Search

Abstract Background Anaplastic large-cell lymphoma primarily involving the omentum is an extremely rare entity with variable clinical presentation. Owing to its rarity and nonspecific clinical manifestation, omental T-cell lymphoma is often diagnosed at a later stage, riddled with complications. While imaging modalities such as computed tomography scan can help a physician reach a diagnosis, cases that present with complications may require a multidisciplinary approach that combines surgical exploration along with consultation from Oncology. Case presentation We hereby report a rare case of a 66-year-old African American male patient who presented to the emergency department with complaints of acute gastrointestinal obstruction. A computed tomography scan of the abdomen and pelvis revealed evidence of an internal hernia and surgical exploration revealed a hemorrhagic and infarcted omentum. Biopsies along with immunophenotypic studies confirmed the diagnosis of anaplastic T-cell lymphoma of the omentum complicated by Massilia timonae infection. Conclusion The case highlights the significance of considering lymphoma, although rare, as a differential in a patient who presents with small bowel obstruction and the importance of investigating for malignancy for early diagnosis and treatment of primary omental lymphomas, before complications develop.

The current study examines the flow characteristics under free flow conditions over a crump weir. The impact of the side slopes of the weir on the coefficient of discharge (Cd) is taken into account. Four physical models with crest heights of 0.15 m under free flow circumstances and four upstream side slope (1:3, 1:2.5, 1:2 and 1:1.5) were used to investigate the impact of various variables on discharge coefficient (Cd). Using the dimensional analysis technique, the elements influencing the crump weir's discharge coefficient were determined based on laboratory tests. For the same flow rate, Cd value decrease by decreasing upstream side slope. It notices that a decrease in upstream slope (from 1:3 to 1:2.5) reducing Cd value about (2.61 %), decrease upstream slope from (1:3 to 1:2) reducing Cd value about (4.16 %) and when decrease upstream slope from (1:3 to 1:1.5) reducing Cd value about (5.81 %).

Abstract Background It is challenging to predict long-term outcomes of interventions without understanding how they work. Health economic models of public health interventions often do not incorporate the many determinants of individual and population behaviours that influence long term effectiveness. The aim of this paper is to draw on psychology, sociology, behavioural economics, complexity science and health economics to: (a) develop a toolbox of methods for incorporating the influences on behaviour into public health economic models (PHEM-B); and (b) set out a research agenda for health economic modellers and behavioural/ social scientists to further advance methods to better inform public health policy decisions. Methods A core multidisciplinary group developed a preliminary toolbox from a published review of the literature and tested this conceptually using a case study of a diabetes prevention simulation. The core group was augmented by a much wider group that covered a broader range of multidisciplinary expertise. We used a consensus method to gain agreement of the PHEM-B toolbox. This included a one-day workshop and subsequent reviews of the toolbox. Results The PHEM-B toolbox sets out 12 methods which can be used in different combinations to incorporate influences on behaviours into public health economic models: collaborations between modellers and behavioural scientists, literature reviewing, application of the Behaviour Change Intervention Ontology, systems mapping, agent-based modelling, differential equation modelling, social network analysis, geographical information systems, discrete event simulation, theory-informed statistical and econometric analyses, expert elicitation, and qualitative research/process tracing. For each method, we provide a description with key references, an expert consensus on the circumstances when they could be used, and the resources required. Conclusions This is the first attempt to rigorously and coherently propose methods to incorporate the influences on behaviour into health economic models of public health interventions. It may not always be feasible or necessary to model the influences on behaviour explicitly, but it is essential to develop an understanding of the key influences. Changing behaviour and maintaining that behaviour change could have different influences; thus, there could be benefits in modelling these separately. Future research is needed to develop, collaboratively with behavioural scientists, a suite of more robust health economic models of health-related behaviours, reported transparently, including coding, which would allow model reuse and adaptation.

