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Abstract Objectives We evaluated the epidemiology and clinical characteristics of colorectal polyps to formulate an appropriate screening program. Methods A retrospective chart review was conducted on all patients who underwent complete colonoscopy at Jordan University Hospital from January to September 2018. Demographics, comorbidities, lifestyle habits, medication history, family history of cancer, laboratory parameters, quality of bowel preparation, and polyp characteristics were evaluated. Binary logistic regression was utilized to find predictors of colorectal polyps. Results A total of 965 patients were included in the study, with a mean age of 53.9 ± 17.1 years and a male predominance (52.7%). Polyps were detected in 28.1% of patients, with 18% having one polyp, 10.4% having two polyps, and 3.3% having more than two polyps. Multivariate analysis demonstrated that older age, high BMI, male gender, diabetes mellitus, dyslipidemia, ischemic heart disease, and family history of CRC were positive predictors of polyps. The right colon (cecum and ascending colon) was the most common location for polyps (51%), followed by the sigmoid colon (24.8%). The most common histologic subtype of polyps was tubular adenoma (48.2%). The prevalence of CRC was 18.65 per 1000 patients. Conclusion We highlight the fair prevalence of colorectal polyps and CRC in a Jordanian cohort. Awareness campaigns, screening strategies, and promotion of healthy lifestyles could help alleviate the burden of the disease, particularly among patients with classical risk factors for CRC.

Abstract In the context of sustainable development, electric vehicles (EVs) and renewable-based distributed generation (RDG) integration into the distribution networks (DNs) introduce various merits. They involve lowering harmful emissions, employing various types of energy sources, and encouraging the dependence of renewable energy. However, the two most challenging issues posing a grave danger to the technical operation of the DN would be the inappropriate integration of RDGs and EVs. Consequently, in order to guarantee safe operation, distribution system operator (DSO) is responsible for precisely identifying two crucial terms, distributed generation hosting capacity (DG-HC) and electric vehicles hosting capacity (EV-HC). Despite an increase in the amount of research on HC approaches, there is still a remarkable research gap in the discussion of models that effectively combine demand response (DR), smart inverters (SI) Volt/VAR control, DG-HC, and EV-HC targets simultaneously. This study offers a hierarchical bi-level optimization HC framework depends on both dynamic tariff-based DR and SI Volt/VAR control. In the lower layer, Participating customers’ load curves and EV aggregators’ charging demands are optimally adjusted, on a forecast basis, based on the proposed dynamic tariff. Nonetheless, the suggested multi-objective function—which includes DG-HC, EV-HC maximization, and loss minimization—is optimized by the DSO at the upper layer based on all of these optimal load curves. To further support the proposed objective function, DR is mixed with the optimal Volt/VAR controlling offered by SIs. In addition, the role of grid-connected EVs (GCEVs) on DG-HC increase is revealed with both uncoordinated and coordinated charging schemes. To check the proposed approach robustness, three types of loads are considered. Through comparison with three other optimization approaches, the effectiveness of the equilibrium optimizer (EO) is demonstrated when it is employed to solve the proposed optimization scheme. The suggested planning approach is applied on both the IEEE 33-bus test system, and a real DN with 59 buses in Cairo, Egypt. Several significant conclusions are validated by the obtained results. First, the DG-HC assessment differs significantly depending on whether the EV charging demand is considered or not. Considering the EV integration in IEEE 33-bus, the mean value of the optimal DG-HC increased by more than 133% during the day. Secondly, the implementation of the proposed dynamic-pricing DR program in the IEEE 33-bus DN significantly improved both the DG-HC and EV-HC, named as the combined DG-EV-HC, with improvements of around 34% and 27% for DG-HC and EV-HC respectively. Finally, in IEEE 33-bus, the combined DG-EV hosting capacity was improved by approximately 49.2% regarding DG-HC and 61.2% regarding EV-HC, using the proposed synergistic DR-Volt/VAR control enhancement technique.

Abstract Background The present study aimed to critically revise the published literature on clinical outcomes and cost-effectiveness of Inspiris Resilia valve. Methods This work was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Full text research articles discussing clinical or cost-effectiveness aspects of Inspiris Resilia bioprosthesis published in English were included in this analysis. Studies were excluded if they weren’t exclusively conducted on patients submitted to surgical aortic valve replacement using the Inspiris Resilia bioprosthesis. Results The technical success rate was almost perfect in all studies. Reported complications included severe prosthesis-patient mismatch, reoperation, endocarditis, and paravalvular leak. In almost all studies, there were significant improvement of NYHA at the end of follow up as compared to baseline. In all studies, there were significant improvement of one or more hemodynamic parameters at the end of follow up as compared to baseline. Conclusions Surgical aortic valve replacement using Inspiris Resilia tissue valve appears to be safe and effective with low rate of aortic valve and systemic complications and mortality. Its performance appears to be equal to or better than many other bioprosthetic valves. As compared to mechanical valves, its use is suggested to be more cost-effective.

Abstract Biomedical researchers must often deal with large amounts of raw data, and analysis of this data might provide significant insights. However, if the raw data size is large, it might be difficult to uncover these insights. In this paper, a data framework named BioLake is presented that provides minimalist interactive methods to help researchers conduct bioinformatics data analysis. Unlike some existing analytical tools on the market, BioLake supports a wide range of web-based bioinformatics data analysis for public datasets, while allowing researchers to analyze their private datasets instantly. The tool also significantly enhances result interpretability by providing the source code and detailed instructions. In terms of data storage design, BioLake adopts the data lakehouse architecture to provide storage scalability and analysis flexibility. To further enhance the analysis efficiency, BioLake supports online analysis for custom data, allowing researchers to upload their own data via a designed procedure without waiting for server-side approval. BioLake allows a one-time upload of custom data of up to 500 MB to ensure that researchers avoid issues with data being too large for upload. In terms of the built-in dataset, BioLake applies reactive continuous data integration, helping the analysis pipeline to get rid of most preprocessing steps. The only pre-built-in dataset of BioLake in the first public version is TCGA-PRAD mRNA expression data for prostate cancer research, which is the primary focus of the development team of BioLake. In summary, BioLake offers a lightweight online tool to facilitate bioinformatic mRNA data analysis with the support of custom online data processing.

Abstract Background Osteoarthritis (OA) is a significant global health concern and is characterized by the degeneration of joint structures, leading to pain, stiffness, and functional limitations It is estimated that 654.1 million individuals are affected by osteoarthritis worldwide, with females, especially those older than 60 years of age, being the population most impacted. However, there remains a gap in understanding the awareness of knee osteoarthritis among specific populations, such as the Palestinian community in the West Bank, thus, highlighting the need for targeted research to address this health disparity. Methods A cross-sectional survey was conducted in the West Bank from August to September 2024. Participants were recruited from 11 cities and a validated questionnaire adapted from a previous study was used to collect the data. The reliability of the questionnaire was assessed using Cronbach’s alpha, yielding a value of standard alpha = 0.71, which is an acceptable value. The survey collected demographic data, clinical characteristics, knowledge of osteoarthritis risk factors, symptoms, and attitudes towards treatment options. R Statistical Software was used for data analysis, which included descriptive statistics, chi-square tests, and logistic regression to explore the relationships between demographic factors and osteoarthritis knowledge, whereby a p-value of ≤ 0.05 was set up as a significance level. Results A total of 725 valid responses were included in our study. Among the participants, 569 were female, predominantly aged 25 or younger (66%, n = 479), and 62% (n = 450) were single. Knowledge assessment revealed that 80% (n = 580) recognized knee osteoarthritis as a chronic disease, while only 51% (n = 369) understood its impact on joint involvement. The majority identified high BMI (87%, n = 632), advancing age (94%, n = 683), and previous knee injury (72%, n = 520) as risk factors, although only 42% (n = 306) acknowledged genetics as one. Most participants were aware of the management strategies, including analgesics (70%, n = 510) and physiotherapy (80%, n = 579). However, 66% (n = 478) scored low for overall knowledge regarding knee osteoarthritis. Conclusion This study emphasizes the critical importance of raising awareness and knowledge about osteoarthritis within the Palestinian community. Despite being widely known as a long-term issue, there are still noticeable gaps in the understanding of the joint impact, potential risks, and effective treatment methods for osteoarthritis. The use of informal sources highlights the importance of specific educational programs by healthcare providers.

