biatrial dilation. Subsequently, cardiac magnetic resonance imaging (CMR) was performed, which revealed left atrium enlargement and asymmetrical myocardial wall thickening, particularly at the septum. White blood axial image revealed thickened inter atrial septum, while late gadolinium enhancement (LGE) magnetic resonance (LGE MR) images showed patchy LGE at the base relative to the apex of the myocardium, highlighting the base-to-apex gradient, subendocardial pattern enhancement at apical lateral wall, and transmural pattern enhancement of the mid anteroseptal and inferoseptal wall. Additionally, a short axis time to invert T1 scout image of left ventricle displayed an abnormal nulling pattern initially in the myocardium, followed by the blood pool, and finally the spleen. These findings collectively led to the diagnosis of cardiac amyloidosis.

Abstract Head lice infestations are the most prominent ectoparasitic infection in the world, including Iran, particularly among school children. Recently, numerous cases of infestation have been reported in various provinces of the country. This study aimed to investigate the prevalence of head louse infestations and analyze kdr gene sequences in terms of resistance mutations in the Torbat-e Heydarieh, Mahvelat, and Zaveh cities of Khorasan Razavi Province, Northeast Iran. The data related to the epidemiological and demographic history of head lice populations were extracted from their medical records and analyzed in Excel software. After extracting the genomic DNA, the kdr fragment was amplified using specific primers. The sequences were also analyzed using bioinformatics software. The prevalence of head louse infestations was 1.59% and 1.7% during 2016 and 2017, respectively. Sequence analysis revealed the frequency distribution of two kdr haplotypes, I and V, in the study areas. The increase in head louse infestations in recent years and the simultaneous presence of kdr mutations indicate the need for new treatments and monitoring/controlling resistance to head louse insecticides.

Abstract Background Conventional MR acceleration techniques, such as compressed sensing, parallel imaging, and half Fourier often face limitations, including noise amplification, reduced signal-to-noise ratio (SNR) and increased susceptibility to artifacts, which can compromise image quality, especially in high-speed acquisitions. Artificial intelligence (AI)-assisted compressed sensing (ACS) has emerged as a novel approach that combines the conventional techniques with advanced AI algorithms. The objective of this study was to examine the imaging quality of the ACS approach by qualitative and quantitative analysis for brain, spine, kidney, liver, and knee MR imaging, as well as compare the performance of this method with conventional (non-ACS) MR imaging. Methods This study included 50 subjects. Three radiologists independently assessed the quality of MR images based on artefacts, image sharpness, overall image quality and diagnostic efficacy. SNR, contrast-to-noise ratio (CNR), edge content (EC), enhancement measure (EME), scanning time were used for quantitative evaluation. The Cohen’s kappa correlation coefficient (k) was employed to measure radiologists’ inter-observer agreement, and the Mann Whitney U-test used for comparison between non-ACS and ACS. Results The qualitative analysis of three radiologists demonstrated that ACS images showed superior clinical information than non-ACS images with a mean k of ~ 0.70. The images acquired with ACS approach showed statistically higher values (p

Abstract This study aims to assess the efficacy of machine learning models in predicting solute concentration (C) distribution in a membrane separation process, using the input parameters which are spatial coordinates. Computational fluid dynamics (CFD) was employed with machine learning for simulation of process. The models evaluated include Kernel Ridge Regression (KRR), Radius nearest neighbor regression (RNN), K-nearest neighbors (KNN), LASSO, and Multi-Layer Perceptron (MLP). Additionally, Harris Hawks Optimization (HHO) was utilized to fine-tune the hyperparameters of these models. Leading the way is the MLP model, which achieves a remarkable test R2 value of 0.98637 together with very low RMSE and MAE values. Strongness and generalization capacity are shown by its consistent performance on test and training datasets. To conclude, the effectiveness of using machine learning regression methods more especially, KRR, KNN, RNN, LASSO, and MLP in estimating concentration from spatial coordinates was demonstrated in this work. For separation science via membranes where predictive modeling of spatial data is essential, the results offer important new perspectives by developing hybrid model.

Abstract Background This research investigates the fundamental factors which may stymie or simplify the adoption of m-learning by medical college educators in Sudan. We made use of the Extended Unified Theory of Acceptance and Use Technology (UTAUT) with COVID-19 fear (CF) and social isolation (SIS) as exogenous components. Objective This research aims to find out factors impacting medical students’ behavioural intention to use mobile learning. Methods Data was gathered from 499 undergraduate learners from different universities in Sudan. Partial Least Square (PLS) and structural equation modeling (SEM) were used to examine the data. The results Showed that expected performance, effort expectancy (EE), social influence (SI), facilitation condition (FC), COVID-19 fear, and social isolation (SIS) are predictors of behavioural intentions (BI). In addition, our findings show that COVID-19 fear and social isolation increase student adoption of mobile learning during the COVID-19 epidemics in developing countries. Conclusions The study unveiled that the suggested framework, derived from UTAUT, effectively discerns the factors impacting students’ intentions in mobile learning during pandemics. Sudanese medical students’ can strategize and execute effective classroom environments based on these findings.

Abstract Phase change materials (PCMs) have emerged as an intriguing option for the storage of thermal energy because of their remarkable capacity to store latent heat. However, the practical application of these materials is hindered by their low thermal conductivity and limited photo-absorbance. For this investigation, graphene nanoplatelets (GNP) and multiwall carbon nanotubes (MWCNT) hybrid nanoparticles were disseminated in RT-54HC organic PCMs at different weight fractions. The nanoparticles were incorporated into the base PCMs using a melt blending technique. Based on the findings, one combination of GNP to MWCNT in a 0.25:0.75 ratio has shown the highest thermal conductivity, with an increase of 40% (0.28 Wm−1 K−1) compared to other hybrid combinations. This breakthrough could potentially open new avenues in the field of thermal energy storage. The chemical stability of the hybrid nanoparticle dispersed composites was assessed through FTIR analysis. In addition, the composites exhibited excellent thermal stability, maintaining their structural integrity even at temperatures as high as 300 ℃. The melting temperature of the composites also showed minimal variation. Based on the evaluation of latent heat enthalpy, the organic PCM known as base RT-54HC demonstrated a heat storage capacity of 230 J/g. However, the composites exhibited a slight decrease in latent heat with increasing nanoparticle weight fraction. In addition, the composite with added hybrid nanoparticles demonstrated an increase in optical absorbance, accompanied by a decrease in transmissibility. Therefore, the hybrid nano-enhanced composites have demonstrated enhanced thermo-physical properties, making them not only suitable but also highly promising for use in applications with mid-range melting temperatures. Graphical Abstract

Abstract In contemporary times, as accident rates continue to rise, there is a growing interest in vehicular ad hoc networks (VANETs) as a means to reduce accidents and vehicle damage, as well as enhance public safety. VANETs facilitate the transmission of messages within predefined areas to ensure system safety and efficiency. However, ensuring message authenticity in such a dynamic environment presents a significant challenge, with previous research focusing less on security aspects. Some previous protocols send plain message, which leads to the compromise of the message confidentiality. Although few algorithms work on security, they involve the communication to the trusted authority, which lead to increased latency. Thus, in this paper we propose a robust cryptographic scheme for reliable data communication in VANET which minimizes the involvement of trusted authority and uses communication ID of vehicle for communication in place of real entities. Security analysis of the proposed scheme is showing the sturdiness of the proposed protocol again various types of safety spasms. The evaluation of its performance includes assessing communication cost and time, revealing the proposed algorithm's efficiency compared to others.

