Search

Introduction: Clinical trials are essential to the advancement of clinical therapies that improve the outcomes of people with cancer. However, enrollment in clinical trials remains a challenge. The Clinical Trial Navigator [CTN] Program was designed to address the current gap in the cancer care journey by assisting with the clinical trials search process. Methods: Between March 2019 and July 2024, applicants of the CTN program included people with cancer, their family members, and/or their care team. Applicants entered the CTN program through a REDCap® survey that collected the patient’s medical history. A final curated list of potential clinical trials was provided to the applicant. Metrics of success included clinical trial referral and enrollment, and we examined the factors that impacted these outcomes. Results: A total of 445 people with cancer applied to the CTN program during the study. Of the 262 patients with referral and enrollment information, a trial referral occurred in 27.5% [n = 72]. Of the 72 patients who were referred to a clinical trial, 13 [18.1%] were enrolled, 9 [12.5%] are pending enrollment, and 50 [69.4%] were not enrolled. We identified a potential trial for 88% of applicants, with a median of one potential trial per patient. Physicians were highly involved as applicants. Interpretation: The CTN program is successful in searching for clinical trials for people with cancer. Ongoing implementation into other Canadian sites, assessments of patient-reported outcomes, website and social media campaigns, and research into the factors that impact referral and enrollment are underway.

Abstract Quinazolinones, particularly 9-azaglycophymines, and closely related derivatives and precursors were tested in vitro against various breast cancer cell lines representing the major types of breast tumors. Among the 49 compounds tested, azaglycophymine derivative 19 with an electron-withdrawing substituent demonstrated the most significant anti-proliferative effects, with IC50 values of around 4 µM. Extensive cell-based investigations revealed that compound 19 induced caspase-dependent apoptosis in HCC1937 (human TNBC), BT-474 (human HER2+/HR+), and 4T1 (mouse TNBC) cells. In contrast, in MDA-MB-468 (human TNBC) and MCF-7 (human HR+) cells, the cell death was induced via a non-apoptotic pathway. The in vivo efficacy of compound 19 was validated using a syngeneic orthotopic 4T1 model in BALB/c mice, resulting in significant reduction of 4T1 breast tumor growth upon intraperitoneal (i.p.) application of doses of 5 or 20 mg/kg. These findings highlight the potential of compound 19 as a promising scaffold for the development of new therapeutic agents for various types of breast cancer and a first structure-activity insight.

Abstract Despite their low nutritional values, cereals are the raw materials used the most for developing different food products. This study aimed to enhance the nutrient content of finger millet flour by developing nutrient-rich flour blended from orange-fleshed sweet potato, finger millet, and soybean. The experiment was conducted to optimize the blending ratio of composite flours. Thirteen formulations of composite flours were generated using a mixture design with varying ratios of finger millet (45–55%), OFSP (30–40%), and soybean (10–20%). The composite flours' physical, functional, and nutritional properties were evaluated using standard protocols and the data were analyzed using Design Expert software version 13. The statistical analysis showed significant (P

Abstract This research explores the challenges posed by variations in cystic duct anatomy during laparoscopic cholecystectomy and the potential use of stapler devices to address such complexities. It aims to assess the safety and efficacy of stapler devices, particularly in cases involving short, and wide cystic duct. The study, conducted at King Abdulaziz Medical City in Riyadh, Saudi Arabia, between 2021 and 2023. The study design involved a retrospective cohort approach, and the sample size encompassed all cases meeting the inclusion criteria during the study period. Data was analyzed using SPSS program. The study involving 568 patients, with the predominant technique for ligation being clipping (89.3%). The primary indication for using the Endo GIA stapler was a wide cystic duct (6.2%). Analysis revealed a significant association between stapler device use and hypertension (p = 0.042), diabetes (p = 0.001), CKD (p = 0.011), and obstructive jaundice (p = 0.006). Multivariate regression demonstrated that older patients were 2.1 times more likely to use stapler devices (AOR = 2.125; p = 0.039), while those with obstructive jaundice had a 2.2 times higher likelihood (AOR = 2.168; p = 0.049). Throughout the years, metal clips have shown the best prognosis compared to any other method for securing the cystic duct during closure in laparoscopic cholecystectomy. However, to avoid incomplete sealing of wide, short, or inflamed ducts, other instruments have emerged as possible alternatives for such conditions. Use of Endo-GIA is a safe and effective method for patients with wide, short cystic duct. Selective usage of endo-GIA is considered cost effective and may add a positive impact in decreasing post operative biliary leak.

Abstract Background The undergraduate medical training programme is demanding and rigorous. This underlines the importance of a peer mentorship strategy to improve the well-being, self-determination, school connectedness, and performance of struggling medical and nursing students. This study is aimed at identifying struggling medical and nursing students using two cumulative continuous assessment test (CAT) scores, assess their subjective vitality and school engagement and evaluate the impact of the peer mentorship intervention on them. Methods The study will adopt a mixed-methods approach and will be conducted in the medical colleges of Nnamdi Azikiwe University, Awka, Nigeria, and the University of Rwanda. Three instruments will be used: The subjective Vitality Scale (SVS), the University Student Engagement Inventory (USEI), and the academic records of the students before and after the commencement of the intervention programme. The consenting least-performing medical and nursing students identified by their low CAT scores (below 45%) in basic medical sciences will be selected for study in each institution. The outcome measures will include students’ CAT scores, subjective vitality, and school engagement scores. The data will be analysed both quantitatively and qualitatively. Thematic content analysis will be adopted in the analysis of the responses generated from the focus group discussion. The mean ± standard deviation or median and interquartile range statistic will be adopted for the quantitative data. Discussion Given the paucity of data on struggling medical and nursing students in Nigeria and Rwanda, this research was designed to help in exploring evidence-based interventions to improve and prevent poor subjective well-being of struggling students. The study is expected to fill these knowledge gaps. Trial registration: Pan African Clinical Trial registry, PACTR202405546896613, registration date: 27th May, 2024. This proposal has been supported by grant 1R25TW011217 from the US National Institutes of Health (NIH)/Fogarty International Center (FIC) which also includes co-funds from the U.S. Department of State’s Office of the U.S. Global AIDS Coordinator and Health Diplomacy (S/GAC) and the President’s Emergency Plan for AIDS Relief (PEPFAR) to the African Forum for Research and Education in Health (AFREhealth). The Grant Principal Investigators are Profs. Nelson K.Sewankambo (contact PI), Prisca Adejumo, Jean Bisimwa Nachega, Fatima Suleman.

The genus Pistacia, with its species having notable ecological, economic, and medicinal implications, demonstrates remarkable environmental adaptability. The central objective of the study is to analyze interspecific variations between Pistacia atlantica subsp. atlantica and Pistacia terebinthus across three distinct bioclimatic zones in the Middle Atlas region of Morocco. The methodology includes collecting dendrometric measurements and conducting macromorphological examinations on these two taxa, with a detailed analysis of 27 qualitative and quantitative variables. A micro-morphological analysis of leaves, using scanning electron microscopy (SEM), is employed to explore specific features such as size and stomatal density, as well as qualitative aspects like epidermal cell shape and trichomes. Dendrometric measurements have revealed that the canopy surface and the number of trunks per tree can serve as distinctive features between the two species. Regarding the sex ratio of Pistacia atlantica subsp. atlantica, 59% of the examined trees are males, primarily associated with the jujube tree in arid zones and the dwarf palm in humid areas. In contrast, female Pistacia terebinthus exhibit a similar percentage, predominantly associated with oak groves and cade juniper in their distribution areas. Principal component analysis of biometric measurements emphasized a significant disparity between the two species, representing 60.25% of the total variance. The use of SEM unveiled new features facilitating the identification of the two species. By leveraging the macromorphological and micromorphological variability of pistachio trees, we can qualify those best suited to diverse bioclimates. In this regard, we suggest incorporating them into reforestation and rehabilitation programs aimed at restoring our declining ecosystems.

