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Abstract The scientific discourse on climate change throughout the US has primarily revolved around changes in mean climate and/or climate extremes. However, little is known about the impacts of climate change on mild weather conditions despite its significant relevance to quality of life. Here, we adopt the concept of “outdoor days” defined as those relatively pleasant days when most people may enjoy outdoor activities (Choi et al., 2024). We project how climate change reshapes seasonality of US outdoor days: relatively large drops in summer, late spring, and early fall; and a significant increase in winter. However, annual outdoor days are projected to change slightly, with notable exceptions. We project relatively large drops in southeast (−23%), south (−19%), and Ohio Valley (−19%), and a significant increase in northwest (14%) toward the end of the century. Our findings have implications for quality of life in different regions, and for nation‐wide travel and tourism.

Key Clinical Message Neuroendocrine tumors of the bladder are rare, accounting for less than 1% of all bladder tumors. Among these, large cell neuroendocrine carcinoma is an extremely uncommon subtype. We report on a histologically confirmed case of mixed both large and small cells neuroendocrine tumor of the bladder in a 64‐year‐old male with a history of bilharzial cystitis. The diagnosis was made after radical cystectomy with Immunohistochemical staining revealing positivity for synaptophysin, CD56, and AE1/3. While bilharzia is commonly linked to squamous cell carcinoma in the bladder, the potential relationship with neuroendocrine tumors is still relatively unexplored in this context. This case marks the first reported instance of the atypical coexistence of bilharzial cystitis and mixed large and small cell neuroendocrine carcinoma of the bladder. This unique case of coexisting highlights a rare phenomenon warranting further study. Similar associations have been documented in other organs, emphasizing the importance of exploring underlying mechanisms and clinical implications for improved patient care and outcomes.

Abstract The toxicity of inhaled particulate air pollution perseveres even at lower concentrations than those of the existing air quality limit. Therefore, the identification of safe and effective measures against pollutant particles‐induced vascular toxicity is warranted. Carnosol is a bioactive phenolic diterpene found in rosemary herb, with anti‐inflammatory and antioxidant actions. However, its possible protective effect on the thrombotic and vascular injury induced by diesel exhaust particles (DEP) has not been studied before. We assessed here the potential alleviating effect of carnosol (20 mg/kg) administered intraperitoneally 1 h before intratracheal (i.t.) instillation of DEP (20 μg/mouse). Twenty‐four hours after the administration of DEP, various parameters were assessed. Carnosol administration prevented the increase in the plasma concentrations of C‐reactive protein, fibrinogen, and tissue factor induced by DEP exposure. Carnosol inhibited DEP‐induced prothrombotic effects in pial microvessels in vivo and platelet aggregation in vitro. The shortening of activated partial thromboplastin time and prothrombin time induced by DEP was abated by carnosol administration. Carnosol inhibited the increase in pro‐inflammatory cytokines (interleukin‐6 and tumor necrosis factor α) and adhesion molecules (intercellular adhesion molecule‐1, vascular cell adhesion molecule‐1, E‐selectin, and P‐selectin) in aortic tissue. Moreover, it averted the effects of DEP‐induced increase of thiobarbituric acid reactive substances, depletion of antioxidants and DNA damage in the aortic tissue. Likewise, carnosol prevented the decrease in the expression of nuclear factor erythroid 2‐related factor 2 (Nrf2) and heme oxygenase‐1 (HO‐1) caused by DEP. We conclude that carnosol alleviates DEP‐induced thrombogenicity and vascular inflammation, oxidative damage, and DNA injury through Nrf2 and HO‐1 activation.

