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Abdirahman Mohamed Hassan Dirie,1 Sedat Çolakoğlu,1 Osman Muhyadin Abdulle,2 Bashir Mohamud Abdi,3 Mohamed Abdi Osman,4 Abdiaziz Mohamud Shire,5 Abdinafic Mohamud Hussein6 1Pulmonology Department, Somalia Mogadishu Turkey Recep Tayyip Erdogan Training and Research Hospital, Mogadishu, Banadir, Somalia; 2Manager of the Multi-Drug Resistant Center in Southern Somalia, Mogadishu, Banadir, Somalia; 3HIV Program manager, Ministry of Health, Somali Federal Government, Mogadishu, Banadir, Somalia; 4Infectious and Microbiology Department, Somalia Mogadishu Turkey Recep Tayyip Erdogan Training and Research Hospital, Mogadishu, Banadir, Somalia; 5National TB program Manager, Somali Federal Government, Ministry of Health, Mogadishu, Banadir, Somalia; 6Cardiovascular Surgery Department, Somalia Mogadishu Turkey Recep Tayyip Erdogan Training and Research Hospital, Mogadishu, Banadir, SomaliaCorrespondence: Abdirahman Mohamed Hassan Dirie, Tel +252615479778, Email dirie515@gmail.comBackground: Tuberculosis (TB) is an infectious disease that is the second most common cause of death from a single infectious agent. TB infection affects anyone, regardless of age, gender, and ethnicity. Drug-resistant TB is a serious public health problem, which needs treatment with a second-line anti-TB drug and it includes poly-drug resistance (PDR), multi-drug resistance (MDR), and extensive drug resistance (XDR). The goal of this research is to find out the prevalence of MDR TB among pulmonary TB patients in Banadir, Somalia.Methods: This was a multicenter retrospective review of data involving 1732 smear-positive pulmonary TB patients visiting Banadir TB centers between July 1, 2019 and June 30, 2020. Demographic, clinical, and drug susceptibility data were retrieved from TB treatment cards. The data were analyzed using Statistical Package for Social Sciences (SPSS) software (IBM SPSS Statistics version 26).Results: All 1732 pulmonary TB cases were previously diagnosed by the Gene Xpert MTB/RIF test. Among them, 70.4% (1219/1732) were males. The mean age was 31.77 years. Overall, the prevalence of drug resistance TB was 10.56% (183/1732). The MDR TB was 1.96%, poly-drug resistance (PDR) was 0.12%, and extensive drug resistance was 0.06%.Conclusion: This study showed a prevalence of MDR-TB among pulmonary TB patients, which is similar to some of the eastern African countries.Keywords: TB, drug-resistance, poly-drug resistance, MDR, XDR

Rasha Elbialy Elsharkawy,1 Ghada Saed Abdel Azim,1 Marwa Abdellah Osman,1 Hend Maghraby Maghraby,2 Rehab Abdelfattah Mohamed,2 Eman Mahmoud Abdelsalam,2 Eman Elshohat Ebrahem,3 Nora Mohamed Ahmed Seliem3 1Department of Neurology, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt; 2Department of Internal Medicine, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt; 3Department of Biochemistry, Faculty of Medicine for Girls, Al-Azhar University, Cairo, EgyptCorrespondence: Hend Maghraby MaghrabyDepartment of Internal Medicine, Faculty of Medicine for Girls, Al-Azhar University, 6 October 3rd Destination, Cairo, 12573, EgyptTel +201114911897Email drhendms@gmail.comBackground: Neuropathy is one of most common complications in diabetic patients. Diagnosis of diabetic neuropathy is essential for decreasing the rate of the disability and death. Neuron-specific enolase (NSE) is released from damaged neuronal cells and enters the blood circulation through an injured blood brain barrier. Therefore, serum NSE can reflect the damage of neurons and brain tissue.Objective: To evaluate peripheral polyneuropathy and cognitive function in Type 2 Diabetes Mellitus (T2DM) and correlate them with NSE level as a possible biomarker of diabetic neuropathy.Subjects and Methods: Forty five T2DM patients with polyneuropathy were randomly recruited in this study compared to 45 healthy age and sex matched subjects as a control. Patients group were divided into two subgroups, 24 diabetic patients with painful peripheral neuropathy and 21 with painless peripheral neuropathy. All were subjected to clinical assessment by diabetic neuropathy symptom score, Dyck neuropathy grading, Mini-Mental State Examination (MMSE), assessment of HbA1c, NSE biomarker and neurophysiological assessment (nerve conduction study (NCS), event related potential (P300wave) and somatosensory evoked potential (SSEP) of the right median nerve).Results: There were significant decrease in cognitive functions in diabetic patients compared to controls and a significant increase in NSE in diabetic patients. There were no significant difference between patients with painless and painful diabetic neuropathy as regard MMSE, HbA1c and NSE. There were significant correlation of P300 in diabetic patients with HbA1c and NSE.Conclusion: Neurophysiological assessment of diabetic patients by NCS, SSEP and P300 have well evaluation of cognitive functions, painless, and painful diabetic polyneuropathy. NSE is a beneficial biomarker in diabetic patients to pick up neurological complications.Keywords: diabetic neuropathy, Mini-Mental State Examination, MMSE, neuron-specific enolase, NSE, nerve conduction study, glycated hemoglobin

