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This research offers detailed insights into managing and preventing meningococcal disease, highlighting Neisseria meningitidis and Neisseria gonorrhoeae as key pathogens. It focuses on the epidemiological diversity and classification of meningococcal serogroups, along with their worldwide distribution. A significant portion of the study is dedicated to advancements in vaccination, especially conjugate and protein-based vaccines, which have markedly enhanced prevention. The study examines the transmission and carriage mechanisms of N. meningitidis, emphasizing its carrier state and potential to cause severe diseases like meningitis and sepsis. It also explores virulence factors such as the polysaccharide capsule, lipooligosaccharide (LPS), and Type IV pili, and their contribution to disease pathogenesis. Additionally, it discusses nasopharyngeal epithelium colonization and the host's immune response role. The research ultimately highlights the crucial need for ongoing surveillance, vaccination, and international public health initiatives in effectively addressing meningococcal disease. The research provides valuable insights into the management and prevention of meningococcal disease. It emphasizes the critical role of vaccination, the need for ongoing surveillance, and the importance of global public health initiatives to mitigate the impact of this disease.

Abstract Background Early childhood caries (ECC) is a major global health issue affecting millions of children. Mitigating this problem requires up-to-date information from reliable surveillance systems. This enables evidence-based decision-making to devise oral health policies. The World Health Organization (WHO) advocates the adoption of mobile technologies in oral disease surveillance because of their efficiency and ease of application. The study describes developing an electronic, oral health surveillance system (EOHSS) for preschoolers in Egypt, using the District Health Information System (DHIS2) open-source platform along with its Android App, and assesses its feasibility in data acquisition. Methods The DHIS2 Server was configured for the DHIS2 Tracker Android Capture App to allow individual-level data entry. The EOHSS indicators were selected in line with the WHO Action Plan 2030. Two modalities for the EOHSS were developed based on clinical data capture: face-to-face and tele/asynchronous. Eight dentists in the pilot team collected 214 events using modality-specific electronic devices. The pilot’s team's feedback was obtained regarding the EOHSS's feasibility in collecting data, and a time-motion study was conducted to assess workflow over two weeks. Independent t-test and Statistical Process Control techniques were used for data analysis. Results The pilot team reported positive feedback on the structure of the EOHSS. Workflow adaptations were made to prioritize surveillance tasks by collecting data from caregivers before acquiring clinical data from children to improve work efficiency. A shorter data capture time was required during face-to-face modality (4.2 ± 0.7 min) compared to telemodality (5.1 ± 0.9 min), p

Abstract New sulfonamide-triazole-glycoside hybrids derivatives were designed, synthesised, and investigated for anticancer efficacy. The target glycosides’ cytotoxic activity was studied with a panel of human cancer cell lines. Sulfonamide-based derivatives, 4, 7 and 9 exhibited promising activity against HepG-2 and MCF-7 (IC50 = 8.39–16.90 μM against HepG-2 and 19.57–21.15 μM against MCF-7) comparing with doxorubicin (IC50 = 13.76 ± 0.45, 17.44 ± 0.46 μM against HepG-2 and MCF-7, rescpectively). To detect the probable action mechanism, the inhibitory activity of these targets was studied against VEGFR-2, carbonic anhydrase isoforms hCA IX and hCA XII. Compoumds 7 and 9 gave favorable potency (IC50 = 1.33, 0.38 μM against VEGFR-2, 66, 40 nM against hCA IX and 7.6, 3.2 nM against hCA XII, respectively), comparing with sorafenib and SLC-0111 (IC50 = 0.43 μM, 53 and 4.8 nM, respectively). Moreover, the docking simulation was assessed to supply better rationalization and gain insight into the binding affinity between the promising derivatives and their targeted enzymes that was used for further modification in the anticancer field.

Abstract Background In humanitarian settings, brief screening instruments for child psychological distress have potential to assist in assessing prevalence, monitoring outcomes, and identifying children and adolescents in most need of scarce resources, given few mental health professionals for diagnostic services. Yet, there are few validated screening tools available, particularly in Arabic. Methods We translated and adapted the Child Psychosocial Distress Screener (CPDS) and the Pediatric Symptom Checklist (PSC) and conducted a validation study with 85 adolescents (aged 10–15) in Lebanon. We assessed internal consistency; test-retest reliability; convergent validity between adolescent- and caregiver-report and between the two measures; ability to distinguish between clinical and non-clinical samples; and concurrent validity against psychiatrist interview using the Kiddie Schedule for Affective Disorders and Schizophrenia. Results The translated and adapted child-reported PSC-17 and PSC-35, and caregiver-reported PSC-35 all showed adequate internal consistency and test-retest reliability and high concurrent validity with psychiatrist interview and were able to distinguish between clinical and non-clinical samples. However, the caregiver-reported PSC-17 did not demonstrate adequate performance in this setting. Child-reported versions of the PSC outperformed caregiver-reported versions and the 35-item PSC scales showed stronger performance than 17-item scales. The CPDS showed adequate convergent validity with the PSC, ability to distinguish between clinical and non-clinical samples, and concurrent validity with psychiatrist interview. Internal consistency was low for the CPDS, likely due to the nature of the brief risk-screening tool. There were discrepancies between caregiver and child-reports, worthy of future investigation. For indication of any diagnosis requiring treatment, we recommend cut-offs of 5 for CPDS, 12 for child-reported PSC-17, 21 for child-reported PSC-35, and 26 for caregiver-reported PSC-35. Conclusions The Arabic PSC and CPDS are reliable and valid instruments for use as primary screening tools in Lebanon. Further research is needed to understand discrepancies between adolescent and caregiver reports, and optimal methods of using multiple informants.

MEK inhibitors (MEKi) represent innovative and promising treatments for managing manifestations of neurofibromatosis type 1 (NF1). To mitigate potential ophthalmic side effects, such as MEKi-associated retinopathy (MEKAR), patients undergoing MEKi therapy routinely receive ophthalmology evaluations. Our study aims to assess the necessity of this regular screening within a predominantly pediatric NF1 population by examining the occurrence of ocular adverse events (OAE). A retrospective study evaluated 45 NF1 patients receiving MEKi. Inclusion criteria included baseline and follow-up examinations following the initiation of MEKi therapy. At each assessment, a comprehensive eye evaluation was performed, comprising a dilated fundus examination, ocular coherence tomography of the macula and nerve fiber layer, and Humphrey visual field testing. Twenty-six patients, with an average age of 13 years (range 2–23 years) and an average follow-up duration of 413 days were included in the analysis. Three different MEKi were used: selumetinib (77%), trametinib (23%), and mirdametinib (4%). None of the patients experienced retinopathy at any point during the study. Some patients had pre-existing optic neuropathies (27%), but no instances of nerve changes occurred after commencing MEKi therapy. Four patients (15%) exhibited symptoms of dry eye, all of which were effectively managed with topical lubrication.

A designer's work is based on creativity, innovation, and fresh ideas therefore, they are constantly searching for creative designs, especially when it comes to furniture and internal design. Meanwhile, innovative materials and ideas are actively sought after by designers for usage in furniture and interior design. In this scope, our study explores the practical implications of using date palm fronds and plastic waste from drinking water bottle to create a composite with varying loadings of date palm frond nanoparticles (DPFNP) at 10, 20, and 30 wt % and its applications on furniture design. A desktop extruder was used to form the composites into filaments, which were subsequently used to create 3D-printed specimens. The impact of adding (DPFNP) on the composite's mechanical, thermal, and chemical properties was assessed. Polyethylene terephthalate (PET) drinking water bottle waste, and filament composites presented similar FTIR spectra; however, filament composites presented increased thermal stability and mechanical strength. The filament with 10 wt% DPFNP has been effectively printed with a 3D printer, demonstrating the practicality of employing the developed filaments and perhaps encouraging new uses in furniture and interior design. As a result, employing DPFNP in the recycled PET (RPET) matrix offers a cheap substitute for making filaments. It could increase the use of 3D printing in furniture and interior design by using more environmentally friendly materials. This result will be considered the first phase of future research investigation on a full-scale furniture prototype, examining its physical, thermal, and mechanical properties.

