Search

Background and objectives: Idiopathic condylar resorption (ICR) can be described as a dysfunctional remodeling of the temporomandibular joint (TMJ). It is clinically characterized by morphological changes in TMJ including reduced ramus height, accelerated mandibular retrusion and reduced growth in juveniles. With a strong predilection towards females (90 %) within an age group of 10 to 40 years, diagnosis and management of ICR is a critical clinical challenge. The aim of this study is to present a comprehensive review of diagnosis and management strategies for ICR. Materials and Methods: Literature search based on keywords relating to ICR was conducted on PubMed (Medline) database. Studies fulfilling the inclusion criteria (reports based on clinical diagnosis and management of ICR) were selected for comprehensive review. Results: 253 articles were identified through literature search. After abstract screening and full-text review, 54 studies were selected for qualitative synthesis. Diagnosis of ICR is established by combination of clinical and radiographic findings, patient history, and exclusion of all known local/systemic factors contributing to condylar resorption. Management of ICR depends on condylar activity and surgeon’s ability to preserve the articular disc and mandibular condyle, and could either be surgical or non-surgical. Surgical treatment can be either by orthognathic surgery alone or through a combination of orthognathic and TMJ surgeries. Conclusion: Based on the present review, it may be concluded that diagnosis and management of ICR requires adequate clinical understanding of the condition. Identifying the stage of ICR is important in deciding optimum treatment plan. While early-stage ICR could be managed non-surgically by orthodontic and splint therapies, advanced stage disease require simultaneous TMJ Surgery with orthognathic correction for skeletal stability. Future research should focus on elucidating underlying mechanisms of ICR, refining diagnostic criteria, and optimizing treatment protocols to enhance patient outcomes.

Introduction Continuous assessment of community health needs is essential to predict, recognize, and act on healthcare issues. Conducting community health needs assessments (CHNAs) in Saudi Arabia has become a priority to overcome the current healthcare challenges and keep pace with the Saudi Arabia 2030 vision. Studies reporting community health needs in Saudi Arabia regions are limited despite the high incidence of chronic diseases. This study aims to understand the community’s health problems and the range of healthy behaviors and determine the priority health problems. Methods We conducted a cross-sectional study based on the adults in Primary Health Care Centers in Hail, Northern Saudi Arabia, by using the CHNA standard questionnaire. In addition to the demographic information, the questionnaire collects data on personal health status, the health status of adults and children, health facilities access information, receiving of healthcare procedures, traveling for healthcare, source of medical information, safety measures and behaviors, health problems, childcare (special needs), and perceived community problems. Results In all, 336 individuals were approached to participate in this study; 303 agreed to participate (response rate: 90%). The analysis comprised 276 individuals after eliminating 27 who did not fulfill the age inclusion criteria or had missing gender data. Of these, 107 (38.8%) were men and 169 (61.2%) were women. Our data revealed that almost half of the participants, 135 (52.9%) constantly or 107 (42%) occasionally, were able to visit the doctors when needed. Conclusion Our findings reported positive health behaviors and good accessibility to healthcare services when needed. However, the study findings also revealed healthcare challenges that required urgent action from Hail healthcare leaders. Developing healthcare strategies, screening/prevention programs, and changing healthcare policies in the Hail region are needed to control and prevent health problems and improve the population’s health.

Abstract Background Higher prevalence rates of diabetes and its complications have been reported among individuals with poor physical activity and a sedentary lifestyle. This study explored the influence of six months of moderate-intensity supervised aerobic training on the serum lipid profile, hs-CRP level, and variable-related correlations in prediabetic and type 2 diabetes patients (T2DM). Design The study was based on a two-arm parallel group pretest‒posttest comparative design. Methods A total of 50 subjects who were diagnosed with diabetes for more than five years and aged 30–70 years were included in this study. The subjects were classified into two groups on the basis of their glycated haemoglobin (HbA1c%) values: Group 1 (patients with the prediabetes; HbA1c % ≤ 6.5, n = 25) and Group 2 (patients with the T2DM; HbA1c % ≥ 6.5, n = 25). Blood sugar, HbA1c %, insulin, lipid profile, and highly sensitive CRP (hs-CRP) were measured via colorimetric and immunoassay techniques at baseline and six months postintervention with moderate aerobic exercise. Results The results revealed that participation in moderate aerobic training interventions for six months resulted in a significant reduction in BMI, fasting blood sugar, glycosylated haemoglobin, hs-CRP, and lipid profile parameters such as T-Cholest, TG, and LDL-C as well as significant improvement in the level of insulin with a reduction in the values of HOMA-IR towards normal values in the patients with prediabetes (P

Abstract Graphene-based nanomaterials have been proved to be robust sorbents for efficient removal of environmental contaminants including arsenic (As). Biobased graphene oxide (bGO-P) derived from sugarcane bagasse via pyrolysis, GO-C via chemical exfoliation, and magnetite nanoparticles (FeNPs) via green approach using Azadirachta indica leaf extract were synthesized and characterized by Ultraviolet-Visible Spectrophotometer (UV-vis.), Fourier transform infrared (FTIR) spectroscopy, X-ray diffraction (XRD), mean particle size and Scanning electron microscopy (SEM) along with Energy dispersive spectroscopy (EDX) analysis. Compared to cellulose and hemicellulose, the lignin fraction was less in the precursor material. The GOC, bGO-P and FeNPs displayed maximum absorption at 230, 236, and 374 nm, respectively. FTIR spectrum showed different functional groups (C-OH, C-O-C, COOH and O-H) modifying the surfaces of synthesized materials. Graphene based nanomaterials showed clustered dense flakes of GO-C and thin transparent flakes of bGO-P. Elemental composition by EDX analysis of GO-C (71.26% C and 27.36% O), bGO-P (74.54% C and 24.61% O) and FeNPs (55.61% Fe, 4.1% C and 35.72% O) confirmed the presence of carbon, oxygen, and iron in synthesized nanomaterials. Sorption study was conducted with soil amended with different doses of synthesized nanomaterials (10, 50 and 250 mg) and exposed to 100, 300 and 500 ppm of As. Arsenic concentrations were estimated by colorimetry and atomic absorption spectroscopy (AAS). GO-C, bGO-P, and FeNPs showed substantial As removal efficiency i.e., 81 to 99.3%, 65 to 98.8% and 73.1–89.9%, respectively. Green synthesis of bGO-P and magnetite nanoparticles removed substantial amounts of As compared to GO-C and can be effectively deployed for As removal or immobilization. Higher and medium sorbent doses (250 and 50 mg) exhibited greater As removal and data was best fitted for Freundlich isotherm evidencing favorable sorption. Nevertheless, at low sorbent doses, data was best fitted for both models. Newly synthesized nanomaterials emerged as promising materials for As removal strategy for soil nano-remediation and can be effectively deployed in As contaminated soils.

Purpose: Non-obstructive azoospermia (NOA) represents the persistent absence of sperm in ejaculate without obstruction, stemming from diverse disease processes. This survey explores global practices in NOA diagnosis, comparing them with guidelines and offering expert recommendations. Materials and Methods:Materials and Methods: A 56-item questionnaire survey on NOA diagnosis and management was conducted globally from July to September 2022. This paper focuses on part 1, evaluating NOA diagnosis. Data from 367 participants across 49 coun-tries were analyzed descriptively, with a Delphi process used for expert recommendations. Results:Results: Of 336 eligible responses, most participants were experienced attending physicians (70.93%). To diagnose azoosper-mia definitively, 81.7% requested two semen samples. Commonly ordered hormone tests included serum follicle-stimulating hormone (FSH) (97.0%), total testosterone (92.9%), and luteinizing hormone (86.9%). Genetic testing was requested by 66.6%, with karyotype analysis (86.2%) and Y chromosome microdeletions (88.3%) prevalent. Diagnostic testicular biopsy, distinguishing obstructive azoospermia (OA) from NOA, was not performed by 45.1%, while 34.6% did it selectively. Differ-entiation relied on physical examination (76.1%), serum hormone profiles (69.6%), and semen tests (68.1%). Expectations of finding sperm surgically were higher in men with normal FSH, larger testes, and a history of sperm in ejaculate. Conclusions:Conclusions: This expert survey, encompassing 367 participants from 49 countries, unveils congruence with recommended guidelines in NOA diagnosis. However, noteworthy disparities in practices suggest a need for evidence-based, international consensus guidelines to standardize NOA evaluation, addressing existing gaps in professional recommendations.