Ashraf M Badawi,1–4 Mai Abdelraouf Osman1 1Dermatology Unit, Department of Medical Applications of Lasers (MAL), National Institute of Laser Enhanced Sciences (N.I.L.E.S.), Cairo University, Giza, Egypt; 2Dermatology and Laser Applications, Szeged University, Szeged, Hungary; 3European Society for Lasers and Energy Based Devices, Strasbourg, France; 4European Society for Cosmetic and Aesthetic Dermatology, Paris, France Background: Melasma is a difficult-to-treat hyperpigmentary disorder. Ablative fractional laser (AFL)-assisted delivery of topically applied drugs to varied targets in the skin has been an area of ongoing study and research.Objective: The objective of this study was to evaluate the efficacy and safety of fractional erbium-doped yttrium aluminum garnet (Er:YAG) laser as an assisted drug delivery for enhancing topical hydroquinone (HQ) permeation into the skin of melasma patients.Patients and methods: Thirty female patients with bilateral melasma were randomly treated in a split-face controlled manner with a fractional Er:YAG laser followed by 4% HQ cream on one side and 4% HQ cream alone on the other side. All patients received six laser sessions with a 2-week interval. The efficacy of treatments was determined through photographs, dermoscopic photomicrographs and Melasma Area Severity Index (MASI) score, all performed at baseline and at 12 weeks of starting therapy. The patient’s level of satisfaction was also recorded.Results: Er:YAG laser + HQ showed significantly better results (p

Abstract Blue economy has the potential to promote economic growth, improve livelihoods, and create jobs while protecting marine ecosystems. This research uses a comprehensive analysis of secondary data sources to assess various blue economy sectors, including maritime transport, fisheries, aquaculture, offshore renewable energy, marine tourism, marine biotechnology, and ocean mining. By examining the blue economy experiences of developed nations like the United States, Canada, Japan, Norway, and Australia, the study identifies the best SDG practices and strategic lessons applicable to Bangladesh. In the case of Bangladesh, the research focuses on the blue economy initiatives, opportunities, and challenges associated with the Sustainable Development Goals (SDGs). The blue economy and SDGs nexus in the context of Bangladesh demonstrates that out of 17 goals, 12 SDGs (SDG 1, SDG 2, SDG 3, SDG 7, SDG 8, SDG 9, SDG 11, SDG 12, SDG 13, SDG 14, SDG 16 and SDG 17) are linked with blue economy practices in Bangladesh. However, in the case of developed countries, only six SDGs (SDG 7, SDG 8, SDG 9, SDG 12, SDG 13, SDG 14) are connected to the blue economy because of the diversity of blue economy practices across the countries. Situated along the Bay of Bengal, Bangladesh has significant potential to utilize its marine resources for sustainable development. However, it faces challenges such as inadequate infrastructure, regulatory gaps, environmental risks, and limited technological advancements. The study thus emphasizes the need for integrated policy frameworks, stakeholder coordination, investments in sustainable infrastructure, public–private partnerships, technological innovation, and community engagement.

Omaima Abdel Majeed Mohamed Salih,1,2 Nahla Hashim Hassan Erwa,3 Abdelrahman Hamza Abdelmoneim,4 Hiba Awadelkareem Osman Fadl,5,6 Brigitte Glanzmann,7,8 Manasik Abdalla Babiker Osman,9 Monzir Ahmed Hassan Osman,10 Thuraya Mohamed Elshiekh Gasim,10 Alamin Mustafa4 1Departments of Pediatrics, Faculty of Medicine, Omdurman Islamic University, Omdurman, Sudan; 2Pediatric Clinical Immunologist, Tropical Disease Teaching Hospital, Omdurman, Sudan; 3Clinical Immunology Consultant, Faculty of Medicine & Soba University Hospital, University of Khartoum, Khartoum, Sudan; 4Faculty of Medicine, Al-Neelain University, Khartoum, Sudan; 5Department of Hematology, Faculty of Medical Laboratory Sciences, Al-Neelain University, Khartoum, Sudan; 6Senior Medical Laboratory Specialist, Saudi Commission for Health Specialties (SCFHS), Makkah, Kingdom of Saudi Arabia; 7DSI-NRF Centre of Excellence for Biomedical Tuberculosis Research, South African Medical Research Council Centre for Tuberculosis Research, Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, 7505, South Africa; 8South African Medical Research Council (SAMRC) Genomics Platform, Cape Town, 7505, South Africa; 9Faculty of Medicine, University of Bahri, Khartoum, Sudan; 10Faculty of Medicine and Health Sciences, Omdurman Islamic University, Khartoum, SudanCorrespondence: Alamin Mustafa, Faculty of Medicine, Al-Neelain University, JG37+2RM, 52nd St, Khartoum, Sudan, Email alamin900005@gmail.comIntroduction: Inborn errors of immunity (IEI) are disorders that present a health issue, especially in developing countries where there is a high rate of consanguineous marriages and an increasing rate of diagnosis. One of these disorders is Bare Lymphocyte Syndrome II (BLS II) which is a rare and genetically complex disease that has high morbidity and mortality. The exact genotypic and phenotypic characteristics are still poorly characterized especially in developing countries.Case Presentation: Here, we report the first case of BLS II in a seven-month-old Sudanese female with recurrent chest infections, dermatitis, persistent diarrhea, and failure to thrive. The patient’s all four sisters and three paternal uncles died in early infancy. Laboratory investigations revealed low CD3+, CD4+, and CD8+ lymphocytes, along with normal CD19+ and CD16+ lymphocytes, and low serum IgM and IgA levels. Genetic analysis revealed two CIITA variants; c.2296C >G p. (Pro766Ala) and c.439+1G >A.Conclusion: Further bioinformatics, immunological and clinical workups supported a pathogenic effect of both mutations affecting the function of CIITA protein, and suggesting a compound heterozygote mutation. The patient was started on prophylactic antibiotics and regular intravenous immunoglobulin replacement therapy. The prognosis of this disease is poor in most of the cases, with only a few reported cases surviving until adulthood.Keywords: inborn errors of immunity, bare lymphocyte syndrome II, CIITA gene, compound heterozygote mutation, primary immunodeficiency

