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Purpose: When exact information regarding the treatment head and initial electron beam is available, the Monte Carlo (MC) approach can properly simulate any linear accelerator. However, manufacturers seldom offer information such as the incident electron beam's energy, radial intensity (spot size), or angular spread. This research aims to forecast these features and verify an MC-simulated linear accelerator model using measurements. Materials and Methods: The BEAMnrc code simulated a 6 MV photon beam from a Radixact™ Tomotherapy Linac. Percentage depth dose and beam profile calculations were conducted using DOSYXZnrc by various electron energies and spot sizes and compared to measurements using a Gamma index with two distinct criterion sets. Furthermore, the fine-tuned electron energy and spot size profiles were created to minimize any disparities using distinct angle spreads. Finally, the output factors (OFs) for various field sizes were compared. Results: The MC model's fine-tuned electron energy was determined to be 5.8 MeV, with 88.6% of the calculation points passing the 1%/1 mm γ test. A circular radial intensity of 1.4 mm best represented the 6 MV photon beam regarding spot size. Furthermore, a mean angular spread of 0.05 reduced the disparity in cross-field profile between computation and measurement. The most considerable disparities between the MC model OFs and observations were 1.5%. Conclusion: Using the BEAMnrc code, a reliable MC model of the Radixact™ Tomotherapy Linac can be created, as shown in this paper. This model can be used to compute dose distributions with confidence. Keywords: BEAMnrc, DOSXYZnrc, Monte Carlo, tomotherapy, Author(s): Danial Seifi Makrani [1,2]; Hassan Ali Nedaei (corresponding author) [1,2]; Ghazale Geraily [1,2]; Alireza Khorami-Moghaddam [3]; Nooshin Banaee [4]; Hussam Jassim [1,2,5] INTRODUCTION In the past few years, intensity-modulated [...]

Objectives: Stroke is a major cause of disability in adults, necessitating consistent patient-therapist interactions and diligent adherence to home-based rehabilitation programs to achieve substantial functional recovery. This study assessed audio-based telerehabilitation's (TR) preliminary effect and feasibility in promoting home-based upper extremity exercises among stroke survivors. Methods: A 4-week parallel two-arm pilot study design was employed. Fourteen stroke survivors (seven each in the experimental and control groups) were recruited. Individuals in the control group received standard care consisting of visits to physiotherapy outpatient clinics, while the intervention group received standard care in addition to audio-based TR. The independent t-test and chi-square test were used to analyze differences in the clinical and sociodemographic data. The independent t-test was used to measure the treatment effect on the upper limb motor function (Fugl-Meyer upper extremity [FMA-UE] and Wolf motor function test [WMFT]), quality of life (QOL) (the World Health Organization (WHO) QOL brief, [WHOQOL-BREF]), and activities of daily living (Barthel index [BI]). Results: The overall Mean±SD age of the participants is 50±8.2 years. The FMA-UE and WMFT scores changed from 17.57 to 25.86 (P=0.02) and 28.14 to 43.71 (P=0.03). No significant improvements in physical health, psychological, and social relationships domains of WHOQOL-BREF were recorded after the intervention. However, the environmental domain showed significant improvement (P=0.001). Scores of BI did not change significantly (P=0.49). Discussion: The findings of this study provided preliminary evidence to support the feasibility and benefits of audio-based TR in promoting functional regain after the stroke. However, further studies with a robust design are needed to validate the reported effectiveness.

Abstract Background: The learning management system (LMSs) are online platforms that are used to conduct and support teaching and training at various institutions worldwide. Therefore, this study aimed to assess the perception towards the use of Moodle and Google classrooms LMS tools in the training among the National Health Emergency Operation Center (NHEOC) staff and compare their perceptions. Methods: This was a cross-sectional study with a post-test design conducted at NHEOC in Saudi Arabia in 2023. A training program regarding crises and disaster situations was delivered via Moodle and Google classrooms. At the end of each session, participants were invited to fill a questionnaire regarding their perception towards these tools. Results: A total of 72 and 65 individuals responded to the questionnaire after the end of Moodle class and Google classrooms, respectively. There were no statistically significant differences in the mean perception scores between Moodle and Google classrooms by; the easy access to the browser (4.18 ± 1.24 versus 4.14 ± 1.09, p-value = 0.692), the easy access to the App (4.02 ± 1.31 versus 4.11 ± 1.08 , p-value = 0.658), the ease of browsing the educational content (4.17 ± 1.13 versus 4.14 ± 1.06, p-value = 0.872), and the ease of dealing with the system functions (4.08 ± 1.14 versus 4.09 ± 1.16, p-value = 0.889). Conclusion: Participants reported similar perception towards the use of Moodle and Google classrooms in training programs. Meanwhile, majority reported that they preferred Moodle to Google classrooms. [SJEMed 2024; 5(2.000): 095-100]

