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Abstract Background The role of HOXA9 requires investigations in pancreatic ductal adenocarcinoma (PDAC) as HOXA9 inhibitors are being developed. HOXA9 might attract CD163 expressed tumor associated macrophages (TAM) and could affect PDAC prognosis. This work aims to study the expression and relevance of HOXA9 and CD163 in PDAC progression. Materials and methods Selected 98 PDAC and 98 adjacent non tumor tissues as a control group were immunostained with HOXA9 and CD163 antibodies. Results PDAC displayed highly significant higher HOXA9 staining intensity, percent and H score values than control group. HOXA9 staining of PDAC cases showed significant associations with poor prognostic indicators including larger tumor size, higher grade and advanced stage. PDAC showed highly significant differences regarding CD163 macrophage-specific staining intensity, percent and H score values than control group. CD163 showed significant higher expressions with larger tumor size, higher histological grade and advanced stage group. HOXA9 staining in PDAC showed highly significant direct correlations with CD163 positive macrophages. Follow up of PDAC cases revealed that high median H score of HOXA9 and CD163 were significantly associated with worse overall survival. CD163 was an independent prognostic marker of worse survival. Conclusions In conclusion, HOXA9 could potentiate PDAC progression by stimulating CD163 expressed TAM attraction in tumors. HOXA9 and CD163 could participate in PDAC therapy. HOXA9 and CD163 could be predictors of worse prognosis and shorter survival in PDAC.

Abstract Background In China, decline disease with unknown etiology appeared as an epidemic among bayberry trees in the southern area of the Yangtze River. Furthermore, the use of beneficial microbes has been reported to be able to reduce the incidence of this disease, emphasizing the association of this disease with microorganisms. Therefore, it has become critical to uncover the microbiome’s function and related metabolites in remodeling the immunity of bayberry trees under biotic or abiotic stresses. Results The amplicon sequencing data revealed that decline disease significantly altered bacterial and fungal communities, and their metabolites in the four distinct niches, especially in the rhizosphere soils and roots. Furthermore, the microbial communities in the four niches correlated with the metabolites of the corresponding niches of bayberry plants, and the fungal and bacterial networks of healthy trees were shown to be more complex than those of diseased trees. In addition, the role of microbiome in the resistance of bayberry trees to the occurrence of decline disease was justified by the isolation, identification, and characterization of important microorganisms such as significantly enriched Bacillus ASV804, Pseudomonas ASV815 in healthy plants, and significantly enriched Stenotrophomonas ASV719 in diseased plants. Conclusion Overall, our study revealed that the occurrence of decline disease altered the microbiome and its metabolites in four ecological niches in particular rhizosphere soils and roots of bayberry, which provides new insight into the control of bayberry decline disease.

Abstract Backgroud Pregnancy is a state of increased metabolic demand, and poor maternal nutrition can exacerbate these changes, potentially increasing the risk of cardiometabolic disorders.This study is significant as it investigates the effect of high energy nutritional supplements on cardio metabolic risk markers in underweight primigravidas. Methodology A single blinded randomized controlled trial was conducted from April 2018- August 2019 among the Pakistani tertiary care facilities of Khyber Pakhtunkhwa. A total of thirty six participants were randomized into two groups receiving either high energy nutritional supplement ‘MAAMTA’ or Placebo. They were instructed to take Placebo/Supplement alongside to their regular prenatal care and food from their first antenatal visit till a week postnatally. Anthropometric measurements and blood samples for biochemical parameters insulinlevels, fasting blood glucose & lipid profile were taken at baseline visit, between 16 and 20 weeks gestation and a post natal visit. Results The two-way repeated measures ANOVA showed that there was a highly significant time effect on participant’s Insulin level (F (1.8, 53.6) = 10.64, P

Abstract Background Type 2 diabetes is a rising health problem, especially in older adults. Health literacy and the degree of diabetes knowledge are among the factors that may influence diabetes self-care activities. The aim of this study was to assess factors affecting self-care activities among older adults living with type 2 diabetes in Alexandria, Egypt. Methods A cross-sectional study included 400 older adults over the age of 60 with type 2 diabetes, recruited from diabetes outpatient clinics affiliated to the health insurance organization in Alexandria, Egypt. A predesigned, structured interview questionnaire was used to assess sociodemographic factors, personal habits, medical history, and drug history. The All Aspects of Health Literacy Scale (AAHLS) and the numeracy section of the Short Test of Functional Health Literacy in Adults (STOFHLA) were used to assess the level of health literacy. Diabetes Knowledge Test 2 (DKT2) was used to assess diabetes knowledge and Summary of Diabetes Self-care Activities scale was used to assess self-care activities. Multiple logistic regression analysis was used to examine the relationship between health literacy and self-care. Results The mean age of the participants was 65.75 ± 5.15 years, and 56.2% of them were males. The mean duration of diabetes was 10.61 ± 5.28 years, 14.3% were illiterate, and 37.2% were university graduates. Positive correlations were found between health literacy, diabetes knowledge, and diabetes self-care activities (p

Abstract Background Though an association between cluster headache (CH) and smoking has been postulated, data from the Middle East region is scarce. Aim of work To study the relationship between smoking and CH clinical characteristics and responsiveness to therapy in Egypt. Methodology This was a prospective cohort hospital-based study conducted on patients with episodic and chronic CH in a tertiary headache clinic in Egypt during the period between 2019 and 2023. Patients were consecutively recruited at the time of their presentation and were followed up for two weeks after initiation of prophylactic treatment and steroids (as transitional therapy). Results Of 172 patients with CH recruited, 144 (83.7%) were smokers. Twenty-eight patients (16.3%) had chronic CH. The mean age was 42.08 ± 10.93 (20–66) years, and 131 (76.2%) were males. Smokers had a significantly higher median number of cluster bouts in the past five years (3.0 (IQR2.0–4.0) versus 2.0 (IQR 1.0–2.0)) and worse HIT-6 scores [51.0 (44.0–59.75) versus 41.0 (38.0–41.75)] than non-smokers (p

