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Objective/Background: Preference for extended-release, once-nightly sodium oxybate (ON-SXB, FT218) vs twice-nightly immediate-release (IR) oxybate was assessed in participants switching from IR oxybate to ON-SXB in an open-label/switch study, RESTORE (NCT04451668). Patients/Methods: Participants aged ≥16 years with narcolepsy who completed the phase 3 REST-ON trial, were oxybate-naive, or were on a stable IR oxybate dose (≥1 month) were eligible for RESTORE. For participants who switched from twice-nightly dosing to ON-SXB, initial doses were closest or equivalent to their previous nightly IR oxybate dose. These participants completed a questionnaire at baseline about nocturnal adverse events associated with the middle-of-the-night IR oxybate dose in the preceding 3 months, a preference questionnaire after 3 months of stable-dose ON-SXB, and an end-of-study (EOS) questionnaire. Results: There were 130 switch participants; 92/98 (93.9 %) who completed the preference questionnaire preferred ON-SXB. At baseline, 69.2 % reported missing their second IR oxybate dose at least once; in these cases, 80 % felt worse the next day. Approximately 39 % reported taking a second nightly IR oxybate dose >4 h after the first dose, 51 % of whom felt somewhat to extremely groggy/unsteady the next morning; 120 participants (92 %) reported getting out of bed after their second oxybate dose. Of those, 9 (8 %) reported falls and 5 (4 %) reported injuries. Of the switch participants who completed the EOS questionnaire, 91.2 % felt better able to follow the recommended ON-SXB dosing schedule. Conclusions: The second nightly IR oxybate dose presents significant treatment burdens and adherence concerns. Participants overwhelmingly preferred the once-nightly dosing regimen of ON-SXB.

Abstract Hydatidosis causes a serious health hazard to humans and animals leading to significant economic and veterinary and public health concern worldwide. The present study aimed to evaluate the in vitro and ex vivo protoscolicidal effects of synthesized poly(amidoamine), PAMAM, nanoemulsion. In this study, PAMAM was characterized through dynamic light scattering technique to investigate the particle size and zeta potential of nanoemulsified polymer. For the in vitro and ex vivo assays, we used eosin dye exclusion test and scanning electron microscope (SEM) to evaluate the effects of the prepared and characterized PAMAM nanoemulsion against protoscoleces from Echinococcus granulosus sensu lato G6 (GenBank: OQ443068.1) isolated from livers of naturally infected camels. Various concentrations (0.5, 1, 1.5 and 2 mg/mL) of PAMAM nanoemulsion at different exposure times (5, 10, 20 and 30 min) were tested against protoscolices. Our findings showed that PAMAM nanoemulsion had considerable concentration- and time-dependent protoscolicidal effect at both in vitro and ex vivo experiments. Regarding in vitro assay, PAMAM nanoemulsion had a potent protoscolicidal effect when compared with the control group with a highest protoscolicidal activity observed at the concentration of 2 mg/mL at all exposure times, such that 100% of protoscolices were killed after 20 min of exposure. Also, the mortality of protoscolices was 100% after 30 min of exposure to 1 and 1.5 mg/mL of PAMAM nanoemulsion, in vitro. Concerning ex vivo assay PAMAM nanoemulsion recorded the highest mortality rates at the concentration of 2 mg/mL (55, 99.4 and 100% at 10, 20, 30 min, respectively). Ultrastructure examination of examined protoscolices after 20 min of exposure to PAMAM nanoemulsion showed a complete loss of rostellar hooks, disruption of suckers with disorganization of hooks with partial or complete loss of them, and damage of protoscolices tegument with loss of their integrity in the form of holes and contraction of the soma region were observed in 1.5 and 2 mg/mL of PAMAM, in vitro and ex vivo, showing more damage in the in vitro conditions. It can be concluded that PAMAM nanoemulsion is a promising protoscolicidal agent offering a high protoscolicidal effect at a short exposure time. Further in vivo studies and preclinical animal trials are required to evaluate its efficacy and clinical applications against hydatid cysts.