Nader Ahmed Mohammed,1 Abdulrahman OE Adam,2 Monzir Ahmed Hassan Osman,2,3 Hibatallah MA Abass,2,3 Awad MA Salih,2,3 Ameer AM Abaker,2,3 Alamin Mustafa,3,4 Mamoun Magoub5 1Department of Medicine, Faculty of Medicine, University of Kassala, Kassala, Sudan; 2Faculty of Medicine, Omdurman Islamic University, Omdurman, Sudan; 3Patient Support Organization Research Unit, Khartoum, Sudan; 4Faculty of Medicine, Al-Neelain University, Khartoum, Sudan; 5Department of Microbiology & Parasitology, Faculty of Medicine & Health Science, West Bank of Gash River, University of Kassala, Kassala, SudanCorrespondence: Mamoun Magoub, Department of Microbiology & Parasitology, Faculty of Medicine & Health Science, West Bank of Gash River, University of Kassala, Kassala, Sudan, Tel +24991291999, Email mamounmagzoub@kassalauni.edu.sd Alamin Mustafa, Faculty of Medicine, Al-Neelain University, JG37+2RM, 52nd St, Khartoum, Sudan, Tel +249902612984, Email alamin900005@gmail.comBackground: Ascaris lumbricoides is a common infectious parasite of the gastrointestinal tract worldwide, but the invasion of the pleural cavity is rare.Case Report: A 45-year-old man from Eastern Sudan presented to the emergency department complaining of breathlessness, cough stained with blood, and chest pain one month before his presentation. Also, he complained of high-grade fever for two weeks associated with sweating. Diagnosis of hydropneumothorax was made and a chest tube was inserted, two days later we found three adult A. lumbricoides worms in the chest drain.Conclusion: The patient was treated with Albendazole 200 mg, orally twice, daily for seven days, he improved and was referred to a cardiothoracic surgeon for more assessment. Our study highlights that internal medicine specialists should know about pleural ascariasis when patients present with respiratory signs and symptoms, especially in A. lumbricoides endemic regions like Eastern Sudan.Keywords: neglectable tropical diseases, pulmonology, pleural cavity, ascariasis, Ascaris lumbricoides

BackgroundPatients with kidney failure undergoing dialysis often suffer from anemia. Iron deficiency, along with a shortage in erythropoietin, is a common cause. Peritoneal dialysis (PD) patients may have a different iron metabolism compared to hemodialysis (HD) patients. This study aims to compare both dialysis modalities regarding their differences in iron management.MethodsPubMed (MEDLINE) and Embase were screened for randomized controlled trials and observational studies including both patients on HD or PD with information on iron management. Outcomes for iron management for this systematic review included: prevalence of supplementation, route of administration, dose, frequency and hemoglobin and iron status parameters.Results15 eligible studies (930,436 patients), of which 8 cohort and 7 cross-sectional, were analyzed. The prevalence of intravenous (IV) iron supplementation ranged from 11.7% to 84.4% in HD patients, compared to 1.6% to 49.0% in PD patients. Ten studies reported that HD patients only received IV iron, while five studies reported this for PD patients. For oral iron supplementation, three studies involved HD patients, whereas seven studies involved PD patients. The cumulative monthly IV iron dose ranged from 108 to 750 mg in the HD group, compared to 65 to 250 mg in the PD group. Hemoglobin levels ranged from 10.0 to 12.0 g/dL in HD patients, versus 9.6 to 11.9 g/dL in PD patients.ConclusionIron management differs between HD and PD patients, with HD patients receiving higher doses and more frequent IV iron. There was significant heterogeneity in the outcomes between the studies, primarily due to the lack of a uniform global policy on iron management. Despite these differences, hemoglobin levels and iron status parameters were comparable between the two groups. Future research should explore the underlying mechanisms and broader impacts of iron treatment, including patient-reported outcomes, to optimize anemia management and improve quality of life for dialysis patients.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42022336970.

INTRODUCTION: Injury is a common health problem globally. Explosions are one of the major causes of injuries. Explosions, about half of which are caused by Improvised Explosive Device (IED), impact on the lives of a considerable number of people. The objective of this study is to analyze individuals injured and survived in the Somalia Medina Hospital as a result of IED explosions between January 1-December 31, 2018. METHODS: A retrospective, cross-sectional study was conducted using a checklist of 907 patients identified and version 20 SPSS was used to analyze the data. RESULTS: The majority of IED victims are between the ages of 21-50 (n = 600, 66.1%), followed by 199 (21.9%) individuals under the age of 20 and 108 (11.9%) over 50. 65.1% (n=590) of the injured are men and 34.9% (n=317) are women. The extremities (n = 580, 63.9%), abdomen (n = 235, 25.9%), head-neck (n = 85, 9.4%), and other body parts (n = 7, 0.8%) were injured by IED blasts. The procedures performed in the hospital were as follows: 520 (57.3 %) patients underwent surgical exploration and 387 (42.7 %) patients received debridement only. DISCUSSION AND CONCLUSION: This study shows that most injured body part is extremities by IED explosions, and men are the most suffer from this condition. Studies should be done across the country to better understand the extent of the event.