Abstract Moyamoya disease (MMD) is a chronic, rare cerebrovascular disorder of unknown cause featured by extensive narrowing of the terminal internal carotid artery (ICA) and its main branches. As a compensatory mechanism, perforators dilate forming fragile collateral vessels that appear as an abnormal vascular network resembling ‘puff of smoke drifting in the air’ observed via angiography around stenotic area in the brain. Patients and methods The database of the current hospital was retrospectively studied. All patients with ischemic strokes owing to MMD treated with surgical revascularization between January 2015 and December 2022 were included. MMD was identified on catheter-based digital subtraction angiography (DSA) by the presence of stenosis at the terminal portions of both internal carotid arteries and the development of abnormal collateral “moyamoya vessels” around the base of the brain. Clinical, radiological and follow-up data were retrospectively analyzed. Results During the mentioned time window, nine patients were diagnosed with moyamoya disease among all pediatric patients with established diagnosis of ischemic stroke in our institute; six of them underwent surgery. Unilateral EDMS was performed in 5 cases (83.3%), while one patient (16.67%) underwent staged bilateral surgeries with no added neurological deficit. Conclusion Indirect revascularization surgery for pediatric moyamoya-related stroke patients has high rates of reperfusion and promising outcomes.

Heavy Whipping Cream (HWC) is rich in saturated fats, but excessive consumption may pose cardiovascular risks. This study explores fortifying HWC with antioxidant-packed pecan and almond powders to improve its lipid composition. We enriched HWC with 10%, 20%, and 30% of these powders and stored the blends for 90 days. Acid and peroxide values were monitored every 30 days. Throughout storage, all variants exhibited increased acid values. Notably, the 30% pecan powder variant reached a 2.26% oleic acid level by day 90, significantly surpassing the control's 0.43% (p

Peptide-drug conjugates (PDCs) have recently gained significant attention for the targeted delivery of anticancer therapeutics, mainly due to their cost-effective and chemically defined production and lower antigenicity compared to ADCs, among other benefits. In this study, we designed and synthesized novel PDCs by conjugating new thiol-functionalized tubulysin analogs (tubugis) to bombesin, a peptide ligand with a relevant role in cancer research. Two tubulysin analogs bearing ready-for-conjugation thiol groups were prepared by an on-resin multicomponent peptide synthesis strategy and subsequently tested for their stand-alone in vitro anti-proliferative activity against human cancer cells, which resulted in IC50 values in the nanomolar range. In addition, various fluorescently labeled [K5]-bombesin(6–14) peptides, non-lipidated and lipidated with fatty acid chains of variable length, were also synthesized using the versatile multicomponent chemistry. These bombesin derivatives were tested for their gastrin-related peptide receptor (GRPR)-mediated internalization into cancer cells using flow cytometry, proving that the lipid tail (especially C14) enhances the cell internalization. Using the tubugi toxins and bombesin peptides, three different bombesin-tubugi conjugates were synthesized with different cleavage propensity and lipophilicity. Preliminary in vitro experiments revealed that, depending on the linker and the presence of a lipid tail, these novel PDCs possess good to potent anticancer activity and moderate selectivity for GRPR-overexpressing cancer cells.

تهدف الدراسةُ الحالية للكشف عن درجة تضمين كتب الفيزياء في المرحلة الثانوية في كلٍّ من قطر والأردن وفلسطين لعادات العقل، بالإضافة إلى المقارنة بين هذه الدول من حيث اشتمال الكتب على عادات العقل. لتحقيق أهداف الدراسة استخدم الباحثون أسلوب تحليل المحتوى؛ فبُنيت أداة تحليل المحتوى لرصد عادات العقل الخمس الرئيسة التي انبثقت عن مشروع (2061) التابع للجمعية الأمريكية لتقدم العلوم (American Association for the Advancement of Science: AAAS)، وهي: "القيم والاتجاهات"، و"الحساب والتقدير"، و"التحكم اليدوي والملاحظة"، و"مهارات الاتصال والتواصل"، و"مهارات الاستجابة الناقدة". تكوَّنت عينة الدراسة من كتب الفيزياء للصف الثاني الثانوي، المقررة من وزارات التربية والتعليم للفصل الدراسي الأول من العام الدراسي (2022-2023)، بالإضافة إلى كتاب الأنشطة المرافق لكتاب الثاني الثانوي في الأردن. أظهرت النتائج وجود ضعفٍ في تضمين كتب الثانوية العامة لعادات العقل، وأظهرت كذلك وجود تباين كبير في تضمين كتب العلوم لعادات العقل الرئيسة؛ فقد جاءت عادة العقل الرئيسة (التحكم اليدوي والملاحظة) في المرتبة الأولى وبتكرارات بلغت (281) تكرارا وبنسبة مئوية بلغت (48%) وبدرجة مرتفعة، لكن اللافت للنظر هو أن عادتَي العقل (القيم والاتجاهات) و(مهارات الاستجابة الناقدة) كانت نسبهما ضعيفة. أما على مستوى الدول، فقد جاءت عادة التحكم اليدوي والملاحظة في المرتبة الأولى في جميع الدول، وجاءت مهارة الاستجابة الناقدة في المرتبة الأخيرة. بناء على النتائج، توصي الدراسة الحالية بإجراء المزيد من الدراسات وتضمين عادات العقل في جميع كتب العلوم.

A zoonotic disease called brucellosis can cause flu-like symptoms and heart inflammation. The bacteria responsible for this disease can also enter the brain, causing a condition called neurobrucellosis that can result in long-term neurological problems. In this study, researchers aimed to determine the changes in the hippocampal cells of rats infected with Brucella. For the study, 24 adult male albino rats were inoculated with 1 × 106 CFU Brucella abortus 544. The rats were then deeply anesthetized, and their hippocampus samples were taken for stereological, histological, and molecular studies. The results showed that the infected rats had increased microgliosis and astrogliosis. Furthermore, a high level of caspase-3 in their hippocampal tissue indicated their susceptibility to apoptosis. Additionally, there was a decrease in expression of Ki67, which further supported this. Sholl's analysis confirmed a significant failure in glial morphology. The study demonstrated that the pathogen has the ability to destroy the hippocampus and potentially affect its normal physiology. However, more research is needed to clarify various aspects of neurobrucellosis.

Abstract This paper describes a novel 4-D hyperchaotic system with a high level of complexity. It can produce chaotic, hyperchaotic, periodic, and quasi-periodic behaviors by adjusting its parameters. The study showed that the new system experienced the famous dynamical property of multistability. It can exhibit different coexisting attractors for the same parameter values. Furthermore, by using Lyapunov exponents, bifurcation diagram, equilibrium points’ stability, dissipativity, and phase plots, the study was able to investigate the dynamical features of the proposed system. The mathematical model’s feasibility is proved by applying the corresponding electronic circuit using Multisim software. The study also reveals an interesting and special feature of the system’s offset boosting control. Therefore, the new 4D system is very desirable to use in Chaos-based applications due to its hyperchaotic behavior, multistability, offset boosting property, and easily implementable electronic circuit. Then, the study presents a voice encryption scheme that employs the characteristics of the proposed hyperchaotic system to encrypt a voice signal. The new encryption system is implemented on MATLAB (R2023) to simulate the research findings. Numerous tests are used to measure the efficiency of the developed encryption system against attacks, such as histogram analysis, percent residual deviation (PRD), signal-to-noise ratio (SNR), correlation coefficient (cc), key sensitivity, and NIST randomness test. The simulation findings show how effective our proposed encryption system is and how resilient it is to different cryptographic assaults.

