Search

This review offers an extensive examination of the evolving landscape of Long Range (LoRa) Microstrip Patch Antennas (MPAs), highlighting their crucial role in optimizing LoRa systems within the Internet of Things (IoT). As the demand for energy-efficient standards like LoRa grows with the expanding IoT market, this research becomes increasingly relevant. This comprehensive review, the first of its kind, serves as a foundational resource for researchers seeking to optimize LoRa systems within the IoT. The study has categorized these LoRa MPAs – including monopole, Planar Inverted F Antenna (PIFA), dipole, yagi-uda, and array – into single band, dual-band, multiband, and wearable antennas, thus providing substantial viewpoints on their diverse design architectures and performance characteristics. Through systematic tabulation, the review facilitates a thorough comparison of antenna advancements. Notably, the review addresses inherent challenges in LoRa MPAs, emphasizing critical aspects that necessitate attention, including the need for miniaturization and integration, advancements in substrate materials and fabrication techniques, and the imperative for reconfigurable and adaptive antennas. Various approaches to enhance antenna performance are explored, including the metamaterial incorporation, slot-based enhancements, Electromagnetic Band Gap (EBG), dielectric resonator antennas (DRAs), substrate material considerations, and corrugation techniques. Looking ahead, the paper explores the future trends and subtle considerations that are poised to shape the trajectory of LoRa MPAs. To the best of our knowledge, this paper represents the first comprehensive review on the multifaceted topic of LoRa MPAs, serving as a foundational resource for researchers in the field.

Abstract Background Autism spectrum disorder (ASD) manifests in early childhood and significantly impairs social and communicative functions. Parents of children with ASD typically experience higher levels of stress compared to parents of children with other disabilities or health issues. This study investigates how a home-based early intervention known as the Portage program influences parenting stress and improves family awareness by using the Parental Stress Scale (PSS), and Family Awareness Scale. We enrolled 41 children diagnosed with ASD and their parents in this study. The median age of the children was 4 years, with a predominance of males (80%). We measured changes in parenting stress and family awareness as primary outcomes, with the children’s behavior as a secondary outcome. Results Post-intervention assessments showed statistically significant improvements in parenting stress and family awareness (P

Abstract Deep neural networks (NNs) encounter scalability limitations when confronted with a vast array of neurons, thereby constraining their achievable network depth. To address this challenge, we propose an integration of tensor networks (TN) into NN frameworks, combined with a variational DMRG-inspired training technique. This in turn, results in a scalable tensor neural network (TNN) architecture capable of efficient training over a large parameter space. Our variational algorithm utilizes a local gradient-descent technique, enabling manual or automatic computation of tensor gradients, facilitating design of hybrid TNN models with combined dense and tensor layers. Our training algorithm further provides insight on the entanglement structure of the tensorized trainable weights and correlation among the model parameters. We validate the accuracy and efficiency of our method by designing TNN models and providing benchmark results for linear and non-linear regressions, data classification and image recognition on MNIST handwritten digits.

Abstract Limiting cellular plasticity is of key importance for the therapeutic targeting of metastatic breast cancer (MBC). Fibroblast growth receptor (FGFR) is a critical molecule in cellular plasticity and potent inhibitors of FGFR enzymatic activity have been developed, but kinase independent functions for this receptor also contribute to MBC progression. Herein, we evaluated several FGFR inhibitors and find that while FGFR-targeted kinase inhibitors are effective at blocking ligand-induced cell growth, dormant cells persist eventually giving rise to MBC progression. To more broadly target FGFR and cellular plasticity, we examined the FGFR1 proximal promoter, and found several sequences with potential to form G-quadruplex secondary structures. Circular dichroism was used to verify formation of G-quadruplex in the FGFR1 proximal promoter. Importantly, use of the clinical G-quadruplex-stabilizing compound, CX-5461, stabilized the FGFR1 G-quadruplex structures, blocked the transcriptional activity of the FGFR1 proximal promoter, decreased FGFR1 expression, and resulted in potent inhibition of pulmonary tumor formation. Overall, our findings suggest G-quadruplex-targeted compounds could be a potential therapeutic strategy to limit the cellular plasticity of FGFR1 overexpressing MBC.

Environmental monitoring for the detection and regulation of toxic gases is of paramount importance. This study proposes the modeling and fabrication of MEMS devices based on the standard Polysilicon Multi-Users MEMS Process (PolyMUMPs) for acetone gas detection. Titanium dioxide ( $TiO_{2}$ ) nanoparticles has been incorporated onto the top sensor’s surface, amplifying its detection sensitivity. The study delves into Electrothermal mechanisms that has integrated with the embedded microheater to induce thermal forces. This enhancement significantly improves the acetone gas detection capabilities of the device with high sensitivity and low detection limit. Results include the displacement amplitude of the uncoated PolyMUMPs sensor, with exploration of the coated device’s behavior under different heating voltages. Electrothermal actuation is employed, and the output voltage is measured using an MS3110 universal capacitive readout circuit. Comparisons of uncoated and coated devices has been investigated, demonstrating the influence of the sensing material that improve the detection performance. This investigation delves into the impact of varying coating thickness on the PolyMUMPs sensor’s performance. The mass sensitivity of the device is found to be 3.8574 mHz/pg, while the detection limit indicates that the device can detect up to 44 part per billion (ppb) at resonance frequency of 7.627 kHz.

This study presents an innovative and compact monopole antenna with dual-band frequency reconfigurability for LoRa applications. It operates within the 915 MHz and 868 MHz frequencies, aligning with the designated bands for use in America, Asia and Europe. No existing compact reconfigurable antenna with these features for LoRa applications within ISM bands below 1 GHz is known. Employing an economical FR-4 substrate in its design, the antenna attains a compact size of $40 \times 42 \text {mm}^{2}$ ( $0.12\,\,\lambda _{0} \times 0.12\,\,\lambda _{0}$ ), where $\lambda _{0}$ denotes the wavelength in free space corresponding to 868 MHz. A single RF PIN diode enables seamless switching between 868 MHz and 915 MHz bands. Design, simulation, and optimization employed CST MWS® software. Supervised regression Machine Learning (ML) models predicted resonance frequencies, with Gaussian Process Regression emerging as optimal, achieving R-squared and variance scores of 92.87% and 93.77%, respectively. A maximum gain of 2 dBi at 915 MHz and 70% efficiency, boasting good radiation patterns and matching was demonstrated by the antenna. Experimental validation in a football field at Universiti Teknologi PETRONAS, Malaysia, assessed the proposed antenna’s performance on a LoRa transceiver system based on LoRa SX1276. The Received Signal Strength Indicator (RSSI) of the proposed antenna consistently exceeded the conventional commercially available monopole antenna by an average of $\mathbf {-12 \mathrm {dBm}}$ at every point up to 300 m, showcasing enhanced signal reception. The antenna proves promising for wireless sensor nodes in long-range applications.

