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Abstract In the absence of any new physics signals at the Large Hadron Collider (LHC), anomalous results at low energy experiments have become the subject of increased attention. We focus on three such results from the LSND, MiniBooNE (MB), and ATOMKI experiments. A 17 MeV pseudoscalar mediator (a ′) can account for two (8Be and 4He) out of the three cases in which excess events have been seen in pair creation transitions in ATOMKI. We incorporate this mediator in a gauge invariant extension of the Standard Model (SM) with a second Higgs doublet and three singlet (seesaw) neutrinos (N i , i = 1, 2, 3). N 1,2 participate in an interaction in MB and LSND which, with a ′ as mediator, leads to the production of e + e − pairs. The N i also lead to mass-squared differences for SM neutrinos in agreement with global oscillation data. We first show that such a model offers a natural joint solution to the MB and LSND excesses, providing excellent fits to their data. Next, using the values of the couplings to the quarks and electrons which are required to explain pair creation nuclear transition data for 8Be and 4He in ATOMKI, we show that these values still lead to fits for MB and LSND data. However, once ATOMKI is incorporated, we find that strong constraints from the decays K + → π + a ′ (a ′ → e + e −) and π + → e + ν e e + e − come into play. While our solution is in conformity with the bounds on the former decay, it remains in tension with 90% CL bounds on the latter. We also discuss other constraints from both collider and non-collider experiments and from electroweak precision data, stability and unitarity. We compute the contributions to the electron and muon g – 2 up to two loops for our model. We discuss tests of the model in upcoming experiments.

Abstract Ovarian germ cell tumors (OVGCTs) account for 28% of all diagnosed ovarian cancers, and malignant germ cell tumors specifically account for approximately 13% of diagnosed ovarian cancers in Saudi Arabia. Although most germ cell tumor patients have a high survival rate, patients who experience tumor recurrence have a poor prognosis and present with more aggressive and chemoresistant tumors. The use of immunotherapeutic agents such as PD-L1/PD-1 inhibitors for OVGCTs remains very limited because few studies have described the immunological characteristics of these tumors. This study is the first to investigate PD-L1 expression in ovarian germ cell tumors and explore the role of PD-L1 expression in tumor microenvironment cells and genetic alterations. A total of 34 ovarian germ cell tumors were collected from pathology archives. The collected tumor tissues included ten dysgerminomas, five yolk sac tumors, five immature teratomas, and one mature teratoma, and the remaining samples were mixed germ cell tumors. The tumors were analyzed using immunohistochemical analysis to determine PD-L1 expression, immune cell infiltration and cancer stem cell populations and their correlation with clinical outcome. Furthermore, the genetic alterations in different subtypes of germ cell tumors were correlated with PD-L1 expression and clinical outcome. Datasets for testicular germ cells (TGCTs) were retrieved from The Cancer Genome Atlas (TCGA) and analyzed using cBioPortal (cbioportal.org) and Gene Expression Profiling Interactive Analysis (GEPIA). Compared with yolk sac tumors, dysgerminomas highly express PD-L1 and are associated with high levels of tumor infiltrating lymphocytes (TILs) and stem cell markers. In addition, compared with PD-L1-negative yolk sac tissue, dysgerminomas/seminomas with high PD-L1 expression are associated with more genetic alterations and a better prognosis. Our findings will contribute to the knowledge about the potential benefits of ovarian cancer immunotherapy in specific subsets of germ cell tumor patients and the risk factors for resistance mediated by tumor microenvironment cells.

Abstract This paper presents a novel spectral algorithm for the numerical solution of multi-dimensional fractional-order telegraph equations, a critical model used to capture the combined effects of diffusion and wave propagation. The core innovation of this work is the application of Jacobi-Romanovski polynomials as the basis functions for spectral discretization. These polynomials offer unique advantages, including the ability to handle nonstandard domains and boundary conditions, making them particularly suitable for partial differential equation (PDE) applications. A comprehensive error analysis is conducted, providing deep insights into the convergence rates and factors affecting the accuracy of the numerical solutions. Extensive numerical experiments further demonstrate the superior performance of the proposed spectral algorithm in solving a wide range of multi-dimensional fractional-order telegraph equation models. The results show a significant improvement in accuracy and computational efficiency compared to traditional numerical methods, such as finite difference or finite element techniques. This research advances the field of computational science by offering a robust, efficient, and versatile numerical framework for the precise solution of complex multi-dimensional PDEs.

Abstract We study the prospect of heavy singlet neutrinos as a dark matter (DM) candidate within a neutrinophilic U(1) model, where the Standard Model (SM) is extended with a U(1) gauge symmetry, and neutrino mass and oscillation parameters are explained through an inverse see-saw mechanism. The lightest of the heavy neutrinos plays the role of the DM, while the newly introduced scalars and the extra gauge boson $$Z'$$ Z ′ act as mediators between the dark sector and the SM sector. We show the range of model parameters where this DM candidate can be accommodated in the Weakly Interacting Massive Particle (WIMP) or Feebly Interacting Massive Particle (FIMP) scenario. The observed DM relic density (DMRD) is achieved via the new gauge boson and singlet scalar portals in the WIMP scenario, whereas within the FIMP scenario, these two particles assume a distinct yet pivotal role in generating the observed DMRD.

Energy efficiency in the building has two dimensions; efficient use of energy resources and energy conservation. Energy-efficient houses play a critical role in energy conservation and achieving sustainable built environment goals. The energy efficiency of a house depends on its building envelope (design, orientation, and energy properties of construction material) and operational characteristics appliance efficiency, energy consumption patterns). Rather than merely ensuring new houses are energy-efficient, it is vital to energy retrofit existing houses. Energy audits can assist in evaluating the energy efficiency of existing houses and identify improvement measures. The main objectives of this study were to identify efficiency improvement opportunities through an energy audit of houses and apartments in Karachi. A detailed energy audit checklist was prepared using literature, standards, expert review, and code requirements. Data was collected through physical and owner-assisted virtual audits of 58 houses in six districts of Karachi. Architectural plans, information about doors, windows, air ducts, thermal images, historical data, and material properties were collected. Audit tools included; an anemometer and thermal imagining camera during physical audits. Android applications were used during owner-assisted audits. Data were analyzed for developing descriptive graphs, U and R-values, Pareto charts, and district-wise mapping of energy properties of the material. As a result, energy improvement opportunities were proposed. These are focused on building envelope aspects, including; window orientation, minimizing air infiltration, and using heatresistant paint. Improvement measures were confirmed through thermal imaging of selected buildings.

Abstract Background Among various growth parameters, liver and spleen size is an important parameter used for the evaluation of patients with certain disorders and abnormalities in these organs. Aim To determine the normal dimensions for the liver, spleen, and kidney in Egyptian infants, children, and adolescents from birth to 18 years. Methods This cross-sectional randomized study was conducted on 1861 Egyptian infants, children, and adolescents from birth to 18 years for the establishment of Z score reference of liver, spleen, and kidney parameters. Results Egyptian children of both sexes (51.5% boys and 48.5% girls) from birth to 18 years old were studied. Then Z scores reference for liver, spleen, and kidney parameters for both sexes were represented in detailed tables and graphs. There was no statistically significant difference between both sexes, so we used unisex tables and graphs (P > 0.05). Conclusions Determination of pathologic changes in the size of the liver, spleen, and kidney necessitates knowing the normal range of dimensions for these organs. So, our study established a Z score chart for normal values of liver, spleen, and kidney size for children and adolescents from birth to 18 years.

