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Abstract Background Studying the public perception of nurses among nursing students is vital in establishing strategic solutions to recruit and retain more students in nursing programs and to contain nurses in the health care system. Aim This study aimed to determine the mediating role of self-concept in the relationship between sociocultural and perceived public image of nurses. Methods This study employed a correlational approach using convenience sampling of 1390 participants. This study was conducted at six large universities in three regions of Saudi Arabia (central, northern, and eastern). Student nurses in their second to fourth years of study were included as participants, with an 89.7% response rate. Data were collected from January to April 2023. Results A significant positive relationship was observed between sociocultural factors and self-concept (r = .685, p = .0001). In addition, there was a significant positive relationship between self-concept and public image (PI) (r = .352, p value = 0.0001). Furthermore, there was a significant positive relationship between sociocultural and public image (r = .456, p = .0001); sociocultural had a direct effect on self-concept (β = 0.324, SE = 0.098, t = 9.429, p

Background and aim: Because they are unaware of the potential adverse effects of medications, people frequently self-medicate as a form of self-care. This study aimed to investigate the factors associated with health literacy and the propensity to self-medicate among the primary healthcare clientele of the city of Hail, Saudi Arabia. Methods: This research employed a cross-sectional approach with the participation of 383 primary health center clientele of the Hail Region of Saudi Arabia. Participation was enacted via convenience sampling from December 2022 to February 2023. The data were collected using a self-administered questionnaire. The investigation utilized descriptive statistics as well as multiple linear regression and correlation for the data analysis. Results: Participants who were aged 30 years and above, single, had a college degree, were non-Saudi, had a white-collar occupation and received information from the internet/Google/YouTube had a significant relationship (p < 0.05) with health literacy. On the self-medication scale (SMS), there were significant relationships with age, marital status, educational level and occupation (p < 0.05). The nationality and source of information factors related to health had a positively significant effect on health literacy (p < 0.01), while middle age (24–29 years) had a positive effect on the self-medication scores (p < 0.01). There was a significant positive correlation between the health literacy screening scale (BRIEF) and the self-medication scale (SMS) scores (r = 421, p < 0.001). Conclusion: Age of 30 years old or above, single status, a college degree, non-Saudi status, white-collar occupation and receiving information from the internet/Google/YouTube were all significant for health literacy. There were also significant relationships with the SMS scores for age, marital status, educational level and occupation. The factors affecting health literacy were older participant age, nationality and the source of information regarding health. Conversely, among the participants, being in the middle-aged group (24–29 years) was a factor that affected their self-medication scores. There was a significant positive correlation between the health literacy screening scale (BRIEF) and the self-medication scale (SMS).

Introduction: Patients’ assessment of care navigating cardiovascular disorders is imperative in improving the quality of care provided. The purpose of this study was to explore the perspectives of people living with cardiovascular disorders on the care they received and its relationship with general self-efficacy. Methods: This investigation employed a cross-sectional correlational approach. The study sample was comprised of patients with cardiovascular disorders from both the King Khalid Hospital and the King Salman Specialist Hospital, in Hail City, Saudi Arabia. Convenience sampling was used, resulting in 104 participants. A survey using a self-administered questionnaire was employed to collect the data, which ran from 10 March to 20 May 2023. Results: The participants perceived that they occasionally (2.75 ± 1.053) received care, and they perceived themselves to have better self-efficacy (25.28/40). Of note, the age (0.062), years of being diagnosed with having the disease (−0.174), sex (0.180), educational attainment (0.125), and occupation (0.206) were found to have no significant relationship with the patient assessment of care with chronic cardiovascular disease (PACIC). However, civil status (0.867) was found to have a strong positive correlation to the PACIC. No significant relationship was found between age and GSE (0.070) and PACIC (0.62), civil status with GSE (0.013), years being diagnosed with having the disease with GSE (0.095), and PACIC (0.174) educational attainment with GSE (0.088) and PACIC (0.125) or occupation (0.115) with GSE. However, sex (0.795) was found to have a strong correlation with general self-efficacy (GSE). Of note, patient activation (0.390) and goal setting (0.360) had a moderate positive correlation while problem solving (0.228) and follow-up (0.278) had a weak positive correlation to GSE. Meanwhile, the delivery system (0.507) had a strong positive correlation to GSE. This study illuminates the value of self-efficacy and patient involvement as self-management techniques for cardiovascular illnesses. Future cardiovascular illness self-management initiatives should concentrate on enhancing patient self-efficacy by adopting the PACIC.

