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Background: Birth injury is defined as impairment of neonate’s body function that occur due to mechanical forces during the process of delivery. Incidence of birth injury varies from place to place, with place of delivery, experience of birth attendants, and mode of delivery. Objective: To determine the incidence, characteristics of birth injury in the Special Care Baby Unit of the University of Maiduguri Teaching Hospital (UMTH). Subjects and methods: This is a prospective observational study that was conducted in a Special Care Baby Unit (SCBU) of the University of Maiduguri Teaching Hospital. The subjects were recruited between 1st January, 2016 and 31st December, 2016. Neonatal birth injury was diagnosed based on paediatrician or senior registrar examination. Demographic variables: maternal age, maternal weight, and height, reproductive and labour variables: prenatal care, parity, gestational age, presence and duration of PROM, duration of labour, type of delivery, and skill of delivery attendance, while neonatal variables, includes: neonatal age, sex, birth weight, length, Apgar score, and type of birth injury. The treatment administered to the patients were either medical management such exchange blood transfusion in case of severe Jaundice complicating cephalhaematoma and/or simple transfusion for anaemia without complication, phototherapy, antibiotics, among others, or surgical/orthopaedic treatment in the presence of surgical injury. Statistical analysis was done using SPSS version 16 (SPSS Inc., Illinois, Chicago USA). A P-value < 0.0001. Soft tissue injury constituted the majority accounting for 37/61 (60.7%), closely followed by sub- conjunctival haemorrhages 25/61 (41.0%). Severe perinatal asphyxia also constituted significant proportion of the birth injury 24/61 (39.3%). Other central nervous system (CNS) birth injuries includes facial nerve palsy and Erb’s palsy 13.1% each. The commonest of the fractures was femoral bone fracture 9/61 (14.8%), followed by clavicular fracture 5/61 (8.2%). It was revealed that urea 2.5 mmol/L, total serum bilirubin (TSSB) 12.4 μmol/L and random blood sugar 2.6mmol/L were deranged in those neonates with three or more birth injuries and all the three parameters were statistically significant p0.05. Four patients died, two with internal organ injury were, of which one with splenic rupture and the other one with liver damage in addition to severe perinatal asphyxia died while the remaining two patients with severe perinatal asphyxia also died with mortality rate of 6.6%. Conclusion: The incidence of birth injury has decreased overtime especially in the affluent economy where obstetric and perinatal diagnosis has remarkably improved, but in the developing economy like ours as demonstrated in this study CC –BY 100 such an improvement is yet to be achieved. However education of the general populace especially the pregnant women so that they attend antenatal care and deliver at health facility with skilled health personnel will remarkably reduce birth injury.

Hadeel Abdulelah Ibrahim College of Nursing, University of Sulaimani, Kurdistan Region, Republic of IraqCorrespondence: Hadeel Abdulelah IbrahimCollege of Nursing, University of Sulaimani, Kurdistan Region, Republic of IraqTel +964(0)7703914402Email hadeel.ibrahim@univsul.edu.iqBackground: The effects of vitamin D3 (VD3) on pregnancy outcomes remain obscure. Thus, this study aims to investigate the relationship between maternal H. pylori infection, low VD3 level, and spontaneous abortion.Methods: This research is conducted in Shahid Ali Qader Consultant Clinic in Sulaimaniyah city in which 100 women with a history of abortion and 100 women with no history of miscarriage were included. Serum detection of anti-H. pyloriIgG, IgA, and VD3 were done using enzyme-linked immunosorbent assay (ELISA) technique.Results: The mean of VD3, H. pylori IgG, and IgAin patients and control group cases was determined and analyzed statistically.Conclusion: H. pylori infection and VD3 play a significant role in early pregnancy loss. Blood group A and O are more prone to spontaneous abortion.Keywords: miscarriage, bacterial infection, vitamin deficiency, antibody detection, ABO grouping

Mohamed El-Shanshory,1,2 Nahed M Hablas,2 Yasmin Shebl,2 Ahmed R Fakhreldin,3 Mohamed Attia,4 Hamdi H Almaramhy,5 Hussam Baghdadi,6 Mongi Ayat,1,6 Amal Albeihany,7 Amr El-Dardear,1,8,9 Hoda Ali Ibrahim,10 Hany Salah Mahmoud,11 Manal Mohamed Helmy Nabo,12,13 Salah Mohamed El Sayed1,6,14 1Prophetic Medicine Course and Research, Taibah College of Medicine, Medina, Saudi Arabia; 2Department of Pediatrics, Tanta University Faculty of Medicine, Tanta Gharbia, Egypt; 3Department of Pediatrics, Aswan Faculty of Medicine, Aswan University, Aswan, Egypt; 4Department of Clinical Pathology, Tanta Faculty of Medicine, Tanta University, Tanta, Egypt; 5Department of Surgery, Taibah Faculty of Medicine, Taibah University, Medina, Saudi Arabia; 6Department of Clinical Biochemistry and Molecular Medicine, Taibah Faculty of Medicine, Taibah University, Medina, Saudi Arabia; 7Department of Hematology, King Fahd Hospital, Ministry of Health, Medina, Saudi Arabia; 8Department of Pediatrics, Faculty of Medicine, Taibah University, Medina, Saudi Arabia; 9Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt; 10Department of Biochemistry, Tanta Faculty of Medicine, Tanta University, Tanta, Egypt; 11Scientific Center for Experimental and Research Studies, Cairo, Egypt; 12Division of Pediatric Intensive Care Unit, King Fahad Hospital, Ministry of Health, Medina, Saudi Arabia; 13Division of Pediatric Cardiology, Pediatrics Department, Sohag Teaching Hospital, Ministry of Health, Sohag, Egypt; 14Department of Medical Biochemistry, Sohag Faculty of Medicine, Sohag University, Sohag, Egypt Background: Thalassemia is a major health problem due to iron overload, iron deposition and oxidative stress-induced tissue damage. Here, we introduce Al-hijamah (a minor surgical excretory procedure) as a novel percutaneous iron excretion therapy. Al-hijamah is a wet cupping therapy of prophetic medicine, and prophet Muhammad, peace be upon him, strongly recommended Al-hijamah, saying: “The best of your treatment is Al-hijamah”. Aim of the study: Our study aimed at investigating the safety, iron chelation, pharmacological potentiation and oxidant clearance effects exerted by Al-hijamah to thalassemic children. Patients and methods: Ethical committee’s approval and patients’ written agreement consents were obtained. We treated 20 thalassemic children (15 males and five females aged 9.07±4.26 years) with iron chelation therapy (ICT) plus Al-hijamah (using sterile disposable sets and in a complete aseptic environment) vs a control group treated with ICT only. This clinical trial was registered in the ClinicalTrial.gov registry under the name “Study of the Therapeutic Benefits of Al-hijamah in Children with Beta Thalassemia Major” (identifier no NCT 02761395) on 30 January 2016. Results: Al-hijamah was quite simple, safe, effective, tolerable (with no side effects) and time-saving procedure (30–60 minutes). A single session of Al-hijamah significantly reduced iron overload (P

Ashraf Othman Sayed,1 Nancy Selim Zeidan,2 Dalia Monir Fahmy,3 Hossam A Ibrahim4 1Department of Pediatrics, Children and Women’s University Hospital, Minia University, El-Minya, Egypt; 2Department of Pediatrics, Faculty of Medicine, Cairo University, Cairo, Egypt; 3Department of Diagnostic Radiology, Mansoura University Hospital, Faculty of Medicine, Mansoura University, Mansoura, Egypt; 4Department of Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt Background: Diagnosis of appendicitis in children is clinically challenging. Computed tomography (CT) is the gold standard for diagnosis; however, radiation exposure early in life is a concern with this technique. Therefore, in this study, we aimed to evaluate the diagnostic reliability of low-dose CT, pediatric appendicitis score (PAS), and abdominal ultrasound (US) in children with acute appendicitis, to reach a safe diagnosis. Patients and methods: This retrospective study was conducted on 140 children who were admitted with clinically suspected acute appendicitis (45 with positive appendicitis and 95 children with negative appendicitis). Low-dose CT was performed, and PAS was retrospectively calculated for all subjects. US was initially performed for 38 subjects. All results were compared with the final diagnosis reached by an operative, histopathological analysis and follow-up. Results: Low-dose CT showed a sensitivity, specificity, and accuracy of 97.8%, 100%, and 99.3%, respectively. At a cutoff value ≥5, PAS showed a sensitivity, specificity, and accuracy of 95%, 84%, and 89%, respectively. Abdominal US examination showed sensitivity, specificity, and accuracy of 55.6%, 85%, and 71%, respectively. Implementing Poortman’s model resulted in higher accuracy (92%) of US. There was a significant difference in accuracy between a low-dose CT and PAS on one side and between Poortman’s model and US examination on the other side. A diagnostic scheme was suggested using PAS as the excluding tool (PAS ≤2 send home and ≥7 send directly to operation) followed by US examination and reserving low-dose CT for inconclusive cases. This scheme would eliminate the use of CT for at least 33.7% and in 7 cases who had initial US examination. Conclusion: Although CT remains the most accurate and less operator-dependent diagnostic tool for pediatric appendicitis, the radiation hazards could however be minimized using PAS as an excluding tool and US as the primary imaging modality followed by low-dose CT for inconclusive cases only. Keywords: acute appendicitis, children, pediatric appendicitis scoring system, PAS, computed tomography, CT, ultrasound, US