Physical activity (PA) has beneficial effects on erectile dysfunction (ED). It has been proposed to affect ED physiologically via the vascular and nervous systems. This study aimed to evaluate the effect of physical activity on endothelial erectile function, sex hormones and sperm production in healthy males. Sixty-one healthy men aged 18–35 years were eligible to participate in this biochemical and questionnaire-based study. The participants were classified into two groups according to their physical activity level: a physically active group (PA = 38) and a physically inactive group (PINA = 23). PA was evaluated using the ACTi graph GT1M accelerometer. Erectile function was evaluated using the International Index of Erectile Function (IIEF-15) questionnaire. The levels of the sex hormones testosterone (T) and free testosterone (f-T), and the nitric oxide (NO) and E-selectin levels were measured by enzyme linked immuno sorbent assay (ELISA). In addition, a complete semen analysis was performed for all subjects. Better sperm production was reported in physically active subjects than in nonactive subjects. There was a significant increase (p = 0.001) in the IIEF-15 score, and the levels of T, f-T, NO and E-selectin were estimated in physically active subjects compared with those in nonactive subjects. Erectile function (IIEF-15 score) correlated positively with PA and with increased levels of T, f-T, NO and E-selectin, whereas the IIEF-15 score correlated negatively with age and adiposity. Seminological parameters such as the spermatozoa concentration, sperm viability, motility, morphology and normal forms were significantly improved in physically active subjects. Physical activity at mild to moderate levels is significantly associated with improved erectile function, increased endothelial function, increased sex hormone levels and better sperm production in healthy men aged 18–35 years. This study proposes that physical activity physiologically affects erectile function and spermatogenesis via cellular free radical-antioxidant mechanisms.

Introduction: Skin-whitening products, often containing mercury, are used worldwide for cosmetic purposes but pose significant health risks. Mercury, a melanotoxin, can cause severe dermatological, renal, and neurological complications. Case Presentation: We report the case of a 27-year-old woman who developed severe nodulocystic acne due to chronic use of a mercury-containing skin-whitening cream. Treatment with isotretinoin and prednisolone led to significant improvement within 3 months. Conclusion: This case underscores the need for public awareness and stricter regulatory actions to prevent mercury-related health hazards from skin-whitening products.

Abstract Green nanotechnology has significant potential for use in agriculture particularly due to their antifungal properties, ability to control fungal diseases and reduce the reliance on chemical fungicides. Biotic stresses in agriculture have caused widespread damage worldwide, and green NPs provided eco-friendly alternatives to traditional chemical treatments, which are frequently toxic and harmful to the ecosystem. Green NPs could become an important tool in modern agricultural practices and environmental remediation if appropriate research is conducted to identify cost-effective production methods as well as safe and sustainable applications. In order to understand the potential of green NPs for sustainable agriculture and identify potential risks, research is ongoing into the effectiveness in agriculture sectors. Research update on green NPs is presented in this paper using data published on science direct over the last 15 to 20 years to clarify and understand the antifungal mechanisms of green metallic NPs, carbon and graphene nanotubes, nanocomposites as well as other type of nanomaterials. These green NPs are found to be more effective against pathogens on crops and humans than conventional fungicide approaches. They are very effective against fungi that affect cereal crops, including Fusarium oxysporum, Botrytis cinerea, and Candida species, etc. The green NPs developed using green synthesis methods are both cost-effective and environmentally friendly. Moreover, research is also required to identify the best methods for applying green NPs for crop production and sustainable agriculture. Furthermore, research should be undertaken to establish the most cost-effective methods of making and deploying green nanoparticles at a large field size study where there is fungal attack that diminishes agricultural output and affects global crop production. Graphical Abstract

Background: Antimicrobial resistance (AMR) and drug resistance have emerged as major global health concerns, threatening the effectiveness of antimicrobial agents and compromising patient outcomes [21]. The rapid spread of resistant pathogens poses significant challenges to healthcare systems worldwide, leading to increased morbidity, mortality, and healthcare costs [20]. Methods: Search Strategy: To find pertinent studies released up until September 2023, a thorough search was done in electronic databases like PubMed, Embase, and Scopus. The search method combined terms linked to Saudi Arabia, drug resistance, and antimicrobial resistance (AMR). The specific search terms and Boolean operators used were tailored to the requirements and functionalities of each database. Results: The systematic review includes 25 papers in total, representing various Saudi Arabian healthcare environments and patient groups. The prevalence of AMR varied across different pathogens and antimicrobial agents. The most resistant Enterobacteriaceae were carbapenem-resistant Enterobacteriaceae (CRE), extended-spectrum -lactamase-producing Enterobacteriaceae (ESBL), and methicillin-resistant Staphylococcus aureus (MRSA). The full manuscript will report the pooled prevalence rates and 95% CIs for each resistance type. The rates for such bacteria were 38.7%, 26.4%, and 15.2% respectively suggesting an imminent need for improvement in surveillance measures & interventions to reduce the burden of AMR (Antimicrobial Resistance). Conclusion: The prevalence of antibiotic resistance (AMR) is alarmingly high in Saudi Arabia. The aim of this study was to examine the prevalence of AMR across different types of pathogens and antimicrobial agents. A meta-analysis was conducted to quantify the pooled prevalence of each type of resistance across hospitals, environments, and food samples from Saudi Arabian locations. The study identified three types of resistance: carbapenem-resistant Enterobacteriaceae (CRE), extended-spectrum -lactamaseproducing Enterobacilli (ESBL), and methicillin-resistant Staphylococcus aureus (MRSA). Furthermore, the study identified several risk factors associated with AMR, including prior antibiotic use, healthcare-associated infections, and prolonged hospital stays.

The dangers that Internet of Things (IoT) devices pose to large corporate corporations and smart districts have been dissected by several academics. Given the ubiquitous use of IoT and its unique characteristics, such as mobility and normalization restrictions, intelligent frameworks that can independently detect suspicious activity in privately linked IoT devices are crucial. The IoTs have led an explosion in traffic through the network, bringing information processing techniques for attack detection. The increase in traffic poses challenges in detecting attacks and differentiating traffic that is harmful. In this work, we have proposed a mechanism that uses the standard algorithms in a system that is designed to detect, track, measure and identify online traffic from organizations with malignant transmission: Random Forest (RF), gradient-boosted decision trees (GBDT), and support vector machines (SVM) gives an optimal accuracy of 80.34%,87.5%, and 88.6% while the random forest-based supervised approach is 5.5% better than the previous techniques. To facilitate comparisons between training time, prediction time, specificity, and accuracy, the proposed approach leverages the NSL KDD dataset accuracy.

Abstract Background Focused ultrasound has emerged as a non-invasive technology with potential for treating various medical conditions, particularly neurological diseases. This article aims to explore recent advancements in the utilization of focused ultrasound for treating neurological conditions. Results A comprehensive literature review was conducted to explore current clinical applications and investigational uses of focused ultrasound, aiming to provide an up-todate overview of the field's progress. By employing different combinations of intensity and frequency, focused ultrasound can induce diverse interactions with soft tissues, including tissue ablation, cavitation, and mechanical effects. High-intensity focused ultrasound is utilized for tissue ablation and has received FDA approval for treating medication-refractory essential tremor. Conversely, low-intensity focused ultrasound is employed for neuromodulation and opening the blood–brain barrier, facilitating enhanced drug delivery for treating brain tumors and other neurological conditions. This article reviews ongoing clinical trials investigating focused ultrasound's role in neurological condition treatment. Conclusion Focused ultrasound holds significant promise for managing and treating various neurologic conditions. Whether employed for tissue ablation or transiently opening the blood–brain barrier to enhance drug delivery, numerous potential applications exist. Further research is necessary to evaluate its safe implementation and compare clinical outcomes with standard-of-care therapies.

[KI-generert sammendrag] Teksten tar for seg emic-etic distinksjonen i forbindelse med islamske studier, spesielt i konteksten av akademia i Oslo, Norge. Emic refererer til innsikt som kommer fra innsiden av en kultur eller religion, mens etic representerer et utenfra-perspektiv som forsøker å forklare fenomenene objektivt. Studien analyserer islamske programmer ved ulike universiteter i Oslo, som MF Norwegian School of Theology, Religion and Society og Universitetet i Oslo. Det blir diskutert hvordan islamske studier ofte plasseres under religionsvitenskap eller historie, og ikke som en selvstendig disiplin, noe som påvirker måten islam blir undervist og forstått på. Forfatteren argumenterer for behovet for å diversifisere metodologiske og epistemologiske tilnærminger for å gi en mer nyansert forståelse av islam i den vestlige akademiske verden.