Abstract Background Sepsis is a leading cause of neonatal mortality, despite the availability of effective treatment of possible serious bacterial illness (PSBI), including when referral to a hospital is not feasible. Gaps in access and delivery worsened during COVID-19. We conducted embedded implementation research in Ethiopia and Kenya aimed at mitigating the impact of COVID-19 and addressing various implementation challenges to improve PSBI management. Methods The implementation research projects were implemented at the subnational level in Ethiopia and Kenya between November 2020-June 2022 (Ethiopia) and December 2020-August 2022 (Kenya). Guided by the implementation research frameworks, both projects conducted mixed formative quantitative and exploratory research from April to May 2021, followed by summative evaluations conducted between June and July 2022. Frameworks encompassed Consolidated Framework for Implementation Research (CFIR), Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM), as well as health systems framework that incorporates cascades of care and World Health Organization Health Systems Building Blocks. Results were synthesized across the projects through document review and sharing cross-project measures and strategies through a project community of practice. Results Despite differences in settings across the projects, cross-cutting facilitators included community health worker program and support, and existence of guidelines for PSBI management at primary care levels. Barriers included community attitudes towards seeking care for sick newborns, COVID-19 risks and fear, and lack of health care worker competence. Country-specific contextual barriers included supply chain issues, civil conflict (Ethiopia), and labor strikes (Kenya). Strategies chosen to mitigate barriers and support implementation and sustainability in both settings included leveraging community health workers to address resistance to care-seeking, health workers’ training, COVID-19 infection prevention measures, stakeholder engagement, and advocacy to integrate PSBI management into existing programs, policies, and training. Other strategies addressing emerging project-specific barriers, included improving follow-up through a community health desk and PSBI mobile app (Kenya) and supply chain strengthening (Ethiopia). Both projects improved PSBI management coverage, increased adoption and uptake, and informed national policy changes supporting potential for sustainability. Conclusions Pragmatic embedded implementation research effectively supports the identification of barriers and mapping to strategies designed to increase effective coverage of PSBI management when referral is not feasible during the COVID-19 pandemic. Despite differences in context, cross-cutting strategies identified could inform broader scale-up in the region, including during future health system shocks.

Electric vehicles (EVs) as a sustainable safety system are being increasingly used and receiving attention from researchers for several reasons including optimal performance, affordability for consumers, and environmental safety. EV speed control is a crucial issue that requires reliable and intelligent controllers for maintaining this matter. The primary goal of this research is to design the linear and nonlinear Proportional, Integral, and Derivative (PID) controllers to control EV speed based on the minimum value of ITAE plus ISU (integral square of control signal) as well as satisfy the constrain on response overshoot. All the proposed PID controllers, conventional PID controller, arc tan PID controller, and nonlinear PID controller (NL-PID) are used in cascade with EV model. In all these PID controllers, a filter is used with the derivative term to avoid the effect of the noise. The tuning of the proposed controller gains is achieved using Aquila Optimization algorithm. The controllers’ parameter tuning is primarily determined by reducing the Integral Time Absolute Error (ITAE) and integral square control signal. Numerical simulation, system modelling, and controller design are done using MATLAB. By comparing the results, the proposed controllers’ efficacy is demonstrated. The proposed NL-PID controller provides promising EV speed regulation control and robustness to external disturbances. Where, the performance specifications of the proposed NL-PID controller when using unit step input with step disturbance of 0.2 and −0.2, and the model parameters increased by 25% from its nominal value are the rise time is 2.608, settling time is 2.608, overshoot is 0.073%, the maximum control signal is 6.230, number of slope sign change in the control signal is 231, and ITAE is 17.6064. The comparative results show the NL-PID controller’s superior performance for tracking the reference signal with the lowest peak for the control signal, rejection of disturbances, ability to overcome model uncertainties, and lowest ITAE value.

Abstract Blood transfusion has a hazard of transmission of many pathogens, including Toxoplasma gondii (T. gondii) and other venereal infections. It is crucial to conduct epidemiological surveillance to detect the prevalence of these pathogens. The study aimed to assess the seroprevalence of T. gondii and common transfusable venereal infections among healthy blood donors in Menoufia Province, Egypt, and identify associated risk factors. Four hundred twenty individuals were recruited between January and April 2023 for cross-sectional descriptive research from the blood banks of Menoufia University medical hospitals. Collected blood samples were screened for anti-T. gondii IgM and IgG, HBsAg, anti-HCV antibodies, HIV p24 antigen and anti-HIV antibodies, and anti-Treponema pallidum antibodies. 46 (11.0%) and 22 donors (5.2%) individuals tested positive for anti-T. gondii IgG with a 95% CI (8.3–14.6) and IgM with a 95% CI (3.5–8.1), respectively, while one patient (0.2%) was positive for both antibodies. Regarding venereal infections, 12 (2.9%) were positive for HBV, 6 (1.4%) were positive for HCV, 7 (1.7%) were positive for HIV, and none of the tested population showed positivity for syphilis. Female gender, consumption of raw meat, agricultural environment, poor awareness about T. gondii, and blood group type (especially AB and O groups) were identified as independent risk factors for T. gondii infection. The study highlights the importance of testing blood donors for T. gondii and common transfusable venereal illnesses. Starting health education programs and preventative measures, such as suitable meat handling and cleanliness practices, is critical for minimizing the occurrence of these illnesses. Larger-scale additional study is advised to confirm these results and provide guidance for public health initiatives.

In the field of energetic materials, traditional materials with high toxicity or other disadvantages are mostly used. There is an urgent need for trinitrotoluene replacements (TNT), which itself is toxic and its production is problematic due to red wastewater. New materials should be safe to handle, have good performance, and be inexpensive to synthesize. Nitratoalkylazoles are known to have low melting points and good energetic properties compared to TNT. In this paper, seven energetic compounds are synthesized starting from 5-methyltetrazole, 5-hydroxymethyltetrazole and 4,5-bishydroxymethyltriazole. The nitrates are characterized in terms of their physical, chemical, and energetic properties. Of those seven compounds, five are solid, melting between 27 °C and 110 °C, and two are liquid. Methylation and hydroxyalkylation were performed and discussed extensively. The organic nitrate is introduced in the last step so that the synthesis remains safe and scalable. Correlations between the molecular geometry and the melting points are explained. Calculations indicate detonation velocities that are 6%–11% higher than those of TNT. A discussion of the effect of isomerism on the properties leads to surprising insights and should help focus and accelerate research on the replacement of TNT.

Chylous ascites (CA) is a rare complication after abdominal surgeries, particularly donor hepatectomy and liver transplantation. We present a case of CA developed following donor right hepatectomy. Initially managed with a high-protein, low-fat diet and Sandostatin® (Octreotide Acetate), the patient’s condition improved but did not resolve. Subsequently, the treatment plan was modified to include clear oral fluids, total parenteral nutrition, and Sandostatin®, resulting in a significant improvement and ultimate discontinuation of CA drainage. This case sheds light on the management strategies for CA following donor hepatectomy and emphasizes the need for a multimodal approach.