Abstract Introduction Person‐centred care (PCC) has been recognized as a critical element in delivering quality and responsive health services. The patient−provider relationship, conceptualized at the core of PCC in multiple models, remains largely unexamined in HIV care. We conducted a systematic review to better understand the types of PCC interventions implemented to improve patient−provider interactions and how these interventions have improved HIV care continuum outcomes and person‐reported outcomes (PROs) among people living with HIV in low‐ and middle‐income countries. Methods We searched databases, conference proceedings and conducted manual targeted searches to identify randomized trials and observational studies published up to January 2023. The PCC search terms were guided by the Integrative Model of Patient‐Centeredness by Scholl. We included person‐centred interventions aiming to enhance the patient−provider interactions. We included HIV care continuum outcomes and PROs. Results We included 28 unique studies: 18 (64.3%) were quantitative, eight (28.6.%) were mixed methods and two (7.1%) were qualitative. Within PCC patient−provider interventions, we inductively identified five categories of PCC interventions: (1) providing friendly and welcoming services; (2) patient empowerment and improved communication skills (e.g. supporting patient‐led skills such as health literacy and approaches when communicating with a provider); (3) improved individualized counselling and patient‐centred communication (e.g. supporting provider skills such as training on motivational interviewing); (4) audit and feedback; and (5) provider sensitisation to patient experiences and identities. Among the included studies with a comparison arm and effect size reported, 62.5% reported a significant positive effect of the intervention on at least one HIV care continuum outcome, and 100% reported a positive effect of the intervention on at least one of the included PROs. Discussion Among published HIV PCC interventions, there is heterogeneity in the components of PCC addressed, the actors involved and the expected outcomes. While results are also heterogeneous across clinical and PROs, there is more evidence for significant improvement in PROs. Further research is necessary to better understand the clinical implications of PCC, with fewer studies measuring linkage or long‐term retention or viral suppression. Conclusions Improved understanding of PCC domains, mechanisms and consistency of measurement will advance PCC research and implementation.

Abstract Aims Portal hypertension is a major complication of liver cirrhosis. Hepatic venous pressure gradient (HVPG) appears to be one of the best surrogates of clinical outcomes. However, the utility of elevated HVPG in predicting subsequent clinical decompensation is unclear. Methods We analyzed 410 patients who underwent HVPG assessment between 2014 and 2018. Of these, we identified and analyzed 20 patients with HVPG >12 mmHg without evidence of clinical decompensation (defined as ascites, nonbleeding esophageal varices or bleeding esophageal varices, hepatic encephalopathy, hepatopulmonary syndrome, or hepatic hydrothorax). Additionally, we compared this group to 40 randomly selected cirrhotic patients with HVPG >12 mmHg with signs of clinical decompensation. Clinical events were subsequently assessed (mean = 33 months) after HVPG measurement. Results Patients with high HVPG without evidence of clinical decompensation had a significantly lower model for end‐stage liver disease (MELD) scores (8 ± 4) compared to decompensated patients (13 ± 8, p = 0.05). HVPG measurements were similar in compensated (17 ± 6 mmHg) and decompensated (18 ± 4 mmHg) patients. Over follow‐up for 33 months, 8/20 compensated patients had a decompensating event and neither MELD (8 and 8, respectively) nor HVPG (17 and 18 mmHg, respectively) differentiated patients who remained compensated versus those that decompensated. Serum albumin at the time of HVPG measurement was significantly higher in patients who remained compensated than those with a decompensating event (3.5 vs. 2.6 g/dl, respectively, p = 0.05). Conclusions A small, unique, population of cirrhotic patients with substantially elevated HVPG appear to remain free of complications over long‐term follow‐up.

Key Clinical Message Penile self‐mutilation may result from a suicidal attempt during a major depression crisis. The management of this urological emergency should be multidisciplinary. A macroscopic penile reimplantation performed meticulously by a urological surgeon may yield an excellent cosmetic and functional outcome. Abstract Penile self‐mutilation is an infrequent form of self‐harming behavior seen primarily in patients with schizophrenia spectrum disorders and rarely reported in those with major depressive disorders. We herewith present a major depression related case of penile self‐mutilation successfully managed by macroscopic penile reimplantation performed 8 h after the incident.

Elevated interstitial fluid hydrostatic pressure is commonly observed in diseased livers. We herein examined the hypothesis that hydrostatic pressure induces hepatic stellate cells to acquire profibrotic properties under pathological conditions. Human hepatic stellate cells were exposed to 50 mmHg pressure for 24 h. Although we observed few changes of cell growth and morphology, PCR array data on the expression of fibrosis‐associated genes suggested the acquisition of profibrotic properties. The exposure of hepatic stellate cells to 50 mmHg pressure for 24 h also significantly enhanced the expression of RhoA, ROCK1, α‐SMA, TGF‐β1, p‐MLC, and p‐Smad2, and this was effectively attenuated by the ROCK inhibitor Y‐27632. Our ex vivo experimental data suggest that elevated interstitial fluid hydrostatic pressure under pathological conditions may promote liver fibrosis by inducing acquisition of profibrotic properties of hepatic stellate cells through the RhoA/ROCK signaling pathway.