Renewable-based distributed generation (DG) offers economic and environmental benefits, but integrating it into the distribution network (DN) poses technical challenges. Hosting capacity (HC) defines the maximum amount of DG that can be safely integrated into the DN without violating technical constraints, with various methods available to enhance the DN and increase HC. This article proposes an optimization-based demand response (DR) program using dynamic pricing to enhance the HC. A hierarchical bi-level optimization framework is developed for the DR program, where the upper level optimizes the hosting capacity depending on the optimal load profiles optimized in the lower level. Additionally, DR is combined with smart inverters’ (SIs) optimal Volt/VAR control to further improve the HC. The pelican optimization algorithm (POA) is employed to solve the optimization problem and is compared with four other optimization techniques, demonstrating its good performance. The proposed planning scheme is implemented on the IEEE 33-bus test system and a real DN consisting of 59 buses in Cairo, Egypt. The results show that applying DR alone can increase the average maximum HC value by 29.4%, while combining DR with optimal Volt/VAR control can achieve a 39.6% increase.

Abstract Background Wnt/β-catenin pathway has an important role in hepatocarcinogenesis. It has been involved in progression, growth, epithelial mesenchymal transition and metastasis of hepatocellular carcinoma (HCC). This pathway may represent a potential target for evolving treatment strategies. β-catenin gene (CTNNB1) has been identified as an important oncogene involved in hepatocarcinogenesis in previous trials to understand the pathogenesis of HCC. This study aimed to spot light on the role of Wnt/ β-Catenin and CTNNB1 gene mutation in HCC development and its relation with different clinicopathological features. Patients and methods This study was conducted on 121 HCC cases that were obtained from liver explants from pathology laboratory at Mansoura Gastroenterology center retrospectively in the period between 2006-2017. Tissue Microarray (TMAs) were prepared. β-Catenin and Wnt immunohistochemical (IHC) staining was performed on these blocks. Detection and scoring of CTNNB1 gene mutation were done by Chromogenic In Situ Hybridization (CISH). The relation between aberrant β-Catenin, Wnt2 IHC staining and CTNNB1 mRNA expression and different clinicopathological characteristics was studied. Results A significant association was detected between aberrent β-catenin IHC staining and larger tumor size (p = 0.011), multiple tumor nodules (p = 0.021), higher stages of the tumor (p = 0.03) and with presence of lymphovascular emboli (LVE) (p = 0.034). However, no significant association was detected with tumor site, presence of lymph node spread, distant metastasis, tumor necrosis, local recurrence and alpha-fetoprotein level. No significant association was seen between Wnt2 IHC staining with either tumor site, tumor size, number of tumor nodules, presence of LVE, tumor necrosis, tumor grade, TNM stage or presence of local recurrence. A significant association was seen between CTNNB1 mRNA expression and larger tumor size (> 5 cm) (p = 0.041), higher tumor stages (Stages III and IV) (p = 0.005) and presence of distant metastasis (p = 0.008).). No significant association between CTNNB1 mRNA expression and LVE, tumor necrosis, tumor grade or occurrance of local recurrence. Conclusion Aberrant β-catenin IHC staining and CTNNB1 gene mutation in HCC correlate significantly with tumor size, number of tumor nodules, tumor stage and presence of LVE. All of these items confer poor prognosis in HCC. A highly significant correlation was detected between CTNNB1 gene mutation and aberrant β-catenin expression in HCC cases.

Abstract This study evaluates the potential of ozonated corn starch (OCS) and ultrasonicated ozonated corn starch (USOCS) as adsorbents for patulin removal in buffer solutions. The results indicated that dual modification significantly altered the starch’s structure, introducing functional groups such as carbonyl and carboxyl groups, and increasing its surface area. These modifications led to enhanced patulin adsorption capacity. Adsorption efficiency was tested across different adsorbent doses (150 mg, 200 mg, 250 mg) and contact times (15, 30, 45, and 60 min). The highest removal efficiency of 92.5% was recorded for the 250 mg dose at 60 min, with USOCS showing superior performance compared to native corn starch and OCS. Kinetic studies revealed that the pseudo-second-order model provided the best fit for the adsorption process, indicating chemisorption as the dominant mechanism. The Langmuir and Freundlich isotherms were used to describe the adsorption behavior, with a maximum adsorption capacity (q max ) of 15.19 µg/mg and a Langmuir constant (K L ) of 54.00 L/µg for the 250 mg dose. Additionally, the modified starch demonstrated consistent adsorption performance at varying concentrations, with a favorable adsorption intensity (n > 1), supporting its potential for practical applications. These findings highlight the modified corn starch as an efficient, biodegradable, and low-cost adsorbent suitable for mitigating patulin contamination in food products, offering a sustainable alternative for improving food safety.

Abstract Edoxaban is an orally active inhibitor of activated factor X (FXa). Population pharmacokinetic (PK) and pharmacodynamic (PD) analyses were performed to characterize the PK and PK–PD relationships of edoxaban in pediatric patients to identify the covariates that may contribute to inter‐subject variability in PK and PD of edoxaban in pediatric patients, and to compare the PK and PD data between pediatric and adult patients. The pediatric PK of edoxaban was best described by a two‐compartment model with transit compartments, first‐order oral absorption, and linear elimination. The estimated glomerular filtration rate (eGFR), body weight, and post‐menstrual age were the significant covariates explaining variability in edoxaban PK among pediatric patients. A function based on renal maturation was applied to edoxaban clearance. The clearance for a 70 kg patient with an eGFR of 110 mL/min/1.73 m2 was estimated to be 42.9 L/h (CV ~ 31.8%). PK simulation showed that exposures across five pediatric age groups were comparable to that in adult patients receiving 60 mg once daily dose. The PK–PD relationship for anti‐factor Xa was best fit with an Emax (8.65 IU/mL) model with an EC50 of 631 ng/mL. The PK–PD relationships for activated partial thromboplastin time and prothrombin time were best fit with linear models (slopes of 0.0467, and 0.0415 s mL/ng, respectively). In addition, due to the small number of efficacy and safety events, an exploratory analysis did not detect a correlation between efficacy events (recurrent venous thromboembolism) or safety events (clinically relevant bleeding) and edoxaban exposure.