The design of wind turbines has been continually evolving to enhance aerodynamic efficiency, which is crucial for improving energy conversion and reducing operational costs. One promising technique is the application of the Co-Flow Jet (CFJ) method, which utilizes simultaneous blowing and suction to augment aerofoil performance. Despite its potential benefits, the relationship between aerofoil thickness and the resulting improvements in lift and drag coefficients has not been thoroughly explored, especially for the NREL aerofoils commonly used in wind turbine applications. This study utilizes Computational Fluid Dynamics (CFD) simulations in order to investigate the aerodynamic efficiency improvements of the NREL S826, NREL S825, and NREL S818 aerofoils through the application of the CFJ technique. Various configurations with different blowing (B) and suction (S) configurations were tested, including 0.08B-0.7S, 0.08B-0.8S, 0.1B-0.7S, and 0.2B-0.7S configurations. The results demonstrate that the S826-0.2B-0.7S, S825-0.2B-0.7S, and S818-0.08B-0.7S configurations yield the most significant enhancements at a common momentum coefficient (Cm) of 0.08. Specifically, there were increases in lift coefficients by about 51.1%, 66.38%, and 109%, and improvements in lift-to-drag ratios by about 11.5%, 14.38%, and 146.18% for the S826-0.2B-0.7S, S825-0.2B-0.7S and S818-0.08B-0.7S configurations, respectively.

Small ruminants and camels are important livestock species in the United Arab Emirates (UAE), although Brucella infection can limit their productivity. This study aimed to investigate the seroprevalence of Brucella infection and its associated risk factors in small ruminants and camels in the Emirate of Abu Dhabi. Additionally, seropositive animals were tested for the DNA of Brucella. Multispecies competitive enzyme-linked immunosorbent assay (c-ELISA) and multispecies indirect (i-ELISA) were used to test 3,086 animals from 2022 to 2023. Brucella cell surface 31 kDa protein (bcsp31) gene-based real-time polymerase chain reaction (q-PCR) was used to detect Brucella DNA. Multivariate logistic regression was used to assess the association between seroprevalence and potential risk factors. The overall seroprevalences of Brucella infection were 1.7% (95% confidence interval [CI], 1.2%–2.2%) and 5.8% (95% CI, 5.0%–6.7%) based on serial and parallel testing, respectively. The DNA of Brucella was detected in 13 of the 51 seropositive animals. The overall seroprevalence of Brucella infection was associated with the region, type of animal holding, species, and age of the animals. In conclusion, this study documented Brucella infection in small ruminants and camels in the Emirate of Abu Dhabi, warranting necessary intervention strategies to eliminate Brucella infections in livestock populations.

This study aimed to evaluate the effects of dietary supplementation with organic selenium (OR-Se) and/or vitamins C and E on the rectal temperature (Rectal-T), growth performance, carcase yield, intestinal morphology, plasma thyroid hormone levels, and antioxidant status of broilers reared in hot environmental conditions. Under heat stress conditions (29.4 to 33.6 °C), 360 Arbour Acres chicks were fed in a (2 × 3) factorial design with two dietary levels of organic selenium (0 and 0.6 mg/kg) and three dietary levels of a mix of vitamins C and E (0, 200 and 250 mg/kg). Chicks were randomly assigned to six treatments (T) with three replicates of 20 birds each: the 1st group (T1): basal diet with no supplementation (control group); the 2nd group (T2): basal diet supplemented with 0.6 mg OR-Se/kg; the 3rd group (T3): basal diet with a mixture of vitamins C and E, 200 mg of each/kg diet (Vita-Mix A); the 4th group (T4): basal diet with a mixture of vitamins C and E, 250 mg of each/kg diet (Vita-Mix B); the 5th group (T5): basal diet with (Vita-Mix A) + 0.6 mg OR-Se/kg diet; the 6th group (T6): basal diet with Vita-Mix B and 0.6 mg OR-Se/kg diet for a five-week feeding period. Results showed that chicks fed diets supplemented with OR-Se and/or vitamins (C, E) had lower (p

Abstract In low- and middle-income countries, data on antimicrobial use (AMU) and antimicrobial resistance (AMR) in aquaculture are scarce. Therefore, summarizing documented data on AMU, antimicrobial residue (AR), and AMR in aquaculture in Africa is key to understanding the risk to public health. Google Scholar, PubMed, African Journals online, and Medline were searched for articles published in English and French following the PRISMA guidelines. A structured search string was used with strict inclusion and exclusion criteria to retrieve and screen the articles. The pooled prevalence and 95% confidence intervals were calculated for each pathogen–antimicrobial pair using random effects models. Among the 113 full-text articles reviewed, 41 met the eligibility criteria. The majority of the articles reported AMR (35; 85.4%), while a few were on AMU (3; 7.3%) and AR (3; 7.3%) in fish. The articles originated from West Africa (23; 56.1%), North Africa (8; 19.7%), and East Africa (7; 17.1%). Concerning the antimicrobial agents used in fish farming, tetracycline was the most common antimicrobial class used, which justified the high prevalence of residues (up to 56.7%) observed in fish. For AMR, a total of 69 antimicrobial agents were tested against 24 types of bacteria isolated. Bacteria were resistant to all classes of antimicrobial agents and exhibited high levels of multidrug resistance. Escherichia coli, Salmonella spp., and Staphylococcus spp. were reported in 16, 10, and 8 studies, respectively, with multidrug resistance rates of 43.1% [95% CI (32.0–55.0)], 40.3% [95% CI (24.1–58.1)] and 31.3% [95% CI (17.5–49.4)], respectively. This review highlights the high multidrug resistance rate of bacteria from aquaculture to commonly used antimicrobial agents, such as tetracycline, ampicillin, cotrimoxazole, gentamicin, and amoxicillin, in Africa. These findings also highlighted the lack of data on AMU and residue in the aquaculture sector, and additional efforts should be made to fill these gaps and mitigate the burden of AMR on public health in Africa.

In the era of climate change-induced extreme rainfall events, the world faces unprecedented natural hazards, notably flooding. These events pose multifaceted risks to life, agriculture, infrastructure, and the well-being of society. Understanding and predicting extreme rainfall events are critical for achieving sustainable development and building resilient communities. This study employed advanced statistical techniques, specifically the generalized extreme value distribution (GEVD) and generalized Pareto distribution (GPD), using a Bayesian approach, to model and forecast annual maximum monthly rainfall in Somalia. Utilizing data spanning from 1901 to 2022, the rainfall extremes were fitted to both GEVD and GPD models using Bayesian Markov chain Monte Carlo (MCMC) simulations. Due to the lack of specific prior information, non-informative and independent priors were used to estimate posterior densities, ensuring objectivity and data-driven results, and minimizing subjective bias. Model comparisons were conducted using the deviance information criterion (DIC), prediction errors, and k-fold cross-validation. Findings reveal the robustness of the GEVD model in forecasting and predicting rainfall extremes in Somalia. Diagnostic plots confirmed the goodness of fit of the chosen model. Remarkably, the Bayesian GEVD return level estimation suggested that extreme rainfall could exceed 106 mm, 163 mm, and 195 mm for return periods of 10, 50, and 100 years, respectively. These precise return level estimates may benefit urban planners, civil engineers, and policymakers. Armed with this knowledge, they can design resilient infrastructure and buildings capable of withstanding the most extreme climatic conditions. Therefore, this study provides critical information for fostering sustainable development and resilience against climate-induced challenges in Somalia and beyond. Accurate estimation of extreme rainfall return levels enables effective mitigation of flooding risks and supports climate-resilient urban planning, civil engineering, and policymaking. These findings also inform strategies to optimize drainage systems, fortify infrastructure, and develop adaptive policies, thereby safeguarding lives, livelihoods, and infrastructure amidst escalating climate uncertainties.