Abstract: Myelofibrosis (MF), a myeloproliferative neoplasm, was most commonly treated with hydroxyurea (HU) before approval of ruxolitinib (RUX), now the standard of care. Factors that influence real-world MF treatment patterns are not well understood. The METER study was a multi-country, retrospective chart review of MF treatment patterns, treatment effectiveness, and health care resource utilization. Of 997 eligible patients, 65.9% had primary MF, and 11.7% were transfusion dependent. Median time from diagnosis to the start of initial treatment (index date) was 29 days (interquartile range [IQR], 1-140). RUX was the most common first-line (1L) therapy (49.0%), followed by HU (40.2%); 48.5% of patients remained on 1L therapy through week 156. Seventy-seven patients underwent allogeneic stem cell transplantation; transplantation was uncommon at 1L, increasing from 2.2% at week 24 to 11.0% at week 156 in patients ≤70 years of age. Median overall survival was 79.1 months (95% confidence interval [95% CI], 70.8 to not estimable [NE]) in all patients, 142.3 months (95% CI, 74.1 to NE) for non-RUX patients, 77.6 months (95% CI, 64.2-85.9) for patients on RUX 1L therapy, and 72.6 months (95% CI, 62.0 to NE) for RUX 2L+ patients. Of patients who experienced ≥1 corresponding event, the median hospital length of stay (LoS; n = 520), intensive care unit LoS (n = 71), and number of transfusions (n = 375) were 16 days (IQR, 7-37), 5 days (IQR, 2-13), and 12 (IQR, 4-26), respectively. Despite improvements, there were numerous hospitalization and transfusion events among these patients in routine practice. This trial was registered at www.ClinicalTrials.gov as #NCT05444972.

The circular Pythagorean fuzzy set is an expansion of the circular intuitionistic fuzzy set (CIFS), in which each component is represented by a circle. Nevertheless, even though CIFS improves the intuitionistic fuzzy set representation, it is still restricted to the inflexible intuitionistic fuzzy interpretation triangle (IFIT) space, where the square sum of membership and nonmembership in a circular Pythagorean fuzzy environment and the sum of membership and nonmembership in a circular intuitionistic fuzzy environment cannot exceed one. To overcome this restriction, we provide a fresh extension of the CIFS called the circular n,m-rung orthopair fuzzy set (Cn,m-ROFS), which allows the IFIT region to be expanded or contracted while maintaining the features of CIFS. Consequently, decision makers can assess items over a wider and more flexible range when using a Cn,m-ROFS, allowing for the making of more delicate decisions. In addition, we define several basic algebraic and arithmetic operations on Cn,m-ROFS, such as intersection, union, multiplication, addition, and scalar multiplication, and we discuss their key characteristics together with some of the known relations over Cn,m-ROFS. In addition, we present and study the new circular n,m-rung orthopair fuzzy weighted average/geometric aggregation operators and their properties. Further, a strategy for resolving multicriteria decision-making problems in a Cn,m-ROF environment is provided. The suggested strategy is tested on two situations: the best teacher selection problem and the best school selection problem. To confirm and illustrate the efficacy of the suggested methodology, a comparative analysis with the intuitionistic fuzzy weighted average, intuitionistic fuzzy weighted geometric, q-rung orthopair fuzzy weighted averaging, q-rung orthopair fuzzy geometric averaging, circular PFWAmax{{\rm{PFWA}}}_{{\rm{\max }}}, and circular PFWAmin{{\rm{PFWA}}}_{{\rm{\min }}} operators approaches is also carried out. Ultimately, in the final section, there are discussions and ideas for future research.

Abstract Aims We aimed to determine the use of sodium–glucose cotransporter 2 inhibitors (SGLT2is) and to identify clinical factors associated with their use in patients with heart failure (HF) in a real‐life setting. Methods Real‐world data on Empagliflozin and Dapagliflozin use in patients with HEART failure: The RED–HEART study is a multicentre, cross‐sectional and observational study that included HF patients in the outpatient setting regardless of ejection fraction from 19 cardiology centres between August 2023 and December 2023. Results The study population consisted of 1923 patients with HF, predominantly men (61.2%), with a median age of 66 (range: 19–101) years. Overall, 925 patients (48.1%) were receiving SGLT2is. Among the study population, 22.1% had HF with preserved ejection fraction, 21.5% had HF with mildly reduced ejection fraction, 56.4% had HF with reduced ejection fraction and the use of SGLT2is was 42.0%, 47.9% and 50.6% in each group, respectively (P = 0.012). The use of SGLT2is was 76.6% in patients with HF and diabetes, 19.8% in patients with HF and chronic kidney disease and 26.8% in patients without diabetes and chronic kidney disease (P

Assessment of stroke severity and recovery progress relies on a therapist’s rating or score. It is typically administered manually with subjective input from therapists. This method is exposed to inconsistency, particularly when involving different therapists which depends on their own experiences and expertise. This paper presents a study on one-way ANOVA analysis to investigate the impact of force, forearm and elbow movement, Activity of Daily Living (ADL) equipment motion, and time duration on the MAL score during the execution of ADLs. A Motor Activity Log (MAL) is employed as the standard clinical assessment benchmark, where ten ADLs have been selected from the MAL standard for data collection purposes involving 30 healthy individuals and 56 stroke patients. The analyses are divided into two which are Analysis 1) focuses on the data with therapist rating 5, while Analysis 2) considers the data with therapist ratings ranging from 1 to 5. Data inputs including force, forearm and elbow movement, ADLs equipment motion, and activity time duration have been collected using sensors of force, distance, Inertial Measurement Unit (IMU), and encoders. Output data in MAL scores are obtained manually from therapists using the current methodology. The results indicate significant differences in 19 out of 40 cases for Analysis 1) and 85 out of 100 cases for Analysis 2). This paper contributes towards an objective and accurate automatic scoring system for a more consistent and efficient assessment of stroke patients’ performance and recovery progress.

Türkiye has experienced many earthquakes of different magnitudes throughout history. Since the destructive consequences of these earthquakes lead to disasters, they have an important place in terms of disaster management. Considering the seismicity of Türkiye, this study aims to present a bibliometric analysis of the studies on earthquakes and Türkiye from the Web of Science (WOS) database. In the study, filters were applied within the framework of various criteria, and analyses were made in the VOSviewer program. Within the scope of the study, it was determined that studies on Earthquake & Türkiye have increased in recent years, the journal with the most publications is Geophysical Journal International, and the most cited study is “Progressive failure on the North Anatolian fault since 1939 by earthquake stress triggering”.It was determined that Barka, Aykut stand out among the authors regarding total link strength and citations, and Ergintav, Semih regarding number of documents and co-authorship. In terms of countries, the USA is the country with the most publications after Türkiye. In terms of keywords, earthquake, Türkiye and the North Anatolian Fault Zone came to the fore. It is thought that this study will be an important reference for researchers who want to study earthquakes in Türkiye.

Modulated Model Predictive Control (MMPC) techniques can be applied to enhance matrix converter (MC) performance in the linear modulation zone (LMZ). However, extending the converter operation in the overmodulation zone (OMZ) remains a problem. A key limitation of existing control methods in the OMZ is using the duty cycles calculated for the LMZ without considering the voltage or current reference vectors. This approach can lead to inaccurate calculations and a slower transient response when switching between the two operational zones. To overcome this challenge, a novel reference vector calculation method is proposed in this paper. The proposed approach simplifies the duty cycle calculation and ensures optimal performance in the OMZ by introducing new vector calculations and dividing the OMZ into two subzones. This method also minimizes the transition time between LMZ and OMZs to maximize the usable operating range of MCs. Simulation and experimental results validate the proposed method outperforms two other MMPC methods in improving the MC performance, reducing the transition times between operational zones, and maximizing the converter utilization.