The purpose of this prospective study was to investigate whether office hysteroscopy (OH) can be used to assess the mechanisms of action of progestogen-only contraceptives (POCs), diagnose possible local causes of abnormal uterine bleeding (AUB), and support the treatment plan of symptomatic patients using POCs compared with those who do not use hormones. The study included 140 women who were divided into two groups. Group A consisted of 70 women who used POCs, whereas group B consisted of 70 women who did not use hormones. They were successively examined using transvaginal ultrasonography (TVS), OH, and endometrial sampling. The TVS results were consistent with those of OH and histopathology. The changes in endometrial thickness and vasculature, as well as fallopian tube (FT) functions, were significantly more pronounced in POC users than in non-POC users. There was a significant reduction in the peristalsis of the proximal part of the FT, as well as a reduction in the bubble flow test in group A compared with group B. In addition, the combination of peristalsis and the bubble flow test (Darwishscope test) was significantly lower in group A. It was concluded that using OH as a simple diagnostic tool in women with POCs would contribute to a better understanding of the mechanisms of endometrial and FT effects and explain some local endometrial causes of AUB. This ensures that the combination of TVS and OH would limit routine endometrial sampling in POCs users.

Abstract The present power generation government companies focus on Renewable Power Sources (RPS) because their features are zero carbon footprint, unlimited power source, fewer greenhouse pollutants, fewer output wastages, plus creatinga very healthy atmosphere. In this work, the sunlight source is utilized for the Photovoltaic (PV) standalone network. The merits of sunlight sources are very optimal human resources needed, unlimited natural sources, plus easy operation. However, the solar power resource is nonlinear fashion. As a result, the operating point of the sunlight network fluctuates concerning sunlight intensity. So, in this article, the Modified Grey Wolf Methodology with Adaptive Fuzzy Logic Controller (MGWM-AFLC) is introduced to maintain the operating point of the sunlight system at the global power point position of the PV array. This controller traces the MPP with very low fluctuations in the PV-produced voltage. The advantages of this proposed method arefewer sensing devices required, less difficulty in development, more useful for rapid changes inthe sunlight temperatures, simpler to realize operation, greater economic growth, plus highly useful for household applications. The sunlight set-up generation voltage is lowwhich is improved by introducing the new Wide Power Rating High Voltage DC-DC Boost Converter (WPRHVBC). The features of this WPRHV converter are low voltage strain on semiconductor devices, few passive elements are enough to develop the circuit, plus easy understanding.

This study proposes a method based on Convolutional Neural Network (CNN) for automated detection of weed in color image format. The image is captured and transmitted to the Internet of Thing (IoT) server following an HTTP request made through the internet which is made available using the GSM based modem connection. The IoT Server save the image inside server drive and the results are displayed on the smartphone (Vision app). The results show that carrot and weed detection can be monitored accurately. The results of the study are expected to provide assistance to farmers in supporting smart farming technology in Indonesia.

ABSTRACT: Background: Low back pain (LBP) is a highly prevalent, disabling condition affecting millions of people. Patients with an identifiable anatomic pain generator and resulting neuropathic lower extremity symptoms often undergo spine surgery, but many patients lack identifiable and/or surgically corrective pathology. Nonoperative treatment options often fail to provide sustained relief. Spinal cord stimulation (SCS) is sometimes used to treat these patients, but the lack of level 1 evidence limits its widespread use and insurance coverage. The DISTINCT RCT study evaluates the efficacy of passive recharge burst SCS compared to conventional medical treatment (CMM) in alleviating chronic, refractory axial low back pain. Methods: This prospective, multicenter, randomized, study with an optional 6-month crossover involved patients who were not candidates for lumbar spine surgery. The primary and secondary endpoints evaluated improvements in low back pain intensity (NRS), back pain-related disability (ODI), pain catastrophizing (PCS), and healthcare utilization. Patients were randomized to SCS therapy or CMM at 30 US study sites. Results: The SCS arm reported an 85.3% NRS responder rate (≥ 50% reduction) compared to 6.2% (5/81) in the CMM arm. After the 6M primary endpoint, SCS patients elected to remain on assigned therapy and 66.2% (49/74) of CMM patients chose to trial SCS (crossover). At the 12M follow-up, SCS and crossover patients reported 78.6% and 71.4% NRS responder rates. Secondary outcomes indicated significant improvements in ODI, PCS, and reduced healthcare utilization. Six serious adverse events were reported and resolved without sequelae. Conclusion: DISTINCT chronic low back pain patients with no indication for corrective surgery experienced a significant and sustained response to burst SCS therapy for up to 12 months. CMM patients who crossed over to the SCS arm reported profound improvements after 6 months. This data advocates for a timely consideration of SCS therapy in patients unresponsive to conservative therapy.

We present particle-in-cell simulations with Monte Carlo collisions of fusion burn waves in compressed deuterium–tritium and proton–boron plasmas. We study the energy balance in the one-dimensional expansion of a hot-spot by simulating Coulomb collisions, fusion reactions, and bremsstrahlung emission with a Monte Carlo model and inverse bremsstrahlung absorption using a new PIC model. This allows us to self-consistently capture the alpha particle heating and radiative losses in the expanding hot-spot and surrounding cold fuel. After verifying our model in a code-to-code comparison with both kinetic and fluid codes for the case of a deuterium–tritium hot-spot, we simulate the expansion of a proton–boron hot-spot initialized at 200 keV and 1,000 g/cm3. Our model predicts that energy radiated by the hot-spot is recaptured by the surrounding high-density opaque fuel reducing the expansion work done by the propagating burn wave. As a result, we find the net fusion energy produced over the course of $20$∼ps is twice the initial hot-spot energy independent of whether radiation physics is included.

The ability of Geographic Information System (GIS) to organize, analyze, visualize and integrate spatial data has been at the top of its primary uses among professional industries. However, considering the extensive adoption of Information System (IS) throughout history for government organizations’ or citizens' disaster response, the implementation of geographical elements is still minimal. Previous GIS models and framework studies, particularly in developing countries, were affected by pandemic pressure, competitiveness pressure, change management, and security factors. Thus, this study aims to develop a model for the successful adoption of GIS using the Technology Acceptance Model (TAM), and De Lone and Mc Lean Information Success Model and analyze the applicability of the existing factors to enhance the performance of Public Sector Organizations (PSOs). From the study, a new conceptual framework was proposed to examine the effects of factors on GIS adoption that impact performance among PSOs from the perspective of Saudi Arabia. Quantitative methods were used to collect data through a questionnaire distributed to 350 respondents from PSO, and only 272 were found to be valid. Partial Least Square Structural Equation Modeling (PLS-SEM) validated the GIS model. The finding revealed that system quality, service quality, change management, competitiveness pressure, perceived ease of use, perceived usefulness, and security factors significantly and positively affected GIS adoption. The study also showed that GIS adoption substantially affected PSO performance. The proposed model provides insight into how GIS adoption can eventually enhance performance among PSOs. In essence, the study contributes to the running of PSO and the decisions taken by policymakers.

Background Cognitive dysfunction (CD) is highly prevalent in systemic lupus erythematosus (SLE), yet the underlying mechanisms are poorly understood. Neuroimaging utilising advanced MRI metrics may yield mechanistic insights. We conducted a systematic review of neuroimaging studies to investigate the relationship between structural and diffusion MRI metrics and CD in SLE.Methods We systematically searched several databases between January 2000 and October 2023 according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Retrospective and prospective studies were screened for search criteria keywords (including structural or diffusion MRI, cognitive function and SLE) to identify peer-reviewed articles reporting advanced structural MRI metrics and evaluating CD in human patients with SLE.Results Eighteen studies (8 structural MRI, 9 diffusion MRI and 1 with both modalities) were included; sample sizes ranged from 11 to 120 participants with SLE. Neurocognitive assessments and neuroimaging techniques, parameters and processing differed across articles. The most frequently affected cognitive domains were memory, psychomotor speed and attention; while abnormal structural and/or diffusion MRI metrics were found more consistently in the hippocampus, corpus callosum and frontal cortex of patients with SLE, with and without clinically diagnosed central nervous system involvement.Conclusion Advanced structural MRI analysis can identify total and regional brain abnormalities associated with CD in patients with SLE, with potential to enhance clinical assessment. Future collaborative, longitudinal studies of neuroimaging in SLE are needed to better characterise CD, with focus on harmonised neurocognitive assessments, neuroimaging acquisitions and postprocessing analyses and improved clinical characterisation of SLE cohorts.