Phosphonium-derived ionic liquids have emerged as a powerful class of thermoresponsive materials with sought after Lower Critical Solution Temperature (LCST) phase separation with applications across a broad range of fields. Herein, we report the spectroscopic examination of phosphonium salts bearing the general structure [X][P444n] wherein systematic structural variations were designed to gain a fundamental understanding behind the impact of alkyl chain length, anion size, and effective nuclear charge on their temperature-dependent phase separation behavior. Using variable temperature 1H, 31P, and 19F NMR, the bonding changes which drive LCST phase separation for the assembled thermoresponsive ILs were elucidated. For the first time, spectroscopic evidence revealed a delicate balance between the interdependence of alkyl chain length and anion size on phase separation that formed the basis of new LCST design principles.

Abstract Post-malaria neurological syndrome (PMNS) is a rare, self-limiting condition that presents with a wide range of neurological manifestations after clearance of malarial infection, especially 𝘗𝘭𝘢𝘴𝘮𝘰𝘥𝘪𝘶𝘮 f𝘢𝘭𝘤𝘪𝘱𝘢𝘳𝘶𝘮, most patients recover without residual deficits. Here we present a case of a 29-year-old, male with a recent history of malaria treated successfully, who presented due to a generalized tonic-clonic seizure, without any other neurological symptoms, the examination and labs were unremarkable, he underwent a computer tomography (CT) scan and Magnetic resonant imaging (MRI) which both showed two areas of vasogenic edema involving the subcortical white matter of left frontal and right posterior parasagittal regions, all autoimmune screens, infection workup from blood and CSF were negative, he underwent a brain biopsy that showed intense perivascular inflammation with neuronal loss and gliosis, findings are nonspecific and can be seen in a variety of condition. The patient’s condition improved, and he was discharged without any complications.

Objectives: A tricalcium silicate-based cement, Biodentine™, has displayed antibiofilm activity when mixed with chitosan powder. This study aimed to assess the effect of chitosan incorporation on the physico-mechanical and biological properties of Biodentine™. Methods: In this study, medium molecular weight chitosan powder was incorporated into Biodentine™ in varying proportions (2.5 wt%, 5 wt%, 10 wt%, and 20 wt%). The setting time was determined using a Vicat apparatus, solubility was assessed by calculating weight variation after water immersion, radiopacity was evaluated and expressed in millimeters of aluminum, the compressive strength was evaluated using an Instron testing machine, and the microhardness was measured with a Vickers microhardness tester. In addition, surface topography of specimens was analyzed using scanning electron microscopy, and the effect of chitosan on the viability of human embryonic kidney (HEK 293) cells was measured by a colorimetric MTT assay. Results: Incorporation of 2.5 wt% and 5 wt% chitosan powder delivered an advantage by speeding up the setting time of Biodentine material. However, the incorporation of chitosan compromised all other material properties and the crystalline structure in a dose-dependent manner. The chitosan-modified material also showed significant decreases in the proliferation of the HEK 293 cells, signifying decreased biocompatibility. Significance: Chitosan incorporation into calcium silicate materials adversely affects the physical and biological properties of the material. Despite the increased antimicrobial activity of the modified material, the diminution in these properties is likely to reduce its clinical value.

Background: Device-associated infections (DAIs) are important components of healthcare associated infection and are associated with increased morbidity and mortality. This study describes DAIs across different intensive care units (ICUs) in a hospital in Saudi Arabia. Methods: The study was conducted between 2017 and 2020 and followed the definitions of National Healthcare Safety Network (NHSN) for DAIs. The calculated the rates of ventilator-associated events (VAE), catheter-associated urinary tract infections (CAUTI) and central line-associated blood stream infections (CLABSI) followed NHSN definitions. Results: During the study period, there were 82 DAIs in adult ICUs and of these 16 (19.5%) were CLABSI, 26 (31.7%) were CAUTI and 40 (48.7%) were VAE. The overall rates for adult ICUs were 1.6, 1.9, 3.8 per 1000 device-days for CAUTI, CLABSI and VAE, respectively. The device-utilization ratio was 0.5, 0.6, and 0.48 for urinary catheters, central lines, and ventilators, respectively. VAE rates for medical and surgical ICU were about 2.8 times the rate in the coronary care unit and the rates were high in 2020 corresponding with the COVID-19 pandemic. Of the adult ICUS, medical ICU had a CLABSI rate of 2.13/1000 device-days and was about double the rate in surgical and cardiac ICU. For CAUTI, the rates per 1000 device-days were 2.19, 1.73, and 1.65 for medical, surgical, and coronary ICUs, respectively. The rate of CLABSI per 1000 device-days for pediatric and neonatal ICUs were 3.38 and 2.28, respectively. Conclusions: CAUTI was the most common infections among adult ICUs and medical ICU had higher rates than other adult ICUs. VAE rate was higher in the first year of the COVID-19 pandemic, indicating increased device-use, change in patients characteristics as well as possible change in practices across the ICUs.

The Hyperledger Fabric (HF) framework is widely studied for securing electronic health records (EHRs) in the healthcare sector. Despite the various cross-domain blockchain technology (BCT) applications, little is known about the role of the HF framework in healthcare. The purpose of the systematic literature review (SLR) is to review the existing literature on the HF framework and its applications in healthcare. This SLR includes literature published between January 2015 and March 2023 in the ACM digital library, IEEE Xplore, SCOPUS, Springer, PubMed, and Google Scholar databases. Following the inclusion and exclusion criteria, a total of 57 articles emerged as eligible for this SLR. The HF framework was found to be useful in securing health records coming from the Internet of Medical Things (IoMT) and many other devices. The main causes behind using the HF framework were identified as privacy and security, integrity, traceability, and availability of health records. Additionally, storage issues with transactional data over the blockchain are reduced by the use of the HF framework. This SLR also highlights potential future research trends to ensure the high-level security of health records.

Abstract Piezoelectric microelectromechanical system (piezo-MEMS)-based mass sensors including the piezoelectric microcantilevers, surface acoustic waves (SAW), quartz crystal microbalance (QCM), piezoelectric micromachined ultrasonic transducer (PMUT), and film bulk acoustic wave resonators (FBAR) are highlighted as suitable candidates for highly sensitive gas detection application. This paper presents the piezo-MEMS gas sensors’ characteristics such as their miniaturized structure, the capability of integration with readout circuit, and fabrication feasibility using multiuser technologies. The development of the piezoelectric MEMS gas sensors is investigated for the application of low-level concentration gas molecules detection. In this work, the various types of gas sensors based on piezoelectricity are investigated extensively including their operating principle, besides their material parameters as well as the critical design parameters, the device structures, and their sensing materials including the polymers, carbon, metal–organic framework, and graphene.

Carbon nanotubes (CNTs) are very promising nanodevices due to their extraordinary electrical, thermal, and optical properties. However, as-grown single-walled CNTs (SWCNTs) contain a mixture of semiconducting and metallic species with great features versatility and variation. Solution-based processing of this nanomaterial is vital for further implementation in applicable platforms. In this paper, important optoelectronic intrinsic properties of SWCNTs in dispersions are studied applying a semi-empirical approach of optical characterization and Tauc/Davis-Mott relation and Max-Planck equations. SWCNTs are found to have a direct bandgap of 2.20 eV, an indirect bandgap of 0.27 eV, an optical conductivity of about 107 S cm-1, and exhibited a metamaterial behavior ascribed to the high negative permittivity. In addition, the optimum parameters for the dispersion of SWCNTs, and the separation of the semiconducting species using simple mechanical methods of ultrasonication and density gradient ultracentrifugation, respectively, without using surfactants are also presented.