Abstract The dentigerous cyst is the second most common odontogenic. The prevalence rates ranging from 0.8% to 3.6% in the general population. It affects people especially at the second and third decade of life with a male predilection. It presents a preference for the mandibular region particularly for the second lower premolar. Surgical marsupialization or decompression are the most conservative treatment modalities as it prevents the risks of cyst removal as nerve injuries and preserves the unerupted tooth. Two clinical cases of two young patients presenting a dentigerous cyst involving impacted teeth, which were successfully treated by decompression will be reported in order to highlight the benefits and limits of cyst decompression as well as detailing its operating protocol and its instructions.

Abstract Significant difficulties about the function of Hazard Analysis and Critical Control Points (HACCP) in manufacture of three genuine varieties of Egyptian cheese, namely Domiati, Karish, and Ras's cheeses, are covered in this review. Benefits of implementing HACCP include complementing other quality management systems, improving food safety, making better use of resources, boosting productivity and quality, providing better security and lowering inspection rates, responding to issues quickly and effectively, and fostering international trade cooperation. The setting is important for the manufacturing, security, and quality control of cheese. A common household item across the world that is fermented dairy‐based and high in protein, calcium, amino acids, vitamins, phosphorus, and fat is cheese. Egypt consumes more cheese than any other country in North Africa, which is helped by the wide selection of cheeses on offer, includes soft, brined, salted, semi‐soft, and hard cheeses. Three illustrated graphics explain the manufacturing flow of each cheese with reference to critical control points determination were created using text that was obtained from the references that were accessible. As lists of dangers, important control limits, monitoring, and corrective measures for cheese manufacturing, three exemplary tables were equally given. These provide readers with a more thorough summary of all results.

Abstract Introduction Growth monitoring surveys provide critical anthropometric data to monitor physical growth and various forms of malnutrition among school age children. In the beginning, growth monitoring programs were introduced to identify the extent of undernutrition among children, which were later considered equally useful in the identification of overweight and obesity among school age children. Observing the shifts in weight categories among school age children provides an important insight to design targeted interventions for improving growth and development of children. Methodology The study used growth monitoring survey data among 5–19‐year school children of two academic years (2016–17 and 2019–20) in Qatar where 2016–17 survey included 186,986 students, whereas 2019–20 survey included 215,279 students. A total of 7514 unique records of students aged 5–14 years available in both survey rounds were included in the final analysis. This study documented shift in BMI‐z‐scores to ascertain the movement of students among obese, overweight, normal, thinness, and severe thinness categories. Python version 3.9.5 was used for data analysis along with a pairwise comparison between each of BMI‐z‐score shift to evaluate the effects of specific shifts in BMI‐z‐score category. Results Overall, the proportion of overweight and obese category of students increased from 44% in 2016–17 to 49.3% in 2019–20 with a decrease in the proportion of students in normal BMI‐z‐score category (from 48.8% to 47.8%) and severe thinness and thinness category (from 7.3% to 3%) between two rounds of growth monitoring survey. Statistically significant shifts in BMI‐z‐score categories were noted for students of different age groups, gender, and nationality. Conclusions Shift from normal BMI‐z‐score to obese and overweight category is a cause of concern and an opportunity to develop appropriate interventions. The significant shift among different categories needs to be investigated further to identify associated reasons to effectively develop interventions.

Abstract Background Iodine deficiency poses a significant public health challenge worldwide, particularly in preschool children and pregnant women. Assessing the iodine intake at a population level is essential, as both deficient and excessive iodine status can have adverse health consequences. The main objective of this survey is to understand the iodine deficiency status in schoolchildren aged 6–12 years in the State of Qatar. Methods A cross‐sectional survey was conducted from March to June 2014 among school‐aged children using a two‐stage cluster sampling technique. Anthropometric, biochemical, clinical, and dietary parameters for seafood were collected. Spot urine samples were collected from 967 participants, and a repeat random subsample urine was collected from 288 participants. Overall median urinary iodine concentration (UIC) was calculated. Iodine content in household salt samples was estimated by qualitative and quantitative methods. Mann–Whitney U test was used for comparison. Results The median UIC was 333.2 μg/L (IQR = 228.6). UIC prevalence rates between 300–999 and >1000 μg/L were 56.7% and 2.8%, respectively. The goiter prevalence was 0.4%. A significant difference was noted in overall median UIC levels between boys and girls (p = 0.003). Adequate iodized salt consumption was reported by 74.9% of households, and weekly seafood consumption was reported by one third of the respondents. Conclusion The results indicate an excess intake of iodine among the studied population in the State of Qatar, and national efforts are needed to bring iodine intake and concentration levels within the cutoff value for the concerned survey population's age group. In addition, a surveillance system needs to be set up for continuous monitoring of iodine content and salt intake at the population level in the State of Qatar.