Abstract This study investigated the adsorption of Oxytetracycline (OTC) from pharmaceutical wastewater using a kappa carrageenan based hydrogel (KPB). The aim of the present study was to explore the potential of KPB for long-term pharmaceutical wastewater treatment. A sustainable adsorbent was developed to address oxytetracycline (OTC) contamination. The hydrogel’s structural and adsorption characteristics were examined using various techniques like Scanning Electron Microscope (SEM), Fourier Transform Infrared (FTIR), X-ray powder diffraction (XRD), and kinetic models. The results revealed considerable changes in the vibrational modes and adsorption bands of the hydrogel, suggesting the effective functionalization of Bentonite nano-clay. Kappa carrageenan based hydrogel achieved the maximum removal (98.5%) of OTC at concerntration of 40 mg/L, pH 8, cotact time of 140 min and adsorbent dose of 0.1 g (KPB-3). Adsorption of OTC increased up to 99% with increasing initial concentrations. The study achieved 95% adsorption capacity for OTC using a KPB film at a concentration of 20 mg/L and a 0.1 g adsorbent dose within 60 min. It also revealed that chemisorptions processes outperform physical adsorption. The Pseudo-Second-Order model, which emphasized the importance of chemical adsorption in the removal process, is better suited to represent the adsorption behavior. Excellent matches were found that R2 = 0.99 for KPB-3, R2 = 0.984 for KPB-2 and R2 = 0.989 for KPB-1 indicated strong chemical bonding interactions. Statisctical analysis (ANOVA) was performed using SPSS (version 25) and it was found that pH and concentration had significant influence on OTC adsorption by the hydrogel, with p-values less than 0.05. The study identified that a Kappa carrageenan-based hydrogel with bentonite nano-clay and polyvinyl alcohol (PVA) can efficiently remove OTC from pharmaceutical effluent, with a p-value of 0.054, but weak positive linear associations with pH, temperature, and contact time. This research contributed to sustainable wastewater treatment and environmental engineering.

Abstract Restoring motor function after stroke necessitates involvement of numerous cognitive systems. However, the impact of damage to motor and cognitive network organization on recovery is not well understood. To discover correlates of successful recovery, we explored imaging characteristics in chronic stroke subjects by combining noninvasive brain stimulation and fMRI. Twenty stroke survivors (6 months or more after stroke) were randomly assigned to a single session of transcranial direct current stimulation (tDCS) or sham during image acquisition. Twenty healthy subjects were included as controls. tDCS was limited to 10 min at 2 mA to serve as a mode of network modulation rather than therapeutic delivery. Fugl-Meyer Assessments (FMA) revealed significant motor improvement in the chronic stroke group receiving active stimulation (p = 0.0005). Motor changes in this group were correlated in a data-driven fashion with imaging features, including functional connectivity (FC), surface-based morphometry, electric field modeling and network topology, focusing on relevant regions of interest. We observed stimulation-related changes in FC in supplementary motor (p = 0.0029), inferior frontal gyrus (p = 0.0058), and temporo-occipital (p = 0.0095) areas, though these were not directly related to motor improvement. The feature most strongly associated with FMA improvement in the chronic stroke cohort was graph topology of the dorsal attention network (DAN), one of the regions surveyed and one with direct connections to each of the areas with FC changes. Chronic stroke subjects with a greater degree of motor improvement had lower signal transmission cost through the DAN (p = 0.029). While the study was limited by a small stroke cohort with moderate severity and variable lesion location, these results nevertheless suggest a top-down role for higher order areas such as attention in helping to orchestrate the stroke recovery process.

Abstract Background The present study aimed to evaluate the effects of 24 weeks of moderate aerobic exercise on lipids and lipoprotein levels; Lipo (a) markers, and their association with cognitive performance in healthy older adults. Methods A total of 150 healthy subjects (100 males and 50 females; age range: 65–95 years) were recruited for this study. Based on the LOTCA test score, subjects were classified into two groups: the control group (n = 50) and the cognitive impairment group (n = 100). Cognitive functioning, leisure-time physical activity (LTPA), lipid profile, total cholesterol, TG, HDL-c, LDL-C, and lipo(a) were assessed at baseline and post-24-week aerobic exercise interventions using LOTCA battery, pre-validated Global Physical Activity Questionnaire (GPAQ) version II, colorimetric, and immunoassay techniques, respectively. Results Significant improvements in cognitive function and modulation in lipid profile and lipoprotein (a) markers were reported in all older subjects following 24 weeks of moderate exercise. LOTCA-7-sets scores significantly correlated with physical activity status and the regulation of lipids and Lipo (a) markers. Physically active persons showed higher cognitive performance along with a reduction in the levels of T-Cholest., TG, LDL-C, Lipo (a), and an increase in the levels of HDL-C and aerobic fitness VO2max compared with sedentary participants. Cognitive performance correlated positively with increased aerobic fitness, HDL-C, and negatively with T-Cholest., TG, LDL-C, and Lipo (a). However, a significant increase in the improvement of motor praxis, vasomotor organization, thinking operations, attention, and concentration were reported among older adults. Conclusions The study findings revealed that supervised moderate aerobic training for 24 weeks significantly enhances cognitive functions via mitigating older adults’ lipid profiles and lipoprotein (a). Cognitive performance is positively correlated with aerobic fitness and HDL-C level and negatively with T-Cholest., TH, LDL-C, and Lipo (a).

Mycetoma, a neglected infection of subcutaneous tissues, poses a significant health burden, especially in tropical regions. It is caused by fungal (eumycetoma) and bacterial (actinomycetoma) pathogens, with current treatments often providing unsatisfactory outcomes. This study aims to discover novel broad-spectrum antimicrobial agents to circumvent the lengthy and costly diagnostic procedures. Eight essential oils (EOs) from the roots and aerial parts of Geigeria alata, Lavandula angustifolia, Melaleuca alternifolia, Myristica fragrans, Pimpinella anisum, Syzigum aromaticum, and Thymus vulgaris were prepared using steam distillation. The in vitro antimycetomal activity against Madurella mycetomatis and Actinomadura madurae strains was assessed using resazurin assays. The chemical compositions of the EOs were analyzed using gas chromatography and mass spectrometry (GC–MS). Promising EOs underwent further in vivo toxicity and efficacy testing in Galleria mellonella larvae models. EOs of G. alata roots, M. fragrans, P. anisum, S. aromaticum, and T. vulgaris showed wide-spectrum dual in vitro antimycetomal activity against all tested strains, with minimum inhibitory concentrations (MICs) ranging from 0.004 to 0.125% v/v. G. alata aerial parts and L. angustifolia EOs demonstrated activity predominantly against A. madurae, while M. alternifolia EO did not inhibit any tested strains. M. fragrans and P. anisum EOs significantly enhanced the survival of M. mycetomatis-infected larvae without inducing toxicity in uninfected larvae. Notably, P. anisum EO tended to enhance the survival of A. madurae-infected larvae, ranking it as the most promising EO among those tested. The investigated EOs, particularly P. anisum, exhibited promising broad-spectrum antimycetomal activity against fungal and bacterial pathogens responsible for mycetoma. These findings highlight the potential of essential oils as a basis for developing novel antimycetomal agents, offering hope for improved treatment strategies for this neglected disease.

OBJECTIVES: There is no sufficient data to provide a clear picture of out-of-hospital cardiac arrest (OHCA) across Türkiye. This study is the first to present the prognostic outcomes of OHCA cases and the factors associated with these outcomes. MATERIALS AND METHODS: The study was conducted in a prospective, observational, multicenter design under the leadership of the Emergency Medicine Association of Turkey Resuscitation Study Group. OHCA cases aged 18 years and over who were admitted to 28 centers from Türkiye were included in the study. Survived event, return of spontaneous circulation (ROSC), survival to hospital discharge, and neurological outcome at discharge were investigated as primary outcomes. RESULTS: One thousand and three patients were included in the final analysis. 61.1% of the patients were male, and the average age was 67.0 ± 15.2. Cardiopulmonary resuscitation (CPR) was performed on 86.5% of the patients in the prehospital period by emergency medical service, and bystander CPR was performed on only 2.9% by nonhealth-care providers. As a result, the survived event rate was found to be 6.9%. The survival rate upon hospital discharge was 4.4%, with 2.7% of patients achieving a good neurological outcome upon discharge. In addition, the overall ROSC and sustained ROSC rates were 45.2% and 33.4%, respectively. In the multiple logistic regression analysis, male gender, initial shockable rhythm, a shorter prehospital duration of CPR, and the lack of CPR requirement in the emergency department were determined to be independent predictors for the survival to hospital discharge. CONCLUSION: Compared to global data, survival to hospital discharge and good neurological outcome rates appear to be lower in our study. We conclude that this result is related to low bystander CPR rates. Although not the focus of this study, inadequate postresuscitative care and intensive care support should also be discussed in this regard. It is obvious that this issue should be carefully addressed through political moves in the health and social fields.