Abstract Background Warthin tumor (WT) is a common benign salivary tumor of the parotid gland. Clinically, it occurs in men in their fifth to seventh decades who typically smoke cigarettes. WTs have been reported with different head and neck neoplasms and other salivary gland tumors within the same or another salivary gland. Kimura disease (KD) is a rare chronic inflammatory disease with unknown etiology affecting young to middle-aged Asian men. KD presents as an asymptomatic nodule in the head and neck area, with regional lymphadenopathy and salivary gland involvement. Case presentation A 64-year-old Arabic man presented with a 10-year history of an asymptomatic swelling of the left face. Computed tomography showed a well-defined, multicystic mass with heterogeneous enhancement. The resected mass was composed of two distinct components. There was a well-demarcated proliferation of papillary and cystic oncocytic epithelium with lymphoid stroma, consistent with WT. Some areas exhibited sclerotic fibrosis, with multiple lymphoid follicles showing folliculolysis, follicular hyperplasia, and eosinophilic infiltrate. The patient’s immunoglobulin E level serum was elevated, confirming a coexisting KD. The patient underwent a left superficial parotidectomy, with no recurrence at a 30-month follow-up. Conclusion This report describes the first concurrent case of WT and KD in the parotid gland.

In this study, we have presented our findings on the deployment of a machine learning (ML) technique to enhance the performance of LTE applications employing quasi-Yagi-Uda antennas at 2100 MHz UMTS band. A number of techniques, including simulation, measurement, and a model of an RLC-equivalent circuit, are discussed in this article as ways to assess an antenna's suitability for the intended applications. The CST simulation gives the suggested antenna a reflection coefficient of -38.40 dB at 2.1 GHz and a bandwidth of 357 MHz (1.95 GHz-2.31 GHz) at a -10 dB level. With a dimension of 0.535λ0×0.714λ0, it is not only compact but also features a maximum gain of 6.9 dB, a maximum directivity of 7.67, VSWR of 1.001 at center frequency and a maximum efficiency of 89.9%. The antenna is made of a low-cost substrate, FR4. The RLC circuit, sometimes referred to as the lumped element model, exhibits characteristics that are sufficiently similar to those of the proposed Yagi antenna. We use yet another supervised regression machine learning (ML) technique to create an exact forecast of the antenna's frequency and directivity. The performance of machine learning (ML) models can be evaluated using a variety of metrics, including the variance score, R square, mean square error (MSE), mean absolute error (MAE), root mean square error (RMSE), and mean squared logarithmic error (MSLE). Out of the seven ML models, the linear regression (LR) model has the lowest error and maximum accuracy when predicting directivity, whereas the ridge regression (RR) model performs the best when predicting frequency. The proposed antenna is a strong candidate for the intended UMTS LTE applications, as shown by the modeling results from CST and ADS, as well as the measured and forecasted outcomes from machine learning techniques.

Training child investigative interviewing skills is a specialized task. Those being trained need opportunities to practice their skills in realistic settings and receive immediate feedback. A key step in ensuring the availability of such opportunities is to develop a dynamic, conversational avatar, using artificial intelligence (AI) technology that can provide implicit and explicit feedback to trainees. In the iterative process, use of a chatbot avatar to test the language and conversation model is crucial. The model is fine-tuned with interview data and realistic scenarios. This study used a pre-post training design to assess the learning effects on questioning skills across four child interview sessions that involved training with a child avatar chatbot fine-tuned with interview data and realistic scenarios. Thirty university students from the areas of child welfare, social work, and psychology were divided into two groups; one group received direct feedback (n = 12), whereas the other received no feedback (n = 18). An automatic coding function in the language model identified the question types. Information on question types was provided as feedback in the direct feedback group only. The scenario included a 6-year-old girl being interviewed about alleged physical abuse. After the first interview session (baseline), all participants watched a video lecture on memory, witness psychology, and questioning before they conducted two additional interview sessions and completed a post-experience survey. One week later, they conducted a fourth interview and completed another post-experience survey. All chatbot transcripts were coded for interview quality. The language model’s automatic feedback function was found to be highly reliable in classifying question types, reflecting the substantial agreement among the raters [Cohen’s kappa (κ) = 0.80] in coding open-ended, cued recall, and closed questions. Participants who received direct feedback showed a significantly higher improvement in open-ended questioning than those in the non-feedback group, with a significant increase in the number of open-ended questions used between the baseline and each of the other three chat sessions. This study demonstrates that child avatar chatbot training improves interview quality with regard to recommended questioning, especially when combined with direct feedback on questioning.

Objectives Pakistan has a hepatitis C virus (HCV) infection prevalence of 6%–9% and aims to achieve World Health Organisation (WHO) targets for elimination of HCV by the year 2030. We aim to evaluate the potential cost-effectiveness of a reference laboratory-based (centralised laboratory testing; CEN) confirmatory testing approach versus a molecular near-patient point-of-care (POC) confirmatory approach to screen the general population for HCV in Pakistan.Study design We used a decision tree-analytic model from a governmental (formal healthcare sector) perspective.Study setting Individuals were assumed to be initially screened with an anti-HCV test at home, followed by POC nucleic acid test (NAT) at nearby district hospitals or followed by NAT at centralised laboratories.Participants We included the general testing population for chronic HCV in Pakistan.Intervention Screening with an anti-HCV antibody test (Anti-HCV) followed by either POC NAT (Anti-HCV-POC), or reference laboratory NAT (Anti-HCV-CEN), was compared, using data from published literature and the Pakistan Ministry of Health.Measures Outcome measures included: number of HCV infections identified per year, percentage of individuals correctly classified, total costs, average costs per individual tested, and cost-effectiveness (assessed as cost per additional HCV infection identified). Sensitivity analysis was also performed.Results At a national level (25 million annual screening tests), the Anti-HCV-CEN strategy would identify 142 406 more HCV infections in 1 year and increase correct classification of individuals by 0.57% compared with the Anti-HCV-POC strategy. The total annual cost of HCV testing was reduced using the Anti-HCV-CEN strategy by US$7.68 million (US$0.31/person). Thus, incrementally, the Anti-HCV-CEN strategy costs less and identifies more HCV infections than Anti-HCV-POC. The incremental difference in HCV infections identified was most sensitive to the probability of loss to follow-up (for POC confirmatory NAT).Conclusions Anti-HCV-CEN would provide the best value for money when scaling up HCV testing in Pakistan.

