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Cilostazol (CTZ), is a BCS class II drug with limited bioavailability. In the current study, orally disintegrating tablets (ODTs) for buccal delivery of CTZ were prepared by two methods; lyophilization (Lyo-ODTs) and direct compression (DC-ODTs). All CTZ-ODTs were evaluated for in vitro disintegration time (DT) and wetting time (WT) tests, in vitro dissolution. Scanning electron microscopic (SEM) analysis was performed for the selected Lyo-ODT-7 and DC-ODT-2. Lyo-ODT-7 composed of aerosil ® 200 and PEG 4000 acquired the shortest DT (13.00 ± 0.14) and WT (33.00 ± 0.26) among the prepared ODTs. It also showed a 2.3 fold significantly enhanced dissolution profile at an early time point (5 min) that was maintained till 1 h, in simulated saliva fluid (pH ∼ 6.8), compared to Pletaal ® IR tablets ( p  < 0.0001). SEM analysis revealed the remarkable porosity of Lyo-ODT-7, confirming its successfully enhanced disintegration and dissolution. Lyo-ODT-7 showed significantly enhanced pharmacokinetic parameters with a 3.5 and 3.6 fold increase in C max ( p  = 0.0493) and AUC 0-24 ( p  = 0.0470), respectively compared to Pletaal ® IR tablets. The relative bioavailability of CTZ after buccal administration of Lyo-ODT-7 to rats was 364.45%, compared to the market oral IR tablets; Pletaal ® . The enhanced bioavailability imposes the successful oromucosal absorption of CTZ via buccal delivery of Lyo-ODT-7. Our study demonstrated that Lyo-ODT-7 could represent a favorable buccal dosage form for patients with intermittent claudication, suffering from dysphagia. It can also be used in cases of acute cerebral or myocardial infarction due to its significantly enhanced rate and extent of absorption. It is considered a promising approach for buccal delivery of BCS class II active pharmaceutical ingredients (APIs) suffering from solubility problems and hepatic first pass effect.HIGHLIGHTSODTs containing CTZ were prepared via lyophilization and direct compression to produce Lyo-ODTs and DC-ODTs, respectively.Lyo-ODT-7 displayed the fastest DT, shortest WT and exhibited significantly enhanced in vitro dissolution at 5 minutes compared to Pletaal ® IR tablets ( p  < 0.0001), at the buccal pH (6.8).SEM images of Lyo-ODT-7 elucidated its extremely porous structure with the appearance of wide pores having average pore diameter that is 2.27 fold significantly greater than the directly compressible ODT-2 (DC-ODT-2) ( p  = 0.0286).Lyo-ODT-7 also showed significantly enhanced C max ( p  = 0.0493) and AUC 0-24 ( p  = 0.0470) that were 3.5 and 3.6 fold greater than Pletaal ® IR tablets, respectively with improved relative bioavailability ∼ 364.45%.A dual porogenic effect was achieved via implementing both lyophilization technique and a pore-former excipient, during pharmaceutical development of CTZ-loaded ODT (Lyo-ODT-7), and still mechanical properties were preserved.The implemented dual porogenic approach can aid in future development of successful buccal drug delivery systems with enhanced oromucosal absorption and improved bioavailability of BCS class II APIs.

Background & Aims: Congestion alters the microenvironment of the liver sinusoid along the portal-central axis. We studied spatial changes in immune cells in the sinusoid that contribute to congestive fibrosis and portal hypertension (PHTN)., Methods: To visualize the distribution of immune cells in congestive hepatopathy (CH), we performed imaging mass cytometry (IMC) on liver tissue from patients with CH, Fontan-associated liver disease (FALD), and controls. We performed partial ligation of the inferior vena cava (pIVCL) to simulate CH in mice and isolated primary liver cells for single-cell RNA-sequencing (scRNA-seq) to study zonation of liver sinusoidal endothelial cells (LSECs). After pIVCL, mice were treated with intraperitoneal injections of AMG487, an inhibitor of the CXCL9 receptor, or a neutralizing antibody to CXCL9., Results: Peri-central macrophages are enriched in CH and FALD. Given the role of CXCL9 in macrophage patterning in the liver, we performed RNA in situ hybridization (RNAish) in CH and determined that CXCL9 was highly expressed in LSECs in FALD, suggesting that LSECs recruit macrophages in CH. After pIVCL, treatment with AMG487 or an antibody to CXCL9 attenuated portal pressures, fibrosis, and intra-hepatic macrophages. To study changes in LSECs that promote macrophage chemotaxis, we performed scRNA-seq after pIVCL and sham procedures. Analysis revealed 3 LSEC subpopulations according to sinusoidal location. RNAish identified peri-central LSECs as the predominant source of CXCL9 in FALD. In vitro analyses revealed that β-catenin and hypoxia inducible factor-1 α regulate CXCL9 transcription in peri-central LSECs., Conclusions: CXCL9 derived from peri-central LSECs enriches intra-hepatic macrophages in CH and FALD, contributing to congestive fibrosis and PHTN. Strategies to target LSEC-derived CXCL9 may prevent the progression of CH and FALD., (Copyright © 2025 The Authors. Published by Elsevier Inc. All rights reserved.)

Polymeric nanoparticles surface functionalised with fluorescent molecules hold significant potential for advancing diagnostics and therapeutic delivery. Despite their promise, challenges persist in achieving robust attachment of fluorescent molecules for real-time tracking. Weak physical adsorption, pH-dependent electrostatic capture, and hydrophobic interactions often fail to achieve stable attachment of fluorescent markers. While covalent attachment offers stability, it often entails laborious multi-step wet-chemistry processes. This work demonstrates that plasma polymerised nanoparticles (PPNs) can directly and covalently attach fluorescent molecules with no need for additional interim treatment processes. For the first time, we provide evidence indicating the formation of covalent bonds between the fluorescent molecules and PPN surfaces. Two model fluorescent molecules, fluorescein isothiocyanate (FITC) and Nile blue (NB), were attached to PPNs in a one-step process. The attached molecules remained on nanoparticle surfaces even after detergent washing, as confirmed by a combination of X-ray photoelectron spectroscopy (XPS), fluorescence spectroscopy, flow cytometry, and time-of-flight secondary ion mass spectrometry (ToF-SIMS) data. The robust attachment of fluorescent molecules on PPNs ensures their stability and functionality, enhancing the potential of these fluorescently labelled nanoparticles for diagnostic, therapeutic, and imaging applications.

The incorporation of rice straw (RS) and Chinese milk vetch (CMV) with reduced chemical fertilizers (CFs) is a viable solution to reduce the dependency on CF. However, limited research has been conducted to investigate the impact of CMV and RS with reduced CF on rice production. A field trial was conducted from 2018 to 2021 with six treatments: CK (no fertilizer), F100 (100% NPK fertilizer (CF)), MSF100 (100% CF+CMV and RS incorporation), MSF80 (80% CF+CMV+RS), MSF60 (60% CF+CMV+RS), and MSF40 (40% CF+CMV+RS). The results revealed that compared with the F100, the MSF80 treatment maintained a significantly higher mean grain yield over the four years, with an increase of 5.8~24.5%. MSF80 treatment also improved nitrogen (N), phosphorus (P), and potassium (K) use efficiencies, sustainable yield index, and partial factor productivity. Soil organic matter (SOM), total nitrogen (TN), ammonium N (NH 4 + -N), nitrate N (NO 3 - -N), available phosphorus (AP), and available potassium (AK) contents were significantly enhanced under MSF80 across different growth stages in both 2020 and 2021 seasons over F100. Pearson correlation analysis revealed a strong positive correlation among SOM, TN, NH 4 + -N, AP, AK, and rice yield. Additionally, Partial Least Squares Path Modeling (PLS-PM) demonstrated significant relationships between organic amendments, soil nutrients, nutrient uptake, and yield. The above findings suggest that combining RS returning with CMV incorporation is a long-term sustainable strategy for maintaining soil health, and it could reduce fertilizer addition by 20% without prejudicing rice grain yield under a rice-green manure rotation system.