Abstract Background Sever’s disease is among the most common causes of foot pain in childhood.The etiology of Sever’s disease is still under debate.The objective of this prospective study is to investigate the relationship between Sever’s disease and attention deficit hyperactivity disorder(ADHD). Methods The study was prospectively conducted for 1 year between 2023–2024.Of 238 children admitted to our clinic with foot pain, 88 children diagnosed with Sever’s disease were included in the study.A control group including 90 individuals was employed.Patients diagnosed with Sever’s disease in the orthopedics outpatient clinic and healthy control group were evaluated by a pediatric psychiatrist in terms of ADHD based on the DSM-4 diagnostic criteria. Results Fifty-seven patients were male, and 31 were female.While 45 male patients were diagnosed with ADHD, 12 of them did not have ADHD.While 17 female patients were diagnosed with ADHD, 14 did not have ADHD. ADHD was detected in 12 (13.3%) of 90 patients in the control group, comprising 9 boys and 3 girls. The prevalence of ADHD in the Sever’s disease cohort was 62 (70.5%) out of 88, significantly higher than the control group’s 12 (13.3%) out of 90 patients (p

The electrification of aviation is predominantly driven by environmental concerns associated with emissions. In this context, while the More Electric Aircraft and Hybrid Electric Aircraft concepts are currently at the forefront, the long-term objective is the utilization of All Electric Aircraft. Presently, the transition to All Electric Aircraft, which includes the electrified propulsion system, seems challenging due to the significant energy and power demands of aircrafts, given that the specific energy of recent energy storage technologies and power density of other electrical parts are not at the desired levels. Nevertheless, various scientific findings are being explored to accelerate this process and fuel cells are emerging as a solution. This study examines the retrofitting of a Cessna 172S, selected as the baseline aircraft, into a fully electric version with a hybrid configuration combining a battery and fuel cell. The modification process includes the development of an electrical power system architecture, selection of the required components, and modeling of the system elements. The new configuration of the platform is investigated through various simulations to evaluate the impacts on power sharing of the battery and fuel cell, and a comparative weight analysis is conducted between the baseline and retrofitted aircraft. The study concludes with a critical examination of the benefits and challenges related to the All Electric Aircraft concept.

Recommender systems in the industrial sector are experiencing a growing application within e-commerce platforms, focusing on tailoring customer shopping experiences. This trend has led to increased customer satisfaction and enhanced sales outcomes for businesses operating in this domain. Despite the widespread prevalence of e-commerce globally, there exists a noticeable gap in the empirical assessment of recommender system performance for business objectives, particularly in the context of utilizing data mining methodologies and big data analytics. This research aims to address this gap by scrutinizing authentic global e-commerce data that spans diverse countries, industries, and scales. The primary objective is to ascertain the impact of recommender systems, measured in terms of contribution rate, click-through rate, conversion rate, and revenue, by leveraging advanced big data analytics and data mining techniques. The study utilizes average values derived from an extensive dataset comprising 200 distinct e-commerce websites, representing a spectrum of 25 countries distributed across five different regions. Notably, this research represents a pioneering initiative in the literature as it harnesses and analyzes empirical data on such a comprehensive scale derived from various global e-commerce platforms.

Objective: Healthcare professionals play a pivotal role in shaping society’s attitudes towards vaccines. The aim of this study is to assess vaccine hesitancy and acceptance among physicians toward COVID-19 vaccines and to identify the factors influencing their attitudes. Methods: This cross-sectional, web-based survey study, which involved physicians, was designed using Google Forms, and all questions were developed by researchers. The survey consists of two parts, including participants’ sociodemographic characteristics and opinions regarding COVID-19 and the vaccine. Results: The study comprised 602 participants, with 67.6% reporting providing healthcare to COVID-19 patients. Among them, 82.9% perceived COVID-19 as highly dangerous, and 98% recommended vaccination to their patients. There were 25 individuals (4.1%) who had never been vaccinated. Among this group, 60% expressed concerns about the vaccine’s safety and were afraid of potential future side effects. Vaccine supporters (VS) were more likely to perceive COVID-19 as “very dangerous” compared to the anti-vaccine group (AVG). Additionally, the VS showed higher support for vaccination and had a higher rate of receiving the influenza vaccine. The AVG believed the vaccine to be effective but not safe. Factors associated with being in the AVG included not receiving the influenza vaccine, not perceiving vaccines as safe and effective, and not considering the pandemic to be dangerous. Conclusion: Despite the concerns, healthcare professionals, particularly physicians, had the highest vaccination rates. The high vaccination rates and confidence in the vaccines among healthcare workers are positive findings that support the effectiveness of vaccination strategies targeted at this group.

Objective: Central venous catheters are mainly used for safe fluid infusion, total parenteral nutrition, and evaluation of hemodynamic parameters. Complications related to central venous access can occur during insertion, after insertion or during catheter maintenance. The aim of this study was to investigate the demographic data and the presence of catheter-related complications in pediatric patients with central venous catheters in our hospital. Methods: This study retrospectively reviewed demographic data and the presence of catheter-related complications in pediatric patients with central venous catheters in our hospital from June 1, 2019, to February 28, 2023. Results: Patients who underwent central venous catheterisation in our hospital between June 2020 and February 2023 were included in the study. When the demographic data of the patients were evaluated, 141 (57.8%) of our patients were male and 103 (42.2%) were female, and there was no statistically significant difference between the groups. In the femoral group, catheterisation of the right femoral vein was preferred more than the left vein (72.2%-27.7%), whereas in the jugular-subclavian group, the right internal jugular vein was preferred more than other sites. The risk of infection was statistically higher in the femoral group compared to the subclavian group. Conclusion: In clinical practice, we think that the risk of complications can be reduced in central venous catheter applications in pediatric patients by experienced personnel by complying with asepsis/antisepsis conditions and using appropriate imaging devices.

Research conducted in diverse contexts revealed a general tendency among language learners and teachers toward mainstream English varieties. There is even a scientific foundation for this personal preference, suggesting that these varieties (particularly American English) are understood better. Besides, computer- and mobile-assisted technologies have fostered language education in general and the learning and teaching of these varieties. Accordingly, this study evaluated the CALL and MALL products (i.e., three websites, one mobile application, and one corpus) about American English using the adapted frameworks of Baya’a et al. (2009) and Reinders and Pegrum (2017). With a particular focus on the technical and pedagogical features and concerns, the analyses indicated potential advantages to language learners and teachers in grammar, pronunciation, vocabulary, listening, reading, intercultural awareness/competence, and pragmatic awareness at varying degrees. The evaluated products’ shortcomings (e.g., insufficient assessment and feedback) were also cited. The study revealed its limitations and made recommendations for further research. It further bridged the gap in the related literature and contributed to our understanding by providing insights.

Vocabulary is an essential component in language learning. In addition to its relationship with other language skills, such as pronunciation (form), reading (meaning), and grammar (use), vocabulary is required for language proficiency. In parallel, language learners must be equipped with specific amounts of vocabulary to comprehend texts of diverse genres (e.g., novels, newspapers, and movies). However, learning vocabulary is incremental, and this skill challenges many language learners in their language-learning journeys for several reasons. Nevertheless, emerging mobile technologies might mitigate the negative impacts on language learning (e.g., lack of motivation and engaging learning environment). In this regard, the present study evaluates a mobile app called WordUp using Kohnke and Moorhouse's (2022) framework.

