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Abstract Nanoparticle-mediated drug delivery offers a promising approach to targeted cancer therapy, leveraging the ability of nanoparticles to deliver therapeutic agents directly to cancerous tissues with minimal impact on surrounding healthy cells. The presence of these nanoparticles is governed by a concentration equation, which accounts for the diffusion, convection, and reaction of the nanoparticles with the blood components. It is well-known that whenever a disease or infection occurs in a human, in 80% of cases a rise in the concentration of hydrogen peroxide in the blood occurs. This is the reason why blood is assumed to contain hydrogen peroxide (in the present study), which is a biomarker of oxidative stress and inflammation. This study explores the integration of machine learning (ML) techniques into the optimization of drug delivery processes within the human cardiovascular system, focusing on the enhancement of these processes through the application of magnetic fields. By employing ML algorithms, we analyze and predict the behavior of nanoparticles as they navigate the complex fluid dynamics of the cardiovascular system, particularly under the influence of an external magnetic field. The predictive power of ML models enables the precise control of nanoparticle trajectories, optimizing their accumulation in cancerous tissues and improving the efficacy of the drug delivery system. The findings of this study demonstrate that ML-enhanced magnetic targeting can significantly enhance the precision and effectiveness of nanoparticle-mediated drug delivery, offering a new paradigm in cancer treatment strategies. This approach has the potential to revolutionize the field by providing personalized and highly efficient therapeutic solutions for cancer patients.

Abstract Background Fluid overload is associated with increased morbidity and mortality in critically ill patients. An accurate assessment of fluid status in neonatal cardiac pediatric patients is required for assessment of fluid overload. Estimation of fluid status using different Doppler parameters may be helpful in determination of fluid status. Purpose To evaluate difference in fluid status in neonates with and without congenital heart diseases. To detect sensitivity of Doppler Ultrasound in early determination of fluid status. To compare between different parameters (IVC diameter, IVCCI, and IVC/AO ratio) between cardiac and healthy neonates. Methods Transabdominal Doppler parameters of 25 full-term newborns with congenital heart diseases and congestive heart failure were compared to 25 post-natal age and sex-matched normal healthy neonates serving as controls. Aortic as well as inspiratory and expiratory inferior vena cava diameters were measured. Subsequently, inferior vena cava collapsibility index (IVCCI) and inferior vena cava-to-aortic ratio (IVC/AO) were calculated. Results Fluid overload detected by increased IVC diameter (decreased IVCCI and increased IVC/AO ratio) was observed in the cardiac compared to the control group. There was positive correlation between the fluid volume and the IVC diameter and IVC/AO ratio and negative correlation with the IVC collapsibility indices. Conclusions Fluid overload with increased IVC diameter and lack of IVC collapsibility were observed in neonates with congenital heart diseases and congestive heart failure compared with those hemodynamically stable controls. We recommend the use of IVC diameter, IVCCI, and IVC/AO ratio as rapid, easy and sensitive parameters in assessing volume status.

Abstract Today, high-energy applications are devoted to boosting the storage performance of asymmetric supercapacitors. Importantly, boosting the storage performance of the negative electrodes is a crucial topic. Fe3O4-based active materials display a promising theoretical storage performance as a negative electrode. Thus, to get a high storage performance of Fe3O4, it must be tailored to have a higher ionic and electronic conductivity and outstanding stability. Functionalized graphite felt (GF) is an excellent candidate for tailoring Fe3O4 with a facile ionic and electronic pathway. However, the steps of the functionalization of GF are complex and time-consuming as well as the energy loss during this step. Thus, the in-situ functionalization of the GF surface throughout the synthesis of Fe3O4 active materials is proposed herein. Fe3O4 is electrodeposited at the in-situ functionalized GF surface with the crystalline nanowires-like structure as revealed from the various analyses; SEM, TEM, Mapping EDX, XPS, XRD, wettability test, and Raman analysis. Advantageously, the synthetic approach introduces full homogeneous and uniform coverage of the large surface area of the GF. Thus, Fe3O4 nanowires with high ionic and electronic conductivity are characterized by a higher storage performance. Interestingly, Fe3O4/GF possesses a high specific capacity of 1418 mC cm−2 at a potential scan rate of 10 mV s−1 and this value retained to 54% at a potential scan rate of 50 mV s−1 at an extended potential window of 1.45 V. Remarkably, the diffusion-controlled reaction is the main contributor of the storage of Fe3O4/GF electrode as revealed by the mechanistic studies.

Introduction: Dentists’ attire includes their choice of clothes and Personal Protective Equipment (PPE) required to follow infection control measures. Investigating and understanding the paediatric patient’s preferences and perceptions towards the dentist’s attire can aid in establishing a more efficient and smoother relationship between them. Aim: To determine the children’s preferences and perceptions of their paediatric dentist’s attire and PPE among four to 12-year-old children. Materials and Methods: This cross-sectional study included four to 12-year-old Arabic-speaking children attending Department of Paediatric Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia for dental treatment with their parents/guardians between February 2022 and April 2022. Data were collected from the participants using a validated Arabic electronic questionnaire to determine their preferences regarding different parts and types of the dentist’s attire and PPE, as well as their perceptions and feelings of comfort towards the dentist wearing the full standard PPE. Data were summarised as frequencies and percentages for categorical variables or means and standard deviations for continuous variables. The significance threshold was set at 0.05. Results: A total of 362 participants with a mean age of 8.4±2.3 years and their parents/guardians participated in the study. Female dentists were significantly more favoured by both male and female participants, with statistical significance among females (p

Vitamin C (VIT C) is an antioxidant that prevents skin aging. Although dermal delivery is one of the most effective routes to transport VIT C to the skin, the impact of this route can be limited by the barrier function of the stratum corneum (SC). Additionally, VIT C rapidly oxidized and degraded under light and temperature. Therefore, this study provides an approach to utilizing microneedles (MNs) to improve the dermal delivery of VIT C and enhance its stability by incorporating a stabilizing system of ethylenediaminetetraacetic acid (EDTA) and sodium metabisulfite (Meta) within the MNs. Vitamin C microneedles (VIT C MNs) were fabricated using different biodegradable polymers and various concentrations of EDTA/Meta. VIT C MNs were evaluated for morphology, VIT C content, mechanical properties, dissolution rate, needles’ insertion, physicochemical properties, ex vivo permeation, viscosity of VIT C polymeric solutions, cytotoxicity, and stability. The results showed that VIT C MNs were uniform and mechanically strong. The recovery of VIT C in MNs was 88.3–90.0 %. The dissolution rate of MNs was

We live in an era when time is a precious resource. Thus, dealing with the vast amount of data collected from different resources for various purposes requires creating systems that can process the data in a reasonable time to make it worthwhile. Accessing big data in machine learning and artificial intelligence models creates efficient, robust models. In this work, we present a method to create a multi-class classification model using Apache-spark. The model is built and trained with the CIC-DDOS2019 dataset to build a DDoS Attack detection model. Ensemble modeling was used to improve the accuracy and robustness of the model. At the same time, Apache-spark was used to distribute the vast amount of training and testing data over the models used to create the intrusion detection model. The proposed model has achieved high accuracy (99.94\%) while reducing the execution time to almost the half when applied without Apache-spark. [JJCIT 2024; 10(2.000): 123-137]