Abstract Chemical fungicides have been used to control fungal diseases like Sclerotinia sclerotiorum. These fungicides must be restricted because of their toxicity and the development of resistance strains. Therefore, utilizing natural nanoscale materials in agricultural production is a potential alternative. This work aimed to investigate the antifungal properties of a nanocomposite (nano-chitosan-coated, green-synthesized selenium nanoparticles) against the plant pathogenic fungus S. sclerotiorum. Chemical reduction was used to produce selenium nanoparticles from citrus peel extracts, and ionotropic gelation was used to produce chitosan nanoparticles. The nanocomposite has been produced using selenium nanoparticles stabilized by chitosan and cross-linked with sodium tripolyphosphate. Transmission electron microscopy, dynamic light scattering, X-ray diffraction, UV-VIS spectroscopy, and Fourier transform infrared spectroscopy were used to characterize all produced nanostructures. The in vitro antifungal activity and minimum inhibitory concentration of all bulk and nanostructures are investigated at (0.5, 1, 5, 10, 50, 100) ppm concentrations. Scanning electron microscopy was used to detect structural deformations in the fungal mycelium. The findings support the successful synthesis and characterization of all nanoparticles. Lemon peel extract produced smaller, more stable, and distributed selenium nanoparticles (42.28 ± 18.5 nm) than orange peel extract (85.7 ± 140.22 nm). Nanostructures, particularly nanocomposite, have shown a considerable increase in antifungal efficacy compared to bulk structures. At a minimum inhibitory concentration of 0.5 ppm, the nanocomposite exhibited 100% inhibitory activity. The nanocomposite with a concentration of 0.5 ppm exhibited the lowest average fungal biomass (0.32 ± 0.05 g) among all tested nanostructures. Fungal hyphae treated with 0.5 ppm of nanocomposite within 18 h of treatment revealed substantial damage and deformation. These results provide new insights into the nanocomposite as an eco-friendly and promising antifungal agent against other plant pathogenic fungi.

Abstract Background Sudden cardiac death (SCD) is a leading cause of cardiovascular-related deaths, often occurring outside hospitals in undiagnosed individuals. Our study aims to assess the baseline awareness and skills in performing CPR among the population in Palestine. Methods A cross-sectional study was conducted using an online questionnaire to assess CPR knowledge among residents of the West Bank, Palestine. Convenience sampling targeted 300 participants via social media. Data were analyzed using descriptive statistics and chi-square tests to examine associations. Results The study surveyed 555 participants, revealing that 58.2% lacked CPR training. Awareness of cardiac arrest signs varied, with chest pain being the most recognized 19%. CPR training significantly improved participants’ recognition and response to cardiac emergencies. Conclusion Addressing the fear of legal consequences is crucial to encourage bystander assistance. We recommend increasing first aid awareness through scientific conferences, free training courses, media campaigns, and incentivized competitions.

Recently, the demand for alleviating the environmental impact triggered by shipping industry is continuously on the rise. To meet the aspired expectations in terms of fuel consumption and emission levels, ships have to adhere to and comply with the effective regulations and design recommendations set by Ship Energy Efficiency Management Plan (SEEMP) and Energy Efficiency Design Index (EEDI). The current work seeks to assess the degree and volume of difference made in ship operation after the full implementation of such operational and technical measures both quantitatively and qualitatively. Extensive analysis and measurements are conducted considering 3 phases for a VLCCs. Phases 1 and 2 involved the case of an existing VLCCs prior to and post enforcing SEEMP. Comparably, phase 3 traces the development and installation of innovative energy efficient technologies for a new VLCCs onboard of which both of SEEMP and EEDI are applied. Fuel consumption, CO2 emissions, and EEOI have, respectively, decreased at phase 3 by 82.6 %, 66.8 %, and 71.5 % compared to their counterparts obtained for phase 1. Moreover, ship overall performance for phase 3 has increased by 46.6 % compared to its peers recorded for phase 2. Apparently, SEEMP and EEDI have brought about significant reductions in the accumulation of Greenhouse Gases (GHGs) and provided a real momentum for the efforts towards a greener maritime world.

Abstract The current work looks at the inhibitory effects of a diolefinic dye, namely 1,4-bis((E)-2-(3-methyl-2,3-dihydrobenzo[d]thiazol-2-yl) vinyl) benzene iodide salt, in relation to CS corrosion mitigation in hydrochloric acid (HCl) environment. This study uses a variety of experimental methodologies, including weight loss (WL) analysis, electrochemical tests, and theoretical considerations. The synergistic effect of diolefinic dye and AgNPs on the corrosion inhibition of CS in 1 M HCl was investigated. The inhibition efficiency (IE) displays a notable enhancement as the concentration of the dye is elevated and as the temperature raises the IE increases. The diolefinic dye exhibited % IE of 83% even at low concentration (1 × 10–4 M) whereas 90% in the presence of (2.26 × 10–10) AgNPs. Tafel graphs demonstrate that the dye follows a mixed type inhibitor. The adsorption of the dye on CS surface follows Langmuir model. Moreover, the influence of temperature and the activation parameters disclose that diolefinic dye is chemisorbed on the CS surface. The synergistic coefficient of the diolefinic dye and AgNPs under various concentration conditions was greater than unity. The surface morphology of CS sheets was confirmed by scanning electron microscopy (SEM) and energy dispersive X-ray analysis (EDX). Density Functional Theory (DFT) calculations provide theoretical support for the inhibitory effects of the examined dye. Notably, there is a high agreement between the findings of practical studies and theoretical expectations.

To enhance the health and performance of poultry, novel approaches have to be created. Using appropriate nutritional interventions to enhance body physiology and thus enhance productivity is one of these approaches. The purpose of the present investigation intended to examine how growing quail physiology and growth is affected by supplementing diets with tryptophan (Trp) and/or canthaxanthin (CX). The sum of 200 unsexed, 1-week-age Japanese quails (Coturnix coturnix japonica), with a nearly similar body weight (BW) of 33.50 ± 1.20 g, were assigned, in random, to four experimental groups. Each group consisted of five replicates, with 10 birds per replicate. Chicks in group 1 (T1) served as the control and were fed a basal diet without any supplementation from week 1 to week 5. The second (T2) and third (T3) groups received feed supplemented with 0.01 % Trp and 0.005 % CX, respectively. The fourth group (T4) was given a diet containing a combination of 0.01 % Trp and 0.005 % CX. Results indicated that supplementation with Trp, CX, or their combination significantly (P < 0.05) enhanced live BW and body weight gain (BWG) at 5 weeks. No noticeable variations in carcass characteristics were found across all treatments over the whole trial duration. Blood levels of high-density lipoprotein were considerably greater in the Trp and/or CX-fed group than in the control group. Adding Trp and/orCX to quail diets significantly (P < 0.05) decreased the activity of liver enzymes (alanine transaminase, ALT; aspartate transaminase, AST; alkaline phosphatase, ALP), along with reduced low-density lipoprotein (LDL) levels. Birds received diets with Trp and/or CX had higher values of antioxidant indices in serum and liver (P < 0.05), accompanied by low values of malondialdehyde compared to control group. We concluded that adding quail diet with Trp and/orCX had positive consequences on the growth performance and some physiological indices.

Abstract Background Kidney transplantation for chronic kidney disease (CKD) in children is the best treatment option. It needs special medical and surgical expertise highly skilled in management of pediatric age group. Our Egyptian profile for causes of end-stage renal failure (ESRF) in transplanted children reflects prevalence of inherited kidney diseases IKD (43%), urologic causes (26%), glomerulonephritis (GN) (17%), and unknown causes (14%). Renal graft availability remains a great challenge. Aim We need pediatric kidney transplantation (PKT) guideline since children have unique causes for ESRF compared to adults. Their transplant team should be skilled in management of children challenges. Recipients may not have one transplant per life. Long-standing immunosuppression will have its toxicity and need regular monitoring. Lots of data are extracted from adult guidelines lacking paediatric background. Young paediatric nephrologists need short version guidelines rich in educational figures for management plans. Children and their families need Arabic orientation booklets and supportive programmes. National Insurance System sponsors should be guided by National Pediatric Guidelines to minimize the centre’s variations. Methods Our National Pediatric Guidelines are evidence based adapted from international four source guidelines with permissions [KDIGO-2020, RA/BTS 2022-2018, EAU 2018] that were appraised with Agree 2 plus tool using PIPOH format health questions. We followed the ‘adapted ADAPTE’ CPG formal adaptation methodology that consists of three phases and 24 steps and tools. It was registered on the practice guideline registration international guideline registry with a registration number IPGRP-2023-12-27 CN 312. Results Summary includes recommendations for assessment of (1) potential living adult donors for age, medical, surgical, immunologic, familial, metabolic, malignancy, and any donor morbidities and (2) transplant recipient assessment for age, weight, nutritional, psychosocial, immunological, infection states, primary native kidney disease, associated morbidities, the presence of genetic, immunologic, infection, and malignancy risks. Conclusion Pediatric kidney transplantation guidelines aim for better donor, recipient, and graft survival. Recommendations are tailored as adopted or adapted statements from evidence-based source guidelines to suit our local pediatric CKD profile.

