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Abstract Background Cirrhotic cardiomyopathy, an intricate and multifaceted complication of end-stage liver disease, manifests as systolic and diastolic dysfunction in patients without previously diagnosed cardiac disease. Our study aims to investigate the prevalence of systolic and diastolic function in patients with cirrhotic cardiomyopathy in our region. Methods We conducted a cross-sectional study on 68 patients with established cirrhosis, and no overt cardiac manifestations, who consequently underwent 2D echocardiography to quantify systolic and diastolic dysfunction, as defined by the 2019 Cirrhotic Cardiomyopathy Consortium. The severity of cirrhosis was determined using various validated scoring systems. Results A total of 19 out of 68 (28%) had systolic dysfunction, while 6/68 (9%) had evidence of diastolic dysfunction. Overall prevalence of cirrhotic cardiomyopathy was 23/68 (34%), and the presence of hepatitis C was strongly associated with systolic dysfunction with p-value of 0.007. However, it was not significantly associated with diastolic dysfunction, p-value = 0.59. Logistic regression analysis did not show any significant association between cardiac dysfunction and the severity of liver cirrhosis, as assessed by Child–Pugh, MELD, ALBI, PALBI, portal hypertension, and FIB-4 score (R 2 = 3.66, F (13, 39) = 1.33, p = 0.234). Conclusion Our study reveals a remarkable prevalence of cirrhotic cardiomyopathy, which despite being a frequently occurring phenomenon often goes unrecognized. Lack of correlation with the severity of liver cirrhosis, based on currently available scoring system, suggests either a still poorly understood pathological mechanism or requires the development of a new validated reliable scoring system through multi-center longitudinal studies.

Abstract Silicon nitride (Si3N4) is a bioceramic material with potential applications. Customization and high reliability are the foundation for the widespread application of Si3N4 bioceramics. This study constructed a new microwave heating structure and successfully prepared 3D printed dense Si3N4 materials, overcoming the adverse effects of a large amount of 3D printed organic forming agents on degreasing and sintering processes, further improving the comprehensive performance of Si3N4 materials. Compared with control materials, the 3D printed Si3N4 materials by microwave sintering have the best mechanical performance: bending strength is 928 MPa, fracture toughness is 9.61 MPa·m1/2. Meanwhile, it has the best biocompatibility and antibacterial properties, and cells exhibit the best activity on the material surface. Research has shown that the excellent mechanical performance and biological activity of materials are mainly related to the high-quality degreasing, high cleanliness sintering environment, and high-quality liquid-phase sintering of materials in microwave environments.

The combination of iron and copper (Fe/Cu) loaded on glass (G-Fe/Cu) has been developed for this study. The green synthesis was used to create bimetallic nanoparticles (G-Fe/Cu) using grape leaves extract, which employed as a natural reducing agent to easily produce nZVI from iron salts. The particle size, surface morphology, elemental composition and degree of crystallinity of the resulting nanocomposite have been analyzed by means of energy-dispersive X-ray spectroscopy (EDX), scanning electronic microscopy (SEM), Fourier-transform infrared spectroscopy (FTIR), Energy dispersive X-ray spectroscopy (EDS), and transmission electron microscopy (TEM). G-Fe/Cu nanocomposite were employed as adsorbent materials to eliminate ciprofloxacin (CIP) from polluted aqueous solution. Some factors affecting the adsorption function, in batch and continuous experimentations have been examined to select the optimum parameters that accomplish the maximum elimination ratio (99 %) and to investigate the efficiency of the nanoparticles as reactive bed materials. It was discovered that the ideal conditions were CIP concentration (50 ppm), pH 7, nanoparticles dosage (0.5 mg/ 50 mL) and 100 min of optimum contact time. In present paper, the response surface methodology (RSM) was applied as statistical tool used to optimize and model complex systems for elimination of CIP antibiotic from aqueous solution with selection the same four factors that mentioned above. The best appropriate isotherm model was the Freundlich model in batch study. The findings imply that hazardous compounds can be successfully eliminated from aqueous solutions using the prepared nanocomposites. The model's predictions aligned well with experimental outcomes, and the G-Fe/Cu nanocomposite effectively removed CIP from the solutions.

This review underscores the fundamentals of MIP-CMs and systematically summarizes their synthetic strategies and applications, and potential developments. MIP-CMs are widely acclaimed for their versatility, finding applications in separation, filtration, detection, and trace analysis, as well as serving as scaffolds in a range of analytical, biomedical and industrial contexts. Also characterized by extraordinary selectivity, remarkable sensitivity, and outstanding capability to bind molecules, those membranes are also cost-effective, highly stable, and configurable in terms of recognition and, therefore, inalienable in various application fields. Issues relating to the potential future for the paper are discussed in the last section with the focus on the improvement of resource practical application across different areas. Hence, this review can be seen as a kind of cookbook for the design and fabrication of MIP-CMs with an intention to expand the scope of their application.

The Languages of the Indian subcontinent are less represented in current NLP literature. To mitigate this gap, we present the IndicDialogue dataset, which contains subtitles and dialogues in 10 major Indic languages: Hindi, Bengali, Marathi, Telugu, Tamil, Urdu, Odia, Sindhi, Nepali, and Assamese. This dataset is sourced from OpenSubtitles.org, with subtitles pre-processed to remove irrelevant tags, timestamps, square brackets, and links, ensuring the retention of relevant dialogues in JSONL files. The IndicDialogue dataset comprises 7750 raw subtitle files (SRT), 11 JSONL files, 6,853,518 dialogues, and 42,188,569 words. It is designed to serve as a foundation for language model pre-training for low-resource languages, enabling a wide range of downstream tasks including word embeddings, topic modeling, conversation synthesis, neural machine translation, and text summarization.

Imogiri - Dlingo road section is a primary collector road located in the Mangunan tourist area, Bantul, Indonesia. This road is a provincial road with hilly terrain, lots of sharp turns, and long ascents and descents, which are potential for traffic accidents. Police data records that in February 2022 there was an accident on this road with 13 deaths and 33 injuries. Therefore, this study aims to evaluate road geometric, both horizontal and vertical alignments on Imogiri - Dlingo road based on Guidelines for Road Geometric Design number 13/P/BM /2021. To do so, road geometric analysis is conducted by employing road safety inspection data, which is then modeled using AutoCAD Civil 3D software. Based on the survey on road geometric, it is known that the number and width of lanes and shoulders are in accordance with Guidelines. Meanwhile, the analysis results using computer program show that this road has 24 horizontal and 6 vertical alignments. Nevertheless, 87% of bend radius, 67% of curve length, 58% of bend angle, 43% of slope, 57% of critical length, and 67% of control design (K) are not fulfilled the requirements. Therefore, Imogiri - Dlingo road is dangerous road and is potentially causing fatal accidents.

This study attempts to study the impact of the moderating role of internal audit between cloud accounting and limiting creative accounting practices in commercial banks. The study utilized a descriptive and analytical approach. The target population of this research consists of all employees of the 13 Jordanian commercial banks listed on the Amman Stock Exchange, while the number of employees in commercial banks is (22,407) employees. This led to the use of a simple random sample of (400) employees. The results found that there is a positive effect of the moderating role of internal audit on the impact of cloud accounting on reducing creative accounting practices in commercial banks. The study suggests that future studies should give recommendations and proposals to improve and develop cloud accounting and internal auditing in commercial banks, increase transparency, monitoring and compliance in accounting and financial operations, and reduce the risks associated with cloud accounting and creative accounting practices.

