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Abstract Background Dental students face the rigorous demands of coursework, which can lead to feelings of inadequacy and stress. These pressures can negatively influence self-efficacy and cause neglect in practicing healthy behaviors that encompass oral health. Identifying the associations of these variables with oral hygiene practices can help in the formulation of interventions tailored toward supporting young students. Therefore, this study aimed to investigate the impact of health behaviors, perceived stress and self-efficacy on oral hygiene practices among undergraduate dental students in Pakistan. Methods A national online survey was carried out among 904 students across the dental colleges of Pakistan. The survey assessed general health behaviors such as tobacco use, sleep, and exercise, among other demographic variables. Perceived stress was evaluated via the Perceived Stress Scale (PSS-10), and self-efficacy was evaluated via the General Self-Efficacy Scale (GSES). Twice daily brushing, brushing for 2 min, and changing toothbrushes after 3 months informed oral hygiene practice of the participants. Results The students experienced moderate perceived stress (20.82 ± 5.92) and high self-efficacy (29.19 ± 5.43). The majority of participants were in their third year (31.9%), were female (65.9%), and resided in home during their studies (64.4%). Perceived stress was observed to have no significant effect on the oral practice of participants. Female gender, non tobacco user, regular exercise, frequent dental visits and higher self-efficacy were associated with good oral hygiene practices. Conclusions The results highlight the importance of addressing stress, enhancing self-efficacy and encouraging healthy behaviors among dental students to improve their oral health, which could be reflected in their professional practice and personal well-being. This study contributes to the understanding of behavioral determinants and emphasizes the need for supportive measures to foster better health behaviors in future dental professionals.

Introduction: Cancer remains a significant global health issue, necessitating innovative management strategies. The tumor suppressor protein PTEN, due to its pivotal role in cancer development, is a promising target for therapeutic intervention. Materials and Methods: We used dried Allium sativum (garlic) seed extract to discover phytocompounds that could inhibit PTEN in cancer. We conducted qualitative tests to determine the phytochemical composition of the extract and employed a DPPH radical scavenging assay to evaluate its antioxidant activity. Computational methods were used to explore the impact of Allium sativum and its constituents on PTEN. This involved predicting and validating 3D structures using the SWISS model and ITASSER, performing docking analysis with natural compounds from the Asinex database, and assessing the drug-likeness and ADMET characteristics of selected compounds using online tools. Molecular dynamics simulations (MDS) were conducted to examine protein–ligand interactions, and the results were analyzed to understand complex stability and fluctuations. Results: A study on Allium sativum revealed the presence of diverse phytochemicals in its seeds and leaves. The leaves contained alkaloids and saponins, while the methanol extract of the leaves exhibited the highest flavonoid and phenolic contents. This methanol extract demonstrated potent antioxidant activity and significantly inhibited cytotoxicity. Through computer-aided drug design, we identified potential anticancer drugs derived from natural botanicals that target the PTEN protein. The virtual screening process led to the discovery of three lead compounds exhibiting high binding affinities and interactions with PTEN. Molecular docking and MDS indicated the strong binding energy and favorable drug-like properties of these compounds. While the protein exhibited some flexibility, the ligand–protein complex remained stable. Conclusion: This study contributes to the expanding literature on cancer drug discovery and emphasizes the importance of investigating natural plant compounds in the search for novel and effective cancer treatments.

Kati Reddy, Mashal Unar, Hira Unar, Sateesh B Arja Medical Education Unit, Avalon University School of Medicine, Willemstad, Netherlands AntillesCorrespondence: Kati Reddy, Email kati.csstudent@avalonu.orgAbstract: According to the World Directory of Medical Schools, the Caribbean region hosts around 100 medical schools, leading to variations in education programs and student performance. Accreditation is crucial for maintaining educational standards. The proliferation of accrediting agencies recognized by the World Federation of Medical Education (WFME) has led to cross-border accreditation practices and market-driven competition. Concerns about the integrity of accreditation processes in the Caribbean region have raised questions about educational quality and global implications. Establishing a framework and scrutiny of the WFME regarding cross-border accreditation is essential to preserve educational standards and prevent global implications. ECFMG’s intervention is urgently needed to investigate and restore the integrity of medical school accreditation in the Caribbean, setting a precedent for global accreditation standards.Keywords: medical education, accreditation standards, educational quality, cross-border accreditation, accreditation challenges