Abstract Background Chronic migraine is a debilitating neurological condition that significantly impairs both individual and socioeconomic outcomes. The aim of the present study was to estimate the remission rates of chronic migraine to episodic migraine, and to identify potential predictors of chronic migraine remission. In addition, to assess impact of chronic migraine remission on headache related disability. Results Out of 300 individuals with chronic migraine (CM) who attended to our institution and continued for follow up in the period from the 1st of January 2021 up to the end of December 2022, approximately 82 cases (27.3%) had remitting CM, while 117 cases (39.0%) had persistent CM, and 101 cases (33.7%) had transitional CM. On multivariate model for detection of potential predictors of CM remission revealed that patients with lowest headache frequency (15–19 frequency/month) were much more likely to remit (OR = 577.826, 95% CI: 15.259 to 21,881.228, P = 0.001) than those with high-frequency CM (25–30 frequency/month), patients with non CM with allodynia (0–2) were more likely to remit (OR = 139.374, 95% CI: 4.634 to 419.879, P = 0.004) compared to those with moderate to severe CM with allodynia (≥ 6). Additionally, those using Topiramate or beta-blockers were more likely to achieve remission (OR = 23.325, 95% CI: 3.289 to 165.400, P = 0.002, and OR = 34.205, 95%CI: 3.591 to 325.842, P = 0.002, respectively), and also non-smokers were 11 times more likely to achieve remission compared to smokers (OR = 11.370, 95% CI: 1.702 to 75.934, P = 0.012). Conclusion These findings identified several potential predictors of remission among patients with chronic headache. However, the majority of these prognostic factors are modifiable.

Abstract Background Magnetic resonance angiography (MRA) is rapidly being employed as an effective substitute for CTA, particularly in situations of poor kidney function. We aimed to examine the inter-observer and inter-modality reliability of non-contrast MR angiography (NC-MRA) and CTA as a non-invasive tool for assessing the anatomical findings of potential living kidney donors. Results All potential donors were referred from specialized kidney transplantation center and underwent NC-MRA of the renal arteries using a respiratory-triggered magnetization prepared 3D balanced steady-state free precession (b-SSFP) with inversion recovery pulses and fat saturation (Inhance 3D Inflow Inversion Recovery (IFIR)). Two experienced radiologists reviewed NC-MRA images and were asked to evaluate both renal arteries anatomy and their branching pattern, presence of accessory or aberrant renal arteries, and identify any anatomical variant. Lin’s correlation test was performed to test MRA readings by each of the two observers against CTA findings which considered as the gold standard for assessment of renal arteries. Additionally, observers were asked to assess the image quality. The study included 60 potential kidney donors (43 males and 17 females) with mean age ± SD of 31.3 ± 5.6 years. Excellent to very good inter-observer agreement was found between both observers in the assessment of renal arteries by NC-MRA. There was perfect concordance between MRA and CTA findings in detecting early arterial division, caliber, and length of left extra-parenchymal segmental branches. Moderate concordance was found in the assessment of the supplied segments of extra-parenchymal segmental renal arterial branches and substantial concordance between both MRA observers’ findings in the remaining variables of the study. There was excellent agreement between both observers in the assessment of image quality parameters. Conclusions NC-MRA for the renal arteries is an effective alternative for CTA without the risks of radiation or contrast media.

This innovative study investigates the flow of ternary hybrid nanofluid containing gyrotactic microorganisms in microchannel. The magnetic field, thermophoresis, and Brownian motion effects are analyzed. The transformation of the PDEs system into ODEs is carried out by using the group transformation method. The innovative findings examine the Newtonian and non-Newtonian models derived from the system of ODEs. Several graphs illustrate how different parameters affect the velocity profile, temperature, concentration, and microorganisms. The power-law index value increases the fluid flow velocity by about 9% at n = 3, 36% at n = 4 relative to the case of n = 2.5 at the center of the boundary layer. Moreover, the ternary hybrid nanofluid exhibits a greater temperature compared to the nanofluid. The current results are compared to the researchers' findings to confirm the validity of the obtained results. When the Prandtl number is between 6 and 10, the Nusselt number reaches 45.49%.

Abstract Most of the conditions involving cartilaginous tissues are irreversible and involve degenerative processes. The aim of the present study was to fabricate a biocompatible fibrous and film scaffolds using electrospinning and casting techniques to induce chondrogenic differentiation for possible application in cartilaginous tissue regeneration. Polycaprolactone (PCL) electrospun nanofibrous scaffolds and PCL film were fabricated and incorporated with multi-walled carbon nanotubes (MWCNTs). Thereafter, coating of chondroitin sulfate (CS) on the fibrous and film structures was applied to promote chondrogenic differentiation of human dental pulp stem cells (hDPSCs). First, the morphology, hydrophilicity and mechanical properties of the scaffolds were characterized by scanning electron microscopy (SEM), spectroscopic characterization, water contact angle measurements and tensile strength testing. Subsequently, the effects of the fabricated scaffolds on stimulating the proliferation of human dental pulp stem cells (hDPSCs) and inducing their chondrogenic differentiation were evaluated via electron microscopy, flow cytometry and RT‒PCR. The results of the study demonstrated that the different forms of the fabricated PCL-MWCNTs scaffolds analyzed demonstrated biocompatibility. The nanofilm structures demonstrated a higher rate of cellular proliferation, while the nanofibrous architecture of the scaffolds supported the cellular attachment and differentiation capacity of hDPSCs and was further enhanced with CS addition. In conclusion, the results of the present investigation highlighted the significance of this combination of parameters on the viability, proliferation and chondrogenic differentiation capacity of hDPSCs seeded on PCL-MWCNT scaffolds. This approach may be applied when designing PCL-based scaffolds for future cell-based therapeutic approaches developed for chondrogenic diseases.

Abstract Background Magnetic resonance imaging (MRI) quantification of intramuscular fat accumulation is a responsive biomarker in neuromuscular diseases. Despite emergence of automated methods, manual muscle segmentation remains an essential foundation. We aimed to develop a training programme for new observers to demonstrate competence in lower limb muscle segmentation and establish reliability benchmarks for future human observers and machine learning segmentation packages. Methods The learning phase of the training programme comprised a training manual, direct instruction, and eight lower limb MRI scans with reference standard large and small regions of interest (ROIs). The assessment phase used test–retest scans from two patients and two healthy controls. Interscan and interobserver reliability metrics were calculated to identify underperforming outliers and to determine competency benchmarks. Results Three experienced observers undertook the assessment phase, whilst eight new observers completed the full training programme. Two of the new observers were identified as underperforming outliers, relating to variation in size or consistency of segmentations; six had interscan and interobserver reliability equivalent to those of experienced observers. The calculated benchmark for the Sørensen-Dice similarity coefficient between observers was greater than 0.87 and 0.92 for individual thigh and calf muscles, respectively. Interscan and interobserver reliability were significantly higher for large than small ROIs (all p

This study investigated the influence of lactoferrin (LF) and N-acetylcysteine (NAC) on the growth rate and immune response of Egyptian Baladi goats. Thirty-five goat kids (2.765 ± 0.135) were comprised seven groups, each with five individuals. The control group received neither LF nor NAC. The subsequent groups received daily doses at 50 mg, 100 mg, or 200 mg NAC. Similarly, the other groups were administered LF at 50 mg, 100 mg, or 200 mg per day. Biweekly assessments were used to measure the weight and daily weight gain (DWG) of the offspring. Additionally, blood samples were collected every 20, 40, and 60 days post-treatment for hemoglobin, total leukocyte counts, and subtypes. Additionally, blood serum was analyzed for total protein, albumin, globulin, creatinine, and alanine aminotransferase levels. The findings showed significant enhancements in the DWG, hemoglobin concentration, total leukocyte count, and various white blood cell types in the groups treated with LF and NAC compared to those in the control group. Notably, the group receiving LF at 200 mg/ml exhibited the most significant improvements with control and other level of LF. LF at 50 mg/ml/day resulted in higher total protein, albumin, and creatinine levels than did both the control and the other treatments with similar dose of 50 mg/mg/day of NAC. Administration of either LF or NAC notably enhanced the growth rate and blood parameters compared to those of the control group. In conclusion, our findings underscore the potential of daily LF and NAC administration during the weaning phase for Egyptian Baladi goat kids to enhance their immune response and accelerate their growth rate.