Abstract Background Parkinson’s disease (PD) is the most common movement disorder and the second most common neurodegenerative disease. The aim of our study was to compare gray–white matter changes (GWC) between Parkinson's disease (PD) patients and age-matched healthy control group as well as comparing GWC between different stages of PD (early and complicated). Our study was prospective cross-sectional case–control observational study with analytic component conducted on twenty patients and ten controls without any signs or symptoms of PD or any history of PD in first-degree relatives. All patients and controls were tested for history taking with stress on resting tremors, rigidity, gait abnormalities, postural instability and any symptoms of cognitive impairment, clinical examination including general examination and neurological examination. Also diffusion tensor imaging (DTI) with fiber tracking (tractography) and susceptibility-weighted MR imaging were performed for all cases. Results As regards DTI and evaluation of fractional anisotropy (FA) and mean diffusivity (MD) values between PD cases and healthy controls, the cases group showed significant decrease in FA values at substantia nigra on both sides and left cingulum as well as significant increase in MD values at substantia nigra on both sides and corpus callosum. Also, there are significant decrease in FA values at substantia nigra on both sides and significant increase in MD values at substantia nigra on both sides and right cingulum in late parkinsonism when compared to early parkinsonism. A cutoff FA value of 0.945 at right substantia nigra and cutoff FA value of 0.585 at left substantia nigra showed significant AUC that could differentiate between cases and controls. Also cutoff MD value of 0.791 at right substantia nigra and cutoff MD value of 0.813 at left substantia nigra showed significant AUC that could differentiate between cases and controls. Conclusions Diffusion tensor imaging showed valuable role in evaluation of gray–white matter changes in Parkinson's disease. Also, it helps to assess degree of gray–white matter changes when comparing late parkinsonism to early parkinsonism through evaluation of FA and MD values at corpus callosum, substania nigra, and cingulum.

Abstract The main focus of this study was on using radiation to make an ultra-absorbent hydrogel (UAH) from sodium alginate (SA) and gelatin (GL) biopolymers. This UAH can effectively handle water and nitrogen in wheat farming during drought stress. The hydrogel was synthesized by gamma irradiation-induced SA/GL/polyacrylamide crosslinking at 10–40 kGy. Varying SA/GL ratios affected swelling and the gel fraction of SA/GL/PAm hydrogels. The (SA/GL 17/83) hydrogel exhibited a 40.03 g/g swelling degree, while increasing SA content resulted in higher swelling, peaking at 75.5 g/g for (SA/GL 83/17). This indicated a synergistic interaction between SA and GL. The gel fraction also increased from 76.8 to 90.3%, with a higher GL content reflecting increased crosslinking. After multiple hydrolysis cycles, the hydrogel achieved 1293 (g/g) swelling and 36 days of water retention. When applied to wheat (Triticuma estivum) under drought stress, it significantly improved shoot length (18%), root length (43%), shoot fresh weight (49%), and shoot dry weight (51%) under extreme drought. The significant increases in protein and carbohydrate content in both shoots (up to 32% and 19%, respectively) and grains (up to 21% and 24%, respectively), along with the reduction in proline content (up to 38%), demonstrate that ultra-absorbent hydrogel (UAH) effectively enhances nitrogen content, photosynthesis, and overall plant health in wheat under varying drought stress levels. This novel SA/GL-based UAH holds promise for addressing water scarcity and agricultural challenges, offering a sustainable solution for water and nitrogen management under drought stress.

Abstract Background The present study investigates the representation of women in the Otolaryngology department in a tertiary academic hospital, and the challenges they face during their residencies. Methods A questionnaire which included demographic information and a series of 54-questions of academic, clinical, social, psychological, and private practice challenges was electronically distributed among female residents registered in the Department of Otolaryngology in the last 10 years (2013–2022) throughout November 2023 to January 2024. Results Eighty-one female residents out of 103 registered (78.6%) responded to the distributed questionnaire highlighting the challenges they faced during their training period. Conclusion The current study addresses the barriers confronted by female residents in the department as well as identifying potential solutions that might help future encouragement of women to select otolaryngology as their specialty.

Abstract Background Vaccination of healthcare workers (HCWs) is pivotal in decreasing the incidence of contagious infections in hospital settings. In this study, we assessed the knowledge, attitude, and practice regarding HCWs’ recommended vaccines among medical students and interns in Egypt. Methods A multicenter, cross-sectional study was conducted using a structured, pilot-tested, and self-administered questionnaire among Egyptian medical students and interns. We invited 1332 participants to our survey using a systematic random sampling that included participants across nine medical schools in Egypt during the 2021–2022 academic year. Results Out of 1332 participants, 1141 completed our questionnaire with a response rate of 85.7%. Overall, 43% of the participants had intermediate knowledge (knew 2–3 HCWs’ recommended vaccines). Furthermore, 36.7% had received a booster dose of at least one of the HCWs’ recommended vaccines over the last 10 years, with only 6.1% having received all recommended vaccines. Hepatitis B vaccine was the most widely known (71%) and received (66.7%). Interns were more likely to know, receive, and recommend HCWs’ recommended vaccines. The majority (> 90%) agreed that vaccination is beneficial and safe, with a median score of eight (interquartile range [IQR: Q25-Q75]: 7–9) out of ten for vaccine efficacy and eight (IQR: 7–8) for safety. However, the median score for hesitancy was five (IQR: 2–7). The most common influential and limiting factors for vaccination were scientific facts (60.1%) and fear of vaccine side effects (44.9%). Conclusion Although medical students in Egypt have good knowledge of and attitudes towards vaccination, there is a gap in their practices. Interventions are needed to improve vaccination uptake among medical students in Egypt.

Abstract Environmental management accounting (EMA) has emerged as a potentially valuable tool for companies seeking to monitor and manage their ecological impacts. However, the connection between EMA and environmental performance (EP) remains unclear, with prior studies yielding mixed results. Moreover, little is known about the mechanisms through which EMA may influence EP. Therefore, this study seeks to examine the link between EMA and EP, with a particular focus on the mediating influence of green innovation (GI) within the context of SMEs situated in least-developed countries, such as Yemen. To this end, data was gathered from 299 manufacturing SMEs in Yemen and analyzed using PLS-SEM technique via SmartPLS software. The results of the statistical analysis revealed a positive and important effect of EMA on EP. Importantly, GI serves as a partial mediator in the EMA-EP relationship. Therefore, the results of this study add significantly to the current body of literature on sustainability and provide important new perspectives.