Skin cancer ranks as one of the most widespread and lethal types of cancer. Without early identification and intervention, there is a propensity for the disease to disperse among the different body parts. This primarily occurs because of the abnormal proliferation of skin cells, which is often triggered by exposure to sunlight. Despite recent advancements in deep convolutional neural networks, there remains a difficulty in concentrating on the semantically meaningful aspects of a lesion. Our study introduces an innovative methodology to tackle this issue that couples deep learning techniques with a soft attention mechanism for feature aggregation, followed by classification layers to exploit the immense capability of the soft attention mechanism in amplifying the significance of crucial features while mitigating the impact of other irrelevant features within neural networks. Our proposed approach achieves a remarkable improvement of 3% in classification accuracy over the EfficientNetV2B3 model, 2.3% over InceptionV3, and 1.7% over InceptionResNetV2, compared to their original pre-trained counterparts on the benchmark ISIC Archive dataset. Our best model is EfficientNetV2B3, which achieved the highest accuracy of 95.6%.

Abstract Background Cryptosporidium parvum is a protozoan parasite of medical and veterinary importance that causes neonatal diarrhea in many vertebrate hosts. In this study, we evaluated the efficacy of an affinity-purified antigen as a C. parvum vaccine candidate using ileal and liver tissues of experimentally infected neonatal mice by immunohistochemical profiling and immune scoring of CD4+, CD8+, Caspase-3, and nuclear factor kappa B (NF-κB). This vaccine was prepared from the C. parvum oocysts antigen using immune affinity chromatography with cyanogen bromide-activated Sepharose-4B beads. Methods Thirty neonatal mice were divided into three groups (10 mice/group): (1) non-immunized non-infected, (2) non-immunized infected (using gastric tubes with a single dose of 1 × 105 of C. parvum oocysts in 250 µl PBS solution 1 h before a meal) and (3) immunized (twice with 40 µg/kg of purified C. parvum antigen at 2-week intervals and then infected with 1 × 105 C. parvum oocysts simultaneously with the second group). After euthanizing the animals on the 10th day, post-infection, their ileal and liver tissues were collected and prepared for immunohistochemistry (IHC) staining to detect CD4+, CD8+, Caspase-3, and NF-κB levels, which are indicators for T helper cells, cytotoxic T cells, apoptosis, and inflammation, respectively. Results The IHC results showed that CD4+, CD8+, Caspase-3, and NF-κB expression varied significantly (P

The escalating demand for enhanced therapeutic efficacy and reduced adverse effects in the pharmaceutical domain has catalyzed a new frontier of innovation and research in the field of pharmacy: novel drug delivery systems. These systems are designed to address the limitations of conventional drug administration, such as abbreviated half-life, inadequate targeting, low solubility, and bioavailability. As the disciplines of pharmacy, materials science, and biomedicine continue to advance and converge, the development of efficient and safe drug delivery systems, including biopharmaceutical formulations, has garnered significant attention both domestically and internationally. This article presents an overview of the latest advancements in drug delivery systems, categorized into four primary areas: carrier-based and coupling-based targeted drug delivery systems, intelligent drug delivery systems, and drug delivery devices, based on their main objectives and methodologies. Additionally, it critically analyzes the technological bottlenecks, current research challenges, and future trends in the application of novel drug delivery systems.

Abstract Purpose The recent coronavirus disease (COVID-19) pandemic mainly affects the respiratory system; however, several oral and maxillofacial post-COVID-19 complications have also been observed. This series reports the growing number of osteonecrosis cases associated with post-COVID-19 patients. Materials and methods This is a retrospective, multi-center case series that reports cases with maxillary osteonecrosis after various periods of SARS-CoV-2 infection in the period between January and August 2021 based on the PROCESS guidelines. Results Twelve cases were reported with post-COVID-19 manifestation of spontaneous osteonecrosis of the maxillary jaw. Five patients were hospitalized during COVID-19 management and all of the twelve cases had at least one systematic Co-morbidity, and undertake corticosteroids prescription based on the COVID-19 disease treatment protocol. The mean onset of osteonecrosis symptoms appearance was 5.5 ± 2.43 weeks calculated from the day of the negative PCR test. The management was successfully done through surgical debridement and pre and post-operative antibiotics. No anti-fungal medications were prescribed as the fungal culture and the histopathological report were negative. Conclusion Post-COVID-related osteonecrosis of the jaw (PC-RONJ) could be now considered as one of the potential post-COVID-19 oral and maxillofacial complications that occurs unprovokedly and mainly in the maxilla.