An interosseous ganglion cyst is a very rare entity, found mostly in skeletally mature patients, particularly in long bones such as the tibia and femur. However, we are the first to report here an unusual case of interosseous ganglion cyst of the upper ribs in a young female patient, which she had an unpredicted presentation of cough and hemoptysis and a large painful lump over the anterior left upper chest. The radiological and pathological workup confirmed the presence of a benign interosseous ganglion cyst arising from the left first rib, invading the second rib and the apex of the left lung. The patient has been treated successfully by surgical resection of this rib cyst. However, we could not find any reported cases in the current literature of an interosseous ganglion cyst pathology arising in the ribs with a similar presentation of cough and hemoptysis.

Objective: To explore the effect of black radish (Raphanus sativus L. var niger) root extract on liver enzymes, oxidative stress, and histopathological alterations in mice with sodium valproate-induced hepatotoxicity. Methods: Thirty-two mice were divided into four groups: the control group received drinking water by gavage, the second group was administered with 100 mg/kg of sodium valproate, the third group received 300 mg/kg of black radish root extract, and the fourth group was given both sodium valproate (100 mg/kg) and black radish root extract (300 mg/kg). After 28 days, the mice were euthanized, and serum levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), and alkaline phosphatase (ALP), along with liver malondialdehyde (MDA), reactive oxygen species (ROS), mitochondrial parameters, tumor necrosis factor-alpha (TNF-α) gene expression, and histopathological changes were assessed. Results: Sodium valproate caused hepatic damage in mice, characterized by elevated serum levels of liver enzymes, increased MDA and ROS levels and TNF-α gene expression, as well as histopathological alterations. The black radish root extract significantly alleviated sodium valproate-caused hepatic injury by decreasing the serum levels of ALT and AST, MDA, ROS, TNF-α gene expression, as well as mitochondrial impairment, but did not have a significant effect on sodium valproate-induced histopathological changes. Conclusions: The black radish root extract demonstrates protective effects against sodium valproate-induced liver injury, possibly through mitigating oxidative stress, mitochondrial impairment, and inflammatory mediator expression.

Abstract Background Hypertension (HTN) and type 2 diabetes mellitus (T2DM) are interconnected metabolic disorders with escalating global incidence and prevalence. However, no longitudinal studies have specifically examined the incidence of HTN and T2DM in the same study population. This study aimed to elucidate the association between HTN and T2DM and ascertain their respective roles in the development of each other. Methods This retrospective cohort study encompassed 809 Saudi patients from primary healthcare centers in Al Madinah Al Munawarah, Saudi Arabia. The sample was stratified into three cohorts: 226 patients with HTN but without T2DM, 274 patients with T2DM but without HTN, and 309 patients devoid of both T2DM and HTN. Over a retrospective follow-up period of approximately 5 years, incidence density rates (IDR) were computed for HTN in the T2DM cohort, T2DM in the HTN cohort, and both HTN and T2DM in the control cohort. Multiple logistic regression analysis was employed to identify predictors of HTN and T2DM. Results The IDR of T2DM among patients with HTN stood at 73.9 (95% confidence interval [CI] 56, 92) per 1000 person-years, in contrast to 33.9 (95% CI 24, 44) per 1000 person-years in the control cohort (adjusted odds ratio [OR] = 7.1, 95%CI 3.55, 14.13). Conversely, the IDR of HTN among patients with type-2 T2DM was 55.9 (95% CI 42, 70) per 1000 person-years, while in the control cohort, it was 20.8 (95% CI 13, 28) per 1000 person-years (adjusted OR = 5.8, 95% CI 3.11, 11.09). Significant predictors of HTN in the logistic regression model encompassed age, smoking status, family history of HTN, T2DM status, and body mass index (BMI). Similarly, significant predictors of T2DM in the logistic regression model included age, sex, family history of T2DM, HTN, and BMI. Conclusion This study unveils HTN and T2DM as mutually significant risk factors. The IDR of each condition in the presence of the other significantly exceeded that among individuals devoid of HTN or T2DM.

Abstract Background Circulating microRNAs have been implicated in a diverse array of biological and pathological phenomena. Their potential utility as noninvasive biomarkers for screening and diagnosing various diseases has been proposed. Objective This study aimed to explore the potential role of the miRNAs miR-122 and miR-486 as molecular biomarkers in the pathogenesis of hepatitis C virus (HCV) infection. Thus, miR-122 and miR-486 were detected in the serum of HCV patients and healthy controls. Moreover, the potential correlations of miR-122 and miR-486 with viral complications, such as physical activity, pain, muscle fatigue, and HCV infection, were identified. Methods A total of 150 subjects aged 30 to 66 years were included in this study. The patients were classified as patients with chronic hepatitis C virus (CHC) (n = 110) or healthy controls (n = 40). Real-time polymerase chain reaction (PCR) analyses were performed to determine miR-122 and miR-486 expression. Physical activity (PA), pain score, HCV genotyping, viral overload, aspartate transaminase (AST), alanine transaminase (ALT), lactic acid dehydrogenase (LDH), creatine kinase (CK), and antioxidant status were also estimated by using prevalidated questionnaires, PCR, and spectrophotometric analyses. Results Compared with those in normal controls, significant increases in the serum levels of miR-122 and miR-486 were reported in patients with CHC. In physically active CHC patients, there was a significant correlation between the expression of miRNAs and increased alanine transaminase (ALT), aspartate transaminase (AST), fibrosis scores, and inflammation activity, but no association was reported for hepatitis C virus (HCV) RNA or viral load. Additionally, significant decreases in LDH, CK, GSSG, and pain scores and increases in TAC, GSH, and the GSH/GSSG ratio were reported. Moreover, the expression of miR-122 and miR-486 was positively correlated with changes in body mass index (BMI) and liver fibrosis stage, as well as negatively correlated with sex, PA, TAC, GSH, GSSG, and the GSH/GSSG ratio. Conclusion MiR-122 and miR-486 expression levels were strongly correlated with physical activity, pain perception, and muscle fatigue biomarkers in HCV-infected patients. These miRNA levels were associated with elevated AST, ALT, fibrosis scores, LDH, CK, and antioxidant status, thus suggesting their potential as biomarkers for disease severity and oxidative stress. However, no correlation was observed with viral load or HCV-RNA expression, thus implying that these miRNAs may impact disease progression and symptoms through host factors, rather than directly affecting viral replication. In summary, the results demonstrated that molecular studies of miR-22 and miR-468 and their associations with PA, pain, adiposity, sex differences, and muscle fatigue, as well as routine biomarkers, could be useful as prognostic nanoninvasive biomarkers, thus providing novel therapeutic targets for CHC infection.

Abstract Cardiovascular diseases, including heart failure, stroke, and hypertension, affect 608 million people worldwide and cause 32% of deaths. Combination therapy is required in 60% of patients, involving concurrent Renin–Angiotensin–Aldosterone-System (RAAS) and Neprilysin inhibition. This study introduces a novel multi-target in-silico modeling technique (mt-QSAR) to evaluate the inhibitory potential against Neprilysin and Angiotensin-converting enzymes. Using both linear (GA-LDA) and non-linear (RF) algorithms, mt-QSAR classification models were developed using 983 chemicals to predict inhibitory effects on Neprilysin and Angiotensin-converting enzymes. The Box-Jenkins method, feature selection method, and machine learning algorithms were employed to obtain the most predictive model with ~ 90% overall accuracy. Additionally, the study employed virtual screening of designed scaffolds (Chalcone and its analogues, 1,3-Thiazole, 1,3,4-Thiadiazole) applying developed mt-QSAR models and molecular docking. The identified virtual hits underwent successive filtration steps, incorporating assessments of drug-likeness, ADMET profiles, and synthetic accessibility tools. Finally, Molecular dynamic simulations were then used to identify and rank the most favourable compounds. The data acquired from this study may provide crucial direction for the identification of new multi-targeted cardiovascular inhibitors.

Lower gastrointestinal bleeding is defined as bleeding that originates distal to the ligament of Treitz. Neoplasms causing lower gastrointestinal bleeding generally originate from the colon. A similar clinical picture can sometimes be caused by the invasion of the colon wall by intra-abdominal masses. Perivascular epithelioid cell tumors (PEComas) are mesenchymal neoplasms composed of histologically and immunohistochemically epithelioid or spindle cells, with immunoreactive properties for smooth muscle and melanocytic markers. The differential diagnosis of patients being evaluated for an intra-abdominal mass should be made meticulously. In the presence of atypical signs, extra care should be taken. This paper reports a case of an ovarian malignant PEComa presenting with melena from an ulcerated lesion in the transverse colon.