Abstract Background Assessing the trends in dietary GHGE considering the social patterning is critical for understanding the role that food systems have played and will play in global emissions in countries of the global south. Our aim is to describe dietary greenhouse gas emissions (GHGE) trends (overall and by food group) using data from household food purchase surveys from 1989 to 2020 in Mexico, overall and by education levels and urbanicity. Methods We used cross-sectional data from 16 rounds of Mexico’s National Income and Expenditure Survey, a nationally representative survey. The sample size ranged from 11,051 in 1989 to 88,398 in 2020. We estimated the mean total GHGE per adult-equivalent per day (kg CO2-eq/ad-eq/d) for every survey year. Then, we estimated the relative GHGE contribution by food group for each household. These same analyses were conducted stratifying by education and urbanicity. Results The mean total GHGE increased from 3.70 (95%CI: 3.57, 3.82) to 4.90 (95% CI 4.62, 5.18) kg CO2-eq/ad-eq/d between 1989 and 2014 and stayed stable between 4.63 (95% CI: 4.53, 4.72) and 4.89 (95% CI: 4.81, 4.96) kg CO2-eq/ad-eq/d from 2016 onwards. In 1989, beef (19.89%, 95% CI: 19.18, 20.59), dairy (16.87%, 95% CI: 16.30, 17.42)), corn (9.61%, 95% CI: 9.00, 10.22), legumes (7.03%, 95% CI: 6.59, 7.46), and beverages (6.99%, 95% CI: 6.66, 7.32) had the highest relative contribution to food GHGE; by 2020, beef was the top contributor (17.68%, 95%CI: 17.46, 17.89) followed by fast food (14.17%, 95% CI: 13.90, 14.43), dairy (11.21%, 95%CI: 11.06, 11.36), beverages (10.09%, 95%CI: 9.94, 10.23), and chicken (10.04%, 95%CI: 9.90, 10.17). Households with higher education levels and those in more urbanized areas contributed more to dietary GHGE across the full period. However, households with lower education levels and those in rural areas had the highest increase in these emissions from 1989 to 2020. Conclusions Our results provide insights into the food groups in which the 2023 Mexican Dietary Guidelines may require to focus on improving human and planetary health.

A turbulence model study was performed to analyze the flow around the Tubercle Leading Edge (TLE) wing. Five turbulence models were selected to evaluate aerodynamic force coefficients and flow mechanism by comparing with existing literature results. The selected models are realizable k-ε, k-ω Shear Stress Transport (SST), (γ−Reθ) SST model, Transition k-kl-ω model and Stress- ω Reynolds Stress Model (RSM). For that purpose, the TLE wing model was developed by using the NACA0021 airfoil profile. The wing model is designed with tubercle wavelength of 0.11c and amplitude of 0.03c. Numerical simulation was performed at chord-based Reynolds number of Rec = 120,000. The Computational Fluid Dynamic (CFD) simulation reveals that among the selected turbulence models, Stress- ω RSM estimated aerodynamic forces (i.e. lift and drag) coefficients closest to that of the experimental values followed by realizable k-ε, (γ−Reθ) SST model, k-ω SST model and k-kl-ω model. However, at a higher angle of attacks i.e. at 16° & 20° k-ω SST model predicted closest drag and lift coefficient to that of the experimental values. Additionally, the critical observation of pressure contour confirmed that at the lower angle of attack Stress- ω RSM predicted strong Leading Edge (LE) suction followed by realizable k-ε, (γ−Reθ)SST model, k-ω SST model and k-kl-ω model. Thus, the superiority of Stress- ω RSM in predicting the aerodynamic force coefficients is shown by the flow behavior. In addition to this pressure contours also confirmed that k-kl-ω model failed to predict tubercled wing aerodynamic performance. At higher angles of attacks k-ω SST model estimated aerodynamic force coefficients closest to that of the experimental values, thus k-ω SST model is used at 16° & 20° AoAs. The observed streamline behavior for different turbulence models showed that the Stress- ω RSM model and k-kl-ω model failed to model flow behavior at higher AoAs, whereas k-ω SST model is a better approach to model separated flows that experience strong flow recirculation zone.