Bangla has a unique script with a complex set of characters, making it a fascinating subject of study for linguists and cultural enthusiasts. Unique in some of its similar characters which are only distinguishable by subtle differences in their shapes and diacritics, there has been a notable increase in research on Bangla character recognition and classification using machine learning-based approaches. However, Handwritten Bangla Character Recognition (HBCR) training requires an adequate amount of data from a diversely distributed dataset. Making diverse datasets for HBCR training is a challenging and tedious task to carry out. Yet, there is limited research on the automatic generation of handwritten Bangla characters. Motivated by this open area of research, this paper proposes a novel approach ‘Okkhor-Diffusion’ for class-guided generation of Bangla isolated handwritten characters using a novel Denoising Diffusion Probabilistic Model (DDPM). No prior research has used DDPM for this purpose, making the proposed approach novel. The DDPM is a generative model that uses a diffusion process to transform noise-corrupted data into diverse samples; despite being trained on a small training set. In our experiments, StyleGAN2-ADA had notably inferior performance compared to Okkhor-Diffusion in generating realistic isolated handwritten Bangla characters. Experimental results on the BanglaLekha-Isolated dataset demonstrate that the proposed Okkhor-Diffusion model generates realistic isolated handwritten Bangla characters, with a mean Multi-Scale Structural Similarity Index Measure (MS-SSIM) score of 0.178 compared to 0.177 for the real samples. The Fréchet Inception Distance (FID) score for the synthetic handwritten Bangla characters is 5.426. Finally, the newly proposed Bangla Character Aware Fréchet Inception Distance (BCAFID) score of the proposed Okkhor-Diffusion model is 10.388. The code for the proposed Okkhor-Diffusion framework is available at https://github.com/MubtasimFuad10/Okkhor-Diffusion.

Abstract Background Current guidelines advocate for colorectal cancer (CRC) screening in adults who are at risk by using direct visualization methods such as colonoscopy. However, in Egypt, there is a paucity of data regarding the current practice of colonoscopy screening. Moreover, more information is needed about the knowledge and attitudes of potential participants regarding the procedure and possible barriers that can limit their participation. Methods We conducted a nationwide cross-sectional study using an interview-based survey of patients aged 45 years or above who presented to outpatient clinics of nine university hospitals throughout Egypt. Participants were surveyed to assess their compliance with CRC colonoscopy screening guidelines, their knowledge of and attitude towards colonoscopy screening, and their perspective on potential barriers to colonoscopy screening. Results A total of 1,453 participants responded to our survey in the nine study centers. Only a minority of participants (2.3%) were referred for CRC screening. Referral rates were higher among those who knew someone with a history of CRC (5.3% vs 1.5%, p

Tuberkulosis (TB paru) adalah penyakit infeksi diakibatkan oleh bakteri Mycobacterium tuberkulosis memiliki ciri umunya seperti batuk dalam waktu 2-3 minggu namun masalah yang sering terjadi kesulitan mengeluarkan dahak dan bisa terjadi sesak napas mengakibatkan saturasi oskigen menurun. Hasil studi pendahuluan di ruang Paru Center RSUD Ulin Banjarmasin pada bulan April-Juni 2023 sebanyak 63 orang. Mengidentifikasi penerapan batuk efektif terhadap peningkatan saturasi oksigen (SPO2) pada TB paru di RSUD Ulin Banjarmasin.Penelitian ini menggunakan metode deskriptif. Sampel berjumlah 12 orang dengan teknik total sampling. Pengumpulan data menggunakan lembar observasi dan SOP batuk efektif yang sudah tersedia di ruang Paru Center. Nilai saturasi oksigen sebelum penerapan batuk efektif 95% sebanyak 2 orang, 96% sebanyak 5 orang, 97% sebanyak 4 orang, 98% sebanyak 1 orang. Nilai saturasi oksigen sesudah penerapan batuk efektif 96% sebanyak 1 orang, 97% sebanyak 4 orang 98% sebanyak 4 orang, 99% sebanyak 3 orang. Penerapan batuk efektif nilai saturasi oksigen terendah 95% dan tertinggi 98%, setelah dilakukan penerapan batuk efektif mengalami peningkatan nilai saturasi oksigen terrendah 96% dan tertinggi 99% diharapkan perawat untuk mengedukasi batuk efektif sesuai SOP

Abstract Background Erector spinae plane block (ESPB) and serratus anterior plane block (SAPB) are regional anesthesia techniques that have shown favorable results in pain management following thoracic surgeries; however, their relative superiority is unclear. This review (PROSPERO: CRD42023443018) aims to compare the analgesic efficacy of ESPB and SAPB in patients undergoing thoracic surgeries through the pooled analysis of co-primary outcomes: postoperative oral-morphine-equivalent (mg) consumption in 24 h and pain scores (static) at 24 h. Methods A literature search was conducted across PubMed, Cochrane Library, and Google Scholar to identify randomized controlled trials (RCTs) from inception to May 2023, comparing ESPB and SAPB in thoracic surgeries. Statistical pooling was done using Review Manager 5.4.1. Bias assessment employed the Cochrane Collaboration Risk-of-Bias 2.0 tool. The strength of evidence was assessed using the guidelines from the GRADE working group. Results Nine RCTs (485 patients) were included in the study. Postoperative pain scores (static) at 24 h (mean difference (MD) = − 0.31 [− 0.57, 0.05], p = 0.02) and postoperative oral-morphine-equivalent (mg) consumption in 24 h (MD = − 19.73 [− 25.65, − 13.80], p

Background: The incidence of Laboratory acquired infections is on the rise despite the existence and continuous upgradation of infection prevention protocols. The objective of this study was to determine the practice of lab staff before and after carrying out an intervention in the form of health education intervention based on WHO protocols for infection prevention. Methods: This is a Quasi-experimental study carried out in three hospitals in Rawalpindi. A total of n=38 technical and non-technical lab staff participated in the study. Laboratory practices were observed by the researchers themselves for a week. Then an education session was conducted for the staff regarding the World Health Organization (WHO) standard protocols for infection control. The post-intervention data were collected after about two weeks of health education sessions. Data were analyzed using SPSS version 22. Paired t-test was applied to compare the mean scores of pre- and post-interventional data. Results: The laboratory staff participated in the study mostly 19(50%) belonging to the age(years) range of 20-27. The percentage of respondents having good practice of infection prevention protocols before intervention was 7.5%, after the intervention this increased to 57.9%. Paired t-test showed that the difference in practice mean score of pre- and post-interventional data was statistically significant (CI=21.55-15.33 p-value=0.001). Conclusion: Pre-intervention data showed that the practice of the staff was not completely in accordance with WHO infection prevention. After delivering the education session on WHO infection prevention protocols, there was a significant improvement in the practices of laboratory staff.