Manal S Ebaid,1,2 Maciej Chyb,3,4 Veronika Furlan,5 Hoda Atef Abdelsattar Ibrahim,6 Urban Bren,5,7,8 Justyna Gatkowska,3 Jaros&lstrok;aw Dziadek,9 Wagdy M Eldehna,10,11 Ahmed Sabt2 1Department of Chemistry, College of Science, Northern Border University, Arar, Saudi Arabia; 2Chemistry of Natural Compounds Department, Pharmaceutical and Drug Industries Research Institute, National Research Center, Dokki, Cairo, Egypt; 3Department of Molecular Microbiology, Faculty of Biology and Environmental Protection, University of Lodz, &Lstrok;ód&zacute;, Poland; 4Bio-Med-Chem Doctoral School of the University of Lodz and Lodz Institutes of the Polish Academy of Sciences, &Lstrok;ód&zacute;, Poland; 5Faculty of Chemistry and Chemical Engineering, University of Maribor, Maribor, Slovenia; 6Pediatric Department, Faculty of Medicine, Cairo University, Cairo, Egypt; 7Faculty of Mathematics, Natural Sciences and Information Technologies, University of Primorska, Glagoljaška 8, Slovenia; 8Institute of Environmental Protection and Sensors, Beloruska Ulica 7, Maribor, Slovenia; 9Laboratory of Genetics and Physiology of Mycobacterium, Institute of Medical Biology of the Polish Academy of Sciences, &Lstrok;ód&zacute;, Poland; 10Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Kafrelsheikh University, Kafrelsheikh, Egypt; 11Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Pharos University in Alexandria, Alexandria, EgyptCorrespondence: Ahmed Sabt; Wagdy M Eldehna, Email sabt.nrc@gmail.com; wagdy2000@gmail.comIntroduction: Toxoplasmosis, a zoonotic infection caused by the apicomplexan parasite Toxoplasma gondii, affects a significant portion of the global human population. This condition, particularly dangerous for pregnant women and immunocompromised individuals, currently lacks effective treatment options.Methods: Eighteen coumarin-based derivatives were synthesized, comprising coumarin-chalcone hybrids (5a-i) and coumarin-pyrazoline hybrids (6a-i). Cytotoxicity was evaluated using L929 mouse fibroblasts and Hs27 human fibroblasts. Anti-T. gondii activity was assessed, and molecular docking studies were performed to predict binding modes with TgCDPK1.Results: Pyrazoline hybrids (6a-i) showed lower toxicity than chalcone-bearing coumarins (5a-i), with CC30 values exceeding the highest tested concentration (500 μg/mL) for most compounds. The synthesized molecules demonstrated strong anti-T. gondii activity, with IC50 values ranging from 0.66 μg/mL to 9.05 μg/mL. Molecular docking studies provided insights into potential binding mechanisms.Conclusion: This study highlights the potential of coumarin-based hybrids as anti-T. gondii agents. The findings should contribute to the growing arsenal of small molecules against T. gondii and underscore the value of molecular hybridization in drug design. Further studies to elucidate these compounds’ mechanism of action and in vivo efficacy are warranted to fully realize their potential as anti-parasitic agents.Keywords: Coumarin sulfonamides, Synthesis, N-acetylpyrazoline, TgCDPK1 enzyme, molecular docking

According to the Ministry of National Education, 2013, children with diverse needs have the right to receive their education in environments designed to meet their needs and allow them to interact with their peers. Instructional programs that can meet all children’s needs are one of the suggested programs during the implementation of inclusive programs. The Naturalistic Teaching Process is a recommended method in this context. The Naturalistic Teaching Process is a natural instructional process that allows children to acquire and reinforce new skills. This study aims to define the perspectives of preschool teachers who have children with diverse needs in their classrooms on the Naturalistic Teaching Process. Semi-structured interviews collected the data. Fifteen preschool teachers participated in this study. The data analysis employed an inductive approach based on content analysis. The study findings indicate that preschool teachers tend to follow a child's lead when setting educational objectives for children with diverse needs and developing an individualized educational program. Additionally, the study defines preschool teachers' abilities as inadequate for collaboration with families and specialists. Preschool teachers partially use the strategies and techniques, environmental arrangements, and prompts used in the Naturalistic Teaching Process, but they do not apply them systematically, indicating a need for teacher training in these areas.

Abstract There are limited data on the effects of a high-fructose diet on the female reproductive system. Although metformin has some functional effects on female fertility, its reproductive outcome on high fructose diet-induced metabolic syndrome is unclear. The aim of the present study is to evaluate the impact of a high fructose diet on histomorphological and molecular parameters of the reproductive organs and vaginal microbiota as well as the treatment potential of metformin. Wistar albino rats were used in the study. The metabolic syndrome model was induced by a high-fructose diet in rats for 15 weeks. Metformin was orally administered once a day for the last 6 weeks. The high-fructose diet increased blood glucose, triglycerides, insulin, and ovarian testosterone levels; however, it reduced ovarian aromatase levels and follicle numbers and caused uterine inflammation. The high-fructose diet-induced molecular abnormalities on ovarian tissue were demonstrated by the downregulation of ovarian insulin signaling pathway proteins and dysregulation of ovarian mitogenic and apoptotic pathway proteins. A high-fructose diet caused vaginal dysbiosis, metformin increased probiotic bacteria in the vaginal microbiota. Our results revealed that metformin improves ovarian impairments by modulating hormonal balance, insulin level, mapk, and apoptotic signaling molecules, as well as regulating the vaginal microbiota.

İbn Sînâ sonrası İslam felsefe geleneğini meşgul eden en canlı tartışmalardan biri mahiyetlerin dışta nasıl bulunduğu ve onlara dair tümel bilgimiz ile haricî varlık arasındaki mutabakat ilişkisinin nasıl kurulacağıyla ilgilidir. Özellikle Fahreddin er-Râzî’nin İbn Sînâcı zihnî temsil anlayışına yönelttiği ve akıldaki suretlerin dıştaki mücerred tabiatları yansıtmadığını öne süren eleştiri neticesinde, temsil teorisini sürdürmeyi amaçlayan düşünürler İbn Sînâ’nın metafiziksel gerçekçiliğinden uzaklaşan yeni bir tutum geliştirmişlerdir. Bu tutum etrafında onlar tikel cevherlerin duyulur yüzü altında, duyulur olmayan ve aynı türe ait tikel cevherlerin tümünde ortak olan bir tabiatın mevcut olduğu anlayışını terk ederek dış varlıkta yalnızca tikel cevherlerin bulunduğunu savunmaya başlamışlardır. İbn Sînâ’nın dışta tikellerin parçası olarak mevcut olduğunu söylediği doğal tümelin haricî varlığını reddetme anlamına gelen bu yaklaşıma ilaveten onlar, tümel tabiatların dışta değil yalnızca zihinde bulunduğunu öne sürmüştür. Tümel tabiatların zihinde ortaya çıkışını tikeller ve onların duyulur özellikleri arasındaki bir mukayese ertesinde meydana gelen aklî suret üzerindeki zihinsel işlemlerle açıklayan bu tutum, zihin ve dış arasındaki mutabakatı da aklî suret ile hariçteki suret arasındaki mutabakat ilişkisinden çıkartarak yeni bir yoruma tâbi tutmuştur. Tabiatların haricî varlığını reddederek İbn Sînâ’nın metafiziksel gerçekliğinin ontolojik yönünü, tabiat denildiğinde aslında tikellerin kastedildiğini öne sürerek semantik yönünü, bildiğimiz şeylerin dıştaki bu tabiat değil tikeller arasındaki ortak özellikler olduğunu ve tümel tabiatların yalnızca zihinde bulunduğunu savunarak da epistemolojik yönünü budayan bu yeni tutum, metafizik gerçekçiliğin hârice bakan kısmını zayıflatıp zihne bakan kısmını güçlendirdiği için zihinselci eğilim olarak adlandırılmıştır. Bu makalede Nasîruddin et-Tûsî ile başlayıp Kutbüddin er-Râzî ile zirvesine çıkan zihinselci eğilimin on beşinci yüzyılda Ali Kuşçu tarafından nasıl sürdürüldüğü gösterilecek, söz konusu eğilimin bir İbn Sînâ yorumu olmaktan uzaklaşarak nasıl bağımsız yeni bir felsefî tutuma evrildiği tartışılacaktır.

Abstract Background Hospitalization of patients with heart failure makes it possible to optimize drug therapy, considerably improving the prognosis of this serious condition. Methods We conducted a retrospective descriptive study of patients with reduced left ventricular ejection fraction (≤ 40%) in the Cardiology Department of a community hospital center in France to measure the prescription rate of heart failure medications in hospitalized patients with reduced ejection fraction heart failure and identify their limiting factors. The primary endpoint was the prescription on the discharge prescription of the following four drug classes: beta-blockers, renin–angiotensin–aldosterone system blockers, mineralocorticoid receptor antagonists, and sodium-glucose co-transporter inhibitors. Results From September 1, 2022, to March 31, 2023, 73 patients were included in the study. About one-third of patients were discharged with the recommended four drug classes. Those discharged with all 4 drug classes were younger and had preserved renal function. Conclusions The low rate of prescription of heart failure medications after hospitalization is a reminder of the need to develop a specialized follow-up structure to optimize the drug treatment of reduced ejection fraction heart failure, even in the most fragile patients.