Abstract Background No doubt that the corpus luteum (CL) plays a vital role in the regulation of female cyclicity in mammals. The scenarios among microRNAs (miRNAs) and their target genes and steroid hormones {estradiol (E2) and progesterone (P4)} are required for better understanding the molecular regulation of CL during its formation, maturation, and regression. We aimed to (I) study the changes in the relative abundance of miR-205, miR-26a-5p, miR-17-5p, and let-7b-5p and their target genes: LHCGR, CASP3, PCNA, AMH, and PLA2G3, during different stages of corpus luteum in Egyptian buffaloes, and (II) and to address different scenarios between steroid concentrations in the serum and the expression pattern of selected miRNAs and their targets. Methods The paired ovaries and blood samples were collected from apparently healthy 50 buffalo cows at a private abattoir. The ovaries bearing CL were macroscopically divided according to their morphological structure and color into hemorrhagic (CLH), developing (CLD), mature (CLM), regressed (CLR), and albicans (CLA). Small pieces from different stages of CL (CLH, CLD, CLM, CLR, and CLA) were cut and immediately kept at − 80 °C for total RNA isolation and qRT-PCR. The serum was separated for steroid level estimation. Results The LHCGR was expressed during different stages of CL, and the peak of expression was at the mid-luteal stage. The CASP3 revealed a stage-specific response at different stages of CL. The PCNA has an essential role in cellular proliferation in buffaloes CL. Both expression patterns of PLA2G3 and AMH were found over the various developmental and regression stages. It was noticed that miR-205 is conserved to target LHCGR and CASP3 transcripts. Moreover, CASP3 and AMH were targeted via miR-26a-5p. Additionally, the CASP3 and PLA2G3 were targeted via let-7b-5p. The P4 level reached its peak during CLM. There were positive and negative strong correlations between miRNAs (miR-26a-5p and miR-205), target genes (LHCGR and CASP3) during different stages of CL, and steroid hormones in the serum. Conclusions Taken together, the orchestrated pattern among miRNAs, target genes, and steroid hormones is essential for maintaining the proper development and function of CL in buffalo cows.

Abstract Background Extracellular vesicles (EVs) are a promising biomarker and play a vital role in cell–cell communication. This study aimed (I) to identify and characterize EVs from low volume uterine lavage (LVL) and serum in mares with endometritis, compared to healthy controls and (II) to measure serum levels of interleukin 6 (IL-6), and prostaglandins (PGF2α and PGE2). Mares were divided into 30 sub-fertile (endometritis) and 20 fertile (controls). Serum and LVL was collected for EV isolation, and determination of serum levels of inflammatory mediators. Characterization and visualization of EVs were done by electron microscopy, dynamic light scattering and flow cytometry. Results Serial ultracentrifugation of LVL and use of a commercial kit for serum were strategies for EVs isolation. Mares with endometritis released higher amounts of larger size EVs. The EVs from mares with endometritis differentially expressed CD9 and CD63, compared to controls. Mares suffering from endometritis evoked higher levels of inflammatory mediators. Conclusions Thus, EVs could be used for a better understanding the regulatory mechanisms associated with developing endometritis in mares.

Inflammatory bowel disease (IBD), which includes Crohn’s disease (CD) and ulcerative colitis (UC), can affect the entire gastrointestinal tract and mucosal layer and lead to intestinal damage and intestinal dysfunction. IBD is an inflammatory disease of the gastrointestinal tract that significantly impacts public health development. Monoclonal antibodies and other synthetic medications are currently used to treat IBD, but they are suspected of producing serious side effects and causing a number of other problems with long-term use. Numerous in vitro and in vivo studies have shown that organic macromolecules from plants and animals have an alleviating effect on IBD-related problems, and many of them are also capable of altering enzymatic function, reducing oxidative stress, and inhibiting the production of cytokines and release of proinflammatory transcriptional factors. Thus, in this paper, the natural products with potential anti-IBD activities and their mechanism of action were reviewed, with a focus on the protective effects of natural products on intestinal barrier integrity and the regulation of tight junction protein expression and remodeling. In conclusion, the insights provided in the present review will be useful for further exploration and development of natural products for the treatment of IBD.

