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This study investigates the substantial contribution of the recent numerical optimization technique known as the White Shark Optimizer (WSO) to evaluate the performance of proton exchange membrane fuel cell (PEMFC) design parameters that play a considerable role in boosting its effectiveness. A numerical code was developed and implemented via MATLAB software to achieve the research goal. The proposed WSO was employed to identify the unknown parameters of the PEMFC equivalent circuit, considering experimental data. The analyzed objective function was the root mean squared error (RMSE) between the measured and estimated fuel cell terminal voltages. Additionally, the proposed WSO was compared with other intelligent approaches such as the salp swarm algorithm (SSA), Harris hawks optimization (HHO), atom search optimization (ASO), dung beetle optimization algorithm (DBOA), stochastic paint optimizer (SPO), and comprehensive learning Archimedes optimization algorithm (HCLAOA). The numerical simulations revealed that the RMSE values varied between lower and higher values of 0.009095329 and 0.028663611, respectively. Additionally, the results indicated that the mean fitness value recorded in the considered PEMFC 250 W stack was 0.020057775. Moreover, the minimum fitness value was obtained using the proposed WSO, with an operating temperature of 353.15 K and working anode and cathode pressures are 3 bar and 5 bar, respectively. The proposed WSO offered the best results in terms of absolute errors compared to the other optimizers, confirming the robustness of the results in all considered cases. [ABSTRACT FROM AUTHOR]

The growing popularity of Invisalign is attributed to the fact that patients find it more aesthetically pleasing than the traditional fixed appliance to have their teeth straightened using the Invisalign system. Invisalign was initially intended for use in less severe conditions of orthodontic malalignment. Invisalign has been an effective and aesthetically acceptable alternative to conventional labial fixed appliances since its launch in 1997. CAD/CAM (Computer-aided design/computer-sided machine) stereolithography and a single silicone or digital impression can be used to make a set of custom aligners. Each aligner is set to gradually shift teeth by 0.25 mm to 0.33 mm over two weeks. More individuals are now receiving orthodontic treatment due to this novel tooth mobility approach. Over 300,000 patients have been treated with Invisalign in the previous decade, with the average patient age being 19.5. In most cases, the Invisalign device can stabilize these patients' anterior, posterior and vertical dimensions. Although many dentists and orthodontists believe that Invisalign appliances cause deep bites, this research disproves this theory. This literature review will determine the level of efficacy Invisalign can offer when it comes to the treatment of deep bites. It was concluded that Invisalign is effective in treating mild to moderate overbite cases and is an effective replacement for metallic braces, and provides a good option for esthetic-conscious patients. [ABSTRACT FROM AUTHOR]

Background: The lungs of particularly newborn are fragile and can be easily damaged. With injury, scarring may follow which is translated into difficult breathing and increased oxygen needs, a condition called bronchopulmonary dysplasia (BPD) or Chronic Lung Disease (CLD). Since inflammation plays an important role in the pathogenesis of CLD, corticosteroids, especially dexamethasone, have been extensively used to avert or treat CLD. Thus, several studies suggest that systemic corticosteroids decrease the duration of ventilator dependence. Aim of the Study: investigate the beneficial and harmful effects of the use of steroid in the prevention and treatment of BPD. Methods: A systematic review and meta-analysis of observational studies and randomized controlled trials was conducted. A review of the scientific literature. Pubmed, Embase and Central were searched to identify randomized controlled trials that investigated postnatal corticosteroids treatment for BPD were the primary endpoints. Identification of papers and data extraction were performed by two independent researchers. We searched for relevant trials in the Cochrane Library, MEDLINE (from 1955), Embase (from 1970), the Transfusion Evidence Library (from 1980), and ongoing trial databases; all searches current to September 2017. Results: The search yielded seven RCTs which enrolled a total of 1862 participants eligible for inclusion in the present review. There were significant beneficial outcomes such as lower rates of failure to extubate and decreased risks of chronic lung disease at both 28 days (RR 0.84, 95% CI 0.83 to 0.87) and 36 weeks' postmenstrual age (RR 0.77, 95% CI 0.72 to 0.84), death or chronic lung disease at 28 days (RR 0.9, 95% CI 0.85 to 0.96) and 36 weeks' postmenstrual age (RR 0.91, 95% CI 0.87 to 0.96). Nevertheless, there were no significant differences in the rates of neonatal mortality (RR= 1.06, 95% CI 0.93, 1.26), periventricular leukomalacia (RR 1.16, 95% CI 0.9 to 1.46), necrotizing enterocolitis or pulmonary haemorrhage (RR 1.21, 95% CI 0.83 to 1.62). In contrast, gastrointestinal bleeding (RR 2.13, 95% CI 1.41 to 2.84) and intestinal perforation (RR 1.77, 95% CI 1.46 to 2.1) were imperative adverse effects. Moreover, many adverse neurological effects were found at follow-up examinations, including developmental delay (RR 1.72, 95% CI 1.4 to 2.05) and cerebral palsy (RR 1.56, 95% CI 1.03 to 2.1). Additionally, the rates of the combined outcomes of death or cerebral palsy (1.92, 95% CI 1.18 to 2.67), or of death or major neurosensory disability (RR 1.25, 95% CI 0.98 to 1.53), were not significantly increased. In subgroup analyses by type of corticosteroid, most of the advantageous and disadvantageous effects were related chiefly to dexamethasone whilst hydrocortisone had slight effect on any of the outcomes except for an increase in intestinal perforation and a borderline reduction in patent ductus arteriosus. The overall risk for bias was low as all were RCTs using robust methods. Conclusion: despite the fact that early corticosteroid treatment can have beneficial outcome for BPD management through facilitation of extubation and decreasing the risk of chronic lung disease and patent ductus arteriosus, it, on the other hand, results in short-term adverse effects including gastrointestinal bleeding, intestinal perforation, hyperglycaemia, hypertension, hypertrophic cardiomyopathy and growth failure. Clinicians should carefully assess the risks of a short course of glucocorticoid therapy to mitigate BPD for premature neonates such that an individualized decision should be made in conjunction with the infant's parents. [ABSTRACT FROM AUTHOR]