Abstract Background Ventricular tachycardia storm is a syndrome defined by the presence of at least three episodes of ventricular tachycardia over a 24-h period, requiring termination by intervention. Standard therapy consists initially of using intravenous betablockers (if left ventricular ejection fraction is preserved) and Amiodarone, in addition to intravenous Lidocaine (in case of ischemic etiology) and light sedation. In the present case, a ventricular tachycardia storm episode is terminated by Esmolol, a particular intravenous betablocker, despite acute decompensated heart failure. Case presentation We report the case of an 89-year-old patient presenting for a ventricular tachycardia storm and acute heart failure with reduced left ventricle ejection fraction of coronary ischemic origin that persisted despite coronary revascularization, oral betablocker, intravenous Amiodarone and Lidocaine, light sedation, and multiple electrical cardioversion. Emergency catheter ablation was not feasible due to meteorological conditions. We decided to use an intravenous betablocker despite the presence of acute heart failure. We favored use of intravenous Esmolol over other intravenous betablockers due to its short half-life and thus his rapid elimination, a unique characteristic for Esmolol. Intravenous Esmolol has successfully terminated the ventricular tachycardia without causing cardiogenic shock. Conclusions Intravenous Esmolol can be used safely in patients with acute decompensated heart failure to terminate an electrical storm after failure of other measures. Close monitoring of the patient remains essential.

The mechanical properties of many prostheses are the causes of the stress shielding effect resulting from the imbalance of the prosthesis and human bone, which leads to the premature failure of the prosthesis after installation for bone replacement or repair. The present study uses statistical design to obtain optimal biomechanical properties of biocomposite prostheses to replace orthopaedic bone. The study utilized Pure Titanium (P-Ti) powder reinforced with Hydroxyapatites (Ha) and Calcium Carbonate (CaCO3) as the factors of the experiment, and the physical and mechanical properties were considered as the response. The experiment design was conducted with statistical software (Design Expert) using Determinant Optimal Mixture Design of Experiment (DM-DOE) and analyzed using analysis of variance (ANOVA). Biocomposites were developed using powder metallurgy techniques, and the experimental samples' mechanical, physical, and morphological characteristics were analyzed. The result showed that the optimum biocomposite formulations are 68.36 Ti, 18.36 Cow Bone-Based Hydroxyapatites (CB-Ha), and 8.17 CaCO3 by maximizing the mechanical properties and minimizing stiffness and physical properties suitable for the replacement bone. The results revealed a closer value of bone modulus with the decreased modulus (54.23 GPa), density (4.09 g/cm3), and porosity (9.56 %). There was also an enhancement of other mechanical properties with predicted compressive strength (162.17 MPa), Hardness (378.62 Hv), impact strength (11.43 KJ/m2), and Fracture toughness (26.11 MPa m0.5). The ANOVA revealed that CB-Ha and CaCO3 are crucial factors in minimizing the prosthesis stiffness, which has interactive effects on the formulation of biocomposite.

The Agri-Food Supply Chain (AFSC) has gained worldwide attention among researchers for its diverse applications. With market expansion and globalization, one of the most challenging issues in the AFSC to connect these diverse research fields with contemporary supply chain trends. Accordingly, it becomes imperative to understand the emerging research structure within the AFSC. This study aims to conduct a comprehensive review of the literature related to the AFSC and proposes a conceptual framework covering the antecedents and outcomes of structural associations among the AFSC factors. This study employs a bibliometric analysis methodology, encompassing 303 papers retrieved from the Scopus database between 1997 and 2021. A rigorous inclusion and exclusion process was carried out by using articles whose titles contained only 'agri-food' and 'supply chain' terms. This systematic approach ensured a feasible dataset for analysis. Microsoft Excel and VOSviewer were used for an in-depth analysis of prolific authors, article trends, institutions, countries, influential articles, and source titles within the domain of AFSC. Co-occurrence analysis was conducted to identify seven core research themes, namely: agri-food supply chain system; agri-food supply chain management; agri-food supply chain industry; agri-food supply chain risk factors; agri-food supply chain information; agri-food supply chain advancement; agri-food supply chain risk management; This study makes a significant contribution by constructing a comprehensive conceptual framework that logically organizes these thematic factors, aligning future research with emerging trends. Additionally, this research highlights the imperative of global collaboration across diverse regions and fields within AFSC to build more resilient supply chains capable of adapting to evolving conditions.

Temporomandibular joint disorders (TMDs) typically manifest with symptoms and signs such as pain, mandibular movement, dysfunction, or joint sounds. Botulinum toxin type A (BTX/A) is a biological toxin that inhibits the release of the neurotransmitter acetylcholine at the neuromuscular junction. This toxin is used to treat hyperactivity of masseter muscles and TMD symptoms. This case report aimed to investigate the effects of BTX/A injection in the masseter and lateral pterygoid muscles of a patient with painful symptoms of TMDs via electromyography (EMG), with a follow-up of six months post-treatment. During each visit, the clinical effects, which were evaluated based on pain intensity (NPRS), the bruxism questionnaire, and maximum mouth opening, were evaluated at five-time points, pre-injection and 2, 6, 12, and 24 weeks after the injection. Based on this case report, there was a clear improvement in the studied parameters, with a significant decrease in the electromagnetic activity of the injected muscles as shown by EMG; thus, BTX/A can be considered an effective treatment to relieve symptoms and improve the quality of life in patients with TMDs of muscular origin, relying on EMG as an effective diagnostic tool and for subsequent evaluation of treatment results.

Background: The devastating earthquakes that struck Turkey have left profound psychological impacts on those affected, with anxiety and trauma being particularly prevalent. Understanding the factors that can mitigate these effects is important for developing effective interventions. Objective: This study seeks to analyse the intermediary functions of perceived social support (PSS) and resilience within the correlations linking earthquake-induced anxiety and the occurrence of traumatic experiences after the seismic event in Turkey. Method: The study involved a sample of 504 young adults (61.31 % females) who survived the earthquake in Turkey on February 6, 2023. Participants aged 18 to 30 (M = 21.57, SD = 2.55) completed an online survey of self-reported measures of earthquake anxiety, traumatic experiences post-earthquake, PSS, and resilience. Results: The results indicated that earthquake anxiety significantly predicted levels of traumatic experiences, PSS, and resilience. Additionally, PSS and resilience emerged as significant predictors of traumatic experiences. Importantly, resilience and PSS served as mediators in the relationship between earthquake anxiety and traumatic experiences. Conclusions: These results highlight the importance of coordinating social and mental assets that focus on strengths in guidelines and interventions designed to enhance positive mental health among earthquake survivors coping with traumatic experiences.

A lot of attention has been drawn to environmentally friendly and sustainable materials in the need to decarbonize the planet. The utilization of agro-waste to meet this need has increased in recent times. Among the various agro-wastes, rice husk has gained more traction due to its abundance, unique constituents, and properties suitable for advanced material synthesis. Precursor materials such as silica and silicon used in advanced materials synthesis are also synthesized from rice husk. The synthesis of these advanced materials depends on the rice husk pretreatment and thermochemical conversion approach. Pretreatment methods such as acid leaching generally yield higher silica purity compared to water leaching. However, the use of acid in leaching impurities during pretreatment leads to the release of harmful chemicals. Among thermochemical methods used in silica synthesis, the hydrothermal method has gained more attention due to the use of water as a liquid medium and the elimination of the raw materials drying step, reducing emissions and energy demand in the process. Metallothermic reduction methods such as magnesiothermic and aluminothermic reduction of silica to silicon have attracted much attention due to their low reduction temperature. This review discusses the composition and properties of rice husk and its thermochemical conversion to silica (SiO2) and silicon (Si). Silica and silicon are essential materials used as framework or precursor materials in the synthesis of other advanced materials such as zeolites and catalyst supports. The second part of the review discusses the various thermochemical conversion approaches and their kinetics. The final part of the review discusses the various rice husk-derived advanced materials and their applications.