BackgroundPoisoning occurs when a person is exposed to an external substance at a too high dose for them. It is possible for young children to be exposed to chemicals. Lungs, the heart, CNS, the digestive tract, and kidneys can be poisoned. In 2004, over 45,000 children and teenagers died from acute poisoning, representing 13% of all accidental poisoning deaths worldwide. Poisoning patterns vary by exposure type, age group, poison type, and dose.AimThis study assessed the pattern of acute poisoning with drugs, chemicals, and natural toxins among children ( 0.05). The age of the children correlated positively with their systolic BP (r = 0.22, p

Background: COVID-19 causes moderate to severe illness and is spreading globally. During a pandemic, vitamins and minerals are vital to health. Therefore, the prevalence and epidemiology of supplement use in Saudi Arabia during the COVID-19 pandemic must be known. Methods: This cross-sectional study was conducted in Saudi Arabia using an online survey. The study was conducted from June to March 2022 on both adults and children. The link to the survey was shared on social media platforms. The survey included questions on participants' demographics, vaccination status, supplements they used, and side effects of supplements. Participation in this study was optional, and there was no obligation to participate. There was a declaration about the aim of the study and different objectives before starting the survey. Results: The present study reported that most of the participants reported that they used vitamin C (64.6 %), zinc (51.9 %), multivitamins (46.1 %), black seeds (26.7 %), garlic (Allium sativum) (15.4 %), omega-3 (22.1 %), vitamin D (22.2 %), echinacea (10.1 %), manuka honey (26.0 %), curcumin (13.6 %), ginger (22.5 %), royal jelly (12.9 %), and propolis (7.5 %) before and during the COVID-19 pandemic period. These supplements were used more frequently by subjects during the pandemic than before. Discussion and conclusion: The respondents' risk of these supplements’ use may partially reflect the public's behavioral response during a pandemic. Future studies can document the health beliefs and motivations of nutritional supplement users.

Mukhtiar Ahmad,1,* Mehran Khan,2,* Rizwan Asif,3,* Nuzhat Sial,4,* Usman Abid,5,* Tahira Shamim,6 Zahid Hameed,7 Muhammad Junaid Iqbal,8,* Uroosa Sarfraz,8 Hina Saeed,1,* Zara Asghar,2 Madeeha Akram,2 Qamar Ullah,9 Qurat ul Ain Younas,10 Laraib Rauf,11 Alishba Hadi,1 Sajida Maryam,12 Yasir Hameed,1 Muhammad Rashid Khan,13,* Eman Tariq,14 Saba Saeed15,* 1Department of Biochemistry and Biotechnology, Islamia University of Bahawalpur, Bahawalpur, Pakistan; 2Department of Pharmacy, Islamia University of Bahawalpur, Bahawalpur, Pakistan; 3Department of Microbiology, Government College University Faisalabad, Faisalabad, Pakistan; 4Department of Zoology, Islamia University of Bahawalpur, Bahawalpur, Pakistan; 5Department of Pharmaceutics, Bahauddin Zakariya University, Multan, Pakistan; 6University College of Conventional Medicine, Islamia University of Bahawalpur, Bahawalpur, Pakistan; 7Department of Bioinformatics and Biotechnology, International Islamic University, Islamabad, Pakistan; 8Department of Biosciences, COMSATS University Islamabad, Islamabad, Pakistan; 9Department of Livestock and Dairy Development, Peshawar, Pakistan; 10Department of Zoology, Cholistan University of Veterinary and Animal Sciences, Bahawalpur, Pakistan; 11Department of Healthcare Management, Riphah International University, Islamabad, Pakistan; 12Arid Agriculture University, Rawalpindi, Pakistan; 13University College of Eastern Medicine, Islamia University of Bahawalpur, Bahawalpur, Pakistan; 14Department of Chemistry, University of Swabi, Swabi, Pakistan; 15Department of Zoology, University of the Punjab, Lahore, Pakistan*These authors contributed equally to this workCorrespondence: Yasir Hameed, Department of Biochemistry and Biotechnology, Islamia University of Bahawalpur, Bahawalpur 63100, Pakistan, Email Yasirhameed2011@gmail.comIntroduction: In light of the increased demand for reliable cancer-associated biomarkers and ANLN oncogenic potential, the present study aimed to investigate ANLN’s role in 24 human cancers.Methods: The UALCAN, Kaplan–Meier (KM) plotter, TNM Plot, GENT2, GEPIA, HPA, cBioPortal, STRING, Enrichr, TIMER, Cytoscape, DAVID, MuTarget, and CTD online databases and bioinformatic tools were used in this study.Results: In three of the cancers analyzed, ANLN expression was downregulated in tumor tissue, while it was overexpressed in the 21 other types of tumor tissue relative to controls. In CESC, ESCA, HNSC, and KIRC patients, ANLN overexpression was correlated with shorter overall survival, relapse-free survival, and metastasis. This suggests that ANLN is significantly involved in the development and progression of these four cancers. Further expression analysis revealed upregulation of ANLN in CESC, ESCA, HNSC, and KIRC patients with different clinical characteristics, regardless of the heterogeneity barrier. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analysis revealed that ANLN-associated genes were coexpressed with ANLN and were included in diverse BP, MF, and KEGG terms. Moreover, some interesting correlations were also documented between ANLN expression and its promoter-methylation level, genetic alterations, other mutant genes, and CD8+ T- and CD4+ T-cell infiltration. Moreover, we also identified ANLN-associated transcription factors, miRNAs, and chemotherapeutic drugs.Conclusion: This pan-cancer study revealed the novel diagnostic and prognostic role of ANLN across four cancers, regardless of heterogeneity.Keywords: cancer, ANLN, diagnostic, prognostic, biomarker

Automated food detection and recognition methods have been studied to enhance end-user life. However, most existing research focused on food ingredient type recognition, with little work has been done for food ingredient state recognition. Successful recognition of food ingredient state plays a significant role in handling the food ingredient by an intelligent system. In this work, we propose a new novel cascaded multi-head approach based on deep learning to simultaneously recognize the state and type of food ingredients. We trained and evaluated the proposed approach on a benchmark dataset of food ingredient images with nine different food states and 18 food types. We compared the proposed approach with a non-cascaded deep learning approach. The cascaded approach shows improvement in food ingredient state recognition with 87% accuracy compared to 81% using a non-cascaded deep learning method. Our proposed method broadly applies to various tasks where food ingredient state recognition is essential, such as feeding elderly and disabled people and automating food recognition and preparation.

The novel coronavirus disease 2019 (COVID-19) added tremendous pressure on healthcare services worldwide. COVID-19 early detection is of the utmost importance to control the spread of the coronavirus pandemic and to reduce pressure on health services. There have been many approaches to detect COVID-19; the most commonly used one is the nasal swab technique. Before that was available chest X-ray radiographs were used. X-ray radiographs are a primary care method to reveal lung infections, which allows physicians to assess and plan a course of treatment. X-ray machines are prevalent, which makes this method a preferable first approach for the detection of new diseases. However, this method requires a radiologist to assess each chest X-ray image. Therefore, different automated methods using machine learning techniques have been proposed to assist in speeding up diagnoses and improving the decision-making process. In this paper, we review deep learning approaches for COVID-19 detection using chest X-ray images. We found that the majority of deep learning approaches for COVID-19 detection use transfer learning. A discussion of the limitations and challenges of deep learning in radiography images is presented. Finally, we provide potential improvements for higher accuracy and generalisability when using deep learning models for COVID-19 detection.