Background: Cardiorespiratory function is one of the key health indicators that promote good health. Knowing the correlation between body mass index (BMI) and cardiorespiratory functioning might assist in the creation of evidence-based therapies that focus on addressing difficulties associated with obesity., Objective: To assess the correlation between BMI and cardiorespiratory functions among medical students at Northern Border University., Materials and Methods: A cross-sectional study was conducted among medical students at Northern Border University, Saudi Arabia. The blood pressure (BP), respiratory rate (RR), heart rate (HR), mean arterial pressure (MAP), pulse pressure (PP), and BMI of the students were measured., Results: The mean age of the students was 17.1 ± 1.9 years. Nearly 40% of students were overweight or obese. Our study revealed a significant positive correlation between BMI and BP, RR, tidal volume (TV), and MAP., Conclusions:  The correlation analysis of our study revealed a significant positive correlation of BMI with BP, RR, TV, and MAP., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Local Committee of Bioethics at Northern Border University (HAP-09-A-043) issued approval 95/23/H. We obtained ethical approval from the Local Committee of Bioethics at Northern Border University (HAP-09-A-043) with decision number 95/23/H, dated: 12-10-2023. There is no risk to participants because the study is questionnaire-based, and students have complete control over whether to participate or not. Data privacy and confidentiality were assured. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Abd El Mawgod et al.)

Purpose: To clinically evaluate and compare the efficacy of indocyanine green mediated photodynamic therapy (PDT) and aloe vera (AV) gel when used as adjunct therapy to scaling and root planing (SRP) for treatment of chronic periodontitis., Materials and Methods: One hundred fifty patients were randomly assigned to three treatment groups: group 1 (SRP), group 2 (SRP+PDT) and group 3 (SRP+AV). Four clinical parameters - plaque index (PI), bleeding on probing (BoP), periodontal (PD) pocket depth and clinical attachment level (CAL) - were evaluated at baseline and 3 and 6 months post treatment. Additionally, the amount of three inflammatory - cytokines IL-6, IL-8 and TNF-α - in gingival crevicular fluid (GCF) was identified using an enzyme-linked immune-sorbent assay (ELISA)., Result: Statistically significant improvement was observed for all clinical parameters in group 3 at follow-up in comparison to groups 1 and 2. Individuals treated with adjunct PDT showed statistically significant reduction in moderate (4-5 mm) and deep (≥6 mm) PD pockets at the 3-month follow-up. Group-2 and -3 patients displayed statistically significant reductions in cytokines IL-6, IL-8 and TNF-α at the 3-month follow-up in comparison to group 1 patients. This reduction in cytokines was maintained at the 6-month follow-up., Conclusion: Adjunct treatment regimens PDT and AV gel statistically significantly contributed to decreasing inflammation in periodontal tissue. AV /gel showed potential to decrease BoP, whereas PDT can facilitate increasing the clinical attachment level.