Mustafa AA Osman,1 Mohamed Alkhouly,1 Ghada F Elmohaseb,2 Eman Mostafa Nassef,2 Ibrahim Ghonim Ramadan Mohamed,2 Ismail Mohamed El mancy,2 Seham Sabry,2 Marwa M Abdulrehim,2 Ahmed Eliwa,2 Yasmine H Eisa,3 Ahmed Abdel-Ghany,4 Yasser Abdelghani5 1Gynecology and Obstetrics Department, Al-Azhar University, Cairo, Egypt; 2Internal Medicine Department, Al-Azhar University, Cairo, Egypt; 3Community Medicine Department, October 6 University, Giza, Egypt; 4Gynecology and Obstetrics Department, Minia University, Minia, Egypt; 5Tropical Medicine Department, Minia University, Minia, EgyptCorrespondence: Eman Mostafa Nassef, Internal Medicine Department, Al-Azhar University, Cairo, Egypt, Tel +20 1098002232, Email nassef.eman@yahoo.comBackground: Polycystic ovary syndrome (PCOS) is the most common endocrinological disease affecting women in the reproductive age. Non-alcoholic fatty pancreas disease (NAFPD) can promote many aspects of pancreatic dysfunction. The present study aimed to determine the prevalence of NAFPD and to identify its association with clinical and biochemical parameters in PCOS patients.Methods: The present study included 150 patients with PCOS and 150 age-matched healthy controls. All patients were submitted to careful history taking and thorough clinical examination. Performed laboratory investigations included fasting and postprandial blood glucose, lipid profile, liver function tests, serum prolactin and total testosterone. Fatty pancreas was diagnosed using abdominal ultrasound.Results: Among PCOS women, NAFPD was diagnosed in 57 women (38.0%) in contrast to 18 women (12.0%) in the control group (p < 0.001). Patients with NAFPD were significantly older [median (IQR): 38.0 (35.0– 43.0) versus 29.0 (25.5– 33.0) years, p = 0.001] with higher BMI [median (IQR): 31.5 (29.1– 34.7) versus 30.4 (28.6– 32.4) kg/m2, 0.042]. Moreover, they had significantly higher frequency of metabolic syndrome (84.2% versus 54.8%, p = 0.001), insulin resistance (68.4% versus 26.9%, p < 0.001) and severe NAFLD (22.8% versus 2.2%, p < 0.001). NAFPD patients had significantly lower sex hormone binding globulin (SHBG) [median (IQR): 36.0 (30.8– 40.7) versus 38.1 (35.15– 42.7), p = 0.002] and significantly higher free androgen index (FAI) [median (IQR): 4.08 (3.3– 4.92) versus 3.47 (3.12– 4.05), p < 0.001].Conclusion: NAFPD is prevalent PCOS. It is related to metabolic syndrome, insulin resistance, dyslipidemia and hyperandrogenism.Keywords: polycystic ovary, non-alcoholic fatty pancreas, free androgen index

Abstract Background Metastatic breast cancer (MBC) is a major health problem worldwide. Some patients improve on tamoxifen and others do not respond to treatment. Therefore, the aim of the current study is to assess genetic aberrations in the Her2/EGFR-PDGFR pathway associated with tamoxifen response in MBC patients. Methods This is a retrospective cohort study, including 157 hormone receptors positive, locally recurrent inoperable and/or MBC patients on tamoxifen treatment. Patients were categorized into 78 (49.7%) tamoxifen responders and 79 (50.3%) tamoxifen non-responder patients. Genetic aberrations of 84 genes involved in the Her2/EGFR-PDGFR pathway were assessed in the tumor tissue samples obtained from the patients using SA-Bioscience assay. The identified panel was correlated to patients’ response to treatment, to detect the differentially expressed genes in tamoxifen responders and non-responders. Results One hundred twenty-three (78.3%) patients were estrogen receptor (ER) and progesterone receptor (PR) positive, 108 (68.8%) were ER only positive, and 78 (49.7%) were PR only positive. There were 56 genes overexpressed in the refractory group compared to responders. However, only five out of these 56 genes, Janus kinase 1 (JAK1), collagen type I alpha 1 (COL1A1), GRB2-associated binding protein 1 (GAB1), fibronectin-1 (FN1), and MAP kinase-interacting serine/threonine-protein kinase (MKNK1), showed statistical significance between the two groups. Patients with bone metastasis showed a better response to treatment compared to those with metastatic deposits in other sites such as visceral metastasis (P

Protozoal infections caused by species belonging to Leishmania donovani complex are responsible for the most severe form of leishmaniasis, especially in Sudan and other developing countries. Drugs commonly used for the treatment of the disease show varying levels of effectiveness and also have associated side effects. Thus, the present work highlights the synthesis of some chalcones to be used as potential anti-leishmanial agents. The activity of the synthesized chalcones has been evaluated against L. donovani. The ADMET profile of the synthesized compounds were tested using various integrated web-based tools. Moreover, in order to investigate the molecular mechanism of action, the chalcone compounds were docked into L. donovani trypanothione reductase (TR) using Autodock 4.0 and molecular dynamics were studies. Eight compounds showed the highest activity against the morphological forms. Among these compounds, chalcones 15 has shown the highest inhibitory effect with IC50 value of 1.1 µM. In addition, pharmacokinetic and toxicological investigations revealed its good oral bioavailability and low toxicity. Furthermore, chalcone 15 was found to interact with high affinity (−13.7 kcal/mol) with TR, an essential enzyme for the leishmanial parasite. Thus, this promising activity against L. donovani supports the use of chalcone 15 as a potential new therapy for visceral leishmaniasis.

Abstract Three probabilistic methodologies are developed for predicting the long-term creep rupture life of 9–12 wt%Cr ferritic-martensitic steels using their chemical and processing parameters. The framework developed in this research strives to simultaneously make efficient inference along with associated risk, i.e., the uncertainty of estimation. The study highlights the limitations of applying probabilistic machine learning to model creep life and provides suggestions as to how this might be alleviated to make an efficient and accurate model with the evaluation of epistemic uncertainty of each prediction. Based on extensive experimentation, Gaussian Process Regression yielded more accurate inference ( $$Pearson\;correlation\;coefficent> 0.95$$ P e a r s o n c o r r e l a t i o n c o e f f i c e n t > 0.95 for the holdout test set) in addition to meaningful uncertainty estimate (i.e., coverage ranges from 94 to 98% for the test set) as compared to quantile regression and natural gradient boosting algorithm. Furthermore, the possibility of an active learning framework to iteratively explore the material space intelligently was demonstrated by simulating the experimental data collection process. This framework can be subsequently deployed to improve model performance or to explore new alloy domains with minimal experimental effort.