Introduction: The need to determine the factors affecting nurse competency is to assist determine practical approaches to enhance competency. Aim: The study aims to map the competencies of emergency department (ED) nurses, its influencing factors, and barriers. Subjects and Methods: This study employed a cross-sectional approach conducted at the government hospitals in Hail, including village hospitals. The participants of this study were the 227 ED nurses as a result of convenience sampling. The researchers utilized the Google Form survey to collect the data. The data collection was conducted between August and September 2022. Results: Nurses in this study were highly competent (227/275). Clinical care competency has emerged as the highest competency (3.79 ± 0.646), followed by leadership (3.53 ± 1.053). Those who are 26–30 years old (B = 0.766; P < 0.000); 95% confidence interval (CI) (0.623–0.909) are far better than the other age groups. Furthermore, 5 years and above were competent compared to those with

Optimal reactive power dispatch (ORPD) has a crucial impact to enhance safety, reliability, and economical operation of the electric power system. ORPD is a non-linear, non-convex and mixed variable problem, which has been solved by many researchers via different meta-heuristic algorithms during the last decade. In this work, a novel algorithm named sine-cosine algorithm (SCA) is utilized to solve ORPD problem by considering both dependent and independent control variable constraints. SCA has been tested and validated on standard 14, 30 and 57-bus power systems. To validate the superiority of proposed algorithm, the outcomes obtained through SCA are compared with recent published results attained through particle swarm optimization (PSO), modified Gaussian barebones teaching–learning based optimization (BBTLBO), ant bee colony optimization (ABCO), whale optimization algorithm (WOA) and backtracking search algorithms (BSA). The results attained using SCA show the improvement in the power losses minimization. Thus, with standard 14-bus system, the power losses are minimized from 0.04% to 4.78%. While, using standard 30-bus, the power losses are minimized from 0.4% to 3.4% and with standard 57-bus, power losses are reduced from 0.9% to 1.99%. Furthermore, a comparative analysis with 30 independent runs on the above-mentioned bus systems is performed to examine the functioning of the proposed method in terms of probability density function (PDF) and cumulative density function (CDF). For such analysis, well-known meta-heuristic algorithms such as PSO, WOA, differential evolution (DE) are compared with proposed SCA in solving the ORPD problem. The results of this analysis clearly show that proposed algorithm is robust, effective, and computationally easy in solving the ORPD problem compared to the existing meta-heuristic algorithms.

Abstract Background Optimum oral health is impossible to achieve without managing dental caries. The first step to manage dental caries at a community level is to know its prevalence and trend. Unfortunately, the prevalence of dental caries at the national/regional level is not known in many developing countries. Pakistan is no exception. The present meta-analysis was planned to document the prevalence of dental caries at the national, as well as regional level. This paper will serve as a baseline for making future health policies, and health promotion activities in the country. Methods Literature was searched through various databases, such as PubMed, SCOPUS, and Web of science using: "Prevalence", "Dental Caries", "Dental Decay" and "Severity" as keywords. Any study that reported the prevalence of dental caries, and was conducted in the Pakistani population was included. Thirty studies fulfilled the inclusion criteria. Quality assessment of all the included studies was performed using Joanna Briggs Institute (JBI) critical appraisal checklist for prevalence studies. MedCalc software was used to analyze the data. Results In total 27,878 subjects were included in a meta-analysis from 30 studies. The prevalence estimate of dental caries at the national level was 56.62% (95% CI: 49.54 to 63.57). The I2 value was 99.07% (95% CI: 98.94 to 99.18), (I2 > 75%) indicating heterogeneity, hence pooled proportion was reported using a random-effect model. The prevalence estimate of dental caries in Sindh was 58.946% (95% CI: 43.796 to 73.274), and in Punjab, it was 55.445% (95% CI: 44.174 to 66.44), whilst in Baluchistan and KPK combined was 51.168% (95% CI: 22.930 to 79.004). Conclusion Based on the existing data nearly 60% of the Pakistani population have dental caries. The proportion is almost the same in all provinces. Most of the included studies were found to be of high risk.

With an ever increasing electrical load demand and the associated fuel price to generate it, researchers are compelled to find alternate, cheap and environment friendly ways for power generation to cater to this technoeconomic conundrum. Renewable Energy Sources (RES) are now being integrated in Distributed Generation (DG) based environment as a solution to this problem, hence resulting in Microgrids, with multiple sources and loads demarcating their footprint. Control and management of a diverse generation profile within a single microgrid is arduous and computationally intensive for a single centralized controller. This paper addresses this inherent problem and proposes a decentralized Multiagent based intelligent control technique to efficiently encompass the heterogeneous generation profile of Microgrids. Artificial Neural Network (ANN) based intelligent agents are deployed at the planning stage for each component of the Microgrid. These agents are responsible for maintaining individual local control parameters within the prescribed control margins, hence creating a multi-agent environment in a Microgrid structure. The proposed intelligent multi-agent control scheme is tested on a test system to furnish its merits over its traditionally employed counterparts. Simulation results show that ANN integration not only reduced the computational burden but also reduced the overall operating cost (around 10.2 %) by reducing the thermal generation.