When multitudes of people need to be evacuated from their homes for various reasons, including natural catastrophes and armed conflicts, time and money are of the essence. Therefore, emergency relief tents are considered the most effective option for this situation. However, the indoor environment of these tent types might be thermally uncomfortable, particularly on hot or extremely cold days. Different techniques were used to overcome this problem including evaporative cooling systems. The present study aims to use a numerical approach to assess the impact of utilizing a two-stage indirect/direct evaporative cooling system on enhancing the interior thermal comfort conditions of the relief tent. The numerical part was done by utilizing software that was written in Fortran language to simulate the case under various parameters, including changing the cellulose pad thickness and the volumetric water flow rates in the second heat exchanger of the indirect cooling stage. The selection of boundary conditions that were applied in numerical analysis was based on experimental data collected over specified days during the summer of 2022, in particular from July 15th to September 15th. According to the findings, having two heat exchangers in the indirect cooling stage of the cooling system helps keep the tent model at a comfortable temperature because of the exceptional performance of the proposed cooling system in lowering both dry and wet bulb air temperatures before entering the direct evaporative cooling stage. In addition, it was found that the indoor temperature drop increased by about 19% when increasing the thickness of the cellulose pad and raising the water flow rate in the second heat exchanger of the indirect cooling stage.

Background: The perioperative arena is a unique and challenging environment that requires coordination of the complex processes and involvement of the entire care team. Pharmacists’ scope of practice has been evolving to be patient-centered and to expand to variety of settings including perioperative settings. Objectives: To critically appraise, synthesize, and present the available evidence of the characteristics and impact of pharmacist-led interventions on clinically important outcomes in the perioperative settings. Design: A systematic review and meta-analysis. Methods: We searched PubMed, Embase, and CINAHL from index inception to September 2023. Included studies compared the effectiveness of pharmacist-led interventions on clinically important outcomes (e.g. length of stay, readmission) compared to usual care in perioperative settings. Two independent reviewers extracted the data using the DEPICT-2 (Descriptive Elements of Pharmacist Intervention Characterization Tool) and undertook quality assessment using the Crowe Critical Appraisal (CCAT). A random-effect model was used to estimate the overall effect [odds ratio (OR) for dichotomous and standard mean difference (SMD) for continuous data] with 95% confidence intervals (CIs). Results: Twenty-five studies were eligible, 20 (80%) had uncontrolled study design. Most interventions were multicomponent and continuous over the perioperative period. The intervention components included clinical pharmacy services (e.g. medication management/optimization, medication reconciliation, discharge counseling) and education of healthcare professionals. While some studies provided a minor description in regards to the intervention development and processes, only one study reported a theoretical underpinning to intervention development. Pooled analyses showed a significant impact of pharmacist care compared to usual care on length of stay (11 studies; SMD −0.09; 95% CI −0.49 to −0.15) and all-cause readmissions (8 studies; OR 0.60; 95% CI 0.39–0.91). The majority of included studies ( n = 21; 84%) were of moderate quality. Conclusion: Pharmacist-led interventions are effective at improving clinically important outcomes in the perioperative setting; however, most studies were of moderate quality. Studies lacked the utilization of theory to develop interventions; therefore, it is not clear whether theory-derived interventions are more effective than those without a theoretical element. Future research should prioritize the development and evaluation of multifaceted theory-informed pharmacist interventions that target the whole surgical care pathway.

Industrial companies aim to minimise production costs and improve product quality by analysing work organisation levels. Workshop scheduling and line balancing are essential in realising production plans, particularly in the fashion industry. Balancing systems must optimise precise criteria while sticking to constraints. Preserving balance needs precise parameters that align theoretical and practical production results. Manual methods overlook the balancing process, where managers rely on experience to prove balance and adjust parameters as needed. This article presents a creative automatic balancing application for fashion companies, leveraging artificial intelligence’s (AI) power. It focuses on utilising ant colony algorithms for optimal balancing. The results show the significance of these algorithms in attaining optimal balancing in production systems. The article highlights outstanding balancing results achieved through this approach, providing alignment with detailed criteria and constraints. The algorithm reliably distributes tasks among operators, improving overall productivity. Therefore, ant colony algorithms are perfect for manufacturers pursuing cost reduction, improved product quality and facilitated production processes. This article introduces an AI-based automatic balancing application for fashion companies. The ant colony algorithms achieve optimal balancing, improve inventory management and enhance productivity.

Abstract Inflammation can play a role in the pathophysiology of depression, and specific types of antidepressants may have inflammatory or anti-inflammatory properties. Furthermore, depression and antidepressant use has been linked to white blood cell (WBC) count, a routinely measured inflammatory marker. We examined the cross-sectional and longitudinal relationships of depressive symptoms and/or antidepressant use with WBC count among postmenopausal women. Analyses of cross-sectional data at enrollment were performed on 125,307 participants, 50–79 years of age, from the Women’s Health Initiative Clinical Trials and Observational Studies who met eligibility criteria, and a subset of those with 3-year follow-up data were examined for longitudinal relationships. Depressive symptoms were defined using the Burnam Algorithm whereas antidepressant use was defined using therapeutic class codes. WBC count (Kcell/ml) was obtained through laboratory evaluations of fasting blood samples. Multivariable regression modeling was performed taking sociodemographic, lifestyle and health characteristics into consideration. At enrollment, nearly 85% were non-users of antidepressants with no depressive symptoms, 5% were antidepressant users with no depressive symptoms, 9% were non-users of antidepressants with depressive symptoms, and 2% were users of antidepressants with depressive symptoms. In fully-adjusted models, cross-sectional relationships were observed whereby women in the 2nd (OR = 1.06, 95% CI: 1.01, 1.13), 3rd (OR = 1.06, 95% CI: 1.00, 1.12) or 4th (OR = 1.10, 95% CI: 1.05, 1.17) quartiles of WBC count were more likely to exhibit depressive symptoms, and women in the 4th quartile were more likely to be users of antidepressants (OR = 1.07, 95% CI: 1.00, 1.15), compared to women in the 1st quartile. Compared to women who exhibited no depressive symptoms at either visit, those with consistent depressive symptoms at enrollment and at 3-year follow-up had faster decline in WBC count (β = −0.73, 95% CI: −1.33, −0.14) over time. No significant bidirectional relationships were observed between changes in depressive symptoms score and WBC count over time. In conclusion, depressive symptoms and/or antidepressant use were cross-sectionally related to higher WBC counts among postmenopausal women. Further evaluation of observed relationships is needed in the context of prospective cohort studies involving older adult men and women, with repeated measures of depression, antidepressant use, and WBC count.

Background Migration and health are key priorities in global health and essential for protecting and promoting the health of migrants. To better understand the existing evidence on migration health, it is critical to map the research publication activity and evidence on the health of migrants and mobile populations. This paper presents a search strategy protocol for a bibliometric analysis of scientific articles on global migration health (GMH), leveraging the expertise of a global network of researchers and academics. The protocol aims to facilitate the mapping of research and evidence on the health of international migrants and their families, including studies on human mobility across international borders.Methods A systematic search strategy using Scopus will be developed to map scientific articles on GMH. The search strategy will build upon a previous bibliometric study and will have two main search components: (1) ‘international migrant population’, covering specific movements across international borders, and (2) ‘health’. The final search strategy will be implemented to determine the final set of articles to be screened for the bibliometric analysis. Title and abstract screening will exclude irrelevant articles and classify the relevant articles according to predefined themes and subthemes. A combination of the following approaches will be used in screening: applying full automation (ie, DistillerSR’s machine learning tool) and/or semiautomation (ie, EndNote, MS Excel) tools, and manual screening. The relevant articles will be analysed using MS Excel, Biblioshiny and VOSviewer, which creates a visual mapping of the research publication activity around GMH. This protocol is developed in collaboration with academic researchers and policymakers from the Global South, and a network of migration health and research experts, with guidance from a bibliometrics expert.Ethics and dissemination The protocol will use publicly available data and will not directly involve human participants; an ethics review will not be required. The findings from the bibliometric analysis (and other research that can potentially arise from the protocol) will be disseminated through academic publications, conferences and collaboration with relevant stakeholders to inform policies and interventions aimed at improving the health of international migrants and their families.