Abstract Background Women’s inability to recognize ovarian cancer (OC) causation myths to be incorrect may lead to behavioral changes that could distract them from actual risk factors and impact their treatment decision making. This study examined Palestinian women’s recognition of OC mythical causes, and explored factors associated with good recognition. Methods A national cross-sectional study was conducted. Adult Palestinian women were recruited from hospitals, primary healthcare facilities, and public areas in 11 governorates. The Cancer Awareness Measure-Mythical Causes Scale was modified and utilized for data collection. Awareness level was determined based on the number of myths around OC causation recognized to be incorrect: poor (0–4), fair (5–9), and good (10–13). Results A total of 5618 participants agreed and completed the questionnaire out of 6095 approached (response rate = 92.1%), and 5411 questionnaires were included in the final analysis. The most recognized food-related myth was ‘drinking from plastic bottles’ (n = 1370, 25.3%) followed by ‘eating burnt food’ (n = 1298, 24.0%). The least recognized food-related myth was ‘eating food containing additives’ (n = 611, 11.3%). The most recognized food-unrelated myth was ‘having a physical trauma’ (n = 2899, 53.6%), whereas the least recognized was ‘using mobile phones’ (n = 1347, 24.9%). Only 273 participants (5.1%) had good awareness of OC causation myths as incorrect. Earning higher monthly incomes as well as visiting governmental healthcare facilities were associated with a decrease in the likelihood of exhibiting good awareness. Conclusion The overall recognition of OC causation myths was low. Addressing mythical beliefs should be included in OC prevention strategies and public health interventions to improve women’s understanding of OC risk factors versus mythical causes.

Abstract Background Vitamin D deficiency is an importance preventable problem in the global and associates with lack levels of awareness about vitamin D. According to prior studies, in the Arab world, there is low of knowledge and awareness toward vitamin D deficiency. The target of our study is evaluating the knowledge level about vitamin D deficiency and determining the associated factors with levels of awareness of its. Method This online cross-sectional study was performed in Syria between 25 February to 29 March 2023 to assess the levels of knowledge about vitamin D deficiency among general Syrian population. The study’s survey was obtained from previously published research and we conducted a pilot study to assure the validity and clarity questionnaire. All Syrian individuals aged 18 or older who were able to read and write and willing to participate were included, while, non-Syrian nationality individuals and all medical staff (doctors, nurses, and medical students…), as well, those under 18 age were excluded. The questionnaire consisted of 23 questions separated into four categories. The first section was sociodemographic information of the study population. The second section measured the level awareness of the study population regarding the benefits of vitamin D. In addition, the third and fourth part evaluated knowing of the respondents about sources of and toxicity consequences of vitamin D. The data were analyzed by utilizing multivariate logistic regression in IBM, SPSS V.28 version. Results Overall, 3172 of the study population accepted to participate in this research and 57.9% the majority of them were aged in the range among 18 and 28. While, the average age of the respondents were 30.80 ± 11.957. Regarding with the awareness toward knowledge of advantages and source of vitamin D and outcomes of vitamin D toxicity. Most of the participants mentioned that vitamin D is used to treat bone disease and rickets and contributes in maintaining calcium and phosphates (91.4% and 84.6%, respectively). Whereas, more than half of them reported that sun exposure does not cause vitamin D poisoning and that vegetarians are more likelihood to have vitamin D than non-vegetarians, (54.1% and 54.9%, respectively). Only, age and occupation out of nine predictors variables were significantly correlated with adequate knowledge of Vitamin D (p-value

OBJECTIVE: The study aimed to determine the mode of delivery and fetal outcome among women with postdated pregnancies. METHODOLOGY: This cross-sectional study was conducted from July to December 2020 in the Department of Gynecology, Hayatabad Medical Complex, Peshawar. A total of 287 women with postdated pregnancies (beyond 41 weeks) were selected through a convenient sampling technique for the study and followed to detect expected fetal outcomes. All women of age 20-45 with no signs of labor onset and cepahlic presentation of singleton pregnancy were included, while women with retained placenta detected by ultrasound, women with a medical disorder like coagulopathies (Haemophilia, Von Willebrand disease, Thrombocytopenia, DIC, Protein S deficiency, Protein C deficiency) detected by the specific investigation were excluded from the study. Data was analyzed using SPSS version 20. RESULTS: The mean age of the sample was 30.5 years, with a standard deviation of 6.1 years. The mean parity of the sample was 2.1±1.5. The mean BMI of the sample was 26.1±3.8kg/m2. On follow-up, fetal distress in 16%, macrosomia in 18.5%, birth asphyxia in 18.1%, meconium aspiration in 8.4% and NICU admission in 9.1%. None of the neonates died in this study. CONCLUSION: Postdated pregnancy carries a high risk of fetal distress, macrosomia and birth asphyxia. We recommend more large-scale surveys as well as trials to determine the efficacy of induction before pregnancy enters the postdate period and reduce the morbidity and mortality due to postdate pregnancies.

Abstract The current decline in freshwater resources presents a significant global challenge to crop production, a situation expected to intensify with ongoing climate change. This underscores the need for extensive research to enhance crop yields under drought conditions, a priority for scientists given its vital role in global food security. Our study explores the effects of using humic and chitosan treatments to alleviate drought stress during critical growth phases and their impact on crop yield and water efficiency. We employed four different irrigation strategies: full irrigation, 70% irrigation at the early vine development stage, 70% irrigation during the storage root bulking stage, and 85% irrigation across both stages, complemented by full irrigation in other periods. The plants received either humic treatments through foliar spray or soil application, or chitosan foliar applications, with tap water serving as a control. Our findings highlight that the early vine development stage is particularly vulnerable to drought, with a 42.0% decrease in yield observed under such conditions. In normal growth scenarios, foliar application of humic substances significantly improved growth parameters, resulting in a substantial increase in yield and water efficiency by 66.9% and 68.4%, respectively, compared to the control treatment under full irrigation. For sweet potatoes irrigated with 70% water at the storage root bulking stage, ground application of humic substances outperformed both foliar applications of chitosan and humic in terms of yield results. The highest tuber yield and water efficiency were attained by combining chitosan and humic ground applications, regardless of whether 70% irrigation was used at the storage root bulking stage or 85% irrigation during both the early vine development and storage root bulking stages.

Abstract Background Atrial fibrillation (AF) is the most prevalent cardiac condition linked to increased mortality due to complications such as stroke. Oral anticoagulant (OAC) is the mainstay in preventing cerebrovascular accidents in patients with AF. Recent evidence identified gaps in physician’s knowledge in diagnosing and managing patients with AF. This study aims to assess Syrian physicians’ knowledge, attitude, and practices regarding the use of anticoagulant therapy in non-valvular AF (NVAF) patients. A cross-sectional study was conducted using a validated web-based questionnaire, which included 56 items separated into four sections that collected information about demographics, knowledge, attitude, and practices. Chi-square and Kruskal Wallis were performed to analyze the statistical relationships between the knowledge, attitude, practice, and demographic variables. Results A total of 497 participants completed the survey, of which 62.6% were between the ages of 25 and 35. The average participant scores for knowledge, attitude, and practices were (48.18 ± 21.57), (81.54 ± 9.26), and (62.83 ± 12.42), respectively. Participants who demonstrated good understanding, a positive attitude, and good practices were 22.3%, 87.3%, and 25.4%, respectively. The fear of bleeding was identified as the most significant barrier to initiating anticoagulant medication in AF patients (55.5%). Doctors who attended training had a better knowledge score than those who did not (mean ± S.D. = 57.24 ± 20.7). Participants who stated that over 70% of their AF patients use aspirin received the highest attitude score (mean ± S.D = 86.98 ± 21.17). PhD participants reported higher practice scores than those with other educational backgrounds (mean ± S.D = 73.96 ± 11.3). Conclusion This research showed that primary care physicians in Syria had optimistic views regarding OAC therapy, suggesting that training interventions targeting physicians may lead to improvement in the treatment of patients with NVAF in Syria.