Abstract Background Acephalic spermatozoa syndrome is a rare type of teratozoospermia causing male infertility due to detachment of the sperm head and flagellum, which precludes fertilization potential. Although loss-of-function variations in several genes, including TSGA10, have been associated with acephalic spermatozoa syndrome, the genetic cause of many cases remains unclear. Results We recruited a Pakistani family with two infertile brothers who suffered from acephalic spermatozoa syndrome. Through whole-exome sequencing (WES) followed by Sanger sequencing, we identified a novel missense variant in TSGA10 (c.1112T > C, p. Leu371Pro), which recessively co-segregated with the acephalic spermatozoa syndrome within this family. Ultrastructural analyses of spermatozoa from the patient revealed that 98% of flagellar cross-sections displayed abnormal axonemal ultrastructure, in addition to the head-flagellum detachment. Real-time quantitative PCR analysis revealed almost no detectable TSAG10 mRNA and western blot analysis also failed to detect TSAG10 protein in patient's sperm samples while TSGA10 expression was clearly detected in control samples. Consistently, immunofluorescence analysis demonstrated the presence of TSGA10 signal in the midpiece of sperm from the control but a complete absence of TSGA10 signal in sperm from the patient. Conclusion Altogether, our study identifies a novel TSGA10 pathogenic variant as a cause of acephalic spermatozoa syndrome in this family and provides information regarding the clinical manifestations associated with TSGA10 variants in human.

The swift progress of 6G cellular networks responds to the urgent demand for seamlessly integrating Internet of Things (IoT) devices on a large scale. Among various emerging technologies, grant-free non-orthogonal multiple access (GF-NOMA) emerges as a standout, offering distinct advantages over traditional networks in accommodating extensive connectivity needs. GF-NOMA optimizes resource usage by reallocating each time-frequency slot to multiple devices with different power levels. Furthermore, it reduces the coordination burden typically associated with uplink communication by broadcasting random access channels. Nonetheless, GF-NOMA faces a significant challenge: the risk of multiple devices inadvertently selecting the same resource and power, resulting in data loss, particularly problematic during emergencies marked by uncoordinated communications. Additionally, the expanding deployment of IoT devices demands a proportional increase in resources, despite advancements in network technology. To address these challenges, this paper introduces an innovative architecture aimed at significantly boosting spatial capacity through the establishment of autonomous social interactions among IoT devices. The proposed SAFE-GF-NOMA aggregation scheme facilitates resource sharing in an independent and ad-hoc trust management environment by ensuring trustworthy sharing. The proposed Social IoT (SIoT) framework reduces uplink access by grouping devices based on trust metrics, resulting in a notable 50% reduction in collision probability, and over a 50% increase in success probability, and a threefold capacity increase compared to conventional systems. Additionally, our system achieves a substantial reduction in energy consumption, cutting it from 17 J to just 5 J per device within the cluster.

The aim of this study was to examine the best electrode design for the electrocoagulation process with the best removal performance, reduced passivation on the electrode surface, and lower energy consumption requirements for removing Chromium (Cr) and Lead (Pb) from leather tannery effluent. Three different electrodes were compared: non-rotating disk electrode (NRDE), rotating disk electrode (RDE) and rotating disk mesh electrode (RDME). All electrodes were used to observe a reduction in passivation on the electrode surface and its effects on the removal performance of Cr and Pb. The material used for the electrodes was iron. The maximum removal efficiency obtained was Cr = 87.9% and Pb = 97.5% under the following operating conditions: pH = 7, treatment time = 90 min, current density = 6.57 mA/cm², and RPM = 80. The results show that the electrical energy requirement for treating chromium and lead using RDME was 4.5 kWh/m³, which was found to be lower than the energy requirement observed in various other studies for treating tannery effluent. According to the results, RDME shows the highest removal performance with lower specific energy consumption compared to NRDE and RDE. RDME can be efficiently employed at a larger scale for treating leather tannery effluent.

Background: Medical students are confronted with substantial academic and psychological stressors during their education. Studies report that examination stress can have a noteworthy effect on the leukocyte count of students. This study aimed to evaluate the physiological effects of examination stress on the total and differential leucocyte cell count in medical students at Peoples University of Medical and Health Sciences for Women, Nawabshah. Methods: A cross-sectional comparative study was conducted from April to October 2019, with 110 MBBS students, divided into two groups of 55 students using a non-probability randomized sampling technique with first-year and second-year female students, whereas hypertensive, diabetic, and with any psychiatric disease were excluded. Blood samples were taken before and during the examination. Data were analyzed by SPSS version 23. All the continuous variables were analyzed by the t-test for Mean±S.D while all the numerical variables were analyzed by Student’s t-test. Results: Pre-exam complete blood count (CBC) test reports of first-year students showed Neutrophils, Lymphocytes, Eosinophil, and Monocytes cell counts of 69.2182, 28.5455, 1.61, 1.2545 cell /microliter whereas complete blood count during exams showed 69.909, 27.9636, 1.41and 1.2000 cells/ microliter. In the second-year student, complete blood count before and during the exam showed Neutrophils 66.5273 to 64.0182, Lymphocytes 31.236 to 30.036, Eosinophil 1.92 to 1.76, and Monocytes 1.473 to 1.364 cells/microliter, the decreased values showing that there is an influence of exam stress on white blood cells. Conclusion: Exams in medical schools can be stressful enough to induce a substantial decrease in blood cell parameters among medical students.