OBJECTIVE: To investigate the hepatoprotective effects of Unacylated Ghrelin (UAG) at varying doses in the management of acute liver injury in Wistar albino rats. METHODS: This quasi-experimental study was conducted at Department of Physiology, Isra University, Hyderabad, Pakistan from March to August 2023. Thirty Wistar albino rats (200-250 grams) were randomly divided into five groups (n=6). Group A served as the control, while liver injury was induced in Groups B, C, D, and E via intraperitoneal injection of 0.1% CCl₄. Groups C, D, and E were subsequently treated with low, medium, and high doses of UAG, respectively. Serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), malondialdehyde, interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), and superoxide dismutase (SOD) levels were assessed, along with liver histopathology. RESULTS: Pre-experimental body weights (Mean±SD) for groups A, B, C, D, and E were 227.33±7.75 g, 229.80±2.08 g, 228.70±5.34 g, 231.33±8.69 g, and 236.38±10.63 g, respectively. The liver index was 4.36±0.28, 6.65±0.37, 5.80±0.17, 5.70±0.08, and 5.06±0.23, respectively, across the groups. A statistically significant (p

Abstract Introduction and importance Choledochal cysts are congenital conditions that affect the biliary tree, typically identified during childhood. These cysts present as dilations in the biliary system, occurring either in the extrahepatic or intrahepatic regions or in some cases, in both areas. Occasionally, it may have associated chronic pancreatitis posing a challenge to the management of both conditions. In the case reported, a female child was diagnosed with a choledochal cyst along with chronic pancreatitis. She had an excision of cyst and lateral pancreaticojejunostomy simultaneously for both conditions resulting in favorable outcomes. Case presentation An 8-year-old child visited the clinic with a complaint of upper abdominal pain accompanied by intermittent vomiting. An ultrasound was performed which showed a dilated common bile duct. To confirm the diagnosis, an MRCP and baseline labs including liver function tests were ordered. The findings were suggestive of a type IA choledochal cyst with concomitant chronic pancreatitis. Subsequently, she had choledochal cyst excision with Roux-en-Y hepaticojejunostomy reconstruction plus lateral pancreaticojejunostomy using the classical Puestow’s technique. The patient’s recovery post-surgery was uneventful, resulting in discharge on the fifth post-operative day for routine outpatient follow-up. Clinical discussion Patients afflicted with choledochal cysts are prone to recurrent pancreatitis, though the precise underlying mechanism is unknown. Certain studies propose an association between abnormal pancreatico-biliary junction and recurrent pancreatitis, often defined as a common channel surpassing 15 mm in length. However, this aberration could not be definitively established in the current case. Diagnosis of choledochal cysts can be confirmed through either ERCP or MRCP, with the latter preferred due to its non-invasive nature. The optimal management strategy for choledochal cysts necessitates cyst resection and Roux-en-Y hepaticojejunostomy reconstruction Moreover, in cases associated with chronic pancreatitis, longitudinal pancreatojejunostomy may be undertaken. Conclusion Thus, it is concluded that although rare choledochal cysts may have associated chronic pancreatitis. Surgical excision of the cyst and lateral pancreaticojejunostomy can be performed simultaneously resulting in favorable post-operative outcomes.

Background: Infertility affects married adults, and In Vitro Fertilization (IVF) is an Assisted Reproductive Technology (ART) that can treat it. Women undergoing IVF are more likely to experience depression. There is a need to reduce depression by supporting and advising sufferers. The aim of this study is to evaluate the effect of depression on pregnancy rates among infertile females underwent IVF treatment. Materials and Methods: This observational study analyzed 149 patients attending the infertility center at Kamal Al-Samaraie hospital seeking a chance of a conception. The participants received a traditional hospital protocol. The study assessed depression status using the CES-D (Center for Epidemiologic Studies Depression) scale at the beginning of the IVF cycle. Results: Conclusion: Our findings show that the pregnancy rate was not related to baseline depression of women underwent the first IVF procedure. .