Abstract Background Pre-eclampsia (PE) is a major contributor to morbidity and mortality in mothers worldwide. Adequate understanding of this condition improves treatment, control, and prevention. This study evaluated preeclampsia awareness among pregnant women in Syria, and the characteristics related to awareness adequacy. Methods This national cross-sectional study was conducted in Syria between 25 October and November 19, 2022. We included pregnant females of all age groups from all Syrian governorates. The questionnaire consisted of sociodemographic characteristics and knowledge of pre-eclampsia and its associated factors, symptoms, and complications. Results Overall, 706 participants were involved in this research, with a mean age of 38.22. Only 52.1% of them reported that they had heard of preeclampsia. Among the participants, 56.5% stated that they would not terminate a pregnancy if they were determined to be likely to develop preeclampsia, while nearly 55.2% agreed to continue the pregnancy rather than deliver prematurely even if their where a potential risk on their health risks. Participants who reported a family history of PE or had already experienced PE were more likely to have appropriate preeclampsia knowledge than those who did not (OR = 2.27, OR = 3.18, respectively). Respondents aged 25 to 35 years had the highest knowledge scores, and participants living in cities scored higher knowledge than rural residents. Conclusion According to our findings, pregnant women in Syria have a awareness gaps regarding the PE topic. This highlights the need to enhance women’s preeclampsia understanding for better pregnancy outcomes. Education through organizations, the media, and national programs is a significant aspect that promotes an adequate understanding of preeclampsia.

AbstractPolycystic Ovarian Syndrome (PCOS) is a prevalent metabolic and hormonal disorder affecting women of reproductive age. Limited data exists on Syrian women’s PCOS awareness and health behaviors. This study aimed to gauge PCOS prevalence, knowledge, awareness, and health-related practices among Syrian women. A cross-sectional online survey was conducted from 11 February to 27 October 2022, targeting Syrian women aged 18–45. Collaborators from specific medical universities distributed a questionnaire adapted from a Malaysian paper through social media platforms. Out of 1840 surveyed Syrian women, 64.2% were aged 21–29, and 69.6% held bachelor’s degrees. Those with a bachelor’s degree exhibited the highest mean knowledge score (12.86), and women previously diagnosed with PCOS had a higher mean knowledge score (13.74) than those without. Approximately 27.4% were confirmed PCOS cases, and 38.9% had possible cases. Women with PCOS were 3.41 times more likely to possess knowledge about the condition. The findings suggest a moderate level of PCOS knowledge and health-related practices among Syrian women, emphasizing the need for increased awareness. Consistent local PCOS screening programs, in collaboration with obstetrics and gynecology professionals, are crucial for improving understanding and clinical symptom recognition of this condition among Syrian women.

Sympathetic activation triggered by chronic stress afflicting cancer survivors is an emerging modulator of tumorigenesis. Adrenergic blockade was previously associated with improving response to doxorubicin (DOX) in triple-negative breast cancer (TNBC), yet the precise underlying mechanisms remain obscure. The resilience of cancer stem cells (CSCs) during chemotherapy fosters resistance and relapse. Hypoxia-inducible factor-1α (HIF-1α) and β-catenin are intertwined transcriptional factors that enrich CSCs and evidence suggests that their expression could be modulated by systemic adrenergic signals. Herein, we aimed to explore the impact of adrenoreceptor blockade using carvedilol (CAR) on DOX and its potential to modulate CSCs overcoming chemoresistance. To achieve this aim, in vitro studies were conducted using adrenaline-preincubated MDA-MB-231 cells and in vivo studies using a chronic restraint stress-promoted solid tumor mouse model. Results revealed that adrenaline increased TNBC proliferation and induced a phenotypic switch reminiscent of CSCs, as evidenced by enhanced mammosphere formation. These results paralleled an increase in aldehyde dehydrogenase-1 (ALDH-1) and Nanog expression levels as well as HIF-1α and β-catenin upsurge. In vivo, larger tumor volumes were observed in mice under chronic stress compared to their unstressed counterparts. Adrenergic blockade using CAR, however, enhanced the impact DOX had on halting TNBC cell proliferation and tumor growth via enhanced apoptosis. CAR also curbed HIF-1α and β-catenin tumor levels subsequently suppressing ALDH-1 and SOX2. Our study unveils a central role for HIF-1α linking stress-induced sympathetic activation fueling CSC enrichment via the β-catenin pathway. It also highlights novel insights into CAR’s capacity in reversing DOX chemoresistance in TNBC.

Summary: Background: Bacille Calmette-Guérin (BCG) vaccination has off-target (non-specific) effects that are associated with protection against unrelated infections and decreased all-cause mortality in infants. We aimed to determine whether BCG vaccination prevents febrile and respiratory infections in adults. Methods: This randomised controlled phase 3 trial was done in 36 healthcare centres in Australia, Brazil, the Netherlands, Spain, and the United Kingdom. Healthcare workers were randomised to receive BCG-Denmark (single 0.1 ml intradermal injection) or no BCG in a 1:1 ratio using a web-based procedure, stratified by stage, site, age, and presence of co-morbidity. The difference in occurrence of febrile or respiratory illness were measured over 12 months (prespecified secondary outcome) using the intention-to-treat (ITT) population. This trial is registered with ClinicalTrials.gov, NCT04327206. Findings: Between March 30, 2020, and April 1, 2021, 6828 healthcare workers were randomised to BCG-Denmark (n = 3417) or control (n = 3411; no intervention or placebo) groups. The 12-month adjusted estimated risk of ≥1 episode of febrile or respiratory illness was 66.8% in the BCG group (95% CI 65.3%–68.2%), compared with 63.4% in the control group (95% CI 61.8%–65.0%), a difference of +3.4 percentage points (95% CI +1.3% to +5.5%; p 0.002). The adjusted estimated risk of a severe episode (defined as being incapacitated for ≥3 consecutive days or hospitalised) was 19.4% in the BCG group (95% CI 18.0%–20.7%), compared with 18.8% in the control group (95% CI 17.4%–20.2%) a difference of +0.6 percentage points (95% CI −1.3% to +2.5%; p 0.6). Both groups had a similar number of episodes of illness, pneumonia, and hospitalisation. There were three deaths, all in the control group. There were no safety concerns following BCG vaccination. Interpretation: In contrast to the beneficial off-target effects reported following neonatal BCG in infants, a small increased risk of symptomatic febrile or respiratory illness was observed in the 12 months following BCG vaccination in adults. There was no evidence of a difference in the risk of severe disease. Funding: Bill & Melinda Gates Foundation, Minderoo Foundation, Sarah and Lachlan Murdoch, the Royal Children's Hospital Foundation, Health Services Union NSW, the Peter Sowerby Foundation, SA Health, the Insurance Advisernet Foundation, the NAB Foundation, the Calvert-Jones Foundation, the Modara Pines Charitable Foundation, the UHG Foundation Pty Ltd, Epworth Healthcare, the National Health and Medical Research Council, the Swiss National Science Foundation and individual donors.