Objective: The global impact of osteoarthritis is growing. Currently no disease modifying osteoarthritis drugs/therapies exist, increasing the need for preventative strategies. Knee injuries have a high prevalence, distinct onset, and strong independent association with post-traumatic osteoarthritis (PTOA). Numerous groups are embarking upon research that will culminate in clinical trials to assess the effect of interventions to prevent knee PTOA despite challenges and lack of consensus about trial design in this population. Our objectives were to improve awareness of knee PTOA prevention trial design and discuss state-of-the art methods to address the unique opportunities and challenges of these studies. Design: An international interdisciplinary group developed a workshop, hosted at the 2023 Osteoarthritis Research Society International Congress. Here we summarize the workshop content and outputs, with the goal of moving the field of PTOA prevention trial design forward. Results: Workshop highlights included discussions about target population (considering risk, homogeneity, and possibility of modifying osteoarthritis outcome); target treatment (considering delivery, timing, feasibility and effectiveness); comparators (usual care, placebo), and primary symptomatic outcomes considering surrogates and the importance of knee function and symptoms other than pain to this population. Conclusions: Opportunities to test multimodal PTOA prevention interventions across preclinical models and clinical trials exist. As improving symptomatic outcomes aligns with patient and regulator priorities, co-primary symptomatic (single or aggregate/multidimensional outcome considering function and symptoms beyond pain) and structural/physiological outcomes may be appropriate for these trials. To ensure PTOA prevention trials are relevant and acceptable to all stakeholders, future research should address critical knowledge gaps and challenges.

BackgroundCardiotoxicity is one of the limiting side effects of the commonly used anticancer agent cyclophosphamide (Cyclo).Materials and methodsThe possible protective effects of telmisartan and nanoformulated Spirulina platensis (Sp) methanolic extract against Cyclo-induced cardiotoxicity were examined in this study. Experimental groups of rats were randomly divided into nine groups as control vehicle, control polymer, telmisartan (TEL, 10 mg/kg), free Sp extract (300 mg/kg), nano Sp extract (100 mg/kg), Cyclo (200 mg/kg), TEL + Cyclo, free Sp + Cyclo, and nano Sp + Cyclo. The groups with Cyclo combinations were treated in the same manner as their corresponding ones without Cyclo, with a single dose of Cyclo on day 18.ResultsThe results indicate that Cyclo causes significant cardiotoxicity, manifesting in the form of notable increases of 155.49%, 105.74%, 451.76%, and 826.07% in the serum levels of glutamic oxaloacetic transaminase (SGOT), lactate dehydrogenase (LDH), creatine kinase MB (CK-MB), and cardiac troponin I (cTnI) enzyme activities, respectively, as compared to the control. In addition, the cardiac glutathione (GSH) content and activity of glutathione peroxidase-1 (GPX-1) enzyme decreased by 65.94% and 73.85%, respectively. Treatment with nano Sp extract showed the most prominent restorations of the altered biochemical, histopathological, and immunohistochemical features as compared with those by TEL and free Sp; moreover, reductions of 30.64% and 43.02% in the p-AKT content as well as 60.43% and 75.30% of the endothelial nitric oxide synthase (eNOS) immunoreactivity were detected in the TEL and free Sp treatment groups, respectively. Interestingly, nano Sp boosted the autophagy signal via activation of beclin-1 (36.42% and 153.4%), activation of LC3II (69.13% and 195%), downregulation of p62 expressions (39.68% and 62.45%), and increased gene expressions of paraoxonase-1 (PON-1) (90.3% and 225.9%) compared to the TEL and free Sp treatment groups, respectively.ConclusionThe findings suggest the protective efficiency of telmisartan and nano Sp extract against cardiotoxicity via activations of the antioxidant, antiapoptotic, and autophagy signaling pathways.

Introduction: Rosettes are a cluster of shiny white dots in the shape of a four-leaf clover seen under polarized dermoscopic light. Historically, rosettes were primarily reported in actinic keratoses and squamous cell carcinoma. However, rosettes have also been reported in other conditions. Objectives: The objective of this systematic review to elucidate the breadth of diagnoses exhibiting this unique dermoscopic phenomenon. Methods: A review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Literature searches were performed in MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials and Web of Science, as well as a manual search of the reference lists of screened articles. Results: A total of 73 articles met the inclusion criteria. Out of these, 47 distinct diagnoses with rosette were identified. Among neoplastic conditions, keratinizing neoplasms had the highest number of articles reported (n=19). Discoid lupus was the most commonly reported diagnosis within the inflammatory category (n = 6). Molluscum contagiosum was the predominant diagnosis among infectious entities (n = 3), while acroangiodermatitis was the sole diagnosis reported in the vascular category (n = 1). Conclusion: These findings confirm rosettes are not specific to keratinocytic growths and are observed in a wide range of conditions. Knowledge of the breadth of conditions with rosettes may aid clinicians when developing a differential diagnosis of a growth or an eruption with rosettes under dermoscopy.

Abstract Blockchain technology has gained widespread adoption in recent years due to its ability to enable secure and transparent record-keeping and data transfer. A critical aspect of blockchain technology is the use of consensus algorithms, which allow distributed nodes in the network to agree on the state of the blockchain. In this review paper, we examine various consensus algorithms that are used in blockchain systems, including proof-of-work, proof-of-stake, and hybrid approaches. We go over the trade-offs and factors to think about when choosing a consensus algorithm, such as energy efficiency, decentralization, and security. We also look at the strengths and weaknesses of each algorithm as well as their potential impact on the scalability and adoption of blockchain technology.

Insulin resistance, induced by high fructose consumption, affects cognitive function negatively. Nifedipine may be suggested for neurological disorders. This study aimed to assess the effect of nifedipine with either a normal diet (ND) or a ketogenic diet (KD) in cognitive dysfunction. Male Wistar rats received 10% fructose in drinking water for 8 weeks to induce insulin resistance. Rats received nifedipine (5.2 mg/kg/day; p.o.) later with ND or KD for an additional five weeks. One and two-way ANOVAs were used in analyzing the data. Reversion to the ND improved insulin resistance and lipid profile, besides brain-derived neurotrophic factor (BDNF), glycogen synthase kinase-3 beta (GSK3β), and insulin-degrading enzyme (IDE) levels. Rats fed KD alone and those that received nifedipine with KD did not show similar improvement in the previously mentioned parameters as the ND group. However, nifedipine-ND rats showed improvement in cognitive behavior and insulin resistance. Treatment with nifedipine-KD ameliorated GSK3β, amyloid β (Aβ), and tau protein levels. As the nifedipine-KD combination succeeded in diminishing the accumulated Aβ and tau protein, KD may be used for a while due to its side effects, then nifedipine treatment could be continued with an ND. This conclusion is based on the finding that this combination mitigated insulin resistance with the associated improved behavior.

One interesting method for environmental remediation is the use of ZnO/ZrO2 composites in the photocatalytic degradation of lead (Pb) in wastewater. Several studies have investigated different types of composites for the removal of heavy metals from wastewater. However, the efficiency of these composites in removing the heavy metals remains debatable. Hence, this study investigated the potential of using a ZnO/ZrO2 composite for the removal of Pb from wastewater. Response surface methodology (RSM) was utilized in this work to maximize the Pb photocatalytic removal over ZnO/ZrO2 in simulated wastewater. Based on a central composite design (CCD), the experimental design included adjusting critical process parameters such as catalyst dosage, initial Pb concentration, and pH. The ZnO/ZrO2 composite was synthesized using a physical mixing technique, and its physicochemical properties were studied by field emission scanning electron microscopy (FESEM), energy dispersive X-ray spectroscopy (EDS), Fourier transform infra-red (FTIR), and X-ray diffraction (XRD). Under visible light irradiation, photocatalytic Pb removal tests were carried out in a batch reactor. The findings showed that a ZnO/ZrO2 dose of 100 mg/L, a pH of 10, and an initial Pb content of 15 ppm were the optimal conditions for maximal Pb removal (above 91.2%). The actual Pb removal obtained from the experimental runs was highly correlated with that predicted using the RSM quadratic model. The usefulness of ZnO/ZrO2 composites for photocatalytic Pb removal is demonstrated in this work, which also emphasizes the significance of RSM in process parameter optimization for improved pollutant degradation. The models that have been proposed offer significant perspectives for the development and scalability of effective photocatalytic systems intended to remove heavy metals from wastewater.