Background: Globally, nearly one-third of workplace violence (WPV) occurs in the health sector. Exposure to WPV among Jordanian nurses has been widely speculated to be underreported. Understanding of the factors contributing to WPV among nurses and their consequences is limited., Objectives: This study aimed to examine the consequences and contributing factors of WPV and explore suggestions for reducing WPV among nurses working in peripheral hospitals., Methods: This descriptive, cross-sectional study included 431 Jordanian nurses. Data were collected using a self-report instrument between December 2022 and June 2023. A modified version of the ILO/ICN/WHO/PSI Workplace Violence in the Health Sector Country Case Study Questionnaire developed and validated in 2003 was used., Results: The ages of the participants ranged from 20 to 49 years. A total of 349 nurses (81%) had experienced verbal violence, while 110 (25.5%) had experienced physical violence. Of the 110 nurses who were physically attacked, 44 (40 %) reported that an investigation was conducted to determine the cause of the incident. Approximately 38.2% of incidents involving physical violence in the last 12 months involved the use of weapons. The current study revealed that 59.6% of the nurses reported that verbal incidents were common in their workplace. The highest level of agreement among all participants was leniency in applying penalties to perpetrators of violence inside hospitals. The majority of participants (95.8%) agreed that improving staff-patient communication skills would effectively reduce violence., Conclusion: Creating awareness among healthcare professionals, patients, and the general public regarding the impact of WPV and the importance of respect and professionalism is crucial., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2025 Alnaeem, Hasan Suleiman, Alzoubi, Sumaqa, Al-Mugheed, Saeed Alabdullah and Farghaly Abdelaliem.)

Cultivated meat production offers solutions in addressing global food security and sustainability challenges. However, serum-free media (SFM) used in cultivating the cells are expensive, contributing to at least 50% of variable operating costs. This review explores technologies for cost-effective SFM, focusing on reducing cost from using growth factors and recombinant proteins, using affordable raw materials for basal media, and implementing cost-saving measures like media recycling and reducing waste build-up., Competing Interests: Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

The field of ribonucleic acid (RNA) biology has revealed an array of noncoding RNA species, particularly long noncoding RNAs (lncRNAs), which play crucial roles in liver disease pathogenesis. This review explores the diverse functions of lncRNAs in liver pathology, including metabolic-associated steatotic liver disease, hepatocellular carcinoma, alcohol-related liver disease, and cholangiopathies such as primary sclerosing cholangitis and cholangiocarcinoma. We highlight key lncRNAs that regulate lipid metabolism, inflammation, fibrosis, and oncogenesis in the liver, demonstrating their diagnostic and therapeutic potential. Emerging RNA-based therapies, such as mRNA therapy, RNA interference, and antisense oligonucleotides, offer approaches to modulate lncRNA activity and address liver disease at a molecular level. Advances in sequencing technologies and bioinformatics pipelines are simultaneously enabling the identification and functional characterization of novel lncRNAs, driving innovation in personalized medicine. In conclusion, this review highlights the potential of lncRNAs as biomarkers and therapeutic targets in liver disease and emphasizes the need for further research into their regulatory mechanisms and clinical applications., Competing Interests: None declared., (Thieme. All rights reserved.)

Background: As artificial intelligence (AI) continues to permeate various sectors including healthcare, understanding its impact on nursing students' attitudes and intentions to use is crucial. To examine the association of AI ethical awareness, attitudes, anxiety, and intention-to-use AI technology among Jordanian nursing students., Method: A descriptive, cross-sectional design was used. The study was conducted in three private universities in Jordan, utilizing a convenience sampling technique; data were collected from a sample of 140 nursing students between January and March 2024., Results: Results showed moderate levels of AI ethical awareness, attitudes toward AI technology, anxiety to use AI, and intention-to-use AI technology among Jordanian nursing students. There are no significant differences found in the levels of AI ethical awareness, attitudes toward AI technology, anxiety to use AI, and intention-to-use AI based on gender and study year ( p  < 0.01). Intention-to-use AI had a significant positive relationship with AI ethical awareness ( r  = 0.521, p  < 0.001), students' attitudes toward AI (0.558, p  < 0.001), and anxiety to use AI ( r  = 0.407, p  < 0.001)., Conclusion: The need to keep pace with technological developments is urgent and crucial, especially in nursing educational institutions. The findings shed important light on the levels of behavioral intention toward AI, as well as on variables such as ethical awareness, attitudes, and anxiety about AI, and the effect of demographics on participants' attitudes, anxiety, and intentions to use AI technology., Competing Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2024.)

The excessive presence of polystyrene microplastic (PS-MPx) and nickel oxide nanomaterials (NiO-NPs) in agriculture ecosystem have gained serious attention about their effect on the legume root-nodule symbiosis and biological nitrogen fixation (BNF). However, the impact of these contaminants on the root-nodule symbiosis and biological N 2 -fixation have been largely overlooked. The current findings highlighted that NiO-NMs at 50 mg kg -1 improved nodule formation and N 2 -fixation potential, leading to enhanced N 2 uptake by both roots and shoots, resulting in increased plant growth and development. While single exposure of PS-MPx (500 mg kg -1 ) significantly reduced the photosynthetic pigment (8-14 %), phytohormones (9-25 %), nodules biomass (24 %), N 2 -related enzymes (12-17 %) that ultimately affected the N 2 -fixation potential. Besides, co-exposure of MPx and NiO at 100 mg kg -1 altered the nodule morphology. Additionally, single and co-exposure of MPx and NiO-NMs at 100 mg kg -1 reduced the relative abundance of Proteobacteria, Gemmatimonadota, Actinobacteria, Firmicutes, and Bacteroidetes is associated with N 2 -cycling and N 2 -fixation potential. The findings of this study will contribute to understanding the potential risks posed by MPx and NiO-NMs to leguminous crops in the soil environment and provide scientific insights into the soybean N 2 -fixation potential., Competing Interests: Declaration of Competing Interest The authors declare that they have no financial or personal relationships that could influence the research work presented in this manuscript. There are no conflicts of interest regarding the publication of this research., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Using a straightforward, sensitive and precise liquid chromatographic approach, it is now possible to concurrently measure the amounts of ibuprofen (IBU) and paracetamol (PAR) in human plasma. A µ BondapakTM C18 column (300 mm × 3.9 mm, 15-20 μm) demonstrated acceptable separation when utilizing a mobile phase of 10 mM disodium hydrogen orthophosphate solution and acetonitrile at an 80:20, v/v ratio. The elution was isocratic at room temperature and a flow rate of 1.0 milliliters per minute. The UV detector was set to monitor PAR and IS (tinidazole) for 6.5 min at 254 nm, then IBU for the next 3 min at 220 nm. PAR and IBU showed linearity across the 0.05 to 100 µg/ml concentration range. The precision of the measurements ranged from 98.5% to 105% for PAR and from 95.1% to 102.8% for IBU. The average drug recovery rate was 100% for PAR and 98.9% for IBU. This method was effectively utilized to assess samples from an actual population administered PAR and IBU (325/200 mg) for pharmacokinetic research. The technique employs green and white tools to evaluate their environmental sustainability and efficacy. The suggested strategy was implemented utilizing the Six Sigma method.

Background: Immediate implant placement (IIP) in compromised extraction sockets poses significant challenges in maintaining the contour and level of mucosal tissues. This study compares the efficacy of vestibular socket therapy (VST) combined with acellular dermal matrix (ADM) versus connective tissue grafts (CTG) in IIP within the esthetic zone., Methods: Twenty participants requiring extraction in the maxillary esthetic zone were randomized into two groups: ADM and CTG (n = 10 each). Both groups underwent VST with bone grafting and dental implant placement. Clinical outcomes were evaluated at baseline, 6 months, and 12 months, measuring soft-tissue level and thicknesses, and the radiographic facial alveolar bone thicknesses and height., Results: Both groups resulted in statistically significant increase in coronal mucosal thickness, facial bone height and thickness over time. CTG showed statistically significant increase at apical mucosal thickness over time, whereas the ADM group had a significantly higher facial bone height after 12 months. No significant differences were observed between groups in mucosal thickness and level at any time point and both groups achieved 100% implant survival., Conclusion: ADM and CTG are both effective for soft tissue augmentation and hard-tissue maintenance in IIP within compromised extraction sockets after 12 months. CTG may offer advantages in apical mucosal thickness, while ADM was associated with greater bone height., Clinical Relevance: Both ADM and CTG effectively enhance soft tissue and maintain hard-tissue levels, with CTG providing better apical mucosal thickness and ADM resulting in greater facial bone height after 12 months. These insights help clinicians to customize treatment plans based on individual goals and patient needs., Competing Interests: Declarations. Competing interests: Dr. Abdelsalam Elaskary received consultation fees from Biohorizons. All other authors declare no competing interest., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

This study aimed to evaluate and compare the effectiveness of mineral trioxide aggregate (MTA), bioceramic putty (BP) and tannic acid (TA) for experimental pulpotomy. Our in-vivo experimental study involved sample of 45 rats that were randomly divided into 4 groups: Group 1 (subdivided into negative (1-A) and positive (1-B) subgroups), Group 2 (MTA treated), Group 3 (BP treated) and Group 4 (TA treated). 4 weeks post pulpotomy, specimens were analyzed histologically, immunohistochemically using dentin sialoprotein marker, and histomorphometrically by assessing the thickness of newly formed dentin bridge. Group 1-B showed pulp necrosis without hard tissue formation. Group 2 showed moderate dentin formation while group 3 presented a thick layer of calcific barrier. Group 4 showed dentin bridge formation, however, irregular pulp calcifications and radicular pulp necrosis were seen. The thickness of newly formed dentin bridge showed a significant difference between group 1-B and group 2, 3 &4. Significant difference was found between group 2&3 and group 3&4. Dentin sialoprotein immunohistochemical expression was negative in group 1-B, mild in group 2, strong in group 3 and moderate in group 4. MTA and BP proved to be effective pulpotomy agents with BP being superior. For TA, further studies are required to explain the recorded unfavorable effects in some specimens., Competing Interests: Declarations. Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