The present study aimed to evaluate the effect of dry turmeric rhizomes on in vitro biogas production and diet fermentability. Turmeric rhizomes were included at gradually increased levels: 0, 0.5, 1, 1.5 and 2% of a diet containing per kg dr matter (DM): 500 g concentrate feed mixture, 400 g berseem hay and 100 g rice straw, and incubated for 48 h. Gas chromatography-mass spectrometry analysis showed that ar-turmerone, α-turmerone and β-turmerone were the major bioactive compounds in the rhizomes. Turmeric rhizomes increased (p

An extended version of (3+1)-dimensional non-linear Schrödinger equation that has a cubic–quintic nonlinear component under the stochastic effects is examined in this investigation. Several stochastic exact solutions of this model is acquired through the application of the improved modified extended tanh-function scheme (IMETFS). This method offers a practical and effective approach to finding precise solutions to several kinds of nonlinear partial differential equations. In addition, these solutions include stochastic soliton solutions (bright, singular, combo dark-singular), and exact solution such as singular periodic, Jacobi elliptic function, Weierstrass elliptic doubly periodic solution, rational, and exponential functions. Since it is the first study of its sort to examine multiplicative white noise’s impacts in this particular setting, it offers fresh insights and innovative research approaches for the field’s future studies. The work adds much to our understanding of soliton theory and how it relates to optical fiber technology while illuminating hitherto unknown facets of multiplicative white noise. To illustrate the impact of the noise, a few recovered solutions with varying noise strengths are given graphically as examples.

This study aimed to evaluate the nutritive value of different vegetative parts of Moringa oleifera (leaves, stems and plant debris) and Leucaena leucocephala (leaves and dried pods after seed harvesting). Nutrient composition, secondary metabolites and kinetics of gas production (GP) from in vitro rumen fermentation were measured to investigate the adequacy of these materials as feed resources for ruminants. Leaves of M. oleifera had the highest (p

Abstract Dyeing using supercritical carbon dioxide (SC-CO2) is carried out on the polypropylene (PP) nanocomposite fabrics with model disperse dye compared with their regular fabric at various dyeing temperatures and pressures. The results are compared with those obtained in aqueous dyeing method. The PP nanocompsite fabrics dyed in SC-CO2 medium exhibited higher colour strength (K/S) values compared with their PP regular fabric. The PP nanocompsite fabrics and their regular fabric dyed in SC-CO2 medium have higher K/S values than those dyed in aqueous medium. The color coordinates of all PP fabrics dyed in SC-CO2 and aqueous medium were positive with respect to a* and b* coordinates depending on the disperse red dye uptake. The PP nanocomposite fabrics dyed in SC-CO2 and aqueous medium exhibited higher antibacterial properties than their regular fabrics. All PP fabrics dyed in SC-CO2 and aqueous medium present very good washing, perspiration and light fastness.

Background and Aims: Postoperative pain after hip surgeries in children could be classified as severe, requiring combined intra- and postoperative opioid analgesia with regional blocks. This study was carried out to investigate ultrasound-guided pericapsular nerve group (PENG) block versus ultrasound-guided erector spinae plane (ESP) block for pain management after paediatric hip surgery. The primary objective was to assess the time of the first request for morphine rescue analgesia. Methods: In this randomised study, 56 children scheduled for elective unilateral hip surgery were distributed randomly to ESP and PENG groups. Intraoperative haemodynamics, fentanyl consumption, postoperative pain measurement, morphine consumption, time of first rescue analgesia, adverse effects and parents’ satisfaction score were studied. The primary outcome was the time of the first request for morphine rescue analgesia. The Chi-square test, Student’s t-test and the Mann–Whitney U test were used, where applicable, to compare the groups. Results: The time to first rescue analgesia was significantly longer in Group ESP than in Group PENG (P < 0.001), with significantly higher postoperative morphine consumption in Group PENG than in Group ESP (P = 0.04). The pain scores of Group ESP were lower than those of Group PENG at 2 and 4 h postoperatively (P = 0.006 and P < 0.001, respectively). At 8 h postoperatively, the score was significantly higher in Group ESP than in Group PENG (P = 0.005). Other outcomes were comparable between both groups (P > 0.05). Conclusion: ESP and PENG could be both effective for intraoperative and postoperative analgesia in paediatric hip surgeries, but the ESP block prolonged the time of first rescue analgesia more than the PENG block.

Abstract Background Sepsis is an infection-related systemic inflammatory response that often leads to elevated lactate levels. Monitoring lactate levels during severe sepsis is vital for influencing clinical outcomes. The aim of this study was to assess the association between plasma lactate levels and mortality in children with severe sepsis or septic shock. Methods The current prospective study was conducted in the PICU of University Children’s Hospital. The International Paediatric Sepsis Consensus Conference criteria for Definitions of Sepsis and Organ Failure in 2005 were used to diagnose patients with sepsis. We measured plasma lactate levels upon admission (Lac H0) and 6 h later (Lac H6). The static indices included the absolute lactate values (Lac H0 and Lac H6), while the dynamic indices included the delta-lactate level (ΔLac) and the 6-hour lactate clearance. The 6-hour lactate clearance was calculated using the following formula: [(Lac H0–Lac H6)100/Lac H0]. ΔLac was calculated as the difference between the Lac H0 and Lac H6 levels. Patient survival or death after a PICU stay was the primary outcome. Results A total of 46 patients were included in this study: 25 had septic shock, and 21 had severe sepsis. The mortality rate was 54.3%. The Lac H0 did not significantly differ between survivors and nonsurvivors. In contrast, the survivors had significantly lower Lac H6 levels, higher ΔLac levels, and higher 6-hour lactate clearance rates than nonsurvivors. Lactate clearance rates below 10%, 20%, and 30% were significantly associated with mortality. The best cut-off values for the lactate clearance rate and Lac H6 for the prediction of mortality in the PICU were

Abstract We assessed university students’ knowledge, attitude, and practice toward blood donation and identified the factors that promote or hinder their willingness to donate. We employed a multicenter cross-sectional design, collecting data from August to October 2022 through self-administered questionnaires available in Arabic and English. Both online (Google Forms) and paper surveys were utilized. Data were analyzed using R Statistical Software (v4.1.3; R Core Team 2022). A total of 12,606 university students (7966 females and 4640 males) from 16 countries completed the questionnaire; of them, 28.5% had a good knowledge level regarding blood donation, and 22.7% had donated blood at least once. Students in health science colleges had significantly more awareness of blood donation (p-value 20 years had significantly higher odds of possessing a high knowledge level (adjusted odds ratio [aOR] 1.77, p 20 years old were more likely to donate (aOR 2.21, p

Background: Multiple sclerosis (MS) MS is a demyelinating and neurodegenerative inflammatory disorder of the brain and the spinal cord that is one of the most frequent neurological disorders at a young age. Several MS centers have established MS registries to estimate the prevalence of the disease in the general community and to investigate the clinical characteristics of MS patients. Objectives: Determining the demographic and clinical patients with MS referred to Qena University Hospital. Patients and methods: In a descriptive cross-sectional study on thirty patients clinically diagnosed to have MS according to 2017 McDonald criteria were included. They were diagnosed in the neuropsychiatry department from November 2018 to April 2020. Results: There were 17 (56.6%) females, 13 (43.3%) males, the mean age was 31.65 (± 8.08 SD), the mean duration of illness was 58.98 (± 44.78 SD). Conclusion: This is the first MS register from the governorate of Qena. The clinical features of MS in Qena are comparable to those seen in other Arab and Western countries. Females are more likely to develop MS than males, and visual symptoms were the most frequent manifestations. Our results also illustrate the importance of developing registries in Egypt so that the clinical path of the disease can be studied prospectively.