Concrete 3D printing is a promising manufacturing technology for producing geometrically complex structures efficiently and cost-effectively, by eliminating the need for formwork, reducing labor, and minimizing waste. This method has the potential to lower carbon emissions and resource use. However, it does not mitigate the carbon emissions associated with cement production. Nonetheless, utilizing waste materials in concrete 3D printing may reduce concrete carbon emissions and support recycling. This study investigates the use of two industrial waste materials–fly ash (FA) and ground waste glass (GWG)–as partial substitutes for ordinary Portland Cement (PC) in 3D printable cement paste. The chemical composition, particle size distribution, rheological properties, and flexural strength of the mixtures were analyzed. Results show that specimens containing waste materials achieved strengths comparable to traditional cement mixtures. The flexural strength reduction in 3D printed versus cast specimens varied across mixtures: control (66% reduction), FA20 (35%), FA10-GWG10 (35%), GWG10 (32%), FA10 (11%), and GWG20 (4%). Hence, incorporating waste materials in concrete 3D printing is recommended, as it maintains mechanical integrity while promoting recycling and upcycling of industrial waste.

Background: This study aimed to examine the efficacy of methylene blue (MB) and toluidine blue O (TBO) photodynamic therapy (PDT) as adjuncts to root surface debridement (RSD). Methods: This split-mouth, randomized, controlled clinical trial included eighteen patients, and a total of 332 sites (control = 102, MB = 124 and TBO = 106) were examined. Two sessions of PDT were completed at baseline and two weeks after RSD. Clinical parameters of bleeding on probing (BOP), plaque index (PI), probing pocket depth (PPD), and clinical attachment level (CAL) were measured pre- and post-treatment. Results: PPD and BOP reductions in sites treated by RSD with adjunctive photosensitizers (MB and TBO) were significantly higher than in control sites. RSD with MB showed higher efficacy in improving moderately deep pockets (OR 3.350), while adjunctive TBO showed better results in treating deeper pockets (OR 4.643). Conclusions: Results suggested that adjunctive use of MB and TBO to RSD could significantly improve periodontal pocket closure and reduce signs of inflammation. In addition, TBO seems to be more efficient in treating deep periodontal pockets than MB, which is more effective in resolving shallower pockets.

Abstract Major depressive disorder (MDD) is accompanied by activated neuro-immune pathways, increased physiosomatic and chronic fatigue-fibromyalgia (FF) symptoms. The most severe MDD phenotype, namely major dysmood disorder (MDMD), is associated with adverse childhood experiences (ACEs) and negative life events (NLEs) which induce cytokines/chemokines/growth factors. To delineate the impact of ACE + NLEs on physiosomatic and FF symptoms in first episode (FE)-MDMD, and examine whether these effects are mediated by immune profiles. ACEs, NLEs, physiosomatic and FF symptoms, and 48 cytokines/chemokines/growth factors were measured in 64 FE-MDMD patients and 32 normal controls. Physiosomatic, FF and gastro-intestinal symptoms belong to the same factor as depression, anxiety, melancholia, and insomnia. The first factor extracted from these seven domains is labeled the physio-affective phenome of depression. A part (59.0%) of the variance in physiosomatic symptoms is explained by the independent effects of interleukin (IL)-16 and IL-8 (positively), CCL3 and IL-1 receptor antagonist (inversely correlated). A part (46.5%) of the variance in physiosomatic (59.0%) symptoms is explained by the independent effects of interleukin (IL)-16, TNF-related apoptosis-inducing ligand (TRAIL) (positively) and combined activities of negative immunoregulatory cytokines (inversely associated). Partial least squares analysis shows that ACE + NLEs exert a substantial influence on the physio-affective phenome which are partly mediated by an immune network composed of interleukin-16, CCL27, TRAIL, macrophage-colony stimulating factor, and stem cell growth factor. The physiosomatic and FF symptoms of FE-MDMD are partly caused by immune-associated neurotoxicity due to T helper (Th)-1 polarization and M1 macrophage activation and relative lowered compensatory immunoregulatory protection.