Abstract Drought stress can have negative impacts on crop productivity. It triggers the accumulation of reactive oxygen species, which causes oxidative stress. Limited water and nutrient uptake under drought stress also decreases plant growth. Using cobalt and fulvic acid with biochar in such scenarios can effectively promote plant growth. Cobalt (Co) is a component of various enzymes and co-enzymes. It can increase the concentration of flavonoids, total phenols, antioxidant enzymes (peroxidase, catalase, and polyphenol oxidase) and proline. Fulvic acid (FA), a constituent of soil organic matter, increases the accessibility of nutrients to plants. Biochar (BC) can enhance soil moisture retention, nutrient uptake, and plant productivity during drought stress. That’s why the current study explored the influence of Co, FA and BC on chili plants under drought stress. This study involved 8 treatments, i.e., control, 4 g/L fulvic acid (4FA), 20 mg/L cobalt sulfate (20CoSO4), 4FA + 20CoSO4, 0.50%MFWBC (0.50 MFWBC), 4FA + 0.50MFWBC, 20CoSO4 + 0.50MFWBC, 4FA + 20CoSO4 + 0.50MFWBC. Results showed that 4 g/L FA + 20CoSO4 with 0.50MFWBC caused an increase in chili plant height (23.29%), plant dry weight (28.85%), fruit length (20.17%), fruit girth (21.41%) and fruit yield (25.13%) compared to control. The effectiveness of 4 g/L FA + 20CoSO4 with 0.50MFWBC was also confirmed by a significant increase in total chlorophyll contents, as well as nitrogen (N), phosphorus (P), and potassium (K) in leaves over control. In conclusion4g/L, FA + 20CoSO4 with 0.50MFWBC can potentially improve the growth of chili cultivated in drought stress. It is suggested that 4 g/L FA + 20CoSO4 with 0.50MFWBC be used to alleviate drought stress in chili plants.

Abstract Background The World Health Organization recommended the use of chemical-based disinfectants as an effective prevention of the COVID-19 pandemic. However, calls for poisoning were reported in several medical centers. The widespread use of chemical-based disinfectants as a preventive measure during the COVID-19 pandemic has underscored potential gaps in community awareness and performance, posing health risks. This study evaluates and compares levels of awareness and performance regarding the safe use of disinfectants in Jordan and UAE. Methods The study was conducted between October 2022 and June 2023 via an online questionnaire. Data of respondents from Jordan (n = 828) and UAE (n = 619) were analyzed using SPSS. ANOVA, Mann-Whitney, and Kruskal-Wallis tests evaluated significant differences in awareness and performance levels across different demographic groups in Jordan/UAE and between them. Spearman’s correlation test examined the correlation between awareness and performance among respondents. Multinomial logistic regression analysis explored associations between various variables and awareness/performance levels within each population. Results Findings reveal weak awareness (72.4% and 9.03% in UAE and Jordan, respectively) and moderate performance level (98.8% in UAE and Jordan), with a weak correlation (UAE, rho = 0.093; Jordan, rho = 0.164) observed between the two countries (P

Abstract The current research focuses on the development of Ag–ZnO heterostructures through a “bottom-up” approach involving the assembly and extraction of Aloe barbadensis Miller gel. These heterostructures composed of metals/semiconductor oxide display distinct and notable optical, electrical, magnetic, and chemical properties that are not found in single constituents and also exhibit photocatalytic applications. These synthesized heterostructures were characterized by XRD, FTIR, SEM, and UV–visible spectroscopy. The high peak intensity of the Ag/ZnO composite shows the high crystallinity. The presence of Ag–O, Zn–O, and O–H bonding is verified using FTIR analysis. SEM analysis indicated the formation of spherical shapes of Ag/ZnO heterostructures. The Zn, O, and Ag elements are further confirmed by EDX analysis. Ag–ZnO heterostructures exhibited excellent photocatalytic activity and stability against the degradation of tubantin red 8BL dye under visible light irradiation.

Abstract Salinity stress significantly hinders plant growth by disrupting osmotic balance and inhibiting nutrient uptake, leading to reduced biomass and stunted development. Using saponin (SAP) and boron (B) can effectively overcome this issue. Boron decreases salinity stress by stabilizing cell walls and membranes, regulating ion balance, activating antioxidant enzymes, and enhancing water uptake. SAP are bioactive compounds that have the potential to alleviate salinity stress by improving nutrient uptake, modulating plant hormone levels, promoting root growth, and stimulating antioxidant activity. That’s why the current study was planned to use a combination of SAP and boron as amendments to mitigate salinity stress in sweet potatoes. Four levels of SAP (0%, 0.1%, 0.15%, and 0.20%) and B (control, 5, 10, and 20 mg/L B) were applied in 4 replications following a completely randomized design. Results illustrated that 0.15% SAP with 20 mg/L B caused significant enhancement in sweet potato vine length (13.12%), vine weight (12.86%), root weight (8.31%), over control under salinity stress. A significant improvement in sweet potato chlorophyll a (9.84%), chlorophyll b (20.20%), total chlorophyll (13.94%), photosynthetic rate (17.69%), transpiration rate (16.03%), and stomatal conductance (17.59%) contrast to control under salinity stress prove the effectiveness of 0.15% SAP + 20 mg/L B treatment. In conclusion, 0.15% SAP + 20 mg/L B is recommended to mitigate salinity stress in sweet potatoes.

Background: The actual burden of the Omicron variants remains unclear. Therefore, this study aims to analyze the epidemiological and clinical features of Omicron-infected patients and investigate factors influencing hospital admission. Methods: This retrospective single-center study included individuals with positive SARS-CoV-2 infection, specifically the Omicron variants (XBB, EG or JN), identified through real-time reverse-transcriptase polymerase chain reaction assays from January 2022 to December 2023. Results: A total of 305 Omicron-infected patients were included; (53.11 %) were females and (46.89 %) were males, with a median age of 39 years [interquartile range (IQR): 30, 53]. Underlying diseases, including endocrine/metabolic disorders (22.30 %), hypertension (12.79 %), chronic respiratory disease (10.49 %), and malignancy (9.18 %) were prevalent, while (40.98 %) were medically free. The XBB variant was predominant (73.11 %), followed by JN (20.33 %), and EG variant (6.56 %). The seasonality analysis demonstrates XBB variants' domination in 2022, with a surge to 40 cases in December. The trend continued in 2023, peaking at 76 XBB cases in March. May 2023 reported 38 XBB cases and the emergence of 17 EG instances. Notably, in December, only one XBB case was reported, and 62 instances emerged with the JN variant. Overall, 233 out of 305 cases were reported during flu season (September to March) (76.39 %). Moreover, hospitalization occurred in (16.39 %), with a (1.31 %) mortality rate (all deaths in the JN variant). Multivariable analysis confirmed renal disease, chronic respiratory disease, endocrine/metabolism issues, and polymicrobial infection as positive predictors of hospitalization (p

Maize stands out as a versatile commodity, finding applications in food and animal feed industries. Notably, half of the total demand for maize is met through its utilization as animal feed. Despite its importance, maize cultivation often grapples with crop failures resulting from delayed disease management or insufficient knowledge about these diseases, impeding timely intervention. The advent of technological advancements, particularly in Machine Learning, presents solutions to address these challenges. This research focuses on employing a Convolutional Neural Network (CNN) to classify maize plant diseases. Two datasets form the foundation of this study. The first dataset encompasses 4144 images distributed across 4 classes, while the second dataset comprises 5155 images distributed among 7 to 8 classes. The second dataset encounters issues related to imbalanced class distribution, where certain classes possess substantially more data than others. To mitigate this imbalance, the weighted cross-entropy loss method is employed. During experimentation, three distinct architectural models—ResNet-18, VGG16, and EfficientNet—are rigorously tested. Additionally, various optimizers are explored, with noteworthy results indicating that both datasets achieve peak accuracy through the use of the SGD (Stochastic Gradient Descent) optimization. For the first dataset, optimal results are obtained with the VGG16 architecture, leveraging a frozen layer in the classification stage and achieving an impressive accuracy of 97.146 %. Shifting the focus to the second dataset, the most favorable outcome is realized by employing the EfficientNet architecture without a frozen layer, coupled with the implementation of weighted loss to address the class imbalance, resulting in an accuracy of 94.798 %.