Abstract This study evaluated the effect of Stemregen® nutritional supplement on inflammation and resorption in apical periodontitis using a rat model. Methodology Rats were divided in three groups: negative control (n=7), positive control (n=10), and Stemregen® (Stem) (n=10). Apical periodontitis was induced in the positive control and Stem groups, and all rats were sacrificed on the 30th day. Serum phosphorus (P), calcium (Ca), and alkaline phosphatase (ALP) were analyzed. Histopathological assessments measured osteoblastic and osteoclastic activity, inflammation, fibrosis, and abscess density. Immunohistochemical analyses evaluated RANKL, TRAP, and OPG levels. Results Results showed significantly lower osteoblastic activity in the negative control compared to Stem and positive control groups (p=0.005). Osteoclastic activity was higher in the positive control (p=0.032). Inflammation and abscess formation were reduced in the Stem group compared to the positive control (p

Neural invasion is a prognostic hallmark of pancreatic ductal adenocarcinoma (PDAC), yet the underlying mechanisms behind the disruption of perineural barriers and access of cancer cells into intrapancreatic nerves remain poorly understood. This study aimed to investigate the role of epithelial-mesenchymal transformation (EMT) in perineural epithelial cells during neural invasion.Histopathological analysis of human and murine primary tumors using perineurium-specific GLUT1 antibody revealed a reduction in perineural integrity, which positively correlated with the extent of neural invasion in human PDAC cases. Human pancreatic cancer cell lines were found to secrete TGFbeta1, which induced EMT of perineural epithelial cells, characterized by the loss of epithelial markers (CK19-9) and the acquisition of mesenchymal markers (alphaSMA, N-Cadherin). Additionally, these transitioning perineural epithelial cells demonstrated increased matrix-degrading capabilities through the upregulation of matrix-metalloproteases 3 and 9 via SMAD2. In an autochthonous mouse model with elevated endogenous TGFbeta1 levels in addition to oncogenic Kras activation (Ptf1aCre/+, LSL-KrasG12D/+, LSL-R26Tgfβ/+), decreased perineural integrity could be reproduced in vivo.Collectively, these findings underscore the role played by TGFbeta1-overexpressing pancreatic cancer cells in the dismantling of perineural barriers during neural invasion.

The management of early-stage colon cancer involves surgical resection of the primary tumor with or without chemotherapy, depending on pathological staging. The benefit of adjuvant chemotherapy for stage II and III colon cancer is approximately 5% and 15%, indicating the need for optimization for risk stratification and patient selection. Several studies have revealed that current clinicopathological factors lack precision. Circulating tumor DNA (ctDNA) is cell-free DNA originating from cancer cells and can be detected even in the absence of radiologically detectable disease among patients with colon cancer. Recent cohort studies revealed that ctDNA is one of the most significant prognostic factors for patients with early-stage colon cancer, surpassing pathological and clinical risk factors. Prospective cohort studies also suggest there may be a predictive role for ctDNA on the decision for consideration of adjuvant therapy. Currently, randomized clinical trials are enrolling to better define this role. In this review article, we review recent literature on ctDNA and its role in patients with colon cancer. We also elaborate on the future clinical utility of ctDNA in clinical practice and the unmet need for research to optimize currently available ctDNA assays.

Technological advancements have not only introduced new tools for language education but also tailored apps and resources for specific language skills. These include mobile apps (e.g., Drops: Language Learning Games for vocabulary), websites (e.g., SpanishDict for Spanish dictionary and grammar), and reference tools (e.g., Grammarly for writing assistance). One such resource is PlayPhrase.me, an online and mobile tool serving as a database of movie clips for language practice, particularly vocabulary. Despite the relative attention similar tools (e.g., YouGlish and Voscreen) have received, only two studies were conducted about the PlayPhrase.me a website. Accordingly, there is a need for a review that outlines its general characteristics and pedagogical affordances. To this end, this review evaluated the website and revealed considerable potential for vocabulary, grammar, and pronunciation learning. Citing the possible pitfalls, such as short video durations, lack of filtering, and absence of evaluative and competitive means, the researcher offered recommendations for improvement. The review concludes with the researcher’s reflections as a teacher and urges further research to validate the findings.

Background/objectives: The swift appearance of asymmetry in breast size and density has been associated with an increased risk of breast cancer and other pathological changes. However, the occurrence of breast asymmetry and the factors influencing it have not been extensively studied among healthy, screened women in the Saudi population. Thus, this study aims to explore bilateral breast asymmetry in breast size and density among healthy, screened Saudi women and factors affecting the asymmetry. Methods: Data of 1048 out of 1173 eligible women screened between 2012 and 2018 were extracted from Sheikh Mohammed Hussien AL-Amoudi Center of Excellence in Breast Cancer. The Laboratory for Individualized Radiodensity Assessment (LIBRA) software was used to measure percent density, dense area, and total area of breast from mammograms. Paired t-test was used to examine asymmetry between right and left breasts, and stratified analysis was performed to investigate the factors associated with breast asymmetry. Results: No significant differences were observed between the right and left breasts in percent density, dense area, and total breast area (p ≥ 0.2). However, for participants who never breastfed, the right breast area was slightly larger (average: 207.9 cm2) than the left breast (average: 202.8 cm2); p = 0.008. Conclusion: There were no significant differences found in the density, and size of the right and left breasts. However, women who breastfed tended to have slightly larger right breasts.

Optimal and cost-effective drilling operations in extended-reach horizontal wells depend on efficient solid cuttings removal from the borehole. Several solids-suspended multiphase processes such as crude petroleum transportation, separation, and processing of oil and gas streams also require the efficient removal of these solids. The terminal settling velocity (Vts) of the solid particle is a vital parameter that controls the removal efficiency of these solids. In a drilling scenario when there is a hold on fluid circulation such as connection time, the accurate estimation of Vs provides the driller with time available to prevent solid deposition. In severe conditions, this can result in a stuck pipe, especially for extended-reach horizontal wells. In this work, both spherical and non-spherical particle deposition were experimentally investigated in several fluid rheology and salinity. Two concentrations (0.1vol% and 0.05vol%.) of partially-hydrolyzed polyacrylamide (PHPA) were used as a drag-reducing additive for water-based drilling mud. The PHPA drag-reducing fluid (reduced pressure loss) acts as a turbulence inhibitor. The PHPA polymer chain suppresses any turbulence in the flow, reducing the turbulent eddy viscosity. The effects of salinity (3wt.%NaCl and 3wt.%CaCl2 contamination) on solid particle settling velocity (Vs) in drag-reducing fluids were also investigated. Terminal velocity was achieved for all experiments and seemed to increase with increased diameter/sphericity. However, cases when this trend was not consistent were observed and therefore a new parameter of Φ (sphericity index × diameter) was proposed. Vs increases with Φ value for all cases. During drilling, PHPA also aids in sealing the fracture in the formation. With and without salt in the fluid, how lowering drag affected the settling velocity of solid particles (drill cuttings) could be observed. The settling velocity tests will be improved in drag-reducing PHPA solutions with the knowledge from this study.

Abstract Background The rate of NAFLD in the general population is estimated to be 25.2%. NAFLD is affected by lifestyle, diet, and inflammation. In this study, the use of probiotics, prebiotics, and synbiotics was aimed to modulate the circadian clock in the liver and improve metabolic disorder through the gut–liver axis. Methods Six-week-old, healthy, 43 Wistar albino rats were included in the study and their average weight was determined as 140.50 g (95.00–177.00) at the beginning of the study. Before the study, the rats were randomly divided into 5 groups, 8 animals were placed in the 1st, 3rd, 4th, and 5th groups and 11 animals were placed in the 2nd group. Rats in group 1 were fed standard food for 13 weeks. Rats in the 2nd, 3rd, 4th, and 5th groups were fed with 10% fructose water during the 1-week adaptation period and then 20% fructose water. After the 7th week, probiotic treatment (2 × 109 CFU/ml Lactobacillus rhamnosus GG) was administered to rats in group 3rd via gavage for 6 weeks, and prebiotic treatment was administered to rats in group 4th with feed containing 10% grape seed extract. Rats in the 5th group were given a feed consisting of 10% grape seed extract and 2 × 109 CFU/ml Lactobacillus rhamnosus GG via gavage. Results It was determined that the use of prebiotics as a treatment option in fatty liver had a more positive effect on glucose, ALT, melatonin, and ZO-1 values. In addition, it was observed that synbiotic use had more positive effects on histopathological findings, NAS score, and the expression level of circadian clock genes. While there was no significant difference between the mRNA levels of circadian clock genes, it was observed that gene expression levels increased with fructose consumption and decreased especially with synbiotic treatment. Conclusion It has been observed that fructose modulates the circadian rhythm by affecting some biochemical and genomic pathways as a result of synbiotic use in order to prevent the negative effects of fructose on fatty liver.