Background: Human papillomavirus (HPV)-related multi phenotypic sinonasal carcinoma (HMSC) is a recently described tumor subtype with an unknown prognosis, often misdiagnosed with other sinonasal carcinomas, and associated with high-risk HPV (HR-HPV). The present study aimed to evaluate the expression of vascular endothelial growth factor (VEGF), Bcl-2-associated X protein (BAX), epidermal growth factor receptors (EGFR), ProEx™C, and human telomerase reverse transcriptase (hTERT) and assess their association with survival and clinicopathological characteristics.Methods: Between 2017 and 2022, 40 HMSC patients underwent surgical resection at the School of Medicine, Zagazig University Hospitals (Zagazig, Egypt). Tissue samples were examined for the presence of HR-HPV; absence of myeloblastosis (MYB), MYB proto-oncogene like 1 (MYBL1), and nuclear factor I/B (NFIB) fusions and the presence of myoepithelial proteins (calponin, S100, SMA), squamous differentiation markers (p63, p40, calponin), VEGF, BAX, ProEx™C, and hTERT by immunohistochemistry. All patients were followed up for about 54 months until death or the last known survival data. Data were analyzed using the Chi square test and Kaplan-Meier method.Results: The expression of VEGF, hTERT, and ProEx™C was significantly associated with age, advanced tumor stages, lymph node metastasis, tumor size, mortality, relapse, poor disease-free survival (DFS), and overall survival (OS) (P

Recently, there has been tremendous interest worldwide in the possibility of using chaos in communication systems. Many different chaos-based secure communication schemes have been proposed up until now. However, systems with strong chaoticity are more suitable for chaos-based secure communication. From the viewpoint of Lyapunov exponents, a chaotic system with a larger positive Lyapunov exponent is said to be more complex. This paper constructing a multistable chaotic system that can produce coexisting attractors is an attractive field of research due to its theoretical and practical usefulness. An innovative 3D dynamical system is presented in this research. It can display various coexisting attractors for the same values of parameters. The new system is more suitable for chaos-based applications than recently reported systems since it exhibits strong multistable chaotic behavior, as proved by its large positive Lyapunov exponent. Furthermore, the accuracy of the numerical calculation and the system's physical implementations are confirmed by analog circuit simulation. Finally, implementing the proposed voice encryption is done using a four-wing chaotic system based on the PRNG.

In this research, we propose an optimal choice for the non-negative constant in the Dai-Liao conjugate gradient formula based on the prominent Barzilai-Borwein approach by leveraging the nice features of the Frobenius matrix norm. The global convergence of the new modification is demonstrated using some basic assumptions. Numerical comparisons with similar algorithms show that the new approach is reliable in terms of the number of iterations, computing time, and function evaluations for unconstrained minimization, portfolio selection and image restoration problems.

Cost overruns represent a continuous challenge within the construction industry, frequently affecting the success of projects. This study explores the factors influencing cost during the construction phase in Saudi Arabia, utilizing data from a survey of 1076 engineers working in the Saudi construction industry. The results identify a number of cost-related factors, including inadequate project management, poor cost estimation, and design errors. Interestingly, some factors, such as currency exchange rate fluctuations and social and cultural influences, were found to have a limited impact on construction costs. Furthermore, the study highlights the role of experience and education level in shaping engineers’ perceptions of these cost factors. The study employs statistical analysis, including Pearson’s chi-squared test, to demonstrate associations between demographics, project characteristics, and cost-influencing factors. The findings suggest the need for refined project management practices, enhanced technical training, and the implementation of digital technologies such as Construction 4.0 to mitigate cost-related risks. This research provides significant insights for construction professionals and policymakers seeking to enhance cost management within the Saudi construction sector, thereby contributing to the ongoing development initiatives aligned with Saudi Arabia’s Vision 2030.

الأهداف: هدفت هذه الدّراسة إلى الكشف عن مستوى التفكير فوق المعرفي والمهارات الحياتية، كما هدفت لمعرفة القدرة التنبؤية لمستوى مهارات التفكير فوق المعرفي بالمهارات الحياتية لدى طلبة جامعة آل البيت بالأردن. المنهجية: استخدمت هذه الدّراسة المنهج الوصفي التنبؤي، ولجمع البيانات تمّ استخدام مقياس التفكير فوق المعرفي، ومقياس المهارات الحياتية بعد التأكد من خصائصهما السيكومترية، والذي تمّ بناؤهما من قبل الباحثين. تكونت عينة الدراسة من (105) فردًا من الطلبة والطالبات الدارسين لمساق تعليم التفكير في جامعة آل البيت، الذين تمّ اختيارهم بالطريقة القصدية. النتائج: أظهرت نتائج الدراسة وجود مستوى مرتفع في التفكير فوق المعرفي وأبعاده، ووجود مستوى مرتفع - أيضًا- في المهارات الحياتية وأبعادها. كما فسَّـر بُعد التخطيط والتنظيم في التفكير فوق المعرفي ما نسبته (5.1٪) من التباين المفسر للمهارات الحياتية. الخلاصة: أوصت الدراسة بضرورة استثمار مستوى التفكير فوق المعرفي والمهارات الحياتية لدى الطلبة للوصول إلى حالة من التكيف النفسي، والأكاديمي، والاجتماعي، وإدماجهم في نشاطات منهجية ونشاطات مرافقة للمناهج مصممة لهذا الغرض.

The fiber of the empty date fruit is one of the waste products left after the date fruit is harvested from the date palm. Optimization of the treatment parameters as well as the economics of the treatment process are critical to the successful commercialization of the treatment of natural fibers for the production of biocomposites. Of the natural fiber treatment methods described in previous work, hot water and alkali treatments are the most cost-effective, which justified the choice of these treatment methods in this work. Here, date empty fruit bunch fibers were pulverized to a particle size of 0–500 µm and then treated with boiling water at 100 °C for 3 h or with sodium hydroxide at different concentrations (2, 5, 10%) for 3 h at room temperature with constant stirring at 800 rpm. To confirm the effect of temperature on the fiber treatment, another fiber sample was treated at a 5% concentration of sodium hydroxide solution at an elevated temperature of 80 °C for the same period and stirring condition. The untreated and treated DEFB fibers were characterized by X-ray diffraction (XRD), Fourier transform infrared (FTIR), nuclear magnetic resonance (NMR), differential scanning calorimetry (DSC), X-ray fluorescence (XRF), and scanning electron microscopy (SEM). Chemical analysis of the fibers showed that DEFB fiber treated with 5% sodium hydroxide solution at room temperature had the highest cellulose content (52.0%), which was also confirmed by the XRD analysis. The DEFB fiber treated with boiling water exhibited higher thermal stability while the sodium hydroxide-treated fiber exhibited higher crystallinity index and cellulose content. Apparently, DEFB fiber treated with sodium hydroxide solution at 5% concentration for 3 h at room temperature for continuous stirring at 800 rpm offered the best properties. The treated fibers are expected to be viable reinforcement in the production of biocomposites with the goal of achieving energy efficiency. The developed materials could be used in industrial applications such as insulating building systems, automotive parts, and home furniture.