Wind resource potential is strongly influenced by the exposure, orientation of the terrain and the wind direction. In Pakistan, the northern areas have very attractive sites for wind power plants. However, due to non-standardized masts installed, the collected data are not reliable. Due to the unreliable nature of available data, the investors normally avoid the investing in the wind power projects. Various software and tools have been used so far for the feasibility analysis but due to unreliable data, the proper feasibility analysis is still out of sight. To overcome this deficiency, a feasibility study of a wind power project in the Hunza Valley of Pakistan using reliable data is presented in this paper. For this purpose, the RETScreen is used by exploiting the standard NASA’s (National Aeronautics and Space Administration) database. Since the developing countries are facing problems in the development of wind projects, it is envisaged that this approach will give an easy way to launch new clean energy projects.

A phase-field model is developed in this paper based on the similarity between mechanical fracture and dielectric breakdown. Electrical treeing is associated with the dielectric breakdown in solid dielectrics by the application of high voltages. Instead of explicitly tracing the propagation of conductive channel, this model initializes a continuous phase field to characterize the extent of damage. So far, limited research has been conducted for simulating the effect of nanofiller dispersion on electrical treeing. No study has modeled the effect of uniform and nonuniform dispersion of nanofillers with varying filler concentration on treeing. Since electrical treeing tends to decrease the breakdown strength of solid dielectrics therefore, nanofillers are widely used to distract the tree from a straight channel to distribute its energy in multiple paths. Diverting a straight treeing channel into multiple paths reduces the chances of its propagation from live to dead-end hence, improving the breakdown strength. The physical and chemical nature of nanofillers has a crucial impact on increasing the resistance to treeing. In this paper, phase-field model is developed and used to simulate electrical treeing in polyethylene for varying concentrations of alumina nanofiller using COMSOL Multiphysics. Tree inception time, tree-growth patterns, and corresponding changes in dielectric strength is studied for both dispersions. Electrical treeing under different concentrations of alumina nanofillers with uniform and nonuniform dispersion is investigated in polyethylene as a base material. It is observed that fillers with uniform dispersion increases the resistance to treeing and tree inception time. Highest resistance to treeing is observed by adding 1% nanoalumina uniformly in raw polyethylene. Moreover, in uniform dispersion the tree deflects into multiple branches earlier than nonuniform dispersion impeding the damage speed as well.

Allopurinol is the well-known first-line treatment option for symptomatic hyperuricaemia and gout. It is cost-effective particularly for the management of chronic gout. The common early side effects of allopurinol are skin rashes, diarrhoea and nausea. Meanwhile, a dangerous concerning complication is Stevens–Johnson syndrome, which can cause severe morbidity and mortality. Delayed hypersensitivity to allopurinol is rare but should be one of the differential diagnoses if a patient with underlying gout on chronic allopurinol treatment presents with skin rashes. The present case highlights the importance of a high index of suspicion in at-risk patients with underlying gout along with skin rashes on long-term allopurinol treatment to avoid unnecessary patient management.

Abstract Much microbiome research has focused on populations that are predominantly of European descent, and from narrow demographics that do not capture the socio-economic and lifestyle differences which impact human health. Here we examined the airway microbiomes of the Orang Asli, the indigenous peoples of Malaysia. A total of 130 participants were recruited from two sites in the north-eastern state of Terengganu in Peninsular Malaysia. Using 16S rRNA sequencing, the nasal microbiome was significantly more diverse in those aged 5–17 years compared to 50+ years (p = 0.023) and clustered by age (PERMANOVA analysis of the Bray–Curtis distance, p = 0.001). Hierarchical clustering of Bray–Curtis dissimilarity scores revealed six microbiome clusters. The largest cluster (n = 28; 35.4%) had a marked abundance of Corynebacterium. In the oral microbiomes Streptococcus, Neisseria and Haemophilus were dominant. Using conventional microbiology, high levels of Staphylococcus aureus carriage were observed, particularly in the 18–65 age group (n = 17/36; 47.2% 95% CI: 30.9–63.5). The highest carriage of pneumococci was in the

Insulation materials are a vital part of the electrical system in all kinds of high voltage (HV) Transmission lines. Environmental stresses affect the performance of all types of insulation materials over time. Dielectric breakdown strength (DBS), Hydrophobicity, Leakage current, internal partial discharge and volume resistivity are all three degraded parameters in the service environment. The materials stand best in outdoor insulation, with the lowest partial discharge, highest breakdown strength, high hydrophobic, Lowest Leakage current, and highest volume resistivity. Enhancement of these parameters is a potential avenue for many researchers over the period. In this study, low-density polyethene (LDPE) under different nanofillers, including SiO2, TiO2, TiO2@SiO2, with different weight percentages, are used. This study investigates the behaviour of dielectric breakdown strength (DBS), Hydrophobicity and Leakage Current (LC) for 1000h test under contaminated conditions such as High voltage, heat, ultraviolet (UV) radiations, salt fog, humidity, and acid rain.