Summary: Background: The COVID-19 pandemic led to the rapid development and deployment of several highly effective vaccines against SARS-CoV-2. Recent studies suggest that these vaccines may also have off-target effects on the immune system. We sought to determine and compare the off-target effects of the adenovirus vector ChAdOx1-S (Oxford-AstraZeneca) and modified mRNA BNT162b2 (Pfizer-BioNTech) vaccines on immune responses to unrelated pathogens. Methods: Prospective sub-study within the BRACE trial. Blood samples were collected from 284 healthcare workers before and 28 days after ChAdOx1-S or BNT162b2 vaccination. SARS-CoV-2-specific antibodies were measured using ELISA, and whole blood cytokine responses to specific (SARS-CoV-2) and unrelated pathogen stimulation were measured by multiplex bead array. Findings: Both vaccines induced robust SARS-CoV-2 specific antibody and cytokine responses. ChAdOx1-S vaccination increased cytokine responses to heat-killed (HK) Candida albicans and HK Staphylococcus aureus and decreased cytokine responses to HK Escherichia coli and BCG. BNT162b2 vaccination decreased cytokine response to HK E. coli and had variable effects on cytokine responses to BCG and resiquimod (R848). After the second vaccine dose, BNT162b2 recipients had greater specific and off-target cytokine responses than ChAdOx1-S recipients. Interpretation: ChAdOx1-S and BNT162b2 vaccines alter cytokine responses to unrelated pathogens, indicative of potential off-target effects. The specific and off-target effects of these vaccines differ in their magnitude and breadth. The clinical relevance of these findings is uncertain and needs further study. Funding: Bill & Melinda Gates Foundation, National Health and Medical Research Council, Swiss National Science Foundation and the Melbourne Children’s. BRACE trial funding is detailed in acknowledgements.

In the recent past, algorithmic stock market trading for financial markets has undergone significant growth and played a major role in investment decisions. Several methods have been proposed with the objective of designing optimum trading strategies to maximize profitability, economic utility, and risk-adjusted returns. Although traditional methods including mean reversion, momentum, and trend following approaches show good results, but have poor generalization and often perform well in specific time frames. Presently, Reinforcement Learning (RL) approaches are more adaptable and continually perceive the environment by making optimum trading decisions. However, it is still difficult to develop a lucrative trading approach in a complicated and dynamic stock market. The primary challenges in RL methods are effective state representation to reflect current market situations and a suitable trading reward to encourage agents to make more informed decisions. To address such challenges, this research presented a multifaceted strategy for multi-stock market trading using RL that incorporates enhanced state representation based on daily historical data, technical indicators, and fundamental indicators from balance sheets, income statements, and cash flow statements. To inform the agent about the impact of decisions taken on a day-to-day basis by considering risk, a novel reward function named PSR is also proposed. The proposed RL agent is trained in a multi-stock environment in which investors have multiple shares and trading signals are needed with the quantity of shares by using Advantage Actor-Critic (A2C), and Deep Deterministic Policy Gradient (DDPG) algorithms. Furthermore, the proposed multifaceted strategy is validated on 30 Dow Jones stocks and the proposed model outperforms the benchmark Dow Jones Industrial Average index during backtesting.

Abstract Background Social accountability (SA) within medical education signifies a commitment to address critical regional, societal, and national issues through educational, research, and service activities. In resource-limited regions, marginalized communities face barriers to accessing quality healthcare, and the concept of SA is often poorly understood by students. This study aims to investigate the perspectives, awareness, and comprehension of Syrian medical students regarding the concepts and principles of SA. Methods This cross-sectional online study was conducted in Syria from June 1st to July 25th, 2023, to assess the perspectives on SA among medical students enrolled in pre-clinical and clinical phases from the 3rd to the 6th year, encompassing both stream I and stream II. The questionnaire included three parts: consent and introduction, socio-demographic data, and a 12-item survey assessing social accountability. Data were analyzed using Statistical Package for the Social Sciences software version 24 (SPSS 24). Results A total of 1312 medical students (62.3% females vs. 37.7% males) participated in our analysis. Less than half of the participants (45.7%) reported that their institution had a limited social mission statement regarding the communities they serve. However, only 39.6% reported that their curriculum partially reflected the needs of the population they serve. A mere 7.5% and 6.8% of respondents indicated that their school had excellent community partners and stakeholders shaping their institution, and they learned significantly about other cultures and social circumstances in the medical context through their curriculum. About 24.1% reported that their institution required them to engage in a substantial amount of community-based learning, and 37.4% believed that their class reflected a good representation of socio-demographic characteristics of the reference population. A significant portion of the participants (44.3%) stated that their school did not encourage them to pursue generalist specialties, and 12.7% felt that their institution did not have a positive impact on the community. Among the included participants, 45.8% had some level of SA status, while 37.7% indicated good SA status. Age, gender, and the phase of study were the only sociodemographic characteristics statistically associated with SA status (p-value 0.05). Conclusion This study underscores the significant influence of clinical experience and gender on Syrian medical students’ perceptions of SA. To enhance these perceptions, medical institutions should tailor support services for different stages of training and target initiatives to engage male students.

The present study included optical degradation of pure polyvinyl films and also when mixing the complex [Aqua diphylcarbazide thiourea Cobalt (||)]chloride by weight (0.1% - 0.00625 %) and polymer films dissolved in water and thickness (60±5) microns. The optical degradation of the prepared chips was followed up with the presence and absence of the added complex by violet-visible spectroscopy (U.V) using light with a maximum wavelength (356nm) and at different irradiation times (0,10,20,40,80) hours by calculating the constant rate of photolysis of the polymer additive. Using (FT. IR) by increasing the absorption coefficient of the hydroxyl group (IOH). It was found that an increase in the concentration of the additive complex leads to an increase in the photolysis of polymer sheets compared to sheets without it, which in turn leads to an increase in the values of hydroxyl absorption coefficients. These results are consistent with the value of the speed constant of optical degradation the highest value of the dissociation constant (KD) and follow-up by changing the viscosity to weight ratio, degree of degradation and rate of chain cutting.

Abstract In the current industrial scenario, cadmium (Cd) as a metal is of great importance but poses a major threat to the ecosystem. However, the role of micronutrient − amino chelates such as iron − lysine (Fe − lys) in reducing Cr toxicity in crop plants was recently introduced. In the current experiment, the exogenous applications of Fe − lys i.e., 0 and10 mg L − 1, were examined, using an in vivo approach that involved plant growth and biomass, photosynthetic pigments, oxidative stress indicators and antioxidant response, sugar and osmolytes under the soil contaminated with varying levels of Cd i.e., 0, 50 and 100 µM using two different varieties of canola i.e., Sarbaz and Pea − 09. Results revealed that the increasing levels of Cd in the soil decreased plant growth and growth-related attributes and photosynthetic apparatus and also the soluble protein and soluble sugar. In contrast, the addition of different levels of Cd in the soil significantly increased the contents of malondialdehyde (MDA) and hydrogen peroxide (H2O2), which induced oxidative damage in both varieties of canola i.e., Sarbaz and Pea − 09. However, canola plants increased the activities of superoxide dismutase (SOD), peroxidase (POD), catalase (CAT), and non-enzymatic compounds such as phenolic, flavonoid, proline, and anthocyanin, which scavenge the over-production of reactive oxygen species (ROS). Cd toxicity can be overcome by the supplementation of Fe − lys, which significantly increased plant growth and biomass, improved photosynthetic machinery and sugar contents, and increased the activities of different antioxidative enzymes, even in the plants grown under different levels of Cd in the soil. Research findings, therefore, suggested that the Fe − lys application can ameliorate Cd toxicity in canola and result in improved plant growth and composition under metal stress.