The majority of conventional osteoarthritis (OA) treatments are based on molecular adjustment of certain signaling pathways associated with osteoarthritis (OA) pathogenesis, however there is a significant need to search for more effective and safe treatments. This study centers around formulating Aceclofenac (ACF) with high bioavailability in combination with Citronellol oil and collagen. The optimal concentrations of Citronellol oil/D-Limonene oil, Tween 80, and Transcutol HP were determined using a pseudoternary phase diagram. The formulated nanoemulsions were studied for thermophysical stability. Thermodynamically stable formula were analyzed for droplet size, zeta potential, and in-vitro permeation. Then, collagen based nanoemulsion were prepared to capitalize on its efficacy in reducing osteoarthritis side effects and characterized for nano size properties. Formulae F10 and F10C were chosen as optimum nanosize formula. Hense, they were prepared and characterized as nanoemulgel dosage form. The nanoemulgel formulae F10NEG1 and F10CNEG1 showed reasonable viscosity and spreadability, with complete drug release after 4 h. These formulae were chosen for further In vivo anti-OA study. Collagen based ACF/citronellol emugel were able to modulate HMGB-1/RAGE/NF-κB pathway, mitigating the production of inflammatory cytokine TNF-α. They were also able to modulate Klotho and miR-499, reducing serum CTXII and COMP, by reducing the cartilage destruction. Histological investigations validated the efficacy, safety, and superiority of Aceclofenac in combination with Citronellol oil and collagen (F10CNEG1) over solo the treated group (F10NEG1 and blank). Hence, the findings of the current work encourage the use of this promising combined formula in treatment of OA patients., (© 2024. The Author(s).)

The aim of this study was to describe the 30-day mortality rate of adult patients with sepsis and septic shock in 6 intensive care units of 2 tertiary hospitals in Jordan. A prospective cohort design was used. Patients with sepsis and septic shock admitted to the medical and surgical intensive care units at 2 tertiary hospitals were followed up during the period between February 2022 and June 2022 (N = 148). Data were analyzed using SPSS, version 23. Moreover, descriptive statistics, chi-square, and binary logistic regression were used. Notably, 52.7% of patients with sepsis and septic shock died within 30 days of diagnosis of sepsis and septic shock. Sequential Organ Failure Assessment score and the history of having solid tumors significantly predicted the 30-day mortality rate. Moreover, 43 (29.0%) patients with sepsis and septic shock had positive blood cultures, and 46 (31.0%) had positive urine cultures. Patients with sepsis and septic shock have a notable mortality rate that can be predicted from total Sequential Organ Failure Assessment scores and from the history of having solid tumors. Early assessment and initiation of treatment for sepsis essentially would reduce the likelihood of progression of sepsis to septic shock and would reduce associated patients' mortality., Competing Interests: The authors have no conflicts of interests to disclose., (Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.)

Background Objectives: Quantum chemical & molecular docking practices to deliver new perceptions into how etoposide, novobiocin, nogalamycin and netropsin interact with the biological targets PF3D7&#95;0918600 (Plasmodium falciparum 3D7). Further the pharmacokinetics of a drug candidate which influenced by a variety of factors, including P- glycoprotein (Pgp) transport, PBB (Plasma protein binding), & BBB (Blood-brain barrier) permeation help to forecast the pharmacological characteristics of acetyl-CoA reductase inhibitors (ADMEs) and their metabolites., Methods: At this point, we have elevated four compounds such as etoposide, novobiocin, nogalamycin & netropsin. We have also studied molecular docking against the target protein of the Plasmodium falciparum (PF3D7&#95;0918600) through exhausting the AutoDock Vina platform and AutoDock-Tools (ADT) and pharmacokinetic properties were carried out using the ADMET 2.0., Results: The relative results of molecular docking recommended a greater binding affinity of novobiocin with the selected receptors among other compounds. In-silico ADME screening is a computational approach utilised to forecast the pharmacological characteristics of acetyl- CoA reductase inhibitors (ADMEs) and their metabolites., Interpretation Conclusion: The ADMEs are based on the adsorption-desorption kinetics and pharmacopoeia. Adsorption and distribution analysis are used to assess the potential of the drug candidate. In vitro ADME is exploited to expect the effect of Pgp transport on the drug candidates. ADME has been used to predict CYP1A2 inhibitors and to predict PPB and BBB penetration. This paper summarizes the current knowledge on molecular docking, ADME and identifies potential drug candidates for ADME in vitro and in vivo., (Copyright © 2024 Copyright: © 2024 Journal of Vector Borne Diseases.)

Cone-beam computed tomography (CBCT) imaging of the maxillary sinus is indispensable for implantologists, offering three-dimensional anatomical visualization, morphological variation detection, and abnormality identification, all critical for diagnostics and treatment planning in digital implant workflows. The following systematic review presented the current evidence pertaining to the use of artificial intelligence (AI) for CBCT-derived maxillary sinus imaging tasks. An electronic search was conducted on PubMed, Web of Science, and Cochrane up until January 2024. Based on the eligibility criteria, 14 articles were included that reported on the use of AI for the automation of CBCT-derived maxillary sinus assessment tasks. The QUADAS-2 (Quality Assessment of Diagnostic Accuracy Studies 2) tool was used to evaluate the risk of bias and applicability concerns. The AI models used were designed to automate tasks such as segmentation, classification, and prediction. Most studies related to automated maxillary sinus segmentation demonstrated high performance. In terms of classification tasks, the highest accuracy was observed for diagnosing sinusitis (99.7%), whereas the lowest accuracy was detected for classifying abnormalities such as fungal balls and chronic rhinosinusitis (83.0%). Regarding implant treatment planning, the classification of automated surgical plans for maxillary sinus floor augmentation based on residual bone height showed high accuracy (97%). Additionally, AI demonstrated high performance in predicting gender and sinus volume. In conclusion, although AI shows promising potential in automating maxillary sinus imaging tasks which could be useful for diagnostic and planning tasks in implantology, there is a need for more diverse datasets to improve the generalizability and clinical relevance of AI models. Future studies are suggested to focus on expanding the datasets, making the AI model's source available, and adhering to standardized AI reporting guidelines., (© 2024 The Author(s). Clinical Implant Dentistry and Related Research published by Wiley Periodicals LLC.)

Background/aim: Coronavirus disease 2019 (COVID-19) increased morbidity and mortality in health institutions worldwide. The present study describes the epidemiological and clinical characteristics of COVID-19 mortality rates. Investigating the factors that affect COVID-19 mortality will be helpful in reducing the burden of morbidity and mortality in healthcare systems., Materials and Methods: The current retrospective observational study was carried out in the Kingdom of Saudi Arabia. COVID-19 cases resulting in death were admitted to hospitals from March 2020 to June 2020. The epidemiological and clinical characteristics of these cases of COVID-19-related death were collected and evaluated., Results: A total of 3260 COVID-19 death cases were included. The mean age of the subjects was 55 years. COVID-19 deaths more frequently in patients aged 50-59 years, 60-69 years, and 40-49 years (26%, 22%, and 17%, respectively). A greater percentage of COVID-19-related deaths (47%) was observed in June than in March (>1%), April (15%), and May (37%). Men accounted for most death cases (76%) compared to women. The COVID-19 mortality rate was higher among non-Saudi (71%) than Saudis (29%). The highest COVID-19 mortality was observed in Tabuk Region, whereas the lowest was observed in Najran. The mean stay duration of COVID-19 cases in the intensive care unit (ICU) was 11 days. The independent t -test indicated a statistically significant increase in the life expectancy (6 days) of ICU cases compared to non-ICU cases., Conclusion: The findings suggest that older age, male gender, and non-Saudi are risk factors that enhance COVID-19 mortality rates, while medical care increases the life expectancy of COVID-19 cases., Competing Interests: There are no conflict of interest., (Copyright: © 2024 Journal of Family Medicine and Primary Care.)