The key goal of the mental health nurse practicing in emergency mental health care services is ensuring that their patients have access to best practice mental health care. The aim of this study was to examine mental health nurses’ perceptions of their role in and preparation for providing mental health care services for pediatric emergency department patients. A qualitative constructivist method was employed. Inductive data were gathered using a focus group discussion model employing open-ended questions as probes. The participants were nine experienced practicing mental health nurses. Discussion was facilitated through detailed probing of the nurses’ experiences in providing care for clients in emergency departments. Four principal themes emerged from the data about mental health nurses’ experiences during the provision of emergency care: (i) barriers to adequate care provision; (ii) problems among populations; (iii) pediatric special needs; and (iv) the general need for improvements to mental health care. Each participant in this study asserted that they endorse the introduction of care by specialized mental health nurses in emergency care departments to better serve this population in Saudi Arabia. Inclusion and acceptance of psychiatric mental health nurses as full members of the multidisciplinary emergency department team, improved education and training opportunities, standards-based evaluation by collegial supervisors, availability of tools for assessment, and recognition of the role of pediatric psychiatric mental health nurses in emergency department care were goals expressed by the focus group members.

A series of methoxy substituted pyrazole based pyrazoline derivatives (4a-j) were synthesized in good to excellent yield from corresponding pyrazole-chalcones (3a-j). All synthesized derivatives were characterized and screened for their in vitro anti-inflammatory, antioxidant, antidiabetic, and antibacterial activities. Among the series, compounds 4f, 4j, 4a, and 4i showed better anti-inflammatory activity as compared to diclofenac sodium. In DPPH free radical scavenging assay, all the compounds were shown excellent activity and moderate to good activity in SO and NO free radical scavenging assay as compared to standard ascorbic acid. Antibacterial screening of synthesized pyrazolines showed that compounds 4f and 4j have significant antibacterial activity. The compounds 4j, 4f, 4h, 4a, and 4c have shown comparable inhibition of alpha-amylase enzyme leading to good antidiabetic activity as compared to standard acarbose. Molecular docking studies suggest that these compounds have strong binding with COX-2 and alpha-amylase enzyme due to significant capability of aromatic and hydrophobic interaction. The outstanding results of reported compounds in all biological screening will pave the way for the design of new drug candidate bearing pyrazole moiety.

Monoamine oxidase B (MAO-B) plays a pivotal role in the deamination process of monoamines, encompassing crucial neurotransmitters like dopamine and norepinephrine. The heightened interest in MAO-B inhibitors emerged after the revelation that this enzyme could potentially catalyze the formation of neurotoxic compounds from endogenous and exogenous sources. Computational screening methodologies serve as valuable tools in the quest for novel inhibitors, enhancing the efficiency of this pursuit. In this study, 43 acefylline derivatives were docked against the MAO-B enzyme for their chemotherapeutic potential and binding affinities that yielded GOLD fitness scores ranging from 33.21 to 75.22. Among them, five acefylline derivatives, namely, MAO-B14, MAO-B15, MAO-B16, MAO-B20, and MAO-B21, displayed binding affinities comparable to the both standards istradefylline and safinamide. These derivatives exhibited hydrogen-bonding interactions with key amino acids Phe167 and Ile197/198, suggesting their strong potential as MAO-B inhibitors. Finally, molecular dynamics (MD) simulations were conducted to evaluate the stability of the examined acefylline derivatives over time. The simulations demonstrated that among the examined acefylline derivatives and standards, MAO-B21 stands out as the most stable candidate. Density functional theory (DFT) studies were also performed to optimize the geometries of the ligands, and molecular docking was conducted to predict the orientations of the ligands within the binding cavity of the protein and evaluate their molecular interactions. These results were also validated by simulation-based binding free energies via the molecular mechanics energies combined with generalized Born and surface area solvation (MM-GBSA) method. However, it is necessary to conduct in vitro and in vivo experiments to confirm and validate these findings in future studies.

Background: Ensuring appropriate step height in buildings, public spaces, and homes is crucial to public health and safety. This study aimed to determine the most comfortable and physiologically optimal step height among healthy adults. As such, this study aimed to determine the most comfortable step height among healthy adults based on heart rate (H.R.), blood pressure (B.P.), rate pressure products (RPPs), body mass index (BMI), and personal satisfaction. Methods: Thirty healthy adults climbed 12-step stairs with 14-cm and 18-cm step heights to compare satisfaction and cardiovascular changes. Results: A step height of 14 cm was the most comfortable and satisfying, with no significant changes in H.R., B.P., and RPP (p < 0.077–0.19). In contrast, the step height of 18 cm significantly increased H.R., B.P., and RPP (p < 0.001) and required much time to climb without satisfying participants. Meanwhile, BMI significantly negatively impacted H.R., B.P., RPP, time to climb stairs, and satisfaction when ascending the stairs with a step height of 18 cm. 14 cm is the most comfortable, satisfying, and recommended step height for healthy adults for homes, public buildings, and attractions. In contrast, an 18-cm step height could be suggested for fitness exercise to increase H.R., B.P., and RPP. Conclusion: The results of this study provide valuable insights for risk management and healthcare policy professionals to develop guidelines and recommendations for step height in homes, public buildings, and other infrastructure. Implementing appropriate step heights can promote active living, proper stair utilization, and avoid related injuries, ultimately contributing to better population health outcomes.

Otitis media (OM) is a common infection or inflammation of the middle ear causing conductive hearing loss that primarily affects children and may delay speech, language, and cognitive development. OM can manifest itself in different forms, and can be diagnosed using (video) otoscopy (visualizing the tympanic membrane) or (video) pneumatic otoscopy and tympanometry. Accurate diagnosis of OM is challenging due to subtle differences in otoscopic features. This research aims to develop an automated computer-aided design (CAD) system to assist clinicians in diagnosing OM using otoscopy images. The ground truths, generated manually and validated by otolaryngologists, are utilized to train the proposed nested U-Net++ model. Ten clinically relevant gray level co-occurrence matrix (GLCM) and morphological features were extracted from the segmented Region of Interest (ROI) and validated for OM classification based on a statistical significance test. These features serve as input for a Graph Neural Network (GNN) model, the base model in our research. An optimized GNN model is proposed after ablation study of the base model. Three datasets, one private dataset, and two public ones have been used, where the private dataset is utilized for both training and testing, and the public datasets are used to test the robustness of the proposed GNN model only. The proposed GNN model obtained the highest accuracy in diagnosing OM: 99.38 %, 93.51 %, and 91.38 % for the private dataset, public dataset1, and public dataset2, respectively. The proposed methodology and results of this research might enhance clinicians' effectiveness in diagnosing OM.

Introduction In the contemporary healthcare landscape, the paradigm of patient experience and patient-centered care has emerged as a crucial point for healthcare reform, emphasizing the patient's active role in shaping healthcare systems. Objective This study aimed to investigate the patient experience level of nursing care and examine associated factors among hospitalized patients in Riyadh, Saudi Arabia. Methods Cross-sectional secondary analysis of patient experience data included more than 8,000 patients discharged from Ministry of Health hospitals in Riyadh during 2022G. The national survey examined patient perceptions of multiple aspects of nursing care. Although most patients gave high overall scores, lower scores were observed for nurse introductions and prompt responses to call buttons. There are opportunities to improve communication and response through interventions targeting nurse staffing, training, and incentives. A checklist called Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) was used to report the study. Results 71.2% Of patients rated their nursing care experience as “very good.” No differences were seen between genders. However, Saudi patients reported higher satisfaction than non-Saudis ( p = .001). The top-scored nursing aspects were friendliness/courtesy (70.2% “very good”) and nurses’ skill level (65.8% “very good”). Lower ratings occurred for nurses who introduced themselves (54.0% “very good”) and for prompt response to call buttons (58.5% “very good”). Targeted improvements in communication and responsiveness could help address these gaps in patient experience scores between nursing care domains. Conclusions Most of the patients indicated overall positive nursing care experiences, which include opportunities for improvement in nurse introductions and responsiveness to patient needs. Boosting communication through nurses consistently introducing themselves and managing heavy workloads to allow faster call button response times could enhance patients’ perceptions of their nursing care quality.

The combination of heterocycles renders a new possibility to synthesize multicyclic compounds having improved biological activities. Furo[3,2-b]pyridine is a fused heterocyclic ring system comprising a furan ring attached at the third and second positions of pyridine. These heterocyclic compounds can be easily synthesized from versatile starting materials including pyridine, furan, benzofuran, and benzopyridine via cycloaddition, cycloisomerization, multicomponent, cross-coupling, and Dakin-type reactions by utilizing microwave, copper, and palladium based catalysts. Among the chemical transformations of furo[3,2-b]pyridine derivatives, the review covered acetylation, addition, condensation, chlorination, Suzuki coupling, Vilsmeier-Haack reaction, and nucleophilic substitution reactions. Furo[3,2-b]pyridine has attracted remarkable attention from researchers due to its wide range of pharmacological and biological applications as antibiotic, antiviral, antifungal, anticancer, inhibitors of nicotinic acetylcholine receptors, CLKs, e1F4A, DYRKIA, α-glucosidase and β-glucosidase. The purpose of the review is to discuss the chemistry of the title reported during 2019–2024.