Abstract Background: All the existing frameworks of Health-Emergency Disaster Risk Management have put great emphasis on the use of educational strategies to be used as a mean of disaster risk reduction (DRR). Thus, this study was conducted to formulate experts' consensus on DRR educational strategies for Middle East/North Africa (MENA) countries. Methods: A Delphi study on expert's opinion for DRR educational strategies was carried out through surveys in two consecutive rounds through convenient sampling technique. Results: A total of 60 responses were included in this study. Most of the participants were Saudi nationals, physicians (36.7% vs. 33.3% in round 1 and round 2, respectively), and males (73.3%) with experience in disaster management (56.7%) of 5-10 years (60% vs. 53.3% in round 1 and round 2, respectively). Around 80% participants suggested that graduate health professional education should be through problem based learning (PBL) approach (36.7%) (P-value = 0.007). Universal Design for Learning (UDL) framework implementation required provision of multiple means of engagement as priority (P-value = 0.007). Best learning situation category was institution based (60%) with best approach for DRR learning as planned scheduled learning (P-value = 0.000). It was found that best learning situations were lectures and small group sessions (73.3% each) (P-value = 0.165) that were delivered through learning management system (90%) (P-value = 0.103), while the major stakeholders that should be involved in national DRR educational planning were Ministry of Health (90%) (P-value = 0.881). Conclusion: Experts have consensus opinion on DRR Educational strategies in MENA countries. [SJEMed 2024; 5(2.000): 064-072]

Abstract Background Several computational and mathematical models of protein synthesis have been explored to accomplish the quantitative analysis of protein synthesis components and polysome structure. The effect of gene sequence (coding and non-coding region) in protein synthesis, mutation in gene sequence, and functional model of ribosome needs to be explored to investigate the relationship among protein synthesis components further. Ribosomal computing is implemented by imitating the functional property of protein synthesis. Result In the proposed work, a general framework of ribosomal computing is demonstrated by developing a computational model to present the relationship between biological details of protein synthesis and computing principles. Here, mathematical abstractions are chosen carefully without probing into intricate chemical details of the micro-operations of protein synthesis for ease of understanding. This model demonstrates the cause and effect of ribosome stalling during protein synthesis and the relationship between functional protein and gene sequence. Moreover, it also reveals the computing nature of ribosome molecules and other protein synthesis components. The effect of gene mutation on protein synthesis is also explored in this model. Conclusion The computational model for ribosomal computing is implemented in this work. The proposed model demonstrates the relationship among gene sequences and protein synthesis components. This model also helps to implement a simulation environment (a simulator) for generating protein chains from gene sequences and can spot the problem during protein synthesis. Thus, this simulator can identify a disease that can happen due to a protein synthesis problem and suggest precautions for it.

Construction projects are prone to accidents and injuries, necessitating a focus on implementing safety programs. However, the implementation of such programs is influenced by various factors. Developing countries often have poor safety performance in their building sectors, with limited research in this area. This study aimed to identify essential safety program activities (SPAs) specific to the building sector. Through a literature review and survey, 25 SPAs were identified and validated via a pilot survey involving building sector experts. A questionnaire survey was conducted with 105 participants from the construction industry and academia. They were then categorized into four interconnected measurements using Exploratory Factor Analysis (EFA): Safety Program Management and Development (SPMD), Safety Culture Development (SCD), Safety Risk and Hazard Management (SRHM), and Safety Leadership, Responsibility, and Commitment (SLRC). The impact of safety implementation (SI) on overall project success (OPS) was analyzed using Partial Least Square- Structural Equation Modelling (PLS-SEM). Subsequently, Synthetic Fuzzy Evaluation (SFE) was employed to determine the criticality and importance of each SPA grouping for construction projects. The PLS-SEM analysis indicates that SI has a moderate impact on OPS, with an R2 value of 45.4%. Moreover, the findings of the SFE highlight that the SLRC group is the most significant in enhancing the safety implementation of the construction industry.