Abstract Background During the reproductive period among pregnant women, the worst pain a woman can experience is labour pain. Untreated labour pain has many detrimental effects on the mother and the fetus. Then, the inadequate levels of awareness and attitudes toward labour analgesia among pregnant women are considered a serious concern that influences no-healthy results for both the mother and the baby. Therefore, this research aimed to define the degree of Awareness, Attitude, and intent to use labour analgesia among pregnant women in Syria. Methods We conducted a cross-sectional study from 7 September to 23 October 2022, in which we included Pregnant Syrian women aged 18 and above. The questionnaire was based on a prior study that included verified and validated scales, which consisted of 23 questions separated into four sections. The sample size was calculated using Fisher’s formula; however, our study included 638 participants. The data was analyzed using IBM SPSS Version 28.0, using descriptive and binary logistic regression methods. Results Among those who had previous deliveries, 39.4% performed a caesarian delivery, and only 1.9% had a delivery at home. Nearly half of the study participants (50.4%) reported adequate knowledge about analgesia for obstetric pain. The inquired pregnant women who had children had more odds of knowledge than participants who had not. Respondents who were childbearing at the health center were more likely to have a good attitude (Adjusted Odds ratio = 4.728, P-value

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This study aims to investigate regional and periodic asymmetries in the impact of the outbreak of the Russia-Ukraine war on global equity markets. Employing the event study methodology, the current study examines global stock market reactions within a 61-day window centred around the event day, i.e., February 24, 2022. MSCI equity indices of 47 sample countries have been utilized to ensure uniformity in the index development methodology. They provide broader coverage of global equity markets by including large and mid-cap companies, representing approximately 85% of the free float-adjusted market capitalization for each sampled country. The study extends the event window to 61 days to assess the enduring effects of the war over a relatively longer period. The research delineates regional and periodic asymmetries and posits that the impact of the war on a market is contingent upon its geographical proximity and trade relations with Russia and Ukraine. Additionally, the impact is stronger during a shorter window surrounding the event date but diminishes over the extended period.

The exacerbation of climatic changes helped to increase the risk of plant diseases in the world. Based on this concept, we suggest Endophytic fungi (EF) and Salicylic acid (SA) alternatives to reduce the spread of Fusarium wilt disease, which is one of the most important agricultural crops globally. Therefore, this study aims to isolate endophytic fungi and test their ability to stimulate plant resistance against Fusarium wilt disease and study the possibility of combining these isolates with salicylic acid as a therapeutic nutrient for tomato plants. Two fungal endophytes were isolated from Vigna unguiculata seeds (VUS) and identified as Aspergillus oryzae and Aspergillus tubingensis according to morphological and molecular identification. Under pot circumstances, the influence of these two fungal endophytes as tomato fusarial wilt depressants and as plant stimulants was evaluated. The combination of A. oryzae and A. tubingensis exhibited a simultaneous efficacy of 80% in conferring protection against Fusarium wilt, while simultaneously resulting in a notable decreasing diseases index to 16.66%. Treatment of infected plants with A. oryzae and A. tubingensis (single or mixed) and salicylic acid not only deterioration influence of Fusarium wilt on plant fitness, but also showed a significant improvement in the levels of photosynthetic pigments, sugars, proteins and phenols, and enhancement in the activity of antioxidant enzymes. The analysis of variability among endophytic fungi revealed the presence of 17 distinct bands exhibiting polymorphism, accounting for approximately 35.294% of the observed genetic variation. In conclusion, endophytic A. oryzae and A. tubingensis work well as stimuli for tomato plant growth and as a means of boosting the plants’ resistance to Fusarium wilt. Further, A. oryzae and A. tubingensis act synergistically with SA toward improving plant growth and fusarial wilt disease resistance.

Introduction Many studies highlight the importance of family support in enhancing the experience of childbirth among women. Objective This qualitative study aimed to describe the lived experience of family support from the perspective of women during and after childbirth in the Jordanian context Methods A qualitative descriptive phenomenological approach was used to explore the experiences of women's family support in the context of their childbirth experiences. A total of 11 Jordanian women participated in the study. Face-to-face semi-structured interviews were conducted to collect data. Results Four major themes emerged from the data describing family support provided to women during and after childbirth. These themes were family support during childbirth, family support in the postpartum period, importance of family support during and after childbirth, and challenges related to receiving family support. Supportive family members primarily included the husband, the woman's family, and the family-in-law, according to the traditions inherited in the Jordanian context and culture. Conclusion The study findings could help maternal health professionals screen pregnant women who are at risk of receiving low family support, contribute to developing effective interventions regarding family-centered care, and enhance the overall childbirth experience for women in Jordanian cultural contexts.

Abstract Background Several factors contribute to delayed presentation with ovarian cancer (OC) symptoms including poor symptom awareness and barriers to seeking help. This study explored the anticipated time to seek medical advice for possible OC symptoms and its association with OC symptom awareness. In addition, it examined perceived barriers that may delay help-seeking among Palestinian women. Methods A cross-sectional study was conducted among adult women (≥ 18 years) recruited from hospitals, primary healthcare centers, and public spaces in 11 Palestinian governorates. A modified version of the OC awareness measure was used to collect data in face-to-face interviews. The questionnaire comprised three sections: sociodemographic details, awareness of 11 OC symptoms and time to seek medical advice, and barriers to early presentation. Results Of 6095 participants approached, 5618 completed the OCAM (response rate = 92.1%). The proportion of participants who would immediately seek medical advice for a possible OC symptom varied based on the symptom’s nature. For OC symptoms with pain, the proportion that reported immediate seeking of medical advice ranged from 7.9% for ‘persistent low back pain’ to 13.6% for ‘persistent pain in the pelvis’. For non-specific potential OC symptoms, the proportion that reported immediate seeking of medical advice ranged from 2.3% for ‘feeling full persistently’ to 15.8% for ‘increased abdominal size on most days’. Good OC symptom awareness was associated with higher likelihood of seeking medical advice within a week from recognizing 10 out of 11 OC symptoms. Emotional barriers were the most common barriers with ‘feeling scared’ as the most reported barrier (n = 1512, 52.4%). Displaying good OC symptom awareness was associated with a lower likelihood of reporting ≥ 4 emotional barriers (OR = 0.61, 95% CI: 0.38–0.98). Conclusion Participants with good OC symptom awareness were more likely to seek medical advice earlier and to display fewer emotional barriers. Establishing educational interventions to raise OC awareness may help in promoting earlier help-seeking and, thus, facilitate earlier diagnosis and improved prognosis.

Abstract Background The stigma associated with mental diseases in the healthcare system and among healthcare professionals has been identified as a significant barrier to treatment and rehabilitation and to the provision of substandard physical care for persons with mental illnesses. The goal of this study is to assess the attitude of physicians in Syria towards individuals with mental health disorders. Methods An online cross-sectional survey was conducted among phyisicians in Syria to evaluate their attitudes toward patients with mental health disorders and their provided treatment in the time period between August 16 and October 1, 2022. The questionnaire for the study was developed based on previous research, and the inclusion criteria for the sample were all medical specialist trainees from all specialties and residents who had direct contact with people suffering from mental health disorders. The questionnaire was divided into two sections; the first included sociodemographic data on the participants and the second assessed physician’s attitudes toward mental illness patients. With the IBM SPSS V. 28.0 package tool (IBM Corporation, Armonk, NY, USA), descriptive and multivariate logistic regression analyses were used to analyze the data. Results 539 medical residents participated in this research; their average age was 26.11 (+- 1.74) years, and 50.27% were males. City residents had the highest stigma score on the third question (2.66 ± 1.06, P value

Abstract Collaborative filtering (CF), one of the most widely employed methodologies for recommender systems, has drawn undeniable attention due to its effectiveness and simplicity. Nevertheless, a few papers have been published on the CF-based item-based model using similarity measures than the user-based model due to the model's complexity and the time required to build it. Additionally, the substantial shortcomings in the user-based measurements when the item-based model is taken into account motivated us to create stronger models in this work. Not to mention that the common trickiest challenge is dealing with the cold-start problem, in which users' history of item-buying behavior is missing (i.e., new users) or items for which activity is not provided (i.e., new items). Therefore, our novel five similarity measures, which have the potential to solve sparse data, are developed to alleviate the impact of this important problem. Most importantly, a thorough empirical analysis of how the item-based model affects the CF-based recommendation system’s performance has also been a critical part of this work, which presents a benchmarking study for thirty similarity metrics. The MAE, MSE, and accuracy metrics, together with fivefold cross-validation, are used to properly assess and examine the influence of all considered similarity measures using the Movie-lens 100 K and Film Trust datasets. The findings demonstrate how competitive the proposed similarity measures are in comparison to their alternatives. Surprisingly, some of the top "state-of-the-art" performers (such as SMD and NHSM) have been unable to fiercely compete with our proposed rivals when utilizing the item-based model.