Carbazole is a heterocyclic aromatic organic compound that has vast applications in pharmaceuticals, and in biological and material sciences. Carbazole derivatives show various biological activities such as antibiotic, anti-inflammatory, anti-tumor and anti-oxidant activities etc. Synthesis of N-arylated carbazoles has become a major area of interest for scientists due to their applications in organic light-emitting diodes, dye-sensitized solar cells, and other organic electronics. The N-arylated carbazoles have unique properties such as high thermal stability, wide band gap, and excellent electrical and optical properties. The methods used for the N-arylation of carbazoles include transition metal-catalyzed reactions and metal-free reactions. The most common and classical methods for the N-arylation of carbazoles are copper-catalyzed Ullmann coupling reactions, while palladium, nickel, and iron catalysts are also used. This review focuses on all the synthetic methods used for the N-arylation of carbazoles and their applications.

Autism was initially identified as a discrete entity in 1943. This now recognized group of disorders is often identified in children, but is a lifelong disorder requiring specialized assessment, planning, and care for patients. Nurses practicing in the Saudi Arabian healthcare system are often the first healthcare providers to encounter autism in the clinical setting. To highlight the perspective of practicing mental health nurses in Saudi Arabia regarding their experiences in caring for clients who have this disorder. A qualitative inquiry, made up of two focus groups of five members each, composed of mental health graduate students with experience in the field, facilitated a detailed investigation of nurses’ experiences in providing care for clients with these aspects of autism in clinical settings. Four principal themes and subthemes emerged from the data, which informed researchers about mental health nurses’ experiences with autism: (1) knowledge of autism; (2) previous experience in caring for those with autism; (3) practical applications used; and (4) challenges felt by mental health nurses. The Saudi nursing community appears to be looking for better training in identifying and caring for autistic patients. There also appears to be a desire to open channels of communication between primary and tertiary care facilities to improve client access.

This article presents a qualitative study of future teachers’ conceptions of democracy in Ukraine, Palestine, and Norway during a pre-war and pre-pandemic period. In recent years, there has been a noticeable decline in the understanding of the democratic concept and reduced engagement, particularly among youth, coinciding with an assumed global recession of democratic recession. However, democracy also evolves with societal developments, whereas education holds the mandate to renew democratic values in society. This study therefore aims to explore student teachers’ own definitions of the democracy concept. Employing a grounded theory approach, we compare the written responses of 619 student teachers from Ukraine, Palestine, and Norway. The analysis reveals that despite different emphases, democracy is articulated along five dimensions: 1) political systems, 2) political culture, 3) values, 4) actions, and 5) actors. However, the study also indicates a striking finding: To our surprise, there were many identical responses across the data material, interpreted as wikied copy-paste responses, which indicate a distance and irony towards standardized democracy concepts. Consequently, democracy education is in a limbo between standardization and fostering new dimensions, whereas the teachers’ tasks will be challenging in providing democracy concepts born anew for the next generation.

We theoretically investigate the frequency shift of a free-running semiconductor laser when optically injected by an optical frequency comb. By numerical integration of the laser rate equations, we have identified two types of frequency shifts, frequency pulling, and frequency pushing. The free-running slave laser seems to switch between pulling and pushing in a regular manner. We have systematically determined the dependence of these shifts on comb parameters, including comb spacing and number of lines. We have found that the occurring frequency pushing seems to be almost independent of comb signals and comb spacing, while in contrast, the frequency pulling shows weak dependence on comb signals but largely affected by comb spacing. We have also shown that carrier density dynamic is the origine of these phenomena.

Background Multiple randomized trials could not establish the noninferiority of endovascular thrombectomy (EVT) alone without preceding intravenous thrombolysis (IVT) or superiority of IVT followed by EVT in anterior circulation large‐vessel occlusion stroke. The role of prior IVT in posterior circulation large‐vessel occlusion remains controversial. Methods In this multicenter, retrospective study, patients with stroke with large‐vessel occlusion in the posterior circulation who received EVT alone or with IVT were selected from the stroke thrombectomy and aneurysm registry between 2013 and 2022. Effects of IVT followed by thrombectomy on favorable functional outcome (defined as modified Rankin scale≤3 at 90 days) and safety were investigated using multivariable logistic and linear regression models. Results Of the 588 included patients, 67% (n = 394) were treated with EVT alone and 29% (n = 170) with EVT after IVT, and 4% (n = 24) have missing values on this variable. Controlling for multiple confounding factors, IVT was not associated with a higher likelihood of favorable functional outcome at 90 days (odds ratio, 1.04 [95% CI, 0.52–2.09; P = 0.901). Thrombectomy alone did not show any safety advantages compared with those receiving IVT. Conclusion Similar functional outcomes and complication rates were seen in patients with posterior circulation large‐vessel occlusion treated with EVT alone versus EVT after IVT. Further prospective studies are required to determine the utility of IVT in posterior circulation stroke, especially in patients being directly admitted to thrombectomy centers.

Background Mechanical thrombectomy has become the standard of care for treatment of acute ischemic stroke secondary to large‐vessel occlusion up to 24 hours from last known normal time. Multiple different techniques for mechanical thrombectomy have been described, including a direct aspiration first‐pass technique and stent retriever thrombectomy. With a direct aspiration first‐pass technique, classically, a large‐bore aspiration catheter is delivered over a microcatheter and microwire to the clot. Recently, a novel macrowire has been introduced as a potential alternative to the use of microwire–microcatheter to allow the delivery of the aspiration catheter. The aim of this study is to develop a multicenter registry comparing delivery of an aspiration catheter for intracranial thrombectomy for acute ischemic stroke secondary to emergent large‐vessel occlusion over a macrowire in comparison with traditional use of microcatheter and microwire. Methods MINT (Macrowire for Intracranial Thrombectomy) is a multicenter, observational study currently enrolling patients with large‐vessel occlusion who underwent mechanical thrombectomy using a macrowire to deliver the aspiration catheter to the intracranial occlusion. All the participating sites will screen and report cases on a monthly basis. The decision to use the macrowire and various aspiration catheters is at the discretion of the interventionalist. Results We will collect patient's clinical, demographic, and radiographic data. In addition, we plan to collect procedure variables and postprocedure clinical and imaging data. Outcomes include successful delivery of the reperfusion catheter to the clot interface, time taken from groin access to first pass, and a bailout strategy for thrombectomy in cases where this is not feasible. Conclusion The MINT registry will add to our understanding of safety and efficacy of this novel macrowire in intracranial thrombectomy. This registry will also highlight and allow for understanding in workflow improvements from simplifying setup and possibly cost effectiveness of this technique.

The presented work addresses the growing need for efficient and reliable DC microgrids integrating renewable energy sources. However, for the sake of practicality, implementing complex control strategies can increase system complexity. Thus, efficient methodologies are required to provide efficient energy management of microgrids while increasing the integration of renewable energy sources. The primary contribution of this work is to investigate the issues related to operating a DC microgrid with conventional control designed to power DC motors using readily available, non-advanced control strategies with the objective of achieving stable and reliable grid performance without resorting to complex control schemes. The proposed microgrid integrates a combination of uncontrollable renewable distributed generators (DGs) alongside controllable DGs and energy storage systems, including batteries and supercapacitors, connected via DC links. The Incremental Conductance (InCond) algorithm is employed for maximum power point tracking to maximize power output from the PV system. The energy management strategy prioritizes the solar system as the primary source, with the battery and supercapacitor acting as backup power sources to ensure overall system reliability and sustainability. The effectiveness of the microgrid under various operating conditions is evaluated through extensive simulations conducted using MATLAB. These simulations explore different power generation scenarios, including normal operation with varying load levels and operation under Standard Test Conditions (STC). Moreover, fault analysis of the DC microgrid is performed to examine system reliability. The system performance is evaluated using real-time simulation software (OPAL-RT) to validate the effectiveness of the approach under real-time conditions. This comprehensive approach demonstrates the efficacy of operating a DC microgrid with conventional controllers, ensuring grid stability and reliability across various operating conditions and fault scenarios while prioritizing the use of renewable energy sources. The results illustrated that system efficiency increases with load, but fault tolerance measures, can introduce trade-offs between reliability and peak efficiency.