Switched Reluctance Machine (SRM) is the advanced version of the stepper motor and since last decade, it is of high interest among researchers and industrial applications. Modelling an SRM relies on accurate data and proper selection of parameters. The next step is the performance analysis of the machine for which losses determination is indispensable. Previous studies have shown losses calculation only at a particular instant of switching of the machine (i.e., conduction angle). Therefore, the impact of losses in a motoring region cannot be justified. This paper investigates the impact of varying conduction angle on the performance of machines for a set of switch-on angle. Losses are calculated and predicted through simulating motor operating parameters carried out in MATLAB environment and accuracy of results are compared with experimental results.

Introduction: Breast cancer poses a significant global challenge, prompting researchers to explore novel approaches for potential treatments.Material and Methods: For in vitro study we used thin layer chromatography (TAC) for phytochemical screening, total antioxidant capacity (TLC) assay for antioxidant capacity, and hemolytic activity test for toxicity of Neuropilins (NRPs). We performed bioinformatic analyses to predict protein structures, molecular docking, pharmacophore modeling, and virtual screening to reveal interactions with oncogenes. We conducted 200 ns Molecular Dynamics (MD) simulations and MMGBSA calculations to assess the complex dynamics and stability.Results: We identified phytochemical constituents in Nigella sativa leaves, including tannins, saponins, steroids, and cardiac glycosides, while phlobatannins and terpenoids were absent. The leaves contained 9.4% ± 0.04% alkaloids and 1.9% ± 0.05% saponins. Methanol extract exhibited the highest yield and antioxidant capacity, with Total Flavonoid Content at 127.51 ± 0.76 mg/100 g and Total Phenolic Content at 134.39 ± 0.589 mg GAE/100 g. Hemolysis testing showed varying degrees of hemolysis for different extracts. In-silico analysis indicated stable Neuropilin complexes with key signaling pathways relevant for anti-cancer therapy. Molecular docking scores at different possesses (0, C-50, C −80, C-120,C −150, C −200 ns) revealed strong hydrogen bonding in the complexes and showed −12.9, −11.6, and −11.2 binding Affinities (kcal/mol) to support their stability. Our MD simulations analysis at 200ns confirmed the stability of Neuropilin complexes with the signaling pathways protein PI3K. The calculated binding free energies using MMGBSA provided valuable quantitative information on ligand potency on different time steps. These findings highlight the potential health benefits of N. sativa leaves and their possible role in anti-cancer treatments targeting angiogenesis.Conclusion:Nigella sativa leaves have shown significant medical potential due to their bioactive compounds, which exhibit strong properties in supporting organogenic processes related to cancer. Furthermore, studies have highlighted the promising role of neuropilins in anticancer treatment, demonstrating stable interactions and potential as targeted therapy specifically for breast cancer.

Abstract Breastfeeding has been consistently associated with higher intelligence since childhood. However, this relation could be confounded due to maternal selection bias. We estimated the association between predominant breastfeeding and intelligence in school‐age children considering potential selection bias and we simulated the intelligence gap reduction between low versus higher socioeconomic status children by increasing breastfeeding. We analysed predominant breastfeeding practices (breastmilk and water‐based liquids) of children 0–3 years included in the Mexican Family Life Survey (MxFLS‐1). Intelligence was estimated as the z‐score of the abbreviated Raven score, measured at 6–12 years in the MxFLS‐2 or MxFLS‐3. We predicted breastfeeding duration among children with censored data with a Poisson model. We used the Heckman selection model to assess the association between breastfeeding and intelligence, correcting for selection bias and stratified by socioeconomic status. Results show after controlling for selection bias, a 1‐month increase in predominant breastfeeding duration was associated with a 0.02 SD increase in the Raven z‐score (p

Introduction Thyroid nodules are common globally in almost one fifth of the adult population. The gold standard treatment for thyroid nodule is thyroid lobectomy or total thyroidectomy depending upon the diagnosis. Thyroidectomy has a few known complications but, as per the ATA consensus statement, it is a safe surgery to be done as a day care procedure.