Introduction: Recently, the industry of launching solar power plants in arid/semi-arid regions has developed. A considerable part of Iran is covered by dry/semi-arid areas, which are exposed to severe wind erosion. Considering the occurrence of dust in these areas, this study investigated the possible impact of the photovoltaic industry on the prevention of dust storms. Materials and methods: The effect of solar power plant construction on atmospheric variables and its possible effect on the occurrence of dust were investigated in Tehran province. The criterion is to compare the monthly average wind and temperature respectively at the height of 10 and 2 m inside and outside the power plant (obtained from the TerraClimate database for 2020 and 2021) on the western side and at the closest point to the power plant. Results: The monthly average of wind and temperature respectively at the height of 10 and 2 m in 2020-2021 decreased inside of the power plant with respect to the outside of that. Significant differences were observed on temperature and wind inside and outside of the power plant during the peak heat in the summer, which increase with increasing temperature. The maximum of differences of monthly average of wind and temperature variables inside and outside of the power plant for Pars Ray Energy Bahar, Tehran Wastewater and Sohail Power Plants respectively are (0.5 °C, 0.55 m/s), (0.6 °C, 0.3 m/s), and (0.7 °C, 0.3 m/s). Conclusion: The photovoltaic industry can change the effective solar radiation, and possibly decrease the occurrence of dust storms by weakening wind power.

Objective: Atherosclerosis, which starts from early stages of chronic kidney disease (CKD), is an important cause for increased morbidity and mortality. We aimed to investigate whether hypomagnesemia is a marker of increased atherogenic dyslipidemia in patients with CKD with a glomerular filtration rate (GFR) 0.05). Conclusion: In this study conducted in patients with CKD, there was no relationship between Mg levels and lipid parameters. There is a need for larger, more comprehensive, prospective studies on this issue.

Abstract The Larson–Miller parameter (LMP) offers an efficient and fast scheme to estimate the creep rupture life of alloy materials for high-temperature applications; however, poor generalizability and dependence on the constant C often result in sub-optimal performance. In this work, we show that the direct rupture life parameterization without intermediate LMP parameterization, using a gradient boosting algorithm, can be used to train ML models for very accurate prediction of rupture life in a variety of alloys (Pearson correlation coefficient >0.9 for 9–12% Cr and >0.8 for austenitic stainless steels). In addition, the Shapley value was used to quantify feature importance, making the model interpretable by identifying the effect of various features on the model performance. Finally, a variational autoencoder-based generative model was built by conditioning on the experimental dataset to sample hypothetical synthetic candidate alloys from the learnt joint distribution not existing in both 9–12% Cr ferritic–martensitic alloys and austenitic stainless steel datasets.

Abstract The class of 9–12% Cr ferritic-martensitic alloys (FMA) and austenitic stainless steels have received considerable attention due to their numerous applications in high temperature power generation industries. To design high strength steels with prolonged service life requires a thorough understanding of the long-term properties, e.g., creep rupture strength, rupture life, etc., as a function of the chemical composition and processing parameters that govern the microstructural characteristics. In this article, the creep rupture strength of both 9–12% Cr FMA and austenitic stainless steel has been parameterized using curated experimental datasets with a gradient boosting machine. The trained model has been cross validated against unseen test data and achieved high predictive performance in terms of correlation coefficient ( $$R^{2} > 0.98 $$ R 2 > 0.98 for 9–12% Cr FMA and $$R^{2} > 0.95 $$ R 2 > 0.95 for austenitic stainless steel) thus bypassing the need for additional comprehensive tensile test campaigns or physical theoretical calculations. Furthermore, the feature importance has been computed using the Shapley value analysis to understand the complex interplay of different features.

Abstract For high-throughput screening of materials for heterogeneous catalysis, scaling relations provides an efficient scheme to estimate the chemisorption energies of hydrogenated species. However, conditioning on a single descriptor ignores the model uncertainty and leads to suboptimal prediction of the chemisorption energy. In this article, we extend the single descriptor linear scaling relation to a multi-descriptor linear regression models to leverage the correlation between adsorption energy of any two pair of adsorbates. With a large dataset, we use Bayesian Information Criteria (BIC) as the model evidence to select the best linear regression model. Furthermore, Gaussian Process Regression (GPR) based on the meaningful convolution of physical properties of the metal-adsorbate complex can be used to predict the baseline residual of the selected model. This integrated Bayesian model selection and Gaussian process regression, dubbed as residual learning, can achieve performance comparable to standard DFT error (0.1 eV) for most adsorbate system. For sparse and small datasets, we propose an ad hoc Bayesian Model Averaging (BMA) approach to make a robust prediction. With this Bayesian framework, we significantly reduce the model uncertainty and improve the prediction accuracy. The possibilities of the framework for high-throughput catalytic materials exploration in a realistic setting is illustrated using large and small sets of both dense and sparse simulated dataset generated from a public database of bimetallic alloys available in Catalysis-Hub.org.