Typhoid fever remains a major public health concern, affecting over nine million individuals globally each year. Mathematical modeling approaches can provide valuable insights into typhoid transmission dynamics and inform preventive strategies. In this study, we developed a compartmental model incorporating key features of typhoid epidemiology and two crucial interventions: vaccination and sanitation practices. The model stratifies the population into susceptible, vaccinated, exposed, asymptomatic infected, symptomatic infected, and recovered compartments and tracks the bacterial load in the environment. We established a disease-free equilibrium and basic reproduction number R0. We also identified the endemic equilibrium and analyzed its existence. Numerical simulations demonstrated the critical impact of enhanced sanitation and vaccination in curtailing infections. Our model underscores the need for multifaceted control measures that encompass vaccine coverage, sanitation enforcement, and healthcare capacity building to mitigate typhoid in high-risk regions. This study provides a comprehensive framework to model the intricate transmission dynamics of typhoid fever, supporting informed public health policies and decision-making.

The demand for lightweight aircraft structures has shifted from traditional metals like aluminum to composite materials such as carbon fiber reinforced polymers (CFRP) to achieve weight reduction. However, this transition has led to decreased lightning strike protection efficiency due to the dielectric nature of CFRP. To address this problem, two CFRP samples—one unprotected and the other shielded with carbon nanotube (CNT) sheets—were subjected to artificial lightning strike testing. The research employed a coupled thermal-electrical finite element analysis method to investigate the lightning strike's impact and damage mechanisms on both samples. The numerical results closely aligned with published experimental data, validating the simulation. Unprotected CFRP sustained damage through the thickness direction up to 8 composite plies and in-plane direction over a length of 110 mm. In contrast, the sample protected with CNT sheets exhibited damage limited to the surface of the first 4 plies, with in-plane damage reduced to 24 mm. Notably, the damage area in the CFRP protected with CNT sheets showed a substantial 78.1 % reduction compared to the unprotected CFRP sample. This suggests that CNT can enhance the electrical conductivity of CFRP when incorporated between interlayers in both in-plane and thickness directions. The study enhances understanding of CFRP damage behavior and failure modes under lightning strike conditions, emphasizing CNT sheets as an improved and viable lightning strike protection system for aerospace applications, warranting further investigation.

Gastrointestinal (GI) complications are significant manifestations of COVID-19 and are increasingly being recognized. These complications range from severe acute pancreatitis to colitis, adding complexity to diagnosis and management. A comprehensive database search was conducted using several databases. Our inclusion criteria encompassed studies reporting severe and long-term GI complications of COVID-19. Digestive disorders were categorized into infections, inflammatory conditions, vascular disorders, structural abnormalities, other diagnoses, and undiagnosed conditions. Of the 73 studies that were selected for full-text review, only 24 met our inclusion criteria. The study highlights a broad range of gastrointestinal complications following COVID-19 infection (excluding liver complications, which are examined separately), including inflammatory conditions, such as ulcerative colitis (UC), acute pancreatitis, and multisystem inflammatory syndrome in children (MIS-C). Other GI complications were reported such as vascular disorders, including diverse thrombotic events and structural abnormalities, which ranged from bowel perforations to adhesions. Additionally, undiagnosed conditions like nausea and abdominal pain were prevalent across different studies involving 561 patients. The findings emphasize the substantial impact of COVID-19 on the GI tract. Ongoing research and monitoring are crucial to understanding the long-term effects and developing effective management strategies for these complications.

The SARS-CoV-2 virus caused a pandemic in the 2020s, which affected almost every aspect of life. As the world is recovering from the effect of the coronavirus, the concept of post-COVID-19 syndrome has emerged. Multiple organ systems have been implicated, including the liver. We aim to identify and analyze the reported cases of severe and long-term parenchymal liver injury post-COVID-19 infection. Several databases were used to conduct a comprehensive literature search to target studies reporting cases of severe and long-term parenchymal liver injury post-COVID-19 infection. Screening, data extraction, and cross checking were performed by two independent reviewers. Only 22 studies met our inclusion criteria. Our results revealed that liver steatosis, non-alcoholic fatty liver disease (NAFLD), and cirrhosis were the most reported liver associated complications post-COVID-19 infection. Moreover, complications like acute liver failure, hepatitis, and liver hemorrhage were also reported. The mechanism of liver injury post-COVID-19 infection is not fully understood. The leading proposed mechanisms include the involvement of the angiotensin-converting enzyme-2 (ACE-2) receptor expressed in the liver and the overall inflammatory state caused by COVID-19 infection. Future studies should incorporate longer follow-up periods, spanning several years, for better insight into the progression and management of such diseases.

The conjugate gradient (CG) directions are among the important components of the CG algorithms. These directions have proven their effectiveness in many applications—more specifically, in image processing due to their low memory requirements. In this study, we derived a new conjugate gradient coefficient based on the famous quadratic model. The derived algorithm is distinguished by its global convergence and essential descent properties, ensuring robust performance across diverse scenarios. Extensive numerical testing on image restoration and unconstrained optimization problems have demonstrated that the new formulas significantly outperform existing methods. Specifically, the proposed conjugate gradient scheme has shown superior performance compared to the traditional Fletcher–Reeves (FR) conjugate gradient method. This advancement not only enhances computational efficiency on unconstrained optimization problems, but also improves the accuracy and quality of image restoration, making it a highly valuable tool in the field of computational imaging and optimization.

Moringa oleifera (M. oleifera) is globally recognized for its medicinal properties and offers high-quality, protein-rich seeds. This study aimed to explore the potential of M. oleifera seeds as a significant source of protein-based nanoparticles (PBNPs) using the ultrasonication technique after desolvation and to evaluate their cytotoxicity in the human leukemia cell line (THP-1) for the first time. The properties of the PBNPs were confirmed by dynamic light scattering (DLS), transmission electron microscopy (TEM), scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDX), X-ray diffraction (XRD), and Fourier-transform infrared spectroscopy (FT-IR). The extracted protein from moringa seed cake flour had a significant protein content of 54.20%, and the resulting PBNPs had an average size of 134.3 ± 0.47 nm with a robust zeta potential of −43.15 mV. Notably, our study revealed that PBNPs exhibited cytotoxic potential at high concentrations, especially against the THP-1 human leukemia cell line, which is widely used to study immunomodulatory properties. The inhibitory effect of PBNPs was quantitatively evidenced by a cytotoxicity assay, which showed that a concentration of 206.5 μg mL−1 (log conc. 2.315) was required to inhibit 50% of biological activity. In conclusion, our findings highlight the potential of M. oleifera seeds as a valuable resource in the innovative field of eco-friendly PBNPs by combining traditional medicinal applications with contemporary advancements in protein nanotechnology. However, further studies are required to ensure their biocompatibility.