Abstract Background Cotton leaf curl virus disease (CLCuD) is one of the major concerns for cotton growers. The traditional approach to managing CLCuD involves the control of the vector (whitefly) population through the use of pesticides. This study compares the efficacy of zinc oxide, iron oxide, copper and silver nanoparticles with conventional pesticides. Nanoparticles dose was optimized by evaluating their phytotoxic threshold in our previous study. In this study, optimized doses of nanoparticles such as zinc oxide (100 ppm), iron oxide (50 ppm), copper (50 ppm) and silver nanoparticles (25 ppm) were applied in a field trial of cotton against cotton leaf curl virus disease (CLCuD). Morphological parameters (height of stem, monopodial branches, sympodial branches, staple length, boll weight and number of bolls), yield parameters (seed cotton yield and ginning outturn), chlorophyll content (chlorophyll a, chlorophyll b, carotenoids and total chlorophyll), biochemical parameters (superoxide dismutase (SOD), peroxidase (POD), ascorbate peroxidase (APX), catalase (CAT), hydrogen peroxide (H2O2) and electrolyte leakage) and disease parameters (reduction infection, disease severity and disease incidence) were determined in this study. Results The incidence of cotton leaf curl virus was confirmed by triple antibody sandwich–enzyme-linked immunosorbent assay (TAS-ELISA). The pesticide Imidacloprid significantly reduced the infection by 79.3%. However, in comparison to pesticide, application of nanoparticles also reduced the infection. ZnO NPs reduced the infection by 42.33%, FeO NPs by 41%, Cu NPs by 34.7%, and Ag NPs by 44.8%. Moreover, these nanoparticles also improved the plant growth parameters as compared to control treatment. ZnO NPs enhanced morphological, yield parameters, and chlorophyll content by 36%, 22%, and 29%, respectively. FeO NPs showed improvements by 38%, 21%, and 29%; Cu NPs 39%, 25%, and 29%; and Ag NPs 31%, 19%, and 18%, respectively. Conclusion Although treatment pesticide showed the least disease incidence compared to nanoparticles, nanoparticles are eco-friendly and safe as compared to pesticides. Farmers can apply these nanoparticles at their optimal thresholds through foliar application as an alternative to traditional pesticides. It is concluded that nanocomposites and hybrid modes may be used for managing CLCuD efficiently in the future. Graphical abstract

Abstract Background The causal agent in a lower respiratory tract sample was identified as severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Objective To evaluate the vaccinated and unvaccinated persons for signs and severity of SARS-CoV-2. Patients and methods This retrospective analysis included 99 cases ranging in age from 25 to 65 with a history of SARS-CoV-2 infection confirmed by polymerase chain reaction (PCR). We compared the incidence and severity of COVID-19 between vaccinated and non-vaccinated groups for a variety of COVID-19 outcomes. We performed the following tests on all cases: blood pressure, pulse rate, oxygen saturation, PCR, CBC, CRP, ferritin, and D-dimer. Results In terms of severity, 60.6% of cases are in the moderate category, and 13.1% are in the critical level. Among the non-vaccinated group, 47.2% had lung symptoms, compared to 22.2% in the vaccinated group (p = 0.001). The vaccinated group had a mix of pulmonary and extrapulmonary symptoms. A significant difference between groups: 36 (100%) of unvaccinated had CT, 26 (96.3%) of two-dose vaccinated cases, and 30 (83.3%) of three-dose vaccinated cases. Conclusion We provided proof that vaccine recipients had reduced CT severity ratings and elevated inflammatory markers compared to those individuals who were not given vaccines. Cases that were not immunized had lower oxygen saturation levels.

Persistent left superior vena cava (PLSVC) is a rare congenital anomaly. We presented PLSVC in a patient with end-stage renal disease (ESRD) requiring hemodialysis. The left internal jugular vein was utilized for central venous access due to difficult central vascular access, resulting in a diagnosis of PLSVC draining in the left atrium. This case underscores the importance of awareness of anatomical variations before central catheter placement.

Background: Category III (AUS; Atypia of Undetermined Significance) of The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) was established to describe thyroid nodule features that are neither benign nor cancerous. OBJECTIVES: This study aims to evaluate the rate of thyroid malignancy in patients diagnosed with AUS at the Armed Forces Hospital Southern Region (AFHSR), Saudi Arabia. Method: The patients (508) diagnosed with AUS in their thyroid nodules underwent fine-needle aspiration cytology (FNAC). Data were collected through a chart-based approach, reviewing patients’ medical records and relevant information. Results: Among the cases, the majority were females (84.6%). Among the different age groups, individuals between 40 and 50 years had the highest prevalence of thyroid nodules (32.5%). Approximately 27% of patients exhibited tumor sizes larger than 4 cm. FNAC results revealed 16.5% benign, 26% AUS, and 22.4% follicular neoplasm cases. Histopathology indicated 54.1% of benign and 37.2% of malignant cases. Papillary carcinoma accounts for 80.4% of all malignant cases. A significant correlation was observed between FNAC and postoperative histopathology (P value < 0.05). Hypoechoic nodules exhibited 33.9% of malignant cases, and calcification was observed in 25% of the cases. A significant association was found between malignancy and echogenicity and between malignancy and calcification (P value = 0.003 and 0.001, respectively). Conclusion: The findings of this study identify malignancy in thyroid nodules with AUS cytopathology, particularly in the Southern region of Saudi Arabia. The correlation between pre-surgery FNAC and postoperative histopathology supports FNAC’s diagnostic value. Additionally, echogenicity and calcification can potentially contribute to predicting nodule malignancy.

Purpose/Background: Hair loss is a common presentation in primary care. This condition is caused by telogen effluvium and alopecia, among others. Several factors such as drugs, trauma, and emotional and physiological stress can lead to the development of hair loss in addition to vitamin and mineral deficiency. This study aimed to assess the knowledge and practice of primary health physicians in Saudi Arabia on the use of vitamins and minerals for the treatment of hair loss with the research question of what is the knowledge and practice level among primary physicians in Kingdom of Saudi Arabia regarding hair loss. Methods: This cross-sectional study was carried out in primary health care centers in Saudi Arabia. Data were collected by a self-administered online questionnaire. The questionnaire included two parts; the first one is the personal information such as age, sex, year of experience, and current medical ranking. The second part included questions assessing the knowledge and practice of using vitamins and minerals for treatment of hair loss. Data were analyzed by using Statistical Package for Social Sciences (SPSS). Results: A total of 146 physicians were included in the final analysis with a mean age of 41.65 (SD = 12.71). Slightly over half (54.1%) were juniors being general practitioners or residents. The mean knowledge score was 12.6 (SD = 2.83), and the mean practice score was 8 (SD = 3.43), with no difference between the total score between the senior and junior physicians, while some significant differences were noted in some items of both scores. No significant association was noted between knowledge and practice scores. Conclusion: The findings show the low scores of knowledge and practice among doctors about the causes and treatment of hair loss. Guidelines should guide practice regardless of seniority. Future studies should address each group separately.

IgG4-related disease (IgG4-RD) is an immune disorder characterized by organ enlargement and fibrosis leading to functional impairment. Key immune cell subsets contributing to the pathogenesis of IgG4-RD include T follicular helper 2 cells (Tfh2), Tfh1, CX3CR1 + cytotoxic T cells (CX3CR1 + CTLs), Tregs and IgG4 + B cells. Tfh2 and Tregs are commonly involved in inducing IgG4 class-switching in this disease. Importantly, IgG4-RD can be classified into four clinical phenotypes based on the distribution of affected organs, with each phenotype showing different dominant immune cell subsets involved in its pathogenesis. Specifically, the clinical phenotype of retroperitoneal fibrosis/aortitis is characterized by CX3CR1 + CTLs as the dominant key immune cell subset, while Mikulicz disease with systemic involvement is dominated by Tfh2. In addition to classification based on organ distribution, IgG4-RD can also be categorized into phenotypes associated with malignancy or allergy. The malignancy phenotype is characterized by an increase in CXCR5 + CD2-double negative T cells compared to the allergy phenotype, along with a decrease in naive CD8 + T cells. Moreover, several autoantigens have been identified, and the presence of autoimmune phenotype has been revealed. Due to the pathogenicity of IgG1-type autoantibodies, Tfh1 may be important inducing IgG1 class-switching by IFNγ in autoimmune phenotype. In IgG4-RD with hypocomplementemia, activation of the complement pathway is thought to be induced by IgG1 or IgG2 antibodies, suggesting the involvement of Tfh1 in the disease pathogenesis. Therefore, elucidating the immunological features specific to each clinical characteristic is believed to lead to a deeper understanding of the pathogenesis of IgG4-RD and the discovery of novel therapeutic targets. This review provides an overview of the immunological mechanisms common to IgG4-RD as well as those specific to each clinical characteristic.