Abstract Background Among the many pressing concerns of the Somali-American community, and other similar immigrant and refugee communities as they grow in the United States, is the provision of care for older adults and adults with disabilities. The implications of effective caregiving range from the facilitation of community building and place-making to the delivery and management of healthcare on a systemic level. However, little is currently known about Somali-American family caregivers, including their duties and responsibilities, primary concerns, and the impacts of surrounding influences on their ability to fulfill their role. Methods Semi-structured interviews were conducted with 10 Somali-American family caregivers in Somali language. The resulting transcripts were translated into English by a professional interpreter and analyzed using an inductive thematic analysis approach. A key informant from the community was additionally consulted for insights regarding cultural nuances and interpretations of idiomatic expressions and concepts. Results Thematic analysis of the reports revealed the principal themes of visitation, patient accompaniment, and self-sacrifice through acceptance and God-consciousness as pervasive and salient concerns across participants. Furthermore, the heightened stresses of the COVID-19 pandemic revealed just how severe the consequences can be when access to culturally habituated navigational tools and coping mechanisms are restricted. Conclusions In light of our findings, the growing concern for discrimination and sociocultural discord in the Somali-American community presents a particularly prescient threat to the well-being and sustainability of family caregivers. Their experiences must be understood and used to promote education and partnership between the healthcare system and the community in order to build trust and ensure a healthy future for this indispensable population.

Abstract Introduction While research has examined the connections between sleep quality, smartphone addiction, and depressive symptoms in general, no studies focused on undergraduate medical students in Nepal have specifically tested the complex relationship between these factors. Therefore, this study aimed to investigate the interaction between smartphone addiction, sleep quality, and depressive symptoms among undergraduate medical students of Maharajgunj Medical Campus, Tribhuvan University Teaching Hospital, Kathmandu, Nepal. Methods A cross-sectional study was conducted among 212 undergraduate medical students at Maharajgunj Medical Campus, Tribhuvan University, Nepal. Sleep quality, smartphone addiction, and depressive symptoms were assessed using the Pittsburgh Sleep Quality Index, Smartphone Addiction Scale Short Version, and Patient Health Questionnaire-9. Data were analyzed using IBM SPSS version 26 via the bootstrap model approach. Results Out of the total participants, 67.9% were male. Males showed higher scores in smartphone addiction and depressive symptoms than females (b = 5.3, Bca 95% CI:1.2, 9.1, p

Abstract The gradual decline of production of the major fields of the Indus Basin has influenced the field pressure. Therefore, the prospects need to be assessed by the petro-elastic relationship. This study highlights the value-addition for identifying gas pockets within the E-Sand of the Lower Goru Formation through estimating and populating petro-elastic properties. A probabilistic neural network (PNN) was employed to develop the relationship of pore pressure to the inverted properties. The outcomes will help identify the high-pressure areas in accordance with the petro-elastic relationship for optimizing production strategy. In order to evaluate the petro-elastic relationship, stochastic seismic inversion was employed to holistically capture the reservoir’s variability. Pore pressure volumetric was estimated from inverted attributes using a PNN, a non-linear algorithm that was more suited to heterogeneous reservoirs. The main objective of the research is achieved via enhanced resolution of elastic properties attained through the integration of stochastic inversion and PNN processes. The high-resolution elastic properties including P-impedance, S-impedance, and Vp/Vs ratio can delineate the heterogeneities more profoundly. The petrophysical volumes obtained via enhanced inverted properties combined with pore-pressure through PNN illuminated the potential facies and the correlations in predicting the properties. The procedure provides a linkage of elastic, petrophysical, and geomechanical properties that is helpful for professionals covering a broad field of the petroleum sector. The developed workflow can be followed globally where problems occur regarding heterogeneities and early depletion.

Fariha Kamal,1 Elaha Somaya Ghafary,2 Mohammad Hassan Hamrah,3 Ghulam Sarwar Khalid,4 Mohammad Hussain Hamrah,5 Zaheruddin Hasam,6 Neghat Ghafoory7 1Department of Oral Medicine, Kabul University of Medical Sciences, Kabul, Afghanistan; 2Department of Periodontics, Kabul University of Medical Sciences, Kabul, Afghanistan; 3Department of Public Health and Health Systems, Nagoya University Graduate School of Medicine, Nagoya, Japan; 4Department of Pharmacology, Alberoni University, Kapisa, Afghanistan; 5Department of Gastroenterological Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan; 6Department of Dentistry, Jawzjan Public Hospital, Sheberghan, Afghanistan; 7Oral and MaxillofacialSurgery Department, Stomatology Teaching Hospital Kabul University of Medical Sciences, Kabul, AfghanistanCorrespondence: Elaha Somaya Ghafary, Department of Periodontics, Kabul University of Medical Sciences, Kabul, Afghanistan, Email elaha.somayaghafary@gmail.comBackground: Oral cancer (OC) is a major global health issue, with tobacco use being one of the most significant preventable risk factors. Despite its strong association with OC, public awareness about the harmful effects of tobacco remains limited. This study aims to evaluate the awareness and knowledge of tobacco use related to oral cancer among patients referred to the Stomatology Teaching Hospital.Methods: A cross-sectional survey was conducted at the Stomatology Teaching Hospital of Kabul University of Medical Sciences (KUMS) between January 1 and July 30, 2023. Using a convenience sampling method, the study included 435 patients aged 15 to 76 years. Logistic regression analysis was employed to determine factors associated with tobacco use, and the data were analyzed using SPSS version 26.0.Results: Participants were divided into two groups: tobacco users and non-tobacco users. Most of them were young (18 to 30 years old) with a significant difference in oral cancer knowledge between the two groups (p < 0.001). Cigarettes were the most common tobacco type among users (62.1%), which was also statistically significant (p < 0.001). Tobacco users were 3.04 times more likely to have knowledge about oral cancer (OR: 3.04, p < 0.001, 95% CI: 1.93– 4.80), indicating a significant association.Conclusion: The study reveals a general lack of awareness about oral cancer in our study population, particularly regarding specific risk factors. To improve awareness, it is essential for both public awareness campaigns and dentists to play a more active role in educating the public about oral cancer.Keywords: awareness, cigarette smoking, tobacco, oral cancer

The study focused on syenogranite and its altered variety, and specifically monitored the activities of 226Ra, 232Th, and 40K using NaI(Tl) gamma-ray spectroscopy. Syenogranites in the study area in Egypt were investigated to determine their potential use in industries such as ornamental stones and ceramics. The main outcrops in the study area consist of metasediments, metavolcanics, metagabbro, syn-to late-orogenic granites, and post-orogenic granites (syenogranites). There are also numerous dikes and veins of various shapes and compositions that have intruded and penetrated all the older rocks in the area. The mean activity (± standard deviation, SD) of these radioelements in the granites is 226Ra (63 ± 71 Bq kg−1), 232Th (76 ± 170 Bq kg−1), and 40K (1248 ± 532 Bq kg−1) were found to be greater than the world average. The radiological hazards are mostly attributed to the γ-rays emitted by granitic rocks. The granites studied in this study deviate from international standards mainly due to the presence of minerals containing radioelements such as zircon, allanite, monazite, sphene titanite, apatite, thorite, samarskite, fergusonite, xenotime, columbite, apatite and fluorite. As a result, granitic rocks are unsuitable for home building.