Objective: To determine the sensitivity, specificity, and diagnostic accuracy of the Sequential Organ Failure Assessment score in predicting one-month mortality in patients requiring critical care. Study Design: Cross-sectional validation study. Place and Duration of Study: Department of Surgery, Combined Military Hospital, Rawalpindi, Pakistan Apr to Oct 2020. Methodology: This study was conducted on 173 patients requiring intensive care. All patients aged between 20 and 70 years diagnosed with disorders secondary to traumatic causes or otherwise who were admitted for critical care were included. Patients were assessed at the time of admission to the intensive care unit, and their Sequential Organ Failure Assessment scores were calculated. A cut-off level of ≥7 was considered to be a high risk for mortality within thirty days of admission. All patients were followed up for thirty days for the mortality. Results: Mean age of our patients was 43.04±11.26 years, of whom 109(60.6%) patients were male. A SOFA score of ≥7 in predicting the mortality within thirty days of admission for critical care carried a sensitivity of 31.40%, a specificity of 25.53%, a positive predictive value of 27.84%, a negative predictive value of 28.92% and a diagnostic accuracy of 28.33%. Conclusion: The Sequential Organ Failure Assessment score lacks the diagnostic accuracy to precisely predict the mortality in critically ill patients within thirty days of developing the requirement for critical care.

BackgroundOver the last decade, there has been an increase in the evidence base supporting the efficacy of video consultations (VCs) in mental health services. Furthermore, the potential of VC treatment was also demonstrated during the COVID-19 pandemic. Despite these promising results and conducive conditions for VCs, several studies have highlighted that the uptake and implementation of VCs continues to be slow, even after the pandemic. To facilitate and strengthen the implementation of VCs and exploit their potential as a useful tool for mental health disorder treatment, there is a need for a deeper understanding of the issues and experiences of implementing and using VCs as a treatment modality in clinical practice. ObjectiveThe aim of this study was to investigate patients’ and clinicians’ experiences and attitudes toward using VCs in clinical practice. MethodsTreatment was conducted through the VC modality. Semistructured interviews were conducted individually with patients (n=10) and focus group interview were conducted with clinicians (n=4). Patients had participated in weekly VC treatment over 2 months as part of mental health outpatient services in Denmark. Data from these interviews were analyzed using thematic analysis. ResultsThematic analysis of the patient interviews yielded two main themes: (1) adjusting to the practicalities of the VC format and (2) the practice of therapy using VCs. Patients experienced that using VCs was easy and convenient, and it was possible to establish and maintain a therapeutic alliance. They also described the contact as different to in-person therapy. The thematic analysis conducted on clinicians’ experiences of using VCs yielded three themes: (1) a shift in mindset from resistance to acceptance, (2) the contact is different when using the VC modality, and (3) adapting to a new way of working. Clinicians experienced that their initial concerns and resistance toward VC implementation gradually diminished over time as they gained clinical experience of using the modality. They expressed that contact with patients can be different when using the VC modality and that it took time to adjust to a new way of working therapeutically. ConclusionsBoth patients and clinicians experienced that VCs could enhance access to treatment and be meaningfully integrated into clinical practice. In addition, both groups described the contact when using the VC modality as being different to in-person therapy. Future research could examine patients’ and clinicians’ perceived differences regarding contact when using the VC modality and the implications for therapeutic interventions.

This study reports the comparative evaluation of yield, physico-chemical composition and biological attributes (antioxidant activity, antimicrobial activity, biofilm inhibition and hemolytic activity) of peppermint (Mentha piperita L.) essential oil (EO) obtained by hydro-distillation (HD) and supercritical fluid (CO2) extraction (SCFE) methods. The yield (%) of EO obtained by HD (0.20 %) was significantly (p