Khaled AbouAitah,1,2 Anna Swiderska-Sroda,1 Ahmed Kandeil,3 Asmaa MM Salman4,†, Jacek Wojnarowicz,1 Mohamed A Ali,3 Agnieszka Opalinska,1 Stanislaw Gierlotka,1 Tomasz Ciach,5 Witold Lojkowski1 1Laboratory of Nanostructures and Nanomedicine, Institute of High Pressure Physics, Polish Academy of Sciences, Warsaw, Poland; 2Medicinal and Aromatic Plants Research Department, Pharmaceutical and Drug Industries Research Division, National Research Centre (NRC), P.C.12622, Dokki, Giza, Egypt; 3Center of Scientific Excellence for Influenza Viruses, Water Pollution Research Department, Environmental Research Division, National Research Centre (NRC) P.C.12622, Dokki, Giza, Egypt; 4Medicinal and Pharmaceutical Chemistry Department, Pharmaceutical and Drug Industries Research Division, National Research Centre (NRC), P.C. 12622, Dokki, Giza, Egypt; 5Biomedical Engineering Laboratory, Faculty of Chemical and Process Engineering, Warsaw University of Technology, Warsaw, Poland†AMM Salman passed away on June 3, 2019Correspondence: Khaled AbouAitah; Witold Lojkowski Email k.abouaitah@labnano.pl; w.lojkowski@labnano.plBackground: Combating infectious diseases caused by influenza virus is a major challenge due to its resistance to available drugs and vaccines, side effects, and cost of treatment. Nanomedicines are being developed to allow targeted delivery of drugs to attack specific cells or viruses.Materials and Methods: In this study, mesoporous silica nanoparticles (MSNs) functionalized with amino groups and loaded with natural prodrugs of shikimic acid (SH), quercetin (QR) or both were explored as a novel antiviral nanoformulations targeting the highly pathogenic avian influenza H5N1 virus. Also, the immunomodulatory effects were investigated in vitro tests and anti-inflammatory activity was determined in vivo using the acute carrageenan-induced paw edema rat model.Results: Prodrugs alone or the MSNs displayed weaker antiviral effects as evidenced by virus titers and plaque formation compared to nanoformulations. The MSNs-NH2-SH and MSNs-NH2-SH-QR2 nanoformulations displayed a strong virucidal by inactivating the H5N1 virus. They induced also strong immunomodulatory effects: they inhibited cytokines (TNF-α, IL-1β) and nitric oxide production by approximately 50% for MSNs-NH2-SH-QR2 (containing both SH and QR). Remarkable anti-inflammatory effects were observed during in vivo tests in an acute carrageenan-induced rat model.Conclusion: Our preliminary findings show the potential of nanotechnology for the application of natural prodrug substances to produce a novel safe, effective, and affordable antiviral drug.Keywords: virucidal action, influenza H5N1 virus, immunomodulatory and anti-inflammatory, nanoformulations-drug delivery system, shikimic acid and quercetin natural prodrugs, mesoporous silica nanoparticles

Partial discharges (PD) are produced in the stator insulation of electrical machines while energized. The sources of PD are internal voids, crack, and manufacturing defects, which keep on extending with its normal operation, leading to the complete failure of insulation. The intensity of PD is considerably influenced by the environmental factors, including surrounding temperature, pressure, humidity, and contamination. This paper investigates the influence of these factors on the PD activity in electrical machines and estimates the lifetime of insulation. The PD measurements were conducted by placing the motors in a climate-controlled chamber. The PD trend under varying environmental stresses was investigated over time. Accordingly, PD inception voltage and various discharge characteristic parameters such as accumulated apparent charge, cumulative energy function, average discharge current, discharge power, and quadratic rate have been determined. The combined effect of various environmental stresses on the PD activity was also investigated. The mathematical relationships were developed to estimate the discharge characteristics as the functions of pressure and temperature using the Gaussian model and the Exponential model. Finally, the endurance of insulation was estimated under different environmental conditions based on the average discharge current to differentiate between correct and incorrect PD measurements and to develop a right maintenance schedule for motors in service.

Conventional fossil-fuel energy resources are being drastically depleted; thus, the current shift towards renewable energy (RE) resources has become imperative. However, there are many impediments to the adoption of renewable power generation. These impediments can be overcome by enacting policies to encourage the acceptance of sustainable energy resources. For instance, the net-metering policy can provide the necessary incentives to promote the development of local distributed energy sources, primarily solar photovoltaic and wind generators. While there has been significant advancement and development in net-metering in Asia with the increased penetration of RE, at present there is a lack of systematic review in this area. This paper aims to present an in-depth review on net-metering advances and challenges, current RE shares, and future RE targets in the Asian region. Additionally, a case study is performed and an economic analysis of net-metering regulations in an Asian country is carried out. In this study, the monetary benefits of net-metering policies for residential consumers are proved. It is envisaged that the information gathered in this paper will be a valuable one-stop source of information for Asian researchers working on this topic.