This study examines stress biomarkers over the process of teaching and their associations with demographics, emotions, and mental health of 56 English as Foreign Language teachers. Participating teachers were invited to complete a questionnaire packet and provide saliva samples over three-time points (i.e., before, during, and end of teaching). Afterward, the saliva samples were assayed for cortisol and [alpha]-amylase as stress biomarkers. The results showed a significant change in the concentrations of cortisol and [alpha]-amylase over the teaching process. In addition, being female, younger, more educated, and having more teaching experience were significantly associated with a higher level of [alpha]-amylase, particularly before and during class time, thereby reflecting a greater level of stress. However, emotions and general mental health were not significantly associated with cortisol and [alpha]-amylase over time. The findings highlighted the changes of biomarkers over the process of teaching and their relationships with other variables.

Purpose: When exact information regarding the treatment head and initial electron beam is available, the Monte Carlo (MC) approach can properly simulate any linear accelerator. However, manufacturers seldom offer information such as the incident electron beam’s energy, radial intensity (spot size), or angular spread. This research aims to forecast these features and verify an MC-simulated linear accelerator model using measurements. Materials and Methods: The BEAMnrc code simulated a 6 MV photon beam from a Radixact™ Tomotherapy Linac. Percentage depth dose and beam profile calculations were conducted using DOSYXZnrc by various electron energies and spot sizes and compared to measurements using a Gamma index with two distinct criterion sets. Furthermore, the fine-tuned electron energy and spot size profiles were created to minimize any disparities using distinct angle spreads. Finally, the output factors (OFs) for various field sizes were compared. Results: The MC model’s fine-tuned electron energy was determined to be 5.8 MeV, with 88.6% of the calculation points passing the 1%/1 mm γ test. A circular radial intensity of 1.4 mm best represented the 6 MV photon beam regarding spot size. Furthermore, a mean angular spread of 0.05 reduced the disparity in cross-field profile between computation and measurement. The most considerable disparities between the MC model OFs and observations were 1.5%. Conclusion: Using the BEAMnrc code, a reliable MC model of the Radixact™ Tomotherapy Linac can be created, as shown in this paper. This model can be used to compute dose distributions with confidence.

Abstract Nuclear receptors (NRs) function as crucial transcription factors in orchestrating essential functions within the realms of development, host defense, and homeostasis of body. NRs have garnered increased attention due to their potential as therapeutic targets, with drugs directed at NRs demonstrating significant efficacy in impeding chronic disease progression. Consequently, these pharmacological agents hold promise for the treatment and management of various diseases. Accumulating evidence emphasizes the regulatory role of exosome-derived microRNAs (miRNAs) in chronic inflammation, disease progression, and therapy resistance, primarily by modulating transcription factors, particularly NRs. By exploiting inflammatory pathways such as protein kinase B (Akt)/mammalian target of rapamycin (mTOR), nuclear factor kappa-B (NF-κB), signal transducer and activator of transcription 3 (STAT3), and Wnt/β-catenin signaling, exosomes and NRs play a pivotal role in the panorama of development, physiology, and pathology. The internalization of exosomes modulates NRs and initiates diverse autocrine or paracrine signaling cascades, influencing various processes in recipient cells such as survival, proliferation, differentiation, metabolism, and cellular defense mechanisms. This comprehensive review meticulously examines the involvement of exosome-mediated NR regulation in the pathogenesis of chronic ailments, including atherosclerosis, cancer, diabetes, liver diseases, and respiratory conditions. Additionally, it elucidates the molecular intricacies of exosome-mediated communication between host and recipient cells via NRs, leading to immunomodulation. Furthermore, it outlines the implications of exosome-modulated NR pathways in the prophylaxis of chronic inflammation, delineates current limitations, and provides insights into future perspectives. This review also presents existing evidence on the role of exosomes and their components in the emergence of therapeutic resistance.