One flavonoid glycoside with demonstrated therapeutic potential for several illnesses, including cancer, is hesperidin. However, because of its limited bioavailability and solubility, it is only marginally absorbed, necessitating a delivery mechanism to reach the intended therapeutic target. Additionally, the cytoskeleton of crustaceans yields chitosan, a naturally occurring biopolymer with mucoadhesive properties that has been used to improve the absorption of advantageous chemical substances like flavonoids. Chitosan/hesperidin nanoparticles (Hes-Nanoparticles) were made using the ion gelation technique. The synthesis of Hes-Nanoparticles was confirmed by several characterization methods, including the swelling test, zeta potential, particle size, FTIR, XRD, TEM, and SEM. DPPH and ABTS were used to demonstrate radical scavenging activity in antioxidant assays of chitosan, hesperidin, and the synthesized Hes-Nanoparticles. In addition, by a viability assay against MDA-MB-231, the anticancer efficacies of chitosan, hesperidin, and the synthesized Hes-Nanoparticles were assessed. Furthermore, annexin-V/PI double staining and the cycle of cell analysis were determined by flow cytometry. The results displayed that Hes-Nanoparticles have higher antioxidant activity than chitosan and hesperidin alone. Also, it has been demonstrated that Hes-Nanoparticles are more effective in early cell cycle arrest, suppressing the viability of cancer cells, and increasing cell apoptosis than chitosan and hesperidin alone. In conclusion, Hes-Nanoparticles demonstrated more antioxidant and antitumor activities than chitosan and hesperidin alone. Moreover, it has been established that Hes-Nanoparticles, in a highly soluble form, increase activity in contrast to the poorly soluble form of hesperidin alone.

Breast cancer (BC) and depression are globally prevalent problems. Numerous reviews have indicated the high prevalence of depression among BC survivors. However, the long-term impact of depression on survival among BC survivors has not been well explored. For this investigation, we aimed to explore the relationship between BC, depression, and mortality from a national random sample of adult American women. Data from the U.S. National Health and Nutrition Examination Survey (years 2005–2010) were linked with mortality data from the National Death Index up to December 31st, 2019. A total of 4719 adult women (ages 45 years and older) were included in the study sample with 5.1% having breast cancer and more than a tenth (12.7%) having depression. The adjusted hazard ratio (HR) for all-cause mortality risk among those with BC was 1.50 (95% CI = 1.05–2.13) compared to those without BC. In the adjusted analysis, the risk of all-cause mortality was highest among women with both depression and BC (HR = 3.04; 95% CI = 1.15–8.05) compared to those without BC or depression. The relationship between BC and mortality was moderated by cardiovascular diseases, anemia, smoking, age, PIR, and marital status. Our analysis provides vital information on factors that could be helpful for interventions to reduce mortality risk among those with BC and depression. In addition, given the higher risk of mortality with co-occurring BC and depression, collaborative healthcare practices should help with widespread screening for and treatment of depression among BC survivors.

Despite limited evidence to support its efficacy, use of pulmonary artery catheter (PAC), a relatively expensive medical device, for monitoring clinical status and guiding therapeutic interventions, has become standard of care in many settings, and especially during and after cardiac surgery. We examined the prevalence and predictors of PAC use and its association with hospitalization charges among cardiac surgery patients generally and for each selected subgroup of high-risk or complex surgical procedures. We conducted an analysis on 1,442,528 records from the National Inpatient Sample (1999–2019) that included cardiac surgery patients ≥18 years of age. Subgroups were categorized based on the presence of specific disorders like tricuspid or mitral valve disease, pulmonary hypertension, heart failure, or cardiac surgery combinations. Multivariable regression models were constructed to assess predictors of PAC use as well as PAC use as a predictor of loge hospitalization charges controlling for patient and hospital characteristics. Based on International Classification of Diseases procedure codes, PAC use was prevalent among 7.15 % of cardiac surgery hospitalizations, and hospitalization charges were estimated at $191,345, with no differences according to PAC use. Overall, being female, having Charlson comorbidity index (CCI) > 0, and non-payer (versus Medicare) status were independently associated with PAC use. Among the subgroup with the selected conditions, being female, having CCI>0, and being a Medicaid (versus Medicare) recipient were independently associated with PAC use, whereas elective admission was inversely related to PAC use. Among the subgroup without the selected conditions, having a CCI >0, elective admission, and non-payer (vs. Medicare) status were independently associated with PAC use. PAC use was not independently related to hospitalization charges overall or among subgroups. In conclusion, approximately 7 % of cardiac surgery hospitalizations received a PAC, with no differences in charges according to PAC use and disparities in PAC use driven by sex, elective admission, CCI and health insurance status. Large randomized trials are required to characterize the safety, efficacy, and cost-effectiveness of PAC use among distinct groups of patients undergoing cardiac surgery.

Nanoparticles are involved in regulating the biology of cancer cell treatment, but their mechanism is not fully understood. We synthesized and characterized new green lead nanoparticles (gPbNPs) by using an extract of Ziziphus spina christi leaves. Its cytotoxic and apoptotic effect on the human colon cancer Cacoa2 cell line was evaluated. The gPbNPs were characterized by using energy dispersive X-rays, scanning electron microscopes, and transmission electron microscopes. The cytotoxic effects of gPbNPs against the human colon cancer Cacoa2 cell line were investigated, as were the possible mechanisms underlying the induction of apoptosis. In this experiment, we observed the production of intracellular reactive oxygen species (ROS) in cells, and the installation of caspase 3/7 was higher in cells at 16 µg/mL of gPbNPs. Moreover, the Bax gene was upregulated and the Bcl2 gene was downregulated, and increased caspase-3/7 activity confirmed the apoptotic effect of gPbNPs in cells. The cytotoxicity test confirmed that gPbNPs were selectively toxic in cancer cells and induced apoptosis by activating bad, bax, caspase-3/7, p27, p53 protein, and proteins involved in apoptosis. Our observation showed that gPbNPs induced cell toxicity, increased generation of intracellular ROS, and gene expression of Bcl2, and Bax, in the Cacoa2 cell line. In conclusion, these findings demonstrated that gPbNPs executed toxic effects on the Cacoa2 cell line by activating caspase-3/7 activity.

The objective underlined in this work is to apply Rotary Friction Welding (RFW) process to joint similar AA2024 and TiAl6V4 welds. The experiment is conducted by varying the input parameters (rotational speed, friction pressure and friction time) using Taguchi’s L9 orthogonal array method. MINITAB software was used to plot the response chart. The output parameter considered in this approach is the Ultimate Tensile Strength (UTS) of the weld joint, where the optimum RFW condition for maximizing the UTS were determined. Besides, the most influential process parameter has been determined using statistical analysis of variance (ANOVA). Finally, the general regression equations of the UTS for both materials are formulated and confirmed by means of the experimental tests values.