Abstract To date, there has been no genomewide association study (GWAS) from the Middle East and North African (MENA) region to identify genetic variants associated with warfarin dose variability using this approach. In this study, we aimed to conduct the first GWAS of warfarin dose requirements in patients from the MENA region. A total of 132 Qatari (discovery) and 50 Egyptians (replication) were genotyped using Illumina Multi‐Ethnic Global BeadChip Array. A GWAS was performed on log‐transformed weekly warfarin dose in the studied population, adjusting for clinical characteristics and ancestry. The genomewide signals from the discovery cohort were tested in the Egyptian cohort. A GWAS meta‐analysis, including the Qatari and Egyptian cohorts, was also performed and the output from this analysis was used in a gene‐based analysis. The discovery analysis in Qatari identified five genomewide single‐nucleotide polymorphisms (SNPs) in chromosome 16. These signals were replicated in the Egyptian cohort. Combining the two data through a GWAS meta‐analysis strengthened the association in chromosome 16 with VKORC1 rs9934438 being the lead genomewide signal (β = −0.17, 6 × 10−15). Other SNPs were identified in chromosome 10 at a p value less than 1 × 10−5. The genetic variants within VKORC1 rs9934438 and CYP2C9 rs4086116 explained 39% and 27% of the variability in the weekly warfarin dose requirement in the Qatari and Egyptians, respectively. This is the first GWAS of warfarin dose variability in the MENA region. It confirms the importance of VKORC1 and CYP2C9 variants in warfarin dose variability among patients from the MENA region.

The goal of this study is to draw attention to the vital nutrients, health advantages, and potential for encouraging the consumption of jamun fruits (Syzygium cumini L.) and making the most of their useful features to create valuable goods. In the current study, efforts have been made to evaluate the jamun fruit’s physicochemical characteristics and bioactive components. Moreover, ready-to-serve beverages, squash, syrup, and jam, have been prepared, and their quality has been monitored throughout the storage. Jamun fruit had an ovoid or spherical form and was a dark purple tint. The initial analysis of fruits showed 83.59% moisture, 17.56 °Brix, 3.63 pH, 328.50 mg cyd-3-Glu/100 g anthocyanin, 219.21 mg GAE/100 g total phenolics, 91.33 mg QE/100 g total flavonoids, and 91.33% antioxidant activity. High-performance liquid chromatography examination, revealed the existence of three main anthocyanin pigments, delphinidin 3, 5-diglucoside, petunidin 3, 5-diglucoside, and malvidin 3, 5-diglucoside, which were measured at 175.80, 156.50, and 83.12 mg/100 g, respectively. While the main phenolic compounds present were chlorogenic, gallic, caffeic, vanillic, and catechin, with respective concentrations of 14.22, 12.18, 10.33, 6.44, and 4.13 mg/100 g. Total soluble solids, pH, and total sugars increased with the storage of jamun products, but acidity, total phenolic, and anthocyanin contents declined. In conclusion, jamun is a fruit that has promise for the future of producing useful goods. The various jamun fruit-based products met good standards and were sensory-acceptable.

Abstract Purpose Total hip and knee arthroplasty periprosthetic joint infection (PJI) poses a management dilemma owing to the emergence of resistant organisms. A promising option is Bacteriophage therapy (BT) was used as an adjuvant for PJI management, aiming at treating resistant infections, decreasing morbidity, and mortality. The current review aimed to demonstrate the role and safety of using BT as an adjuvant to treat PJIs. Methods A systematic search was performed through four databases (Embase, PubMed, Web of Science, and Scopus) up to March 2022, according to the predetermined inclusion and exclusion criteria. Results Our systematic review included 11 case reports of 13 patients in which 14 joints (11 TKAs and three THAs) were treated. The patients’ average age was 73.7 years, underwent an average of 4.5 previous surgeries. The most common organism was the Staphylococcus aureus species. All patients underwent surgical debridement; for the 13 patients, eight received a cocktail, and five received monophage therapy. All patients received postoperative suppressive antibiotic therapy. After an average follow‐up of 14.5 months, all patients had satisfactory outcomes. No recurrence of infection in any patient. Transaminitis complicating BT was developed in three patients, needed stoppage in only one, and the condition was reversible and non‐life‐threatening. Conclusion BT is a safe and potentially effective adjuvant therapy for treating resistant and relapsing PJIs. However, further investigations are needed to clarify some BT‐related issues to create effective and reproducible therapeutics. Furthermore, new ethical regulations should be implemented to facilitate its widespread use.