In order to combat environmental pollution and the depletion of non-renewable fuels, feasible, eco-friendly, and sustainable biodiesel production from non-edible oil crops must be augmented. This study is the first to intensify biodiesel production from castor oil using a self-manufactured cylindrical stator-rotor hydrodynamic cavitation reactor. In order to model and optimize the biodiesel yield, a response surface methodology based on a 1/2 fraction-three-level face center composite design of three levels and five experimental factors was used. The predicted ideal operating parameters were found to be 52.51°C, 1164.8 rpm rotor speed, 27.43 min, 8.4:1 methanol-to-oil molar ratio, and 0.89% KOH concentration. That yielded 95.51% biodiesel with a 99% fatty acid methyl ester content. It recorded a relatively low energy consumption and high cavitation yield of 6.09 × 10 5  J and 12 × 10 -3  g/J, respectively. The generated biodiesel and bio-/petro-diesel blends had good fuel qualities that were on par with global norms and commercially available Egyptian petro-diesel. The preliminary cost analysis assured the feasibility of the applied process., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Postintubation tracheal stenosis is the most common cause of benign tracheal stenosis. Surgical treatment is more challenging in long-segment stenosis. Suprahyoid release can increase tracheal length resected without anastomotic tension in patients with post-intubation tracheal stenosis. Its effect on swallowing has not been objectively studied and this article aims to explore its virtues and potential complications in a tertiary center for airway surgery. A prospective cohort study was conducted on forty consecutive patients from June 2020 till December 2023. Patients of both genders had tracheal resection anastomosis surgery with routine suprahyoid muscle release for resected tracheal segment of more than 2.5 cm in length aiming to decrease the anastomotic tension. Within two weeks postoperatively, a video naso-laryngoscope was done on all the patients to detect any vocal cord disorders, then they were examined by video fluoroscopy swallowing study VFSS to detect swallowing problems. Follow up was done for 6 months postoperatively. 40 patients were studied. Twenty-five patients (62.5%) were males. 21 patients (52.5%) had a cricotracheal resection. VFSS was performed on 38 patients (two patients excluded for serious morbidity). Six (15.7%) and four (10.5%) patients had residual semisolid and solid food in the vallecula and pyriform fossa respectively during swallowing. Five patients (13%) out of eight patients with abnormal VFSS had aspiration and dysphagia. Video nasolaryngoscopy was done pre- and post-operatively and showed that 7 patients (17.5%) had unilateral vocal cord paralysis, two of them had the same lesion preoperatively. Two patients developed postoperative anastomotic complications. All symptoms of dysphagia improved within 3 weeks of the procedure and improvement persisted for 6 months. Suprahyoid muscle release had a considerable reversible drawback on the process of swallowing. Its routine use in high-risk patients requiring long segment tracheal resections could be considered., (© 2024. The Author(s).)

The present microstructural evaluation was carried out on the woods of three ethnobotanically important local fruit trees, namely, Ziziphus mauritiana Lam., Z. spina-christi (L.) Willd., and Z. nummularia (Burm.f.) Wight and Arn., of family Rhamnaceae from Cholistan Desert of Pakistan. Wood samples were sectioned with sliding sledge microtome to make permanent slides for observing different anatomical parameters under the light microscope. All selected species were observed to have diffuse-porous wood with indistinct growth rings. The vessels were rounded in outline in all the species studied and found mostly solitary or in radial multiples of 2 in Ziziphus mauritiana and Z. nummularia , while in radial multiples of 2 to 5 in Z. spina-christi . The intervessel pits were scalariform to opposite. The rays were uniseriate in Ziziphus mauritiana , while mostly were biseriate in Ziziphus spina-christi . Simple perforation plates and diffuse, confluent, and vasicentric types of axial parenchyma were present in all the selected species. The fibers were thin-walled and nonseptate. One-way ANOVA followed by the Tukey test was conducted to observe different anatomical variations within selected species. Principal component analysis revealed correlations among studied anatomical parameters. The number of rays per mm was comparatively larger in Ziziphus nummularia, showing its greater susceptibility to wood-deteriorating agents than in other selected species. The Runkel ratio indicated the selected species suitable for making paper., Competing Interests: The authors declare that they have no conflicts of interest that influence the work reported in this study., (Copyright © 2024 Muhammad Bilal et al.)

Introduction: Antenatal care (ANC) services play a crucial role in safeguarding the health of pregnant women during their reproductive years. This study aimed to evaluate the primary factors influencing the utilization of ANC among women of childbearing age in Isari town, Jigawa State., Methods: We conducted a cross-sectional study among 400 mothers of childbearing age, selecting them using a simple random sampling method. Data were collected using interviewer-administered questionnaires. The statistical analyses performed were descriptive analysis, Pearson's chi-square test, and binary logistic regression analysis., Results: The majority of respondents (92.5%) indicated awareness of ANC, with a significant proportion expressing the necessity of ANC services (85.7%). 57.8% of the respondents indicated attending ANC services at least four times during pregnancy. Furthermore, the number of visits has a significant relationship with age ( P < 0.001), educational level ( P = 0.003), occupation ( P = 0.043), mother's knowledge of pregnancy danger signs ( P = 0.001), and husband's support for ANC ( P < 0.001)., Conclusion: Enhancing ANC utilization will necessitate focusing on women residing in rural areas and those with limited educational attainment., Competing Interests: The authors declare that they do not have any conflicts of interest., (Copyright © 2024 Sabo, Alzoubi, Saidu, Usman, Saulawa, Al-Mugheed, Farghaly Abdelaliem and Saeed Alabdullah.)

Background: Endotracheal Tube Suctioning (ETS), which involves either an open or closed suctioning system, is a crucial practice for mechanically ventilated patients. The nursing practice of airway suctioning is inevitable. This study was designed to compare the intensive care nurses' performance of open versus closed endotracheal suction on critically ill patients in Ismailia City., Materials and Methods: A non-participant structured observational study design was conducted on a convenient sample (N = 63) at intensive care units at a teaching hospital through March and August 2022 to evaluate how nurses practice different procedures in open suctioning compared with the closed suctioning system of Endotracheal Suction (ES) through a 32-item structured checklist. Additionally, authors compared their levels of knowledge in both suctioning systems., Results: Approximately 75% and 65% of the study participants had a satisfactory level of knowledge about the open system compared with the closed system, respectively. The total percentage of patients who achieved a satisfactory level of practice was 72% for the open-system group, compared with 56% for the closed-system group. Overall, there were significant differences between total nurses' performances in the open-system and closed-system systems. Independent sample t-tests revealed a statistically significant correlation between overall nurses' performance in both systems (t = 6.04, p < 0.001)., Conclusions: The findings revealed significant differences in nurses' performance between open and closed-system suctioning. The researchers recommend in-service-led training programs to improve nurses' performance, and other studies with larger sample sizes should be supported., Competing Interests: Nothing to declare., (Copyright: © 2024 Iranian Journal of Nursing and Midwifery Research.)

Purpose: Rigid bronchoscopy is widely used for diagnosis and treatment of foreign body aspiration (FBA) in children, but negative results can be reported, especially with radiolucent organic FBA. This study aimed to evaluate the clinical features and pre-procedure predictors of organic FBA in children under 5 years of age., Methods: Children aged less than 5 years old who underwent rigid bronchoscopy for suspected organic FBA were retrospectively evaluated for demographics, history of aspiration, relevant clinical symptoms and signs, radiological findings, in addition to type and location of foreign body (FB). To determine the predictors of positive FBA, stepwise backward logistic regression was applied., Results: A total of 228 children were included (69.7% boys). The mean age was 1.98 ± 1.07 years. Foreign bodies were found in 202 cases (88.59%). Age ≤ 3 years and history of witnessed choking had the highest sensitivity while diminished breath sounds had the highest specificity for diagnosing FBA. In multivariate analysis, witnessed choking, wheezy chest, diminished breath sounds, and respiratory distress were independently associated with increased risk of FBA., Conclusion: Children under 5 years of age with suspected organic FBA have varied clinical and radiological findings. The history of choking, wheezy chest, diminished air entry, or respiratory distress increases the chance of positive rigid bronchoscopy in this age group., Competing Interests: Conflict of interestThe authors declare that they have no competing interests., (© Indian Association of Cardiovascular-Thoracic Surgeons 2024. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