Abstract Recognizing the importance of evidence-based research in informing migration policies and empowering migrant domestic workers (MDWs), this study aims to provide a comprehensive analysis of MDW research patterns and trends. Using a descriptive cross-sectional study design, research articles on MDWs were retrieved from the Scopus database. The findings reveal a substantial increase in research output in recent years, with notable contributions from journals in the fields of social sciences and humanities. Key contributors include scholars from the United States, the United Kingdom, and institutions such as the National University of Singapore and the Chinese University of Hong Kong. Journals in the field of migration have prominent role in publishing research on MDWs. At the author level, Yeoh, B.S.A, at the National University of Singapore was the most prolific author. Academic activities were the main driver of research and that funding was suboptimal in this field. Highly cited articles focused on topics such as transnational motherhood, the international division of reproductive labor, and the negotiation of citizenship rights. Major research hotspots in the retrieved articles included mental health aspects, caregiving especially of the elderly, and struggles for legal rights. Specific nationalities, such as Filipina/o and Indonesian MDWs, have been the focus of numerous studies, shedding light on their narratives, challenges, and agency within transnational contexts. Overall, this study underscores the urgency of addressing the needs and rights of MDWs, advocate for human rights, and enhance understanding of occupational health and safety in the unique context of domestic work.

Abstract Enterococci, common hospital-acquired infections in immunocompromised patients, have garnered attention in clinical microbiology. To determine the clinical relevance of enterococci as food-borne pathogens, 116 fish, 90 vegetables, and 120 human diarrheal samples were tested for E. faecalis and E. faecium pathogenicity. Conventionally, 69 of 326 (21.17%) samples were positive for Enterococcus species, 52 (15.95%) of which were molecularly classified as E. faecalis and 13 (3.99%) as E. faecium. The E. faecalis contamination percentage of fresh fish (19.70%) was higher than frozen fish (4%). Cauliflower had the highest E. faecalis percentage (16.67%) when fish and vegetable samples didn’t harbor the E. faecium atpA gene. 23.33% and 10.83% of participants’ samples were molecularly confirmed as E. faecalis and E. faecium positive, respectively. E. faecalis isolates had all virulence genes, with gels being the most common (65.38%), while cylA and asa1 genes couldn’t be detected in E. faecium isolates. E. faecalis showed the highest resistance against vancomycin and tetracycline (69.23%), whereas E. faecium extremely resisted tetracycline (76.92%) and erythromycin (69.23%) with the recognition of MDR among 44.2% of E. faecalis and 38.5% of E. faecium isolates. The great similarity of our isolates showed the clinical importance of food-borne antibiotic-resistant enterococci.

Abstract Background This work aimed to study the role of penile duplex in predicting the outcome of anastomotic urethroplasty. Methods Between March 2022 and February 2023, all patients presented with posterior urethral distraction defect (PUDD) underwent anastomotic end to end urethroplasty. Preoperative evaluation of sexual function was performed using international index of erectile function (IIEF-5) and penile doppler parameters (the response E1 to E5, peak systolic velocity (PSV), end diastolic velocity (EDV) and resistivity index (RI)). Each patient was, routinely, evaluated through 12 month-follow up using IIEF-5, penile doppler parameters, uroflowmetry for Qmax and pelvic ultrasound for postvoid residual urine (PVR). The procedure was considered successful if Qmax > 15 ml/s and PVR

Abstract This study aimed to explore the effect of enterprise resource planning (ERP), innovation (IN), and strategic planning (SP) on the organizational performance (OP) of large industrial companies in Saudi Arabia, with the mediating role of strategic decision-making (SDM). To this end, data was collected from 358 participants and analyzed using structured equation modeling (SEM) via SmartPLS 4. The findings confirmed that ERP positively affects both SDM and OP. Likewise, IN positively affects SDM but does not directly affect OP. On the contrary, SP positively affects both SDM and OP. These results emphasized the important role of SDM as a mediator. Theoretical implications highlight the integration of ERP, IN, SDM, and SP into a coherent model that explains OP dynamics. In practical terms, organizations can leverage these insights to enhance SDM processes aimed at improving operational processes. Overall, this study contributes to the literature by providing a nuanced understanding of how ERP, IN, SDM, and practices collectively drive operational processes in industrial contexts, particularly in Saudi Arabia.

Water scarcity is an extreme global concern due to changing climate and rapid population growth. Worldwide, freshwater sources are depleting and there is a need to implement water-conserving approaches in water-limited or arid areas for sustainable crop production. Therefore, this study aimed to investigate the impact of deficit irrigation on cucumber plant physiology, growth, and fruit yield traits grown under greenhouse conditions. The experiment was conducted in a complete randomized design with four water regimes, 100%, 80%, 60%, and 40% crop water requirement (ETc). Results showed that the highest plant leaf chlorophyll contents (43.2 µmol m-2), plant biomass (12.43 g), plant height (172.39 cm), number of leaves (19.85), fruit yield (2.49 kg), and total soluble solids (3.73 °Brix) were in plants irrigated at 100% level. In comparison, the lowest plant height (115.73 cm), number of leaves (15.77) and fruit yield (1.81 kg) were recorded at 40% irrigation. Results revealed that reduced irrigation regimes up to 80% or 60% have no significant inhibitory effects on cucumber agro-morphological traits. However, 40% of irrigation levels showed significantly reduced plant morphological and fruit yield traits. Overall, the result demonstrated that regulated deficit irrigation can significantly conserve water without negatively impacting cucumber yield.

Abstract Background The rapid adoption of ChatGPT in academic settings has raised concerns about its impact on learning, research, and academic integrity. This study aimed to develop and validate a comprehensive ChatGPT Usage Scale specifically tailored to postgraduate students, addressing the need for a psychometrically sound instrument to assess the multidimensional nature of ChatGPT usage in higher education. Methods A cross-sectional survey design was employed, involving 443 postgraduate students from two Egyptian universities. The initial 39-item scale underwent Exploratory Factor Analysis (EFA) using principal component analysis with Varimax rotation. Confirmatory Factor Analysis (CFA) was conducted to assess the model fit and psychometric properties of the final 15-item measure. Internal consistency reliability was evaluated using Cronbach’s alpha and McDonald’s omega. Results EFA revealed a three-factor structure explaining 49.186% of the total variance: Academic Writing Aid (20.438%), Academic Task Support (14.410%), and Reliance and Trust (14.338%). CFA confirmed the three-factor structure with acceptable fit indices (χ2(87) = 223.604, p