Purpose: Methicillin-resistant Staphylococcus aureus (MRSA) infections are emerging as a cause of suppurative thyroiditis. The resistance to several antibiotics and finding treatment has grown more difficult. Hence, the purpose of this study was to examine biosynthesized iron oxide nanostructures’ antimicrobial activity as well as their cytotoxicity on normal and thyroid cancer cells. Methods: By using the sugar alcohols of Cystoseira sp., the authors synthesized the advanced biosynthesis of iron oxide nanoparticles (COINs). An agar-well diffusion method and a broth dilution method were used to investigate COINs’ antimicrobial activity against MRSA isolates. However, their cytotoxicity against normal and thyroid cancer cell lines was determined by the MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) assay. Results: A GC–MS analysis of the dried Cystoseira sp. extract revealed a high percentage of D-mannitol, which is essential for the synthesis of spherical nanoparticles with a mean average size of 5.8 ± 0.8 nm. The COINs showed a higher inhibition zone (9–15 mm) for 66.6 % of MRSA isolates, and the MIC of COINs was 256 μg/ml. The cell wall of these bacteria inhabits the absorption of COINs. As a result, a large concentration of COINs is required to restrict bacterial growth. Moreover, COINs have cytotoxicity on thyroid cancer cell proliferation and normal thyroid cell lines at IC50s of 1.71 ± 0.1 and 25.9 ± 1.6 μg/ml, respectively. This can be due to the negative charge of sugar alcohols, which affect protein absorption and subsequent biological behaviors. Conclusion: The promising findings of this study are in favor of the creation of very small iron oxide nanostructures for therapy.

In this paper, four new mono-nuclear Ni(II), Pd(II), Pt(II) and Zn(II) complexes were prepared by using a bi-dentate Schiff base ligand, (E)-2-(((4-bromo-2,6-dichlorophenyl)imino)methyl)-5-chlorophenol (BrcOH), with bivalent ions in a methanol and distil water mixture as solvent in presence of NaOH as base. The structures of the prepared compounds were characterized by spectroscopic techniques (IR and 1H NMR), CHN analysis, and molar conductivity. The M(II) (Ni, Pd and Pt) ions are four-coordinated by a bi-dentate N2O2 donor ligand, forming square planar geometry, whereas the Zn(II) is coordinated as a tetrahedral geometry. The newly synthesized compounds, which include the Schiff base ligand and its complexes, underwent antibacterial screening against E. coli and S. aureus. The results demonstrated a remarkable and noteworthy biological activity of these compounds against these pathogenic bacterial strains. Different binding energies showed good correlation, with Pd showing the strongest binding. Small energy differences indicated high reactivity, with Ni and Pd complexes being the most reactive. Electrophilicity index exhibited electron-accepting properties, with Zn showing the highest reactivity. The dipole moments showed polarity and charge separation, with Pt having the highest polarity. We evaluated the pharmacokinetic properties (ADME) of a ligand and its metal complexes using the Swiss ADME website. The results of the in-silico prediction of physicochemical properties revealed that ten compounds in total adhered to Lipinski's rule.

We introduce a novel technique for efficiently cooling many-body quantum systems with unknown Hamiltonians down to their ground states with a high fidelity. This technique involves initially applying a strong external field followed by a sequence of single-degree-of-freedom (single-qubit) measurements and radio frequency pulses to polarize the system along the field direction. Subsequently, the field is adiabatically switched off, allowing the system to evolve toward its ground state as governed by the quantum adiabatic theorem. We present numerical simulation results demonstrating the effectiveness of the technique applied to quantum spin chains with long-range and short-range interactions as prototypes for many-body quantum systems.

Ensuring the safety of drugs is a critical aspect of healthcare. Accurate interpretation of drug safety evidence is vital to understand the safety profile and to evaluate the benefits and risks of the medicinal product. However, validity of this evidence has numerous challenges that must be carefully considered, highlighting the need for a heightened appreciation of data interpretation pitfalls. This paper aims to delve into the intricacies of analytic considerations in drug safety data interpretation aiming at providing insights into the safety profile of pharmaceutical interventions. The applicability of these analytic considerations extends to controlled and observational data as well as spontaneously reported individual case reports. Increasing the understanding of scientific underpinnings of evidence interpretation empowers Pharmacovigilance professionals to grasp fundamental concepts, use appropriate terminology, engage in meaningful discussions with colleagues conducting analyses, and critically evaluate evidence. These skills and knowledge enable them to make informed decisions and enhance their expertise in drug safety. By correct utilization of analytic approaches while appreciating their strengths and limitations, one can advance drug safety and benefit-risk research using evidence-based decision-making and ultimately ensure better healthcare outcomes for patients.

Abstract Background and objectives Alterations of hemostasis in patients with decompensated cirrhosis are complex. Accordingly, standard coagulation tests are not feasible to evaluate bleeding risk in these patients. The aim of this study was to assess the coagulation kinetics in cirrhotic patients with variceal bleeding using rotational thromboelastometry (ROTEM). ROTEM including EXTEM, INTEM, and FIBTEM which represent extrinsic, intrinsic pathways, and fibrinogen activity, respectively, was measured in 60 cirrhotic patients with variceal bleeding who were compared to 60 patients with stable cirrhosis. APTEM was optionally performed to evaluate fibrinolysis. Results Overall, cirrhosis patients displayed features of hypofibrinolysis, whereas the state of hypocoagulability was significantly higher in cirrhotic patients with variceal bleeding (61.7% versus 30%, p = 0.001). Values of clot formation time (CFT) by EXTEM and INTEM correlated positively with those of model for end-stage liver disease score (r = 0.529, p = 0.001, and r = 0.595, p

Abstract Objective With potential therapies for many forms of Charcot‐Marie‐Tooth disease (CMT), responsive outcome measures are urgently needed for clinical trials. Quantitative lower limb MRI demonstrated progressive calf intramuscular fat accumulation in the commonest form, CMT1A with large responsiveness. In this study, we evaluated the responsiveness and validity in the three other common forms, due to variants in GJB1 (CMTX1), MPZ (CMT1B) and MFN2 (CMT2A). Methods 22 CMTX1, 21 CMT1B and 21 CMT2A patients and matched controls were assessed at a 1‐year interval. Intramuscular fat fraction (FF) was evaluated using three‐point Dixon MRI at thigh and calf level along with clinical measures including CMT examination score, clinical strength assessment, CMT‐HI and plasma neurofilament light chain. Results All patient groups had elevated muscle fat fraction at thigh and calf levels, with highest thigh FF and atrophy in CMT2A. There was moderate correlation between calf muscle FF and clinical measures (CMTESv2 rho = 0.405; p = 0.001, ankle MRC strength rho = −0.481; p

Abstract Background Acacia species are economically significant as medicinal plants that have been utilized since ancient times. Acacia modesta has been reported to possess potent antibacterial and antioxidant properties, but its growth rate is slow. In this study, we hypothesized that inducing callus in vitro from A. modesta could enhance the production of antibacterial and antioxidant secondary metabolites, thereby circumventing the issues of slow growth and excessive harvesting of the plant. Results The callus was induced from axillary buds on MS medium supplemented with 1 mg/L of 2,4-D and 1 mg/L of BAP. The secondary metabolites, volatile compounds, antibacterial activity, and antioxidant activity of the callus and parent plant leaf extracts were evaluated. The results revealed that the content of phenolics and flavonoids, the number of volatile compounds, and the antibacterial and antioxidant activities of the callus extract were significantly enhanced (P ≤ 0.05) compared to the leaf extract. The antibacterial and antioxidant effects were strongly correlated with the total phenolic and flavonoid content in the extracts. Conclusions Our findings suggest that in vitro callus culture increases the production of phenolics, flavonoids, and volatile compounds. This subsequently enhances the antibacterial and antioxidant properties of A. modesta.