The number of exotic animal practitioners in Southeast Asia (SEA) has increased over the last 30 years to match the increase in ownership of exotic pets. Fortunately, veterinary health care has advanced due to the leaders in the field educating other practitioners and promoting exotic animal practice. Continuing education opportunities are available for exotic medicine in SEA. In Thailand and Singapore, there is a niche of clients with high spending power that has transcended to increased demand for exotic health care. This has led to the establishment of exotic-only specialist hospitals and more access to advanced imaging for exotic pets., Competing Interests: Disclosure The authors have nothing to disclose., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Introduction: Automated segmentation of 3-dimensional pulp space on cone-beam computed tomography images presents a significant opportunity for enhancing diagnosis, treatment planning, and clinical education in endodontics. The aim of this systematic review was to investigate the performance of artificial intelligence-driven automated pulp space segmentation on cone-beam computed tomography images., Methods: A comprehensive electronic search was performed using PubMed, Web of Science, and Cochrane databases, up until February 2024. Two independent reviewers participated in the selection of studies, data extraction, and evaluation of the included studies. Any disagreements were resolved by a third reviewer. The Quality Assessment of Diagnostic Accuracy Studies-2 tool was used to assess the risk of bias., Results: Thirteen studies that met the eligibility criteria were included. Most studies demonstrated high accuracy in their respective segmentation methods, although there was some variation across different structures (pulp chamber, root canal) and tooth types (single-rooted, multirooted). Automated segmentation showed slightly superior performance for segmenting the pulp chamber compared to the root canal and single-rooted teeth compared to multi-rooted ones. Furthermore, the second mesiobuccal (MB2) canalsegmentation also demonstrated high performance. In terms of time efficiency, the minimum time required for segmentation was 13 seconds., Conclusion: Artificial intelligence-driven models demonstrated outstanding performance in pulp space segmentation. Nevertheless, these findings warrant careful interpretation, and their generalizability is limited due to the potential risk and low evidence level arising from inadequately detailed methodologies and inconsistent assessment techniques. In addition, there is room for further improvement, specifically for root canal segmentation and testing of artificial intelligence performance in artifact-induced images., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: Instantaneous wave-free ratio (iwFR) is a well-validated method for functional evaluation of intermediate coronary lesions. A recently developed Murray law-based QFR (µQFR) allows wire-free FFR estimation using a high-quality single angiographic projection. We aim to determine the diagnostic accuracy of µQFR as compared to wire-based iwFR for physiological assessment of coronary lesions in a sample of Egyptian patients., Results: Over a one-year period, patients who previously underwent iwFR assessment of an intermediate coronary stenosis (40-90%) were retrospectively included. μQFR analysis was then performed offline using a dedicated artificial intelligence (AI)-aided computation software. All the measurements were performed blinded to iwFR results, and the agreement between iwFR and μQFR values was tested. Forty-nine patients (mean age 57.9 ± 9 years, 72.9% males) were included. Mean value of iwFR and μQFR was 0.90 ± 0.075 and 0.79 ± 0.129, respectively. There was a significant moderate positive linear correlation between μQFR and iwFR (r = 0.47, p = 0.001; 95% CI 0.22-0.68) with moderate-to-substantial agreement between the two methods (Kappa 0.6). In assessing the diagnostic accuracy of μQFR, the receiver operating characteristic (ROC) curve yielded an area under the curve (AUC) of 0.84 (95% CI 0.717-0.962) for predicting functionally significant lesions defined as iwFR < 0.89. The sensitivity and specificity of μQFR < 0.8 for detecting physiological significance of coronary lesions were 89% and 74% with positive and negative predictive values of 70 and 91%, respectively., Conclusion: µQFR has good diagnostic accuracy for predicting functionally significant coronary lesions with moderate correlation and agreement with the gold standard iwFR. Angiography-derived µQFR could be a promising tool for improving the utilization of physiology-guided revascularization., (© 2024. The Author(s).)

Background/Objectives : This study looks at how a kinematic chain exercise regimen that targets the lower, core, and upper body affects university shot put participants' shoulder muscle strength and throwing efficiency. This study fills an apparent research void on shot put training approaches by presenting a comprehensive kinematic chain workout program. It was anticipated that this method would improve performance the most, considering the complex biomechanical requirements of the sport. Methods : Eighty athletes aged (19.87 ± 1.31 years), were assigned into two groups at random: experimental (n = 40) and control (n = 40). While the control group carried on with their usual training, the experimental group participated in an 8-week kinematic chain training program. Pre- and post-training evaluations were carried out to evaluate shot put-throwing ability, shoulder muscle strength, and participant satisfaction with the exercise regimen. Results : The analyses were performed to evaluate the between- and within-group effects in the 10-week intervention period using a two-way ANOVA. This study demonstrated that, when compared to the control group, the athletes in the kinematic chain program had significantly increased throwing distance ( p = 0.01) and shoulder muscle strength ( p = 0.01). Furthermore, there was a significant increase ( p = 0.005) in the athletes' satisfaction levels with the workout program among those in the experimental group. Conclusions : In shot put athletes, this study suggests that a kinematic chain-focused strategy can improve throwing performance and shoulder muscle strength. The findings suggest that incorporating kinematic chain workouts into shot put training programs could be beneficial. However, conclusions should be drawn with caution, and further research is necessary to confirm the effectiveness of kinematic chain-based approaches across various sports and to understand their broader implications in sports science.

Background: Patient safety remains an area of global concern, and patient safety culture among healthcare staff is one of its most important determinants. Saudi Arabia is investing much effort in enhancing patient safety. Assessment of patient safety culture is enlightening about the impact of such efforts and invaluable in informing policy makers about future directions. This study aimed to assess patient safety culture in King Abdullah Medical City (KAMC), a tertiary referral center in Makkah, Saudi Arabia., Methods: In this cross-sectional study the Hospital Survey on Patient Safety Culture (HSOPSC) version 2.0 was distributed electronically to all staff of KAMC. The HSOPSC version 2.0 Data Entry and Analysis Tool was used to compare results obtained from KAMC to those obtained from global data. Additional analyses were performed on SPSS to explore the presence of associations between responses and participant characteristics., Results: A total of 350 participants completed the questionnaire, 58.6% of whom were nurses. A comparison of the composite measure of all 10 domains of the HSOPSC showed 62% positive responses at KAMC versus 70% in the global database. This difference was statistically significant, with a chi-square of 10.64 and a p value of 0.001. The percentages of positive responses from the KAMC data exceeded those from the global data in the "Organizational learning and continuous improvement" and the "Communication about error" domains (p = 0.002 and 0.003, respectively)., Conclusion: Although safety culture seems to score lower at KAMC than globally, accelerated improvement in the future is expected based on improvement trends in the literature and the national efforts focused on patient safety., (© 2024. The Author(s).)

Acne vulgaris, a prevalent skin condition, arises from an imbalance in skin flora, fostering bacterial overgrowth. Addressing this issue, clindamycin molecularly imprinted polymeric nanoparticles (Clin-MIP) loaded onto polyurethane nanofiber scaffolds were developed for acne treatment. Clin-MIP was synthesized via precipitation polymerization using methacrylic acid (MAA), ethylene glycol dimethacrylate (EGDMA), and azoisobutyronitrile (AIBN) as functional monomers, crosslinkers, and free-radical initiators, respectively. MIP characterization utilized Fourier-transform infrared spectroscopy (FTIR) and transmission electron microscopy (TEM) before being incorporated into polyurethane nanofibers through electrospinning. Further analysis involved FTIR, scanning electron microscopy (SEM), in vitro release studies, and an ex vivo study. Clin-MIP showed strong antibacterial activity against S. aureus , with inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) values of 0.39 and 6.25 μg/mL, respectively. It significantly dropped the bacterial count from 1 × 10 8 to 39 × 10 1 CFU/mL in vivo and has bactericidal activity within 180 min of incubation in vitro. The pharmacodynamic and histopathology studies revealed a significant decrease in infected animal skin inflammation, epidermal hypertrophy, and congestion upon treatment with Clin-MIP polyurethane nanofiber and reduced pro-inflammatory cytokines (NLRP3, TNF-α, IL-1β, and IL-6) conducive to acne healing. Consequently, the recently created Clin-MIP polyurethane nanofibrous scaffold. This innovative approach offers insight into creating materials with several uses for treating infectious wounds caused by acne.

Background: In heart failure with reduced ejection fraction (HFrEF), sodium-glucose co-transporter inhibitors (SGLT-2i) have persistently shown cardiovascular benefits through different trials. However, their impact on ventricular remodeling and cardiac hemodynamics has not been sufficiently studied. This study aimed to study how SGLT-2i initiation affects invasive hemodynamics and cardiac magnetic resonance imaging (CMR)-derived ventricular volumes, function, and fraction of the extracellular volume (ECV) in HFrEF patients with non-ischemic dilated cardiomyopathy (NIDCM)., Results: In this study, 23 patients with HFrEF and a mean age of 42, including 82.6% males, all have NIDCM and underwent right heart catheterization and CMR at the initiation of dapagliflozin and at 6-month follow-up. The addition of dapagliflozin resulted in significant reductions in the following invasive hemodynamic parameters compared to baseline: left ventricular end-diastolic pressure (23.4 vs 19.7 mmHg, p = 0.003), mean pulmonary artery pressure (31.3 vs 27.7 mmHg, p = 0.03), and systemic vascular resistance (18 vs 15 Wood units, p = 0.047). Among the studied CMR-derived measurements, only the percentage of extracellular volume fraction was significantly less at follow-up (33.7 vs 32.16%, p = 0.001). Additionally, functional class showed significant improvement with a notable reduction of the NT-proBNP level and a considerable decrease in diuretic dose (median: 40 vs 80 mg, p = 0.01)., Conclusion: Adding dapagliflozin to patients with HFrEF due to NIDCM improved invasively measured hemodynamics and significantly reduced left ventricular extracellular volume fraction measured by CMR, with no significant change in ventricular volumes or ejection fraction., (© 2024. The Author(s).)