Background 18Fluorine-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) CT imaging has been used in many inflammatory and infectious conditions to differentiate areas of increased metabolic activity. FDG uptake differs between areas of normal lung parenchyma and interstitial lung disease (ILD).Objectives In this study, we investigated whether FDG-PET/CT parameters were associated with a change in the quality of life (QoL) in patients with ILD over 4 years of follow-up.Methods Patients underwent PET-CT imaging at diagnosis and were followed up with annual QoL assessment using the St George’s Respiratory Questionnaire (SGRQ) until death or 4 years of follow-up. Maximum standard uptake value (SUVmax) and Tissue-to-Background Ratio (TBR) were assessed against SGRQ overall and subscale scores.Results 193 patients (94 patients in the idiopathic pulmonary fibrosis (IPF) subgroup and 99 patients in the non-IPF subgroup) underwent baseline FDG-PET/CT imaging and QoL assessment. Weak-to-moderate correlation was observed between baseline SUVmax and SGRQ scores in both ILD subgroups. No relationship was observed between baseline SUVmax or TBR and change in SGRQ scores over 4 years of follow-up. In the IPF subgroup, surviving patients reported a decline in QoL at 4 years post diagnosis whereas an improvement in QoL was seen in surviving patients with non-IPF ILD.Conclusions Weak-to-moderate positive correlation between baseline SUVmax and SGRQ scores was observed in both ILD subgroups (IPF:rs=0.187, p=0.047, non-IPF: rs=0.320, p=0.001). However, baseline SUVmax and TBR were not associated with change in QoL in patients with IPF and non-IPF ILD over 4 years of follow-up. At 4 years post diagnosis, surviving patients with IPF reported declining QoL whereas improvement was seen in patients with ILD who did not have IPF.

Objectives The aim of this study is a descriptive presentation of cases of acute watery diarrhoea (AWD) that were presented to Aleppo University Hospital (AUH) during the recent cholera outbreak in Syria.Design Prospective, observational, cohort study.Setting and participants A total of 1061 patients with AWD were admitted to AUH during the timeframe of 20 September 2022 to 20 October 2022. The data collection was done through a structured questionnaire. This includes comprehensive clinical observation, laboratory analyses, therapeutic interventions and holistic case evaluations.Results The analysis has revealed notable insights: a predominant proportion of patients (58.6%) were residents from urban areas and 40.3% were residents from rural areas. Intriguingly, a diverse range of potential infection sources emerged from patient data within our hospital, including uncontrolled well water, vegetables and faecal-oral transmission through contaminated street/fast food. At discharge, most patients were in good health (79.7%), followed by moderate health (17.6%) and poor health (2.3%), with a minimal percentage dying before discharge (0.4%). The most common complications reported at admission and during hospitalisation included electrolyte imbalance (28.2%), followed by severe dehydration (16.3%). In the follow-up period, the majority of patients exhibited good health (81.0%). Older patients (>60 years) had poorer outcomes, with 8.4% having poor health and 4.2% death rate.Conclusions The study found results consistent with previous AWD outbreaks in developing countries like Yemen, Nigeria and Lebanon. Preventative measures like improving water sanitation and hygiene practices are essential to prevent future outbreaks and ease the strain on healthcare systems. Therefore, future studies must investigate the risk factors that increase the spread and the severity of the disease and investigate the best management method.

This study aims to examine the role of attitude in mediating the relationship between emotional maturity, emotional intelligence and emotional sensitivity to teacher performance. This study used a quantitative approach involving 101 teachers from various levels in Demak, Central Java, Indonesia. Data was collected through a questionnaire using 5 Likert scale. The data Processing using SEM PLS version 3.2.9 to test exogenous variables against endogenous variables. The results show that emotional intelligence and emotional sensitivity can shape teacher performance, however, emotional maturity canot shape teacher performance significantly. On the other hand, teacher emotioanl intelligence has been proven to be a strong predictor in shaping teachers’ attitutde, while attitude cannot shape teacher performance. Therefore, it can be said that attitude cannot shape the teacher performance.

Intelligent Transportation Systems (ITS) are becoming increasingly important as traditional traffic management systems struggle to handle the rapid growth of vehicles on the road. Accurate traffic prediction is a critical component of ITS, as it can help improve traffic management, avoid congested roads, and allocate resources more efficiently for connected vehicles. However, modeling traffic in a large and interconnected road network is challenging because of its complex spatio-temporal data. While classical statistics and machine learning methods have been used for traffic prediction, they have limited ability to handle complex traffic data, leading to unsatisfactory accuracy. In recent years, deep learning methods, such as Recurrent Neural Networks (RNNs) and Convolutional Neural Networks (CNNs), have shown superior capabilities for traffic prediction. However, most CNN-based models are built for Euclidean grid-structured data, while traffic road network data are irregular and better formatted as graph-structured data. Graph Convolutional Neural Networks (GCNs) have emerged to extend convolution operations to more general graph-structured data. This paper reviews recent developments in traffic prediction using deep learning, focusing on GCNs as a promising technique for handling irregular, graph-structured traffic data. We also propose a novel GCN-based method that leverages attention mechanisms to capture both local and long-range dependencies in traffic data with Kalman Filter, and we demonstrate its effectiveness through experiments on real-world datasets where the model achieved around 5% higher accuracy compared to the original model.

Urban planning, which is inherently multifaceted, requires the development of innovative tools to navigate its complexities. This study introduces a pioneering approach that presents an AI-driven framework tailored for urban data collection and analysis. The impetus for this framework is highlighted through the unique narrative of Most city, which is profoundly transformed by mininginduced displacement and resettlement. While most cities serve as a vivid illustration of the challenges cities can face, especially in the wake of industrial imperatives, this study focuses on the potential of AI in addressing such challenges. The proposed framework, while grounded in advanced computational methodologies, is designed with keen emphasis on real-world applications, ensuring its relevance and adaptability. By integrating Most city’s detailed account with this AI-centric methodology, this study emphasizes the importance of a data-driven approach in understanding and addressing urban dilemmas. Importantly, this study is preparatory, laying the groundwork for the framework’s future application, especially in contexts such as Most city. By bridging advanced AI techniques with tangible urban challenges, this research illuminates a path forward, suggesting a future in which urban planning is not only informed by data but also empowered by AI’s analytical process.

The ageing European population is driving the demand for age-friendly communities that support older individuals’ health and well-being. As communities navigate this transition, Transition Design emerges as a promising approach for addressing complex social and environmental challenges. This study explores the potential of Transition Design to create age-friendly communities in Europe. Drawing on examples from several European countries, this paper describes the key principles of Transition Design and how they can be applied to the development of age-friendly communities. This article highlights the importance of participatory processes in involving older people and other stakeholders in the design process, and discusses the role of technology in creating more accessible and inclusive environments. It also considers some of the challenges of implementing a transition design approach in a European context. In conclusion, this study asserts that Transition Design offers a promising approach for creating sustainable, inclusive, and responsive age-friendly communities.

Smart cities continue to be discussed throughout Europe as a result of the continent’s rising urbanization and the need for sustainable development. Artificial intelligence (AI) has the potential to significantly promote this shift by assisting cities in becoming more effective, sustainable, and receptive to the requirements of their residents. The goal of this study is to examine the potential and difficulties of AI in urban development and present a framework for incorporating AI into city planning and management in European cities. This is done by analyzing case study examples from European cities and examining primary and secondary data sources, with the aim of providing a comprehensive framework for the sustainable integration of AI systems. This study presents a set of ethical and inclusive AI criteria, such as transparency, inclusion, and accountability, to enable responsible AI research and implementation. It continues by emphasizing the need for efficient AI integration in smart cities and pushing for a holistic AI-enabled transition to inclusive and sustainable smart cities.