Abstract THz radiation detection using FET devices has attracted increasing attention lately. In this paper, we further study a simulated model of FET rectification detection in short channel length. To achieve this, both physics-based analytic model and a detailed TCAD simulation were contacted and compared. The analytical model provided detailed dependence of the response on the channel length below the extension length of the radiation. However, the simulation results were validated by comparison with the experimental data to confirm the validity of the theoretical model. These results present a new model of rectification for short channel lengths and its dependence on the extinction of AC signal through the channel.

Gamification and card games have gained increased popularity across diverse educational domains, particularly in the field of foreign language learning (FLL). They offer potent tools that can transform the learning process into an engaging, interactive, and enjoyable experience. Currently, numerous instances of gamified or card game–based language learning methods have demonstrated their significant impact on sustaining learners’ engagement and advancing their proficiency levels. However, it is noteworthy that these approaches often prioritize the motivational aspect while neglecting the imperative need to enhance student learning outcomes (SLOs). The latter holds pivotal importance not only in determining the success of academic courses but also in evaluating the effectiveness of e-content. To address this gap, the primary objective of this work is to enhance the achievement of SLOs within the context of foreign language courses. A novel framework is proposed for learning foreign languages, harnessing the potential of gamification and card games. This framework, developed through the integration of contemporary technologies used in e-learning systems and foreign language applications, encompasses agent technology and the microlearning strategy. A case study was conducted to evaluate the effectiveness of the proposed framework. The results revealed a statistically significant improvement in SLOs. This study contributes significantly to the advancement of both gamification and game-based learning, presenting a promising pedagogical paradigm for language teaching and learning.

Children prefer to learn from confident rather than hesitant informants. However, it is unclear how children interpret confidence cues: these could be construed as strictly situational indicators of an informant's current certainty about the information they are conveying, or alternatively as person-specific indicators of how "knowledgeable" someone is across situations. In three studies, 4- and 5-year-olds (Experiment 1: N = 51, Experiment 3: N = 41) and 2- and 3-year-olds (Experiment 2: N = 80) saw informants differing in confidence. Each informant's confidence cues either remained constant throughout the experiment, changed between the history and test phases, or were present during the history but not test phase. Results suggest that 4- and 5-year-olds primarily treat confidence cues as situational, whereas there is uncertainty around younger preschoolers' interpretation due to low performance.

Considering that it satisfies high strength and stiffness at a low weight, the grid structure is the ideal option for meeting the requirements for developing the wall panel structure for the satellite. The most attractive grid structures for the satellite wall panel industry are isogrid and honeycomb structures. The first part of this work involves studying the mechanical and dynamic performance of five designs for the satellite wall panel made of 7075-T0 Al-alloy. These designs include two isogrid structures with different rib widths, two honeycomb structures with different cell wall thicknesses, and a solid structure for comparison. The performance of these designs was evaluated through compression, bending, and vibration testing using both finite element analysis (FEA) with the Ansys workbench and experimental testing. The FEA results are consistent with the experimental ones. The results show that the isogrid structure with a lower rib thickness of 2 mm is the best candidate for manufacturing the satellite wall panel, as this design reveals the best mechanical and dynamic performance. The second part of this work involves studying the influence of the length of the sides of the best isogrid structure in the range of 12 mm–24 mm on its mechanical and dynamic performance to achieve the lowest possible mass while maintaining the structure’s integrity. Then, a modified design of skinned wall panels was introduced and dynamically tested using FEA. Finally, a CAD model of a hexagonal satellite prototype using the best-attained design of the wall panel, i.e., the isogrid structure with a 2 mm rib width and 24 mm-long sides, was built and dynamically tested to ensure its safe design against vibration. Then, the satellite prototype was manufactured, assembled, and successfully assessed.

Introduction The COVID-19-related restrictions imposed to reduce viral transmission have highlighted the need to support the importance of maternal breastfeeding. Clear guidelines for consistent practices across settings have been drawn up on the basis of the best available data. Emerging recommendations call to increase nurses’ and midwives’ awareness of these guidelines. Objective This study aimed to explore nurses’ and midwives’ awareness of the recommended breastfeeding practices and associated factors in Jordan during the COVID-19 pandemic. Methods An online descriptive cross-sectional design was adopted. This study was conducted in clinical settings representing Jordan's North, Middle, and Southern regions. One hundred seventy nurses and midwives were selected through a convenient sampling technique. Results The mean total score of the awareness was 7.78 (SD = 1.60); 62.9% of participants were highly aware of the recommended breastfeeding practices. Nurses and midwives who were aware of the recommended breastfeeding practices during the pandemic of COVID-19 (90.7%) were more likely to perceive COVID-19 preventive measures as effective than those who were not aware of breastfeeding practices (74.6%) (χ 2 = 7.886, p = .005), while work experience in years (χ 2 = 8.966, p

Nano-fertilizers protect the soil from the excessive addition of traditional fertilizers, enhancing the efficiency of the elements and diminishing the number of additive fertilizers. The effect of Fe2O3NPs-Boron (Fe2O3NPs-B), and Fe2O3 NP-Humic Acid (Fe2O3NPs-HA) at 100, 150 and 250 ppm, Fe2O3, and control (without any iron fertilizers) on the vegetative growth, flowering, photosynthetic pigments, nutrient element content and isozymes activity (peroxidase, superoxide dismutase and polyphenol oxide) of Gardenia jasminoides plants was investigated. Gamma-rays at 25 kGy were conducted for the promising synthesis of Fe2O3NPs-B, and Fe2O3NPs-HA. The experiment was carried out under greenhouse conditions during two successive seasons. The results stated that Fe2O3NPs-B and Fe2O3NPs-HA at the highest concentration (250 ppm) had a significant positive effect in all vegetative characteristics, photosynthetic pigments, nutrient element content and isozymes activity. Fe2O3NPs-HA showed the optimal result in all morphological and biochemical characteristics. The highest activity of enzymes appeared in the treated plants with Fe2O3 NPs-B followed by Fe2O3 NPs-HA at 250 ppm. The advantage nano-fertilizer usage may be summarized as saving the soil from the unreasonable accumulation of classic fertilizers, improving the use efficiency of parts and reducing the number of different fertilizers as a consequence of their increased surface area and their nano-size.