Drought had affected the crops production in Morocco, during the last decade. Plants breeding is still a solution to increase crops tolerance for water scarcity. Using natural biofertilizer based on microorganisms still a good practice to enhance the resilience of agriculture to drought. The objective of this study is to investigate the effect of water shortage and use of a biofertilizer based on the strain of Pseudomonas putida on five genotypes of eggplants selected for drought tolerance under the semi-arid of the northeast of Morocco. Two irrigations regimes: 100% (amount of water irrigation made by growers) and 50% of this amount with and without the biofertilizer (1x108 UFC/g). The biofertilizer was applied three times during the plant growth stages. The experiment was conducted at commercial farm production and using a randomized complete block design. Plants were organized in blocks containing 3 plants for each genotype and repeated in 5 repetitions. Crops were planted on August 3rd, 2022, and experiments ended on January 2d, 2023. The results showed different responses among the genotypes in terms of growth. The effect of Pseudomonas on plant height showed that there was a significant increase, at 100% irrigation for C14, B3, C8, B5 and C11 with 20%, 19%, 17%, 14,29% and 12,5%, respectively compared with the control. For C8 and B3, when subjected to 100% water with biofertilizer, there was an increase in the average number of fruits compared to 100% water without the biofertilizer. The highest yield was recorded with B5 under 100% irrigation + fertilizer (1,35 kg/plant). Water shortage impacted the productivity of all genotypes and the fruit number and yield increased with the use of the biofertilizer. Our study is still valuable under the conditions of this trial and more experiments will be needed at several seasons and at different growing conditions.

This paper presents the findings about implementing a machine learning (ML) technique to optimize the performance of 5 G mm wave applications utilizing multiple-input multiple-output (MIMO) antennas operating at the 28 GHz frequency band. This article examines various methodologies, including simulation, measurement, and the utilization of an RLC-equivalent circuit model, to evaluate the appropriateness of an antenna for its intended applications. In addition to its compact dimensions, the proposed design exhibits a maximum gain of 10.34 dBi, superior isolation exceeding 26 dB, and a broad bandwidth of 16.56 % Centered at 28 GHz and spanning from 25.905 to 30.544 GHz. Another supervised regression machine learning technique is utilized to predict the antenna's gain accurately. Machine learning (ML) models can be assessed by several measures, such as the variance score, R square, mean square error (MSE), mean absolute error (MAE), root mean square error (RMSE), and Mean Absolute Percentage Error (MAPE). Among the six machine learning models considered, it is seen that the Gaussian Process Regression (GPR) model exhibits the lowest error and achieves the highest level of accuracy in forecasting gain. The antenna under consideration has promising qualities for its intended use in high-band 5 G applications. This is evidenced by the modelling findings obtained from Computer Simulation Technology (CST) and Advanced Design System (ADS)and the measured and projected results derived using machine learning methodologies.

The transport sector is experiencing a notable transition towards sustainability, propelled by technological progress, innovative materials, and a dedication to environmental preservation. This study explicitly examines the incorporation of electric vehicles (EVs) into the power grid, with a particular emphasis on passenger automobiles. Our analysis emphasises the vital importance of updated transport infrastructure in decreasing greenhouse gas emissions and aiding carbon reduction efforts in electricity networks. The analysis uncovers that adopting electric vehicles offers significant advantages, including enhanced grid efficiency and decreased emissions. However, it also brings issues concerning the design and operation of power systems at both the transmission and distribution levels. Key players are crucial in tackling these difficulties to improve electric vehicle integration into the grid. The study determines the most effective ways for distributing and providing electric vehicle charging infrastructure, and investigates the efforts made to establish common standards in order to solve current challenges. This research contributes to the advancement of sustainable mobility and energy systems by conducting a thorough examination of the impact of electric vehicles on power systems and offering appropriate integration solutions.

Our manuscript is related to use Caputo fractional order derivative (CFOD) to investigate results of non-linear mode in plasma. We establish results for both temporal and spatial approximate solution. For the require results, we use reduction perturbation method (RPM) to find the analytical solution of the dust acoustic shock waves. Further, using the same technique we find the solitary wave potential and compared the solutions obtained with another very useful technique known as Homotopy perturbation method (HPM). The comparison of results for both approaches are more precise and agreed with the exact solution of the problem. Finally, we present graphical representation for different fractional order for both temporal and spatial approximate solution.

Liver transplantation represents the only definitive treatment for patients with end-stage liver disease. However, the shortage of liver donors provokes a dramatic gap between available grafts and patients on the waiting list. Whole liver bioengineering, an emerging field of tissue engineering, holds great potential to overcome this gap. This approach involves two main steps; the first is liver decellularization and the second is recellularization. Liver decellularization aims to remove cellular and nuclear materials from the organ, leaving behind extracellular matrices containing different structural proteins and growth factors while retaining both the vascular and biliary networks. Recellularization involves repopulating the decellularized liver with appropriate cells, theoretically from the recipient patient, to reconstruct the parenchyma, vascular tree, and biliary network. The aim of this review is to identify the major advances in decellularization and recellularization strategies and investigate obstacles for the clinical application of bioengineered liver, including immunogenicity of the designed liver extracellular matrices, the need for standardization of scaffold fabrication techniques, selection of suitable cell sources for parenchymal repopulation, vascular, and biliary tree reconstruction. In vivo transplantation models are also summarized for evaluating the functionality of bioengineered livers. Finally, the regulatory measures and future directions for confirming the safety and efficacy of bioengineered liver are also discussed. Addressing these challenges in whole liver bioengineering may offer new solutions to meet the demand for liver transplantation and improve patient outcomes.

OBJECTIVE: To evaluate acute stroke care services in Sindh province of Pakistan. METHODS: This cross-sectional descriptive study, conducted from January to May 2024, assessed stroke care services in hospitals across Sindh, Pakistan. The study included hospitals that admitted more than one stroke patient per month and excluded facilities such as maternity homes and rehabilitation centers. Data were collected via structured proformas from hospital administrators through phone and email, focusing on stroke admissions, acute services, and rehabilitation capabilities. Informed consent was obtained, and ethical approval was granted by the Shifa International Hospital Ethical Committee. Data analysis utilized SPSS version 20 for continuous and categorical variables. RESULTS: Among the 34 surveyed hospitals, 15(44.1%) treated 1 to 10 stroke patients monthly, and 14 (41.2%) admitted over 300 patients annually. Neurologists were on staff in 15(44.1%) of hospitals, and 13 (38.2%) had stroke-trained physicians available 24/7. CT brain scans were accessible 24/7 in 23 (67.6%) of hospitals, with 19(55.9%) prioritizing these scans for stroke patients. Stroke units and 24/7 availability of intravenous tissue plasminogen activator (TPA) were available in 07 (20.6%) of hospitals only. Inpatient rehabilitation facilities were available in 21(61.8%) of hospitals, and 13 (38.2%) collaborated with external rehabilitation centers. Community stroke awareness programs were established in 12 (35.3%) of hospitals, and 09 (26.5%) had designed stroke prevention programs. CONCLUSION: The study highlights significant gaps in acute stroke care services in Sindh, Pakistan, emphasizing the need for improved access to thrombolytic therapy, specialized training, and community awareness programs.