Abstract Background Vietnam and Saudi Arabia have high disease burden of primary hepatocellular carcinoma (HCC). Early detection in asymptomatic patients at risk for HCC is a strategy to improve survival outcomes in HCC management. GALAD score, a serum-based panel, has demonstrated promising clinical utility in HCC management. However, in order to ascertain its potential role in the surveillance of the early detection of HCC, GALAD needs to be validated prospectively for clinical surveillance of HCC (i.e., phase IV biomarker validation study). Thus, we propose to conduct a phase IV biomarker validation study to prospectively survey a cohort of patients with advanced fibrosis or compensated cirrhosis, irrespective of etiologies, using semi-annual abdominal ultrasound and GALAD score for five years. Methods We plan to recruit a cohort of 1,600 patients, male or female, with advanced fibrosis or cirrhosis (i.e., F3 or F4) and MELD ≤ 15, in Vietnam and Saudi Arabia (n = 800 each). Individuals with a liver mass ≥ 1 cm in diameter, elevated alpha-fetoprotein (AFP) (≥ 9 ng/mL), and/or elevated GALAD score (≥ -0.63) will be scanned with dynamic contrast-enhanced magnetic resonance imaging (MRI), and a diagnosis of HCC will be made by Liver Imaging Reporting and Data System (LiRADS) assessment (LiRADS-5). Additionally, those who do not exhibit abnormal imaging findings, elevated AFP titer, and/or elevated GALAD score will obtain a dynamic contrast-enhanced MRI annually for five years to assess for HCC. Only MRI nearest to the time of GALAD score measurement, ultrasound and/or AFP evaluation will be included in the diagnostic validation analysis. MRI will be replaced with an abdominal computed tomography scan when MRI results are poor due to patient conditions such as movement etc. Gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid-enhanced MRI will not be carried out in study sites in both countries. Bootstrap resampling technique will be used to account for repeated measures to estimate standard errors and confidence intervals. Additionally, we will use the Cox proportional hazards regression model with covariates tailored to the hypothesis under investigation for time-to-HCC data as predicted by time-varying biomarker data. Discussion The present work will evaluate the performance of GALAD score in early detection of liver cancer. Furthermore, by leveraging the prospective cohort, we will establish a biorepository of longitudinally collected biospecimens from patients with advanced fibrosis or cirrhosis to be used as a reference set for future research in early detection of HCC in the two countries. Trial registration Name of the registry: ClinicalTrials.gov Registration date: 22 April 2022 Trial registration number: NCT05342350 URL of trial registry record

Abstract Objective To evaluate the efficacy of strength exercise or aerobic exercise compared to usual care on knee-related quality of life (QoL) and knee function at 4 months and 1 year in individuals with knee osteoarthritis. Methods A three-arm randomized controlled trial (RCT) compared 12 weeks of strength exercise or aerobic exercise (stationary cycling) to usual care supervised by physiotherapists in primary care. We recruited 168 participants aged 35–70 years with symptomatic knee osteoarthritis. The primary outcome was The Knee Injury and Osteoarthritis Outcome Score (KOOS) QoL at 1 year. Secondary outcomes were self-reported function, pain, and self-efficacy, muscle strength and maximal oxygen uptake (VO2max) at 4 months and 1 year. Results There were no differences between strength exercise and usual care on KOOS QoL (6.5, 95% CI -0.9 to 14), or for aerobic exercise and usual care (5.0, 95% CI -2.7 to 12.8), at 1 year. The two exercise groups showed better quadriceps muscle strength, and VO2max at 4 months, compared to usual care. Conclusion This trial found no statistically significant effects of two exercise programs compared to usual care on KOOS QoL at 1 year in individuals with symptomatic and radiographic knee osteoarthritis, but an underpowered sample size may explain lack of efficacy between the intervention groups and the usual care group. ClinicalTrials.gov Identifier NCT01682980.

ABSTRACTThe medicinal use of Salsola tetragona Delile (Amaranthaceae) aerial parts is a longstanding tradition. This study delved into the plant’s potential as an antioxidant, anti-diabetic, and anti-Alzheimer agent. The aerial portion extracted and evaluated four fractions (n-hexane, dichloromethane, ethyl acetate, n-butanol) for their antioxidant activity using DPPH, FRAP, and anti-hemolysis tests, as well as the inhibitory activity of cholinesterase and carbohydrate digesting enzymes. The results showed that the dichloromethane fraction (St.DCM) of S. tetragona had a significant ability to scavenge DPPH• radicals. The ethyl acetate fraction (St.EtOAc) had the best reduction power test activity compared to other solvent fractions. The n-hexane fraction (St.Hex) was most effective in the anti-hemolysis test. The ethyl acetate fraction also had inhibitory activities (p

Abstract To examine associations of pulmonary artery catheter (PAC) use with in-hospital death and hospital length of stay (days) overall and within subgroups of hospitalized cardiac surgery patients. Secondary analyses of 1999–2019 National Inpatient Sample data were performed using 969,034 records (68% male, mean age: 65 years) representing adult cardiac surgery patients in the United States. A subgroup of 323,929 records corresponded to patients with congestive heart failure, pulmonary hypertension, mitral/tricuspid valve disease and/or combined surgeries. We evaluated PAC in relation to clinical outcomes using regression and targeted maximum likelihood estimation (TMLE). Hospitalized cardiac surgery patients experienced more in-hospital deaths and longer stays if they had ≥ 1 subgroup characteristics. For risk-adjusted models, in-hospital deaths were similar among recipients and non-recipients of PAC (odds ratio [OR] 1.04, 95% confidence interval [CI] 0.96, 1.12), although PAC was associated with more in-hospital deaths among the subgroup with congestive heart failure (OR 1.14, 95% CI 1.03, 1.26). PAC recipients experienced shorter stays than non-recipients (β = − 0.40, 95% CI − 0.64, − 0.15), with variations by subgroup. We obtained comparable results using TMLE. In this retrospective cohort study, PAC was associated with shorter stays and similar in-hospital death rates among cardiac surgery patients. Worse clinical outcomes associated with PAC were observed only among patients with congestive heart failure. Prospective cohort studies and randomized controlled trials are needed to confirm and extend these preliminary findings.

Dysferlin is a large transmembrane protein involved in critical cellular processes including membrane repair and vesicle fusion. Mutations in the dysferlin gene (DYSF) can result in rare forms of muscular dystrophy; Miyoshi myopathy; limb girdle muscular dystrophy type 2B (LGMD2B); and distal myopathy. These conditions are collectively known as dysferlinopathies and are caused by more than 600 mutations that have been identified across the DYSF gene to date. In this review, we discuss the key molecular and clinical features of LGMD2B, the causative gene DYSF, and the associated dysferlin protein structure. We also provide an update on current approaches to LGMD2B diagnosis and advances in drug development, including splice switching antisense oligonucleotides. We give a brief update on clinical trials involving adeno-associated viral gene therapy and the current progress on CRISPR/Cas9 mediated therapy for LGMD2B, and then conclude by discussing the prospects of antisense oligomer-based intervention to treat selected mutations causing dysferlinopathies.

Healthy dietary patterns rich in flavonoids may benefit cognitive performance over time. Among socioeconomically disadvantaged groups, the association between flavonoid intake and measures of cognition is unclear. This study sought to identify associations between flavonoid intake and cognitive performance among Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study participants (n = 1947) across three study visits. Flavonoid intakes were assessed via two 24-h dietary recalls. Cognitive performance was assessed via the Trail Making Test (TMT)-A and TMT-B, which provide measures of attention and executive function, respectively. Mixed effects linear regression was used to model TMT scores over three study visits against visit 1 (v1) flavonoid intake, time (years from v1), and the interaction between v1 flavonoid intake and time, capturing both the cross-sectional association between flavonoid intake and time at v1 as well as the longitudinal association between v1 flavonoid intake and the change in TMT scores over time. Prior to adjustment, inverse cross-sectional associations at v1 were observed between (1) anthocyanidin intake and TMT-A scores for the overall sample and (2) total flavonoid, anthocyanidin, flavan-3-ol, flavone, and flavonol intake and TMT-B scores for the overall sample and among White adults. Only the association between anthocyanidin intake and TMT-B at v1 among White adults persisted after adjustment (for demographic characteristics such as age). One possible explanation for the few significant associations is universally low flavonoid intakes resulting from the consumption of an unhealthy dietary pattern.

Methicillin-resistant Staphylococcus aureus (MRSA) is a common resistant bacterium, whose resistance has expanded to commonly used antibiotics. It is crucial to create novel treatments to tackle bacterial resistance. Trans-resveratrol and curcumin are naturally occurring phenolic compounds, whose effects on MRSA virulence are the subject of this investigation. Sub-MICs of trans-resveratrol and curcumin were tested on the virulence factors of 50 MRSA clinical isolates (CIs), including biofilm, hemolysin, hemagglutination, protease, and lecithinase. The distribution of the virulence factors of the CIs was as follows: hemolysin: 98%, hemagglutination: 70%, protease: 62%, biofilm: 56%, and lecithinase: 52%. The sub-MIC that could reduce the effect of the tested virulence factors by 50% or more (IC50) was observed in the strains that showed susceptibility to the individual administration of trans-resveratrol at 50 µg/mL and curcumin at 20 µg/mL. Hemagglutination and hemolysin activity were inhibited by at least 50% in the majority of CIs (57–94%). Meanwhile, the IC50 for protease and biofilm was observed in 6.5–17.8% of the CIs. A few of the CIs were susceptible to lecithinase inhibition, but all showed a full inhibition. This research supports the possibility of the use of these compounds to reduce the bacterial virulence that can reduce antibiotic utilization, and eventually, they can become a potential alternative treatment in combating bacterial resistance.