الأهداف: هدفت الدّراسة التّعرّف إلى درجة تقويم أثر وسائل التّواصل الاجتماعيّ على الدّعوة والتّحديات المتّصلة بها من وجهة نظر طلبة كليّة الشّريعة في الجامعة الأردنيّة. المنهجية: اتبعت الدراسة المنهج الوصفي المسحي، حيث تكوّنت عيّنة الدّراسة من (286) طالبًا وطالبة من كليّة الشّريعة، وتم اختيارهم بصورة عشوائية. واستخدمت الدّراسة أداة الاستبانة لجمع البيانات بعد التّحقق من صدقها وثباتها حسب الأصول، وتكونت من بعدين؛ الأول يُعنى بقياس درجة تقويم أثر وسائل التواصل الاجتماعي على الدعوة من وجهة نظر طلبة كليّة الشّريعة في الجامعة الأردنيّة، وأمّا الثاني فعُني بقياس درجة تقويم تحديات الدعوة على مواقع التواصل الاجتماعي من وجهة نظر مجتمع الدراسة ذاته. تم التحليل الإحصائي باستخدام المتوسطات الحسابيّة والانحرافات المعياريّة لمعرفة التمايز بين الفقرات بناء على مقياس ليكرت. النتائج: كشفت الدّراسة عن نتائج "مرتفعة" في كلّ من بعدي الاستبانة، فأشارت إلى وعي مجتمع الدّراسة بأهميّة الدّعوة عبر وسائل التّواصل الاجتماعيّ من جهة، والتّحديات التي فرضتها هذه الوسائل في مجال الدّعوة الإسلاميّة من جهة أخرى. كما أوضحت الدّراسة وجود فروق ذات دلالة إحصائيّة عند مستوى (0.05>α) تبعًا لمتغيّر الجنس في البعد الأول الخاصّ بالآثار لصالح الإناث، وعدم وجود فروق ذات دلالة إحصائيّة عند مستوى (0.05>α) تبعا لمتغيري الجنس والتّخصص في البعد الثاني الخاصّ بالتّحديات. الخلاصة: توصي الدراسة بضرورة الاهتمام بمتابعة أهم التحديات الدعوية على منصات التواصل الاجتماعي، منها خطورة تصدي غير المؤهلين للدعوة عبر هذه المنصات، ودراسة آثار ذلك من جوانب عديدة معرفية واجتماعيّة. بالإضافة إلى ضرورة الاهتمام بالخطاب الديني الموجّه للمرأة على منصات التواصل الاجتماعي، وتعزيزه، وإثرائه بالمعلومة الدقيقة والمفيدة.

هدفت الدراسة إلى استقصاء فاعلية برنامج إرشادي في تنمية مستوى المهارات الاجتماعية وخفض السلوك لدى الأشخاص ذوي الإعاقة في مركز الشفلح بدولة قطر، تكونت العينة من (100) منتسب ومنتسبة، وتكونت العينة شبه التجريبية من (22) منتسبًا ومنتسبة، وهؤلاء هم الذين سجَّلوا في القياس القبلي أقل الدرجات في مستوى المهارات الاجتماعية، وأعلى الدرجات في السلوك الانسحابي، وُزِّعوا عشوائيًا مُناصفة إلى مجموعتين: تجريبية وضابطة. ولتحقيق أهداف الدراسة طُوِّر مقياسان: مقياس المهارات الاجتماعية ومقياس السلوك الانسحابي، وقد تمتعا بدلالات صدق وثبات مناسبين، كما بُني برنامج إرشادي تضمن (13) جلسة إرشادية، طُبِّق على أفراد المجموعة التجريبية بواقع جلستين أسبوعيًا ولمدة (40) دقيقة للجلسة الواحدة. أشارت النتائج إلى أن مستوى المهارات الاجتماعية في القياس القبلي جاء متوسطًا لدى أفراد عينة الدراسة، في حين جاء مستوى السلوك الانسحابي مُرتفعًا، كما أظهرت النتائج وجود فروق ذات دلالة إحصائية بين متوسطات درجات أفراد عينة الدراسة في المجموعتين: التجريبية والضابطة في مستوى المهارات الاجتماعية والسلوك الانسحابي، ولصالح أفراد المجموعة التجريبية، كما أشارت النتائج أيضًا إلى عدم وجود فروق ذات دلالة إحصائية بين متوسطات درجات أفراد المجموعة التجريبية في مستوى المهارات الاجتماعية والسلوك الانسحابي في القياسين البعدي والتتبُعي، مما يشير إلى فاعلية البرنامج الإرشادي واستمرار تأثيره خلال فترة الُمتابعة. وخلُصَت الدراسة إلى مجموعة من التوصيات، أهمها: ضرورة توفير فرص متعددة لممارسة الأنشطة والممارسات اليومية التي من شأنها تنمية المهارات الاجتماعية وخفض السلوك الانسحابي لدى هؤلاء الأفراد.

This research study proposes a novel hyperchaotic finance system with profit margin and then utilizes the Adomian Decomposition Method (ADM) to tackle the solution of the associated Caputo-derivative based fractional-order hyperchaotic finance system with profit margin. Numerical simulations and analyses, such as the evaluation of Lyapunov exponents (LE), the creation of bifurcation diagrams (BD), the complexity analysis (CA), and the 0-1 test, are used to get a full picture of the system. The results of our study demonstrate the occurrence of periodic, chaotic, and hyperchaotic dynamics in the system. Furthermore, the overall criteria for the existence and the uniqueness of the exact solutions for Caputo fractional-order models are presented. In addition, we present a control methodology for the fractional-order hyperchaotic financial system utilizing the Laplace transform and linear feedback control. Significantly, our research showcases a noteworthy correlation between the analytical results and numerical simulations, emphasizing the soundness and effectiveness of our methodology.

ABSTRACT Objective: To determine the role of the IL8 rs4073 polymorphism in predicting the risk of central nervous system (CNS) toxicity in patients receiving standard pharmacological treatment for multidrug-resistant tuberculosis (MDR-TB). Methods: A cohort of 85 consenting MDR-TB patients receiving treatment with second-line antituberculosis drugs had their blood samples amplified for the IL8 (rs4073) gene and genotyped. All patients were clinically screened for evidence of treatment toxicity and categorized accordingly. Crude and adjusted associations were assessed. Results: The chief complaints fell into the following categories: CNS toxicity; gastrointestinal toxicity; skin toxicity; and eye and ear toxicities. Symptoms of gastrointestinal toxicity were reported by 59% of the patients, and symptoms of CNS toxicity were reported by 42.7%. With regard to the genotypes of IL8 (rs4073), the following were identified: AA, in 64 of the study participants; AT, in 7; and TT, in 11. A significant association was found between the dominant model of inheritance and CNS toxicity for the crude model (p = 0.024; OR = 3.57; 95% CI, 1.18-10.76) and the adjusted model (p = 0.031; OR = 3.92; 95% CI, 1.13-13.58). The AT+TT genotype of IL8 (rs4073) showed a 3.92 times increased risk of CNS toxicity when compared with the AA genotype. Conclusions: The AT+TT genotype has a tendency to be associated with an increased risk of adverse clinical features during MDR-TB treatment.

The performance of a packed bed reactor for CO2 conversion to methanol was investigated. Because of the exothermic reaction, temperature and concentration gradients happen along the reactor. A 2D packed-bed reactor model was applied for numerical investigations, coupled with detailed reaction kinetics and transport phenomena. The effect of feed inlet pressure and temperature on CO2 conversion and temperature profiles along the reactor was evaluated. The results showed that firstly increase in the temperature in the reactor because of the presence of exothermic reactions and then slight decrease in the temperature at top section of the reactor. Pressure was decrease from 55 bar to around 54 bar along the reactor. It was found that the CO2 conversion at outlet of reactor was 18.18 % at T = 475 K and it was increased to 23 % at temperature of 498 K and 555 K. The CO2 conversion was reached its maximum at short distance from the reactor entrance at T = 555 K. Also, the outlet temperature of gas mixture was increased from 522.53 K to 534.56 K with increasing feed inlet pressure from 35 bar to 55 bar. The CO2 conversion was 18.12 %, 20.77 %, and 22.96 % at pressures equal to 35, 45, and 55 bar respectively.

BackgroundRussian current (RC), a well-known neuromuscular electrical stimulation operating at 2500 Hz, has demonstrated significant strength improvement over traditional exercises due to its high tolerance and low pain provocation. Despite extensive NMES parameter research, the specific effects of expert modes, particularly ON2 and Rest, remain unexplored. This study investigates the direct effect of these expert modes on quadriceps muscle strength in healthy adults.MethodsThis is a single-blind, randomization-controlled trial. Forty-eight healthy university students (31 females, 17 males) were assigned in two randomized experimental groups either the ON2 or Rest mode for a 15-minute electrical stimulation session. Quadriceps maximum voluntary isokinetic contraction measurements were taken before and directly after RC application using Biodex Medical Systems 4 pro isokinetic dynamometer.ResultsBoth RC modes significantly increased the quadriceps muscle torque in healthy adults compared to baseline (pConclusionThe findings of this study align with previous research on NMES and RC supporting the idea that electrical stimulation enhances muscle strength, selecting the appropriate RC expert modes can assist physiotherapist in tailoring rehabilitation program to achieve their specific strength goals.