Androgenic alopecia (AGA) affects both men and women worldwide. New blood vessel formation can restore blood supply and stimulate the hair regrowth cycle. Recently, our group reported that 2-deoxy-D-ribose (2dDR) is 80%-90% as effective as VEGF in the stimulation of neovascularization in in vitro models and in a chick bioassay. In this study, we aimed to assess the effect of 2dDR on hair growth. We prepared an alginate gel containing 2dDR, polypropylene glycol, and phenoxyethanol. AGA was developed in C57BL6 mice by intraperitoneally injecting testosterone (TE). A dihydrotestosterone (DHT)-treated group was used as a negative control, a minoxidil group was used as a positive control, and we included groups treated with 2dDR gel and a combination of 2dDR and minoxidil. Each treatment was applied for 20 days. Both groups treated with 2dDR gel and minoxidil stimulated the morphogenesis of hair follicles. H&E-stained skin sections of C57BL/6 mice demonstrated an increase in length, diameter, hair follicle density, anagen/telogen ratio, diameter of hair follicles, area of the hair bulb covered in melanin, and an increase in the number of blood vessels. Masson's trichrome staining showed an increase in the area of the hair bulb covered in melanin. The effects of the FDA-approved drug (minoxidil) on hair growth were similar to those of 2dDR (80%-90%). No significant benefit were observed by applying a combination of minoxidil with 2dDR. We conclude that 2dDR gel has potential for the treatment of androgenic alopecia and possibly other alopecia conditions where stimulation of hair regrowth is desirable, such as after chemotherapy. The mechanism of activity of 2dDR remains to be established., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Anjum, Zulfiqar, Chaudhary, Rehman, Bullock, Yar and MacNeil.)

Objectives: Hospitals' accreditation process is carried out to enhance the quality of hospitals' care and patient safety practices as well. The current study aimed to investigate the influence of hospitals' accreditation on patient safety culture as perceived by Jordanian hospitals among nurses., Methods: A descriptive cross-sectional correlational survey was used for the current study, where the data were obtained from 395 nurses by convenient sampling technique who were working in 3 accredited hospitals with 254 nurses, and 3 non-accredited hospitals with 141 nurses, with a response rate of 89%., Results: The overall patient safety culture was (71.9%). Moreover, the results of the current study revealed that there were no statistically significant differences between the perceptions of nurses in accredited and non-accredited hospitals in terms of perceptions of patient safety culture., Conclusion: The current study will add new knowledge about nurses' perceptions of patient safety culture in both accredited and non-accredited hospitals in Jordan which in turn will provide valid evidence to healthcare stakeholders if the accreditation status positively affects the nurses' perceptions of patient safety culture or not. Continuous evaluation of the accreditation application needs to be carried out to improve healthcare services as well as quality and patient safety., (© 2024. The Author(s).)

Layered double hydroxides (LDH) are promising 2D nanomaterials being investigated for several engineering and biomedical applications. In this work, quinary Zr Al Fe Co Ni LDH and its Al Fe Co Ni LDH quaternary and Fe Co Ni LDH tertiary roots were prepared and characterized. All samples showed an aggregated, layered morphology with zero surface charge and approximately 300 nm of hydrodynamic size. BET surface area of Al Fe Co Ni LDH showed a remarkable value of 143.25 m 2 g -1 as opposed to 26.2 m 2 g -1 and 45.4 m 2 g -1 for Fe Co Ni LDH and Zr Al Fe Co Ni LDH, respectively. The antimicrobial activity of the prepared samples was assessed against the many pathogenic bacteria; Bacillus ( B. ) subtilis , Escherichia ( E. ) coli , Haemophilus ( H. ) influenza , Listeria ( L. ) monocytogenes , Staphylococcus ( S. ) aureus , and Streptococcus ( St. ) pneumonia , and six fungal species. Furthermore, anti-biofilm activity, growth curve assay, and effect of UV illumination were examined against various pathogenic microbes. Zr Al Fe Co Ni displayed remarkable antibacterial activity, as indicated by the lowest values of the minimum inhibitory concentrations (MIC) of 4-166.7 μg mL -1 . Results for fungal strains varied in terms of their susceptibilities for the different samples tested. Zn Al Fe Co Ni was able to inhibit the biofilm formation of S. aureus (96.09%), E. coli (98.32%), and Candida ( C. ) albicans (95.93%). This study shown that certain LDH categories, particularly Zr Al Fe Co Ni, may be promising antibacterial agents against variety of pathogenic microorganisms that cause serious infections., Competing Interests: None of the authors have a conflict of interest to disclose., (This journal is © The Royal Society of Chemistry.)

In the present study, the commercially available three different fabrics cotton, nylon and cotton/nylon were modified by chitosan and silver nanoparticles using a crosslinker triethyl orthoformate (TEOF). Resulted cotton‑silver (Ag-Cs-Cot), nylon‑silver (Ag-Cs-Nyl) and cotton-nylon silver (Ag-Cs-Cot-Nyl) fabrics showed significant anti-bacterial activity even after 50 washing cycles. Silver nanoparticles were prepared by reducing silver nitrate through sodium borohydride at 0 °C. In FTIR spectra the peak at near 1650 cm -1 confirmed that TEOF mediated attachment of chitosan with fabrics (due to C=N) and the stretching of secondary amine near the 3375 cm -1 indicated the silver attachment to the amine group of the chitosan. In Scanning Electron Microscope (SEM) images smooth surfaces of fabrics without any damage by modification process were observed. The antibacterial activity was Analyzed by agar diffusion and broth dilution assays against Escherichia coli and Staphylococcus aureus bacterial strains and results showed 90% bacterial inhibition against E. coli and 89% bacterial inhibition against S. aureus. For testing the antibacterial durability, the modified fabrics were washed with non-ionic detergent (10g/l) for 15 minutes under aggressive stirring (100 rpm) at room temperature. The modified fabrics retained antibacterial activity over the 50 washing cycles. Finally, the commercial potential of cotton-silver fabric was evaluated by stitching it with the socks of football players and interestingly results showed that the modified fabric on the socks showed more than 90% bacterial inhibition as compared to the plain fabric after 70 minutes of playing activity., Competing Interests: Declaration of competing interest The authors declare no conflict of interest., (Copyright © 2024 Elsevier B.V. All rights reserved.)

A novel eco-friendly high throughput continuous hydrothermal flow system was used to synthesise phase pure ZnO and doped ZnO in order to explore their properties for tissue engineering applications. Cerium, zirconium, and copper were introduced as dopants during flow synthesis of ZnO nanoparticles, Zirconium doped ZnO were successfully synthesised, however secondary phases of CeO and CuO were detected in X-ray diffraction (XRD). The nanoparticles were characterised using X-ray diffraction, Brunauer-Emmett-Teller (BET), Dynamic Light scattering Measurements, Scanning Electron Microscopy (SEM), Transmission Electron Microscopy (TEM), Fourier transform infrared spectroscopy (FT-IR) and RAMAN spectroscopy was used to evaluate physical, chemical, and structural properties. The change in BET surface area was also significant, the surface area increased from 11.35 (ZnO&#95;2) to 26.18 (ZrZnO&#95;5). However. In case of CeZnO&#95;5 and CuZnO&#95;5 was not significant 13.68 (CeZnO&#95;5) and 12.16 (CuZnO&#95;5) respectively. Cell metabolic activity analysis using osteoblast-like cells (MG63) and human embryonic derived mesenchymal stem cells (hES-MP) demonstrated that doped ZnO nanoparticles supported higher cell metabolic activity compared to cells grown in standard media with no nanoparticles added, or pure zinc oxide nanoparticles. The ZrZnO&#95;5 demonstrated the highest cell metabolic activity and non-cytotoxicity over the duration of 28 days as compared to un doped or Ce or Cu incorporated nanoparticles. The current data suggests that Zirconium doping positively enhances the properties of ZnO nanoparticles by increasing the surface area and cell proliferation. Therefore, are potential additives within biomaterials or for tissue engineering applications., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. Professor Gwendolen Reilly and University of Sheffield reports financial support, equipment, supplies were provided by University of Sheffield. Prof. Jawwad Darr provided the access to Green synthesis lab, University college London., (© 2024 Published by Elsevier Ltd.)