Abstract Introduction Significant hepatic steatosis affects the outcome of surgery when living donors are transplanted. The gold standard for diagnosing and evaluating hepatic steatosis is hepatic imaging-guided biopsy. Hepatic steatosis assessment using MR spectroscopy and the proton density fat fraction (MR-PDFF) method has produced positive findings. Objectives Is to compare the pre-operative assessment of liver fat quantification using MRI-PDFF methods, a non-invasive method, with histopathology. Subjects and methods A 42 potential donors were then operated surgically for liver transplantation, consequently, were available for the assessment of the efficiency and sensitivity of the radiological findings MRI-PDFF procedures and imaging-guided liver biopsy. This radiological workup of these donors was done through a period of 7 months. Results In many liver transplantations centers, liver imaging-guided biopsy histopathological examination is the gold standard. The study examined the MR proton density fat fraction modality, a recently developed test for hepatic steatosis measurement. The findings indicate 86.8% sensitivity, 50% specificity, 94.2% PDV, 28.5% NPV, 83.3% accuracy, and 0.684 AUC. On analyzing the fat percent, we found that the recorded fat percent using liver imaging-guided biopsy ranges between 1 and 10% with a median of 3. On the other hand, the recorded fat percent using MRI ranged between 2 and 15% with a median of 5. Conclusion The non-invasive magnetic resonance hepatic proton density fat fraction approach using IDEAL sequence is a reliable and accurate means of quantitatively evaluating hepatic steatosis with excellent sensitivity, specificity, and accuracy.

Abstract Maximum power point tracking (MPPT) is a technique involved in photovoltaic (PV) systems for optimizing the output power of solar panels. Traditional solutions like perturb and observe (P&O) and Incremental Conductance (IC) are commonly utilized to follow the MPP under various environmental circumstances. However, these algorithms suffer from slow tracking speed and low dynamics under fast-changing environment conditions. To cope with these demerits, a data-driven artificial neural network (ANN) algorithm for MPPT is proposed in this paper. By leveraging the learning capabilities of the ANN, the PV operating point can be adapted to dynamic changes in solar irradiation and temperature. Consequently, it offers promising solutions for MPPT in fast-changing environments as well as overcoming the limitations of traditional MPPT techniques. In this paper, simulations verification and experimental validation of a proposed data-driven ANN-MPPT technique are presented. Additionally, the proposed technique is analyzed and compared to traditional MPPT methods. The numerical and experimental findings indicate that, of the examined MPPT methods, the proposed ANN-MPPT approach achieves the highest MPPT efficiency at 98.16% and the shortest tracking time of 1.3 s.

In this study, we explored the efficacy of random forest algorithms in downscaling CHIRPS (Climate Hazards Group InfraRed Precipitation with Station data) precipitation data to predict Argane stand traits. Nonparametric regression integrated original CHIRPS data with environmental variables, demonstrating enhanced accuracy aligned with ground rain gauge observations after residual correction. Furthermore, we explored the performance of range machine learning algorithms, encompassing XGBoost, GBDT, RF, DT, SVR, LR and ANN, in predicting the Leaf Area Index (LAI) and crop yield of Argane trees using condition index-based drought indices such as PCI, VCI, TCI and ETCI derived from multi-sensor satellites. The results demonstrated the superiority of XGBoost in estimating these parameters, with drought indices used as input. XGBoost-based crop yield achieved a higher R2 value of 0.94 and a lower RMSE of 6.25 kg/ha. Similarly, the XGBoost-based LAI model showed the highest level of accuracy, with an R2 of 0.62 and an RMSE of 0.67. The XGBoost model demonstrated superior performance in predicting the crop yield and LAI estimation of Argania sinosa, followed by GBDT, RF and ANN. Additionally, the study employed the Combined Drought Index (CDI) to monitor agricultural and meteorological drought over two decades, by combining four key parameters, PCI, VCI, TCI and ETCI, validating its accuracy through comparison with other drought indices. CDI exhibited positive correlations with VHI, SPI and crop yield, with a particularly strong and statistically significant correlation observed with VHI (r = 0.83). Therefore, CDI was recommended as an effective method and index for assessing and monitoring drought across Argane forest stands area. The findings demonstrated the potential of advanced machine learning models for improving precipitation data resolution and enhancing agricultural drought monitoring, contributing to better land and hydrological management.

This comprehensive review explores the ecological significance of the Argane stands (Argania spinosa) in southwestern Morocco and the pivotal role of remote sensing technology in monitoring forest ecosystems. Argane stands, known for their resilience in semi-arid and arid conditions, serve as a keystone species, preventing soil erosion, maintaining ecological balance, and providing habitat and sustenance to diverse wildlife species. Additionally, they produce an extremely valuable Argane oil, offering economic opportunities and cultural significance to local communities. Remote sensing tools, including satellite imagery, LiDAR, drones, radar, and GPS precision, have revolutionized our capacity to remotely gather data on forest health, cover, and responses to environmental changes. These technologies provide precise insights into canopy structure, density, and individual tree health, enabling assessments of Argane stand populations and detection of abiotic stresses, biodiversity, and conservation evaluations. Furthermore, remote sensing plays a crucial role in monitoring vegetation health, productivity, and drought stress, contributing to sustainable land management practices. This review underscores the transformative impact of remote sensing in safeguarding forest ecosystems, particularly the Argane forest stands, and highlights its potential for continued advancements in ecological research and conservation efforts.

Background: Multiple family members have been reported to have Alzheimer's disease (AD), according to family and twin studies. Several ApoE genetic variations have been linked to AD because of their involvement in lipid dysregulation. It has been observed that the Angiotensin converting enzyme 2 (ACE2) gene influences the accumulation of β-amyloid peptide (Aβ). Objectives: To assess the ACE2 G8790A (rs2285666) and Apo E (rs 121918398) SNPs among cohort of Egyptian AD patients and to explore their probable connection to the occurrence and severity of AD. Patients and methods: This is a case-control research included 50 Egyptian patients with AD and 50 healthy participants. AD patients were assessed using mini-mental state examination. Genetic analysis for ACE2 (rs2285666) SNPs and Apo E (rs 121918398) SNPs was done using restriction fragment length polymorphism-polymerase chain reaction (RFLP-PCR). Results: The age, and gender distributions of the study and control groups were matched. Patients with AD were more prevalent in rural areas. In terms of ACE2 genotyping, a higher frequency of AA genotype and A allele in the AD group, indicating their significant association with increased AD risk. They were linked to the severity of the illness as well. Regarding Apo E genotyping, there were statistically frequent (P