In children under 5 years of age, acute respiratory infections (ARIs) represent a significant cause of morbidity and mortality, potentially leading to severe outcomes such as hearing loss and developmental delays. This study aims to assess the prevalence of frequent medication use and identify epidemiological risk factors associated with ARIs in this age group. The research was conducted at Dr. Jamal Pediatric Hospital in Sulaimani city, employing a cross-sectional descriptive approach that included a sample of 42 patients, from June 11th to July 1st, 2024. Data collection involved interviewing mothers and reviewing their children’s medical records. The findings indicated that 45.2% of the children were under 1-year-old, 52.3% resided in metropolitan areas, and 66.7% were male. Notably, 47.6% of the children had received only partial vaccinations, 42.8% consumed bottle milk, and 66.7% experienced recurring illnesses. The majority of illnesses lasted between 1 and 5 days (83.3%). The medications administered included amoxicillin (26.2%), acetaminophen (54.8%), ventolin nebulizer (52.4%), dexamethasone (88%), and antihistamines (4.8%). Regarding parental education, 40.4% of mothers were illiterate, and 76.1% were unemployed. In contrast, 42.9% of fathers had completed elementary school. In addition, 73.9% of families reported insufficient financial resources. Smoking prevalence was high among fathers (71.4%) and lower among mothers (26.1%). Moreover, 12% of fathers had previously smoked, and 28.5% of mothers had been exposed to secondhand smoke. The majority of families (52.3%) were nuclear, with 66.7% consisting of three or more members. Data analysis was performed using Statistical Package for the Social Sciences version 24. The study concluded that significant risk factors for ARIs include male gender, incomplete immunization, exposure to smoking, low parental education and economic status, and inadequate diet. Public health initiatives should focus on improving nutrition, educating parents, reducing smoking exposure, and ensuring complete immunization to effectively decrease the prevalence of ARIs.

Introduction: Quality of life (QoL) is a multidomain concept that assesses a person through health status, functional status, and symptoms. The patient's QoL is greatly reduced due to the course of disease, severity of symptoms, and side effects of chemotherapy treatment. This study aimed to assess the QoL in advanced lung cancer patients using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-C30 (EORTC QLQ-C30). Methods: This descriptive and observational study was conducted at the Pulmonary Polyclinic, Prof. Dr. Chairuddin Panusunan Lubis Universitas Sumatera Utara (USU) Hospital from February to July 2024, with a cross-sectional design using patient medical records and EORTC QLQ-C30 questionnaire. The EORTC QLQ-C30 questionnaire was analyzed with a score formula and categorized as good, moderate, and bad. The sample was 100 lung cancer patients using a purposive sampling technique according to the criteria. Results: The results showed that almost all QoL was in the moderate category (80%). The general health status was mostly in the moderate category (61.66%), the functional status was mostly in the good category (75.35%), and the symptoms were in the moderate category (35.65%). In the functional scale, the role domain had the lowest mean, 69.99 ± 29.43. In the symptoms scale, the pain domain had the highest mean, 52.66 ± 29.43. Conclusion: The overall QoL of lung cancer patients was in the moderate category, lower than the healthy population. It needs to be improved, especially in the role domain, by providing supportive-expressive group therapy.

Abstract Besides many efforts on the detection and quantification of reactive oxygen and nitrogen species (RONSs) in the aqueous media activated by the cold atmospheric plasma, to get a better insight into the dominant mechanism and reactive species in medical applications, a challenge still remains in monitoring the real-time evaluation of them. To this end, in the present work, relying on the photonic technology based on the time-resolved phosphorescence spectroscopy, real-time tracking of RONSs concentration in treated aqueous media is achieved by following the dissolved oxygen (DO) production/consumption. Using a photonic-based dissolved oxygen sensor, the dependence of real-time RONS concentration evaluation of plasma activated medium on plasma nozzle distance, non-thermal plasma jet exposure time, various culture media, and presence of cells is investigated. Analyzing the results, the activation parameters including the time of reaching maximum RONS concentration after treatment and defined activation parameter $$\epsilon\:$$ of the treated media for each case is measured and compared together. Moreover, employing the scavengers related to two involved ROSs, the dominant chemical reactions as well as ROS contributed in the DMEM medium is determined. As a promising result, the obtained correlation between the real-time DO level and viability and toxicity of the cancer cells, MCF-7 breast cancer cells, could enable us to exploit the present photonic setup as an alternative technique for the biological assessment.

Abstract Background It is widely recognized that the right ventricle plays a significant role in the prognosis of numerous diseases. However, the assessment of right ventricular function (RV) has not been given much attention until recently. This study used speckle-tracking echocardiography (STE) to assess RV functions in ischemic cardiomyopathy (ICM) patients. Results This study included 74 patients diagnosed with ischemic cardiomyopathy (ICM) and an ejection fraction (EF) of less than 50%. Although all the selected patients had normal RV systolic function by tricuspid annular plane systolic excursion (TAPSE), a considerable percentage of them had subtle RV systolic dysfunction, which could be identified by right ventricular free wall longitudinal strain (RV FWLS) (36.5%) and right ventricular global longitudinal strain (RV GLS) (55.4%). Moreover, the mean RV FWLS was significantly higher than RV GLS (− 20.4 ± 5.08% vs. − 17.5 ± 6.89%), respectively. Advanced left ventricle (LV) adverse remodeling was associated with subtle RV dysfunction. Using multivariate regression analysis, increased E/e' (p = 0.016, CI 1.135–3.423) and RV myocardial performance index (MPI) (p = 0.007, CI 0.000–0.007) were identified as independent factors of impaired RV FWLS with the greatest effectiveness. Conclusion When standard RV measures are normal in patients with ICM, RV systolic strain analysis offers an incremental utility to detect subtle abnormalities in RV function, especially in resource-constrained settings where cardiac magnetic resonance (CMR) is not practical.

Modern power systems are growing in complexity due to the installation of large generators, long transmission lines, the addition of inertialess renewable energy resources (RESs) with zero inertia, etc., which can all severely degrade the system frequency stability. This can lead to under-/over-frequency load shedding, damage to turbine blades, and affect frequency-sensitive loads. In this study, we propose a methodology to improve the two critical frequency stability indices, i.e., the frequency nadir and the rate of change of frequency (RoCoF), by formulating an optimization problem. The size and placement location of battery energy storage systems (BESSs) are considered to be the constraints for the proposed optimization problem. Thereafter, the optimization problem is solved using the three metaheuristic optimization algorithms: the particle swarm optimization, firefly, and bat algorithm. The best performing algorithm is then selected to find the optimal sizing and placement location of the BESSs. The analyses are all performed on the IEEE 9-bus and IEEE 39-bus test systems. Several scenarios which consider multiple generator outages, increased/decreased loading conditions, and the addition of RESs are also considered for both test systems in this study. The obtained results show that under all scenarios, the proposed method can enhance system frequency compared to the existing method and without BESSs. The proposed method can be easily upscaled for a larger electrical network for obtaining the optimized BESS size and location for the improvement of the system frequency stability.

This survey paper provides a comprehensive analysis of big data algorithms in recommendation systems, addressing the lack of depth and precision in existing literature. It proposes a two-pronged approach: a thorough analysis of current algorithms and a novel, hierarchical taxonomy for precise categorization. The taxonomy is based on a tri-level hierarchy, starting with the methodology category and narrowing down to specific techniques. Such a framework allows for a structured and comprehensive classification of algorithms, assisting researchers in understanding the interrelationships among diverse algorithms and techniques. Covering a wide range of algorithms, this taxonomy first categorizes algorithms into four main analysis types: user and item similarity based methods, hybrid and combined approaches, deep learning and algorithmic methods, and mathematical modeling methods, with further subdivisions into sub-categories and techniques. The paper incorporates both empirical and experimental evaluations to differentiate between the techniques. The empirical evaluation ranks the techniques based on four criteria. The experimental assessments rank the algorithms that belong to the same category, sub-category, technique, and sub-technique. Also, the paper illuminates the future prospects of big data techniques in recommendation systems, underscoring potential advancements and opportunities for further research in this fields.