In this study, the use of linear alkylbenzenes (LABs) was employed to pinpoint the sources of human activity that cause detrimental impacts on the coastal environment and river ecosystems. LABs were detected using GC–MS in sediment samples assembled from Kim Kim River (KKR) and the Port Dickson coast (PDC). To assess the significance of variations in the distribution and concentrations of LABs across the sampling sites, this study utilized several statistical techniques such as post hoc tests, LSD techniques, analysis of variance (ANOVA), and the Pearson correlation coefficient using a significance level of p < 0.05. The degradation levels of LABs and wastewater treatment were assessed in the study using internal congeners (I/E), homologs of C13 and C12, and long-to-short-chain (L/S) ratios. The results revealed that the LAB concentrations varied between 88.3 and 112 ng/g dw in KKR and 119 to 256 ng/g dw in the PDC. Most of the surveyed areas exhibited a substantial count of C13–LABs homologs that displayed a significant difference (p < 0.05). The I/E ratios ranged from 1.7 to 2.0 in KKR and from 2.0 to 4.1 in the PDC, suggesting that the effluents originated from sources associated with the physical phase and biological phase in wastewater treatment systems (WWTSs). The results revealed that the degradation of LABs varied between 34% and 38% in KKR and between 40% and 64% in the PDC. This study underscores the importance of ongoing improvements to WWTSs and emphasizes the potential of LABs as indicators for monitoring wastewater contamination.

Bloodstream infection (BSI) prevalence in hospitalized patients has increased owing to the spread of antibiotic-resistant pathogens; moreover, antimicrobial resistance in bacteria is a global problem. Here, BSIs are investigated in several patients at a hospital in Saudi Arabia, and the resistance of bacterial isolates to widely used drugs is determined. Throughout 2020, bacteria isolated from patients were identified and subjected to antibiotic susceptibility testing. In total, 1125 bacterial isolates were obtained from 1039 patients; among them, gram-positive bacteria were significantly more abundant than gram-negative bacteria. The most prevalent bacteria were Staphylococcus epidermidis and Klebsiella pneumoniae. Notably, gram-negative bacteria were mainly isolated from adult patients, and 20.63% of the gram-positive isolates were from pediatric patients, which was significantly higher than the corresponding percentages in elders and adults. The gram-positive isolates were mainly resistant to cephalothin, oxacillin, amoxicillin-clavulanate, and erythromycin and susceptible to penicillin, gentamicin, ciprofloxacin, and vancomycin. Additionally, the gram-negative isolates were mainly resistant to ampicillin, cephalothin, and amoxicillin-clavulanate and susceptible to amikacin, ertapenem, aztreonam, colistin, and trimethoprim-sulfamethoxazole. Consequently, the high prevalence of infective multidrug-resistant bacteria may account as a significant health issue; it is considered a hazard in Riyadh hospitals and must be prevented at all costs.

Nuzhat Sial,1 Saba Saeed,2 Mukhtiar Ahmad,3 Yasir Hameed,3 Abdul Rehman,4 Mustansar Abbas,5 Rizwan Asif,6 Hamad Ahmed,5 Muhammad Safdar Hussain,3 Jalil Ur Rehman,7 Muhammad Atif,7 Muhammad Rashid Khan8 1Department of Zoology, The Islamia University of Bahawalpur, Bahawalpur, Pakistan; 2Department of Zoology, University of the Punjab, Lahore, Pakistan; 3Department of Biochemistry and Biotechnology, The Islamia University of Bahawalpur, Bahawalpur, Pakistan; 4Department of Eastern Medicine, Qarshi University, Lahore, Pakistan; 5Department of Eastern Medicine, Government College University Faisalabad, Faisalabad, Pakistan; 6Department of Microbiology, Government College University Faisalabad, Faisalabad, Pakistan; 7University College of Conventional Medicine, The Islamia University of Bahawalpur, Bahawalpur, Pakistan; 8University College of Eastern Medicine, The Islamia University of Bahawalpur, Bahawalpur, PakistanCorrespondence: Yasir HameedDepartment of Biochemistry and Biotechnology, The Islamia University of Bahawalpur, Bahawalpur, 63100, PakistanEmail Yasirhameed2011@gmail.comIntroduction: Cancer is one of the most common malignancies and the leading cause of death worldwide. As a member of the transmembrane emp24 domain (Tmed)/p24 family of proteins, TMED2 expression variations have been documented earlier in only a few subtypes of human cancers, and the multi-omics profiling of TMED2 as a shared biomarker in different other subtypes of human cancers remains to be uncovered.Methods: In the current study, TMED2 multi-omics analysis in 24 major subtypes of human cancer was performed using different authentic online databases and bioinformatics analysis including UALCAN, Kaplan–Meier (KM) plotter, Human Protein Atlas (HPA), GENT2, MEXPRESS, cBioportal, STRING, DAVID, TIMER, and CTD.Results: In general, the TMED2 expression in 24 major subtypes of human cancers was higher relative to normal controls and was also strongly associated with the lower overall survival (OS) and relapse-free survival (RFS) duration of CESC, ESCA, HNSC, KIRC, LIHC, and LUAD patients. This implies that TMED2 plays a significant role in the development and progression of these cancers. Furthermore, the TMED2 overexpression was also correlated with different clinicopathological features of CESC, ESCA, HNSC, KIRC, LIHC, and LUAD patients. TMED2-associated genes network was involved in 3 diverse pathways, and finally, few stronger correlations were also explored between TMED2 expression and its promoter methylation level, genetic alterations, and CD8+ T immune cells level.Conclusion: In conclusion, via this in silico study, we have elucidated that TMED2 can serve as a shared diagnostic and prognostic biomarker in CESC, ESCA, HNSC, KIRC, LIHC, and LUAD patients of different clinicopathological features but, further in vitro and in vivo research should be carried out to confirm these findings.Keywords: TMED2, cancer, expression variations, biomarker

The fact that groundwater is the only source of drinking water in Yemen mandates strict monitoring of its quality. The aim of this study was to measure the levels of fluoride in the groundwater resources of Dhamar city. Dhamar city is the capital of Dhamar governorate located in the central plateau of Yemen. For this purpose, fluoride content in the groundwater from 16 wells located around Dhamar city was measured. The results showed that 75% of the investigated wells contain fluoride at or below the permissible level set by the World Health Organization (0.5 – 1.5 mg/L), whereas 25% of the wells have relatively higher fluoride concentrations (1.59 – 184 mg/L). The high levels of fluoride have been attributed to the anthropogenic activities in the residential areas near the contaminated wells. Interestingly, some wells contain very low fluoride concentrations (0.30 – 0.50 mg/L). Data were statistically treated using the principal component analysis (PCA) method to investigate any possible correlations between various factors. PCA shows a high correlation between well depth and its content of fluoride. On the other hand, health problems dominating in the study area necessitate further studies to investigate any correlation with imbalanced fluoride intake.