يهدف البحث إلى رصد وتحليل السمات البصرية والرمزية، المستقاة من التراث العُماني، والمستلهِمة لمفهوم الهوية المحلية، لنخبة من أعمال فن الجرافيك العُماني المعاصر، التي تمثل نماذج بحثية مختلطة، متعددة الفئات، تشمل مستوياتٍ ثلاثة، هي: أعمال فنانين عُمانيين محترفين، وأعمال لشباب الفنانين الواعدين والطلاب المتخصصين، وكذا أعمال عدد من الأكاديميين الفاعلين في مجال الجرافيك تنظيرًا وتدريسًا. كما تنقسم النماذج – من حيث التصنيف التقني – إلى فئة من الأعمال المنفذة بوسائط الحفر والطباعة التقليدية Printmaking، وفئة من الأعمال المنفذة بوسائط الطباعة الجرافيكية المستحدثة والرقمية. ومن خلال البيانات والاستنتاجات الناجمة عن هذا التحليل، يتطرق البحث إلى استقراء مسارات فن الجرافيك العُماني، بهويته البصرية المميزة، في سياق الفئات الثلاث المذكورة سابقًا

PVC is widely used as an electrical insulation for low-voltage indoor wiring and underground cabling. These cables are attacked by contaminants and chemicals present in the soil. The elevated temperatures and pressures inside the soil also adds up to stresses and deteriorates their insulations and sheaths and this eventually goes on damaging the conductors. So their performance in the contaminated service environment should be investigated considering extreme conditions in order to predict and ensure reliable service life. In this research 4 different PVC cable samples (2 core 10 mm2, 4 core 10 mm2, 4 core 120 mm2 and 4 core 240 mm2) were subjected to mechanical (via small punches), thermal, chemical and electrical stress over each core of the cable. Electrical stress was applied with 1 kV AC transformer. These samples were aged for 1000 hours under International Electrotechnical Commission (IEC) 1000 hours multistress aging conditions. Visual inspection and electrical characterization was done by Breakdown Voltage and Insulation Resistance Test for insulation and sheath at different intervals to investigate early stage degradation and reduction in lifetime. The results were compared with the characterizations already reported in the literature. Physical appearance and chemical degradations were apparent from the visual inspection of end aged samples. Quantitatively the results also indicated the continual decline in the breakdown voltage and insulation resistance over the aging time. Our findings inferred that the depreciation in quality of PVC cables (insulations and sheaths) is likely due to the chemical stresses which also instigates all other stresses

Although numerous scholars have studied resilience during the COVID-19 pandemic, research exploring its relationship with emotional intelligence is scarce. The aim of this study was to determine the relationship between the resilience and emotional intelligence (EI) of staff nurses during the COVID-19 pandemic. Data for this quantitative correlational study were gathered from the staff nurses of hospitals in the city of Hail, Saudi Arabia. The researchers employed simple random sampling, which yielded 261 staff nurses. Nationality (t = 6.422; p < 0.001) was found to have a significant relationship with resilience. Sex (t = 5.22; p < 0.001), ward assignment (t = 5.22; p < 0.001), age (F = 6.67; p < 0.001), and years of experience (F = 6.67; p < 0.001) revealed significant relationships with emotional intelligence. Resilience had a moderate positive relationship with EI (r = 0.55; p < 0.023), a weak positive relationship with self-emotion (r = 0.21; p < 0.003), and a very strong relationship with emotional appraisal (r = 0.85; p < 0.001). Improving emotional-intelligence skills is critical for assisting nurses during pandemic outbreaks. This can increase their individual and social resilience, while also improving their professional and life outcomes. These research findings suggest that emotional intelligence should be integrated into clinical practice and that EI data should be integrated into decision-making.

The current paper talks about the horrors of the inescapable class system that has us hooked blindly. The basic issue lies in the fact that the society we live in and grow operates on the system of class consciousness. The rich /bourgeoisie class uses and abuses the low or poor class to attain maximum benefits from them, whereas the poor or the proletariat have no choice except to be manipulated by the rich class for the cost of labor, for they know that it is the only step towards survival and it lies in manipulation. The rich class has become totally dependent on the proletariat and they know they cannot move without and out of it. As the society is designed and planned on unequal footings so, on the one hand, the rich class has found a medium to exploit the labor class but at the same time the proletariat are not allowed to interact with them and furthermore there are bleak chances of unification as the lower/labor class is itself a stigma in the eyes of the bourgeoisie.

The study examined the coverage of general issues and to find out the performance of Pakistan Peoples Party from 2008 to 2013; through English Pakistani newspaper. The aim of this study to investigate the coverage of general issues that how the newspapers framed these issues in a "Good" and "Bad" frame. Furthermore, these frames were showing the credibility of the government. The quantitative content analysis method was used and, the population, all news stories related to general issues, published in selected newspapers, last five years in a selected Regime from 2008 to 2013 in Pakistan. The systematic Random sampling method was deemed appropriate and employed for this study. The finding of this study shows that The PPP government completed its five years term, in that tenure bad governance was in peak. Due to bad governance, poverty was on peak, and the worst model was adobe to control law and order situation, corruption was on peak, all type of terrorism practically active and had no proper plan to fulfil basic needs of the general public. There were waves of political unrest ahead of the 2008 and 2013 general election. The unfortunate incident happened in December 2007 assassination of Benazir Bhutto, the former prime minister and chair of the PPP, and there were several attacks in KP and FATA targeting leftist politicians and political rallies in the weeks preceding the 2008 general election.