INTRODUCTION[|]Spontaneous ascitic fluid infection (SAI) is one of the frequent and important complication of decompensated cirrhosis with high mortality. Mean platelet volume (MPV) is a parameter that shows the activity, stimulation and production of platelets. Changes in MPV are important indicators of platelet production, and are also an indicator of the severity of many diseases, such as sepsis, thrombosis, or even respiratory distress syndrome. In our study, we aimed to analyze the relationship between spontaneous ascites infection and mean platelet volume. [¤]METHODS[|]98 cirrhosis patients (42 females, 56 males) with various etiologies were participated to the study. The patients were divided into two groups as SAI positive group including patients with ascitic culture positive and/or ascites polymorphonuclear leukocyte count (PMNL) >250 mm3 and SAI negative group including patients with no bacterial reproduction in their ascites fluid culture and ascites PMNL count 0.05). [¤]DISCUSSION AND CONCLUSION[|]Mean platelet volume in patients with spontaneous ascites infection who have developed, decompensated cirrhosis significantly increases. It is possible to use this test which is cheap, non-invasive and fast in the early diagnosis and treatment to follow-up of spontaneous ascites infection.[¤]

Breast cancer (BC) incidence is progressively increasing in Egypt. However, there is insufficient knowledge of the acquired somatic mutations in Egyptian BC patients which limit our understanding of its progression. To the best of our knowledge, this is the first Egyptian cohort to sequence a multiple-gene panel of cancer related genes on BC patients. Four hundred and nine cancer related genes were sequenced in 46 fresh breast tumors of Egyptian BC patients to identify somatic mutations and their frequencies.TP53 and PIK3CA were the most top two frequently mutated genes. We detected 15 different somatic mutations in TP53 and 8 different ones in PIK3CA, each in 27 samples (58.7%). According to Clinvar database; we found 19 pathogenic somatic mutations: 7 in Tp53, 5 in PIK3CA, and single variants of VHL, STK11, AKT1, KRAS, IDH2, PTEN and ERBB2. We also identified 5 variants with uncertain significance (4 in TP53 and 1 in CEBPA) and 4 variants with conflicting interpretations of pathogenicity (2 in TP53 and 1 in each of APC and JAK3). Moreover, one drug response variant (p.P72R) in TP53 was detected in 8 samples. Furthermore, four novel variants were identified in JAK2, MTOR, KIT and EPHB. Further analysis, by Ingenuity Variant Analysis software (IVA), showed that PI3K/AKT signaling is altered in greater than 50% of Egyptian BC patients which implicates PI3K/AKT signaling as a therapeutic target. In this cohort, we shed the light on the most frequently detected somatic mutations and the most altered pathway in Egyptian BC patients.

Neuroendocrine prostate cancer (NEPC) is characterized by loss of androgen receptor (AR) signaling during neuroendocrine transdifferentiation, resulting in resistance to AR-targeted therapy. Here they report ONECUT2 to drive NEPC tumorigenesis via regulation of hypoxia signaling and tumor hypoxia, and find hypoxia directed therapy to be effective in NEPC.

Carbapenem resistance (CR) is an emerging health issue. Epidemiological surveys on carbapenem-resistant Gram-negative bacilli (CR-GNB) in Lebanon remain scarce. In this study, we determined the prevalence of CR-GNB isolated between 2015 to 2019 in three hospitals in northern Lebanon: 311 CR-Enterobacterales (out of 11210; 2.8%), 155 CR-Pseudomonas (out of 1034; 15%) and 106 CR- Acinetobacter (out of 184; 57.6%) were identified. CR mechanisms were determined for 146 randomly chosen isolates: the Carba NP test revealed an enzymatic resistance to carbapenems in 109 isolates (out of 146, 74.7%). Produced carbapenemases were evaluated by the NG-Test Carba5, NG-Test OXA-23 immunochromatographic assays and PCR. Carbapenemase-producing (CP) Enterobacterales expressed blaOXA-48-like, blaNDM-like and blaVIM-like genes and CP-Pseudomonas expressed blaIMP-like and blaVIM-like genes, whereas CP-Acinetobacter expressed blaOXA-23-like genes. The NG-Test Carba5 results were confirmed by PCR sequencing and revealed several variants, such as NDM-19, VIM-62 and OXA-162, never described so far in Lebanon. Isolates with discordant results were sequenced by WGS and highlighted novel variants of the natural oxacillinases of Pseudomonas aeruginosa: blaOXA-50-like genes. Their role in carbapenem resistance should be further studied. Overall, our findings highlight an alarming situation and encourage health care centers to establish performant registration systems that could help in limiting resistance spread.

Camel trypanosomoses is considered a devastating disease with severe health consequences that can be caused by different hemoprotozoan parasites. Camel samples (388) from the five regions in Northern Oman were assessed using a thin blood film. In addition, 95 seropositive samples were analyzed using various primers of mechanically transmitted trypanosomes. Out of the 388 blood smears examined, 0.8% (CI 95%, 2/388) were found to be positive for Trypanosoma sp. using a microscope. The parasitologically positive cases were detected in samples from females. The overall molecular prevalences were as follows: TBR was 78/95, 77% (CI 73.1–89.2%); ITS was 30/95, 31.6% (CI 73.1–89.2%); and T. evansi type A (RoTat 1.2) was 8/95, 8.4% (CI 4.0–16.0%). There were two species of trypanosomes that were observed in the camels.

Application of appropriate level of nitrogen fertilization is a major objective to increase nitrogen use efficiency by rice varieties. Field experiments were conducted during 2016 and 2017 growing seasons to evaluate the efficiency of varying nitrogen fertilizer rates on growth and yield parameters, along with nitrogen use efficiency of some newly released rice varieties (Sakha 108) and some promising lines GZ9399-4-1-1-3-2-2, GZ10101- 5-1-1-1 and GZ10154-3-1-1-1. Five nitrogen levels (i.e. 0, 55, 110, 165 and 220 kg N ha-1) were used. The results from both growing seasons indicated that, Sakha 108 recorded the highest grain yield while GZ10154 and GZ10101 recorded the lowest grain yields. A linear increase in grain yield was observed with continuous rate increase of nitrogen from 0 to 220 kg ha-1, while 220 kg N ha-1 treatment showed maximum grain yield followed by 165 kg N ha-1, with control as minimum. Agronomic nitrogen use efficiency (AE) for studied rice genotypes varied significantly, and ranged from 3.63 to 32.9 and from 2.72 to 34.12 kg grain yield produced per kg of nitrogen applied in 2016 and 2017 respectively. Across N levels, GZ9399 recorded the highest values of AE for the nitrogen fertilizer rate of 165 kg N ha-1 in both seasons.