Methanol poisoning is a challenging issue due to its inducing acute multiple organ failures, and especially due to a lack of preparedness, available antidotes, and management protocols. The current study presents six cases of methanol poisoning that attended the emergency department of King Abdul Aziz Specialist Hospital, Taif, Saudi Arabia, between March and November 2022. All of the patients suffered from severe metabolic acidosis and visual impairment following the ingestion of homemade alcoholic beverages and colonia. Three patients were comatose, suffered from post-cardiac pulmonary arrest, and, finally, died, while the other three were non-comatose and discharged from the ICU after improvement. Management was based on clinical symptoms and other laboratory findings due to a shortage of methanol level measurement resources. The antidote, fomepizole, was not given to all of the cases due to its deficiency, and ethanol was given only to one patient due to difficulties in administering it without monitoring its concentration. Methanol poisoning and its outbreak provide insights into the dangers of hazardous homemade alcohol and other pharmaceutical preparations that might be adulterated with methanol, particularly to the shortage of suitable diagnostic testing and antidotes in addition to poor resources for management of intoxicated patients in some regions of Saudi Arabia.

Sadia Saeed,1 Vijayan Pillai,2 Azka Gouher3 1Department of Sociology, Quaid-i-Azam University, Islamabad, Pakistan; 2School of Social Work, University of Texas at Arlington, Arlington, TX, 76015, USA; 3Truth Iinternational, Islamabad, PakistanCorrespondence: Vijayan PillaiSchool of Social Work, University of Texas at Arlington, 211 South Cooper Street, Arlington, TX, 76019, USATel +1 817 681 3784Email Pillai@uta.eduIntroduction: This study investigates the effects of utilization of health care and the level of reproductive rights knowledge on contraceptive use. Current family planning programs in developing countries utilize a two-pronged strategy involving improvement of level of reproductive rights and, right to access health care systems. The effectiveness of this strategy in developing countries such as Pakistan remains poorly investigated. This study aimed at examining the effect of reproductive rights knowledge on contraceptive use.Methods: The target population is educated, 18- to 45-year-old married Pakistani women. The sample is composed of 160 nonrandomly selected purposive group of women. We gathered data using a structured questionnaire and analyzed the data using several multivariate methods such as latent class analysis and multiple classification analysis.Results: Our results suggest that reproductive rights knowledge has no direct effect on contraceptive use. Furthermore, the level of utilization of the health care system plays a significant intervening role between reproductive rights knowledge and contraceptive use.Discussion: Our results call for improving access and availability of health care while strengthening the awareness and knowledge of reproductive rights among women to improve their capacity to utilize family planning methods. Public awareness and educational programs are indeed necessary to promote knowledge of reproductive rights among women in developing countries. As public health campaigns propagandize the crucial role reproductive rights play in improving women’s reproductive health, it is important to maintain a structurally harmonious relationship between health care systems and family planning programs promoting contraceptive use. This approach is more likely to result in significant returns for public awareness campaigns promoting reproductive rights in developing countries.Keywords: reproductive health, women’s rights, multiple classification analysis, Pakistan

Afreenish Hassan,1 Aamer Ikram,1 Abida Raza,2 Sidra Saeed,2 Rehan Zafar Paracha,3 Zumara Younas,1 Muhammad Tahir Khadim1 1Department of Microbiology, Armed Forces Institute of Pathology, National University of Medical Sciences, Rawalpindi, Pakistan; 2NILOP Nanomedicine Research Laboratories, National Institute of Lasers and Optronics College, Pakistan Institute of Engineering and Applied Sciences, Islamabad, Pakistan; 3National University of Sciences and Technology, Islamabad, PakistanCorrespondence: Abida RazaNILOP Nanomedicine Research Laboratories, National Institute of Lasers and Optronics College, Pakistan Institute of Engineering and Applied Sciences, Lehtrar Road, Nilore, Islamabad, PakistanTel +92519248671-6 ext. 3103, 3177Fax +92 51 2208051Email abida_rao@yahoo.comAfreenish HassanDepartment of Microbiology, Armed Forces Institute of Pathology, National University of Medical Sciences, Rawalpindi, PakistanTel +92515176406 ext. 345Email afreenish.hassan@yahoo.comPurpose: Acinetobacter baumannii antibiotic resistant infections in high-risk patients are a great challenge for researchers and clinicians worldwide. In an effort to achieve potent bactericidal outcomes, a novel chitosan–mastoparan nanoconstruct (Mast-Cs NC) was designed and assessed for its therapeutic potential through in silico, in vitro and in vivo experimentation against clinical multidrug-resistant (MDR) A. baumannii.Methods: Optimized 3D structures of mastoparan and chitosan were coupled computationally through an ionic cross-linker to generate a circular ring of chitosan encasing mastoparan. The complex was assessed for interactions and stability through molecular dynamic simulation (MDS). Binding pocket analysis was used to assess the protease–peptide interface. Mast-Cs NC were prepared by the ionic gelation method. Mast-Cs NC were evaluated in vitro and in vivo for their therapeutic efficacy against drug-resistant clinical A. baumannii.Results: MDS for 100 ns showed stable bonds between chitosan and mastoparan; the first at chitosan oxygen atom-46 and mastoparan isoleucine carbon atom with a distance of 2.77 Å, and the second between oxygen atom-23 and mastoparan lysine nitrogen atom with a distance of 2.80 Å, and binding energies of − 3.6 and − 7.4 kcal/mol, respectively. Mast-Cs complexes approximately 156 nm in size, with +54.9 mV zeta potential and 22.63% loading capacity, offered > 90% encapsulation efficiency and were found to be geometrically incompatible with binding pockets of various proteases. The MIC90 of Mast-Cs NC was significantly lower than that of chitosan (4 vs 512 μg/mL, respectively, p< 0.05), with noticeable bacterial damage upon morphological analysis. In a BALB/c mouse sepsis model, a significant reduction in bacterial colony count in the Mast-Cs treated group was observed compared with chitosan and mastoparan alone (p< 0.005). Mast-Cs maintained good biocompatibility and cytocompatibility.Conclusion: Novel mastoparan-loaded chitosan nanoconstructs signify a successful strategy for achieving a synergistic bactericidal effect and higher therapeutic efficacy against MDR clinical A. baumannii isolates. The Mast-Cs nano-drug delivery system could work as an alternative promising treatment option against MDR A. baumannii.Keywords: Acinetobacter baumannii, mastoparan, antimicrobial resistance, simulation, chitosan, antimicrobial peptides, therapeutic efficacy, interactions

Concussions, both single and repetitive, cause brain and body alterations in athletes during contact sports. The role of the brain-gut connection and changes in the microbiota have not been well established after sports-related concussions or repetitive subconcussive impacts. We recruited 33 Division I Collegiate football players and collected blood, stool, and saliva samples at three time points throughout the athletic season: mid-season, following the last competitive game (post-season), and after a resting period in the off-season. Additional samples were collected from four athletes that suffered from a concussion. 16S rRNA sequencing of the gut microbiome revealed a decrease in abundance for two bacterial species, Eubacterium rectale, and Anaerostipes hadrus, after a diagnosed concussion. No significant differences were found regarding the salivary microbiome. Serum biomarker analysis shows an increase in GFAP blood levels in athletes during the competitive season. Additionally, S100β and SAA blood levels were positively correlated with the abundance of Eubacterium rectale species among the group of athletes that did not suffer a diagnosed concussion during the sports season. These findings provide initial evidence that detecting changes in the gut microbiome may help to improve concussion diagnosis following head injury.