Abstract Background Conus artery occlusion is a rare life-threatening event, typically secondary to iatrogenic etiology, and is treated mainly with conservative therapy and/or balloon angioplasty without stenting. However, treatment remains challenging. Case presentation We report the case of a 60-year-old man with a known history of coronary artery disease presenting with multiple internal defibrillator cardioversions due to an electrical storm (recurrent ventricular fibrillation). The coronary angiography showed an acute occlusion of the conus artery arising from the proximal segment of the right coronary artery, treated by percutaneous transluminal coronary angioplasty with stenting (drug-eluting stent) without any serious complications. Conclusions To our knowledge, this is the first case in the literature where a non-iatrogenic occlusion of the conus artery causing a ST-segment elevation myocardial infarction and electrical storm was treated with percutaneous coronary intervention with drug-eluting stenting. Graphical abstract

Abstract Non-Insulin-Dependent Diabetes Mellitus (NIDDM) is a chronic health condition caused by high blood sugar levels, and if not treated early, it can lead to serious complications i.e. blindness. Human Activity Recognition (HAR) offers potential for early NIDDM diagnosis, emerging as a key application for HAR technology. This research introduces DiabSense, a state-of-the-art smartphone-dependent system for early staging of NIDDM. DiabSense incorporates HAR and Diabetic Retinopathy (DR) upon leveraging the power of two different Graph Neural Networks (GNN). HAR uses a comprehensive array of 23 human activities resembling Diabetes symptoms, and DR is a prevalent complication of NIDDM. Graph Attention Network (GAT) in HAR achieved 98.32% accuracy on sensor data, while Graph Convolutional Network (GCN) in the Aptos 2019 dataset scored 84.48%, surpassing other state-of-the-art models. The trained GCN analyzed retinal images of four experimental human subjects for DR report generation, and GAT generated their average duration of daily activities over 30 days. The daily activities in non-diabetic periods of diabetic patients were measured and compared with the daily activities of the experimental subjects, which helped generate risk factors. Fusing risk factors with DR conditions enabled early diagnosis recommendations for the experimental subjects despite the absence of any apparent symptoms. The comparison of DiabSense system outcome with clinical diagnosis reports in the experimental subjects was conducted using the A1C test. The test results confirmed the accurate assessment of early diagnosis requirements for experimental subjects by the system. Overall, DiabSense exhibits significant potential for ensuring early NIDDM treatment, improving millions of lives worldwide.

Hospital menus are profoundly important to meet the nourishment needs of patients. So, this study is conducted to determine the nutrient adequacy of adult patients’ normal diet menus. Methods: An evaluation of 30-day fixed menus consisting of 4 dishes was conducted in four different public hospitals in Ankara, the capital of Türkiye. Mean adequacy ratio (MAR) and nutrient adequacy ratio (NAR) were used to examine the sufficiency of nutrients and meals. Results: For all the hospitals, MAR value was found higher than %85. However, nutrient adequacy ratio of dietary fiber, calcium and magnesium were lower than the other nutrients. It was determined that total fat, saturated fat, salt and cholesterol (except hospital D) contents were high according to the recommended values. Nevertheless, these fixed menus supplied 75% daily fiber on average. Hospital A and D menus met calcium requirements by 73% and 67%, respectively. While hospital D menus met magnesium (76%) and potassium (67%) requirements moderately, other hospitals approached 100% sufficiency for potassium. It is remarkable that in all the hospitals the amount of fruits seemed very low, up to 34%. Conclusion: As the hospital meal is an essential part of in-patients’ institutional care and nutritional support, the nutrient contents of menus should be monitored for nutritional requirements and, if necessary, there should be initiatives and arrangements in standard recipes to reduce salt and fat contents.

Abstract This research introduces an advanced finite control set model predictive current control (FCS-MPCC) specifically tailored for three-phase grid-connected inverters, with a primary focus on the suppression of common mode voltage (CMV). CMV is known for causing a range of issues, including leakage currents, electromagnetic interference (EMI), and accelerated system degradation. The proposed control strategy employs a system model that predicts the inverter’s future states, enabling the selection of optimal switching states from a finite set to achieve dual objectives: precise current control and effective CMV reduction, a meticulously designed cost function evaluates the potential switching states, balancing the accuracy of current tracking against the necessity to minimize CMV. The approach is grounded in a comprehensive mathematical model that captures the dynamics of CMV within the system, and it utilizes an optimization process that functions in real-time to determine the most suitable control action at each interval, Experimental validations of the proposed FCS-MPCC scheme have demonstrated its effectiveness in significantly improving the performance and durability of three-phase grid-connected inverters, Experimental validations of the proposed (MPC with CMV) scheme have demonstrated its effectiveness in significantly improving the performance and durability of three-phase grid-connected inverters. The proposed method achieved substantial reductions in CMV, notable improvements in current tracking accuracy, and extended system lifespan compared to conventional control methods.

Abstract Colorectal cancer (CRC) is the third most common cancer in the United States. Recent epidemiological evidence demonstrates an increasing incidence of young-onset CRC cases, defined as CRC cases in individuals 50 years old or younger. Studies have established that alterations in both the WNT and TGF-Beta signaling pathways have contributed to CRC development. While this is well understood, the comprehensive analysis of WNT and TGF-Beta pathway alterations in young-onset CRC cases has yet to be investigated. Here, we conducted a comprehensive bioinformatics analysis of mutations associated with each of the WNT and TGF-Beta signaling pathways according to age (≤ 50 years old versus > 50 years old) utilizing published genomic data from the cBioPortal. Chi-square results demonstrated no significant difference in WNT alterations between young-onset CRC and those > 50 years old. However, across all age groups, WNT alterations were frequently found in rectal cancers. We also found that WNT alterations were associated with better outcomes. The mutations associated with TGF-beta were observed at a higher rate in older CRC patients when compared to those ≤ 50 years old. Additionally, these mutations were found more frequently in colon primaries.

Objective: The aim of this study was to investigate whether spinal cord stimulation (SCS), a neuromodulation technique, causes any changes in sleep, quality of life, anxiety and depressive symptoms before and after the procedure in patients with chronic pain.Methods: The study was completed with 14 patients who were planned to undergo SCS for treatment-resistant chronic neuropathic pain and who applied to the psychiatry outpatient clinic for pre-treatment consultation. Patients were evaluated twice, before and 1 month after treatment. Patients were evaluated with LANNS Pain Scale, Hamilton Depression Scale (Ham-D), Hamilton Anxiety Scale (HAM-A), Pittzburg Sleep Quality Inventory (PUKI), and Quality of Life Scale Short Form (WHOQOL-Bref). Scale scores before and after the treatment were compared using a two-sample dependent t-test.Results: Depressive disorder was detected in 85.8% of the cases, anxiety disorder in 71.5%, and sleep disorder in 78.6%. The cases’ LANSS pain scale scores were 19.00±5.11 pre-treatment and 7.57±4.59 post-treatment, the difference being statistically significant (P=0.001). Significant differences were observed between pre- and post-test HAM-D, HAM-A, PSQI, quality of life (QoL) general health, QoL physical health, or QoL psychological health scores (P=.002, P=.014, P=.002, P=.002, P=.002, and P=.001, respectively). However, no significant differences were determined between pre- and post-test QoL social relationships or QoL environmental health scores (P=.160 and P=.831, respectively)Conclusion: Our data in this study suggest that SCS not only effectively reduces pain in treatment-resistant chronic pain, but also mediates significant improvements in sleep quality, anxiety and depressive states.

Abstract In humans, blood Classical CD14+ monocytes contribute to host defense by secreting large amounts of pro-inflammatory cytokines. Their aberrant activity causes hyper-inflammation and life-threatening cytokine storms, while dysfunctional monocytes are associated with ‘immunoparalysis’, a state of immune hypo responsiveness and reduced pro-inflammatory gene expression, predisposing individuals to opportunistic infections. Understanding how monocyte functions are regulated is critical to prevent these harmful outcomes. We reveal platelets’ vital role in the pro-inflammatory cytokine responses of human monocytes. Naturally low platelet counts in patients with immune thrombocytopenia or removal of platelets from healthy monocytes result in monocyte immunoparalysis, marked by impaired cytokine response to immune challenge and weakened host defense transcriptional programs. Remarkably, supplementing monocytes with fresh platelets reverses these conditions. We discovered that platelets serve as reservoirs of key cytokine transcription regulators, such as NF-κB and MAPK p38, and pinpointed the enrichment of platelet NF-κB2 in human monocytes by proteomics. Platelets proportionally restore impaired cytokine production in human monocytes lacking MAPK p38α, NF-κB p65, and NF-κB2. We uncovered a vesicle-mediated platelet-monocyte-propagation of inflammatory transcription regulators, positioning platelets as central checkpoints in monocyte inflammation.