Abstract Background Arachnoid cysts (AC) are associated with a risk of rupture or haemorrhage following head impact and pose a potential predisposing factor for significant complications of sport-related concussion. Despite a recognised association between ACs and intracranial haemorrhage/cyst rupture, the risk profile of participating in contact sports with AC is not well defined. We report a retrospective case series of players presenting to the Birmingham Sports Concussion Clinic between 2017 and 2023 and underwent MRI head, with a comprehensive review of the prior literature. Results 432 athletes underwent MRI of which 11 were identified to have AC (middle fossa n = 8; posterior fossa n = 2, intraventricular n = 1). Average maximal diameter was 4.1 ± 1.2 cm. 64% had a protracted recovery (≥ 3 months). 9% experienced an AC specific complication (cyst rupture, complete neurological recovery, maximal diameter 6.5 cm, Galassi II, 4 previous concussions). 91% of patients (mean maximal diameter 3.9 ± 1.0 cm) experienced no complications despite multiple previous accumulated sports-related concussions (mean 3.3, range 1–9). Case studies from the literature are summarised (n = 63), with 98% reporting complications, none of which resulted in adverse or unfavourable neurological outcomes. Across prospective and retrospective cohort studies, 1.5% had a structural injury, and (where outcome was reported) all had a favourable outcome. Conclusions AC is an incidental finding in athletes, with the majority in our cohort having sustained serial concussions without AC complication. The single complication within this cohort occurred in the largest AC, and AC size is proposed as a tentative factor associated with increased risk of contact sports participation. Complications of AC appear to be a rare occurrence. This case series and review has not identified evidence to suggest that participation in sports with AC is of significant risk, though individualised assessment and discussion of the potential risks of contact sports participation should be offered.

Keyuri Adhikari,1,&ast; Khalid M Kamal,1,&ast; Ki Jin Jeun,1 David A Nolfi,2 Mohammed Najeeb Ashraf,3 Christopher Zacker4 1Department of Pharmaceutical Systems and Policy, West Virginia University School of Pharmacy, Morgantown, WV, USA; 2Gumberg Library, Duquesne University, Pittsburgh, PA, USA; 3Medical Affairs, SciVoc Consulting Inc, Toronto, Ontario, Canada; 4Global Value & Access, Cerevel Therapeutics, Cambridge, MA, USA&ast;These authors contributed equally to this workCorrespondence: Khalid M Kamal, Department of Pharmaceutical Systems and Policy, West Virginia University School of Pharmacy, Email kkamal@hsc.wvu.eduBackground: Schizophrenia is a complex, chronic mental health disorder that confers a substantial disease burden globally. Oral antipsychotic treatments (OATs) are the mainstay for treating early and advanced stages of schizophrenia. Our systematic review aimed to synthesize literature describing real-world effectiveness, economic, and humanistic outcomes of OATs (asenapine, brexpiprazole, cariprazine, iloperidone, lumateperone, lurasidone, olanzapine/samidorphan, paliperidone, and quetiapine) for successful management of the disease.Methods: PubMed, American Psychological Association PsycINFO (EBSCOhost), and Cumulative Index of Nursing and Allied Health Literature were searched according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies reporting real-world effectiveness, costs, humanistic, behavioral (eg, interpersonal relations, suicide ideation), medication adherence, and product-switching outcomes for selected OATs published in English from January 2010 to March 2022 were identified and evaluated qualitatively.Results: We included 48 studies with different designs providing extensive evidence on schizophrenia. All studies were conducted in countries outside of the United States. In most studies, antipsychotic medications were more effective than placebo, suggesting their value in the management of schizophrenia. Sixteen studies measured the economic outcomes of OATs. Eight studies assessed humanistic outcomes, while one reported behavioral outcomes in three second-generation antipsychotics. Medication adherence was described in two studies, while five studies evaluated product switching. Non-adherence was commonly reported for OATs. Medication non-adherence and treatment discontinuation were predominant factors contributing to the economic burden of schizophrenia.Conclusion: Our research showcased a significant knowledge gap across OATs spanning the humanistic and behavioral outcomes and medication adherence and switching, suggesting a need for robust evidence generation to help clinicians and payers make informed decisions regarding treatment opportunities and cost-effective strategies for patients with schizophrenia.Keywords: schizophrenia, behavioral outcomes, cost-effectiveness, humanistic outcomes, medication adherence, product switching

Crop production stands as a pivotal pillar of global food security, but its sustainability faces complex challenges from plant diseases, which pose a substantial threat to agricultural productivity. Climate change significantly alters the dynamics of plant pathogens, primarily through changes in temperature, humidity, and precipitation patterns, which can enhance the virulence and spread of various plant diseases. Indeed, the increased frequency of extreme weather events, which is a direct consequence of climate change, creates favorable conditions for outbreaks of plant diseases. As global temperatures rise, the geographic range of many plant pathogens is expanding, exposing new regions and species to diseases previously limited to warmer climates. Climate change not only affects the prevalence and severity of plant diseases but also influences the effectiveness of disease management strategies, necessitating adaptive approaches in agricultural practices. This review presents a thorough examination of the relationship between climate change and plant pathogens and carefully provides an analysis of the interplay between climatic shifts and disease dynamics. In addition to insights into the development of effective strategies for countering the adverse impacts of climate change on plant diseases, these insights hold significant promise for bolstering global crop production resilience against mounting environmental challenges.

This study investigates the relationship between groundwater quality and agricultural productivity across six experimental stations in Morocco: Doukkala, Bahira, Tassaout, Beni Amir, Beni Moussa and Tadla. To assess groundwater suitability for irrigation, a comprehensive suite of indices was employed, including the permeability index (PI), Kelly index (KI), sodium strength percentage (SSP), sodium adsorption ratio (SAR), residual sodium carbonate (RSBC), magnesium hazard (MH), Langelier saturation index (LSI), Ryznar stability index (RSI), aggression index (AI), Larson and Skold index (LS), and Puckorious saturation index (PSI). Results indicated significant variations among the stations. Doukkala showed moderate permeability and low salinity risk but high sodium levels (SSP 50.14, SAR 6.87). Bahira had similar trends with slightly higher PI and KI values. Tassaout demonstrated lower values across all indices, suggesting better groundwater quality. Beni Amir and Beni Moussa exhibited decreasing trends in indices, with Beni Moussa having the lowest values overall. Notably, Beni Amir had the most negative RSBC value, indicating a high sodium hazard and potential soil structure issues, while Tadla had the least negative RSBC value, indicating favorable conditions. Water in Beni Amir and Beni Moussa, with MH values of 56.37 and 56.84 respectively, was deemed unsuitable for irrigation, whereas Doukkala, Bahira, Tassaout, and Tadla, with MH values below 50, were considered suitable. The study concludes that groundwater quality varies significantly across regions, impacting agricultural productivity, with some regions posing higher risks due to sodium and magnesium hazards.