Abstract Trastuzumab-emtansine (T-DM1) is an antibody-drug conjugate (ADC) that efficiently delivers a highly potent microtubule inhibitor to HER2 overexpressing cells. Herein, we utilize HER2 transformed human mammary epithelial cells (HME2) to demonstrate in vitro and in vivo response and recurrence upon T-DM1 treatment. Continuous in vitro dosing of HME2 cells with T-DM1 failed to produce a spontaneously resistant cell line. However, induction of epithelial–mesenchymal transition (EMT) via pretreatment with TGF-β1 was capable of promoting emergence of T-DM1-resistant (TDM1R) cells. Flow cytometric analyses indicated that induction of EMT decreased trastuzumab binding, prior to overt loss of HER2 expression in TDM1R cells. Kinome analyses of TDM1R cells indicated increased phosphorylation of ErbB1, ErbB4, and FGFR1. TDM1R cells failed to respond to the ErbB kinase inhibitors lapatinib and afatinib, but they acquired sensitivity to FIIN4, a covalent FGFR kinase inhibitor. In vivo, minimal residual disease (MRD) remained detectable via bioluminescent imaging following T-DM1-induced tumor regression. Upon cessation of the ADC, relapse occurred and secondary tumors were resistant to additional rounds of T-DM1. These recurrent tumors could be inhibited by FIIN4. Moreover, ectopic overexpression of FGFR1 was sufficient to enhance tumor growth, diminish trastuzumab binding, and promote recurrence following T-DM1-induced MRD. Finally, patient-derived xenografts from a HER2+ breast cancer patient who had progressed on trastuzumab failed to respond to T-DM1, but tumor growth was significantly inhibited by FIIN4. Overall, our studies strongly support therapeutic combination of TDM1 with FGFR-targeted agents in HER2+ breast cancer.

Vaccination against any infectious disease is considered to be an effective way of controlling it. This paper studies a fractional order model with vaccine efficacy and waning immunity. We present the model’s dynamics under vaccine efficacy, the impact of immunization, and the waning of the vaccine on coronavirus infection disease. We analyze the model under their equilibrium points. The model under the equilibrium points is discussed and proven that it is locally asymptotically stable if Rv is lesser than unity. We present the backward bifurcation hypothesis of the model and show that there is a parameter β2 that causes the backward bifurcation in the imperfect vaccine model. We show certain assumptions when ψ=1 for the imperfect vaccine case; the model is both stable globally asymptotically at the disease-free (R0≤1) and endemic cases (R0>1). By using infected cases from the recent wave throughout Pakistan, we shall estimate the model parameters and calculate the numerical value of the basic reproductive number R0≈1.2591. We present the comprehensive graphical results for the realistic parameter values and show many useful suggestions regarding the elimination of the infection from society. The vaccination efficacy that provides an important role in disease elimination is discussed in detail.

(1) Background: Favipiravir (FVP) is a new antiviral drug used to treat COVID-19. It has been authorized to be used in the kingdom of Saudi Arabia in the treatment of COVID-19. The mechanism of action of FVP is working as a specific inhibitor for the RNA-dependent RNA polymerase of the RNA chain virus. FVP has the potential to be hepatotoxic because of the structure similarity with pyrazinamide. This retrospective study aimed to determine the prevalence of liver injury in FVP-treated COVID-19 patients in General East Jeddah Hospital, Saudi Arabia, during the COVID-19 pandemic. (2) Methods: A total of 6000 patients infected with COVID-19 and treated at the East Jeddah Hospital were included, with a sample size of 362 patients. The participants ranged from 18 to 70 years of age, both males and females, with normal hepatic and renal function and had a confirmed diagnosis of COVID-19 infection. Patients who had gouty arthritis, hepatic and renal dysfunction, dead patients, pregnant women, and breastfeeding mothers were all excluded from this study. A retrospective cohort study compared two groups of patients treated with and without FVP and who followed the Saudi Ministry of Health protocol to manage COVID-19 infection. (3) Results: An adverse effect of FVP on the liver was found that ranged from mild to severe. Stopping treatment with FVP was associated with an observed important increase in the levels of liver enzymes AST (p < 0.001), ALT (p < 0.001), alkaline phosphatase (p < 0.03), total bilirubin (p < 0.001), and direct bilirubin (p < 0.001) in the treated compared with the untreated group. (4) Conclusion: This study showed a significant difference between the treated and the untreated groups with FVP in liver injury. FVP influences the liver, increasing the blood levels of the liver function parameters.

The objective of this study is to assess the frequency and severity of adverse events following immunization (AEFI) in Indian children aged 5–17 years who received the Pfizer-BioNTech mRNA COVID-19 vaccine, as well as to investigate for predictors of AEFI. To examine AEFI following the first and second doses of Pfizer’s vaccine, semi-structured questionnaires were distributed as Google forms at Indian schools in Saudi Arabia. The 385 responses included 48.1% male and 51.9% female children, with 136 responses of children aged 5–11 years (group A) and 249 responses from children aged 12–17 years (group B). Overall, 84.4% of children had two shots. The frequency of AEFI was reported to be higher after the first dose than after the second (OR = 2.12, 95% CI = 1.57–2.86). The reported AEFIs included myalgia, rhinitis, local reaction with fever, a temperature of 102 °F or higher, and mild to moderate injection site reactions. While group B frequently reported multiple AEFIs, group A typically reported just one. Local reaction with low grade fever was more frequently reported in group B after the first dose (24.1%) and second dose (15.4%), while local reaction without low grade fever was most frequently observed in group A after the first (36.8%) and second dose (30%). Only prior COVID-19 infection (OR = 2.98, 95% CI = 1.44–6.2) was associated with AEFI after the second dose in the study sample, whereas male gender (OR = 1.71, 95% CI = 1.13–2.6) and prior COVID-19 infection (OR = 2.95, 95% CI = 1.38–6.3) were predictors of AEFI after the first dose. Non-serious myocarditis was reported by only one child. According to the analysis conducted, the Pfizer’s mRNA COVID-19 vaccination was found to be safe in Indian children.

Diffuse lamellar keratitis (DLK) is not an uncommon complication of the small-incision lenticule extraction (SMILE) operation. Instrumental causes, such as contamination, are usually the underlying etiological route. Herein, we present an atypical case of DLK with numerous foci of cellular infiltrates on day 1. No evidence of any diffuse inflammatory response was reported. On the other hand, the multifocal response began to improve starting on the third day, after the administration of systemic steroids, with pain and discomfort significantly disappearing on the second day. Antibiotics were given as well, in the case of secondary infections. After 1 week of treatment and close monitoring, significant improvement was reported, and the slit-lamp examination was unremarkable.