Smart grid is a transformative advancement that modernized the traditional power system for effective electricity management, and involves optimized energy distribution by load forecasting. Precise load forecasting provides the best utilization of energy resources and increases sustainability. Dynamic changes of several connected factors, such as temporal and geographical variability, pose challenges to accurate load prediction. Integrating Artificial Intelligence (AI) in the smart grid can enhance the performance of the forecasting process by capturing these changes. This study investigated load forecasting tasks on four different datasets. Several preprocessing and augmentation techniques are applied to increase the data quality. An attention-based 1D-CNN-GRU model is proposed to capture the temporal patterns from the time-series data, and the hyperparameters of the model are optimized using a particle swarm optimization (PSO) algorithm that also accelerates the convergence and results in an efficient training session. Empirical evaluations highlight that the proposed model substantially minimizes the loss, reflecting the ability to make accurate predictions. It obtains MAE values of 0.12, 0.8, 16.48, and 82.64 for the four datasets. Moreover, the explainable AI (XAI) technique is applied using Shapley Additive explanations (SHAP) to interpret the model prediction, providing the feature ranking based on their prediction score. Moreover, this study utilizes federated learning, enables collaborative training, maintains the privacy of the grid data, and secures the process comprehensively. The aggregation mechanism in federated learning is modified using pruning-based methods that reduce the parameters and computational cost, resulting in a more efficient framework. Integrating all these approaches provides valuable insights for developing a load forecasting model and outlines potential contributions in the smart grid domain.

Until today, microbial infections epitomize a serious universal health threat. Subsequently, developing a potential antimicrobial prototype remains an urgent, global necessity. Despite several reports discussing the biological utility of some bis-thiazoles, the use of bis-dihydrazothiazoles and their corresponding metal chelates as potent antimicrobials, is yet to be explored. The current report outlines an attempt to fill that void by representing a successful synthesis of a new class of bis-dihydrazothiazoles as well as three of their transition metal chelates and their use as potential antimicrobials. This report presents the design of some novel hydroxy-tagged bis-dihydrazothiazoles 6a-e and bis-dihydrazothiazolones 9a-e via the reaction of a bis-aldehyde thiosemicarbazone 3, as a common synthetic precursor, with two groups of hydrazonoyl halide derivatives 4a-e and 7a-e. The chelation affinity of these novel bis-dihydrazothiazoles to behave as neutral tridentate ligands coordinating to the metal ions; Fe(III), Co(II), or Zn(II) through azomethine-N, thiazole-S, and azo-N atoms to form metal complexes with a metal/ligand ratio of 2:1 was confirmed. In-vitro, antimicrobial screening of the novel hydroxy-tagged bis-dihydrazothiazole derivatives, as well as a selected group of their transition metal chelate complexes [M2L], was inspected, and the data were measured in comparison to those of ketoconazole and gentamycin as antimicrobial reference standards. Most bis-dihydrazothiazoles 6a-e and bis-dihydrazothiazolones 9a-e showed decent to excellent antimicrobial activities against the screened microbes, but the chloro-substituted bis dihydrazothiazole derivatives 6c and 9c showed exceptional inhibition of Bacillus subtilis (20 mm), Escherichia coli (25 mm), and Candida albicans (19 mm), and Salmonella typhimurium (19 mm), respectively. Additionally, amongst the three synthesized metal complexes [M2L], only the zinc complex, [Zn2L] showed remarkable inhibition of both Staphylococcus aureus (21 mm) and Salmonella typhimurium (19 mm) compared to the reference standard Gentamycin, and was more potent than the free ligand, 6a itself (no activity and 11 mm respectively). Antimicrobial inspection was assessed by the agar well diffusion assay method against all bacterial and fungal strains. Magnetic moment, diffused reflectance, FT-IR, 1H NMR, molar conductivity, thermogravimetric analysis (TGA), X-ray diffraction (XRD), and scanning electron microscope (SEM) were among the many techniques used to elucidate the structures of all novel hydroxy-tagged bis-heterocyclic ligands and their metal chelate complexes.

Climate change is a significant global environmental issue that has attracted extensive research and debate. Consequently, the concept of sustainability in the context of aluminium encompasses multiple dimensions. Within the discussions surrounding waste and resource management, there is ongoing deliberation about the actual environmental advantages offered by material recycling. The high demand for raw materials has prompted researchers to explore sustainable recycling processes, with a particular focus on processing technologies. A comprehensive examination of these diverse methods is crucial for understanding three main techniques for aluminium forming: conventional recycling (CR), semi-direct recycling (SDR), and direct recycling (DR). Through a systematic review, it becomes evident that SDR and DR, which incorporate a forming process, present substantial environmental, energy, and cost benefits while promoting sustainability awareness in the manufacturing sectors. This extensive review also encompasses nine life cycle analysis (LCA) studies, comprising sixteen scenarios that have employed various methodologies to assess the environmental impact of managing waste aluminium through different approaches: recycling (melting and solid-state), incineration, or landfill. The outcomes of this comprehensive international review provide a more unbiased evaluation of the environmental effects associated with various wastes management systems. The majority of the studies indicate that recycling offers superior environmental solutions and fewer environmental effects compared to alternative waste green forming management options.

The underground water pipeline system is a crucial infrastructure that largely remains out of sight. However, it is the source of a clean and uninterrupted flow of water for our everyday lives. Various factors, including corrosion, material degradation, ground movement, and improper maintenance, cause pipe leaks, a silent crisis that causes an estimated 39 billion dollars of loss every year. Prompt leakage detection and localization can help reduce the loss. This research investigates the potential of two machine learning models as supporting tools for surveying extensive areas to identify and pinpoint the location of underground leaks. The presented combined approach ensures the speed and accuracy of the leakage survey. The first machine learning model is a hybrid ML model that employs thermal imaging to identify subterranean water leakage. It relies on detecting thermal anomalies and distinctive signatures associated with water leakage to identify and locate underground water leakage. The developed model can detect up to 750 mm underground leakage with 95.20 % accuracy. The second model uses binaural audio from geophones to localize the leakage position. The model utilizes interaural time difference and interaural phase difference for localization purposes, and the 1D-CNN network delivers an angle in twenty-degree increments with an accuracy of 88.19 %. Large-scale implementation of the proposed model could be a powerful catalyst to reduce water loss in the water supply system.

Salinity poses a significant threat to the floral plants. Melatonin has emerged as a potential phytohormone to cope with the adverse effects of salinity on plants due to its multifaceted roles in regulating abiotic stresses. The current study aimed to investigate the impact of melatonin on pansy by modifications in physiological indices under salinity stress. Pansy plants were subjected to salinity stress (0, 50, and 100 mM NaCl) and melatonin (control, 50, and 100 µM). Salinity-induced oxidative stress was apparent through enhanced generation of toxic substances. However, melatonin supplementation improved chlorophyll ‘a’, chlorophyll ‘b’, total chlorophyll, glycine betaine (GB), superoxidase dismutase (SOD), peroxidase (POD), catalases (CAT), and glutathione-reductase (GR), thus promoting improved growth under salinity. The activation of plant defense system and regulation of signaling molecules is indication of lessening of toxic substances within the plant cells. Current findings revealed that supplementation of melatonin enhanced pansy tolerance against salinity stress.

Lead (Pb), as heavy metal, poses substantial threats to plant health, impeding growth, disrupting nutrient uptake, and inducing oxidative stress. Its interference with crucial processes such as photosynthesis and water uptake, combined with its capacity to accumulate in plant tissues, results in stunted development and compromised overall productivity. To address this issue, the application of gibberellic acid (GA3) emerges as an effective amendment, promoting seed germination, stem elongation, and flowering. Additionally, the inoculation of rhizobacteria, specifically Agrobacterium fabrum (A. fabrum), offers resistance, improved nutrient uptake, and enhanced growth under conditions of heavy metal toxicity. Therefore, the present study was designed to investigate the impact of GA3 and A. fabrum on Solanum melongena L. cultivated under Pb toxicity. The experiment comprised four treatments: control, A. fabrum, 30 mg/L GA3 (30GA3), and A. fabrum + 30GA3, applied in four replications following a completely randomized design. Results indicated that A. fabrum + 30GA3 significantly enhanced Solanum melongena L. shoot and root length, fresh and dry weight over the control under Pb stress. Furthermore, a notable increase in Solanum melongena L. chlorophyll contents, stomatal conductance, transpiration rate, and photosynthetic rate over the control under Pb stress validated the effectiveness of A. fabrum + 30GA3. Additionally, improvements in N, P, and K concentration in roots and shoots confirmed the efficacious functioning of A. fabrum + 30GA3 from the control under Pb stress. In conclusion, A. fabrum + 30GA3 is recommended as an amendment for the mitigation of Pb stress in Solanum melongena L.