Post-combustion carbon capture (PCC) technique has been extensively investigated over the past two decades to mitigate the effects of greenhouse gas (GHG) emissions. Nowadays, integrating solar energy with a PCC retrofit has become an active area of research due to its potential to slash the energy penalty on power plants. The economic aspects of both solar-assisted PCC (SA-PCC) and solar-powered PCC (SP-PCC) counterparts have already been studied in literature. Therefore, this paper aims at analysing and comparing the environmental footprints of SA-PCC and SP-PCC systems throughout their life cycle using the ReCiPe 2016 method. A cradle-to-grave framework is employed to specify the life cycle inventories in OpenLCA software for capturing one carbon capture unit (tonne of CO2) over the project’s lifespan. Results showed that SP-PCC significantly reduces environmental burdens (>10%) in various midpoint categories compared to SA-PCC counterpart. Furthermore, the endpoint assessment of SA-PCC revealed that particulate matter formation, global warming, land use, and mineral scarcity have substantial damaging impacts on the endpoint areas of protection, accounting for 37.29%, 49.48%, 76.18%, and 13.49% of the total impact, respectively. As a result, they are classified as critical impact categories that should receive priority attention for improvements. Further categorization of critical categories showed that the key difference between the examined systems lies in the contributions of nitrate salts and mono-ethanolamine (MEA) production. Furthermore, MEA contributions in SP-PCC are considerably lower than those of nitrate salts in SA-PCC across the critical categories. This demonstrates the superiority of SP-PCC over the SA-PCC in mitigating the environmental burdens when incorporating solar energy in carbon capture process

Abstract Background Anaplasma ovis (A. ovis) is the predominant causative agent of anaplasmosis in goats and sheep in most tropical and subtropical regions of the world. However, there is considerable variation in reported infection rates, breed susceptibility, and controversial findings regarding the haemolytic effects of A. ovis infection in goats. Objectives Thus, we investigated the molecular and haematological aspects of A. ovis infection in goats from Ahvaz city. Methods One hundred and fifty apparently healthy goats (74 blacks and 76 Najdi goats) were randomly sampled from six flocks in the Ahvaz suburb during ticks’ activity season. Haematological evaluation, smear microscopic (SM) examination and PCR assay were performed to assess A. ovis infection. Additionally, the percentage of parasitemia was determined from blood smears. Results SM examination revealed that 25.7% of the goats displayed erythrocyte Anaplasma‐like inclusion bodies. PCR analysis indicated that 54% of the goats were positive for A. ovis infection (44.6% of blacks and 63.2% of Najdi goats). No significant difference in haematological values was observed between healthy and infected goats based on PCR testing. However, a significant difference in haematological indices was observed between the group with parasitemia level of 0.01–0.02% (SM and PCR positive) compared to the healthy goats (SM and PCR negative), particularly concerning Hb, PCV and RBC count (p < 0.01). Conclusions When the parasitemia exceeds 0.01%, A. ovis infection may disrupt haematological parameters in infected goats. The high prevalence of A. ovis infection (54%) among the studied goats underscores the importance of giving special attention to implementing necessary measures for disease control in the Ahvaz suburb.

Writing as a productive skill is extremely challenging for EFL students. To promote their writing effectiveness, students' intrinsic motivation must be enhanced by allowing them to self-assign writing topics or write about topics of interest. Therefore, this study describes how EFL students become motivated by self-assigning their writing topics and identifies students' attitudes and writing skills in topic-based interest in the EFL writing context. A descriptive–diagnostic method was applied to achieve the study objectives. A sample of 200 EFL students responded to a closed-item questionnaire on intrinsic motivation based on topic-based interest in writing. In addition, 20 students participated in semi-structured interviews on their attitudes toward topic-based interest. The study sample showed a high level of intrinsic motivation based on their self-assignment of writing topics. Furthermore, female students showed higher intrinsic motivation if they could self-assign their writing topics than male students. In addition, students with higher GPAs exhibited higher intrinsic motivation. Moreover, the interviews revealed that intrinsically motivated students most enhanced their writing skills in ideas, vocabulary, and choice of words. The researchers suggest that students' self-assignment of writing topics be considered in teaching writing as it contributes to improving intrinsic motivation.