Velaphi C Thipe,1 Nya Hall,1 Amoolya Pandurangi,2 Samuel Ajayi,3 Prosper Emeh,3 Iti Gauttam,3 Rania Ghamgui,3 Fatima Hameedat,3 Sihem Khelil,3 Nhu Ky Ly,3 Mahmoud Salim,3 Anum Shahid Waleed,3 Prajna Hegde,4 Vrushali Hegde,4 Deepa Prakash,4 Ilaadevi Hegde,4 Kavita Katti,1 Alice Raphael Karikachery,1 Emilie Roger,3,5 Anne Landreau,3,6 Kattesh V Katti1,7,8 1Department of Radiology, University of Missouri, Columbia, MO, 65212, USA; 2Department of Biology, Saint Louis University, St. Louis, MO, 63103, USA; 3Pharmacy School, UNIV Angers, Angers, F-49000, France; 4Kadamba Intrac Private Ltd, Bangalore, KA, 560011, India; 5MINT, INSERM 1066, CNRS 6021, University of Angers, Angers, France; 6Univ Angers, Univ Brest, IRF, SFR ICAT, Angers, F-49000 France; 7Departments of Physics, Medical Pharmacology and Physiology, University of Missouri, Columbia, MO, 65211, USA; 8Department of Biotechnology and Food Technology, University of Johannesburg, Doornfontein, 2028, South AfricaCorrespondence: Kattesh V Katti, Department of RadiologyUniversity of Missouri-ColumbiaOne Hospital Drive, Columbia, Missouri, 65212, USA, Tel +1 573 882 5656, Fax +1 573 884 5679, Email KattiK@health.missouri.eduPurpose: Breast cancer is a significant global health issue, contributing to 15% of cancer-related deaths. Our laboratory has pioneered a novel approach, combining Ayurvedic principles with green nanotechnology, to develop a scientifically rigorous medical modality referred to as Nano-Ayurvedic Medicine, recently approved by the US Patents and Trademarks Office. Here in we report a new Nano-Ayurvedic medicine agent derived from gold nanoparticles encapsulated with phytochemicals from Ginkgo biloba plant (GB-AuNPs).Methods: We have developed biocompatible gold nanoparticles using electron-rich phytochemicals from Ginkgo biloba as reducing agent cocktail. Ginkgo biloba phytochemical-encapsulated gold nanoparticles (GB-AuNPs) were fully characterized, and their anticancer activity, including immunomodulatory profiles, were evaluated against breast (MDAMB-231) cancer cell lines.Results: Characterization revealed spherical morphology for GB-AuNPs and possessed optimum in vitro stability through high zeta potential of − 34 mV for optimum in vivo stability. The core size of GB-AuNPs of 19 nm allows for penetration into tumor cells through both EPR effects as well as through the receptor-mediated endocytosis. The Antitumor efficacy of this nano-ayurvedic medicine agent revealed strong antitumor effects of GB-AuNPs towards MDAMB-231. Our investigations reveal that GB-AuNPs enhance anti-tumor cytokines (IL-12, TNF-α, IFN-γ) and reduce pro-tumor cytokines (IL-10, IL-6), promoting the conversion of protumor M2 macrophages into M1-like macrophage antitumor phenotype. Cellular studies show that GB-AuNPs offer superior anti-tumor efficacy and a better safety profile against breast tumors compared to cisplatin.Conclusion: Our investigations have demonstrated that the nano-ayurvedic medicine agent, GB-AuNPs, treats cancers through an immunomodulatory mechanism facilitated by elevated levels of anti-tumor cytokines (TNF-α, IFN-γ and IL-12) with concomitant downregulation of pro-tumor cytokines expression (IL-6 and IL-10). The green nanotechnology approach for the development of nano-ayurvedic medicine agent (GB-AuNPs), as described in this paper, presents new and attractive opportunities for treating human cancers and other debilitating diseases and disorders.Keywords: Ginkgo biloba, gold nanoparticles, anticancer, Nano-Ayurvedic

Abstract Objective This study aimed to determine the prevalence of polypharmacy, comorbidities and to investigate factors associated with polypharmacy among adult patients with Chronic Obstructive Pulmonary Disease (COPD). Methods This was a retrospective single-centre cross-sectional study. Patients with a confirmed diagnosis of COPD according to the GOLD guidelines between 28 February 2020 and 1 March 2023 were included in this study. Patients were excluded if a pre-emptive diagnosis of COPD was made clinically without spirometry evidence of fixed airflow limitation. Population characteristics were presented as frequency for categorical variable. Logistic regression analysis was used to identify predictors of polypharmacy. Results The study sample included a total of 705 patients with COPD. Most of the study sample were males (60%). The mean age of the study population was 65 years old. The majority of the study population had comorbid diseases (68%), hypertension and diabetes were the most common co-existent diseases. Around 55% of the study sample had polypharmacy. Females were significantly less likely to be on polypharmacy compared to males (OR = 0.68, 95% CI = [0.50–0.92], P-value = 0.012)). On the other hand, older patients aged 65.4 or more (OR = 2.31, 95% CI = [1.71–3.14], P-value ≤ 0.001), those with high BMI (≥ 29.2) (OR = 1.42, 95% CI = [1.05–1.92], P-value = 0.024), current smokers (OR = 1.9, 95% CI = [1.39–2.62], P-value ≤ 0.001), those who are receiving home care (OR = 5.29, 95% CI = [2.46–11.37], P-value ≤ 0.001), those who have comorbidities (OR = 19.74, 95% CI = [12.70–30.68], P-value ≤ 0.001) were significantly more likely to be on polypharmacy (p ≤ 0.05). Conclusions Polypharmacy is common among patients with COPD. Patients with high BMI, previous ICU hospitalization and older age are more likely to have polypharmacy. Future analytical studies are warranted to investigate outcomes in patients with COPD and polypharmacy.

Abstract Continuously reinforced concrete pavement (CRCP), crucial for the resilience of transportation infrastructure owing to its continuous steel reinforcement, confronts a critical challenge in the form of spalling—a distress phenomenon posing a threat to pavement durability and overall structural integrity. The detachment or breakage of concrete from the surface compromises CRCP’s functionality and raises safety concerns and escalating maintenance costs. To address this pressing issue, our study investigates the multifaceted factors influencing spalling, employing a comprehensive approach that integrates statistical and machine learning techniques for predictive modeling. Descriptive statistics meticulously profile the dataset, emphasizing age, thickness, precipitation, temperature, and traffic parameters. Regression analysis unveils key relationships, emphasizing the significance of age, annual temperature, annual precipitation, maximum humidity, and the initial International Roughness Index (IRI) as influential factors. The correlation matrix heatmap guides feature selection, elucidating intricate interdependencies. Simultaneously, feature importance analysis identifies age, Average Annual Daily Traffic (AADT), and total pavement thickness as crucial contributors to spalling. In machine learning, adopting models, including Gaussian Process Regression and ensemble tree models, is grounded in their diverse capabilities and suitability for the complex task at hand. Their varying predictive accuracies underscore the importance of judicious model selection. This research advances pavement engineering practices by offering nuanced insights into factors influencing spalling in CRCP, refining our understanding of spalling influences. Consequently, the study not only opens avenues for developing improved predictive methodologies but also enhances the durability of CRCP infrastructure, addressing broader implications for informed decision-making in transportation infrastructure management. The selection of Gaussian Process Regression and ensemble tree models stems from their adaptability to capture intricate relationships within the dataset, and their comparative performance provides valuable insights into the diverse predictive capabilities of these models in the context of CRCP spalling.

Abstract Learning operators with deep neural networks is an emerging paradigm for scientific computing. Deep Operator Network (DeepONet) is a modular operator learning framework that allows for flexibility in choosing the kind of neural network to be used in the trunk and/or branch of the DeepONet. This is beneficial as it has been shown many times that different types of problems require different kinds of network architectures for effective learning. In this work, we design an efficient neural operator based on the DeepONet architecture. We introduce U-Net enhanced DeepONet (U-DeepONet) for learning the solution operator of highly complex CO2-water two-phase flow in heterogeneous porous media. The U-DeepONet is more accurate in predicting gas saturation and pressure buildup than the state-of-the-art U-Net based Fourier Neural Operator (U-FNO) and the Fourier-enhanced Multiple-Input Operator (Fourier-MIONet) trained on the same dataset. Moreover, our U-DeepONet is significantly more efficient in training times than both the U-FNO (more than 18 times faster) and the Fourier-MIONet (more than 5 times faster), while consuming less computational resources. We also show that the U-DeepONet is more data efficient and better at generalization than both the U-FNO and the Fourier-MIONet.