Background: Laryngeal squamous cell carcinoma (LSCC) constitutes about 98% of all laryngeal carcinomas with high mortality rates. The transcription factors Glioma-associated oncogene homolog1 (GLI1) and pituitary tumor transforming gene-1 (PTTG1) were associated with poor prognosis in several carcinomas. To date, no previous studies addressed the role of GLI1 in LSCC and limited studies have examined the role of PTTG1 in LSCC. Objectives: This study aims to evaluate the immunohistochemical (IHC) expression of GLI1 and PTTG1 in LSCC, to correlate their expression with clinicopathological features and patients' survival, and to assess the correlation between both proteins in LSCC. Materials and methods: GLI1 and PTTG1 expression was immunohistochemically examined in 60 LSCC specimens and 50 benign vocal fold polyps (control group). Results: GLI1and PTTG1 expression were significantly higher in LSCC than in the control group (p

Abstract Background Dengue infection is a mosquito-borne, endemic viral disease, particularly in developing countries. Here, we report the results of the clinicodemographic, serologic profile and the monthly occurrence of a recent dengue fever outbreak in Puntland State (Somalia). Methodology We analyzed the data of 956 dengue-suspected patients who were investigated using the rapid diagnostic testing (RDT) method for detecting NS1 (dengue virus non-structural protein) and IgM antibodies employing the SD Biosensor Dengue Dou NS Ag and IgM test kit (Germany) at the Puntland Public Health Referral Laboratory from November 21, 2022, to May 27, 2023. Results We found that 118 cases were positive for dengue among the suspected patients enrolled in the present study. Of these cases, 76.2% were dengue NSI positive, 13.6% were dengue IgM positive, and 10.2% were both NSI and IgM positive. The number of females and males in the confirmed cases was equal, and most (48.3%) were aged 20 years or less. 43.1% of them lived in the Nugal region, particularly in Garowe. Clinically, fever was the most frequent symptom (88.9%). The cases peaked in December 2022 but dropped from January to March, with a slight rise in February, and then increased in April and May 2023. Conclusion This study highlights the clinicodemographic characteristics, seroprevalence, and monthly occurrence of dengue in Puntland. We recommend improving vector control measures, enhancing case management, strengthening dengue surveillance, developing an early warning system, and conducting future studies to characterize the circulating strains.

Introduction: Right hemicolectomy (RHC) remains the treatment standard for goblet cell adenocarcinoma (GCA), despite limited evidence supporting survival benefit. This study aims to explore factors influencing surgical management and survival outcomes among patients treated with RHC or appendicectomy using NCRAS (UK) and SEER (USA) data. Methods: A retrospective analysis was conducted using 998 (NCRAS) and 1703 (SEER) cases. Factors influencing procedure type were explored using logistic regression analyses. Overall survival (OS) probabilities and Kaplan–Meier (KM) plots were generated using KM analysis and the log-rank test compared survival between groups. Cox regression analyses were performed to assess hazard ratios. Results: The NCRAS analysis revealed that age and regional stage disease were determinants of undergoing RHC, with all age groups showing similar odds of receiving RHC, excluding the 75+ age group. The SEER analysis revealed tumour size > 2 cm, and receipt of chemotherapy were determinants of undergoing RHC, unlike the distant stage, which was associated with appendicectomy. Surgery type was not a significant predictor of OS in both analyses. In NCRAS, age and stage were significant predictors of OS. In SEER, age, stage, and Black race were significant predictors of worse OS. Conclusions: The study shows variations in the surgical management of GCA, with limited evidence to support a widespread recommendation for RHC.

Abstract Breast cancer remains a leading cause of cancer-related deaths among women globally, necessitating the development of more effective therapeutic agents with minimal side effects. This study explores novel 1,2,4-triazine-3(2H)-one derivatives as potential inhibitors of Tubulin, a pivotal protein in cancer cell division, highlighting a targeted approach in cancer therapy. Using an integrated computational approach, we combined quantitative structure–activity relationship (QSAR) modeling, ADMET profiling, molecular docking, and molecular dynamics simulations to evaluate and predict the efficacy and stability of these compounds. Our QSAR models, developed through rigorous statistical analysis, revealed that descriptors such as absolute electronegativity and water solubility significantly influence inhibitory activity, achieving a predictive accuracy (R2) of 0.849. Molecular docking studies identified compounds with high binding affinities, particularly Pred28, which exhibited the best docking score of − 9.6 kcal/mol. Molecular dynamics simulations conducted over 100 ns provided further insights into the stability of these interactions. Pred28 demonstrated notable stability, with the lowest root mean square deviation (RMSD) of 0.29 nm and root mean square fluctuation (RMSF) values indicative of a tightly bound conformation to Tubulin. The novelty of this work lies in its methodological rigor and the integration of multiple advanced computational techniques to pinpoint compounds with promising therapeutic potential. Our findings advance the current understanding of Tubulin inhibitors and open avenues for the synthesis and experimental validation of these compounds, aiming to offer new solutions for breast cancer treatment.

Abstract The deposition of paraffin on pipelines during crude oil transit and low-temperature restart processes poses a significant challenge for the oil industry. Addressing this issue necessitates the exploration of innovative materials and methods. Pour point depressants (PPDs) emerge as crucial processing aids to modify paraffin crystallization and enhance crude oil flow. This study focuses on the combustion of polyethylene terephthalate (PET) waste, a prevalent plastic, in two distinct oils (castor and jatropha). The resulting black waxy substances (PET/Castor and PET/Jatropha) were introduced in varying weights (1000, 2000, and 3000 ppm) to crude oil. The PET/castor oil combination demonstrated a remarkable reduction in pour point from 18 to −21 °C at 3000 ppm concentration, significantly more effective than PET/jatropha blends. Substantial decreases in viscosity (up to 75%) and shear stress (up to 72%) were also observed for both blends, most prominently at lower temperatures near the pour point. The synergistic effect of PET and oils as nucleating agents that alter crystallization patterns and restrict crystal growth contributes to this enhanced low-temperature flow. This highlights the potential of PET plastic waste as an economical, abundant, and eco-friendly additive to develop high-performance PPDs for crude oil.

Abstract Background This study aimed to assess the quality of various obturation techniques to fill perforation caused by internal root resorption using Micro-computed Tomography. Methods Cone-beam computed tomography images of a maxillary central incisor tooth with perforating internal resorptive defect were used to create a 3D printed model of the affected tooth. The replicas were divided into four groups based on the obturation technique used. The techniques included Group 1: a polydimethylsiloxane-based sealer (GuttaFlow-2) with gutta-percha. Group 2: same as Group 1 except for using a pre-mixed Bioceramic-based sealer (NeoSEALER Flo). Group 3: the defect was filled entirely using the NeoSealer Flo Bioceramic-based sealer. Group 4: the samples were obturated using the warm vertical compaction technique with a resin-based sealer (ADSeal). The resin models were then scanned a micro-computed scanner to evaluate the percentage of voids in each group. Results The results showed that NeoSEALER Flo groups had significantly the highest volume of voids while GuttaFlow-2 and warm vertical compaction groups had the lowest void volume. Conclusions GuttaFlow-2 and warm vertical compaction techniques performed best in filling the internal resorptive defect.