Social media has given voice to people around the globe. However, all voices are not counted due to the scarcity of lexical computational resources. Such resources could harness the torrent of social media text data. Computational resources for rich languages such as English are available. More are being developed, meanwhile strengthening and enhancing the current ones. However, Roman Sindhi, a resource-poor writing style, is a phonetically rich language lacking computational resources, creating a working space for researchers. This work attempts to develop lexical sentiment resources that will help calculate the public opinion expressed in Roman Sindhi and bring their point of view into the limelight. This work is one of the initial efforts to develop lexical Roman Sindhi sentiment dictionary resources to help detect sentiment orientation in a text. Furthermore, it also developed two interfaces to leverage the lexical resources—a Roman Sindhi to English translator (RoSET) that translates a Roman Sindhi feature into an equivalent English word and a Roman Sindhi rule-based sentiment scorer ( RBRS 3 ) that assigns sentiment score to a Roman Sindhi script features. The results obtained from the developed system accommodated the bilingual dataset (Roman Sindhi + English) more adequately. An increase of 20.8% was recorded for positive sentence detection, and a 16% increase was obtained for negative sentences, whereas neutral sentences were marginalized to a lower number (59.31% decrease). The resultant system makes those public voices expressed in the Roman Sindhi script get counted, which otherwise are in vain.

Abstract Background Parents are exposed to breastmilk substitutes and baby foods marketing on the internet and social media, which hinders adequate breastfeeding and complementary feeding. This study identifies digital marketing strategies for breastmilk substitutes, specifically commercial milk formula and baby foods used by the industry to influence infant and young children’s feeding practices in Mexico and proposes regulatory recommendations that can be useful for similar countries. Methods Qualitative study based on the CLICK monitoring framework developed by the World Health Organization, adapted for digital marketing of commercial milk formula and baby foods. Semi-structured interviews (n = 53) with key actors were conducted between November 2020 and March 2021, and used grounded theory for the analysis and interpretation with the MAXQDA 20 software. Results Commercial milk formula and baby food companies use digital media to contact and persuade parents to use their products by sending electronic newsletters with advertising. Companies hire influencers to market their products because there is no regulation prohibiting the advertisement of breastmilk substitutes on social media, and promote formula among health professionals inviting them to participate in sponsored webinars on infant nutrition, ignoring conflict of interest and the International Code of Marketing of Breastmilk Substitutes. Parents trust formula and baby food advertisements, which use emotional messages and health and nutrition claims to encourage their consumption. Health professionals consider that claims contribute to the indiscriminate use of formula, and some actors propose the use of plain packaging for these products. Conclusions Breastmilk substitutes companies promote their products in digital media using unethical strategies that fail to comply with the International Code of Marketing of Breastmilk Substitutes. They generate strong conflicts of interest with health professionals, taking advantage of legal framework gaps and the lack of monitoring and effective sanctions for non-compliers. Updating the legal framework and monitoring compliance, including digital media, is urgently needed to protect children’s right to breastfeeding, healthy nutrition and life, and the rights of women to health and informed decision-making.

Multiple morphological abnormalities of the sperm flagella (MMAF) is a severe form of asthenozoospermia categorized by immotile spermatozoa with abnormal flagella in ejaculate. Whole-exome sequencing (WES) is used to detect pathogenic variants in patients with MMAF. In this study, a novel homozygous frameshift variant (c.6158_6159insT) in dynein axonemal heavy chain 8 (DNAH8) from two infertile brothers with MMAF in a consanguineous Pakistani family was identified by WES. Reverse transcription-polymerase chain reaction (RT-PCR) confirmed DNAH8 mRNA decay in these patients with the DNAH8 mutation. Hematoxylin–eosin staining and transmission electron microscopy revealed highly divergent morphology and ultrastructure of sperm flagella in these patients. Furthermore, an immunofluorescence assay showed the absence of DNAH8 and a reduction in its associated protein DNAH17 in the patients' spermatozoa. Collectively, our study expands the phenotypic spectrum of patients with DNAH8-related MMAF worldwide.