Abstract This study explores the interconnections among industrialization, urbanization, Foreign Direct Investment (FDI), and carbon emissions (CO2e) across 31 OECD (Organization for Economic Cooperation and Development) countries from 1998 to 2020. In addition, it analyzes how education moderates these relationships. This study employs CO2e as the explained variable, while industrialization, urbanization, and FDI serve as explanatory variables, with education as a moderator. This research utilized Hierarchical regression analysis to examine how education moderates the associations among industrialization, urbanization, FDI, and CO2e. Additionally, to validate the reliability of our results, we utilized the Generalized Method of Moments (GMM). The results of this study imply that CO2e levels increase with the level of industrialization and urbanization. The pursuit of education also contributed to the increase in CO2e. Moreover, education and industrialization have detrimental effects on CO2e. To fill this gap in the existing literature, this study investigates the relationship between industrialization, urbanization, FDI, and CO2e, a domain with scarce empirical investigations. Furthermore, this study contributes uniquely to the literature by investigating the moderating influence of education on the relationships between independent variables and CO2e. This original aspect of this research aims to enhance our understanding of the complex connections between these factors.

Abstract Background The most prevalent cause of peripheral nerve entrapment is carpal tunnel syndrome, which is characterized by compression of the median nerve at the wrist as a result of nearby or localized microvascular interference as well as structural alterations to the median nerve or adjacent tissues. However, no special information regarding the median nerve or its surroundings is provided by clinical examination or electrophysiological testing. The purpose of this study is to evaluate the effectiveness of magnetic resonance neurography (MRN) and ultrasound in identifying changes and abnormalities of the median nerve in carpal tunnel syndrome. Methods The twenty-five patients in this study ranged in age from 27 to 63 years old, with a mean age of 47. There were 18 female patients and seven male patients. All patients were sent to the radiology department from the orthopedics, neurology, outpatient clinic, and neurology department, at Ain Shams Hospital, Faculty of Medicine, Ain Shams University. All of the patients had clinically manifested pain along the median nerve distribution, each of the sixteen patients had hand paresthesia, and four had thenar muscle atrophy. Results In the current study, Ultrasound exhibits low negative predictive value of 67% and specificity of 67%, but high positive predictive value of 95%, sensitivity of 95%, and overall accuracy of 92%. On the other hand, (MRN) exhibits a low negative predictive value of 60% and a high specificity of 75% in the diagnosis of nerve entrapment, but it also displays a high positive predictive value of 95%, sensitivity of 90%, and overall accuracy of 88%. Regarding the assessment of the recurrence cause and post-surgical evaluation is more reliable by Magnetic Resonance Neurography examination. Conclusions Magnetic resonance neurography and high-resolution ultrasonography can be utilized to diagnose patients with median nerve entrapment and patients who cannot be diagnosed electrophysiologically. MRN is a more accurate method for detecting the exact location of nerve entrapment and evaluating nerve recovery after surgical intervention than nerve conduction studies and electromyography. Additionally, MRN can be used to identify causes that were not previously recognized based on physical examination and electrophysiological tests.

This study examines the practices of the UN Sustainable Development Goals (SDGs) in Asian countries with special reference to listed firms in China, India, Indonesia, Japan, Malaysia, Singapore, and Saudi Arabia. Further, it evaluates the impact of firms’ specific factors on SDGs practices. The original sample consists of 1462 companies for the 2018–2021 financial years. Data are extracted from the Refinitiv Eikon Database. One-way ANOVA and regression analysis are used to estimate the data. Results reveal that there is a significant difference in SDGs practices among the elected countries. Moreover, results reveal that Return on Assets (ROA), Return on Equity (ROE), market value added, leverage, and current ratio have a negative and significant impact on SDGs practices, while the Earnings per Share (EPS) has a positive and significant impact on SDGs practices. This research contributes to the existing literature by making a comparison among the Asian largest economies regarding the achievement of UN sustainable development goals.

One of the main causes of death worldwide is lung cancer, which is largely caused by cigarette smoking. The crucial transcription factor NF-κB, which controls inflammatory responses and various cellular processes, is a constitutively present cytoplasmic protein strictly regulated by inhibitors like IκB proteins. Upon activation by external stimuli, it undergoes phosphorylation, translocates into the nucleus, and modulates the expression of specific genes. The incontrovertible association between pulmonary malignancy and tobacco consumption underscores and highlights a public health concern. Polycyclic aromatic hydrocarbons and nitrosamines, potent carcinogenic compounds present in the aerosol emitted from combusted tobacco, elicit profound deleterious effects upon inhalation, resulting in severe perturbation of pulmonary tissue integrity. The pathogenesis of smoking-induced lung cancer encompasses an intricate process wherein NF-κB activation plays a pivotal role, triggered by exposure to cigarette smoke through diverse signaling pathways, including those associated with oxidative stress and pro-inflammatory cytokines. Unraveling the participation of NF-κB in smoking-induced lung cancer provides pivotal insights into molecular processes, wherein intricate crosstalk between NF-κB and pathways such as MAPK and PI3K-Akt amplifies the inflammatory response, fostering an environment conducive to the formation of lung cancer. This study reviews the critical function of NF-κB in the complex molecular pathways linked to the initiation and advancement of lung carcinogenesis as well as potential treatment targets.

Aging leads to a gradual decline in kidney function, making the kidneys increasingly vulnerable to various diseases. Oxidative stress, together with cellular senescence, has been established as paramount in promoting the aging process of the kidney. Oxidative stress, defined as an imbalance between ROS formation and antioxidant defense mechanisms, has been implicated in the kidney's cellular injury, inflammation, and premature senescence. Concurrently, the accumulation of SCs in the kidney also exacerbates oxidative stress via the secretion of pro-inflammatory and tissue-damaging factors as the senescence-associated secretory phenotype (SASP). Recently, SIRT1, a nicotinamide adenine dinucleotide (NAD)-dependent deacetylase, has been pivotal in combating oxidative stress and cellular senescence in the aging kidney. SIRT1 acts as a potential antioxidant molecule through myriad pathways that influence diverse transcription factors and enzymes essential in maintaining redox homeostasis. SIRT1 promotes longevity and renal health by modulating the acetylation of cell cycle and senescence pathways. This review covers the complex relationship between oxidative stress and cellular senescence in the aging kidney, emphasizing the protective role of SIRT1.

Background: Stressful and challenging intensive care settings may influence nurses’ professional quality of life (ProQOL), in terms of job satisfaction, burnout (BO), and secondary traumatic stress (STS). Aims: This study aimed to measure the ProQOL of critical care nurses, and its association with sociodemographic variables. Settings and Design: The study was conducted in the intensive care unit (ICU) of a tertiary referral hospital in Saudi Arabia. Materials and Methods: Cross-sectional design utilizing the self-administered ProQOL 5.0 questionnaire composed of three subscales for compassion satisfaction (CS), BO, and STS. Statistical Analysis: scores of the three subscales of the ProQOL questionnaire were presented as mean and standard deviation, and their association with categorical sociodemographic variables was explored using analysis of variance or Kruskal–Wallis test. Results: With a response rate of 48.4%, the majority of nurses were in the moderate category of all three subscales of the questionnaire, with mean scores of CS, BO, and STS of 35.8 ± 6.6, 27 ± 4.4, and 23.9 ± 8.7, respectively. Higher levels of education and longer experience were significantly associated with lower STS scores. Conclusion: Moderate levels of all subscales of ProQOL prevail in our ICU. Longer experience and higher educational levels may be significant factors in minimizing STS.