Abstract Background The importance of high-resolution computed tomography (HRCT) in the diagnosis of idiopathic interstitial pneumonia (IIP) is being recognized more and more. Pulmonary arterial hypertension is common in patients with idiopathic pulmonary fibrosis, the presence of PAH is linked to higher mortality rates and might explain why some people who otherwise have normal pulmonary function are displaying symptoms of deterioration. The aim of this work was to find out the potency of integration of high-resolution computed tomography (HRCT) scoring system with pulmonary artery systolic pressure (PASP) for ascertaining the disease severity of patients with idiopathic pulmonary fibrosis and to predict the prognosis for proper management, along with incorporation of the key disparity of different HRCT scoring systems for the ILD. Results This prospective study included 80 patients, who came with idiopathic pulmonary fibrosis. A strong positive correlation (r = 0.989) was noted between total lung zone HRCT score and PASP, pulmonary artery size, grades of dyspnea and PCO2. Nonetheless, total lung zone HRCT score proved to have good correlation and inversely proportional to (r = − 0.71) 6MWT, PO2, SPO2, FVC and FEV1/FVC. We utilized a ROC curve to identify the optimal cutoff value in HRCT scoring systems, for detecting pulmonary hypertension associated with the IPF. The sensitivity and specificity of Warrick score cutoff value was higher compared to that of the HRCT scoring system-based grading scale. Both HRCT scoring systems attained high correlation coefficient factors with various incorporated parameters in the study. Conclusion We can safely say that in order to reveal the severity and prognosis of idiopathic pulmonary fibrosis, a high-resolution computed tomography scoring system should be incorporated with echocardiography measurement of pulmonary artery systolic pressure —which proved to be the most potent predictive factor; especially when measured after a specific HRCT score cutoff value—followed by (FEV1/FVC), the 6MWT and the severity of dyspnea. Their integration collectively will aid in precise management and follow-up of IPF cases. Both HRCT scoring systems proved to be potent and perfect for short-term interval follow-up, yet the Warrick score was easier and faster to use and attained relatively increased sensitivity and specificity for the cutoff value of the pulmonary hypertension detection compared to the HRCT scoring system-based grading scale.

Objective: In this research, by comparing the features of the Qur'anic manuscripts of the Herat method in the Timurid and Safavid periods, it was seeking to identify the prescription pillars of these Qurans, and based on that, it identified other Qurans whose authorship and artistic style were unknown.Methodology: This research has been carried out in terms of developmental goal and descriptive and analytical method with purposive sampling from among 21000 Quranic manuscripts available in the manuscripts’ treasure of Astan Quds Razavi Library, which is the statistical population of this research. Due to the lack of access to the original sources, the information gathering tool is the library catalogs and the information checklist obtained from the objective Qurans, which is based on the analysis of the bibliographic information of the reference and precious the Qurans of this course.Findings: Based on the characteristics of the scribe's promotion and the bibliographic information of the library catalog from the Timurid period, Quranic booklet 416 and Mushaf No. 153 and from the Safavid period Mushaf No. 281, 206 and 210 from the Herat method were identified as reference and Musahafs. Their bibliographic information was analyzed in a comparative manner and finally it was determined that among all the features and pillars of bibliographic science, four features of the decorations of the Fatiha al-Kitab tablet, the script of the surahs, the decorations accompanying the text of the Quran and the composition of motifs from are the most important features that can be used to identify the Qur'anic manuscripts of this method of art in the researched periods.Conclusion: By studying the findings of the research, it was found that it is possible to identify the Masahifs of the Herat method based on the elements of epistemology. The results of this research determined that: 1) the design of the Fatih al-Kitab surah, these decorations took up more space on the page in the Safavid period, and the margin of the tablet is two-part wide with an azure background and narrow with a black background, and a half-orange is drawn on the margin and the beginning of the surah is in Rafa's script. In the Timurid period, an azure part and a nim- toranj motif are not drawn on the border, and the head of the surah is decorated with Kufic script. 2) The decorations accompanying the Qur'an text, khoms va ‘ashar in the Timurid period are in the form of an almond and a circle, respectively, while in the Safavid period it is in the form of a circle. 3) The composition of motifs, in the Timurid period, is dominated by Islamic motifs and Roman motifs, but in the Safavid period, alvan Khatai motifs were drawn.