Abstract Aims/Introduction To study the epidemiology, genetic landscape and causes of childhood diabetes mellitus in the State of Qatar. Materials and methods All patients (aged 0–18 years) with diabetes mellitus underwent biochemical, immunological and genetic testing. American Diabetes Association guidelines were used to classify types of diabetes mellitus. The incidence and prevalence of all the different types of diabetes mellitus were calculated. Results Total number of children with diabetes mellitus was 1,325 (type 1 n = 1,096, ≥1 antibody; type 2 n = 104, type 1B n = 53; maturity onset diabetes of the young n = 20; monogenic autoimmune n = 4; neonatal diabetes mellitus n = 10;, syndromic diabetes mellitus n = 23; and double diabetes mellitus n = 15). The incidence and prevalence of type 1 diabetes were 38.05 and 249.73 per 100,000, respectively, and for type 2 were 2.51 and 23.7 per 100,000, respectively. The incidence of neonatal diabetes mellitus was 34.4 per 1,000,000 live births, and in indigenous Qataris the incidence was 43.6 per 1,000,000 live births. The prevalence of type 1 diabetes and type 2 diabetes in Qatari children was double compared with other nationalities. The prevalence of maturity onset diabetes of the young in Qatar was 4.56 per 100,000. Conclusions This is the first prospective and comprehensive study to document the epidemiology and genetic landscape of childhood diabetes mellitus in this region. Qatar has the fourth highest incidence of type 1 diabetes mellitus, with the incidence and prevalence being higher in Qatari compared with non‐Qatari. The prevalence of type 2 diabetes mellitus is also higher in Qatar than in Western countries. The incidence of neonatal diabetes mellitus is the second highest in the world. GCK is the most common form of maturity onset diabetes of the young, and a large number of patients have type 1B diabetes mellitus.

Abstract Background Some pieces of the literature report impaired cognitive functioning in tramadol dependence. Whether extended abstinence improves cognitive functioning or not is not well studied. Aim We aimed to measure the change in cognitive functioning following complete abstinence among individuals with tramadol dependence. Methods Eighty‐three male tramadol‐dependent (TD) and 57 matched healthy controls participated in this study. Cognitive functions were assessed using: The Trail making test (TMT), Wechsler Memory Scale‐Revised (WMS‐R), and Wechsler Adult Intelligence Scale (WAIS). Patients were assessed in the first week immediately after the end of the in‐patient treatment program (T1), and after six months of sustained abstinence (T2). Results At T1, the TD group showed deficits on all tested cognitive parameters (visual attention, task switching, working memory, visual memory, verbal memory, verbal knowledge, Verbal IQ, Performance IQ, and Full‐Scale IQ) in comparison to the control group. At T2, significant improvements had occurred in all the tested parameters except performance IQ. The cognitive performance of the abstinent individuals at T2 was comparable to the control group for the verbal subsets of WMS‐R, Verbal IQ, Performance IQ, and Full‐Scale IQ. Nevertheless, it was still worse than the control group in TMT, and all other WMS subsets. Conclusion tramadol dependence has negative effects on cognitive performance, which improves with extended abstinence.

Abstract In order to improve the current knowledge of the topography and the anatomy of the paranasal sinuses of the one‐humped dromedary (Camelus dromedarius), we applied both conventional and advanced imaging techniques, namely, radiography and computed tomography (CT). Twelve heads of healthy dromedaries were used; eight heads were dissected to obtain skulls for the fenestration of the sinuses, two heads underwent anatomical sections, and two heads were imaged respectively by radiography and CT. Sinus fenestration allowed observation of sinuses and their communications. In each dissected dromedary's head, the frontal sinus is a large compartment delimited by thick partitions. The sphenoid sinus is divided into small compartments by bony plates. The lacrimal sinus occupies a small cavity in the rostro‐medial lacrimal bone of the orbit. In all dissected heads, there was neither palatal sinus nor ventral conchal sinus. Five images obtained by CT were selected with an excellent correspondence with the anatomical sections. These images allowed a good differentiation between bones and sinus cavities. The visualisation of the sinus cavities and their anatomical limits has better quality using the CT compared to the radiography. Radiographic and CT images are therefore very useful for the interpretation of clinical imaging studies of the dromedary's paranasal sinuses.