Key Clinical Message Paragangliomas (PGLs) are rare neuroendocrine tumors. Sometimes, these tumors secrete excessive catecholamines, which results in the manifestations of various signs and symptoms, usually with a triad of hypertension, tachycardia, and headache. We report the case of a 42‐year‐old woman presenting with uncontrolled hypertension, right facial palsy, vomiting, and disturbed gait. Diagnosis for PGL was confirmed on postoperative histological examination of the excised mass and correlated with preoperative clinical and radiological findings. Tumor excision was done via a suboccipital craniotomy approach. Our case presents the typically severe features of a jugulotympanic PGL, but most importantly, it highlights the necessity of biochemical diagnosing, thorough probing of the causes of hypertension, and a multi‐disciplinary approach in dealing with these tumors. Moreover, the case emphasizes necessitating the use of preoperative embolization in vascular tumors of the head and neck to avoid a hemorrhagic crisis during surgery. Unfortunately, due to a lack of adequate hospital funds, the surgeon had to proceed without preoperative embolization. Despite such a risk, the excision was a success.

Introduction: The cytochrome P450 enzyme subfamilies, including CYP3A4 and CYP1A2, have a major role in metabolism of a range of drugs including several anti-cancer treatments. Many factors including environmental exposures, diet, diseaserelated systemic inflammation and certain genetic polymorphisms can impact the activity level of these enzymes. As a result, the net activity of each enzyme subfamily can vary widely between individuals and in the same individual over time. This variability has potential major implications for treatment efficacy and risk of drug toxicity, but currently no assays are available for routine use to guide clinical decision-making.Methods: To address this, a mass spectrometry-based method to measure activities of CYP3A4, CYP1A2 was adapted and tested in free-living participants. The assay results were compared with the predicted activity of each enzyme, based on a self-report tool capturing diet, medication, chronic disease state, and tobacco usage. In addition, a feasibility test was performed using a low-volume dried blood spots (DBS) on two different filter-paper supports, to determine if the same assay could be deployed without the need for repeated standard blood tests.Results: The results confirmed the methodology is safe and feasible to perform in free-living participants using midazolam and caffeine as test substrates for CYP3A4 and CYP1A2 respectively. Furthermore, though similar methods were previously shown to be compatible with the DBS format, the assay can also be performed successfully while incorporating glucuronidase treatment into the DBS approach. The measured CYP3A4 activity score varied 2.6-fold across participants and correlated with predicted activity score obtained with the self-report tool. The measured CYP1A2 activity varied 3.5-fold between participants but no correlation with predicted activity from the self-report tool was found.Discussion: The results confirm the wide variation in CYP activity between individuals and the important role of diet and other exposures in determining CYP3A4 activity. This methodology shows great potential and future cross-sectional and longitudinal studies using DBS are warranted to determine how best to use the assay results to guide drug treatments.

Background and objectives: Gelastic seizures due to hypothalamic hamartomas (HH) are challenging to treat, in part due to an incomplete understanding of seizure propagation pathways. Although magnetic resonance imaging-guided laser interstitial thermal therapy (MRgLITT) is a promising intervention to disconnect HH from ictal propagation networks, the optimal site of ablation to achieve seizure freedom is not known. In this study, we investigated intraoperative post-ablation changes in resting-state functional connectivity to identify large-scale networks associated with successful disconnection of HH. Methods: Children who underwent MRgLITT for HH at two institutions were consecutively recruited and followed for a minimum of one year. Seizure freedom was defined as Engel score of 1A at the last available follow-up. Immediate pre- and post- ablation resting-state functional MRI scans were acquired while maintaining a constant depth of general anesthetic. Multivariable generalized linear models were used to identify intraoperative changes in large-scale connectivity associated with seizure outcomes. Results: Twelve patients underwent MRgLITT for HH, five of whom were seizure-free at their last follow-up. Intraprocedural changes in thalamocortical circuitry involving the anterior cingulate cortex were associated with seizure-freedom. Children who were seizure-free demonstrated an increase and decrease in connectivity to the pregenual and dorsal anterior cingulate cortices, respectively. In addition, children who became seizure-free demonstrated increased thalamic connectivity to the periaqueductal gray immediately following MRgLITT. Discussion: Successful disconnection of HH is associated with intraoperative, large-scale changes in thalamocortical connectivity. These changes provide novel insights into the large-scale basis of gelastic seizures and may represent intraoperative biomarkers of treatment success.

Surface mining is one of the hazardous industries that have several risky operations, including transportation, treatment, and mineral extraction. To avoid the risk of disaster, it is important to evaluate safety procedures and determine expected hazards. The aim of this study is to develop a thorough safety evaluation model for the surface mining industry based on the analytic hierarchy process (AHP), one important multi-criteria decision-making approach. A total of 11 criteria and 36 sub-criteria that are both independent and homogeneous were involved in the decision problem. Further, a deep sensitivity analysis was conducted to assess the stability of the ranking preference. The findings indicate that four out of the eleven criteria are particularly significant. To test the model’s applicability and effectiveness, a case study was conducted involving three surface mining companies located in the north of Jordan. The results demonstrate that the model is reliable, applicable, and effective in addressing real-world problems.

Metastases to the breast from a nonmammary primary are rare. Primary fallopian tube carcinoma is one of the rarest malignancies of the female genital tract. Therefore, breast metastases from primary fallopian tube carcinoma are considered extremely rare. In this article, we shared the case of serous carcinoma of fallopian tube with metastasis to an intramammary lymph node, presenting as a solitary breast mass. On initial staging 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography for this patient with serous carcinoma of fallopian tube, a solitary FDG avid breast mass was found, along with FDG avid multistation nodes. The breast mass was evaluated with diagnostic mammogram and ultrasound and eventually biopsy of this mass revealed metastatic lymph node from carcinoma of fallopian tube origin.

In the study, humic acid was applied to soybean (Glycine max L.), which has high economic value and importance, to determine the tolerance level of the plant against salt stress, and physical and chemical changes in the plant were observed. The study was carried out in the climate room of Van Yuzuncu Yil University Faculty of Agriculture, Department of Field Crops in 2019. In the research, İlksoy soybean variety was used. The experiment was carried out in 4 factorial orders according to the factorial experiment was designed based on Completely Randomized Design. In the research, four different Humic acid doses (0, 500, 1000 and 2000 ppm) and 3 different NaCl salt doses (0, 125 and 250 mM) were used. In the study, root length, stem length, root fresh weight, stem fresh weight, root dry weight, stem dry weight, leaf area, chlorophyll content, ion leakage in leaf tissues, lipid peroxidation level (MDA), relative water content and membrane resistance index in leaf tissues were determined. Properties such as index were also examined. As a result of the study, the longest root was 38 cm for the control plots that salt and humic acid didn’t apply to the plants. The highest root fresh weight was 2.08 g and the stem fresh weight was 1.87 g of the plots where 500 ppm humic acid dose applied. In addition, the plants with the highest chlorophyll ratio was 51.05 under 250 mM salt applied without humic acid application.

