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Background: Toxoplasma gondii is widely distributed in most parts of the world, affecting animals and humans. Toxoplasmosis is considered the third cause of death associated with food-borne infections in Europe (EFSA, 2007) and USA (Mead et al., 1999). Milk was implicated as a source of Toxoplasma gondii infection in several reports (Jackson and Hutchison). Bonametti et.al., described toxoplasmosis in breast fed child whose mother had acquire toxoplasmosis by ingestion of raw goat milk. Manal et,al.(2005) reported a prevalence of 61.7% in Sudanese camels. The aim of this study is to improve the role of naturally infected camel's milk as a source of human toxoplasmosis in Butana area - Sudan. Methods & Materials: Ten milk samples were collected from infected camels at Butana area (Eastern Sudan). The infection was confirmed by IgM anti-T. gondii ELISA test, using a commercial kit (DRG Instruments GmbH, Germany). For each milk sample, two naive kittens (3-week-old) were fed with 10 ml for each and four Albino mice were inoculated by gavage, 2 ml per sample for each mice. For each batch of samples inoculated, one kitten and three mice were kept as control and not inoculated. ELISA test was carried out on the survived infected kittens and mice sera. Fecal samples from kittens were examined daily for oocysts detection. An autopsy was carried out on mice and tissues were fixed in 10% formalin for histopathology to detect Toxoplasma tachyzoites or cysts. Results: All infected kittens began to shed Toxoplasma oocysts 3-5 days post infection. Infection was documented in all infected kittens and 21 of the 23 surviving mice by positive serology (ELISA) results. 17 mice were died at 3-14 day post infection. Toxoplasma tachyzoites were observed in the survived mice specimens. Non of the control kittens or mice showed evidence of infection by ELISA test. Conclusion: The excretion of Toxoplasma gondii tachyzoites in camel's milk documented in this study and the high sero-reactivity of Toxoplasma in camel's herders in Butana area (100%) reported previously by Khalil (2004), warrant a closer look into its public health significance among Sudanese nomads who consume raw camel's milk. [ABSTRACT FROM AUTHOR]

Background: Many classes of pathogens excreted in animals and human feces are responsible for waterborne disease. Protozoans are known to cause outbreaks disease worldwide and they are very robust in water environments and are strongly resistant to most disinfectants, including chemical procedures. Access to adequate supplies of good quality drinking water continues to be limited among many nomadic communities in Sudan where the major source of water, for both humans and livestock, is a rain-fed natural surface reservoir (hafir). The purpose of this work was to investigate the occurrence of oocysts and/or cysts, including those of Toxoplasma gondii, Cryptosporidium spp., and Giardia, which are the main parasites associated with waterborne diseases. Methods & Materials: Water samples from 21 stagnant small ponds (hafir) at Eastern Sudan, were collected, from October to March 2014, in sterile containers. Conventional detection of Giardia and Cryptosporidium spp relies on filtration, cyst concentration, purification, and detection steps by Fluoresceinated monoclonal antibodies. After that the eluate was centrifuged, the supernatant discarded and the pellet suspended in a sucrose suspension (density 1.15). After another centrifugation, 2 ml of this supernatant was collected and mixed with 8 ml of de ionized water, then, a final centrifugation was performed in order to collect sediment for Toxoplasma oocyst detection. Toxoplasma oocyst was confirmed by mice bioassay after sporulation in 2.5% potassium dichromate in an aerated tube for 7 days. ELISA test was carried out on the surviving mice, an autopsy was carried out on mice and tissues were fixed in 10% formalin for histopathology. Results: T. gondii oocysts were detected in 17 water samples, Cryptosporidium oocysts in 9 samples and Giardia cysts in 15 samples. Infection was documented in all surviving mice by positive serology (ELISA) results. Toxoplasma tachyzoites were observed in the mice specimens. There was no correlation between T. gondii presence in environmental water and the presence of Cryptosporidium or Giardia. Conclusion: The present study investigated fecal water pollution at the point of consumption among nomadic pastoralists communities and also showed that poor quality water continues to be a major risk factor for public health in Eastern Sudan communities. [ABSTRACT FROM AUTHOR]

Modern technology and analysis of emotions play a crucial role in enabling intelligent healthcare systems to provide diagnostics and self-assistance services based on observation. However, precise data predictions and computational models are critical for these systems to perform their jobs effectively. Traditionally, healthcare monitoring has been the primary emphasis. However, there were a couple of negatives, including the pattern feature generating the method's scalability and reliability, which was tested with different data sources. This paper delves into the Discriminant Input Processing Scheme (DIPS), a crucial instrument for resolving challenges. Data-segmentation-based complex processing techniques allow DIPS to merge many emotion analysis streams. The DIPS recommendation engine uses segmented data characteristics to sift through inputs from the emotion stream for patterns. The recommendation is more accurate and flexible since DIPS uses transfer learning to identify similar data across different streams. With transfer learning, this study can be sure that the previous recommendations and data properties will be available in future data streams, making the most of them. Data utilization ratio, approximation, accuracy, and false rate are some of the metrics used to assess the effectiveness of the advised approach. Self-assisted intelligent healthcare systems that use emotion-based analysis and state-of-the-art technology are crucial when managing healthcare. This study improves healthcare management's accuracy and efficiency using computational models like DIPS to guarantee accurate data forecasts and recommendations.