The periosteum, a vascularized tissue membrane, is essential in bone regeneration following fractures and bone loss due to some other reasons, yet there exist several research gaps concerning its regeneration. These gaps encompass reduced cellular proliferation and bioactivity, potential toxicity, heightened stiffness of scaffold materials, unfavorable porosity, expensive materials and procedures, and suboptimal survivability or inappropriate degradation rates of the implanted materials. This research used an interdisciplinary approach by forming a new material fabricated through electrospinning for the proposed application as a layer-by-layer tissue-engineered periosteum (TEP). TEP comprises poly(ε-caprolactone) (PCL), PCL/gelatin/magnesium-doped zinc oxide (vascular layer), and gelatin/bioactive glass/COD liver oil (osteoconductive layer). These materials were selected for their diverse properties, when integrated into the scaffold formation, successfully mimic the characteristics of native periosteum. Scanning electron microscopy (SEM) was employed to confirm the trilayer structure of the scaffold and determine the average fiber diameter. In-vitro degradation and swelling studies demonstrated a uniform degradation rate that matches the typical recovery time of periosteum. The scaffold exhibited excellent mechanical properties comparable to natural periosteum. Furthermore, the sustained release kinetics of COD liver oil were observed in the trilayer scaffold. Cell culture results indicated that the three-dimensional topography of the scaffold promoted cell growth, proliferation, and attachment, confirming its non-toxicity, biocompatibility, and bioactivity. This study suggests that the fabricated scaffold holds promise as a potential artificial periosteum for treating periostitis and bone fractures., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Automobile exhaust releases different types of pollutants that are at great risk to the air quality of the environment and incidental distress to the nature of roadside plants. Mimusops elengi L. is an evergreen medicinal tree cultivated along the roadside of Lahore City. This research aimed to investigate physiological, morphological and genomorphic characteristics of M. elengi under the influence of air pollution from vehicles. Healthy and mature leaves were collected from trees on Canal Bank and Mall roads of Lahore as the experimental sites and control sites were 20 km away from the experimental site. Different physiochemical, morphological, air pollution tolerance index (APTI) and molecular analysis for the detection of DNA damage were performed through comet assay. The results demonstrated the mean accumulated Cd, Pb, Cu and Ni heavy metal contents on the leaves were higher than the control plants (1.27, 3.22, 1.32 and 1.46 μg mg -1 ). APTI of trees was 9.04. Trees in these roads significantly (p < 0.01) had a lower leaf area, petiole length and leaf dry matter content in comparison to control site. Increased comet tail showed that DNA damage was higher for roadside trees than trees in the control area. For tolerance of air pollution, it necessary to check the APTI value for the M. elengi at the polluted road side of Lahore city. For long-term screening, the source and type of pollutants and consistent monitoring of various responses given by the trees should be known., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors. Published by Elsevier Ltd.)

This report describes the understudied co-occurrence of temporomandibular joint ankylosis (TMJA) and extrahepatic portal vein obstruction (EHPVO), exploring a shared pathway involving hypercoagulability. TMJA is an acquired pathology where joint surfaces fuse, causing restricted mouth opening and facial asymmetry. Globally, TMJA is prevalent among 1.5 to 5 patients/million, with a higher incidence in developing countries. While trauma and infections often cause TMJA, the pathogenesis remains unclear in many cases. Recent literature notes a link between TMJA and EHPVO, a noncirrhotic vascular disorder causing portal hypertension and upper gastrointestinal bleeding in children. Prothrombotic disorders such as protein C and S deficiency may contribute to EHPVO, mirroring TMJA's association with hypercoagulability. This report focuses on an 11-year-old female diagnosed with TMJA, accompanied by a history of ear infection and concurrent EHPVO. We further presented clinical observations, surgical interventions, and outcomes alongside a literature review to understand the probable connection between EHPVO and TMJA., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Burman et al.)

Background: Orthodontic treatment is a common dental procedure aimed at correcting malocclusions and improving dental aesthetics. However, one of the potential side effects of orthodontic treatment is root resorption, which can lead to permanent damage to the tooth's root structure., Materials and Methods: In this comparative study, 60 orthodontic patients were divided into three groups, each receiving a different orthodontic treatment approach: Group A-conventional fixed orthodontic appliances, Group B-self-ligating orthodontic appliances, and Group C-clear aligners. Digital radiographs were taken before and after treatment to assess root resorption. The extent of root resorption was quantified using a standardized measurement scale., Results: The results indicated that Group A exhibited an average root resorption of 0.2 mm, Group B showed an average root resorption of 0.1 mm, and Group C had the lowest average root resorption of 0.05 mm. These findings suggest that clear aligners resulted in significantly less root resorption compared to conventional fixed orthodontic appliances and self-ligating orthodontic appliances ( P < 0.05)., Conclusion: This comparative study highlights the differential effects of various orthodontic mechanics on root resorption. Clear aligners demonstrated the least amount of root resorption when compared to conventional fixed orthodontic appliances and self-ligating orthodontic appliances., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Pharmacy and Bioallied Sciences.)

Purpose: This study aimed to assess the impact of the Nursing Spiritual Care Module on the competence of nurses in providing spiritual care in the context of Malaysia., Method: This study employed an experimental design and involved a total of 122 nurses, with 59 in the experimental group and 63 in the control group. Participants were selected from palliative care wards associated with Hospital Universiti Sains Malaysia. Nurses in the experimental group underwent a two-week educational module on nursing spiritual care, while nurses in the control group attended a single lecture on spiritual care provided by the hospital., Results: The results indicated no significant differences in sociodemographic characteristics between the two groups. A significant difference in spiritual care competence within the intervention group and the control group over time (p-value = 0.001), between the two groups (p-value = 0.038), and in the interaction between time and group (p-value = 0.001)., Conclusion: The Nursing Spiritual Care Module is crucial in aiding nurses and healthcare professionals in cultivating the appropriate and wholesome attitudes and practices necessary to address the spiritual needs of patients., (© 2024. The Author(s).)

Aim: This retrospective cohort study aimed to evaluate the association between body weight and oral cGVHD (chronic graft versus host disease)., Methods: Patients with oral cGVHD were compared with an age and gender-matched non-GVHD cohort in terms of demographic information, body mass index (BMI), date of transplant, length of hospitalization, and oral complications. Weight was stratified in pre-and post-transplant weight, mean weight after acquiring cGVHD for the first year, and post-oral cGVHD BMI. Each patient was matched and compared with two controls at a 1:2 ratio. Firth's penalized likelihood logistic regression was used to investigate the association between oral complications and weight loss greater than 5% in the oral cGVHD group., Results: This study included 137 patients (n = 42 oral cGVHD, n = 12 non oral-cGVHD and n = 83 non-GVHD). The oral cGVHD cohort had a 1.44 times higher risk (RR) of being underweight (BMI<18.5 kg/m2) compared to the non-GVHD cohort. Oral mucositis was an independent predictor of weight loss above 5% in the oral cGVHD cohort (p < 0.001)., Conclusion: The weight loss was more prevalent among oral cGVHD, and oral mucositis was linked to significant weight loss. Weight loss may indicate the need to initiate early and aggressive symptomatic oral cGVHD treatment., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Aboalela et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Rationale: Obesity and diabetes of different types are considered global health risks with rising prevalence. In addition to low-calorie diet and daily exercise, several treatment options have been introduced to help patient in needs. Semaglutide (Ozempic) is one popular agent, which attracted the attention of both physicians and patients due to its positive outcome in improving glucose control and weight loss. However, no reports on the effect of semaglutide use on the oral cavity and specifically xerostomia are available in the literature. We are reporting 3 cases for patients who were using semaglutide and developed secondary xerostomia., Patient Concerns: Three female patients with median age of 34 (range 27-46) presented to the oral medicine clinic with chief complaint of xerostomia. All patients were overweight with a mean body mass index of 35.6 (range 35-37) and have been using semaglutide for weight loss for a mean duration of 11.3 weeks (range 6-16)., Diagnoses: All 3 patients had severe dryness in the mouth with minimal frothy saliva with mean modified Schirmer test of 9 mL at 3 minutes (range 8-10 mL). Following exclusion of other possible underlying medical problems, the diagnosis of semaglutide-induced hyposalivation was given to all patients., Interventions: The patients' management varied between discontinuation of the drug, the use of pilocarpine, and conservative symptomatic management., Outcomes: The patients resumed acceptable salivary flow., Lessons: We are reporting for the first time hyposalivation associated with the use of semaglutide. Further prospective, larger studies are warranted to confirm these findings., Competing Interests: The authors have no funding and conflicts of interest to disclose., (Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.)