Abstract Background and Aims The COVID‐19 pandemic and the resultant change in sedentary behaviors have had immense health, economic, and social implications globally. As governments worldwide imposed lockdowns and curfews, the amount of time spent indoors greatly increased. This lead to a dramatic change in physical activity (PA) levels and profound consequences on daily routines. Our study aimed to investigate patterns of PA during the COVID‐19 pandemic among adults residing in Saudi Arabia. Methods This cross‐sectional survey‐based study aimed to investigate patterns of PA during the COVID‐19 pandemic among adults residing in Saudi Arabia. The International Physical Activity Questionnaire was utilized to measure participants' PA levels between April 2021 and May 2021. Participants were then classified into three groups according to their PA level, and their PA levels and sedentary behaviors were analyzed. Results We surveyed 463 participants, 315 (68%) of which were female and 134 (32%) of which were male with a median age of 23 (interquartile range, 21–35) years. Moderate‐to‐high PA was reported by 257 (55.7%) of the participants. There was a significant decrease in PA during the COVID‐19 pandemic and resultant lockdowns among the participants (p = 0.04), with higher rates of sedentary behavior among males than females (p = 0.14). Conclusions The decline in PA is a profound challenge of the COVID‐19 pandemic that needs to be addressed by health practitioners and policymakers. Our study highlights the decline in PA levels seen during the COVID‐19 pandemic and the importance of promotional programs and interventions to increase PA among the Saudi Arabian population without compromising the essential health restrictions and social distancing.

Background. In Saudi Arabia, there are many people with disabilities that do not receive adequate healthcare, especially in the field of dentistry. Objective. This study focused on assessing caregivers’ perception of the relationship between oral healthcare and the overall health status of individuals with special healthcare needs (SHCN) in Qatif, Saudi Arabia. Methodology Design. This cross-sectional study was conducted using a questionnaire that was divided into two sections. The first part included demographic information such as the age and gender of both the caregiver and the person with a disability and the type of disability. The second part investigated the systemic health of the individual with a disability and the caregivers’ perception of the relationship between the management and treatment of systemic health and oral healthcare in relation to the overall health status. The results of descriptive analyses were summarized using frequency distribution tables. Bivariate analyses (chi-square test) were also performed. Significant differences were considered at a p value of 0.05. Setting. Initiated in school setting. Results. A total of 186 caregivers participated in the study. As much as 83.3% agree that oral health affects overall health, and 48.9% agreed that untreated dental problems could affect cardiac health. Age was the only factor found to be significantly associated with caregiver perception as younger caregivers were more likely to rightly understand the relationship between oral health and general health (p

Background. Denture stomatitis has been linked to the adhesion and proliferation of Candida albicans (C. albicans) on denture bases, which is a common and recurrent problem in denture wearers. The current study aimed to evaluate the effect of incorporating caffeic acid phenethyl ester (CAPE) into autopolymerized polymethyl methacrylate (PMMA) acrylic resin on C. albicans adhesion, surface roughness, and hardness as well as the correlation between tested properties. Methods. Autopolymerized acrylic resin discs (N = 100, 50/C. albicans adhesion; 50/C. albicans surface roughness and hardness test) were fabricated in dimensions 15 × 2.5 mm, samples were categorized into 5 groups (n = 10) based on CAPE concentrations; unmodified (control), 2.5, 5, 10 and 15% wt of acrylic powder. Specimens were stored in distilled water for 48 h at 37°C. C. albicans adhesion was evaluated via direct culture method. Profilometer and Vickers hardness tester were used for surface roughness and hardness measurement. Post hoc Tukey’s HSD with ANOVA test was performed to compare the difference of means amongst groups. P values were statistically significant at ≤0.05. Results. The addition of 2.5% of CAPE to PMMA has significantly reduced C. albicans counts in comparison to higher CAPE concentrations (p

Abstract Mycetoma, commonly known as Madura foot, is a chronic granulomatous infection caused either by fungi (eumycetoma) known as actinomycete. This disease occurs preferentially in young adults, and it affects the foot in particular. We report a Tunisian case of mycetoma occurring in an old patient, particular by its cystic presentation.

Abstract The World Health Organization (WHO) classifies odontomas as odontogenic tumors, consisting of odontogenic epithelium and ectomesenchyme. They result from developmental abnormalities and, therefore, do not constitute authentic tumors. It is a local malformation that has no growth autonomy. They are rarely symptomatic and are usually discovered accidentally during the realization of a radiographic examination. There are two variants of odontomas: complex and compound. Complex odontomas are made of a mass consisting of an anarchic assembly of mineralized tissue (enamel, dentin, and cementum) and dental pulp; while compound odontomas are consisting of a set of small rudimentary teeth, assembling in clusters. They rarely show the features of both types together. The aim of this work is to report a rare presentation of an odontoma in a 24‐year‐old male patient, which present the characteristics of both complex and compound variants. Surgical excision of the lesion was performed. Anatomopathological examination confirmed the diagnosis. Clinical and radiological survey does not show any recurrence.