Designers actively pursue the use of novel materials and concepts in furniture and interior design. By providing insights into their processing behavior and suitability for 3D-printing processes, this research helps to highlight the potential of using waste materials to create more environmentally friendly and sustainable 3D-printing filaments that can be used in furniture and interior design. Furthermore, the study evaluates the effect of incorporating palm midrib nanoparticles (DPFNPs) to reinforce a high-density polyethylene (HDPE) matrix with different loadings such as 10, 20, 30, 40, and 50 wt.%. The composites were extruded into filaments using a manual extruder, which was then utilized to fabricate 3D-printed specimens using a 3D-printing pen. The effect of adding DPFNPs on the composite’s chemical, thermal, and mechanical properties was evaluated, with a particular focus on how these modifications influence the melt flow rate (MFR) and, subsequently, the material’s printability. The results revealed that HDPE and filament composites presented similar FTIR spectra. On the other hand, the filament composites presented an increase in the thermal stability and a decrease in the mechanical strength with increasing DPFNP content in the HDPE matrix. The filaments were successfully printed using a 3D-printing pen. Thus, using DPFNPs in the HDPE matrix presents a low-cost alternative for filament production and may expand 3D-printing applications in interior and furniture design with more sustainable materials. Future work will delve into optimizing these composites for improved printability and assessing their recyclability, aiming to broaden their applications in 3D printing and beyond.

Abstract Hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) are the most common healthcare-associated infections, with rates varying between countries. Antimicrobial resistance (AMR) among common HAP/VAP pathogens has been reported, and multidrug resistance (MDR) is of further concern across Middle Eastern countries. This narrative review summarizes the incidence and pathogens associated with HAP/VAP in hospitals across Gulf Cooperation Council (GCC) countries. A PubMed literature search was limited to available data on HAP or VAP in patients of any age published within the past 10 years. Reviews, non-English language articles, and studies not reporting HAP/VAP data specific to a GCC country were excluded. Overall, 41 articles, a majority of which focused on VAP, were selected for inclusion after full-text screening. Studies conducted over multiple years showed a general reduction in VAP rates over time, with Gram-negative bacteria the most commonly reported pathogens. Gram-negative isolates reported across GCC countries included Acinetobacter baumannii, Pseudomonas aeruginosa, and Klebsiella pneumoniae. Rates of AMR varied widely among studies, and MDR among A. baumannii, K. pneumoniae, Escherichia coli, P. aeruginosa, and Staphylococcus aureus isolates was commonly reported. In Saudi Arabia, between 2015 and 2019, rates of carbapenem resistance among Gram-negative bacteria were 19–25%; another study (2004–2009) reported antimicrobial resistance rates in Acinetobacter species (60–89%), P. aeruginosa (13–31%), and Klebsiella species (100% ampicillin, 0–13% other antimicrobials). Although limited genotype data were reported, OXA-48 was found in ≥ 68% of patients in Saudi Arabia with carbapenem-resistant Enterobacteriaceae infections. Ventilator utilization ratios varied across studies, with rates up to 0.9 reported in patients admitted to adult medical/surgical intensive care units in both Kuwait and Saudi Arabia. VAP remains a burden across GCC countries albeit with decreases in rates over time. Evaluation of prevention and treatment measures and implementation of a surveillance program could be useful for the management of HAP and VAP.

In the ozonation process, the phenol degradation in wastewater undergoes a low mass transfer mechanism. In this study, ozonized packed bubble column reactor was designed and constructed to remove phenol. The reactor’s inner diameter and height were 150 and 8 cm, respectively. The packing height was kept constant at 1 m in accordance with the reactor hydrodynamics. The gas distributor was designed with 55 holes of 0.5 mm. The phenol removal efficiency was evaluated at ozone concentrations of 10, 15, and 20 mg/L, contact times of 15, 30, 45, 60, 75, 90, 105, and 120 min, and phenol concentrations of 3, 6, 9, 12, and 15 mg/L. The results indicated that the highest phenol removal efficiency of 100% was achieved at 30 min in presence of packing. Moreover, the use of packing improved the contact between the gas and liquid, which significantly enhanced the phenol degradation. Actually, a thin film over a packing surface enhances the mass transfer. Also, it was found that the phenol is degraded into CO2 and H2O through a series of reaction steps. Additionally, a kinetic study of a first-order reaction provided an efficient estimation of reaction parameters with a correlation factor of 0.997.

ازداد في الآونة الأخيرة الاتجاه نحو استخدام اللعاب كبديل عن المصل في تشخيص العديد من الحالات في طب الأسنان , وكذلك الاهتمام بالأنزيمات والبحث عن وجود علاقة بين مستويات الأنزيمات والمعالجات المختلفة.وباعتبار الفوسفات القلوي من المحددات الأساسية لإعادة تشكيل العظام توجهالاهتمام بالبحث عن علاقة لاختلاف تركيز اللعاب لهذا الانزيم وربطها بالحركة السنية التقويمية . هدف الدراسة: تقييم مستويات أنزيم الأكالين فوسفات(Alp) في اللعاب عند المرضى المعالجون بأجهزة تقويمية ثابتة في مرحلة رصف وتسوية الأسنان. المواد والطرق: تضمنت عينة الدراسة( 9) مرضى من مراجعين قسم تقويم الأسنان والفكين وهم بحاجة لمعالجة بجهاز تقويمي ثابت، تم أخذ عينة من اللعاب من خلال محقنة بلاستيكية نبوذة( 3مل ) قبل العمل وبعد تركيب الجهاز وبعد عدة فترات أخرى ومعايرة اللعاب ضمن جهاز مقياس الطيف الضوئي . النتائج: كان هناك ارتفاع بمستوى الأنزيم بعد 7 أيام من العمل و بعد 14 يوم وكان هذا الارتفاع هام احصائيا.في حين لم يكن هناك أي تغيرات خلال الساعة الأولى و اليوم الأول. الاستنتاجات: يمكن استخدام الألكالين فوسفات (Alp)كمؤشر حيوي في اللعاب.

Background: Magnesium (Mg) deficiency is closely linked with proteinuria. Objectives: To assess the impact of oral Mg citrate supplementation on the clinical outcome of diabetic nephropathy (DN) patients. Design: This was a prospective, randomized, controlled, open-label study. Methods: Sixty DN patients were recruited from Nephrology and Endocrinology departments, Ain Shams University Hospitals, Cairo, Egypt. Patients were assigned by stratified randomization based on their Mg status, to either Mg citrate group, ( n = 30), who received the standard regimen + oral Mg citrate 2.25 g/day or Control group, ( n = 30), who received the standard regimen only. The primary endpoint was a change in urinary albumin to creatinine ratio (UACR) after 12 weeks. Secondary outcomes were insulin resistance, glycemic control, lipid profile, serum osteocalcin, quality of life (QoL) and Mg tolerability. Results: Out of a total of 60 patients enrolled, only 54 patients (26 in Mg citrate group and 28 in the control group) completed the study. Groups were comparable at baseline. The UACR median percent reduction was significantly higher in the Mg citrate group (−6.87%) versus (−0.9%) in the Control group, p = 0.001. After 12 weeks, the estimated glomerular filtration rate significantly improved in the Mg citrate group versus Control group ( p = 0.001). Comparable change was observed in glycemic indices. Lipid profile significantly improved in the Mg citrate group versus Control group ( p = 0.001). Serum osteocalcin levels significantly declined in the Mg citrate group ( p = 0.001) versus control group. Regarding QoL, the total score and all domains significantly improved in the Mg citrate group compared to control. The Mg supplement was tolerable with only mild reported side effects that required no intervention. Conclusion: Oral Mg citrate supplementation improved microalbuminuria in DN patients. It also had favorable effects on serum osteocalcin, lipid profile and QoL with no reported major side effects. Trial registration: ClinicalTrials.gov identifier: NCT03824379.