Extracranial meningioma is very rare with few cases reported, especially in the oral cavity. Its diagnosis is considered a challenge owing to the unusual site of occurrence. We report, to the best of our knowledge, the first case of extra-cranial meningioma as a primary tumor in the hard palate with no detected intracranial extension. A 59-year-old Egyptian female patient presented with a 22-year history of a large painless swelling at the right side of the hard palate, which could not be seen on radiographs. An incisional biopsy was taken and, after assessment with a panel of immunohistochemical markers, the lesion was diagnosed as extracranical grade I mengiothelial meningioma. The patient did not show up for surgical excision and follow-up was not performed because of the lose of contact with the patient. Intraoral meningioma is a rare tumor. Immuohistochemical markers are important for confirming this diagnosis.

Identifying and meeting the specific expectations of customers and delivering high-quality service to customers in the tourism industry is imperative for sustaining competitiveness. This study aims to identify the mediation effect of strategic thinking between six sigma and the operational performance of tourism companies in Iraq. A survey of 47 companies was conducted and analyzed using the structural equation modeling method to test the study framework. The findings suggests that strategic thinking is relevant and effective in this sector and increasing the effect of six sigma, operational performance is positively affected by the adoption of strategic thinking with six sigma. The study proves that implementing Six Sigma with strategic thinking will make processes efficient and effective which will ultimately result in increased customer satisfaction, improved product and service quality by improving the operational performance.

Ameloblastic carcinoma (AC) is an extremely rare malignant odontogenic tumour arising from odontogenic epithelium. It was classified into primary type and secondary type. A previous study revealed that primary ameloblastic carcinoma cases were associated with more favourable prognosis than secondary cases. The aim of the present work was: to report the clinical, histopathological, immunohistochemical, and ploidy status, and therapeutic details of four cases of primary AC, and to review the literature with regard to clinical, follow-up, prognosis, histopathological, and immunohistochemical information of primary AC. The Medline database was searched using the term ameloblastic carcinoma and primary type. The review of English literature revealed that primary ameloblastic carcinoma favours the posterior mandible with profound male predilection and appears as an ill-defined radiolucency. Metastasis and invasion are more likely to occur in maxillary cases. The treatment of choice is wide surgical resection with or without cervical lymph node dissection. Adjuvant postoperative radiotherapy is beneficial in incomplete resection cases and advanced soft tissue invasion. The most specific diagnostic methods of AC, as concluded from review, are α-SMA in epithelial cells in conjunction with Ki-67 index value and SPF more than 11.5%.

Background: Since the novel coronavirus disease (COVID-19) outbreak, the cases of COVID-19 co-infections have been increasingly reported worldwide. Mucormycosis, an opportunistic fungal infection caused by members of the Mucorales order, had been frequently isolated in severely and critically ill COVID-19 patients. Methods: Initially, the anamnestic, clinical, and paraclinical features of seven COVID-19-associated mucormycosis (CAM) cases from Egypt were thoroughly reported. Subsequently, an extensive review of the literature was carried out to describe the characteristics of CAM cases globally, aiming to explore the potential risk factors of mortality in CAM patients. Results: Out of the seven reported patients in the case series, five (71.4%) were males, six (85.7%) had diabetes mellitus, and three (42.9%) had cardiovascular disease. All patients exhibited various forms of facial deformities under the computed tomography scanning, and two of them tested positive for Mucorales using the polymerase chain reaction (PCR) testing. Liposomal amphotericin B (LAmB) was prescribed to all cases, and none of them died until the end of the follow-up. On reviewing the literature, 191 cases were reported worldwide, of which 74.4% were males, 83.2% were from low-middle income countries, and 51.4% were aged 55 years old or below. Diabetes mellitus (79.1%), chronic hypertension (30%), and renal disease/failure (13.6%) were the most common medical comorbidities, while steroids (64.5%) were the most frequently prescribed medication for COVID-19, followed by Remdesivir (18.2%), antibiotics (12.7%), and Tocilizumab (5.5%). Conclusions: As the majority of the included studies were observational studies, the obtained evidence needs to be interpreted carefully. Diabetes, steroids, and Remdesivir were not associated with increased mortality risk, thus confirming that steroids used to manage severe and critical COVID-19 patients should not be discontinued. Lung involvement, bilateral manifestation, and Rhizopus isolation were associated with increased mortality risk, thus confirming that proactive screening is imperative, especially for critically ill patients. Finally, surgical management and antimycotic medications, e.g., amphotericin B and posaconazole, were associated with decreased mortality risk, thus confirming their effectiveness.