Abstract Background In Malaysia, leptospirosis is considered an endemic disease, with sporadic outbreaks following rainy or flood seasons. The objective of this study was to develop and validate a new knowledge, attitude, belief and practice (KABP) questionnaire on leptospirosis for use in urban and rural populations in Malaysia. Methods The questionnaire comprised development and validation stages. The development phase encompassed a literature review, expert panel review, focus-group testing, and evaluation. The validation phase consisted of exploratory and confirmatory parts to verify the psychometric properties of the questionnaire. A total of 214 and 759 participants were recruited from two Malaysian states, Kelantan and Selangor respectively, for the validation phase. The participants comprised urban and rural communities with a high reported incidence of leptospirosis. The knowledge section of the validation phase utilized item response theory (IRT) analysis. The attitude and belief sections utilized exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Results The development phase resulted in a questionnaire that included four main sections: knowledge, attitude, belief, and practice. In the exploratory phase, as shown by the IRT analysis of knowledge about leptospirosis, the difficulty and discrimination values of the items were acceptable, with the exception of two items. Based on the EFA, the psychometric properties of the attitude, belief, and practice sections were poor. Thus, these sections were revised, and no further factor analysis of the practice section was conducted. In the confirmatory stage, the difficulty and discrimination values of the items in the knowledge section remained within the acceptable range. The CFA of the attitude section resulted in a good-fitting two-factor model. The CFA of the belief section retained low number of items, although the analysis resulted in a good fit in the final three-factor model. Conclusions Based on the IRT analysis and factor analytic evidence, the knowledge and attitude sections of the KABP questionnaire on leptospirosis were psychometrically valid. However, the psychometric properties of the belief section were unsatisfactory, despite being revised after the initial validation study. Further development of this section is warranted in future studies.

This study aims to determine the types of marketing channels, marketing function in each channel marketing, marketing costs, share margins and prices spread on each channel as well the level of marketing efficiency in the red pepper and tomato Shelter Market Medan. This study uses field observation and interview questionnaire, a population, of 75 respondents comprising 17 merchant traders village, town collectors 26 and 32 retailers in the market Shelter Medan. The model used data analysis is descriptive and quantitative analysis. The results showed that there were there (four) marketing channels in the red pepper and tomato Shelter Market Medan, Channels Marketing I : Farmers – Trade Village – City Traders – Trade Retailers – Konsumen, Channel Marketing II : Farmers – Trade Retailers – Consumers, Channels Marketing III : Farmers – Consumer. Each institution plays the marketing of at least 4 function, of which there are 4 2 channels apparently have a good level of efficiency than most other 2 channels for the smallest value of marketing efficiency. Keywords : Vegetable Soup, Chili, Tomato, Marketing, Channel Marketing, Efficiency

The aim of this study was to use morphometry to investigate the essential organs of sheep fed with non-conventional diets. Twelve male Omani sheep were fed with one of two types of roughages supplemented with a commercial concentrate for 63 days and then slaughtered. The volumes of their kidneys, testes, and livers were measured. Random samples from the organs were fixed in formalin and embedded in paraffin. Random five micrometer sections from each block were stained with hematoxylin and eosin. Images from four random fields were taken from each slide using a digital camera attached to the microscope and then loaded onto a stereology software installed on a personal computer. Morphometric measurements of body organs were taken. Animals fed diets containing tannins had lower final total body weight and lower weights and volumes of their livers, testes and kidneys. There was high variability in the results of intestinal parts measurements, but there was a general trend of the treated animals having higher duodenal and ilial height, villus height, crypt depth and epithelial thickness. The only significant diet effect was higher liver l and lower Vfrac cytoplasm in the control animals than in those treated. The only significant treatment effect on the kidney measurements was a higher tube length/density in treated animals. There were no treatment effects on the testes measurements. The current study indicates that sheep may safely utilize diets containing the levels of polyphenols and tannins used here with no drastic effects on the digestive system and vital organs.

Introduction: The Accessible Quality Healthcare (AQH) project in Kosovo is funded by the Swiss Agency for Development and Cooperation (SDC) and implemented by Swiss Tropical and Public Health Institute (Swiss TPH) and Save the Children. It supports the implementation of health reform, with a focus on Primary Health Care (PHC) and non-communicable diseases, in 12 municipalities of Kosovo. In Kosovo the complex needs of older people are often neglected, and providing person-centred care is a challenge when: there is limited collaboration between health and other sectors; patient record-keeping is generally weak; and care is often provided based on what services each sector wants to provide rather than what services the patient actually needs.The Municipality of Fushe Kosova is piloting an integrated care model that aims to improve the quality of care provided for patients over the age of 65yrs that have been diagnosed with Type 2 Diabetes, through better coordination of services provided by the health and social sectors. Methodology and Discussion: A key success factor of the progress made so far has been the establishment of a municipality-level multi-sectoral working group (WG), with representatives from: Health Sector, Social Services, local Non-Government Organizations, the Patients' Rights Association, and the Association of Retirees. This participatory approach was used as the basis for looking at how the coordination of services between health and social sectors, including community involvement, could be improved by adopting a patient-centered approach. An international expert has supported the WG through the process and, whilst the expert brings their experience and international best practice, it is the local multi-sectoral WG that ensures feasibility and sustainability of the integrated care model at Municipality level. The project has organized several trainings for medical staff on the WHO protocols for the management of diabetes, and is providing glucometers for self-management to identified patients. Health education and patient information materials have been also been produced as health literacy is generally recognized as being low. The most innovative intervention in the Kosovo context has been the development of a geriatric assessment tool, which comprises a questionnaire to collect information about health and social status of patients. For the first time, a joint assessment is now carried out by both a nurse and social worker in the patients’ home. Based on the findings of the assessment, a joint individualised patient care plan is then developed by a multi-disciplinary team comprising Family Medicine doctors, nurses and social workers. A Monitoring and Evaluation framework has been developed and this is now being used to monitor the implementation of activities and evaluate to what extent the quality of care for older people with Type 2 Diabetes has been improved. Conclusion: Integrated services, person-centered care and care-planning are all new concepts in the Kosovo context. The participatory approach of having a multi-sectoral WG lead the reform and ensure that all activities are locally – driven and entirely appropriate for the local context has been a huge asset in ensuring a clear commitment to implementation of integrated care model.