Latar Belakang : Perkembangan pada balita yaitu suatu proses dialami balita dimulai dari bertambahnya sel-sel di organ tubuh. Perkembangan balita yang dievaluasi yaitu bicara dan bahasa jika kurang stimulasi mengalami keterlambatan bicara dan bahasa (Speech delay) sehingga orang tuanya mengalami kecemasan Tujuan : Mengidentifikasi kejadian speech delay pada balita dengan kecemasan orang tua di RSUD Ulin Banjarmasin Metode : Penelitian ini menggunakan metode statistik deskriptif. Sampel berjumlah 69 orang dengan teknik accidental sampling. Pengumpulan data menggunakan kuesioner yang sudah uji valid dan reliabel analisa data dengan uji mean, median, modus, standar deviasi dan distribusi frekuensi Hasil : Balita yang didiagnosa speech delay orang tuanya tidak mengalami kecemasan rendah, mengalami kecemasan sedang sebanyak 13 orang (18,84%), dan orang tua yang balitanya speech delay mengalami kecemasan tinggi sebanyak 3 orang (4,35%). Balita yang didiagnosa speech delay dengan masalah lain yang orang tuanya mengalami kecemasan rendah sebanyak 1 orang (1,45%), orang tua yang anaknya speech delay dengan masalah lain mengalami kecemasan sedang sebanyak 45 orang (65,22%) dan orang tua yang anaknya speech delay dengan masalah lain mengalami kecemasan tinggi sebanyak 10 orang (14,49%).Aspek kognitif dari kecemasan memiliki skor paling tinggi dengan keluhan kesulitan tidur dengan sebesar 6,16% Simpulan : Kecemasan orang tua yang memiliki balita speech delay dan speech delay dengan masalah lain mayoritas kecemasan sedang. Direkomendasikan perawat pentingnya mengkaji kecemasan orang tua yang anaknya speech delay dari aspek kognitif

Background: Fibromyalgia syndrome (FMS) is a commonly occurring and disabling chronic pain disorder of unknown etiology. It is a syndrome of widespread diffuse pain with a low pain threshold and different FMS allied symptoms. Obesity is a comorbidity that is commonly occurring with FMS and may be linked to its severity. This study aims to estimate the prevalence of overweight and obesity in FMS and their effect on pain and FMS allied symptoms. Methods: One hundred and ten (10 male and 100 female) FMS patients diagnosed following the 1990 American College of Rheumatology (ACR) classification criteria for FMS completed a questionnaire about age, gender, and pain severity on a visual analog scale (VAS), evaluated for morning stiffness, disturbance of sleep, fatigue, anxiety, depression, and irritable bowel and the count of tender points. Weight, height, and body mass index (BMI) were calculated for all participants. Results: Seventy-four (67.27%) were overweight/obese; of them, 68 (61.81%) were females. All the FMS allied symptoms were more prevalent in overweight/obese FMS patients. Overweight/obese FMS patients have a high number of TP and greater pain sensitivity to TP palpation. Conclusion: Overweight and obesity are commonly associated with FMS. Obesity may contribute to the severity of FMS and its allied symptoms.

Pulse Width Modulation (PWM) driven power converters are widely used in realizing the function of rectification and inversion in renewable and emerging power applications. They play a key role in tying renewable energy sources of solar and wind to conventional energy grid systems. Such emergying styles of power systems are referred to as Distributed Generation (DG) or energy mix. The PWM-based switching devices are also sources for injecting harmonics to degrade the quality level in this emerging style of DG systems causing steady-state waveform distortion. Thus power converters operated by finely tuned PWM play an important role in mitigating the voltage waveform distorting harmonics and consequently improving the stability of the system. This paper presents the mitigation of harmonic contents by reproducing as a novel space vector-based switching pattern of SVPWM. In this work, the proposed switching pattern will have a DC link RMS current equal to or less than that of a conventional SVPWM current under the same switching frequency (SF), load, L-C filter, DC bus voltage, and Modulation Index (MI). The results include a 13.43% improvement in Total Harmonic Distortion (THD) at relatively high modulation indices. The Weighted Total Harmonic Distortion (WTHD) has also improved by 47.37% and the number of thyristors has been reduced lowering switching losses. The Matlab-Simulink simulation results have been experimentally verified with an Advanced Digital Analog Learning Module (ADALM M2k)-based experimental setup, improving the proposed SVPWM THD by 13.49%. The conventional and proposed SVPWM performance comparison is done by obtaining Fast Fourier Transform (FFT) by driving a two-level three-phase voltage source inverter.

With the development of wireless technology, users not only have wireless access to the Internet, but this has also sparked the emergence of Wireless Ad-hoc Networks (WANETs); this promising networking paradigm has the potential to adopt the shape of new emergent networks such as the Internet of Things (IoT), Vehicular Ad-hoc Networks (VANET) and Wireless Sensor Networks (WSN). However, channel contention (CC) is one of the key reasons why the TCP performs poorly in WANETs. This paper presents a mechanism called Cross-layer Solution for Contention Control (CSCC) to enhance TCP performance in WANETs. Each node starts marking packets in the proposed mechanism when its CC level reaches a certain threshold. As a result, the source node adjusts the congestion window (cwnd) size to a good state to control the insertion ratio of packets into the network. To provide a fair share to each flow, the flow having a large cwnd is penalized more. Numerous simulations have been conducted across several topologies to clarify the performance of the suggested mechanism. The simulation findings show that, in the presence of the Ad-hoc On-demand Distance Vector (AODV) routing and Dynamic Source Routing (DSR) protocols, the proposed CSCC mechanism outperformed TCP NewReno in terms of throughput and fairness. In comparison to TCP NewReno, the suggested mechanism has fewer retransmitted packets.

Recent earthquakes worldwide have led to significant loss of life and structural damage to infrastructure, especially road bridges. Existing bridge monitoring systems have limitations, including restricted detection capabilities, subjectivity, human error, labor-intensive inspections, limited access to remote areas, and high costs. Aging infrastructures pose a critical concern for organizations and government funding policies, showing signs of decay and impending structural failure. To address these challenges, this research proposes an IoT-based bridge health status monitoring and warning system that is wireless, low-cost, durable, and user-friendly. The proposed system builds upon engineering standards and guidelines to classify bridge health status into categories ranging from excellent to collapse condition. It incorporates deflection, vibration, temperature, humidity, and infrared sensors, combined with IoT and a fuzzy logic algorithm. The primary objective is to reduce bridge maintenance costs, extend lifespans, and enhance transportation safety through an early warning system via a mobile application. Additionally, a Google Maps interface has been developed to display bridge conditions along with real-time traffic video. To validate the proposed system, a 3-D prototype model was constructed and tested. Practical testing of the fuzzy logic algorithm aligned with the simulation outcomes, demonstrating expected accuracy in determining bridge health status.