Declaration of Interest: The authors have no conflicts of interest to declare.

Objectives: Comparative effectiveness of fenestrated endovascular aneurysm repair (FEVAR) and chimney graft endovascular aneurysm repair (ChEVAR) for juxtarenal aortic aneurysms (JAAs) remains unclear. Our objective was to identify and analyze the current body of evidence comparing the effectiveness of both techniques for JAA., Methods: We performed a systematic review and meta-analysis comparing the effectiveness of FEVAR and ChEVAR for JAA repair. We searched MEDLINE, EMBASE, and Cochrane Register for Controlled Trials from January 1, 1990, for randomized and non-randomized studies assessing outcomes of FEVAR and ChEVAR for JAA repair. Screening, data extraction, risk of bias assessment, and GRADE (Grading of Recommendations, Assessments, Development, and Evaluations) certainty of evidence were performed in duplicate. Data were pooled statistically where possible., Results: Nine retrospective cohort studies comparing the use of FEVAR and ChEVAR for juxtarenal aneurysm were included for meta-analysis. The FEVAR and ChEVAR arms of the meta-analysis consisted of 726 participants and 518 participants, respectively. There were 598 (86.8%) and 332 (81.6%) men in each arm. The mean diameter was larger in the ChEVAR arm (59 mm vs 52.5 mm). Both techniques had similar rates of postoperative 30-day mortality, 3.38% (8/237) versus 3.52% (8/227), acute kidney injury, 16.76% (31/185) versus 17.31% (18/104), and major adverse cardiac events, 7.30% (46/630) versus 6.60% (22/333). The meta-analysis supported the use of FEVAR for most outcomes, with significant advantage for technical success (odds ratio [OR]: 3.24, 95% CI: 1.24-8.42) and avoidance of type 1 endoleak (OR: 5.76, 95% CI: 1.94-17.08), but a disadvantage for spinal cord ischemia (OR: 10.21, 95% CI: 1.21-86.11), which had a very low number of events. The quality of evidence was "moderate" for most outcomes., Conclusion: Both endovascular techniques had good safety profiles. The evidence does not support superiority of either FEVAR or ChEVAR for JAA., Clinical Impact: While lack of equipoise has hampered the design of randomised trials of open versus endovascular repair of juxtarenal aortic aneurysms, concern about the durability of endovascular repair highlights the need for stronger evidence of the comparative efficacy of endovascular techniques. This review performed meta-analysis and evidence appraisal of recent data from large observational studies comparing fenestrated and chimney techniques, using a comprehensive outcome set. Superiority of either intervention could not be established due to differences in participants' baseline risk in each study arm. However, data suggests that both techniques are safe and suitable for use when indicated., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Timely diagnosis of medical conditions can significantly mitigate the risks they pose to human life. Consequently, there is an urgent demand for an effective auxiliary model that assists physicians in accurately diagnosing medical conditions based on imaging data. While multi-threshold image segmentation models have garnered considerable attention due to their simplicity and ease of implementation, the selection of threshold combinations greatly influences the segmentation performance. Traditional optimization algorithms often require substantial time to address multi-threshold image segmentation problems, and their segmentation accuracy is frequently unsatisfactory. As a result, metaheuristic algorithms have been employed in this domain. However, several algorithms suffer from drawbacks such as premature convergence and inadequate exploration of the solution space when it comes to threshold selection. For instance, the recently proposed optimization algorithm RIME, inspired by the physical phenomenon of rime-ice, falls short in terms of avoiding local optima and fully exploring the solution space. Therefore, this study introduces an enhanced version of RIME, called IDRM, which incorporates an interactive mechanism and Gaussian diffusion strategy. The interactive mechanism facilitates information exchange among agents, enabling them to evolve towards more promising directions and increasing the likelihood of discovering the optimal solution. Additionally, the Gaussian diffusion strategy enhances the agents' local exploration capabilities and expands their search within the solution space, effectively preventing them from becoming trapped in local optima. Experimental results on 30 benchmark test functions demonstrate that IDRM exhibits favorable optimization performance across various optimization functions, showcasing its robustness and convergence properties. Furthermore, the algorithm is applied to select threshold combinations for brain tumor image segmentation, and the results are evaluated using metrics such as Peak Signal-to-Noise Ratio (PSNR) and Structural Similarity Index Measure (SSIM). The overall findings consistently highlight the exceptional performance of this approach, further validating the effectiveness of IDRM in addressing image segmentation problems., Competing Interests: Declaration of Competing Interest We declare that we have no financial and personal relationships with other people or organizations that can inappropriately influence our work, there is no professional or other personal interest of any nature or kind in any product, service and/or company that could be construed as influencing the position presented in, or the review of, the manuscript entitled., (Copyright © 2023. Published by Elsevier Ltd.)