Treated chicken feather meal with 20, 35 and 50% replacement of fish meal (20, 35, 50 CHF), algal meal with 20 and 35% replacement of fish meal (20, 35 AM) and control diet (CNL) were tested for attractability and palatability to juvenile gilthead seabream, Sparus aurata. Biochemical analysis of the ingredients revealed that treated chicken feather meal (CHF) had high levels of amino acids (AA), and high levels of protein whereas, AM and CNL had high levels of amino acid compositions (AA) except protein content for AM. The biochemical profile of CHF was only moderately superior to that of CNL. Algal meals (20% and 35%) were more attractable and palatable than the control whereas, 20, 35 and 50% CHF were not attractive. The 20 and 35% CHF were not palatable while 50% CHF was more palatable than CNL, 20 and 35% CHF. Attractability and palatability of treated chicken feather meal and algal meal to juvenile seabream were fairly consistent with the biochemical profile of the formulated diets. Keywords: Attractability, Palatability, Feeding effectors, Rendered animal proteins, Algal meal

Ranunculus (buttercup or mayflower) is an important plant species causing chemical irritation. It is one of the traditional treatment methods usually used for rheumatic disorders in Central Anatolia particularly in spring and summer months. Here we report three cases of burn injury that developed secondary to mayflower use. We are of the opinion that modern medical therapies should be preferred over herbal remedies since the benefits of the latter remains to be proved. [Med-Science 2016; 5(3.000): 838-44]

Atrial fibrillation is the most common rhythm disturbance in general population. We present a 19-year-old man who was admitted to emergency department with progressive weakness, intermittent nausea, vomiting, and palpitations for 1-2 hours. He stated that he had palpitations for the first time. His past history was notable for venlafaxine use for panic disorder. He was diagnosed with AF with rapid ventricular rate and admitted to coronary care unit. Medical cardioversion with amiodarone was attempted and normal sinus rhythm was restored. He had no additional problems during hospital stay and was discharged on anticoagulant therapy (warfarin sodium). Atrial fibrillation should be born in mind in cases presenting to emergency department with palpitations, chest pain, syncope, or weakness in order to provide early diagnosis and treatment for this important disorder causing many complications. [Med-Science 2016; 5(1.000): 275-9]

Background: Calciphylaxis is a serious disorder often observed in dialysis patients and less frequently in chronic renal failure patients with secondary hyperparathyroidism. Mortality rate increases following the development of calciphylaxis, immediate application of parathyroidectomy along with other treatment options may be lifesaving. Case Presentation: A 44-year-old male patient had been on regular hemodialysis three times per week, with 4-hour sessions since December 2003. The etiology of his renal failure was unknown and the patient had no systemic disease when hemodialysis was started, painful, erythematous skin lesions were detected over and around the external malleolus of the right foot. In the next two months, erythematous skin lesions gained a necrosed character and spread into the malleolar and posterior tibial region and back of the ankle in both extremities. The patient showed no clinical signs of recovery and despite anti-biotherapy, debridement and protective measures, the skin lesions got infected and presented as intolerable, painful wounds. The patient was diagnosed with calcific uremic arteriolopathy (CUA) and hospitalized for parathyroidectomy. All parathyroid glands were removed after having checked quick PTH intraoperatively. A small amount of parathyroid tissue was intramuscularly auto-implanted into the right forearm .Skin lesions showed fast improvement in further follow-ups. Three months after parathyroidectomy, iPTH value was measured as 1197 pg/ml. After 6 months of medical treatment, iPTH was found as 970 ng/L and we decided to remove the implanted parathyroid tissue from the right forearm. Conclusion: In this article, we present a case of calciphylaxis accompanied by severe secondary hyperparathyroidism.

Growing muscle tissue in culture from animal stem cells to produce meat theoretically eliminates the need to sacrifice animals. So-called “cultured” or “synthetic” or “in vitro” meat could in theory be constructed with different characteristics and be produced faster and more efficiently than traditional meat. The technique to generate cultured muscle tissues from stem cells was described long ago, but has not yet been developed for the commercial production of cultured meat products. The technology is at an early stage and prerequisites of implementation include a reasonably high level of consumer acceptance, and the development of commercially-viable means of large scale production. Recent advancements in tissue culture techniques suggest that production may be economically feasible, provided it has physical properties in terms of colour, flavour, aroma, texture and palatability that are comparable to conventional meat. Although considerable progress has been made during recent years, important issues remain to be resolved, including the characterization of social and ethical constraints, the fine-tuning of culture conditions, and the development of culture media that are cost-effective and free of animal products. Consumer acceptance and confidence in in vitro produced cultured meat might be a significant impediment that hinders the marketing process.

A study was carried out to investigate the effects of feeding low quality non-conventional feeds (NCF) containing phenols and condensed tannins on health and performance characteristics in Omani sheep. Twelve Omani sheep were fed one of two base roughages, urea-treated palm frond (UTPF) or Rhodesgrass hay, (RGH) plus a commercial concentrate for 63 days. Haematological, serum biochemical and urine analyses were used to assess sheep health. Serum protein fractions were measured using electrophoresis. Urea-treated palm frond contained higher levels of polyphenols and condensed tannins and fiber than Rhodesgrass hay or concentrate feed. Animals fed UTPF had lower feed intake (P