Objective: To evaluate the protective effect of Azilsartan against Cisplatin-induced ocular damage by ameliorating the oxidative stress and inflammation status, as well as to compare two different doses of Azilsartan to the Resveratrol. Fifty-six male Wister albino-rats, weighing 270±30 g. The rats were allocated at random into seven groups (n=8 per group), as follows: Group 1 (Healthy control) was given 0.5% CMC orally for the 14 days. Group 2 (Positive control) was given a single injection of 7mg/kg Cisplatin intraperitoneally and then 0.5% CMC orally for the following 14 days. Group 3 was given 3.5mg/kg Azilsartan orally for the following 14 days. Group 4 was given 7mg/kg Azilsartan orally for the following 14 days. Group 5 was given a single injection of 7mg/kg Cisplatin intraperitoneally and then 3.5mg/kg Azilsartan orally for the following 14 days. Group 6 was given a single injection of 7mg/kg Cisplatin intraperitoneally and then 7mg/kg Azilsartan orally for the following 14 days. Group 7 (standard) was given 25mg/kg/day Resveratrol orally for following 14 days.Azilsartan at low dose (3.5mg/kg) showed a significant reduction in IL-1β pro-inflammatory marker level, whereas there was no significant effect on MDA and SOD levels in cisplatin-induced ocular damage. Histologically, there were significant reduction in inflammatory exudates, edema, and inflammatory cells infiltration with both doses. Additionally, there were no significant difference among Azilsartan only received groups and Resveratrol group. Azilsartan shows a promising anti-inflammatory effect in ocular tissue in Cisplatin experimental rat models by significantly reducing IL-1β overexpression, through its potent AT1receptor blocking effect. However, Azilsartan showed a slight effect on MDA levels and marginal effect on SOD levels in Cisplatin-induced ocular toxicity. Furthermore, Azilsartan at a low dose slightly mimicked the effect of resveratrol on normal ocular tissue, suggesting an advancement in prophylactic application in ocular injury. Keywords: Azilsartan, IL-1β, Cisplatin, Ocular Toxicity

Oxidative coupling reactions are one of the significant methods used in the estimation of certain drugs in pharmaceutical formulations. This study describes the development of a fast and sensitive spectroscopic method considering the determination of trace amounts of methyldopa in an acidic aqueous solution.The adopted method centered on oxidative coupling due to the drug Methyldopa with the reagent 1, 5-diaminonaphthalene in the presence of ceric (IV) ammonium nitrate as oxidizing agent to form a stable blue-colored product, giving the highest absorption at 730 nm. The product was appeared to agree Beer's law within the limits of (5.4 - 39.6) μg /ml, and a value of molar absorptivity equal to 4.79471 ×104 L/ mol. cm. Sandell’s index, 0.0044 μg/ cm2, Relative standard deviation was in the range (0.5942 - 0.9687) %, whereas recovery average and determination factor were 99.908% and 0.9998. The proposed method has been successfully applied in the determination of Methyldopa in its pharmaceutical preparations.

Background: This study was conducted to find out the correlations and influences of students’ anxiety and motivation to students’ speaking English achievement. Methodology: One hundred and thirteen students Islamic Boarding School of Nabil Husein Samarinda participated in this study. A stratified random sampling technique was used in this study. Foreign Language Classroom Anxiety (FLCAS) and Attitude Motivation Test Battery (AMTB) were used as instruments. Multiple Regression and Path Analysis were used as data analysis techniques to analyze the data. Findings: 80.4% of students’ anxiety influenced to students’ speaking English Achievement. The next finding showed that students’ anxiety correlated to students’ motivation at 94.7%. It indicated a strong correlation where the degree of correlation at 0.897. As well the students’ motivation also affected students’ speaking English achievement on the degree at 79.9%. The last finding showed that students’ speaking English was affected by students’ anxiety and motivation simultaneously. Conclusion: This article explains how the students’ anxiety and motivation influence speaking English achievement. Originality: This research was conducted to find out the correlations and the influences of students’ anxiety, and students’ motivation to students’ speaking English achievement.

A variety of methods, including both modeling and non-modeling water balance techniques, are used in this study to estimate water availability allocated for different demands. The area under investigation is the shared Diyala River basin between Iraq and Iran, which is vulnerable to climate change impact and upstream control and aims to enhance watershed management. Two rainfall-runoff models were applied, the Tanh curve model and the modified Tanh curve model for runoff simulation at the Derbendkhan and Hemmrin hydrometric stations. Data from two meteorological stations in Iraq (Khanakin and Sulymania) and one in Iran (Sanandaj) for 20 hydrological years (2000–2020) was used. Some goodness of fit indicators were used to evaluate the reliability of the model outcomes, including the correlation coefficient, the root mean squared error, the mean absolute error, the deviation of runoff volume, and the index of agreement. Statistical analysis shows no statistically significant difference between observed and predicted runoff at all stations in winter, spring, and annual time scales when using the Tanh curve model, or for monthly and extreme wet events when using the modified Tanh curve method. The modified Tanh curve model was more accurate than the Tanh model and applied only to Sulymania and Sanandaj stations, as it required a considerable amount of precipitation in at least semi-humid areas. HIGHLIGHTS Two empirical models are used to predict Diyala River runoff. The Tanh curve model produces a reasonable fit for winter, spring, and annual time scales, and the modified Tanh curve model gives a reasonable fit on a monthly time scale.; The modified Tanh curve model performed better than the Tanh curve model.; The modified Tanh curve model does not work for arid or semi-arid climates.; Wet extreme events are represented well by the modified Tanh curve model, while the Tanh curve model could not represent dry or wet extreme events.;

Readiness Index Predictors will be developed to predict the level of an individual’s productivity as a result of adopting bring-your-own-device (BYOD) concept. This predictor is capable of helping institutions to plan their BYOD strategies in preparing their users in BYOD implementation. For the purpose of determining the predictors and impacts of the subject matter, a methodology known as a Systematic Literature Review (SLR) was used. Findings of the SLR searches were uploaded into EndNote to lead the systematic literature searches, and further analysis was performed to remove irrelevant literature and duplicate results. Various parameters are expected to be included as part of the predictors, such as user experiences, readability and ease of use.

BackgroundEmotion regulation is an ability related to psychological well-being; when dysregulated, individuals may have psychiatric symptoms and maladapted physiological responses. Virtual reality–assisted cognitive behavioral therapy (VR-CBT) is an effective psychotherapy to target and strengthen emotion regulation; however, it currently lacks cultural sensitivity and can be improved by adapting it to the cultural context of service users. During previous participatory research, we co-designed a culturally adapted cognitive behavioral therapy (CBT) manual and 2 virtual reality (VR) environments to function as a complement to therapy (VR-CBT) for Inuit who would like to access psychotherapy. Emotion regulation skill building will occur in virtual environments that have interactive components such as heart rate biofeedback. ObjectiveWe describe a protocol for a proof-of-concept 2-arm randomized controlled trial (RCT) with Inuit (n=40) in Québec. The primary aims of this research are to investigate the feasibility, benefits, and challenges of the culturally adapted VR-CBT intervention versus an established VR self-management that is available commercially. We will also investigate self-rated mental well-being and objective psychophysiological measures. Finally, we will use proof-of-concept data to identify suitable primary outcome measures, conduct power calculations in a larger trial for efficacy, and collect information about preferences for on-site or at-home treatment. MethodsTrial participants will be randomly assigned to an active condition or active control condition in a 1:1 ratio. Inuit aged 14 to 60 years will receive a culturally adapted and therapist-guided VR-CBT with biofeedback or a VR relaxation program with nonpersonalized guided components over a 10-week period. We will collect pre- and posttreatment measures of emotion regulation and biweekly assessments over the treatment and at 3-month follow-up. The primary outcome will be measured by the Difficulties in Emotion Regulation Scale (DERS-16) and a novel psychophysiological reactivity paradigm. Secondary measures include psychological symptoms and well-being via rating scales (eg, anxiety or depressive symptoms). ResultsAs this is the prospective registration of an RCT protocol, we do not yet report any results from the trial. Funding was confirmed in January 2020, and recruitment is expected to start in March 2023 and is set to finish in August 2025. The expected results are to be published in spring 2026. ConclusionsThe proposed study responds to the community’s desire for accessible and appropriate resources for psychological well-being, as it was developed in active collaboration with the Inuit community in Québec. We will test feasibility and acceptance by comparing a culturally adapted, on-site psychotherapy with a commercial self-management program while incorporating novel technology and measurement in the area of Indigenous health. We also aim to fulfill the needs for RCT evidence of culturally adapted psychotherapies that are lacking in Canada. Trial RegistrationInternational Standard Randomized Controlled Trial Number (ISRCTN) 21831510; https://www.isrctn.com/ISRCTN21831510 International Registered Report Identifier (IRRID)PRR1-10.2196/40236