Background: Children with congenital heart defects (CHD) now live longer due to advances in surgical and catheter techniques. Their neurodevelopment, including intellectual functioning, has become a major area of concern, attracting both clinical and research interest. Objectives: To assess the cognitive functions in children with CHD after cardiac surgeries and to compare between cyanotic and acyanotic heart disease regarding cognitive functions. Patients and methods: This cross-sectional study included sixty patients with CHD, 30 patients with cyanotic heart disease and 30 patients with acyanotic heart disease, who underwent cardiac surgeries and were examined by Stanford Binet IQ test 5th edition. They were recruited from the post cardiac intervention clinic at Pediatric Hospitals of Cairo University. Results: The mean ± SD age of the children with cyanotic and acyanotic heart diseases was 5±2 and 4 ±1 years respectively (p= 0.345). The IQ was higher among the children with cyanotic compared to those acyanotic heart diseases with mean ± SD (range) of 85.4 ± 12 and 99.9 ± 13 respectively (p= 0.0001). IQ was not influenced by age at operation (p= 0. 171), type of operation (p= 0. 381), sex (p= 0.323), or oxygen saturation (p= 0.308). Mean ±SD IQ of those with cyanotic CHD who underwent closed and open heart surgeries was 88±11 and 84±13 respectively (p= 0.381), and in acyanotic group was 104±14 and 98±13 respectively (p= 0.323). Conclusion: Children with congenital heart defects may have cognitive dysfunction. Children with cyanotic CHD have significantly lower IQ values than those with acyanotic CHD. No significant differences in IQ were found between patients who underwent closed and open heart surgery.

In order to deepen our understanding of the ecosystems around thermal springs and contribute to their preservation and enhancement, our study focused on the physico-chemical analysis of soils located in the immediate vicinity of two thermal springs (Ain El Haouamed (S1) and Ain Hamra (S2)) in the eastern region of Morocco. At the same time, we identified the plants that thrive in these areas and have developed specific adaptations to particular environmental conditions. The results of physico-chemical soil analyses revealed distinct characteristics. Around the first thermal spring (S1), the soil has a sandy loam texture, while around the second spring (S2), a clayey loam texture. The pH of both soils is slightly basic. In terms of organic matter, significant variations were observed between soil samples taken in these areas. Electrical conductivity and other physico-chemical parameters showed variable values. A study of the vegetation near the thermal springs shows the presence of (Matricaria chamomilla, Juncus acutus, Carex sylvatica) at site 1 and (Tamarix gallica, Inula viscosa, Phragmites australis, Typha angustifolia) at site 2. This information will certainly contribute to a better understanding of these specific thermal ecosystems. The present study has led to the identification of several plant species of great interest, representing an important advance in our knowledge of the biodiversity of these areas. These results can also be used to develop strategies for the preservation and sustainable management of these particular ecosystems.

Background: Sentinel lymph node (SLN) biopsy is the preferred method for diagnosing axillary nodal involvement in breast cancer. Touch imprint cytology (TIC) and frozen section (FS) are two intraoperative techniques used to assess SLNs. Both methods have their disadvantages, and the superior technique remains uncertain. Aim: To determine the accuracy of TIC compared to FS in identifying metastases in SLNs in preoperatively node-negative axilla. Methods: Forty-six females with breast cancer and clinically and radiologically negative axillary lymph nodes were included in the study. For TIC, SLNs were bisected, imprinted onto clean slides, stained, and evaluated. For FS, tissue slices of the same lymph nodes were embedded in an appropriate medium and frozen to -25ºC. Tissue sections were prepared using a cryostat, stained, and evaluated. Results: The patients' ages ranged from 30 to 71 years. There was a strong agreement between TIC and FS results (κ=0.864; p < 0.0001). Both TIC and FS findings strongly correlated with the final nodal evaluation of SLNs by paraffin section (κ=0.909; p < 0.0001 and κ=0.955; p < 0.0001, respectively). The sensitivity, specificity, positive predictive value, and negative predictive value of TIC for detecting axillary lymph node metastasis were 96.4%, 94.4%, 96.4%, and 94.4%, respectively. For FS, these values were 96.4%, 100%, 100%, and 94.7%, respectively. Conclusion: Touch imprint cytology is a feasible, quick, and cost-effective alternative to frozen section for intraoperative evaluation of SLNs in breast cancer.

Abstract Employer of choice (EOC) is a relatively new phenomenon, particularly in Human Resources Management. Existing employees and prospective talent have reasons and expectations to designate an employer as an EOC. While EOC has received extensive attention from both academics and practitioners over the past few years, the work has mostly focused on managerial and marketing perspectives, and thus far lacks a strong theoretical foundation. Drawing on Social Exchange Theory (SET), based on Human Resources and employees’ perceptions and experiences, this research aims to explore and investigate the factors that constitute/designate an employer as an Employer of Choice EOC. Two qualitative triangulated data sets were collected from existing full-time employees at a Saudi multinational corporation: open interviews and document analysis (cross-sectional and longitudinal). Thematic analysis (TA) was employed to analyze both methods. The findings reveal that company image, training, and development, satisfaction, involvement and commitment, fairness, work culture, reward, opportunities for growth, teamwork, motivation, and corporate social responsibility are the factors that lead employees to designate an employer as an EOC. This research contributes to knowledge conceptually, theoretically, and empirically, mainly in the area of Human Resources Management. This research represents one of the first studies to empirically identify and investigate employee-related factors and evaluate them all together in a multinational Saudi organization. Recognizing the findings of this empirical-based research assists HR managers in designating their organizations as an EOC for current employees and prospective talents.