Abstract Background Stress and dissatisfaction are common issues among patients undergoing in vitro fertilization (IVF). The process of IVF can be emotionally and psychologically challenging, leading to stress, anxiety, and depression in patients. This can be exacerbated by factors such as the length of infertility, the uncertainty of the outcome, and the financial burden of treatment. Additionally, the physical demands of the treatment, the side effects of medication, and the fear of failure can contribute to dissatisfaction and emotional strain in IVF patients. This pre-post intervention study design aimed to evaluate the effect of a health education program on knowledge, stress, and satisfaction among 100 infertile women undergoing IVF attending the Woman’s Health Hospital’s infertility outpatient clinic and IVF unit at Assiut University. Knowledge and stress were measured by women’s knowledge about IVF and the perceived stress scale, respectively. The satisfaction was measured using the Scale of Patient Satisfaction about IVF. Results There is a marked improvement in the knowledge of infertile women, with a significant reduction in their stress levels after the health education program. Furthermore, the satisfaction scores of the women who participated in the program improved significantly. Conclusion The health education program demonstrated a positive impact on knowledge, stress levels, and satisfaction among infertile women undergoing IVF. These findings highlight the positive impact of the program on the participants and emphasize the importance of continuous educational programs regarding IVF to improve knowledge, decrease stress levels, and increase their overall satisfaction with the treatment.

The excessive integration of renewable distributed generation (RDG) and electric vehicles (EVs) could be considered the two most problematic elements representing the greatest threat to the distribution network (DN) technical operation. In order to avoid going beyond technical limitations, the term hosting capacity (HC) was proposed to define the highest permitted amount of distributed generation (DG) or EVs that can be integrated safely into the DN. The connection of RDGs was first brought to the attention of researchers and DN operators since it accounts for the most notable portion of these technical issues. Hence, the phrase ‘DG-HC’ was initially proposed and evolved significantly over the last few years. Currently, EV integration in most DNs worldwide is still low, but given the worldwide support for clean transportation options, expectations are raised for a significant increase. As a result, it is anticipated that over the next years, the effect of EV integration on the DN will be highly noticeable, requiring greater attention from researchers and DN operators to define the accepted limits of EV penetration levels, ‘EV-HC,’ which is expected to pass along the same line of DG-HC. This article provides an in-depth review of both DG-HC and EV-HC. It first analyses how the DG-HC research has grown over the years and then studies the published EV-HC papers, illustrating to what extent there is a similarity between them and, finally, employs these analyses to expect future development in the EV-HC research area. This article includes the different uses of the term HC, the most common performance indices of DG-HC, the various methods for assessing DG-HC, the different techniques for DG-HC enhancement, the effects of integrating EVs on the DG-HC, and finally, calculating and enhancing methods for EV-HC.

Abstract Background The residual burden of coronary artery disease (CAD) after percutaneous coronary intervention (PCI) drew a growing interest. The residual SYNTAX Score (rSS) was a strong prognostic factor of adverse events and all-cause mortality in patients who underwent PCI. In addition, the SYNTAX Revascularization Index (SRI), a derivative of rSS, was used to figure out the treated proportion of CAD and could be used as a prognostic utility in PCI for patients with multi-vessel disease (MVD). Purpose We aimed at the assessment of the use of rSS and the SRI as predictors of in-hospital outcomes and up to two-year cumulative follow-up outcomes in patients with MVD who had PCI for the treatment of ST-Elevation Myocardial Infarction (STEMI) or Non-STEMI (NSTEMI). Methods We recruited 149 patients who had either STEMI or NSTEMI while having MVD and received treatment with PCI. We divided them into tertiles based on their rSS and SRI values. We calculated baseline SYNTAX Score (bSS) and rSS using the latest version of the calculator on the internet, and we used both scores to calculate SRI. The study end-points were In-hospital composite Major Adverse Cardiovascular Events (MACE) and its components, in-hospital death, and follow-up cumulative MACE up to 2 years. Results Neither rSS nor SRI were significant predictors of in-hospital adverse events, while female sex, hypertension, and left ventricular ejection fraction were independent predictors of in-hospital MACE. At the two-year follow-up, Kaplan-Meyer analysis showed a significantly increased incidence of MACE within the third rSS tertile (rSS > 12) compared to other tertiles (log rank p = 0.03). At the same time, there was no significant difference between the three SRI tertiles. Unlike SRI, rSS was a significant predictor of cumulative MACE on univariate Cox regression (HR = 1.037, p 12 had a significantly higher incidence of cumulative MACE after 2 years. The best prognosis was achieved with complete revascularization.

The aim of the study was to evaluate the effect of feeding regime (FR) and the combination of FR with pasture on the carcass composition and meat quality parameters of fast-growing chickens. Ross 308 chickens were split into three groups: Group 1 was fed ad libitum, and Groups 2 and 3 had a restricted diet. The chickens were feed-restricted at a rate of 70% ad libitum from 8 to 14 days of age. In Group 3, after restriction at the age of 21 days, chickens were kept on a pasture until the end of the experiment at 35 days of age. The chickens were fed ad libitum prior to and following restriction. Feed restriction and the combination of feed restriction and pasture significantly reduced final body weight, but the dressing out percentage was not affected. The breast percentage was the highest (P = 0.005) in the ad libitum group (30.5%), followed by the restricted group (28.2%) and the lowest in the group with a combination of feed restriction and pasture (27.4%). Breast pH and colour measured 24 h post mortem were not affected, whereas texture expressed as Fmax was the lowest in the group with the combination of feed restriction and pasture (P = 0.05). There was no effect of the group on meat dry matter, crude protein, cholesterol, and fatty acid content, but ether extract was the highest, and significantly so, in the ad libitum-fed group. In summary, feed restriction and the combination of feed restriction and pasture negatively affected final body weight and breast and abdominal fat percentages, which might be related to a short realimentation period for compensatory growth. However, these conditions negligibly affected carcass composition and the physical and chemical parameters of the meat.