This paper aims to review the various surgical techniques for gastrocnemius–soleus recession and Achilles tendon lengthening, with a special focus on the treatment of clubfoot and cerebral palsy (CP) equinus contracture. This descriptive review article comprehensively explores different techniques for gastrocnemius recession, including the Hoke percutaneous triple hemisection, Baker’s method (Tongue-in-Groove Gastrocnemius–Soleus Recession), the Vulpius method, the Baumann procedure, and the Strayer procedure (Gastrocnemius Recession). The objective is to present a detailed analysis of these methods, covering their indications, procedural nuances, relevance in clinical practice, and outcomes.

This work aims to provide a new Galerkin algorithm for solving the fractional Rayleigh-Stokes equation (FRSE). We select the basis functions for the Galerkin technique to be appropriate orthogonal combinations of the second kind of Chebyshev polynomials (CPs). By implementing the Galerkin approach, the FRSE, with its governing conditions, is converted into a matrix system whose entries can be obtained explicitly. This system can be obtained by expressing the derivatives of the basis functions in terms of the second-kind CPs and after computing some definite integrals based on some properties of CPs of the second kind. A thorough investigation is carried out for the convergence analysis. We demonstrate that the approach is applicable and accurate by providing some numerical examples.

Cooperative communication through energy harvested relays in Cognitive Internet of Things (CIoT) has been envisioned as a promising solution to support massive connectivity of Cognitive Radio (CR) based IoT devices and to achieve maximal energy and spectral efficiency in upcoming wireless systems. In this work, a cooperative CIoT system is contemplated, in which a source acts as a satellite, communicating with multiple CIoT devices over numerous relays. Unmanned Aerial Vehicles (UAVs) are used as relays, which are equipped with onboard Energy Harvesting (EH) facility. We adopted a Power Splitting (PS) method for EH at relays, which are harvested from the Radio frequency (RF) signals. In conjunction with this, the Decode and Forward (DF) relaying strategy is used at UAV relays to transmit the messages from the satellite source to the CIoT devices. We developed a Multi-Objective Optimization (MOO) framework for joint optimization of source power allocation, CIoT device selection, UAV relay assignment, and PS ratio determination. We formulated three objectives: maximizing the sum rate and the number of admitted CIoT in the network and minimizing the carbon dioxide emission. The MOO formulation is a Mixed-Integer Non-Linear Programming (MINLP) problem, which is challenging to solve. To address the joint optimization problem for an epsilon optimal solution, an Outer Approximation Algorithm (OAA) is proposed with reduced complexity. The simulation results show that the proposed OAA is superior in terms of CIoT device selection and network utility maximization when compared to those obtained using the Nonlinear Optimization with Mesh Adaptive Direct-search (NOMAD) algorithm.

Drilling fluid is one of the crucial parts of the drilling operation and has a significant role in carrying rock cuttings to the surface, stabilizing the wall of the borehole and controlling formation pressure. Most of the depleted reservoirs drilled by water-based drilling fluid are subjected to high overbalance pressures due to the difference in density of drilling fluid compared with the formation fluid. This overbalance pressure creates the lost circulation of mud, pipes sticking and formation damage. Underbalanced drilling can be considered to eliminate the above-mentioned problems. However, it has safety issues and prohibitive in many depleted fields. This study focuses on the development of the Aphrons-based drilling fluid from adding two types of surfactants (City-Termidyl Ammonium Bromide (CTAB) as a stabilizer, and Sodium Dodecyl Benzene Sulfate ( SDBS) as a generator) and xanthan gum (XC) polymer to be used for drilling of Dawood Bai-Hassan Reservoir. (20) samples of Aphrons drilling fluids were formulated at different concentration of xanthan gum (0.2 and 0.4 wt.%), CTAB (0.2 and 0.4 wt.%) and SDBS (0.1 to 1 wt.%). All the developed drilling fluids subjected different experiments of rheological and filtration properties. The obtaining results show that better rheological behavior were obtained with adjusting the concentration of the used additives as 0.4 wt.% xanthan gum, 0.2 wt.% CTAB and 0.4 wt. SDBS when achieved and added to the base drilling fluid. The results showed that (XC) Polymer combination with surfactants (CTAB and SDBS) have a major effect on mud filtration at even under-surface conditions, where it was lowered by 47% at surface ( 20°C, 100 psi) and lowered by 41.67%, 50% at conditions 60 °C, 90 °C (600 psi) temperature respectively. In addition, for maintaining other mud properties such as viscosity, yield point, gel strength and cleaning capacity as well.

Abstract Background Substance use disorders (SUDs) and mental health disorders (MHDs) are significant public health challenges with far-reaching consequences on individuals and society. Dual diagnosis, the coexistence of SUDs and MHDs, poses unique complexities and impacts treatment outcomes. A research landscape analysis was conducted to explore the growth, active countries, and active journals in this field, identify research hotspots, and emerging research topics. Method A systematic research landscape analysis was conducted using Scopus to retrieve articles on dual diagnosis of SUDs and MHDs. Inclusion and exclusion criteria were applied to focus on research articles published in English up to December 2022. Data were processed and mapped using VOSviewer to visualize research trends. Results A total of 935 research articles were found. The number of research articles on has been increasing steadily since the mid-1990s, with a peak of publications between 2003 and 2012, followed by a fluctuating steady state from 2013 to 2022. The United States contributed the most articles (62.5%), followed by Canada (9.4%). The Journal of Dual Diagnosis, Journal of Substance Abuse Treatment, and Mental Health and Substance Use Dual Diagnosis were the top active journals in the field. Key research hotspots include the comorbidity of SUDs and MHDs, treatment interventions, quality of life and functioning, epidemiology, and the implications of comorbidity. Emerging research topics include neurobiological and psychosocial aspects, environmental and sociocultural factors, innovative interventions, special populations, and public health implications. Conclusions The research landscape analysis provides valuable insights into dual diagnosis research trends, active countries, journals, and emerging topics. Integrated approaches, evidence-based interventions, and targeted policies are crucial for addressing the complex interplay between substance use and mental health disorders and improving patient outcomes.

Abstract Background The present study investigates the representation of women in the Otolaryngology department in a tertiary academic hospital, and the challenges they face during their residencies. Methods A questionnaire which included demographic information and a series of 54-questions of academic, clinical, social, psychological, and private practice challenges was electronically distributed among female residents registered in the Department of Otolaryngology in the last 10 years (2013–2022) throughout November 2023 to January 2024. Results Eighty-one female residents out of 103 registered (78.6%) responded to the distributed questionnaire highlighting the challenges they faced during their training period. Conclusion The current study addresses the barriers confronted by female residents in the department as well as identifying potential solutions that might help future encouragement of women to select otolaryngology as their specialty.