سيرة وني الذاتية (2) بعض الملاحظات على بعثة حتنوب [AR] تجري الدراسة الحالية فحصًا دقيقًا لجزء من المساعي الملاحية المسجلة في السيرة الذاتية لويني خلال عهد الملك مرنرع، وتبين تفاصيله بشكل دقيق؛ إذ سجل وني في سيرته الذاتية قيامه برحلة نهرية نجح فيها في بناء مركب ذي خصائص محددة - نوعًا ومادًة وأبعادًا - لنقل مائدة قرابين من حتنوب إلى سقارة خلال مدة محددة. وعلى الرغم من بساطة مفردات وني، وخلوها من التعقيد، إلا أنها لا تزال عصية على الفهم بشكل واضح - رغم تعدد ترجمات النقش وتنوعها - لاعتماد وني على أسلوب بلاغي ذي مسحة شديدة الإيجاز. الأمر الذي حال كثيرًا دون إماطة اللثام عن عدد كبير من التفاصيل اللغوية من ناحية والملاحية من ناحية أخرى. ويكمن مفتاح فك رموز هذا النقش في خطوتين أساسيتين: أولًا، تحديد معاني المصطلحات المتعلقة ببناء المركب مثل و ، وتبيان دلالاتهما اللغوية والسياقية بشكل دقيق. ثانيًا، مقارنة هذين المصطلحين بالأفعال الأخرى المستخدمة لأغراض مماثلة في أنشطة وني الملاحية في سيرته الذاتية. ثالثًا، تفسير أسباب استخدام وني لهذا الأسلوب في وصف بعثته النهرية. ويهدف هذا النهج إلى التحقق من صحة فترات بناء المركب والملاحة، بالإضافة إلى تمييز الأهمية الحقيقية للإطار الزمني المكون من السبعة عشرة يومًا، والجوانب الملاحية الأخرى ذات الصلة. ومما لا شك فيه أن التكامل بين دراسات الآثار المصرية وعلم الآثار البحرية كفيل بإلقاء الضوء على هذه الاستفسارات. [EN] The current study undertakes a closer examination of a segment of the nautical endeavors chronicled in Weni's autobiography, which pertains to an expedition involving the construction of a barge with specific characteristics in terms of type, wood, and dimensions for the transportation of an offering table from Hatnub to Saqqara within a determined period. Despite the apparent simplicity of the vocabulary used in this inscription, it poses several challenges due to adopting the literal meanings, thereby impacting the translation and comprehension of the inscription. The key to deciphering this inscription takes two primary steps: Firstly, delineating the meanings of terms related to boatbuilding in the inscription, such as and , and understanding their precise and contextual significance; secondly, comparing these verbs with others employed for similar purposes elsewhere in Weni’s autobiography. This approach aims to validate the durations for the barge construction and navigation and discern the true significance of the seventeen-day timeframe and other pertinent nautical aspects. Undoubtedly, the integration of studies in Egyptian archaeology and nautical archaeology promises to shed light on these inquiries.

Abstract Background Hepatic cancer endures a major health scourge as the consequence of a high incidence of > 1 million cases by 2025. Plant-based products are typically effective in ameliorating health conditions. Pomegranate peel extract (PE) with its high polyphenolic content has anticancer effects against different types of cancer. Herein, we aimed to maximize the PE chemotherapeutic efficacy by loading it in a suitable delivery system to overcome the limitations of PE, to control its release and to achieve liver targeting. Method A nanoprecipitation procedure was adopted to incorporate PE into biodegradable and biocompatible natural polymeric zein (ZN)-based nanoparticles (NPs) (PE-ZN NPs). A full factorial design (22 × 31) was developed to study the effects of the formulation variables, namely pH of dispersion, PE-to-ZN ratio and surfactant concentration. Results The optimization revealed a surfactant-free stable PE-ZN NPs formula with a small particle size of 99.5 ± 6.43 nm, high PE encapsulation efficiency % of 99.31% ± 3.64 (w/w) and controlled release of PE over 24 h. Conclusion Moreover, the cytotoxicity of the optimum formula against hepatic cancer HepG2 cell lines was assessed and attained about a 2.5-fold reduction in the inhibitory concentration (IC50) values compared to the free PE affording a promising green platform to combat hepatic cancer. Graphical abstract

Abstract Background The staging and management of patients with breast cancer are significantly influenced by the pathological state of the axillary lymph nodes (ALN). Thus, it is very desirable to have a differential diagnosis of metastatic ALN. Purpose The aim of this research is to assess the effectiveness of non-invasive ALN staging using PEM versus traditional breast mammography and ultrasound in patients presenting with early-stage breast cancer. This study focuses on determining if PEM can reliably stage ALNs and potentially eliminate the need for more invasive methods. Methods In a study involving 94 breast cancer patients, PEM was used to assess ALNs. The nodes were visually evaluated for positive or negative uptake, and further categorized as non-specific, indeterminate, or malignant based on their maximum uptake values. This classification was then compared with histopathological results. Results There were a total of 94 breast cancer patients; the results from PEM demonstrated an ALN detection sensitivity of 83.3%. The specificity of PEM in this context was found to be 98.08%, and the overall accuracy rate was 91.49%. Additionally, the Positive Predictive Value (PPV) was calculated to be 97.2%, and the Negative Predictive Value (NPV) was 87.9%. Conclusions The initial study has shown encouraging outcomes in terms of accurate lymph node assessment.

Abstract Background This crossover clinical study aimed to evaluate and compare masticatory performance and patient satisfaction for patients rehabilitated with conventional heat-cured acrylic resin and 3D-printed mandibular implant overdentures retained with bar attachment. Materials and methods Sixteen completely edentulous healthy participants received new conventional dentures. In the mandible, four interforaminal implants were inserted. Following the stage of osseointegration, the bar was constructed in a trapezoidal configuration. Each patient randomly received the following overdentures using a crossover design: (1) conventional heat-cured acrylic resin overdenture and (2) 3D-printed overdenture (developed by scanning of mandibular conventional overdenture). The masticatory performance was assessed by conducting a two-colour mixing ability test at 5, 10, 20, 30, and 50 masticatory cycles. Moreover, the McGill Denture Satisfaction Questionnaire (MDSQ) was employed to assess patient satisfaction. Evaluation was performed after 3 months of using each overdenture. Paired sample t tests were used to compare the masticatory performance and MDSQ scores of patients for both prostheses. Results No significant difference in masticatory performance was reported between the two types of overdentures. Regarding patient satisfaction, only the esthetic aspect was significantly better for conventionally processed overdentures than for printed overdentures. Insignificant differences were observed regarding other MDSQ items between the two overdentures. Conclusion Within this clinical study, 3D-printed implant overdentures showed promising results in terms of chewing efficiency and patient satisfaction compared to conventionally fabricated implant overdentures. Trial registration Retrospectively registered at www.clinicaltrials.gov : NCT06148727.(28/11/2023).

Concrete completely submerged in sulfate solutions has been used as the primary study subject for the durability of concrete subjected to sulfates. On the other hand, empirical data from the field indicates that concrete exposed to sulfates may exhibit physical attack-induced surface scaling above. This study aims to study the two different types of local bacteria, (BS) and (BM), with content of 0%, 0.25%, 1%, 2.50%, and 5.00% by cement weight used in this work under curing in sulfate to examine the efficiency of bacterial self-healing of cracks for sustainable concrete in aggressive sulfate attack environments. The results show that in both curing in freshwater, FW, and sulfate, SUL, the optimum bacteria ratio was 2.5% BM, and the compressive strength improved by 43.34% for FW and 47.65% for sulfate. On the other hand, the results proved that the crack-filling and crack-repairing methods may be considered quicker than conventional methods. Moreover, a detailed conclusion about the preparation and processing of bacteria to provide the most significant content of locally accessible bacteria in Egypt, mainly when using chemical and mineral additives.