Developing innovative, eco-friendly fungicide alternatives is crucial to mitigate the substantial threat fungal pathogens pose to crop yields. In this study, we assessed the in vitro effectiveness of SiO2, CuO, and γFe2O3 nanoparticles against Rhizoctonia solani. Furthermore, greenhouse experiments were conducted in artificially infested soil to evaluate the in vivo impact of nanoparticles under study. Two application methods were employed: soil drenching with 10 mL per pot at concentrations of 50, 100, and 200 mg L−1, and seedling dipping in nanoparticle suspensions at each concentration combined with soil drench. The combined treatment of 200 mg L−1 γFe2O3 or CuO nanoparticles showed the highest in vitro antifungal activity. Conversely, SiO2 nanoparticles demonstrated the lowest in vitro activity. Notably, the application of 200 mg/L SiO2 via the dipping and soil drenching methods decreased counts of silicate-solubilizing bacteria and Azospirillum spp. Whereas, application of 100 mg L−1 γFe2O3 nanoparticles via soil drenching increased soil bacterial counts, and CuO nanoparticles at 50 mg L−1 through dipping and soil drenching had the highest dehydrogenase value. γFe2O3 nanoparticles improved plant photosynthetic pigments, reduced malondialdehyde levels, and minimized membrane leakage in lettuce plants. A root anatomical study showed that 200 mg L−1 CuO nanoparticles induced toxicity, whereas 200 mg L−1 γFe2O3 or SiO2 nanoparticles positively affected root diameter, tissue structure, and various anatomical measurements in lettuce roots. γFe2O3 nanoparticles hold promise as a sustainable alternative for managing crop diseases.

Abstract This paper introduces a novel approach aimed at enhancing the control performance of a specific class of unknown multiple-input and multiple-output nonlinear systems. The proposed method involves the utilization of a fractional-order fuzzy sliding mode controller, which is implemented through online fractional-order reinforcement learning (FOFSMC-FRL). First, the proposed approach leverages two Takagi–Sugeno–Kang (TSK) fuzzy neural network actors. These actors approximate both the equivalent and switch control parts of the sliding mode control. Additionally, a critic TSK fuzzy neural network is employed to approximate the value function of the reinforcement learning process. Second, the FOFSMC-FRL parameters undergo online adaptation using an innovative fractional-order Levenberg–Marquardt learning method. This adaptive mechanism allows the controller to continuously update its parameters based on the system’s behavior, optimizing its control strategy accordingly. Third, the stability and convergence of the proposed approach are rigorously examined using Lyapunov theorem. Notably, the proposed structure offers several key advantages as it does not depend on knowledge of the system dynamics, uncertainty bounds, or disturbance characteristics. Moreover, the chattering phenomenon, often associated with sliding mode control, is effectively eliminated without compromising the system’s robustness. Finally, a comparative simulation study is conducted to demonstrate the feasibility and superiority of the proposed method over other control methods. Through this comparison, the effectiveness and performance advantages of the approach are validated.

Abstract Background The dyslipidemia and changes in D-dimer values that occur in children with severe sepsis remain unidentified. Objective The current research aimed to explore the relationship between D-dimer and lipid profile values, including total cholesterol (TC), lipoproteins, apolipoprotein A-V (Apo A-5), triglycerides (TG), and in-hospital nonsurvival in children with severe sepsis or septic shock in pediatric intensive care. Study design The study design is as follows: prospective cohort study. Participants Children with severe sepsis or septic shock who were admitted to the intensive care unit of a university pediatric hospital. Intervention Vital signs, sepsis assessment, pediatric sequential organ failure assessment (PSOFA) score, high-density lipoprotein (HDL), Apo A-5, TG, low-density lipoprotein (LDL), TC, D-dimer, mortality outcome, and pediatric risk of mortality (PRISM) III score were evaluated. Outcomes The primary outcome was in-hospital nonsurvival. Results The nonsurvivors had significantly higher D-dimer levels than the survivors, with a significant cutoff level of 0.87 μg/mL (AUC: 0.85, sensitivity: 93.3%, PVN: 90.6%, accuracy: 79.0%, PVP: 72.5%, and specificity: 64.7%). D-dimer was inversely correlated with WBC count and positively correlated with patient age, PRISM III score, PSOFA score, and INR. However, nonsurvivors had higher TG levels and lower TC, HDL, LDL, and Apo A-5 levels than survivors, but this variation was insignificant. Apo A-5 levels were inversely correlated with HDL and positively correlated with TG levels. Conclusions This study suggests that D-dimer is a promising biomarker for severe sepsis in children, with a mortality cutoff level of 0.87 μg/mL. However, lipid profiles are not predictors of sepsis-related mortality.

Abstract Background This experimental study was conducted during two successive seasons 2021–2022 on 10-year-old Washington navel orange trees (Citrus sinensis) budded on sour orange rootstock (Citrus aurantium) under sandy loamy soil conditions in Belbeis district, Sharkia Governorate, Egypt. This experimental study was conducted to compare some irrigation systems with different water stress levels on Washington navel trees and to determine the best system in terms of irrigation water use efficiency using different irrigation systems (drip and micro-sprinklers) under different levels of water supply (100, 80, and 60% of ETc, i.e., the estimated water requirements of crops). Results The included data demonstrated that irrigation water amounts can be reduced by 20% for Washington navel trees, while maintaining production, with the possibility of increasing by using micro-sprinkler irrigation systems. In summary, water use efficiency increased with micro-sprinkler irrigation systems under ETc 80%, which resulted in 2.57 and 2.67 kg of fruit per cubic meter of irrigation water in the first and second seasons, respectively. Conclusion The results of the present study showed that using ETc 80% combined with micro-sprinklers irrigation system had a high economic return through increasing total yield, water use efficiency, and water unit return (WUR) which reached to 10.26 EGP/one cubic meter of irrigation water and using less water irrigation amount by 20% at the same time. Thus, we recommend applying the treatment of ETc 80% combined with micro-sprinklers irrigation system to Washington navel orange trees budded on sour orange rootstock to gain a high economic return.

Abstract Background Transcatheter mitral valve replacement (TMVR) using the Tendyne™ valve is regarded as one of the most studied TMVR systems. The first human experience with the procedure was reported in 2013. The present study aims to systemically revise the published literature to document the global experience with TMVR using the Tendyne™ valve. Methods The present review was conducted in line with the PRISMA statement on systematic reviews. Database included in the search process were Scopus, Web of Science and Pubmed. Search was processed using multiple keywords combinations and was adjusted to English literature only. Results We included 26 articles in the final analysis reporting data from 319 patients. Patients recruited by the included studies comprised 192 males (60.2%) and 127 females (39.8%). In the studied patients, mitral annular calcification (MAC) was reported in 107 patients (33.5%). Preoperatively, MR grades 1,2 and 3–4 were reported in 3,5 and 307 patients respectively. Postoperatively, MR grades 1, 2 and 4 were reported in only 12, 3 and 1 patients respectively. Technical success was achieved in 309 patients (96.9%). Follow up durations widely varied among different studies from just days before discharge to 6 years. At the end of follow up, 79 patients died (24.8%) including 52 patients (16.3%) due to cardiovascular causes. Conclusions Management of mitral valve disease using the Tendyne system appears to be a promising minimally invasive option for many high-risk patients with accepted procedural feasibility and safety profile.

Abstract This article presents model-free adaptive control based on an intuitionistic fuzzy neural network for nonlinear systems with event-triggered output. Essentially, model-free adaptive control (MFAC) is constructed by establishing an online approximate model of the controlled system using the pseudo-partial derivative (PPD) form. By the proposed scheme, first, an intuitionistic fuzzy neural network (IFNN) is developed as an estimator for time-varying PPD in both compact-form dynamic linearization (CFDL) and partial-form dynamic linearization (PFDL) for the MFAC technique. Second, two periodic event-triggered output methods are integrated with the proposed IFNN-based MFAC in both forms to save communication resources and reduce the computation burden and energy consumption. Based on the Lyapunov theory and BIBO stability approach, necessary conditions are established to guarantee the convergence of the adaptive law of the IFNN controller and the boundary of the tracking error of the closed loop system. Third, regarding the feasibility and the effectiveness of the developed control method, two simulation examples including the continuous stirred-tank reactor (CSTR) system and the heat exchanger system are given. Finally, the practical validation of the proposed data-driven control method is conducted via the speed control of a DC motor.