Chemicals and pesticides contamination in the food, drinking water, and environment ecosystem have become one of the most serious problems for human public health in the world due to their large amount used and wide application in the agriculture industry. Therefore, the detection and analysis of contamination in the food and drinking water by using techniques that are simple and suitable for fast screening are important. This review gives an overview of the last trends and recent advances biosensors for chemicals and pesticides detection based on electrochemical, optical and mechanical transducers strategies. Furthermore, the biosensors are classified according to their immobilized biorecognition elements including aptamer, antibodies, enzymes, and molecularly imprinted polymers. The implementation of nanomaterials such as graphene, carbon nanotubes, and metals nanoparticles are also emphasized and discussed in this review, these nanomaterials provides remarkable features to the biosensors such highly sensitive and accurate which allowing efficient pesticides detection. In addition to highlighting and summarizing various novel sensors, this review also provided some drawbacks, challenging, prospects as well as the current efforts to enhanced optical sensors.

Deep learning training typically starts with a random sampling initialization approach to set the weights of trainable layers. Therefore, different and/or uncontrolled weight initialization prevents learning the same model multiple times. Consequently, such models yield different results during testing. However, even with the exact same initialization for the weights, a lack of repeatability, replicability, and reproducibility may still be observed during deep learning for many reasons such as software versions, implementation variations, and hardware differences. In this article, we study repeatability when training deep learning models for segmentation and classification tasks using U-Net and LeNet-5 architectures in two development environments Pytorch and Keras (with TensorFlow backend). We show that even with the available control of randomization in Keras and TensorFlow, there are uncontrolled randomizations. We also show repeatable results for the same deep learning architectures using the Pytorch deep learning library. Finally, we discuss variations in the implementation of the weight initialization algorithm across deep learning libraries as a source of uncontrolled error in deep learning results.

Clostridium is a genus comprising Gram-positive, rod-shaped, spore-forming, anaerobic bacteria that cause a variety of diseases. However, there is a shortage of information regarding antibiotic resistance in the genus in Saudi Arabia. This comprehensive analysis of research results published up until December 2021 intends to highlight the incidence of antibiotic resistance in Clostridium species in Saudi Arabia. PubMed, Google Scholar, Web of Science, SDL, and ScienceDirect databases were searched using specific keywords, and ten publications on antibiotic resistance in Clostridium species in Saudi Arabia were identified. We found that the rates of resistance of Clostridium difficile to antibiotics were as follows: 42% for ciprofloxacin, 83% for gentamicin, 28% for clindamycin, 25% for penicillin, 100% for levofloxacin, 24% for tetracycline, 77% for nalidixic acid, 50% for erythromycin, 72% for ampicillin, and 28% for moxifloxacin; whereas those of C. perfringens were: 21% for metronidazole, 83% for ceftiofur, 39% for clindamycin, 59% for penicillin, 62% for erythromycin, 47% for oxytetracycline, and 47% for lincomycin. The current findings suggest that ceftiofur, erythromycin, lincomycin, and oxytetracycline should not be used in C. perfringens infection treatments in humans or animals in Saudi Arabia.

The Saudi Food and Drug Authority (SFDA) approved sodium-glucose cotransporter-2 (SGLT2) inhibitors in 2018. The efficacy and safety of empagliflozin (EMPA) have been confirmed in the U.S., Europe, and Japan for patients with type 2 diabetes mellitus (T2DM); however, analogous evidence is lacking for Saudi T2DM patients. Therefore, the current study aimed to assess the efficacy and safety of EMPA in Saudi patients (n = 256) with T2DM. This is a 12-week prospective, open-label, observational study. Adult Saudi patients with T2DM who had not been treated with EMPA before enrolment were eligible. The exclusion criteria included T2DM patients less than 18 years of age, adults with type one diabetes, pregnant women, paediatric population. The results related to efficacy included a significant decrease in haemoglobin A1c (HbA1c) (adjusted mean difference −0.93% [95% confidence interval (CI) −0.32, −1.54]), significant improvements in fasting plasma glucose (FPG) (−2.28 mmol/L [95% CI −2.81, −1.75]), and a reduction in body weight (−0.874 kg [95% CI −4.36, −6.10]) following the administration of 25 mg of EMPA once daily as an add-on to ongoing antidiabetic therapy after 12 weeks. The primary safety endpoints were the change in the mean blood pressure (BP) values, which indicated significantly reduced systolic and diastolic BP (−3.85 mmHg [95% CI −6.81, −0.88] and −0.06 mmHg [95% CI −0.81, −0.88], respectively) and pulse rate (−1.18 [95% CI −0.79, −3.15]). In addition, kidney function was improved, with a significant reduction in the urine albumin/creatinine ratio (UACR) (−1.76 mg/g [95% CI −1.07, −34.25]) and a significant increase in the estimated glomerular filtration rate (eGFR) (3.54 mL/min/1.73 m2 [95% CI 2.78, 9.87]). Furthermore, EMPA reduced aminotransferases (ALT) in a pattern (reduction in ALT > AST). The adjusted mean difference in the change in ALT was −2.36 U/L [95% CI −1.031, −3.69], while it was −1.26 U/L [95% CI −0.3811, −2.357] for AST and −1.98 U/L [95% CI −0.44, −3.49] for GGT. Moreover, in the EMPA group, serum high-density lipoprotein (HDL) significantly increased (0.29 mmol/L [95% CI 0.74, 0.15]), whereas a nonsignificant increase was seen in low-density lipoprotein (LDL) (0.01 mmol/L [95% CI 0.19, 0.18]) along with a significant reduction in plasma triglyceride (TG) levels (−0.43 mmol/L [95% CI −0.31, −1.17]). Empagliflozin once daily is an efficacious and tolerable strategy for treating Saudi patients with insufficiently controlled T2DM as an add-on to ongoing antidiabetic therapy.

Aim: The aim of this study is to investigate the opinions, current knowledge, and expectations of Saudi endodontic residents regarding the use of regenerative endodontics as part of future dental treatment and establishing a baseline for further research and development. Materials and Methods: Saudi endodontic residents all over Kingdom of Saudi Arabia (KSA) were contacted, for participation. A survey form consisting of 28 questions was personally distributed to all endodontic residents who were actively enrolled in a residency training program either Saudi board program or Master Degree and provided informed consent for inclusion into the study. Data were collected and statistical analysis was carried out using SPSS version 22. Results: Out of one hundred and fifteen endodontic residents 97 participated in this questionnaire-based survey. Two forms were excluded due to incomplete and unclear information. Out of the remaining 95 majority of the residents were male (67.4%) and belonged to Saudi board program. The greater part of residents agreed for the inclusion of regenerative endodontics in the dental curricula. Most of the candidates wanted to improve their skills in regenerative endodontics by participating in continuing dental education programs. The most popular belief (n = 81) was that regenerative therapy to save teeth is better than implants. Use of regenerative procedures in clinics was carried out by only 44 participants. Conclusion: The emerging importance of regenerative endodontics in KSA is evident through this study. This study highlights many core issues which need attention and forms a baseline for further research in regenerative endodontics.