The present study was conducted to prepare the fish scales' hydroxyapatite/collagen beads (FsHA/FsCol) and characterize their biological, physical, and chemical properties. A new method was used to prepare FsHA/FsCol composite beads by infiltrating the beads of FsHA in the solution of FsCol as a green method. X-ray diffraction analysis (XRD), scanning electron microscopy (SEM) analysis, Fourier-transform infrared (FTIR) spectroscopy analysis and energy dispersive X-ray analysis (EDX), used to evaluate the physical-chemical properties of the synthesized samples. Meanwhile, the cytotoxic and attachment studies of the FsHA/FsCol beads were used to investigate the biological features against the MG-63 human cell line. The results specified the efficiency of the new method, functional groups of FsCol were indicated to be present inside the beads of FsHA according to the XRD analysis which shows the functional peaks of FsCol. The SEM image were conformed successfully use starch as a porous agent to increasing the porous of the FsHA beads after adding 20 wt% of it. Alamar Blue assay has been used to evaluate the cytotoxicity of FsHA/FsCol beads the results were shown 87% average cell viability of the MG-63 human cell line on the beads and attached very well to the surface of the composites, indicating no toxicity being exerted by all the composites at high concentrations.

BackgroundThe WEAICOR (Wearables to Investigate the Long Term Cardiovascular and Behavioral Impacts of COVID-19) study was a prospective observational study that used continuous monitoring to detect and analyze biometrics. Compliance to wearables was a major challenge when conducting the study and was crucial for the results. ObjectiveThe aim of this study was to evaluate patients’ compliance to wearable wristbands and determinants of compliance in a prospective COVID-19 cohort. MethodsThe Biostrap (Biostrap USA LLC) wearable device was used to monitor participants’ biometric data. Compliance was calculated by dividing the total number of days in which transmissions were sent by the total number of days spent in the WEAICOR study. Univariate correlation analyses were performed, with compliance and days spent in the study as dependent variables and age, BMI, sex, symptom severity, and the number of complications or comorbidities as independent variables. Multivariate linear regression was then performed, with days spent in the study as a dependent variable, to assess the power of different parameters in determining the number of days patients spent in the study. ResultsA total of 122 patients were included in this study. Patients were on average aged 41.32 years, and 46 (38%) were female. Age was found to correlate with compliance (r=0.23; P=.01). In addition, age (r=0.30; P=.001), BMI (r=0.19; P=.03), and the severity of symptoms (r=0.19; P=.03) were found to correlate with days spent in the WEAICOR study. Per our multivariate analysis, in which days spent in the study was a dependent variable, only increased age was a significant determinant of compliance with wearables (adjusted R2=0.1; β=1.6; P=.01). ConclusionsCompliance is a major obstacle in remote monitoring studies, and the reasons for a lack of compliance are multifactorial. Patient factors such as age, in addition to environmental factors, can affect compliance to wearables.

Abstract Background Almost eight children per 1000 live births are expected to have a congenital heart defect globally. The seven most critical congenital heart conditions that cause severe compromise on the patient’s quality and duration of life are collectively referred to as the Critical Congenital Heart Diseases (CCHD). CCHD is a critical condition that requires prompt detection and intervention as a life-saving measure. Pulse oximetry is a non-invasive, highly specific, and moderately sensitive method that can be used for screening new-borns for CCHD. The Emirates Health Services (EHS), UAE, adopted a strategy of developing a stringent program for newborn screening of Critical Congenital Heart disease, which would help in the early diagnosis and treatment of CCHD patients. An automated EMR (Wareed) driven solution was introduced to enhance this program as part of the routine workflow for the nurse care providers. Methods Our study is a retrospective observational study that aims to understand: the prevalence of CCHD in our target population and to study the impact of an automated program on screening compliance and its implications for early diagnosis of CCHD. Results We found that an EMR-driven automated screening program was highly effective in achieving high compliance (98.9%). It created a (statistically significant) improvement in the disease identification for CCHD in live births at EHS facilities. Conclusion We conclude that implementing an automated protocol through the EMR can effectively improve new-born screening coverage. It reduces the days to CCHD diagnosis, which would improve health outcomes in neonates.

Tujuan penelitian ini dilakukan untuk memberikan gambaran minat belajar matematika siswa SD di masa covid 19 berdasarkan perspektif gender melalui penggunaan indikator minat belajar yakni perasaan senang/suka terhadap matematika, ketertarikan siswa terhadap pembelajaran matematika, perhatian siswa terhadap pembelajaran matematika, keterlibatan siswa dalam proses pembelajaan matematika, dan kepuasan terhadap pembelajaran matematika. Motode yang digunakan adalah metode kualitatif dengan jenis penelitian studi kasus. Peneliti, guru, dan siswa yang terdiri atas 3 siswa laki-laki dan 3 siswa perempuan berasal dari satu sekolah dasar negeri di Kabupaten Kabupaten Tapin. Pengumpulan data menggunakan teknik observasi, angket, dokumentasi, dan wawancara. Berdasarkan hasil analisis data ditemukan bahwa terdapat perbedaan minat belajar siswa yakni siswa laki-laki memperoleh skor prosentase 97,50 % dan siswa perempuan memperolah skor 96,67%. Data tersebut menunjukkan bahwa siswa laki-laki memiliki minat belajar yang lebih tinggi daripada perempuan, tetapi perbedaannya tidak signifikan. Temuan ini menunjukkan bahwa dalam proses pembelajaran matematika, perbedaan jender bukan merupakan variabel yang menentukan perbedaan minat belajar siswa. Oleh karena itu, dalam proses pembelajaran matematika di SD, yang penting guru perlu menyajikan pembelajaran secara menarik agar minat belajar para siswa tetap baik.

Thyroid cancer is a type of malignancy that is considered to have a low morbidity and an indolent disease course in most patients. Though some of its pathologic variants such as anaplastic carcinoma may present with advanced disease staging, it is important to consider the possibility of metastasis to thyroid which may present like a thyroid primary. Solid organ carcinomas form the bulk of the uncommon metastasis to the thyroid, though sarcomas from various organs also rarely exhibit this activity. Literature demonstrating sound diagnostic criteria for these occurrences is sparse. We present a case of uterine sarcoma with distant metastasis to the thyroid gland that initially presented as hypercapnic respiratory failure. Only an inpatient episode of uterine bleeding prompted our team to explore the potential of a metastatic process. Our diagnosis was made utilizing a multidisciplinary approach that we feel is important for clinicians dealing with metastatic disease to the thyroid. In addition to sound physical exam, and use of appropriate imaging modality, we feel it is essential to utilize a detailed cytohistologic specimen evaluation, immunohistochemistry, and genetic sequencing to effectively work up such patients. Although our patient did not survive her hospital stay, we hope this paper brings greater awareness of this malignancy and acts as a benchmark for diagnosing such an unusual remote primary.