Objective: The aim of the study is to evaluate the natural history of extracranial cervical artery dissection (CAD) including comorbidities, symptoms at presentation, recurrence of symptoms, and long-term outcome following different treatment approaches., Methods: A retrospective review of patients treated for acute CAD was performed over a 5-year period from January 2017 to April 2022., Results: Thirty-nine patients were included in the study, 25 (64.1%) with acute internal carotid artery dissection and 14 (35.9%) with acute vertebral artery dissection. Thirty-four patients (87.1%) had spontaneous CAD, and five patients (12.8%) had traumatic CAD. The mean age of the cohort was 54.2 years. The mean time from symptom onset to presentation was 4.34 days. The most common symptoms in internal carotid artery dissection were unilateral weakness (44%), headache (44%), slurred speech (36%), facial droop (28%), unilateral paraesthesia (24%), neck pain (12%), visual disturbance (8%), and Horner's syndrome (8%). The most common symptoms in vertebral artery dissection were headache (35.7%), neck pain (35.7%), vertigo (28.57%), ataxia (14.28%), and slurred speech (14.28%). The imaging modalities used for diagnosis included computed tomography angiography (48.7%), magnetic resonance angiography (41%), and duplex ultrasound (10.2%). In patients with carotid artery dissection, 57% had severe stenosis, 24% had moderate stenosis, and 20% had mild stenosis. All patients treated were managed conservatively with either anticoagulation or antiplatelets. Long-term clinical follow-up was available for 33 patients (84.6%). Thirty patients (90.9%) reported complete resolution of symptoms, and three patients (9%) reported persistent symptoms. Anatomic follow-up with imaging was available for 17 patients (43.58%). Thirteen patients (76.47%) had complete resolution of dissection, two patients (11.76%) had partial resolution of dissection, and two patients (11.76%) had persistent dissection. There was one death unrelated to CAD in a multi-trauma patient. There were four early recurrent symptoms in the first 3 to 8 weeks post discharge. The mean follow-up time was 308.27 days., Conclusions: The majority of CADs can be managed conservatively with good clinical and anatomical outcome and low rates of recurrence., (Copyright © 2023 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.)

ABSTRACT Due to industrialization, activities of human and urbanization, environment is getting polluted. Air pollution has become a main issue in the metropolitan areas of the world. To protect people from diseases, monitoring air quality plays an important thing. This air pollutant may lead to many health issues like respiratory and cardiac problems. The major air pollutants are NO, C 6 H 6 , CO, etc. Many research works have been done in predicting air pollution-based health issues, predicting air pollution levels, monitoring and controlling the polluted levels. But they are not efficient, cost of maintenance is high and insufficient tool for monitoring it. To overcome these issues, this paper implements hybrid algorithm of Decision Tree J48 and Grey Wolf Optimizer (DT-GWO). This DT-GWO is a better model to addresses the predicting of Air Quality Index (AQI), which minimizes the error rate, accurately and effectively predicting the air quality. The AQI values are categorised as good, moderate, unhealthy, very unhealthy and hazardous. The dataset used in this work is collected from Kaggle website which contains air pollutants details with air quality index values. Accuracy obtained for decision Tree J48 is 93.72%, grey wolf optimizer is 96.83% and our proposed work DT-GWO is 99.78%.

Objectives: Venous thromboembolism is a potentially fatal complication of superficial endovenous treatment. Proper risk assessment and thromboprophylaxis could mitigate this hazard; however, there are currently no evidence-based or consensus guidelines. This study surveyed UK and Republic of Ireland vascular consultants to determine areas of consensus., Methods: A 32-item survey was sent to vascular consultants via the Vascular and Endovascular Research Network (phase 1). These results generated 10 consensus statements which were redistributed (phase 2). 'Good' and 'very good' consensus were defined as endorsement/rejection of statements by >67% and >85% of respondents, respectively., Results: Forty-two consultants completed phase 1. This generated seven statements regarding risk factors mandating peri-procedural pharmacoprophylaxis and three statements regarding specific pharmacoprophylaxis regimes. Forty-seven consultants completed phase 2. Regarding venous thromboembolism risk factors mandating pharmacoprophylaxis, 'good' and 'very good' consensus was achieved for 5/7 and 2/7 statements, respectively. Regarding specific regimens, 'very good' consensus was achieved for 3/3 statements., Conclusions: The main findings from this study were that there was 'good' or 'very good' consensus that patients with any of the seven surveyed risk factors should be given pharmacoprophylaxis with low-molecular-weight heparin. High-risk patients should receive one to two weeks of pharmacoprophylaxis rather than a single dose.