In recent times, various real word problems including infectious diseases, engineering problems, and chemical processes, etc are modelled by using differential equations with fractals and fractional orders. The mentioned area provides a powerful tool to investigate the aforesaid problems from different perspectives like analysis, numerical investigation, and qualitative theory. Similarly, one of the global issue is devoted to re-infection of viral diseases like COVID-19. The said behaviour has produced very saviour impact on human life worldwide. Also, this is very critical for health system of a country as well as for its economics situation. To study the aforesaid phenomenon of re-infection, a hybrid type fractal–fractional three compartments model is formulated. The basic results related to boundedness, positivity, equilibrium points, basic reproductive number, and sensitivity analysis of the basic threshold are included in the theoretical aspect. Additionally, the Volterra–Lyapunov approach is used to establish both local and global stability analysis under fractals and fractional derivative. Furthermore, utilizing techniques from numerical functional analysis and fixed point theory, the existence and Hyers–Ulam stability of the solutions are also examined. A numerical algorithm based on Lagrange’s interpolation polynomials is extended to simulate the results of various compartments. Graphical interpretations corresponding to different fractals–fractional order values are presented. For verification of our numerical results, a comparison is provided between the real and simulated data. Here it should be kept in mind that the differential operator of fractals–fractional order is considered with Mittag-Leffler kernel. The mentioned operator is more general among the available fractals fractional differential operators in literature.

This comprehensive study seeks to assess the upper Jurassic Alif reservoir within the Halewah oil field in the Marib-Shabwa (Sab’atayn) Basin of Yemen. The Halewah oil field is considered one of the most promising areas for petroleum production and is greatly favoured by exploration activities. The study’s data set consists of digitised wireline logs for four wells and ten lines of 2D seismic profiles. Several faults affected the upper and lower salt members of the Sab’atayn Formation, which caused the Red Sea and Gulf of Aden tectonic activity. Results show that sandstone, shaly sandstone, calcite, and anhydrite comprise most of the Alif reservoir. Halewah well No. 02 has a high porosity of 21% and permeability of 1073 mD, with the highest net thickness of about 71.17 m. In contrast, Halewah well No. 06 has the lowest percentage in net thickness of 21.8 m with porosity of 15% and permeability of 511.2 mD. Alif reservoir exhibits promising characteristics, particularly in the upper reservoir unit. Intensifying exploration and prospecting operations in this unit is recommended.

This research investigates the security challenges posed by worm propagation in wireless sensor networks (WSNs). A novel stochastic susceptible – infectious – vaccination – recovered model is introduced to analyse the dynamics of worm spread. Conditions for the existence of a unique global solution are examined, and necessary conditions for worm eradication are established. By incorporating random environmental fluctuations, the proposed model provides a more precise depiction of propagation dynamics than deterministic models. Empirical findings are presented to validate the model’s predictive accuracy across diverse scenarios, underscoring its robustness. Numerical simulations affirm the effectiveness of the analytical approach in understanding worm propagation within WSNs. The study offers valuable insights into worm dynamics and proposes a methodological framework to enhance network security. The findings underscore the significant role of stochastic systems in modelling and provide strategic perspectives for designing resilient defensive frameworks against worm attacks in WSNs.

Ferroptosis, a form of regulated cell death, has emerged as a crucial process in diverse pathophysiological states, encompassing cancer, neurodegenerative ailments, and ischemia-reperfusion injury. The glutathione (GSH)-dependent lipid peroxidation pathway, chiefly governed by glutathione peroxidase 4 (GPX4), assumes an essential part in driving ferroptosis. GPX4, as the principal orchestrator of ferroptosis, has garnered significant attention across cancer, cardiovascular, and neuroscience domains over the past decade. Noteworthy investigations have elucidated the indispensable functions of ferroptosis in numerous diseases, including tumorigenesis, wherein robust ferroptosis within cells can impede tumor advancement. Recent research has underscored the complex regulatory role of non-coding RNAs (ncRNAs) in regulating the GSH-GPX4 network, thus influencing cellular susceptibility to ferroptosis. This exhaustive review endeavors to probe into the multifaceted processes by which ncRNAs control the GSH-GPX4 network in ferroptosis. Specifically, we delve into the functions of miRNAs, lncRNAs, and circRNAs in regulating GPX4 expression and impacting cellular susceptibility to ferroptosis. Moreover, we discuss the clinical implications of dysregulated interactions between ncRNAs and GPX4 in several conditions, underscoring their capacity as viable targets for therapeutic intervention. Additionally, the review explores emerging strategies aimed at targeting ncRNAs to modulate the GSH-GPX4 pathway and manipulate ferroptosis for therapeutic advantage. A comprehensive understanding of these intricate regulatory networks furnishes insights into innovative therapeutic avenues for diseases associated with perturbed ferroptosis, thereby laying the groundwork for therapeutic interventions targeting ncRNAs in ferroptosis-related pathological conditions.

ABSTRACTIn this study, we study a two-strain nonlinear model for the transmission of COVID-19 with a vaccinated class. Here, it is remarkable that the model we consider contains two kinds of viruses known as Omicron and Delta variants denoted by [Formula: see text] and [Formula: see text], respectively. Also, the uninfected population is denoted by [Formula: see text], the vaccinated class by [Formula: see text] and the recovered individuals by [Formula: see text]. In the presented study, we consider the proposed model under conformable fractional order derivatives. The fundamental reproductive number and equilibrium points are computed. Moreover, we determine the existence and uniqueness of the solution to the suggested model using fixed-point theory. Furthermore, we provide a suitable methodology by applying the Euler numerical method to calculate the approximate solution of each compartment of the proposed model. Additionally, using MATLAB-16, we simulate the given results graphically for a variety of fractional orders using some real values of the parameters and initial conditions.

With the growing interest in energy optimization, corrugated surfaces are arguably an excellent choice, finding applications in areas as diverse as heat exchangers, automobiles, building energy efficiency, and chemical reactors. However, due to the poor thermal properties of conventional fluids, heat transfer is limited. The introduction of nanoparticles into fluids is a promising solution to improve their thermal performance. This paper does a detailed numerical analysis of how different factors affect the forced convection heat transfer in a two-dimensional ribed channel. The shape of the ribs is one of the factors that are looked at, along with some new parameters like e/H, which is the ratio of rib height to channel height, and L2/P, which is the test section to the pitch between the ribs. The aim is to determine the optimum geometry that maximizes the Nusselt number while minimizing the pressure drop. The study also examines the effects of nanoparticle type and concentration on heat transfer and fluid flow characteristics. To this end, the continuity, momentum, and energy equations were solved with the finite volume method using the SIMPLE scheme with the k-ε turbulence model at different Reynolds numbers ranging from 4000 – 14,000. The results indicate that triangular ribs with ratios e/H = 0.15 and L2/P = 4 increase the Nusselt number by 63.3 % while reducing the pressure drop by 22 % compared with the other cases. The improvement in heat transfer in the water-SiO2 case was the greatest compared with the other nanofluids tested. Particle size fraction and Reynolds number increased the Nusselt number in ribbed channels by 20.7 % compared with water.