The study aims to monitor the reality of the Authority control of Arabic names in the Union Catalog of Egyptian Universities Libraries Consortium (EULC), in terms of identifying the rules and mechanisms used when drafting Arabic persons names entries in the bibliographic records on the Future Library System (FLS), the procedures that cataloguers perform when drafting Arabic names entries, the extent of their ability to carry out the Arabic names reference control process in bibliographic records and create reference records on the future system, and identifying the obstacles and issues that they face when drafting Arabic names entries and proposals. One of the most prominent findings of the study, there is no unified nor standardized policies and practices for catalogers rely when drafting entries for Arabic persons names in the bibliographic records in the Union Catalog, as the drafting process depends on catalogers’ diligence, whether or not they possess the skills, without relying on an already existing authority file. The study also recommended that the necessity of developing work tools and policies that are applied to train and qualify catalogers on working in the Union Catalog in accordance with modern trends in the field, and not to pay attention to quantity at the expense of quality.

Rubber composite sleepers can experience significant temperature variations in service, causing temperature-induced deformation. Real-time monitoring of this deformation is crucial for operational safety and maintenance; however, it is costly, time-consuming, and requires substantial resources and personnel. Developing temperature-dependent predictive models offers a cost-effective and efficient alternative, providing accurate insights into sleeper behaviour under different conditions while saving time, labour, and materials. This study attempts to develop a novel deformation model of rubber composite sleepers using response surface methodology (RSM) and machine learning (ML) techniques. Platinum temperature (Pt) sensors, embedded at various points on a full-scale rubber composite sleeper model, were used to measure both the sleeper temperature field and ambient temperature in real-time at 30-minute intervals over the period of a year. Simultaneously, lateral deformation was recorded using linear variable differential transducer (LVDT) displacement sensors. The temperature data were filtered to remove noise and normalized based on the Log-Pearson Type III outlier detection method and Box-Cox transformation, respectively, before being used to develop temperature-dependent models for sleeper deformation. To ensure accurate ML predictions, the dataset was split into 70% for training and 30% for testing. Model performance was evaluated using the correlation coefficient (R2), mean square error (MSE), root means square error (RMSE), and mean absolute error (MAE). The analysis revealed that the sleeper’s body temperature closely follows the changing trend of the ambient environment. Also, like any polymer material, the rubber composite sleeper expands when it absorbs heat from sunlight and contracts as it cools when sunlight intensity decreases, potentially reversing much of the deformation. The K-nearest neighbour algorithm outperformed the RSM and other ML techniques with R2, MSE, RMSE, and MAE values of 0.999, 0.000258, 0.016, and 0.000896, respectively. The developed model can serve as an important reference for monitoring lateral deformation for safety and maintenance purposes.

In this study, green synthesis methods were employed to fabricate zinc oxide nanoparticles (ZnONPs) using Newbouldia laevis leaves plant extract. Several analytical methods, including Fourier-Transform Infrared Spectroscopy (FTIR), Thermogravimetric Analysis (TGA), Transmission Electron Microscopy (TEM), and UV-Vis spectrophotometer, were used to characterise the green synthesised ZnONPs. The synthesis of ZnONPs with distinct properties was successfully demonstrated by the structural and morphological investigations. The existence of functional groups involved in the stabilisation and reduction of the nanoparticles was established by FTIR. The shape of the nanoparticles was revealed by TEM. It produced non-spherical particles with a well-defined size distribution, a crystalline structure with a hexagonal shape morphology, and an average nanoparticle size of 34.8 nm. The ZnONPs that were green-synthesised demonstrated unique antioxidant characteristics. The findings showed that the ZnONPs’ capacity to scavenge radicals increased in a concentration-dependent manner. Excellent antifungal activities against Trichophyton rubrum, Aspergilus fumigatus, and Candida albicans were also demonstrated by the synthesised ZnONPs. This suggests that at 100, 200, and 400 mg/mL, the environmentally friendly ZnONPs show inhibitory zones that range from 9 to 18 mm. The use green synthesized ZnO NPs have shown excellent antifungal, antioxidant and photocatalytic reduction of 4-nitrophenol under sunlight. Green synthesis, zinc oxide nanoparticles, 4-ntrophenol, Trichophyton rubrum.

ABSTRACT Cardiac metastases are a rare site for metastatic hepatocellular carcinoma (HCC). We describe an atypical presentation of an isolated right ventricular metastasis of HCC following successful treatment with no evidence of primary disease recurrence. The case presented as gradually worsening hypertension and erythrocytosis in the setting of normal surveillance scans and alpha‐fetoprotein levels. The mass was detected on transthoracic echocardiogram and treated with surgical resection. Histopathological features of the tumor demonstrated features associated with WNT/β‐catenin mutated HCC, such as microtrabecular, acinar, and bile staining with positive glutamine synthetase expression.

Introduction The Integrated Sustainable Childhood Pneumonia and Infectious diseases Reduction in Nigeria-Lagos project introduced pulse oximetry and oxygen as part of a ‘stabilisation room’ intervention in primary healthcare facilities (PHCs) in Lagos state, Nigeria. However, impact evaluation found minimal effects on treatment and referral practices for children with pneumonia, largely attributed to persistently low pulse oximetry use. We aimed to understand how the stabilisation room intervention worked (or did not work) to improve pulse oximetry practices, for whom, and in what contexts.Methods We conducted a preplanned mixed-methods realist evaluation. We used an initial programme theory to guide data collection and analysis, focusing on pulse oximetry adoption. We described oximetry adoption using quantitative data from the impact evaluation, then used training observations, monitoring data, quarterly site reports and qualitative interviews with purposefully selected healthcare workers (HCWs) to explore how pulse oximetry was perceived and adopted. We used inductive content analysis, iteratively triangulating emerging themes with process data to generate and test theories.Results We identified four inter-related themes explaining low adoption of pulse oximetry for children in this setting: (1) In contexts of frequent staff turnover and competing demands, oximetry training was desired, appreciated and may have increased HCW knowledge and skills, but largely failed to reach frontline HCWs. (2) Pulse oximetry was not perceived as a usual part of PHC practice. HCWs relied on external motivation to adopt a fundamentally new practice, seeing it as extra work and getting easily discouraged without external supervision or strong local leadership. (3) Without institutional norms and expectations regarding pulse oximetry, HCWs needed to be convinced they were capable (self-efficacy) and would typically only use pulse oximetry selectively. (4) Technical challenges and faulty equipment, in the absence of confident and accessible troubleshooters, were demotivating and discouraging to users.Conclusion Implementation of pulse oximetry for children in primary care facilities requires clarity on the intended role of oximetry in primary care, clear normative guidance and close support and supervision during the early adoption phase.

Introduction Childhood pneumonia is a leading cause of child mortality in Nigeria and poor quality of care is a persistent issue. We aimed to understand whether introducing primary care stabilisation rooms equipped with pulse oximetry and oxygen systems alongside healthcare worker (HCW) training improved the quality of care for children with pneumonia in Lagos State.Methods Setting: Ikorodu local government area, Lagos. Population: children aged 0–59 months with clinically diagnosed pneumonia. Intervention: establishment of ‘stabilisation rooms’ within government (n=7) and private (n=7) primary care facilities, designed for short-term oxygen delivery for hypoxaemic children prior to hospital transfer, alongside HCW training on integrated management of childhood illness (IMCI), pulse oximetry and oxygen therapy. Two secondary facilities with inpatient oxygen systems received training and pulse oximeters. Primary outcome: composite ‘correct management’ of hypoxaemic pneumonia including oxygen therapy administration, referral and admission to hospital. Analysis: mixed-effects logistic regression comparing baseline (September 2020–August 2021) and implementation (September 2021–November 2022) periods, adjusted for clustering by facility.Results We screened 20 158 children, of which 160 children with hypoxaemic pneumonia (SpO2

With the proliferation of research in recent decades, pronunciation has ceased to be the “Cinderella” of language teaching. However, there are still gaps between research findings and classroom implementations (Olson, 2014). To this end, this classroom-based, experimental study explored pronunciation knowledge, perception, and production among first-year Turkish EFL teacher trainees in the context of a sixteen-week-long undergraduate course. Data were collected through three diagnostic tests. In this regard, eighty participants were pretested before and post-tested after the course. The collected data were examined descriptively and inferentially via the IBM SPPS Version 25. Findings indicated dissimilar levels of rise in knowledge (modest), perception (slight), and production (substantial) performances of teacher trainees. Nevertheless, specific gaps in knowledge and problems with segmental and suprasegmental pronunciation features remained. Results were discussed, pedagogical implications were thoroughly assessed, limitations to the study were recognized, and recommendations for future research were made.