Summary: The plasma proteome can mediate the association of hospital-treated infections with dementia incidence. We screened up to 37,269 UK Biobank participants aged 50–74 years for the presence of a prevalent hospital-treated infection, subsequently tested as a predictor for ≤1,463 plasma proteins and dementia incidence. Four-way decomposition models decomposed infection-dementia total effect into pure mediation, pure interaction, neither or both through the plasma proteome. Hospital-treated infections increased dementia two-fold. The strongest mediation effect was through the growth differentiation factor 15 (GDF15) protein. Top 17 proteomic mediators explained collectively 5% of the total effect, while pathway analysis of all mediators (k = 221 plasma proteins) revealed top pathways including the immune system, signal transduction, metabolism, disease and metabolism of proteins, with the GDF15 cluster reflecting most strongly the “transmembrane receptor protein tyrosine kinase signaling pathway”. The association of hospital-treated infections with dementia was partially mediated through GDF15 and other plasma proteomic markers.

Background Concern exists regarding the renal safety of blocking the renin-angiotensin system (RAS) during acute illness, especially in the presence of volume depletion and hemodynamic instability.Methods We explored the impact of loop diuretics and RAS blockers on the likelihood of developing acute kidney injury (AKI) or acute kidney functional recovery (AKR) among inpatients. Adjusted odds ratio for AKI, AKR and mortality was calculated, using logistic regression models, with subgroup analysis for patients with estimated glomerular filtration rate (eGFR)

Background: There is a need for scalable evidence-based psychological interventions for young adolescents experiencing high levels of psychological distress in humanitarian settings and low- and middle-income countries. Poor mental health during adolescence presents a serious public health concern as it is a known predictor of persistent mental disorders in adulthood. This study evaluates the effectiveness of a new group-based intervention developed by the World Health Organization (Early Adolescent Skills for Emotions; EASE), implemented by non-specialists, to reduce young adolescents' psychological distress among mostly Syrian refugees in Lebanon. Methods: We conducted a two-arm, single-blind, individually randomized group treatment trial. Adolescents aged 10 to 14 years who screened positive for psychological distress using the Pediatric Symptom Checklist (PSC) were randomly allocated to EASE or enhanced treatment as usual (ETAU) (1:1.6). ETAU consisted of a single scripted psycho-education home-visit session with the adolescent and their caregivers. EASE consists of seven group sessions with adolescents and three sessions with caregivers. The primary outcome was adolescent-reported psychological distress as measured with the PSC (internalizing, externalizing, and attentional symptoms). Secondary outcomes included depression, posttraumatic stress, well-being, functioning, and caregivers' parenting and distress. All outcomes were assessed at baseline, endline, and 3 months (primary time point) and 12 months follow-up. Results: Due to the COVID-19 pandemic and other adversities in Lebanon at the time of this research, the study was prematurely terminated, resulting in an under-powered trial sample (n = 198 enrolled compared to n = 445 targeted). We screened 604 children for eligibility. The 198 enrolled adolescents were assigned to EASE (n = 80) and ETAU (n = 118), with retention rates between 76.1 and 88.4% across all timepoints. Intent-to-treat analyses demonstrated no between-group differences on any of the outcome measures between the EASE and ETAU. We did observe a significant improvement on the primary outcome equally in the EASE and ETAU groups (−0.90, 95% CI: −3.6, 1.8; p = .52), − a trend that was sustained at three months follow-up. Sub-group analyses, for those with higher depression symptoms at baseline, showed ETAU outperformed EASE on reducing depression symptoms (difference in mean change = 2.7, 95% CI: 0.1, 5.3; p = .04; d = 0.59) and internalizing problems (difference in mean change 1.0, 95% CI: 0.08, 1.9; p = .03; d = 0.56) . Conclusion: No conclusions can be drawn about the comparative effectiveness of the intervention given that the sample was underpowered as a result of early termination. Both EASE and single session psycho-education home visits resulted in meaningful improvements in reducing psychological distress. We did not identify any indications in the data suggesting that EASE was more effective than a single session family intervention in the context of the COVID-19 pandemic and other crises in Lebanon. Fully powered research is needed to evaluate the effectiveness of EASE.

Explain in this study, thickness has an inverse relationship with electrical resistivity and a linear relationship with Grain boundary scattering. According to the (Fuchs-Sondheier, Mayadas-Shatzkces) model, grain boundary scattering leads To an Increase in electrical Resistivity. The surface scattering Coefficient of Ag, which Fuchs-Sondheier and Mayadas-Shatzkces measured at , Ag's grain boundary reflection coefficient , which Mayadas-Shatzkces measured at , If the concentration of material has an effect on metal's electrical properties, According to this silver is a good electrical conductor and is used frequently in electrical and electronic circuits.

The aim of this work is to investigate the effect of normal pressure upon the mechanical properties and their related microstructures of the similar Ti-6Al-4V and AA2024 Rotary Friction Welding (RFW) joints. The main characteristic of this process is the use of friction to generate adequate energy and raise temperature locally in order to create favorable conditions for welding at the interface between two parts. Successful welds were produced showing, among many others, that the fracture occurres at the weld interface for the AA2024 alloy, hence its low tensile strength. However, the fracture occurres outside the weld interface for the Ti-6Al-4V alloy, which indicates that the weld joint is more resistant than the base metal. The microscopic observation of the fracture surfaces of the AA2024 samples exhibits a mixture of morphologies with a majority of rough cupular surfaces, indicating a dominant ductile fracture mode. For the Ti-6Al-4V RFW joints, cupules of different sizes are observed over the entire surface that also exhibits a ductile fracture mode.

Abstract Background Globally, there is a vast mental health treatment gap, whereby the majority of adolescents living in low- and middle-income countries requiring mental health services, do not have access to adequate care. To improve access, the World Health Organization (WHO) developed a range of interventions, designed to be low-cost and delivered by non-specialists. We conducted a two-arm, individually randomised group treatment feasibility trial of a new WHO group intervention for young adolescents with emotional distress (‘Early Adolescent Skills for Emotions’; EASE) in Lebanon. Method The aim of this study was to determine the feasibility of the intervention and study procedures. Adolescents aged 10 to 14 years were eligible to take part if they scored above a validated cut-off on the Child Psychosocial Distress Screener. Participants were randomized to EASE or enhanced treatment as usual (ETAU) control using a 1:1 ratio. EASE consisted of seven group sessions with adolescents and three sessions with caregivers. ETAU consisted of a single brief psychoeducation home visit. Child and caregiver outcomes were measured by blind assessors at baseline, endline (8 weeks post-randomisation), and three month follow-up (20 weeks post-randomisation), with the primary outcome measure being child psychological symptoms on the Pediatric Symptom Checklist. Qualitative interviews were conducted with adolescents (n = 13), caregivers (n = 17), facilitators (n = 6), trainers (n = 3), and outreach staff (n = 1) at endline to assess barriers and facilitators related to the feasibility and delivery of EASE and study procedures. Results Of 154 adolescents screened, 67 (43%) were eligible, completed baseline, and were randomized. Sixty adolescents (90%) completed endline assessments (31 EASE, 29 ETAU), and fifty-nine (88%) completed three-month assessments (29 EASE, 30 ETAU). Qualitatively, participants provided overall positive feedback about the intervention. Several challenges and suggestions for improvement were raised around logistics, intervention content, and acceptability of assessment measures. Implementation data highlighted challenges with intervention uptake and attendance. Outcome measures generally had strong psychometric properties (range: α = 0.77 to α = 87), however did not demonstrate change over time in either group. Conclusions The EASE intervention and study procedures are acceptable and feasible for implementation with vulnerable adolescents in Lebanon, however several improvements are necessary prior to full-scale evaluation. Trial registration #ISRCTN60799626, retrospectively registered on 04/10/2022.