In last two decades a promising performance improvement in the electrical insulation materials has been reported by many researchers using different nano fillers (NFs). In recent years another type of NFs called core–shell type nano fillers have shown even more attention than ordinary NFs. The core–shell NFs are a combination of nano particle core coated with outer nano layer of different material. The core–shell NFs combine the beneficial properties of two material with in one NF. Recently a few studies have reported a considerable improvement in the dielectric properties of epoxy by utilising TiO _2 @SiO _2 core–shell NFs. The TiO _2 @SiO _2 particles have a core of TiO _2 coated with an out layer of SiO _2 at nano level. This study investigates the improvement in tracking performance of silicone rubber (SiR) using TiO _2 @SiO _2 core–shell nano particles which has not been reported previously. The tracking immunity of low (below 1%) and high (above 1%) filler concentrations of nano TiO _2 @SiO _2 incorporated into SiR was investigated according to IEC 60587. The results showed that an optimum percentage of 0.6 wt% of TiO _2 @SiO _2 imparts best immunity to silicone rubber against tracking.

Solid insulation materials are the backbone for all kinds of outdoor insulation applications. Environmental stresses degrade every outdoor insulation material with the passage of time. Internal partial discharges and external surface tracking are the two major factors governing the health of outdoor insulation. Best outdoor insulation is the one having lowest level of partial discharge and highest resistance to tracking. Improvement in tracking resistance of polymeric insulation materials has been a concern of many researchers. This study investigates the improvement in partial discharge and tracking resistance of LDPE under the effect of three different nano fillers including SiO _2 , TiO _2 , TiO _2 @SiO _2 . A very little has been reported on the effect of these nano fillers on the tracking performance of LDPE. TiO _2 @SiO _2 is a novel core–shell nano filler. No study has reported the effect of these core–shell nano fillers on the partial discharge and tracking performance of LDPE. It has been observed in this study that core–shell nano fillers are much more efficient in improving partial discharge and tracking resistance of solid insulation materials than ordinary nano fillers.

Solid insulation defects are a major cause of power failures. Incorporation of micro and nanoparticles in the solid insulation materials has proven its advantage. It has been reported that nanocomposites are far superior in terms of insulation to microcomposites because of larger interphase area between nanofillers and polymer in nanocomposites. In addition to that nature, size, shape, concentration and alignment of nanofillers affect the properties of resulting nanocomposite insulation. A lot of work has reported the effect of nanofiller’s nature, size and concentration but very little is reported on the effect of filler’s shape and alignment on the insulation and dielectric properties. In this paper nanocomposite dielectrics with nanofillers of various shapes and alignment are modelled by varying their permittivity using finite element method. To characterize the effect of various shapes and orientation electric field intensity and energy density models are computed. Simulations are performed using AC/DC module of COMSOL Multiphysics. The results revealed that shape and alignment of nanofillers are the two key factors in tuning the breakdown strength and permittivity of nanocomposite dielectrics for their applications in insulation as well as high voltage capacitors.

This paper presents an optimization method for solving the Power Economic Dispatch (PED) problem of thermal generation units with multiple fuels and valve point loadings. The proposed optimizer is a variant of Differential Evolution (DE) characterized as a Stud Differential Evolution (SDE), which has been proposed earlier and implemented on a hydrothermal energy system. In SDE, an operator named Stud Crossover (SC) is introduced in the conventional DE during the trial vector updating process. In SC operator, a best vector gives its optimal information to all other population members through mating. The proposed algorithm’s effectiveness to solve Multiple Fuel PED problem, with and without Valve Point Loading Effects (VPLEs), has been validated by testing it on 10 machine multiple fuel standard test systems having 2400 MW, 2500 MW, 2600 MW, and 2700 MW load demands. The results depict the strength of SDE over various other methods in the literature.

A 29-year-old woman who underwent laser in situ keratomileusis (LASIK) for myopic astigmatism in both eyes presented with severe pain, photophobia and decreased visual acuity in the left eye eight days after surgery. Examination revealed severe anterior uveitis with fibrinous exudates in the anterior chamber, flap edema and epithelial bullae. Laboratory investigations for uveitis were negative and the patient required systemic and intensive topical steroids with cycloplegics to control the inflammation. This case demonstrates that severe anterior uveitis may develop after LASIK and needs prompt and vigorous management for resolution.

Bilateral keratitis usually occurs in predisposed individuals such as contact lens wearers, those suffering from malnutrition and immunodeficiency or patients undergoing bilateral refractive corneal surgery. We report a 30-year-old man without any obvious predisposing factors who presented with complaints of pain and decreased vision in both eyes. Examination revealed corneal ulcers in both eyes, which on microbiological culture grew Pseudomonas aeruginosa . The patient underwent a therapeutic keratoplasty in the right eye while the left eye was managed medically. Bilateral Pseudomonas keratitis can develop in the absence of any obvious predisposing factors.