Summary: Despite extensive global research into genetic predisposition for severe COVID-19, knowledge on the role of rare host genetic variants and their relation to other risk factors remains limited. Here, 52 genes with prior etiological evidence were sequenced in 1,772 severe COVID-19 cases and 5,347 population-based controls from Spain/Italy. Rare deleterious TLR7 variants were present in 2.4% of young (

Background: Individuals with diabetes are vulnerable to a weakened immune response, increasing the risk of pulmonary tuberculosis (TB), particularly in low- to middle-income countries like Pakistan with prevalent poverty and unsanitary conditions. This study aimed to determine the prevalence of T2DM in Pulmonary TB patients. Method: This cross-sectional study was conducted at the Primary Health Care (PHC) Center in Sikandar Abad and private clinics in Hyderabad, Pakistan. A total of 200 individuals, irrespective of age and gender, diagnosed with primary pulmonary tuberculosis and undergoing either first-line or second-line therapy, were recruited during a period of six months from 1st April 2022 to 30th September 2022 through simple random sampling. All TB patients were screened for Diabetes. The collection of relevant information, including demographic and clinical details, was executed using a standardized study proforma. Data analysis was performed using SPSS version 25, allowing for statistical exploration and interpretation of the findings. Results: Prevalence of DM in TB patients was (38%) 19. The average age of the participants was 36.6+14.8 years. The computed BMI of 17.14+2.9kg/m2 revealed that the majority of the patients were underweight. Weight loss was the symptom that co-occurred with TB and DM. Conclusion: Study revealed a notable 38% prevalence of Type 2 Diabetes Mellitus (T2DM) among Pulmonary TB patients, indicating a risk of co-occurrence. This co-morbidity poses an important public health concern, emphasizing the importance of understanding the interplay between these two conditions.

Background. The health of retirees, as an expanding and vulnerable group, is of particular importance in society, and it is necessary to prioritize their problems in critical situations such as the spread of the coronavirus. The current study aimed to investigate the impact of social and cultural capital on the level of fear of COVID-19 among retired employees of Tabriz University of Medical Sciences (TUOMS). Methods. This survey-based research employed a descriptive-explanatory design and was practical in terms of purpose. This study selected 410 retirees from TUOMS in Iran using a simple random sampling method. The data collection tools in this study included three questionnaires: cultural capital, social capital, and fear of COVID-19. We tested the research hypotheses using SPSS software (version 22). Results. The bivariate results of the study indicated that social capital and its dimensions (social networks, social trust, and social participation) and cultural capital and its dimensions (embodied, objective, and institutional) had a significant and inversed effect on the level of fear of COVID-19 among the retirees. The regression model of fear of COVID-19 also found that both independent variables (social capital and cultural capital) were statistically significant and could explain about 36% and 31% of the changes in the dependent variable (fear of COVID-19 among retirees), respectively. Conclusion. This study indicated a significant and inverse relationship between social and cultural capital and the level of fear of COVID-19 among the retirees of TUOMS. The findings of the present study can be generalized to all retired TUOMS employees. Therefore, healthcare policymakers should take effective measures to increase the funds allocated to diseases such as COVID-19 and reduce the fear of the disease, which is a risk factor for physical and mental diseases.

One of the main causes of death worldwide is lung cancer, which is largely caused by cigarette smoking. The crucial transcription factor NF-κB, which controls inflammatory responses and various cellular processes, is a constitutively present cytoplasmic protein strictly regulated by inhibitors like IκB proteins. Upon activation by external stimuli, it undergoes phosphorylation, translocates into the nucleus, and modulates the expression of specific genes. The incontrovertible association between pulmonary malignancy and tobacco consumption underscores and highlights a public health concern. Polycyclic aromatic hydrocarbons and nitrosamines, potent carcinogenic compounds present in the aerosol emitted from combusted tobacco, elicit profound deleterious effects upon inhalation, resulting in severe perturbation of pulmonary tissue integrity. The pathogenesis of smoking-induced lung cancer encompasses an intricate process wherein NF-κB activation plays a pivotal role, triggered by exposure to cigarette smoke through diverse signaling pathways, including those associated with oxidative stress and pro-inflammatory cytokines. Unraveling the participation of NF-κB in smoking-induced lung cancer provides pivotal insights into molecular processes, wherein intricate crosstalk between NF-κB and pathways such as MAPK and PI3K-Akt amplifies the inflammatory response, fostering an environment conducive to the formation of lung cancer. This study reviews the critical function of NF-κB in the complex molecular pathways linked to the initiation and advancement of lung carcinogenesis as well as potential treatment targets.

The prospect of decoupling economic development from CO2 emissions in Ghana is examined in this paper, with an emphasis on the manufacturing, export, and adoption of renewable energy sectors. The paper investigates the long-term and short-term correlations among CO2 emissions, renewable energy consumption (RNE), population growth (POP), manufacturing value-added (MVA), Economic growth (GDP), and exports (EXP) using an Autoregressive Distributed Lag (ARDL) bounds testing method using time series data from 1990 to 2020. The outcomes show that the variables are long-term cointegrating. Long-term GDP and CO2 emissions show a positive but negligible correlation, whereas exports show a negative and insignificant correlation. In the near term, using renewable energy has a markedly undesirable consequence on releases, yet, over time, the connection is positive and negligible. Because the turning point when economic expansion results in lower emissions is not apparent, the Environmental Kuznets Curve concept is not entirely substantiated. The report emphasizes how specific laws encouraging the use of renewable energy, environmentally friendly export and manufacturing processes, and technical advancements are necessary to help Ghana move toward a low-carbon economy.

Background: Pressure injury is a frequently occurring health issue in healthcare environments, especially within hospitals. The risk is increased in hospital settings where patients are frequently confined to beds or wheelchairs. Objectives: This study evaluated the prevalence of pressure injury in regular inpatients at H. Adam Malik Hospital, Medan, from 2020 to 2022. Methods: This study employs a descriptive design with a cross-sectional research approach, describing all variables using secondary data from patient medical records. Results: The research findings indicate that the most common age group is 41-60 years old (28,4%), with females comprising the majority (52,9%). The primary diagnoses related to the occurrence of pressure injury is neurological disorders (25.5%). The most frequent location of injury is the buttocks region (45.1%), and the most prevalent stage of injury is stage III (36.3%), with the most common management approach being debridement (43.6%). Conclusion: In H. Adam Malik Hospital, Medan, from 2020 to 2022, pressure injury was mostly found at ages 41-60 years old, in women, the most prevalent underlying primary disease was neurological disorders, on the buttocks region, at stage III, and the most common management approach being debridement. Latar Belakang: Ulkus Dekubitus merupakan masalah kesehatan yang sering terjadi di lingkungan perawatan kesehatan, terutama di rumah sakit. Risiko ini meningkat di rumah sakit yang pasiennya sering terbaring di tempat tidur atau kursi roda. Tujuan: Mengetahui gambaran Ulkus Dekubitus pasien rawat inap reguler di RSUP H. Adam Malik Medan pada tahun 2020 - 2022. Metode: Penelitian ini merupakan studi deskriptif dengan rancangan penelitian cross-sectional yang seluruh variabel dilihat menggunakan data sekunder berupa rekam medis pasien. Hasil: Penelitian ini menunjukkan bahwa kelompok usia yang paling banyak adalah usia 41-60 tahun (28,4%), dengan mayoritas adalah perempuan (52,9%). Diagnosis utama yang berhubungan dengan terjadinya Ulkus Dekubitus adalah gangguan neurologis (25,5%). Lokasi ulkus yang paling sering adalah daerah bokong (45,1%), dan derajat ulkus yang paling banyak terjadi adalah stadium III (36,3%), dengan penatalaksanaan yang paling banyak dilakukan adalah debridemen (43,6%). Kesimpulan: Di RSUP H. Adam Malik Medan pada tahun 2020 hingga 2022, Ulkus Dekubitus umumnya dijumpai pada usia 41-60 tahun, wanita, diagnosis utama gangguan neurologis, lokasi bokong, derajat III, dan tata laksana debridemen.