Abstract Background Chronic obstructive pulmonary disease (COPD) is associated with dysfunctional diaphragmatic breathing we assess the diaphragmatic excursion at different stages of COPD patients by transthoracic ultrasound. Objective The present study aimed to assess the diaphragmatic excursion at different stages of COPD patients by transthoracic ultrasound. Patients and methods In this observational case–control study, 80 COPD patients were included according to GOLD guidelines 2020 attending the Chest Clinic in Badr Hospital, Helwan University. All patients were divided equally into 5 groups according to FEV1 measured by spirometer: group (1) normal person; group (2) mild stage FEV1_80% predicted; group (3) moderate stage 50%_FEV1

Abstract Background The purpose of the study was to assess visual outcomes, complications, intraocular lens (IOL) stability, and corneal status after sutured scleral-fixated intraocular lens implantation combined with penetrating keratoplasty (PKP). Methods This retrospective single-arm cohort study included patients who underwent PKP and sutured scleral-fixated intraocular lens implantation between 2013 and 2018 at the Dhahran Eye Specialty Hospital. The eyes were examined postoperatively at 1, 3, 6, 12, and 24 months. Corneal status, complications, and IOL status were also evaluated periodically, and the number of eyes with a BCVA of > 20/200 was recorded. Results Twenty-two eyes from 22 patients were included. The median duration of follow-up was 3 (IQR 1.8; 4.4) years. Reasons for surgery were traumatic globe rupture (six eyes, 27.3%), bullous keratopathy (nine eyes, 40.1%), failed previous graft (five eyes, 22.7%), and corneal scarring (two eyes, 9.1%). Twelve (54.5%) eyes showed a BCVA of > 20/200 (non-blind) at 12 months after surgery and only five (22.7%) before surgery. Twelve months after surgery, 13 patients showed an improvement in BCVA in two lines (59.1%), seven remained the same (31.8%), and 2 deteriorated (9.1%). The indication for surgery (p = 0.2) and the stability of the sutured-scleral fixated IOL (p = 0.8) were not associated with an improvement in BCVA at the final follow-up. The corneal graft remained clear in nine eyes (40.9%) at a median duration of 3 years. The overall average survival period for all corneal grafts was 42.9 months. Conclusions The combination of sutured scleral-fixated intraocular lens implants and PKP is an effective intervention for preserving visual acuity in patients with complex cases. However, the risk of graft failure and then need for repeat transplantation should be taken into consideration.

Abstract Surface-enhanced Raman scattering (SERS) remains a significant area of research since it’s discovery 50 years ago. The surface-based technique has been used in a wide variety of fields, most prominently in chemical detection, cellular imaging and medical diagnostics, offering high sensitivity and specificity when probing and quantifying a chosen analyte or monitoring nanoparticle uptake and accumulation. However, despite its promise, SERS is mostly confined to academic laboratories and is not recognised as a gold standard analytical technique. This is due to the variations that are observed in SERS measurements, mainly caused by poorly characterised SERS substrates, lack of universal calibration methods and uncorrelated results. To convince the wider scientific community that SERS should be a routinely used analytical technique, the field is now focusing on methods that will increase the reproducibility of the SERS signals and how to validate the results with more well-established techniques. This review explores the difficulties experienced by SERS users, the methods adopted to reduce variation and suggestions of best practices and strategies that should be adopted if one is to achieve absolute quantification. Graphical Abstract

Purpose: This review aims to discuss the psychological aspects of Graves’ ophthalmopathy (GO), estimate the prevalence of depression and anxiety disorders in GO, examine whether these psychiatric disorders are more prevalent in GO than in Graves’ disease (GD) without eye disease, and evaluate the main contributors for depression and anxiety in GO. Methods: A review of the literature. Results: Both depression and anxiety are associated with GO. The prevalence of depression and anxiety disorders specifically in GO patients was estimated at 18–33% and 26–41%, respectively. The reported prevalence in GD patients ranged from 9% to 70% for depression and from 18% to 88% for anxiety disorders. Significantly higher levels of depression and anxiety were found in GD patients compared with patients with non-autoimmune hyperthyroidism. Conflicting results have been reported regarding the association of antithyroid autoantibodies with depression and anxiety disorders. Serum thyroid hormone levels do not correlate with the severity of depression and anxiety. An improvement of psychiatric symptoms is observed in hyperthyroid patients after treatment of thyrotoxicosis. Moreover, depression and anxiety are significantly related to impaired quality of life (QoL) in GO. Exophthalmos and diplopia were not associated with depression nor anxiety, but orbital decompression and strabismus surgery do seem to improve QoL in GO patients. Conclusions: The results of this review suggest that altered thyroid hormone levels and autoimmunity are prognostic factors for depression and anxiety in GO. With regard to the visual and disfiguring aspects of GO as contributing factors for depression and anxiety, no decisive conclusions can be made.

Abstract Background Equitable geographical distribution of health resources, such as hospital beds, is fundamental in ensuring public accessibility to healthcare services. This study examines the distribution of hospital beds across Saudi Arabia's 20 health regions. Methods A secondary data analysis was conducted using the 2022 Saudi Ministry of Health Statistical Yearbook. The study focused on calculating the hospital beds-per-1,000-people ratio across Saudi Arabia's 20 health regions. The analysis involved comparing regional bed distributions using the Gini index and Lorenz curve to assess the distribution of hospital beds. Results The national average beds-per-1,000-people ratio was 2.43, serving a population of approximately 32.2 million. The calculated mean Gini index for bed distribution was 0.15, which indicates a relatively equitable distribution. Further analysis revealed some regional disparities, with health regions like Makkah and Jeddah displaying critically low bed-to-population ratios. In contrast, others like Al-Jouf and the Northern region reported higher ratios. The study also identified the need for an additional 17,062 beds to meet international standards of 2.9 beds per 1,000 people. Conclusions The findings revealed a national average beds-per-1,000-people ratio of 2.43, with some regional disparities. The study highlights the critical need for targeted healthcare planning and policy interventions to address the uneven distribution of hospital beds across Saudi Arabia. Trial registration Not applicable.

Abstract Bentonite plastic concrete (BPC) is extensively used in the construction of water-tight structures like cut-off walls in dams, etc., because it offers high plasticity, improved workability, and homogeneity. Also, bentonite is added to concrete mixes for the adsorption of toxic metals. The modified design of BPC, as compared to normal concrete, requires a reliable tool to predict its strength. Thus, this study presents a novel attempt at the application of two innovative evolutionary techniques known as multi-expression programming (MEP) and gene expression programming (GEP) and a boosting-based algorithm known as AdaBoost to predict the 28-day compressive strength ( ) of BPC based on its mixture composition. The MEP and GEP algorithms expressed their outputs in the form of an empirical equation, while AdaBoost failed to do so. The algorithms were trained using a dataset of 246 points gathered from published literature having six important input factors for predicting. The developed models were subject to error evaluation, and the results revealed that all algorithms satisfied the suggested criteria and had a correlation coefficient (R) greater than 0.9 for both the training and testing phases. However, AdaBoost surpassed both MEP and GEP in terms of accuracy and demonstrated a lower testing RMSE of 1.66 compared to 2.02 for MEP and 2.38 for GEP. Similarly, the objective function value for AdaBoost was 0.10 compared to 0.176 for GEP and 0.16 for MEP, which indicated the overall good performance of AdaBoost compared to the two evolutionary techniques. Also, Shapley additive analysis was done on the AdaBoost model to gain further insights into the prediction process, which revealed that cement, coarse aggregate, and fine aggregate are the most important factors in predicting the strength of BPC. Moreover, an interactive graphical user interface (GUI) has been developed to be practically utilized in the civil engineering industry for prediction of BPC strength.

The shift, towards cars (EVs) plays a role in the global effort to combat climate change by reducing dependence on fossil fuels. An important part of this shift involves creating user EV charging systems. This study looks into how a connected coil design in a wireless power transfer system can help overcome challenges in EV charging when dealing with varying loads. We examine how well the system performs under load resistances that mimic states of charge and battery capacities in EVs. By assessing the stability of output voltage and efficiency of power transfer across these loads we focus on maintaining resonance within the system. Our findings show that the LCCL to LC WPT system maintains efficiency in power transfer (50-94) % when Coupling Coefficient change (0-0.9) at load resistance 3ꭥ and stable output voltage when facing changes in load resistance (1-4.5)ꭥ. This suggests that the system is resilient against load variations, which's crucial for real world EV charging situations. This research supports the potential of WPT systems as an efficient solution to meet the evolving demands of EV infrastructure leading towards increased adoption of EVs and a sustainable future, for transportation.