Objectives Monoclonal antibodies can slow COVID-19 progression. This study describes the experience of using sotrovimab in patients with COVID-19 at high risk for disease progression and hospitalisation within the United Arab Emirates (UAE).Design Observational cohort study.Setting A tertiary hospital in the Emirate of Sharjah, UAE.Participants Patients with mild or moderate COVID-19 at high risk for disease progression.Interventions Infusion with a single 500 mg dose of the monoclonal antibody drug sotrovimab.Primary and secondary outcome measures Any adverse effect within 24 hours, disease progression within 5 days, emergency department visit within 10 days, hospital admission within 10 days or mortality within 28 days of infusion.Results 3227 high-risk COVID-19 patients were infused with sotrovimab during the mild (n=3107, 96.3%) or moderate (n=120, 3.7%) disease stages. The incidence of at least one outcome was recorded in 196 (6.1%) of the patients (60.7 per 1000 patients). The most common outcome was disease progression within 5 days of infusion in 129 patients (4.0%), followed by emergency department visits by 90 patients (2.8%) within 10 days. Twenty-nine (0.9%) patients were hospitalised within 10 days of infusion with only two deaths (0.1%). Patients infused with sotrovimab during the moderate disease stage had 11 times greater odds of developing at least one outcome compared with patients infused during the mild stage (adjusted OR, aOR 10.86, 95% CI 7.14 to 16.54). SARS-CoV-2 vaccinated (aOR 12.8, 95% CI 7.3 to 20.5) and unvaccinated (aOR 7.2, 95% CI 3.4 to 15.3) patients infused with sotrovimab during the moderate disease stage had similar odds of at least one outcome compared with patients infused during the mild stage.Conclusions Among high-risk sotrovimab-infused COVID-19 patients, there were relatively low incidences of disease progression and hospitalisation. Regardless of vaccination history, monoclonal antibody intervention during the early stages of COVID-19 results in better outcomes.

Artikel ini nejelaskan tentang hasil sebuah penelitian kualitatif yang mendiskusikan: 1) perencanaan Problem Based Learning berbantuan sway melalui Whatsapp Group, 2) proses pelaksanaan Problem Based Learning berbantuan Sway melalui Whatsapp Group, 3) Evaluasi pelaksanaan Problem Based Learning berbantuan sway melalui Whatsapp Group. Penelitian ini merujuk kepada metode penelitian kualitatif diskriptif. Data dikumpulkan melalui observasi, wawancara, dan dokumentasi. Data divalidasi melalui teknik triangulasi. Hasil penelitian menunjukkan: 1) perencanaan pembelajaran dengan Problem Based Learning berbantuan Sway diawali dengan menginformasikan pembelajaran menggunakan Sway dan membuat Rencana Pelaksanaan Pembelajaran (RPP) yang memuat langkah-langkah Problem-Based Learning yang disampaikan melalui Whatsapp Group 2) Proses pelaksanaan pembelajaran dilakukan sesuai langkah-langkah Problem Based Learning dan Sway yang disampaikan melalui Whatsapp Group sehingga pembelajaran lebih interaktif dan mandiri 3) evaluasi pelaksanaan Problem Based Learning berbantuan Sway melalui Whatsapp Group tak lepas dari kendala-kendala dalam pembelajaran, misalnya masalah jaringan internet dan kuota yang terbatas. Hasil penelitian ini dapat menjadi model alternatif dalam pembelajaran online. Namun, guru harus memberikan perhatian pula pada permasalahan yang dapat timbul saat menerapkan model ini dalam mengajar.

Abstract G Protein-Coupled Receptors (GPCRs) represent the largest superfamily of cell-surface proteins. However, the expression and function of majority of GPCRs remain unexplored in breast cancer (BC). We interrogated the expression and phosphorylation status of 398 non-sensory GPCRs using the landmark BC proteogenomics and phosphoproteomic dataset from The Cancer Genome Atlas. Neuropeptide Y Receptor Y1 (NPY1R) gene and protein expression were significantly higher in Luminal A tumors versus other BC subtypes. The trend of NPY1R gene, protein, and phosphosite (NPY1R-S368s) expression was decreasing in the order of Luminal A, Luminal B, Basal, and human epidermal growth factor receptor 2 (HER2) subtypes. NPY1R gene expression increased in response to estrogen and reduced with endocrine therapy in estrogen receptor-positive (ER+) BC cells and xenograft models. Conversely, NPY1R expression decreased in ER+ BC cells resistant to endocrine therapies (estrogen deprivation, tamoxifen, and fulvestrant) in vitro and in vivo. NPY treatment reduced estradiol-stimulated cell growth, which was reversed by NPY1R antagonist (BIBP-3226) in ER+ BC cells. Higher NPY1R gene expression predicted better relapse-free survival and overall survival in ER+ BC. Our study demonstrates that NPY1R mediates the inhibitory action of NPY on estradiol-stimulated growth of ER+ BC cells, and its expression serves as a biomarker to predict endocrine sensitivity and survival in ER+ BC patients.

This is a 51-year-old male who presented with abdominal pain, bilateral proximal upper and lower extremities pain and weakness, and decreased urine output with abnormal kidney function test; Urea and creatinine levels were elevated at 231.5 mg/dl and 11.05 mg/dl, respectively. Initial bone scan showed increased uptake within several muscles suspicious for polymyositis, this was confirmed by biopsy of the right triceps, identified by bone scan as the best superficial biopsy site. Pelvis and thigh MRI demonstrated diffuse hyperintense signal on fluid sensitive sequences involving several muscles. Renal biopsy showed acute tubular injury. He was treated with steroids resulting in significant improvement. A repeat bone scan showed near complete resolution of the muscular uptake seen at presentation. This case nicely illustrates the role of bone scanning in the initial recognition and determination of the extent of polymyositis with identification of a suitable biopsy site as well as assessment of response to treatment.

DTC accounts for the majority of endocrine tumors. While the incidence of thyroid cancer has been increasing globally over the past few decades, papillary thyroid carcinoma (PTC) generally shows an excellent prognosis, except in cases with aggressive clinicopathological features. This study aimed to assess the 5- and 10-year overall survival (OS) and progression-free survival (PFS) of 528 Arabic patients diagnosed with primary DTC from 1998 to 2021. Additionally, the study aimed to analyze the impact of various factors on both OS and PFS. An univariable survival analysis was conducted using Kaplan–Meier curves. The 5- and 10-year OS for patients with DTC have exceeded 95%. Additionally, PFS showed very good rates (ranging between 96.5 and 85% at 5 and 10 years, respectively). Age, male gender, risk of recurrence, and distant metastasis were identified as the main negative prognostic factors for both OS and PFS, while RAI treatment was found to be a significant factor in improving OS. Moreover, adherence to the King Hussein Cancer Center’s (KHCC) CPG demonstrated significant improvement in PFS. These findings highlight common prognostic factors and favorable outcomes in Arabic patients with DTC treated at a tertiary cancer center using standard of care approaches.