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Reducing carbon dioxide (CO2) emissions urgently requires the large-scale deployment of carbon-capture technologies. These technologies must separate CO2 from various sources and deliver it to different sinks1,2. The quest for optimal solutions for specific source-sink pairs is a complex, multi-objective challenge involving multiple stakeholders and depends on social, economic and regional contexts. Currently, research follows a sequential approach: chemists focus on materials design3 and engineers on optimizing processes4,5, which are then operated at a scale that impacts the economy and the environment. Assessing these impacts, such as the greenhouse gas emissions over the plant's lifetime, is typically one of the final steps6. Here we introduce the PrISMa (Process-Informed design of tailor-made Sorbent Materials) platform, which integrates materials, process design, techno-economics and life-cycle assessment. We compare more than 60 case studies capturing CO2 from various sources in 5 global regions using different technologies. The platform simultaneously informs various stakeholders about the cost-effectiveness of technologies, process configurations and locations, reveals the molecular characteristics of the top-performing sorbents, and provides insights on environmental impacts, co-benefits and trade-offs. By uniting stakeholders at an early research stage, PrISMa accelerates carbon-capture technology development during this critical period as we aim for a net-zero world.

Large-language models (LLMs) such as GPT-4 caught the interest of many scientists. Recent studies suggested that these models could be useful in chemistry and materials science. To explore these possibilities, we organized a hackathon. This article chronicles the projects built as part of this hackathon. Participants employed LLMs for various applications, including predicting properties of molecules and materials, designing novel interfaces for tools, extracting knowledge from unstructured data, and developing new educational applications. The diverse topics and the fact that working prototypes could be generated in less than two days highlight that LLMs will profoundly impact the future of our fields. The rich collection of ideas and projects also indicates that the applications of LLMs are not limited to materials science and chemistry but offer potential benefits to a wide range of scientific disciplines.

Abstract In plant production, evaluation of salt stress protectants concerning their potential to improve growth and productivity under saline stress is critical. Bacillus subtilis (Bs) and cobalt (Co) have been proposed to optimize salt stress tolerance in coriander (Coriandrum sativum L. cv. Balady) plants by influencing some physiological activities. The main aim of this work is to investigate the response of (Bs) and (Co) as eco-safe salt stress protectants to resist the effect of salinity, on growth, seed, and essential oil yield, and the most important biochemical constituents of coriander produced under salt stress condition. Therefore, in a split-plot factorial experiment design in the RCBD (randomized complete block design), four levels of salinity of NaCl irrigation water (SA) were assigned to the main plots; (0.5, 1.5, 4, and 6 dS m−1); and six salt stress protectants (SP) were randomly assigned to the subplots: distilled water; 15 ppm (Co1); 30 ppm (Co2); (Bs); (Co1 + Bs); (Co2 + Bs). The study concluded that increasing SA significantly reduced coriander growth and yield by 42.6%, which could be attributed to ion toxicity, oxidative stress, or decreased vital element content. From the results, we recommend that applying Bs with Co (30 ppm) was critical for significantly improving overall growth parameters. This was determined by the significant reduction in the activity of reactive oxygen species scavenging enzymes: superoxide dismutase (SOD), catalase (CAT), and malondialdehyde (MDA) and non-enzyme: proline by 5, 11.3, 14.7, and 13.8% respectively, while increasing ascorbic acid by 8% and preserving vital nutrient levels and enhancing plant osmotic potential to buffer salt stress, seed yield per plant, and essential oil yield increased by 12.6 and 18.8% respectively. The quality of essential oil was indicated by highly significant quantities of vital biological phytochemicals such as linalool, camphor, and protein which increased by 10.3, 3.6, and 9.39% respectively. Additional research is suggested to determine the precise mechanism of action of Bs and Co's dual impact on medicinal and aromatic plant salt stress tolerance.

Abstract The accurate classification of human activities in crime scenes during forensics (criminalistics) is of utmost importance in classifying suspicious and unlawful activities, easing their acceptability and interpretability by judges during legal procedures in courts or by other non-experts in the field of forensics. This paper implements machine learning (ML) algorithms: support vector machine (SVM) and decision tree (DT), to demonstrate with a high accuracy, how data emanating from smartphones’ sensors reveal and isolate relevant information about static and dynamic human activities in criminalistics. Smartphones’ data from five different sensors (accelerometer, gravity, orientation, Gyroscope and light), related to ten recurrent crime scenes activities, grouped into three classes of events (normal, felony and none-felony events) are classified by the proposed algorithms, with novelty being the classification decisions based on the entire period of the events and not instantaneous decision makings. Three independent data-subsets were made, with permutations done between them and at each time, two sets used for training and the third set used for testing. Time- and frequency-domain features were initially used separately and then combined for the model training and testing. The best average training accuracies of 100% and 97.8% were obtained for the DT and SVM, respectively, and the testing accuracies of 89.1% were obtained for both algorithms. We therefore believe that these results will serve as a solid persuasive and convincing argument to judges and non-experts of the field of forensics to accept and easily interpret computer-aided classification of suspicious activities emanating from criminalistic studies.