Abstract Aims/Introduction Corneal confocal microscopy is a rapid, non‐invasive ophthalmic technique to identify subclinical neuropathy. The aim of this study was to quantify corneal nerve morphology in children with type 1 diabetes mellitus compared with age‐matched healthy controls using corneal confocal microscopy. Materials and Methods A total of 20 participants with type 1 diabetes mellitus (age 14 ± 2 years, diabetes duration 4.08 ± 2.91 years, glycated hemoglobin 9.3 ± 2.1%) without retinopathy or microalbuminuria and 20 healthy controls were recruited from outpatient clinics. Corneal confocal microscopy was undertaken, and corneal nerve fiber density (n/mm2), corneal nerve branch density (n/mm2), corneal nerve fiber length (mm/mm2), corneal nerve fiber tortuosity and inferior whorl length (mm/mm2) were quantified manually. Results Corneal nerve fiber density (22.73 ± 8.84 vs 32.92 ± 8.59; P

Abstract Background Programed cell death protein 1 (PD‐1) is a key mediator for the development of T cell exhaustion that develops in response to persistent antigen stimulation. Aim In this study, we measured PD1 expression on CD3 positive bone marrow T‐lymphocytes in newly diagnosis AML patients and its relation to clinical/ prognostic outcomes in addition to response to induction therapy (day 28). Methods This study was conducted on 59 newly diagnosed AML patients and 20 healthy controls. Complete blood counts, flow cytometry using acute leukemia panel in addition to PD1 monoclonal antibodies were performed on bone marrow lymphocytes (CD3+), whereas cytogenetic/molecular studies were used to determine risk group. The patients’ remission status following induction therapy was determined. Results PD1 was brightly expressed in 91.5% of the cases than control sample with highly significant difference (P = .001). A cutoff of 3.5 for mean fluorescence intensity was used to divide patients into two groups (higher vs normal PD1 expression). A significant difference between the two groups regarding platelet count and aberrant CD7 expression (P = .007 and .023, respectively) was found. Those normally expressed PD1 respond better to induction therapy. Conclusion PD1 expression on BM T‐cells had a predictive value and providing an immunotherapeutic target for AML.

In this article, we acquire a variety of new exact traveling wave solutions in the form of trigonometric, hyperbolic, and rational functions for the nonlinear time-fractional Clannish Random Walker’s Parabolic (CRWP) equation in the sense of beta-derivative by employing the two modified methods, namely, modified G′/G2− expansion method and modified F− expansion method. The obtained solutions are verified for aforesaid equations through symbolic soft computations. To promote the essential propagated features, some investigated solutions are exhibited in the form of 2D and 3D graphics by passing on the precise values to the parameters under the constrain conditions. The obtained solutions show that the presented methods are effective, straight forward, and reliable as compared to other methods. These methods can also be used to extract the novel exact traveling wave solutions for solving any types of integer and fractional differential equations arising in mathematical physics.

The reactivation of inherited tectonic structures formed during the Paleoproterozoic Trans-Hudson Orogeny (THO) has played a significant role in generating high-grade unconformity-related uranium deposits in the eastern Athabasca Basin. The role of these tectonic structures is now investigated through a series of two-dimensional hydrothermal numerical models. Two modelling scenarios are considered: (1) models during the THO peak of metamorphism and (2) models with a permeable layer mimicking the presence of the Athabasca Basin, deposited unconformably over the THO basement. In the first scenario, general fluid patterns are strongly affected by the applied permeability configurations. Unidirectional high fluid flow zones (from 10-9 to 10-8 m·s-1) and high thermal gradients (up to 65°C·km-1) can be observed above and within the deep-seated tectonic structures. In the second scenario, well-established fluid convection cells or unidirectional fluid flow zones are observed within the basin layer, with upflow originating from the core of the deep-seated structures, regardless of the applied fluid pressure regime. These results highlight that these deep-seated structures can efficiently transport fluids and heat towards the upper parts of the crust and the basin. In the second scenario, the loci for preore alteration are then evaluated by computing a rock alteration index based on temperature and fluid velocity constraints. These alteration areas reside along and above the deep-seated structures and are potential regions for structural reactivation during mineralization. These results imply that the analysis of the inherited tectonic structures, combined with the alteration regions, can serve as markers for uranium exploration.