A reemerging viral disease known as Marek's disease affects chickens and has a devastating financial impact on the global poultry sector. The emergence of pathogenic strains must be continuously monitored using molecular approaches of Marek’s disease and to adevise to use appropriate vaccination program with implement bio-security. This study was continued from May 2021 to August2021. Clinical symptoms and postmortem lesions were used to identify MD, and PCR testing for the Meq gene provided further confirmation. The meq gene's phylogenetic analysis was also performed, and such test revealed clustering of the our Iraqi field strains with Euroasian cluster, where the genetic characteristics of the present study MD strains were similar to those of Chinese and European strains

Presentation: A child presented to the emergency department with a one-day history of accidental ingestion of a cylindrical battery. Diagnostic Method: An abdominal radiograph confirmed the presence of the foreign body in the abdomen. Management: The patient was managed conservatively with oral clear fluids, laxatives to aid in the passage of the cylindrical battery, and serial plain abdominal radiographs to monitor its movement from the stomach to the descending colon until it was expelled through the rectum. Discussion: Daily clinical examinations, serial abdominal radiographs, and conservative management with oral clear fluids and laxatives can facilitate the passage of an intact cylindrical battery through the rectum in children without causing corrosive effects or complications. However, if the battery casing is compromised, it can cause caustic damage to the airways or gastrointestinal tract.

Introduction Erection dysfunction (ED) is an important health problem that affects millions of men throughout the world. Biofeedback (BF) pelvic floor training is reeducation therapy to teach patients with erectile dysfunction how to strengthen their PFMs which play a role in erection through the enhancement of blood flow to the penis.Aim of the Work The aim of this study was to assess improvement of BF pelvic floor training in the management of patients with erectile dysfunction (ED).Material & Methods Thirty men presenting with ED were evaluated with Erectile function domain of International Index of Erectile Function (IIEF), Erectile Dysfunction-Effect on Quality of Life (ED-EQoL) and Maximum squeezing pressure of pelvic floor muscles (PFMS) according to manometric BF before and after receiving BF pelvic floor training.Results The patients who received BF showed significant subjective improvement in their Erectile functions according to (IIEF)and (ED-EQoL) questionnaires and significant objective improvement in the form of mean of maximum squeezing pressure of PFM susing BF (McNemar test, McN = 0.031, p = 0.001*).Conclusion Biofeedback pelvic floor training is highly effective easily applicable tool of management in the patients with ED with good outcomes on patient’s complaints and quality of life through their effect on improving strength of their PFMs.

Introduction Detrusor sphincter dyssynergia (DSD) is the urodynamic description of bladder outlet obstruction from detrusor muscle contraction with concomitant involuntary urethral sphincter activation. DSD is associated with neurologic conditions such as spina bifida. It is associated with urinary incontinence (UI), nocturnal enuresis, urgency, intermittency, and recurrent urinary tract infections (UTIs).The Aim of this Study It aims to assess the efficacy of biofeedback (BF) for achieving perineal synergy and improving symptoms in thirty children with refractory DSD who failed to improve with medical treatment in the last 2 to 3 years.Material and Methods Thirty children (20 girls and 10 boys) aged 6–18 years (mean: 9.2 ± 2.2 yrs) with refractory DSD who failed to show improvement after 2–3 years of medical treatment with recurrent UTI and failure to emptying completely their bladder using urodynamic study. After patients understood the concept of BF pelvic floor training were regularly scheduled twice weekly for up to 3 months. Improvement was assessed using interview with parents after 3 months with measurement of manomeric pelvic floor muscles (PFMs) during straining and urodynamic study.Results Seven (23.3%) of the 30 children had daytime UI and 11 (36.7%) had nighttime incontinence. 4/30 (13.3%) children had increased urgency and 5 (16.7%) had straining intermittency and 3% (10%) had Dysuria. After 3 months of BF pelvic floor training 7/30 (23.3%) of children were fully responsive 100% decrease of symptoms, 14/30 (46%) responded more than 90% decrease of their symptoms, 7/30 (23.3%) of children responded partial decrease of symptoms and 2/30 (0 to 49%) decrease of symptoms to BF pelvic floor training.Conclusions BF pelvic floor training is an effective therapeutic option for children with refectory DSD. It improves symptoms of children with DSD with decreased UTIs through decreasing pressure of PFMs during urination.

Abstract Background Cardiovascular disease (CVD) is a leading cause of global mortality. Early intervention and prevention of CVD depend on accurately predicting the risk of CVD. This study aimed to investigate the association between the TyG index and the risk of coronary heart disease (CHD), congestive heart failure (CHF), heart attack (HA), stroke, and hypertension (HTN) among patients without diabetes in the United States. Methods In this retrospective, cross-sectional study, we used data from the National Health and Nutrition Examination Survey (NHANES) from 2001 to 2020. We conducted several regression analysis models and calculated the sensitivity and specificity of (TyG) index for predicting the onset of CHD, CHF, HA, stroke, and HTN. Results A total of 10,937 individuals without diabetes participated in our study. Individuals with a TyG index greater than 8.96 displayed significant increasing in various parameters, including BMI, systolic/diastolic blood pressure, total cholesterol, LDL, and Apo-B levels (p

Freshwater is becoming increasingly vulnerable to pollution due to both climate change and an escalation in water consumption. The management of water resource systems relies heavily on accurately predicting fluctuations in lake water levels. In this study, an artificial neural network (ANN), a deep learning (DL) neural network model, and an autoregressive integrated moving average (ARIMA) model were employed for the water level forecasting of the St. Clair and Ontario Lakes from 1981 to 2021. To develop the models, we utilized the average mutual information and incorporated lag periods of up to 6 months to identify the optimal inputs for the water level assessment in the lakes. The results were compared in terms of the root mean square error (RMSE), coefficient of correlation (r), and mean absolute percentage error (MAPE) and graphical criteria. Upon evaluating the results, it was observed that the error values for the deep learning models were insignificant at the designated stations: Lake St. Clair—0.16606 m < RMSE < 1.0467 m and Lake Ontario—0.0211 m < RMSE < 0.7436 m. The developed deep learning model increased the accuracy of the models by 5% and 3.5% for Lake St. Clair and Lake Ontario, respectively. Moreover, the violin plot of the deep learning model for each lake was most similar to the violin plot of the observed data. Hence, the deep learning model outperformed the ANN and ARIMA model in each lake.

Middle lobe torsion (MLT) is an unusual complication in lung surgery that is usually associated with upper lobe lobectomy and rarely develops postlower lobectomy. In the case of MLT, urgent surgical intervention is required to decrease the risk of mortality and morbidity, and diagnosis is challenging due to the nonspecific symptoms of MLT. In this article, we present a case of a recurring lung abscess treated by the right lower lobectomy, complicated by the right MLT and to our knowledge MLT consider rarest complication postright lower lobectomy.

Background: Pregnancies that extend beyond due date (post-term) are associated with an increased risk of complications for both the mother and fetus, including morbidity and mortality. Doppler ultrasound offers a non-invasive way to assess blood flow patterns in the fetal renal artery, but the current evidence regarding the link between altered renal flow and oligohydramnios (low amniotic fluid volume) remains inconclusive. Objectives: To assess the correlation between fetal renal artery Doppler measurements and amniotic fluid volume indices. Patients and methods: In a study of 68 post-term pregnant women, two groups were formed. The first group had oligohydramnios (AFI < 5 cm), while the second group had normal amniotic fluid capacity (AFI > 5-25 cm). Researchers conducted a thorough history, sonographic evaluation, clinical examination, and standard laboratory tests. Doppler examination assessed fetal renal artery characteristics, including blood flow (FRABF), resistance index (RI), pulsatility index (PI), acceleration time (AT), and systolic/diastolic ratio (S/D). Results: A significant positive correlation between AFI and FRABF were identified in our investigation. On the other hand, AFI exhibited substantial negative correlations with the doppler of renal artery indices: RI, PI, PS, and AT (correlation coefficients r=-0.549, r=-0.330, r=-0.258, and r=-0.478, respectively; all p-values