Abstract Background Celiac disease (CD) is a chronic immune-mediated disorder with multiple extraintestinal manifestations. The increased incidence of cardiac morbidities in celiac patients highlights the importance of early detection of subclinical myocardial dysfunctions. In this study, we aimed to assess the cardiac functions and explore early subclinical myocardial dysfunctions in celiac patients by tissue Doppler imaging. Results A cross-sectional analytical study which included 42 celiac patients with CD and 36 age- and sex-matched controls. They were subjected to full medical history and examination and complete transthoracic echocardiography including tissue Doppler imaging to assess cardiac functions. Evidences of early subclinical systolic and diastolic dysfunctions were found in our patients; they had significantly lower tricuspid E/A ratio; lower S, E′, a′ in both ventricles; reduced mitral E′/a′ (2.13 ± 0.87, 2.94 ± 0.061 respectively, p

Abstract Bone fractures are a global public health concern, yet no thorough investigation of low-dose aspirin usage to prevent fractures in the elderly has been conducted. Many interventional human and animal studies have tried to detect the correct role of low-dose aspirin on fractures in elderly persons. The literature doesn't consist of a retrospective observational study that includes a large number of older individuals and evaluates the accurate effect of aspirin on the fractures post falling from low heights. This cross-sectional includes 7132 elderly persons and aimed to detect if there was a link between taking low-dose aspirin to prevent fractures in the elderly. Data was extracted from the National Health and Nutrition Examination Survey (NHANES) database for 2017–2020 and 2013–2014. Demographic and examination data were collected during in-home interviews and study visits to a mobile examination center. Standardized questionnaires were used to collect information such as age, gender, race, educational level, and family income-to-poverty ratio. Body mass index (BMI), weight, standing height, upper leg length, upper arm length, arm circumference, and wrist circumference were all measured during the examination. The study examined 8127 patients, with 7132 elderly patients suitable for data analysis. The odds ratio of fractures due to a fall from standing height or less was 0.963 (95 percent confidence interval 0.08–1.149) in low-dose aspirin users, while having parents with osteoporosis had a related risk of 1.23. (95 percent confidence interval 0.81–1.8). The total number of fractures was 1295; with hip fractures constituting up to 13.82%, wrist fractures of 66.56%, and spine fractures of 19.61%. There was no significant difference in femur and spine bone mineral density (BMD) in the two groups (use low dose aspirin and don't use). Females had a 5.6 times greater fracture risk related to a fall from standing height or less (1 time or more) than males (P-value 0.05). This cross-sectional study reveals that taking low-dose aspirin to prevent fractures in the elderly is statistically insignificant. However, fractures are more common in older persons, especially in older women; thus, more widespread injury prevention initiatives and access to osteoporosis prevention and diagnosis for older people should improve to minimize the overall burden.

Microneedling, also known as percutaneous collagen induction, using microneedling devices and fabricated microneedle patches, has been widely employed in cosmetic applications for acne scar treatment, skin care, hair loss, melasma, skin rejuvenation, and skin cancer. The micro-channels formed by microneedling through the stratum corneum facilitate the delivery of cosmetic agents and stimulate collagen and elastin production by inducing the wound-healing cascade, keeping the skin shiny and wrinkle-free. Several cosmetic agents, such as ascorbic acid, hyaluronic acid, retinoids, niacinamide, and peptides, have been delivered by microneedling. This review aims to highlight the use of microneedling devices and fabricated microneedle patches in facilitating the delivery of cosmetic agents through the skin layers. Moreover, the differences between the microneedling devices, commonly used alone or in combinational treatments with topical formulations, are explored. Furthermore, the safety of microneedling in terms of skin irritation, pain sensation, skin or systemic infection, and chemical and biological materials used in the fabrication of microneedles is discussed.

Mastitis is a common phenomenon experienced by a lot of breastfeeding women. Lactational mastitis, commonly occurs because of prolonged milk duct engorgement, which allows bacteria to enter through breaks in the skin, resulting in an infection. Mastitis can occur at various stages of lactation, although it is most observed within the second and third weeks following childbirth. For isolation and identification of bacteria associated with mastitis, Blood agar medium, MacConkey agar, and mannitol salt agar were used, whereas Sabouraud Dextrose Agar (SDA) was used for fungal isolation. Different biochemical test has been performed for bacterial isolates including gram stain, catalase, coagulase, and Vitec 2 compact. For fungal isolates, KOH treatment and lactophenol cotton blue test were performed. Fungal DNA was extracted then PCR was used for the detection ITS Gene of candida spp. Using gel electrophoresis of PCR product on 2% agarose. The study revealed Staphylococcus aureus, Klebsiella pneumoniae, and Candida spp. as significant bacteria that are commonly related to mastitis in women. The prevalence of Staphylococcus aureus was seen to be high, with a notable manifestation of lesions. Additionally, both Staphylococcus aureus and Klebsiella pneumoniae were shown to be associated with the presence of redness. Candida albicans had a notable prominence, displaying a heightened prevalence in the regions of the nipple. Furthermore, it demonstrated a correlation with the presence of lesions and redness. The presence of redness was observed as a notable sign in cases linked with Candida tropicalis. This study provides insights into the microbial diversity linked to mastitis mainly in breastfeeding women, highlighting the prevalence of Staphylococcus aureus, Klebsiella pneumoniae, and Candida spp.

Summary: Background: Recurrences of herpes simplex virus (HSV) in the orofacial region (herpes labialis or cold sores) impact quality-of-life. We aimed to study whether the bacille Calmette-Guérin (BCG) vaccine can attenuate cold sore recurrences through off-target immunomodulatory effects. Methods: In this nested randomised controlled trial within the multicentre, phase 3 BRACE trial, 6828 healthcare workers were randomised in 36 sites in Australia, the Netherlands, Spain, the United Kingdom and Brazil, to receive BCG-Denmark or no BCG (1:1 ratio using a web-based procedure) and followed for 12 months with 3-monthly questionnaires. Exclusion criteria included contraindication to BCG vaccine or previous vaccination with BCG within the past year, any other live-attenuated vaccine within the last month, or any COVID-specific vaccine. The intervention group received one intradermal dose of 0.1 mL of BCG-Denmark corresponding to 2−8 x 105 colony forming units of Mycobacterium bovis, Danish strain 1331. The primary outcome was the difference in restricted mean survival time (i.e., time to first cold-sore recurrence), in participants with frequent recurrent herpes labialis (≥4 recurrences/year), analysed by intention-to-treat. Secondary outcomes addressed additional questions, including analyses in other sub-populations. Adverse events were monitored closely during the first 3 months and were reported in all participants who received one dose of study drug according to intervention received. The BRACE trial is registered with ClinicalTrials.gov, NCT04327206. Findings: Between March 30, 2020 and February 18, 2021, 84 individuals with frequent recurrent cold sores were randomly assigned to BCG (n = 38) or control (n = 46). The average time to first cold-sore recurrence was 1.55 months longer in the BCG group (95% CI 0.27–2.82, p = 0.02) than the control group (hazard ratio 0.54, 95% CI 0.32–0.91; intention-to-treat). The beneficial effect of BCG was greater in the as-treated population (difference 1.91 months, 95% CI 0.69–3.12, p = 0.003; hazard ratio 0.45, 95% CI 0.26–0.76). In prespecified subgroup analyses, only sex modified the treatment effect (interaction p = 0.007), with benefit restricted to males. Over 12 months, a greater proportion of participants in the BCG group compared with the control group reported a decrease in duration (61% vs 21%), severity (74% vs 21%), frequency (55% vs 21%), and impact on quality of life (42% vs 15%) of cold sore recurrences. In participants who had ever had a cold sore, there was also a decrease in self-reported burden of recurrences in the BCG group. In participants who had never had a cold sore, there was an increased risk of a first episode in the BCG group (risk difference 1.4%; 95% CI 0.3–2.6%, p = 0.02). There were no safety concerns. Interpretation: BCG-Denmark vaccination had a beneficial effect on herpes labialis, particularly in males with frequent recurrences, but may increase the risk of a first cold sore. Funding: Bill & Melinda Gates Foundation, the Minderoo Foundation, Sarah and Lachlan Murdoch, the Royal Children's Hospital Foundation, Health Services Union NSW, the Peter Sowerby Foundation, SA Health, the Insurance Advisernet Foundation, the NAB Foundation, the Calvert-Jones Foundation, the Modara Pines Charitable Foundation, the UHG Foundation Pty Ltd, Epworth Healthcare, and individual donors.