Background and Objectives. Acute bronchiolitis is a common respiratory disease in children. C-reactive protein (CRP) is an indicator of bacterial coinfection. This study is aimed at assessing the frequency of elevated CRP in children with acute bronchiolitis and at comparing the clinical characteristics, laboratory and radiological findings, antibiotics use, and outcome according to CRP levels. Material and Methods. We retrospectively reviewed medical records of children with acute bronchiolitis admitted to Pediatric Department, Salmaniya Medical Complex, Bahrain, in 2019-2020. Demographic, clinical, laboratory and radiological data, and outcomes were collected. Patients with high CRP were compared with those with normal levels. Results. Of 287 patients, 229 (79.2%) were included. 132 (57.6%) were males. Median presentation age was 3.7 (interquartile range (IQR), 1.27-12.33) months. Median CRP level was 10.4 (IQR, 2.8-35.1) mg/L. CRP was high in 167 (72.9%) patients. 17.6% (33/187 patients) had confirmed bacterial coinfection. Respiratory syncytial virus (RSV) was detected in 84 (36.7%) patients. Mean CRP level was higher in RSV-negative compared to RSV-positive patients, 31.3±44.3 versus 21.5±27.7 mg/L, respectively (P=0.042). Respiratory viral serology profile was positive in 34.7% (17/49 patients). 66.9% (107/160 patients) had positive chest X-ray. Antibiotics were used in 78.1% (179/227 patients). Thirteen (5.7%) patients required intensive care, five (2.2%) had surgical intervention, four (1.8%) required endotracheal intubation, and four (1.8%) died. Patients with high CRP were older at presentation (P

Cancer therapies are associated with various challenges including the emergence of multidrug resistant tumors, toxicological issues, severe side effects, and economic burden. To counteract these effects, natural products as substitutes and adjuvant therapies have received considerable attention owing to their safety, efficacy, and economic aspects. Various preclinical and clinical studies revealed that natural products and their combinations with chemotherapeutics mediate their anticancer effects via modulation of various signaling pathways implicated in promoting apoptosis, inhibiting excessive cellular proliferation, and mobilizing the immune system. Several lead phytochemicals including curcumin, resveratrol, quercetin, and cannabinoids synergistically act with cancer chemotherapeutics reducing cell proliferation and inducing apoptosis and cell cycle arrest. However, clinical studies on the subject matter are limited and need further extensive studies. It has been observed that patients undergoing chemotherapy use alternative therapies to ameliorate the symptoms associated with the use of chemotherapeutic agents. Nevertheless, some of the patients inform their physicians regarding herbal medicine during chemotherapy while others do not, and even most of the patients do not know the composition of herbal medicine they consume during chemotherapy. Herbal interactions with chemotherapeutics are associated with both beneficial and harmful aspects, but the beneficial aspect overweighs the harmful ones in terms of controlling the symptoms associated with the chemotherapy. Nonetheless, a large number of herbal medicines have been demonstrated to have synergistic effect with chemotherapy and alleviate the side effects of chemotherapeutic agents. The concomitant use of the majority of herbal medicines with chemotherapy has been demonstrated to be beneficial in multiple malignant tumors like cancer of blood, lungs, kidneys, liver, skin, and gastrointestinal tract. However, herbal medicines which possess positive interaction and improve the quality of life of patients should be sorted out and integrated with the chemotherapy. There should be a quality control system for the appraisal of herbal medicine, and there should also be an appropriate system of patient-doctor communication to counsel the patients regarding the beneficial and deleterious effects of the herbal medicine in combination with chemotherapy.

Let q∈0,1. We know that, when q tends to 1, we recover “classical” quantum mechanics. However, when q is not equal to one, we have a theory of quantum mechanics in a spacetime, i.e., a theory where the vacuum has a nonzero energy density. As a q-analogue on the space variable of the wave equation, we introduce the q-space wave equation. Solutions of these equations are given for q∈0,1 and for q⟶0. Since some states have more spin degrees of freedom than the physical particle has, the q-space wave equations remove the additional degrees of freedom.

This study attempts to introduce continuous static games with fuzzy parameters. Piecewise quadratic fuzzy numbers (PQFNs) are used to represent the fuzzy parameters. The close interval approximation of the PQFNs, which is one of the most accurate approximations, is applied. To overcome the problem, Stackelberg leaders with min-max follower’s solutions are examined. The given solution is accompanied by a parametric analysis. An algorithm for identifying the first-kind stability set is presented. Finally, to demonstrate and clarify the method’s steps, a numerical example is given