PURPOSE: Endometrioid ovarian carcinoma (ENOC) is the second most-common type of ovarian carcinoma, comprising 10%-20% of cases. Recently, the study of ENOC has benefitted from comparisons to endometrial carcinomas including defining ENOC with four prognostic molecular subtypes. Each subtype suggests differential mechanisms of progression, although tumor-initiating events remain elusive. There is evidence that the ovarian microenvironment may be critical to early lesion establishment and progression. However, while immune infiltrates have been well studied in high-grade serous ovarian carcinoma, studies in ENOC are limited. EXPERIMENTAL DESIGN: We report on 210 ENOC, with clinical follow-up and molecular subtype annotation. Using multiplex IHC and immunofluorescence, we examine the prevalence of T-cell lineage, B-cell lineage, macrophages, and populations with programmed cell death protein 1 or programmed death-ligand 1 across subtypes of ENOC. RESULTS: Immune cell infiltrates in tumor epithelium and stroma showed higher densities in ENOC subtypes with known high mutation burden (POLEmut and MMRd). While molecular subtypes were prognostically significant, immune infiltrates were not (overall survival P > 0.2). Analysis by molecular subtype revealed that immune cell density was prognostically significant in only the no specific molecular profile (NSMP) subtype, where immune infiltrates lacking B cells (TILB minus) had inferior outcome (disease-specific survival: HR, 4.0; 95% confidence interval, 1.1-14.7; P < 0.05). Similar to endometrial carcinomas, molecular subtype stratification was generally superior to immune response in predicting outcomes. CONCLUSIONS: Subtype stratification is critical for better understanding of ENOC, in particular the distribution and prognostic significance of immune cell infiltrates. The role of B cells in the immune response within NSMP tumors warrants further study.

Introduction he Disability Rating Scale (DRS) is a short, efficient, rapid instrument for monitoring general functional recovery from moderate to severe traumatic brain injury (TBI). The 8-item DRS is a published and validated assessment instrument but has not yet been adapted to native Arabic-speaking caregivers of patients with TBI. This study aimed to translate, cross-culturally adapt, and test the reliability of the Arabic version of the DRS. Methods Cross-cultural adaptation and translation were performed according to the recommended guidelines: translation, back-translation, expert review, and pretesting. Reliability was assessed via a test-retest procedure at 2-week intervals using the Kappa coefficient among 42 caregivers of patients with TBI. Results The agreement among the raters was excellent, varying from 0.88 to 1. Translating the DRS into Arabic was easy based on the translators’ information. The test-retest reliability was excellent (interclass correlation coefficient = 0.99 with a 95% CI 0.998 to 0.999 [ F (41) = 1100.7, p < 0.001]. The Cronbach’s alpha for the internal consistency of the DRS was 0.917. There was good agreement (convergent validity) between the DRS scores with the Short Form 36 Health Survey Questionnaire [ rs (42) = 0.895, p = 0.001]. Conclusions The Arabic version of the DRS can be used among Arabic-speaking caregivers of patients with TBI. The Arabic translated version of the DRS can be used among caregivers of patients with TBI telephonically by expert professional. The translated questionnaire was easy to comprehend among caregivers of patients with TBI, with excellent test re-test reliability and good convergent validity.

Abstract Background Human activities have significantly contributed to a persistent climate change trend, posing substantial threats to human health. Nurses regularly interact with patients experiencing the consequences of climate change, making their engagement in addressing this issue crucial. Nonetheless, our understanding of nurses' viewpoints regarding climate change remains limited. Aim This scoping review aims to identify practicing nurses' and nursing students' perceptions of climate change. Design To fulfil this objective, a documentary search strategy was developed using an iterative process. Methods The search strategy was tested in four bibliographic databases, as well as in the grey literature. A 2‐stage selection process was conducted, and relevant data were extracted from selected articles for analysis. Results Twenty‐two scientific articles and 11 documents from nursing associations were selected. The findings suggest that while many nurses and nursing students are concerned about climate change and its effects on their patients' health, their role in addressing the climate crisis is not well understood. Many barriers such as having a heavy workload and the lack of support hindered their ability to adjust their practice in response to the changing climate. Furthermore, many expressed a need for trainings on climate change issues. Conclusions These results raise a great and urgent demand for these professionals to receive appropriate training to cope with climatic threats to health. Future research should focus on the development of nursing climate leadership, and healthcare organizations should support nursing initiatives and help raise nurses' awareness regarding climate change.