Gene Selection (GS) is a strategy method targeted at reducing redundancy, limited expressiveness, and low informativeness in gene expression datasets obtained by DNA Microarray technology. These datasets contain a plethora of diverse and high-dimensional samples and genes, with a significant discrepancy in the number of samples and genes present. The complexities of GS are especially noticeable in the context of microarray expression data analysis, owing to the inherent data imbalance. The main goal of this study is to offer a simplified and computationally effective approach to dealing with the conundrum of attribute selection in microarray gene expression data. We use the Black Widow Optimization algorithm (BWO) in the context of GS to achieve this, using two unique methodologies: the unaltered BWO variation and the hybridized BWO variant combined with the Iterated Greedy algorithm (BWO-IG). By improving the local search capabilities of BWO, this hybridization attempts to promote more efficient gene selection. A series of tests was carried out using nine benchmark datasets that were obtained from the gene expression data repository in the pursuit of empirical validation. The results of these tests conclusively show that the BWO-IG technique performs better than the traditional BWO algorithm. Notably, the hybridized BWO-IG technique excels in the efficiency of local searches, making it easier to identify relevant genes and producing findings with higher levels of reliability in terms of accuracy and the degree of gene pruning. Additionally, a comparison analysis is done against five modern wrapper Feature Selection (FS) methodologies, namely BIMFOHHO, BMFO, BHHO, BCS, and BBA, in order to put the suggested BWO-IG method's effectiveness into context. The comparison that follows highlights BWO-IG's obvious superiority in reducing the number of selected genes while also obtaining remarkably high classification accuracy. The key findings were an average classification accuracy of 94.426, average fitness values of 0.061, and an average number of selected genes of 2933.767.

Considering cohousing as a new typology in the United Arab Emirates’ (UAE) housing market is a challenge due to the cultural and societal dimensions. However, the variety of societies in the Emirates reflecting various habits, experiences, and traditions can allow testing such new types of housing which can be adapted to the local context, considering the needs of the society. This study aims at developing design guidelines for future cohousing in the UAE, considering the pillars of the Estidama program, i.e., social, cultural, economic, and environmental aspects, in addition to the role of architecture design. The present study is based on an empirical investigation from the viewpoint of future cohousing residents in the UAE. Semi-structured interviews considering 87 individuals were conducted. Moreover, a focus group discussion targeting eight professionals was performed. Furthermore, the Quality Function Deployment (QFD) method was applied to include the people’s voices directly when developing the design guidelines for cohousing in the UAE. The study showed that the aspects of culture and privacy are crucial in the future of cohousing in the UAE. In addition, providing local facilities such as majlis and praying rooms is vital to consider. Moreover, other aspects such as sustainable design, universal design, and safety are also valuable. For the outdoor environment, the study highlighted the importance of urban design quality, landscape solutions, shading, and natural ventilation strategies in outdoor spaces. Future cohousing in the UAE is expected to enhance social interaction and contribute to sustainability in the long-term perspective.

Keloids are benign, fibroproliferative dermal tumors that typically form owing to abnormal wound healing. The current standard of care is generally ineffective and does not prevent recurrence. To characterize keloid scars and better understand the mechanism of their formation, we performed transcriptomic profiling of keloid biopsies from a total of 25 subjects of diverse racial and ethnic origins, 15 of whom provided a paired nonlesional sample, a longitudinal sample, or both. The transcriptomic signature of nonlesional skin biopsies from subjects with keloids resembled that of control skin at baseline but shifted to closely match that of keloid skin after dermal trauma. Peripheral keloid skin and rebiopsied surrounding normal skin both showed upregulation of epithelial–mesenchymal transition markers, extracellular matrix organization, and collagen genes. These keloid signatures strongly overlapped those from healthy wound healing studies, usually with greater perturbations, reinforcing our understanding of keloids as dysregulated and exuberant wound healing. In addition, 219 genes uniquely regulated in keloids but not in normal injured or uninjured skin were also identified. This study provides insights into mature and developing keloid signatures that can act as a basis for further validation and target identification in the search for transformative keloid treatments.

Mobile health (mHealth) applications rely on personal data visualisations to promote user adoption and engagement. To ensure the success of these applications, it is crucial to understand user requirements when utilising these visualisations. This study investigates the needs and challenges of mHealth app users with a focus on data visualisations. This paper presents the results of a user survey with 56 participants, which found curiosity to be the top motivation behind using health-tracking apps. 51% of the participants had to use more than one mHealth app to achieve their health tracking goals, which usually come with inconsistency and duplication of data entry. Bar and pie charts were the most preferred forms for viewing health data. Users do not want to use complex charts. Furthermore, users preferred a combination of text summaries and charts to make sure they correctly interpret the charts. On the other hand, users face challenges related to improper information presentation, inaccurate touch interface, and an overwhelming amount of data. Customisable and readable charts encouraged frequent app usage. The implications of these findings confirms the gap we identified in existing data visualisation design and development guidelines. We have developed a set of data visualisation guidelines to address these challenges, and currently conducting evaluations on designers and end users.

Background and Aims: Cirrhotic patients are prone to hypotension during anesthesia. The primary aim of the study was to compare the effects of automated gas control (AGC) of sevoflurane and target-controlled infusion (TCI) of propofol on systemic and cardiac hemodynamics in hepatitis C cirrhotic patients undergoing surgery. The secondary aim was to compare the recovery, complications, and costs between the two groups. Material and Methods: This was a randomized controlled trial in adults with hepatitis C cirrhosis (Child A) who underwent open liver resection and received AGC (n = 25) or TCI (n = 25). AGC was initially set at FiO2 40% and end-tidal sevoflurane (ET SEVO) at 2.0% with a fresh gas flow of 300 mL/min. TCI of propofol was given using Marsh pharmacokinetic mode with an initial propofol target concentration (Cpt) of 4 μg/mL. Bispectral index score (BIS) was maintained between 40 and 60. Invasive arterial blood pressure (IBP), electrical cardiometry (EC), cardiac output (CO), and systemic vascular resistance (SVR), Fi SEVO, ET SEVO, propofol Cpt, and effect-site concentration (Ce) were recorded. Results: IBP and EC CO, and SVR were least affected by TCI propofol. Only one (4.00%) patient required vasopressors with TCI vs. 4 (16.00%) with AGC (χ2(Y) (df = 1) = 0.88, P (Y) = 0.34). There was no delayed recovery, hypoxia, or awareness; however, ICU stay was shorter with TCI, (P = 0.006). BIS and EC guided median of ET SEVO was 1.90%, Fi SEVO was 2.10% with AGC, and propofol Cpt and Ce were 3.00 μg/dL with TCI. Only 0.14 [0.12–0.15] mL/min of SEVO was consumed with AGC and 0.87 [0.85–0.97] mL/min propofol with TCI. The cost was higher with TCI, P < 0.00. Conclusions: Both techniques are well tolerated hemodynamically, but TCI-propofol was found to be hemodynamically better. The recovery and complications were comparable in both groups, but TCI Propofol infusion was costlier.

In this review, we checked the harsh influence of high temperature or heat stress on plant metabolism and crop yield. Plants can bear a minimum range of temperature; temperature more than this optimum range comes in the term of heat stress. Climate changes increase the number and severity of heat waves that reduced the development of plants and resulted in the death of the entire plant. Heat stress is a major stressful environment that destroys plant growth, biochemical reactions, and the yield of crops across the world. High-temperature influences many physiological and chemical reactions in plants. HS is now a big deal for crop production and the essential goal of agriculture is to maintain a high yield of crops. A plant lives in the conditions of high temperature based on its capacity to receive the HT stimulus, generate and change the signal, and then initiate physiological and biochemical changes. The plants show physiological and biochemical responses to heat the stress, is an active area of research. To deal with HT, different molecular techniques are in progress. After thoroughly reviewed of the different discoveries on plants’ responses, adaptation, and forbearance to HT at the cellular, organelles, and entire plant levels, this article described several approaches that could be taken to increase thermo- forbearance in plants.