Presence of exfoliation syndrome (XFS) is associated with an increased risk of complications during cataract surgery. This risk is, in part, dependent on the severity of XFS. We describe a central bulge ("lenticonus") in the anterior lens capsule of some eyes with XFS. This finding is associated with very fragile zonules and a high risk for intraoperative zonular dialysis.

The attainment of academic superiority relies heavily upon the accessibility of scholarly resources and the expression of research findings through faultless language usage. Although modern tools, such as the Publish or Perish software program, are proficient in sourcing academic papers based on specific keywords, they often fall short of extracting comprehensive content, including crucial references. The challenge of linguistic precision remains a prominent issue, particularly for research papers composed by non-native English speakers who may encounter word usage errors. This manuscript serves a twofold purpose: firstly, it reassesses the effectiveness of ChatGPT-4 in the context of retrieving pertinent references tailored to specific research topics. Secondly, it introduces a suite of language editing services that are skilled in rectifying word usage errors, ensuring the refined presentation of research outcomes. The article also provides practical guidelines for formulating precise queries to mitigate the risks of erroneous language usage and the inclusion of spurious references. In the ever-evolving realm of academic discourse, leveraging the potential of advanced AI, such as ChatGPT-4, can significantly enhance the quality and impact of scientific publications., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Masson SAS. All rights reserved.)

Polycythemia vera (PV) is a primary acquired marrow condition that causes erythrocytosis. It may present with erythromelalgia, pruritus, splenomegaly, and thrombotic events. Secondary causes of polycythemia should be ruled out before labeling a patient as having PV. Serum erythropoietin (EPO) level helps distinguish primary and secondary polycythemia, but it should be aided by further testing such as the JAK-2 gene mutation test. We present a case of a previously healthy 47-year-old female who came to the hospital with a headache and transient left-sided body weakness. She had no similar episodes in the past. Her initial workup showed a high hemoglobin and a high hematocrit level. A plan computed tomography (CT) scan of the head showed evidence of a thalamo-capsular infarct. The serum EPO level was elevated, and a bone marrow biopsy returned positive for JAK-2 mutation indicating the diagnosis of polycythemia vera despite the high EPO level. The World Health Organization (WHO) consensus criteria for diagnosing PV demand the presence of two major criteria and one minor criterion or the presence of the first major criterion and two minor criteria. Decreased EPO is considered a minor WHO criterion for PV diagnosis. A low EPO is also used to discriminate PV from secondary thrombocytosis, as it might be low, as expected, or elevated. Phlebotomy primarily treats PV with low risk with a target hematocrit of less than 45%. PV patients with high risk can benefit from low-dose aspirin. Anticoagulation may be added for patients with thromboembolism. Patients with polycythemia vera can present with a high or low serum EPO level. Further diagnostic tests are usually required to confirm the final diagnosis., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Alsayed et al.)

Introduction Contact precautions or the use of personal protective equipment (PPE), specifically gowns and gloves, has become a common practice in intensive care units (ICUs) as part of robust infection prevention and control efforts. Hence, a positive attitude toward PPE used among healthcare workers (HCWs) is critical to prevent healthcare-associated infections (HAIs). Aim This study aimed to determine the perception and compliance of HCWs working at critical care units regarding PPE used at government hospitals (GHs) in Bahrain. Subject and methods A cross-sectional study was conducted among HCWs working in critical units at GHs, Bahrain. A self-administered questionnaire consisting of three sections was sent to the targeted HCWs. The questionnaire consisted of socio-demographic characteristics (i.e., age, gender, job category, etc.), previous participation in PPE training, and a 15-item questionnaire to assess the perception and compliance of HCWs regarding PPE use. Results Among the 119 HCWs enrolled, 73.1% were females, and 48.7% were between 31 and 40 years old. The results of this study suggested that although 95.8% of participants received education about PPE use, only 48.7% had a good perception of PPE, and an even smaller percentage (12.6%) demonstrated good compliance. A positive, highly statistically significant correlation was found between perception and compliance scores (p<0.001). Increased perception and compliance scores were associated with increasing age, non-Bahrainis, and years of experience. Interestingly, doctors were more likely to demonstrate lower perception and compliance scores toward PPE use. Conclusion The perception of HCWs regarding PPE use was adequate, but their actual adherence was unsatisfactory. However, doctors' perceptions and compliance with PPE use were significantly lower than other HCWs. Further larger studies are required to establish the level of perception and compliance among HCWs in our region., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Research & Research Ethics Committee for Government Hospitals - Bahrain issued approval 62-230524. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Naser et al.)