The LMWL was re-plotted from the isotopic analysis data (δ2H and δ18O) for rainwater samples collected from three stations in Baghdad city in the current study and data from previous studies. Four samples of shallow groundwater and five samples from the Tigris River were isotopically analyzed for 2H and 18O using a Liquid-Water Stable Isotope Analyzer (LWSIA). The samples were collected from the Al-Jaderia area within the University of Baghdad. The analysis was done against Vienna Standard Main Oceanic Water (VSMOW). The isotopic composition of groundwater ranges between -43.91‰ and -37.57 ‰ for 2H with an average of -40.06±2.7 ‰, while it ranges between -6.28‰ and -6.01‰ for 18O with an average of -6.14±0.1‰. These values are slightly more depleted compared to the isotopic composition of the Tigris River water (-38.79 ‰ to -37.87 ‰) for 2H with an average of -38.05±0.9‰ and between -6.23‰ to -5.11 ‰ for 18O with an average of -5.74±0.4 ‰. This is a logical result since the river is usually fed with fresh new rainwater, which isotopically is relatively more enriched. The current study confirms that the Local Meteoric Water Line (LMWL) has a formula of δ 2H‰ = 7.5 δ 18O‰ + 13. The LMWL is located above the Global MWL by +13.9‰ toward the Eastern Mediterranean (EMMWL δ2H‰ = 8 δ 18O‰ + 22), indicating the origin rainwater from the Mediterranean Sea and the Atlantic Ocean. The groundwater and surface water isotopic compositions were below the LMWL due to the evaporation of shallow groundwater. There is interconnection between river water and groundwater, directly or by recharge from irrigation water. Iraq may have two different MWLs, one for the northeastern region and the other for the middle, western and southern Iraq. The MWL for the northern eastern region of Iraq is close to that of the EMMWL, indicating Mediterranean climate and vapor source, while the rest of the areas of Iraq have MWL with various isotopic compositions affected by more hot climate in these regions and by the continental tropical air masses.

Abstract Suspensions containing microencapsulated phase change materials (MPCMs) play a crucial role in thermal energy storage (TES) systems and have applications in building materials, textiles, and cooling systems. This study focuses on accurately predicting the dynamic viscosity, a critical thermophysical property, of suspensions containing MPCMs and MXene particles using Gaussian process regression (GPR). Twelve hyperparameters (HPs) of GPR are analyzed separately and classified into three groups based on their importance. Three metaheuristic algorithms, namely genetic algorithm (GA), particle swarm optimization (PSO), and marine predators algorithm (MPA), are employed to optimize HPs. Optimizing the four most significant hyperparameters (covariance function, basis function, standardization, and sigma) within the first group using any of the three metaheuristic algorithms resulted in excellent outcomes. All algorithms achieved a reasonable R-value (0.9983), demonstrating their effectiveness in this context. The second group explored the impact of including additional, moderate-significant HPs, such as the fit method, predict method and optimizer. While the resulting models showed some improvement over the first group, the PSO-based model within this group exhibited the most noteworthy enhancement, achieving a higher R-value (0.99834). Finally, the third group was analyzed to examine the potential interactions between all twelve HPs. This comprehensive approach, employing the GA, yielded an optimized GPR model with the highest level of target compliance, reflected by an impressive R-value of 0.999224. The developed models are a cost-effective and efficient solution to reduce laboratory costs for various systems, from TES to thermal management.

Christopher Zacker,1 Justin T Puckett,2 Sachin Kamal-Bahl2 1Cerevel Therapeutics, LLC, Cambridge, MA, USA; 2COVIA Health Solutions, Ambler, PA, USACorrespondence: Sachin Kamal-Bahl, COVIA Health Solutions, 915 Brewster Lane Ambler, PA 19002, Tel +1 267-337-4250, Email sachin@coviahealthsolutions.comPurpose: Little is known about adherence to and discontinuation of newly initiated oral antipsychotics (OAPs) as well as associated factors among Medicare beneficiaries with schizophrenia. This study aimed to examine rates of OAP adherence and discontinuation and associated factors in a national sample of fee-for-service Medicare beneficiaries with schizophrenia.Patients and Methods: This retrospective study used 100% fee-for-service Medicare claims data to identify adult beneficiaries with schizophrenia, initiating a new OAP between 01/01/2017 and 12/31/2019 (index date = date of new OAP prescription). Outcomes included adherence and discontinuation. Factors associated with adherence were assessed using logistic and linear regressions; Cox regressions were used to assess factors associated with discontinuation.Results: In our final sample of 46,452 Medicare beneficiaries with schizophrenia, 35.4% were adherent to their newly initiated OAP (mean [SD] PDC: 0.52 [0.37]) over 12 months after initiation. Most patients (79.4%) discontinued their new OAP (median [IQR] time to discontinuation: 3.6 (1.0, 9.9) months). Factors associated with lower odds of adherence included younger age (OR: 0.43; 95% CI: 0.40– 0.47, p < 0.001 for patients aged 18– 35 relative to patients aged ≥ 65 years); non-White race (OR: 0.72; 95% CI: 0.69– 0.75, p < 0.001 relative to White patients); and evidence of prior schizophrenia-related hospitalization (OR: 0.80; 95% CI: 0.77– 0.83, p < 0.001 relative to patients without evidence of prior schizophrenia-related hospitalization). Similar associations were observed for discontinuation outcomes. Twice-daily dosing frequency was also associated with lower odds of adherence (odds ratio [OR]: 0.93; 95% CI: 0.89– 0.97, p = 0.0014) and higher hazard of discontinuation (hazard ratio [HR]: 1.03; 95% CI: 1.00– 1.05, p = 0.0244) relative to once-daily dosing frequency.Conclusion: We found high rates of non-adherence and discontinuation among Medicare beneficiaries initiated on currently available OAPs. We also identified risk factors that contribute to increased odds of medication non-adherence. By identifying at-risk patient populations, targeted interventions can be initiated to facilitate treatment continuity.Plain Language Summary: Although half of patients with schizophrenia are covered by Medicare, little is known about how consistently they take their antipsychotic medications, which is a crucial part of successful treatment. We found that only 1/3 of Medicare beneficiaries consistently took their medications and nearly 80% discontinued treatment, often shortly after starting it. Younger patients, non-White patients, and patients who had to take pills multiple times per day were less likely to consistently take their medications.Keywords: adherence, antipsychotic, Medicare, discontinuation

Abstract Recently, the area devoted to fractional calculus has given much attention by researchers. The reason behind such huge attention is the significant applications of the mentioned area in various disciplines. Different problems of real world processes have been investigated by using the concepts of fractional calculus and important and applicable outcomes were obtained. Because, there has been a lot of interest in fractional differential equations. It is brought on by both the extensive development of fractional calculus theory and its applications. The use of linear and quadratic perturbations of nonlinear differential equations in mathematical models of a variety of real-world problems has received a lot of interest. Therefore, motivated by the mentioned importance, this research work is devoted to analyze in detailed, a class of fractal hybrid fractional differential equation under Atangana- Baleanu- Caputo ABC derivative. The qualitative theory of the problem is examined by using tools of non-linear functional analysis. The Ulam-Hyer’s (U-H) type stability criteria is also applied to the consider problem. Further, the numerical solution of the model is developed by using powerful numerical technique. Lastly, the Wazewska-Czyzewska and Lasota Model, a well-known biological model, verifies the results. Several graphical representations by using different fractals fractional orders values are presented. The detailed discussion and explanations are given at the end.