There is an increasing need to improve the competency and quality of non-specialists delivering psychological interventions. As part of the Ensuring Quality in Psychological Support (EQUIP) initiative, this study evaluates the process of roleplay-based competency assessments using three tools to assess the competencies of facilitators delivering a psychological intervention for children in Lebanon. With a group of five competency raters, five facilitators and four actors, this study uses a mixed methods approach, comprising competency assessment data, qualitative interviews and focus group discussions. Data were collected during a two-phase process. Findings of the study showed inter-rater agreement was generally acceptable after additional training of raters. Eventually, it is feasible to prepare actors, facilitators and raters on roleplays for effective implementation of competency-driven training. As for the non-specialists, it was found that overall the experience of taking part in competency assessments was useful to understand their points of improvement. Pre- to post-training improvements in competencies showed that despite reported feelings of anxiety, the facilitators benefited from the feedback given on their competencies. We concluded that using roleplay-based competency assessments and preparing for competency-based training is feasible and useful to ensure quality control in mental health and psychosocial support (MHPSS) service provision.

Social engineering attacks rely on human errors and behavioral choices. The semantic attack, a subcategory of social engineering attacks, utilizes behavioral or cosmetic deception vectors (e.g., attacker creates a malicious website that looks like and behaves like the legitimate one). The most common types of social semantic attacks include phishing, spamming, defacement, and malware attacks. We investigate the feasibility of developing URL-based social semantic attack detection models utilizing character-aware language models. Specifically, we developed three types of models: long short-term memory (LSTM)-based detection model, convolutional neural network (CNN)-based detection model, and CharacterBERT-based detection model. We benchmarked performances of different models for different attacks. Using the characterBERT-based detection model, the overall evaluation recorded a high detection accuracy of 99.65% by averaging the results of performing a 5-fold cross-validation. Considering the model performance per class, the CharacterBERT model ranked the best model among our 3 models in detecting the social semantic attacks, reaching best accuracy of 99.90% in detecting defacement attack.

Introduction: Infection control procedures are implemented in dental clinics to reduce the risk of cross-contamination; saliva, blood, or airborne droplets containing infective agents are example of direct contamination, while indirect exposure via contact with contaminated surfaces and dental equipments such as dental chair, tray, faucet, air syringe, suction tip, gutta percha, paper points, retraction cords, and dental floss containers. Dental floss is known to be an integral part of most dental procedures. Objectives: The objective of this study was to assess the knowledge and awareness regarding cross-contamination of dental floss containers among a selected population of dental assistants in dental clinics at King Saud University (KSU). Material and Methods: A swab was taken from 60 dental floss containers selected by simple random sampling among 60 different dental clinics at KSU and culture test was done using a charcoal transport swab to identify the type of bacteria that might be present on the dental floss containers. Also a Google forms questionnaire which consisted of 20 multiple choice questions, including demographic questions on gender, nationality, and professional experience, followed by questions to evaluate different infection control concepts and practices. Results: This study included 70 dental assistants, most of whom were female (94.3 %). A significant number (41.4 %) of the dental assistants have never heard of OSHA course, and most of them (77.1 %) have never taken an OSHA course. Some participants who attended > 2 infection control courses (37.8 %) did not disagree that it is a waste of material to use new gloves to clean each clinic. Regarding the laboratory results for the collected samples, the highest frequency was noted for Staphylococcus hominis (27.8 %). Conclusion: The present study concluded that there is still further need for implementation of infection control programs and raising more awareness regarding this subject.

Autism spectrum disorder (ASD) is a developmental disorder that encompasses difficulties in communication (both verbal and non-verbal), social skills, and repetitive behaviors. The diagnosis of autism spectrum disorder typically involves specialized procedures and techniques, which can be time-consuming and expensive. The accuracy and efficiency of the diagnosis depend on the expertise of the specialists and the diagnostic methods employed. To address the growing need for early, rapid, cost-effective, and accurate diagnosis of autism spectrum disorder, there has been a search for advanced smart methods that can automatically classify the disorder. Machine learning offers sophisticated techniques for building automated classifiers that can be utilized by users and clinicians to enhance accuracy and efficiency in diagnosis. Eye-tracking scan paths have emerged as a tool increasingly used in autism spectrum disorder clinics. This methodology examines attentional processes by quantitatively measuring eye movements. Its precision, ease of use, and cost-effectiveness make it a promising platform for developing biomarkers for use in clinical trials for autism spectrum disorder. The detection of autism spectrum disorder can be achieved by observing the atypical visual attention patterns of children with the disorder compared to typically developing children. This study proposes a deep learning model, known as T-CNN-Autism Spectrum Disorder (T-CNN-ASD), that utilizes eye-tracking scans to classify participants into ASD and typical development (TD) groups. The proposed model consists of two hidden layers with 300 and 150 neurons, respectively, and underwent 10 rounds of cross-validation with a dropout rate of 20%. In the testing phase, the model achieved an accuracy of 95.59%, surpassing the accuracy of other machine learning algorithms such as random forest (RF), decision tree (DT), K-Nearest Neighbors (KNN), and multi-layer perceptron (MLP). Furthermore, the proposed model demonstrated superior performance when compared to the findings reported in previous studies. The results demonstrate that the proposed model can accurately classify children with ASD from those with TD without human intervention.

Nalbuphine is associated with a significant risk of respiratory depression. Its central nervous system entry is hindered by P-glycoproteins, and lower P-glycoprotein activity is a risk factor for respiratory depression. We assessed the effect of hyperlipidemia on nalbuphine pharmacokinetics, brain and liver uptake, and analgesic response following single (2.5 mg/kg) and multiple (2.5 mg/kg/day for three days) doses in normolipidemic and hyperlipidemic rats. Trends of reduction and increase in nalbuphine Cmax and Vdss/F were observed, respectively, in hyperlipidemic rats. Negative correlations were observed between Cmax and serum lipoproteins. Serum-normalized brain and liver levels at 1 h post-dose were lower in hyperlipidemic rats, with brain and liver levels being negatively and positively correlated with TG and HDL, respectively. At steady state, marked nalbuphine accumulation was observed in hyperlipidemic rat brains (R = 1.6) compared with normolipidemic rats (R = 1.1). Nalbuphine analgesic response was not altered by hyperlipidemia at steady state. Caution should be exercised since greater brain accumulation in hyperlipidemic patients treated with nalbuphine could increase their risk of respiratory depression. Our study highlights an unexpected role of lipoproteins in drug absorption and tissue uptake. We also propose a model for reduced nalbuphine absorption based on interaction with intestinal HDL-3.

The Q&U Bolometric Interferometer for Cosmology (QL’BIC) is the first bolometric interferometer designed to measure the primordial B-mode polarization of the Cosmic Microwave Background (CMB). Bolometric interferometry is a novel technique that combines the sensitivity of bolometric detectors with the control of systematic effects that is typical of interferometry, both key features in the quest for the faint signal of the primordial B-modes. A unique feature is the so-called “spectral imaging”, i.e., the ability to recover the sky signal in several sub-bands within the physical band during data analysis. This feature provides an in-band spectral resolution of ∆v/v ~ 0.04 that is unattainable by a traditional imager. This is a key tool for controlling the Galactic foregrounds contamination. In this paper, we describe the principles of bolometric interferometry, the current status of the QU BIC experiment and future prospects.

Indonesia faced several challenges regarding water quality such as water exploitation and contamination caused by human activities. Comprehensive and sustainable water management is required to ensure its availability for the society. Ecosystem quality monitoring is needed to make sure the availability of water resource all year round by using modelling to assist. This paper presented application of Artificial Neural Network (ANN) utilizing multilayer perception model with a backpropagation algorithm to predict water clarity in Saguling Reservoir provided by PT Indonesia Power. ANN performance of predicting water clarity level were evaluated using regression analysis (R2), Mean Absolute Error (MAE) and Mean Square Error (MSE). Based on the results, prediction data during rainy season shows better performance than dry season with R2 value of 0.94, MAE value of 0.035, and MSE value of 0.0032 meanwhile dry season data of R2, MAE, and MSE are 0.83, 0.041, and 0.0045 respectively. ANN prediction model demonstrated a relatively good prediction capability of water clarity and may be used as one of references in classifying the water quality level of Saguling Reservoir quantity and quality integrated maintenance.