Now, the present electric vehicle industry is focusing on the fuel cell technology because its features are high flexibility, continuous power supply, less atmospheric pollution, fast startup, and rapid response. However, the fuel cell gives nonlinear power versus current characteristics. Due to this nonlinear behavior, the maximum power extraction from the fuel stack is quite difficult. So, in this work, an adaptive genetic algorithm with an adaptive neuro-fuzzy inference system (ACS with ANFIS) MPPT controller is introduced for finding the MPP of the fuel stack system thereby extracting the peak power from the fuel stack. The proposed hybrid maximum power point tracking (MPPT) controller is compared with the other MPPT controllers which are enhanced incremental conductance-fuzzy logic controller (EIC with FLC), improved hill climb with fuzzy logic controller (IHC with FLC), adaptive beta with FLC, enhanced differential evolutionary with FLC (EDE with FLC), and marine predators optimization with FLC (MPO with FLC). Here, these hybrid controllers’ comprehensive investigations have been carried out in terms of tracking speed of the MPP, oscillations across the MPP, settling time of the converter voltage, maximum power extraction from the fuel stack, and working efficiency of the MPPT controller. The fuel stack generates a very low output voltage which is improved by using the boost DC-DC converter, and the overall fuel stack-fed boost converter system is designed by utilizing the MATLAB/Simulink tool. From the simulation results, the AGA with ANFIS MPPT controller gives high MPP tracking efficiency when compared to the other hybrid controller.

This study aims to identify the moderating construct of trust in the performance of agricultural cooperatives in North-Western Nigeria. Business management cannot be overseen by the owner alone; it may require the services of other professionals. However, the high incidence of corrupt practices in the public and private sectors in developing African countries cripples many businesses. It makes it difficult to entrust the management of organisations to a third party. Trust is essential, especially in an environment with a loose execution of legal charges. Although a direct relationship between corporate governance and performance has been established across many disciplines, the influence of trust as an interactive construct has yet to be established. Therefore, this study addresses this gap. This study used concurrent triangulation design with a significant quantitative approach complemented by the qualitative segment involving seven open-ended questions. Data were collected from 384 cooperative for rice farmer’s by used of a survey design. Structural Equation Modelling was used to assess the measurement model to test the hypotheses. An Excel spreadsheet was used to pre-code the data derived from open-ended questions, and later exported to ATLAS.ti software for qualitative analysis through coding, group coding and network. The findings revealed that corporate governance and trust significantly influenced agricultural cooperative performance. The moderating effect of trust on corporate governance was supported. The findings illustrate how social capital theory explains the processes of African trust, especially in corrupt environments with weak legal penalties. This study examines corporate governance within the internal control mechanisms of an agricultural cooperative society. Further studies should understand corporate governance within an external tie. To our knowledge this is the first study to examine the moderating effect of trust on the interacting variables in the African social capital theory model.

This study explores the opportunities and challenges of integrating artificial intelligence (AI) into engineering education. Through a review of the literature and a qualitative focus group study, an assessment was made for the role of AI in personalizing learning, enhancing simulation engagement, providing real-time feedback, and preparing students for AI-integrated workplaces. The study emphasizes how AI may significantly improve educational experiences by making them more dynamic, interactive, and successful. It also draws attention to important issues, such as moral questions, algorithmic biases in AI, infrastructure constraints, the need for AI literacy training for educators, and a range of student perspectives on AI engineering education. The results support a systematic approach to AI integration, highlighting the necessity of cooperative efforts by educators, legislators, curriculum designers, and technologists in order to overcome these obstacles. The study makes the case that AI can transform engineering education by negotiating these challenges and providing students with the information and skills needed for the digital future, all the while assuring fair and moral access to technology-enhanced learning.

This article is devoted to the study of high-order, accurate difference schemes’ numerical solutions of local and non-local problems for ordinary differential equations of the fourth order. Local and non-local problems for ordinary differential equations with constant coefficients can be solved by classical integral transform methods. However, these classical methods can be used simply in the case when the differential equation has constant coefficients. We study fourth-order differential equations with dependent coefficients and their corresponding boundary value problems. Novel compact numerical solutions of high-order, accurate finite difference schemes generated by Taylor’s decomposition on five points have been studied in these problems. Numerical experiments support the theoretical statements for the solution of these difference schemes.

Commercial repellent treatments incorporating plant-based components have recently gained favourable among users due to the fact They are considered “safe” in compared to long-established synthetic repellents however, this is usually not accurate. Many essential oils included in insect repellents and insecticides are very volatile, which adds to their short lifespan as insect repellents. This problem, however, can be resolved by adding fixatives to increase their lifespan. The objective of developing this organic repellent is to give a productive, totally natural preventive solution to repel cold-blooded and harmful insects. The aim of this project is to produce an organic repellent utilizing chrysanthemum oil and chrysanthemum oil + peppermint oil, and to test the efficacy of both end products. The experimental results exhibited that all three-parameter concentration revealed significant influence on 5 ml, 7 ml and 9 ml given the average mortality time of killing was 2.62 min, 2.34 min, and 3.38 min, respectively, as Chrysanthemum oil and Chrysanthemum oil + peppermint oil that the average mortality time of killing was 2.81 min, 3.04 min, and 2.79 min to cold-blooded insects such as cockroach, flies, and ants. As a result, there is a need to analysed natural materials as biopesticides since they are harmless to humans and the environment. Knowledge gained from ethnobotanical studies on traditional repellent plants is a great resource for the creation of new natural products.

Migraine is a common issue during pregnancy, often affected by hormonal changes. More than half of the women affected by migraine experience improvement in or remission of migraine symptoms, particularly during the second and third trimesters, with those having menstrual migraines or migraines without aura benefiting the most. However, a small percentage of women may see a worsening of their migraines, especially those with migraine with aura, and some may even develop migraines for the first time during pregnancy, often in the first trimester. Postpartum, many women experience a recurrence of migraines, likely due to the drop in estradiol and endorphin levels. A literature search was performed in PubMed for articles published from 2013 through 2023, and 80 out of 362 publications were included. When it comes to managing pregnant women with migraine, non-pharmacological treatments are preferred, including lifestyle modifications and avoiding known triggers. When medication is necessary, acetaminophen is the first-line treatment, with nonsteroidal anti-inflammatory drugs and triptans regarded as secondary options, though trimester-specific risks limit their use. Preventive treatments, if required, may include low doses of β-blockers or amitriptyline but should be used cautiously. This article aims to provide a concise overview of the existing research on the acute and prophylactic use of medications to treat migraines in pregnant and lactating women. Furthermore, it presents recommendations for healthcare professionals managing pregnant females presenting with migraine in clinical settings., Competing Interests: Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Ibrahim et al.)