Predicting the operating temperature of lithium-ion battery during different cycles is important when it comes to the safety and efficiency of electric vehicles. In this regard, it is vital to adopt a suitable modeling approach to analyze the thermal performance of a battery. In this paper, the temperature of lithium-ion NMC pouch battery has been investigated. A new formulation of lumped model based on the thermal resistance network is proposed. Unlike previous models that treated the battery as a single entity, the proposed model introduces a more detailed analysis by incorporating thermal interactions between individual cells and tabs within a single cell scenario, while also considering interactions between cells and insulators or gaps, located between the cells, within the module case. This enhancement allows for the precise prediction of temperature variations across different cells implemented within the battery module. In order to evaluate the accuracy of the prediction, a three-dimensional finite element model was adopted as a reference. The study was performed first on a single cell, then on modules composed of several cells connected in series, during different operating conditions. A comprehensive comparison between both models was conducted. The analysis focused on two main aspects, the accuracy of temperature predictions and the computational time required. Notably, the developed lumped model showed a significant capability to estimate cell temperatures within the modules. The thermal results revealed close agreement with the values predicted by the finite element model, while needing significantly lower computational time. For instance, while the finite element model took almost 21 h to predict the battery temperature during consecutive charge/discharge cycles of a 10-cell module, the developed lumped model predicted the temperature within seconds, with a maximum difference of 0.42 °C.

The fact that English teachers encounter challenges while employing student-centered pedagogy and assessment practices is beyond argument. Empirical evidence indicates that, particularly in the context of Najran University, relatively little attention has been paid to researching the issue and offering solutions to coping with it. Consequently, this study examined English as a foreign language (EFL) teachers' employment of student-centered pedagogy and assessment practices in the Saudi EFL context concerning execution, challenges, and solutions. Also, it correlated the respondents' answers with their gender, experience, degree, and specialization. The descriptive survey design was used to achieve the study objectives. The study tools, a questionnaire and a semi-structured interview were applied to a convenient sample of (73) faculty members. The results showed that the study sample highly employs pedagogy and assessment practices focused on students. In addition, the demographic variables of gender, experience, degree, and specialization did not have any significant role in affecting the responses to employing pedagogy and assessment practices. Finally, the content analysis of the semi-structured interview revealed the challenges and solutions to employing pedagogy and assessment practices. In light of the current results, the researchers proposed recommendations and implications.

The sources of knowledge have diversified and increased due to the widespread use of the Internet and smartphones. However, this diversity requires learners to know how to deal with and obtain knowledge and the extent of their credibility and usefulness. Subsequently, they must learn language learning strategies, including Memory Strategies (MSs) and Cognitive Strategies (CSs). This study scrutinizes the employment of reading MSs and CSs mediated by selected applications and tools of Internet-Connected Smartphones (ICSs) among Saudi undergraduates in an English as a Foreign Language (EFL) reading context. The study followed a quasiexperimental research design with two groups. The data was collected through a questionnaire and an achievement test. While the control group used the traditional methods of learning, the experimental group utilized their ICSs to employ reading MSs and CSs in the online learning mode after they received the necessary training. The study showed that students improved their performance in Reading Comprehension (RC) and use of reading MSs and CSs compared to their peers in the control group. The researcher recommends conducting workshops to train students on effectively employing MSs and CSs through ICSs to learn EFL reading skills.

Pedagogy and assessment practices have always been the two pertinent domains of the EFL world, and there is a voice, which supports swapping the attention from teacher-centered to student-centered. Studies are available to research the two practices separately but researching them, with the view that they complement each other, as an integrated approach seems to be very limited, especially in Najran University context. Therefore, this study aims to explore learners' perceptions of teachers' employment for the practices focused on student-centered pedagogy and assessment in the EFL classroom. In addition, it correlates the participants' responses with their gender and specialization. The survey-descriptive approach was used to achieve the study objectives. The study tools, a questionnaire and a semi-structured interview were applied to a stratified sample of 200 participants. The results show that the study sample medially perceived the teacher's employment of pedagogy practices focused on students. The assessment practices focused on students were highly perceived by the respondents. Moreover, the variables of gender and specialization did not have any influence on the respondents' answers to the questionnaire. Finally, the content analysis of the semi-structured interview reveals that the majority of the interviewees approved that student-centered pedagogy and assessment practices play a positive role in improving their classroom efficacy. In light of the current results, recommendations and implications are suggested.