So far the intimate link between serum microRNA (miRNA) and uterine inflammation in mares is unknown. We aimed (I) to investigate expression profile of eca-miR-155, eca-miR-223, eca-miR-17, eca-miR-200a, and eca-miR-205 (II) and to measure concentrations of interleukin 6 (IL-6), and prostaglandins (PGF2α and PGE2) in serum of mares with healthy and abnormal uterine status (endometritis). This study was conducted on 80 Arabian mares: young (4–7 years), and old (8–14 years). Mares were divided into 48 sub-fertile (endometritis) and 32 fertile (control) at stud farms. Serum was collected for measuring IL-6, PGF2α, and PGE2, as well as miRNA isolation and qRT-PCR. Concentrations of IL-6, PGE2, and PGF2α were higher in mares with endometritis compared to control. Age of mares had a remarkable effect on IL-6, PGE2, and PGF2α concentrations. Relative abundance of eca-miR-155, eca-miR-223, eca-miR-17, eca-miR-200a, and eca-miR-205 was higher in both young and old mares with endometritis. We noticed that eca-miR-155, eca-miR-223, eca-miR-200a, and eca-miR-205 revealed higher expression level in old than young mares with endometritis. This is the first study that has revealed the changes in cell free miRNA and serum inflammatory mediators during endometritis, and these findings could be used for a better understanding the pathophysiology mechanisms of endometritis in equine.

This research aims to explore the practices of business colleges in the Middle East and North Africa (MENA) region to reveal their engagement with the society and the factors affecting their engagement with the community. The study utilized a content analysis approach in collecting data from the websites of business colleges in 2016. The sample size comprised 142 business colleges from 20 countries in the MENA region. A regression model was established for the relationship between the independent variables (age, type and academic accreditation of business school and income level, population density and Internet user rate in the country of the college) and the dependent variable (behavior of business schools in disclosing their societal role on their websites). The results indicate that situation and economic stability are central factors influencing the level of disclosure about the business schools’ engagement with the community. This gives an impression that university practices of social responsibilities come as a result of economic and social development, not as a result of the needs of the society itself. Accordingly, the study recommends that business schools in less developed societies reemphasize their roles according to their community needs and facilitate technology in the process of fulfilling this responsibility.

Introduction: Primordial odontogenic tumors are a rare recently described mixed odontogenic tumor composed histopathologically of dental papilla like tissue and enamel organ like tissue. Only nine cases have been documented worldwide and we are reporting the tenth case which is from Egypt. Clinical finding: A 2-year-old Egyptian boy that presented with an asymptomatic swelling of the mandible which appeared with multilocular radiolucency associated with an impacted developing tooth on a computerized tomography (CT) scan. Diagnoses, interventions, and outcomes: The lesion was excised and diagnosed as a primordial odontogenic tumor. The patient was followed up for two years with no recurrence. Conclusion: Differentiation of primordial odontogenic tumors from other odontogenic tumors, which resemble it histopathologically is crucial to avoid unnecessary aggressive treatment.