Background: Disseminated Intravascular Coagulation (DIC) has been assessed by the International Society of Thrombosis and Hemostasis (ISTH) 2001 and the ISTH 2018-modified version. More investigations are needed to assess usability and visibility of those DIC scoring systems in the intensive care units (ICU)., Aims: This study investigated the predictive performance of the ISTH-Overt DIC versions of 28-day mortality in ICUs compared to SOFA as a gold standard assessment tool of sepsis., Methods: A retrospective design (2015-2017) included 220 adult patients enrolled from medical and surgical ICUs in two major hospitals in Jordan. We calculated ISTH-Overt DIC scores and SOFA score on time of DIC diagnosis. Overt DIC was categorized based on a score of ≥ five for ISTH DIC 2001; and ≥ 4 for ISTH DIC 2018. Provided, a score > 12 was categorized as Multiple-Organ- Dysfunction-Syndrome (MODS) for Sequential Organ Failure Assessment (SOFA) score. Then, 28-day mortality follow-up was performed., Results: More than half of sample died before 28-days of follow-up. The analysis of Receiver Operating Characteristic (ROC) showed that higher scores of ISTH DIC 2001(≥ 5), ISTH DIC 2018 (≥ 4), and SOFA score (>12) were highly associated with 28-day mortality. The ISTH DIC 2001 and SOFA score were superior on the modified ISTH 2018 in predicting 28-day mortality, with an Area Under the Curve (AUC) of (0.724 vs. 0.822 vs. 0.507, respectively). Yet, the accuracy of the SOFA score was better than the ISTH DIC 2001., Conclusion: This study suggests that ISTH DIC 2001 score is helpful when applied on medical and surgical ICU Jordanian populations. It showed better results compared to the Modified ISTH DIC 2018 in mortality prediction, regardless of the underlying diseases., Competing Interests: Declaration of Competing Interest None., (Copyright © 2023 Society for Vascular Nursing, Inc. Published by Elsevier Inc. All rights reserved.)

Background: Clavicle fracture (CF) is the tenth most prevalent fracture, accounting for an annual incidence of 37/10,000. This systematic review highlights the factors contributing to the nonunion union of the clavicular fracture., Method: A systematic search was conducted using three web-based databases up to August 12, 2022, for conducting qualitative analysis. Articles were screened for relevance, and only studies that met inclusion criteria based on PECOS; P (patients): participants diagnosed with clavicular fracture; E (exposure): nonunion, C (control): not applicable; O (outcomes): factors contributing to nonunion or delayed union; S (studies): trials and observational studies. The Newcastle-Ottawa Scale was used to assess the quality of the cohort studies. The Cochrane risk of bias tool was used to assess the bias in randomized control trials., Results: Ten studies were selected after the final literature search. Two thousand seven hundred and sixty-six adult participants who were radiologically and clinically diagnosed with nonunion clavicular fracture were included to pool the qualitative results. Fall was the most dominant cause of clavicular fracture, followed by road traffic collisions. Open reduction was widely used to treat nonunion correction. The qualitative results suggested a prominent correlation of nonunion with advancing age, female gender, high energy trauma, high Disabilities of the Arm, Shoulder, and Hand Score, smoking, fracture displacement, clavicular shortening, the callus on radiography, and fracture movement. The mid-shaft fracture was the most dominant type of fracture in the included studies; highly associated with nonunion in comparison to medial or lateral CF. The previous history of operation was an independent factor contributing to nonunion., Conclusion: The results of this systematic review suggested the predictors contributing to nonunion in the CF. Demographic factors such as advancing age with female gender are at higher risk of developing clavicular nonunion. Smoking was the most dominantly highlighted environmental factor contributing to nonunion. Diaphyseal or midshaft fracture was the most common site for nonunion. Therefore, we suggested that patients with the predictors mentioned above require special attention to prevent nonunion of the CFs. More studies should be conducted on this subject to assess the factors that pose a risk associated with the nonunion of the bone for better clinical management and outcomes of the fracture., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Cultivation of high-yield varieties and unbalanced fertilization have induced micronutrient deficiency in soils worldwide. Zinc (Zn) is an essential nutrient for plant growth and its deficiency is most common in alkaline and calcareous soils. Therefore, this study aimed to evaluate the effect of Zn applied either alone or in combination with foliar application on the quality and production of wheat grown in alkaline soils. Zn was applied in the form of zinc sulfate (ZnSo 4 ) to the soil and as a foliar spray during the sowing and tillering stages, respectively. Results showed that Zn fertilization of wheat, irrespective of modes of application, significantly increased grain and biological yield, grain per spike, and 1,000 grains weight over control; however, its effect was more noticeable when applied as 7.5 kg ha -1 of soil Zn combined with foliar Zn at 2.5 kg ha -1 . Zn application significantly increased the grain protein content from 9.40% in the control to a maximum of 11.83% at soil Zn of 10 kg ha -1 . Similarly, Zn application improved Zn, phosphorus (P), and potassium (K) concentrations in wheat grains. Moreover, correlation analysis showed that the grain Zn concentration was positively correlated with the grain P concentration. The correlation between P concentration in wheat grains and 1,000 grain weight was not significant. A total of 1,000 grains weight was positively correlated with tillers per plant, grain yield, and biological yield. There were positive correlations between protein content, biological yield, grain yield, and tillers per plant. Therefore, soil-applied Zn + foliar application in alkaline soils with limited Zn availability is crucial for improving wheat yield and grain quality., Competing Interests: The authors declare that there are no competing interests., (©2023 Khan et al.)

Cystic hypersecretory lesions of the breast are a spectrum of conditions ranging from cystic hypersecretory hyperplasia with atypia and invasive cystic hypersecretory carcinoma (CHC). It is a subtype of ductal carcinoma of the breast. The tumour is very infrequent and hence, extensive literature is limited. This culminates in the fact that it does not feature as part of the WHO classification of breast tumours. However, a good knowledge about its distinct pathological features can avert misdiagnosis and help differentiate CHC from other conditions. Thus far, only 22 cases of invasive CHC have been reported, of which 3 were microinvasive. Only 7 cases of axillary lymph node metastasis have been documented. We report a case of invasive CHC of the breast that was metastatic to the axilla and refractory to neoadjuvant chemotherapy. Our case report aims to add to the literature on the disease, aiming to support large-scale studies in the future in order to elaborate on its clinical and biological characteristics., Competing Interests: The authors have no conflicts of interest to declare., (© 2023 The Author(s). Published by S. Karger AG, Basel.)

Microplastics (MPx) and nanoplastics (NPx) are increasingly accumulating in terrestrial ecosystems, heightening concerns about their potential adverse effects on human health via the food chain. Techniques aimed at recovering the most challenging colloidal fractions of MPx and NPx, especially for analytical purposes, are limited. This systematic review emphasises the absence of a universal, efficient, and cost-effective analytical method as the primary hindrance to studying MPx and NPx in soil and plant samples. The study reveals that several methods, including density separation, organic matter removal, and filtration, are utilized to detect MPx or NPx in soil through vibrational spectroscopy and visual identification. Instruments such as Pyrolysis Gas Chromatography Mass Spectrometry (Py-GCMS), Transmission Electron Microscopy (TEM), Scanning Electron Microscopy (SEM), Fourier Transform Infrared (FTIR) Spectroscopy, and fluorescence microscopy are employed to identify MPx and NPx in plant tissue. In extraction procedures, organic solvents and sonication are used to isolate NPx from plant tissues, while Pyrolysis GC-MS quantifies the plastics. SEM and TEM serve to observe and characterize NPx within plant tissues. Additionally, FTIR and fluorescence microscopy are utilized to identify polymers of MPx and NPx based on their spectral characteristics and fluorescence signals. The findings from this review clarify the identification and quantification methods for MPx and NPx in soil and plant systems and provide a comprehensive methodology for assessing MPx/NPx in the environment., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Masson SAS. All rights reserved.)

Globally, obesity is a severe health issue. A more precise and practical approach is required to enhance clinical care and drug development. The FTO (fat mass and obesity-associated) gene variant rs1421085 is strongly associated with an increased susceptibility to obesity in numerous populations; however, the precise mechanism behind this association concerning metabolomics is still not understood. This study aims to examine the association between metabolites and obesity-related anthropometric traits based on the variant FTO rs1421085. This study was based on a case-control design involving a total of 542 participants including overweight/obese cases and healthy controls. The blood samples were collected from all the participants. The isolated serum samples were subjected to untargeted metabolomics using GC-MS. The isolated DNA samples were genotyped for the FTO rs1421085 variant. Initially, a total of 42 metabolites were identified on GC-MS, which were subjected to further association analyses. The study observed a significant association of two metabolites, glycerol and 2,3-dihydroxypropyl stearate with FTO gene variant rs1421085 and obesity-related anthropometric traits including % BF, WHtR, WC, and HC. The CT genotype of FTO rs1421085 may greatly increase the risk of overweight/obesity by changing the lipid metabolism-related metabolites. Therefore, this study highlights the significance of biochemical networks in the progression of obesity in carriers of the FTO rs1421085 risk genotype.