Aim: To assess patients' satisfaction with the quality of nursing care and the relationship between patients' characteristics and their level of satisfaction., Design: A descriptive correlational cross-sectional design was used in this study., Methods: Convenient sampling was utilized to include 1014 inpatients from six hospitals in Jordan: three private hospitals; two governmental hospitals; and one university-affiliated hospital. The data collection process occurred from September 2022 to January 2023. The data were collected using the Arabic version of the Patients' Satisfaction with Nursing Care Quality Questionnaire. The data were analysed using Pearson correlation, t-test, one-way ANOVA and multiple hierarchal regression., Results: The study included 1014 patients with an average age of 51.3 (SD = 18.6), and 59.9% were females. More than two thirds of the sample reported having health insurance, and 62.7% were unemployed. The mean total score of patients' satisfaction with nursing care quality (NCQ) was 68.2 (SD = 12.9), indicating high satisfaction. Higher-income levels (p < 0.001), higher education levels (p = 0.003), having health insurance (p < 0.001), being admitted to private hospitals (p < 0.001), being admitted to critical care units (p = 0.002), being in a single room (p = 0.001), excellent perceived health status (p < 0.001) and willingness to recommend the hospital to family and friends (p < 0.001) were significant predictors of patients' satisfaction with NCQ., Conclusions: Patient and hospital environment characteristics affected patients' satisfaction with NCQ. Hospital management should consider these characteristics to improve patient satisfaction and outcomes., Implications for the Profession And/or Patient Care: Policymakers and hospital management should consider improving the physical environment of their facilities to improve patients' satisfaction. Continuous professional development should emphasize nurses' communication skills to enhance their abilities to deliver information to their patients., Impact: This study examined levels and predictors of patients' satisfaction with the quality of nursing care. The results indicated that improving patients' satisfaction can be achieved by focusing on areas of nurses' communication skills and explaining information to patients., Reporting Method: The study adhered to STORBE guidelines for reporting observational studies., Patient or Public Contribution: Hospitalized patients contributed to the data of this study. Hospital administrators facilitated its implementation., (© 2024 The Author(s). Nursing Open published by John Wiley & Sons Ltd.)

This cross-sectional study aimed to estimate the relationship between food insecurity (FI) and health-related quality of life (HRQoL) in patients with celiac disease (CD) and assess whether this relationship is mediated or moderated by adherence to the gluten-free diet (GFD). The results of 1162 samples of patients diagnosed with CD showed that 8.3% of individuals who have a combined score of less than 13 exhibited excellent or very good adherence to the GFD. Furthermore, moderate and fair to poor adherence to the GFD was demonstrated, respectively and 71.9% of the patients had poor HRQoL levels. A significant and moderate positive correlation between FI and GFD adherence (r = 0.489) was found, indicating that 24% of the variance in FI is shared with GFD adherence. The patients' gender, marital status, and monthly income made statistically significant contributions to the prediction ( p < 0.05). Females had significantly lower HRQoL scores than males (B = -4.619, 95% CL: -6.08, -3.16) after holding all other variables constant. In conclusion, FI is mediated by GFD adherence to HRQoL. Moreover, a significant total effect relation was found between HRQoL and both FI and GFD adherence, suggesting that lowering symptoms and complications associated with CD may reduce the impact of FI on HRQoL.

Background: Neglected tropical diseases, affecting over a billion people, include leishmaniasis, a protozoan parasite found in over 20 species. It is classified into three types: visceral, cutaneous, and muco-cutaneous leishmaniasis, with cutaneous leishmaniasis being the most common. Dogs and rodents are the primary reservoirs of leishmaniasis, which is transmitted by infected female sandflies. Cutaneous leishmaniasis, found on exposed parts such as the arms, face and legs, presents with diverse clinical manifestations, including erythematous lesions, large, painless nodules, ulceration and an eventual volcanic form., Objective: To assess the clinical pattern and treatment outcome of cutaneous leishmaniasis patients in the Somali region of eastern Ethiopia., Methods: This descriptive study was conducted in the Somali region using neglected tropical disease surveillance data collected from 1 September 2023, to 8 February 2024. The data were cleaned and then exported to STATA version 17 for analysis., Results: From 1 September 2023, to 8 February 2024, 900 patients were diagnosed with cutaneous leishmaniasis. Of these, 105 (11.67%) patients had localised cutaneous leishmaniasis, 741 (82.33%) had disseminated cutaneous leishmaniasis, 20 (2.22%) had diffuse cutaneous leishmaniasis, 8 (0.89%) had mucocutaneous leishmaniasis, 12 (1.33%) had mucocutaneous and disseminated leishmaniasis and 14 (1.56%) had localised and mucocutaneous leishmaniasis. All of the cases were male; the most common signs and symptoms the patients showed were papule, nodule, ulcer and crust 791 (87.89%) and itching, fever and discharges 758 (84.22%), respectively. Most of the patients, 823 (93.34%), were given systemic pentavalent antimonials, and the cure rate was 886 (98.44%). Of the patients, 14 (100%) who were defaulted on had diffuse cutaneous leishmaniasis., Conclusions: All the participants had travelled to an area where sandflies were common. The majority of patients complained of itching, fever and discharges, with over two-thirds having disseminated cutaneous leishmaniasis (DCL) and 0.89% having mucocutaneous leishmaniasis. The regional health bureau should set up a strong surveillance system and launch educational campaigns to raise awareness about cutaneous leishmaniasis, its transmission, symptoms and preventive measures. Furthermore, patients should be advised to strictly adhere to their treatment schedule and follow-ups., Competing Interests: None to declare., (© 2024 The Author(s). Skin Health and Disease published by John Wiley & Sons Ltd on behalf of British Association of Dermatologists.)

Introduction: International guidelines recommend routine screening for syphilis (aetiological agent: Treponema pallidum subspecies pallidum) amongst key populations and vulnerable populations using tests detecting treponemal and non-treponemal antibodies. Whilst treponemal tests have high sensitivities and specificities, they differ regarding subjective or objective interpretation, throughput and workload. Chemiluminescence immunoassays (CLIAs) are cost- and time-effective automated methods for detecting treponemal antibodies. The Treponema pallidum particle agglutination assay (TPPA) has been considered the "gold standard" treponemal assay, however, this includes a highly manual procedure, low throughput and subjective interpretation. The present multi-country study evaluated the ADVIA Centaur® Syphilis CLIA (Siemens Healthcare) assay compared to the reference SERODIA-TP·PA® (Fujirebio Diagnostics) for the serodiagnosis of syphilis amongst men who have sex with men (MSM)., Method: 1,485 MSM were enrolled in Brighton (UK), Malta, and Verona (Italy) as part of a larger WHO multi-country and multi-site ProSPeRo study. Ethical approval was obtained. Serum was tested with the ADVIA Centaur® Syphilis CLIA assay and SERODIA-TP·PA®, in accordance with the manufacturers' instructions, for a first round of validation. A second round of validation was carried out for discrepant results that were additionally tested with both Western Blot (Westernblot EUROIMMUN®) and an Immunoblot (INNO-LIA, Fujirebio Diagnostics). Sensitivity, specificity, positive and negative predictive value (PPV and NPV), likelihood ratios (positive/negative), and the Diagnostic Odds Ratio (DOR)/pre-post-test probability (Fagan's nomogram) were calculated., Results: Out of 1,485 eligible samples analysed in the first phase, the SERODIA-TP·PA® identified 360 positive and 1,125 negative cases. The ADVIA Centaur® Syphilis CLIA assay (Siemens) identified 366 positives, missclassifying one TPPA-positive sample. In the second phase, the ADVIA Centaur® Syphilis CLIA resulted in 1 false negative and 4 false positive results. Considering the syphilis study prevalence of 24% (95% CI: 22-26.7), The sensitivity of the ADVIA Centaur® Syphilis CLIA assay was 99.7% (95% CI: 98.5-100), and the specificity was 99.4% (95% CI: 98.7-99.7). The ROC area values were 0.996 (95% CI: 0.992-0.999), and both the PPV and NPV values were above 98% (PPV 98.1%, 95% CI: 96.1-99.2; NPV 99.9%, 95% CI: 99.5-100)., Conclusions: The ADVIA Centaur® Syphilis CLIA assay showed similar performance compared to the SERODIA-TP·PA®. Considering the study is based on QUADAS principles and with a homogeneous population, results are also likely to be generalisable to MSM population but potentially not applicable to lower prevalence populations routinely screened for syphilis. The automated CLIA treponemal assay confirmed to be accurate and appropriate for routine initial syphilis screening, i.e. when the reverse testing algorithm is applied., (© 2024. The Author(s).)