In the present study, we used an in vitro model to investigate the response of the oviduct with respect to inflammatory mediators and their regulatory microRNAs in case of bacterial infection and subsequent association with embryo survival. For this, we conducted two experiments. In the first experiment, cultured primary bovine oviductal cells (BOEC) were challenged with lipopolysaccharide (LPS) for 24h and the temporal expression pattern of inflammatory mediators and their regulatory microRNAs were measured at 0, 3, 6, 12, 24 and 48h after LPS treatment. Intriguingly, the temporal patterns of all miRNAs except miR-21 were significantly up-regulated at 6h after LPS treatment. Whereas, we observed significant overexpression of pro-inflammatory mediators as tumor necrosis factor alpha (TNFα) and interleukin-1 beta (IL1β) after LPS challenge for 24h. On the other hand, the expression level of essential elements like oviductal glycoprotein 1 (OVGP1) and insulin-like growth factor 2 (IGF2) was significantly decreased in challenged groups compared with control. Moreover, miR-155, miR-146a, miR-223, miR-21, miR-16 and miR-215 have shown a clear suppression in challenged group after LPS treatment. In the 2nd experiment there were four groups of blastocysts produced, namely embryo+LPS free media, embryo+LPS, BOEC+embryo and BOEC+embryo+LPS. The suboptimal oviduct environment due to LPS challenge is found to have a significant influence on the expression of inflammatory response genes (TNFα and CSF1), stress response genes (SOD and CAT), mitochondrial activity, reactive oxygen species (ROS) accumulation and apoptotic level either in cultured or co-cultured blastocysts. Collectively, LPS challenge led to aberrant changes in oviductal transcriptome profile, which could lead to a suboptimal environment for embryo development.

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Ameloblastic carcinoma (AC) is an extremely rare malignant odontogenic tumour arising from odontogenic epithelium. It was classified into primary type and secondary type. A previous study revealed that primary ameloblastic carcinoma cases were associated with more favourable prognosis than secondary cases. The aim of the present work was: to report the clinical, histopathological, immunohistochemical, and ploidy status, and therapeutic details of four cases of primary AC, and to review the literature with regard to clinical, follow-up, prognosis, histopathological, and immunohistochemical information of primary AC. The Medline database was searched using the term ameloblastic carcinoma and primary type. The review of English literature revealed that primary ameloblastic carcinoma favours the posterior mandible with profound male predilection and appears as an ill-defined radiolucency. Metastasis and invasion are more likely to occur in maxillary cases. The treatment of choice is wide surgical resection with or without cervical lymph node dissection. Adjuvant postoperative radiotherapy is beneficial in incomplete resection cases and advanced soft tissue invasion. The most specific diagnostic methods of AC, as concluded from review, are α-SMA in epithelial cells in conjunction with Ki-67 index value and SPF more than 11.5%. [ABSTRACT FROM AUTHOR]

This research aims to explore the practices of business colleges in the Middle East and North Africa (MENA) region to reveal their engagement with the society and the factors affecting their engagement with the community. The study utilized a content analysis approach in collecting data from the websites of business colleges in 2016. The sample size comprised 142 business colleges from 20 countries in the MENA region. A regression model was established for the relationship between the independent variables (age, type and academic accreditation of business school and income level, population density and Internet user rate in the country of the college) and the dependent variable (behavior of business schools in disclosing their societal role on their websites). The results indicate that situation and economic stability are central factors influencing the level of disclosure about the business schools' engagement with the community. This gives an impression that university practices of social responsibilities come as a result of economic and social development, not as a result of the needs of the society itself. Accordingly, the study recommends that business schools in less developed societies reemphasize their roles according to their community needs and facilitate technology in the process of fulfilling this responsibility. [ABSTRACT FROM AUTHOR]

Ameloblastic carcinoma (AC) is an extremely rare malignant odontogenic tumour arising from odontogenic epithelium. It was classified into primary type and secondary type. A previous study revealed that primary ameloblastic carcinoma cases were associated with more favourable prognosis than secondary cases. The aim of the present work was: to report the clinical, histopathological, immunohistochemical, and ploidy status, and therapeutic details of four cases of primary AC, and to review the literature with regard to clinical, follow-up, prognosis, histopathological, and immunohistochemical information of primary AC. The Medline database was searched using the term ameloblastic carcinoma and primary type. The review of English literature revealed that primary ameloblastic carcinoma favours the posterior mandible with profound male predilection and appears as an ill-defined radiolucency. Metastasis and invasion are more likely to occur in maxillary cases. The treatment of choice is wide surgical resection with or without cervical lymph node dissection. Adjuvant postoperative radiotherapy is beneficial in incomplete resection cases and advanced soft tissue invasion. The most specific diagnostic methods of AC, as concluded from review, are α-SMA in epithelial cells in conjunction with Ki-67 index value and SPF more than 11.5%.