Hemoptysis is a common presenting symptom of pulmonary tuberculosis (TB). Rasmussen aneurysm can present with severe hemoptysis, which is usually diagnosed using computed tomography (CT) angiography. A false aneurysmal dilatation of the pulmonary artery is known as a Rasmussen aneurysm. It occurs due to a gradual weakening of the arterial wall adjacent to pulmonary cavitation. Computed tomography angiography of the chest is the standard diagnostic technique for Rasmussen aneurysm. An early angiographic or surgical procedure with vascular embolization is recommended following a definitive diagnosis. We present a 29-year-old woman whom the medical commission referred due to a cavitary lesion on a screening chest X-ray. Hospital admission was preferred for the Mycobacterium tuberculosis infection workup, which revealed radiological evidence of the Rasmussen aneurysm. The patient was eventually treated as a case of active tuberculosis on a radiological basis via the decision of the local infectious disease (ID) team. The most common symptoms reported in patients with tuberculosis infection are hemoptysis, cough, low-grade fever, night sweats, and weight loss. Hemoptysis can rarely originate from the Rasmussen aneurysm of the pulmonary artery. However, hemoptysis is the predominant symptom in chronic cavitary tuberculosis with Rasmussen aneurysm. A CT pulmonary angiogram (CTPA) is considered the imaging modality of choice to confirm the diagnosis of Rasmussen aneurysm. Fatal hemoptysis is one of the consequences of a Rasmussen aneurysm if it is massive and not treated promptly. Confirming the diagnosis with proper follow-up is essential to preventing devastating outcomes., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Fadul et al.)

The major mortality factor for women globally is breast cancer, and current treatments have several adverse effects. Hesperetin (HSP) is a flavone that occurs naturally with anti-tumor capabilities and has been investigated as a potential treatment for cancer. This study aimed to investigate the cytotoxic and anti-malignant potential of HSP on breast cancer cells (BT-474) and normal cells (MCF-10a). The results indicated that HSP has dose-dependent cytotoxicity in BT-474 and MCF-10a cells. The elevated concentration of HSP lowered cell viability and proliferation. The half-maximal inhibitory concentration (IC 50 ) of HSP in BT-474 cancer cells after a 48-h exposure was 279.2 μM/ml, while the IC 50 in normal cells was 855.4 μM/ml. The cytotoxicity of HSP was more significant in cancer cell lines than in normal cell lines and this aspect presents a favorable factor in utilizing the drug for the treatment of breast cancer. The apoptotic effect of HSP in BT-474 cells was investigated, and it was found that the higher the concentration of HSP more the cells underwent apoptosis. Furthermore, the highest concentration of HSP led to overexpression of the MLH1 and MSH2 genes in both breast cancer and normal cell lines. Overall, our study suggests that HSP has an anticancer effect on breast cancer cell lines, and the effect is concentration dependent., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Advanced Pharmaceutical Technology & Research.)

Adjuvanted protein vaccines offer high efficacy, yet most potent adjuvants remain proprietary. Several adjuvant compounds are being developed by the Vaccine Formulation Institute in Switzerland for global open access clinical use. In the context of the R21 malaria vaccine, in a mouse challenge model, we characterize the efficacy and mechanism of action of four Vaccine Formulation Institute adjuvants: two liposomal (LQ and LMQ) and two squalene emulsion-based adjuvants (SQ and SMQ), containing QS-21 saponin (Q) and optionally a synthetic TLR4 agonist (M). Two R21 vaccine formulations, R21/LMQ and R21/SQ, offer the highest protection (81%-100%), yet they trigger different innate sensing mechanisms in macrophages with LMQ, but not SQ, activating the NLRP3 inflammasome. The resulting in vivo adaptive responses have a different T H 1/T H 2 balance and engage divergent innate pathways while retaining high protective efficacy. We describe how modular changes in vaccine formulation allow for the dissection of the underlying immune pathways, enabling future mechanistically informed vaccine design., Competing Interests: Declaration of interests The authors declare no competing interests., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

A simply designed, highly sensitive, stretchable, compact wearable, and skin-like optical fiber sensing instrument is designed and demonstrated for joint motion monitoring. The fiber sensing scheme comprises only a section of single-mode fiber (SMF) deformed in the knot-like configuration, which performs as a Mach-Zehnder interferometer (MZI) based on a modal coupling mechanism between the core and cladding modes of the deformed SMF section. This proposed optical fiber sensor based on a knot-like configuration is mounted onto wearable woven fabric and then garments on the limbs of a healthy human's body. As the flexion angle of the human limb is varied, the interference fringe coding based on the spectral shift difference of the periodical transmission spectra is perceived. The proposed wearable optical fiber sensor exhibits excellent sensitivities from around -0.431 to -0.614 n m / ∘ realized for elbow and knee joint flexion between a range of motion around 0°-90°. Additionally, this sensor also displays high repeatability and stability and a fast response time of 1.4 ms, combined with a small standard deviation of about 2.585%. The proposed sensor device possesses manufacturing simplicity, high processing accuracy, lightness, and elasticity, as well as certain improvements over other goniometers and optical fiber sensors. These attributes of the proposed sensor prove its applicability for human joint angle monitoring.