Growth differentiation factor-15 (GDF-15) is an emerging biomarker in several conditions. This SLR, conducted following PRISMA guidelines, examined the association between GDF-15 concentration and range of adverse outcomes in patients with heart failure (HF). Publications were identified from Embase® and Medline® bibliographic databases between January 1, 2014, and August 23, 2022 (congress abstracts: January 1, 2020, to August 23, 2022). Sixty-three publications met the eligibility criteria (55 manuscripts and 8 abstracts; 45 observational studies and 18 post hoc analyses of randomized controlled trials [RCTs]). Of the 19 outcomes identified, the most frequently reported longitudinal outcomes were mortality (n = 32 studies; all-cause [n = 27] or cardiovascular-related [n = 6]), composite outcomes (n = 28; most commonly mortality ± hospitalization/rehospitalization [n = 19]), and hospitalization/re-hospitalization (n = 11). The most common cross-sectional outcome was renal function (n = 22). Among longitudinal studies assessing independent relationships with outcomes using multivariate analyses (MVA), a significant increase in risk associated with higher baseline GDF-15 concentration was found in 22/24 (92 %) studies assessing all-cause mortality, 4/5 (80 %) assessing cardiovascular-related mortality, 13/19 (68 %) assessing composite outcomes, and 4/8 (50 %) assessing hospitalization/rehospitalization. All (7/7; 100 %) of the cross-sectional studies assessing the relationship with renal function by MVA, and 3/4 (75 %) assessing exercise capacity, found poorer outcomes associated with higher baseline GDF-15 concentrations. This SLR suggests GDF-15 is an independent predictor of mortality and other adverse but nonfatal outcomes in patients with HF. A better understanding of the prognostic role of GDF-15 in HF could improve clinical risk prediction models and potentially help optimize treatment regimens.

The heat capacity of a material is a fundamental property of great practical importance. For example, in a carbon capture process, the heat required to regenerate a solid sorbent is directly related to the heat capacity of the material. However, for most materials suitable for carbon capture applications, the heat capacity is not known, and thus the standard procedure is to assume the same value for all materials. In this work, we developed a machine learning approach, trained on density functional theory simulations, to accurately predict the heat capacity of these materials, that is, zeolites, metal-organic frameworks and covalent-organic frameworks. The accuracy of our prediction is confirmed with experimental data. Finally, for a temperature swing adsorption process that captures carbon from the flue gas of a coal-fired power plant, we show that for some materials, the heat requirement is reduced by as much as a factor of two using the correct heat capacity.

Abstract Family relationships are the basis for a stable family atmosphere. Now with the internet, which has become a tangible part of our lives, membership of virtual communities, including social networks, has grown. It has created fundamental changes in the structure of social relationships and human interaction, forming a new framework of virtual interactions that transcend international borders. Due to their significance, unavoidability, availability, confidentiality, ease of use, and intrusive nature through interaction and sharing, virtual communities now extend beyond the individual and related level of risk. This study aimed to assess the cultural and behavioral risks of virtual interactions for Saudi families and their level of incidence and likelihood. It belonged to descriptive studies, using the social survey for a sample (1524) from Hail region families between 15 December 2022 and 31 January 2023, and was based on the list of cultural and behavioral risks of virtual interactions. Results showed that the most dangerous social networking sites for Saudi families were TikTok, Twitter, Snapchat, YouTube, and Instagram respectively. Matrix results showed that 66.7% of virtual interaction threats have a high severity and likelihood, namely: adopting atheistic ideas, spreading the thought of hate, undermining the values of the Saudi family, and adopting ideas that incite violence from cultural threats, privacy hacks, cyber-bullying, fraud, violence, social isolation and cybercrime from behavioral threats. The study recommends adopting a social risk management (SRM) concept, especially regarding risks to family, because it is a new dimension of social protection.

Abstract The impacts of climate change on heritage collections in Mediterranean museums are serious and lead to accelerated material degradation, loss of value, increasing conservation costs and climatisation. Climate change scenarios and simulation models have been developed to predict the extreme and average future environmental conditions and to assess the future long-term risks caused by global warming for museum buildings and their collections in Mediterranean countries, with Egypt being particularly at risk. This paper presents the results of the risk analysis of the indoor and outdoor environments in Alexandria Museum of Fine Arts (AMFA) in Egypt to provide an overview of the current situation of conservation and museum management and to provide evidence-based data to support decision-making regarding preventive conservation given the museum's limited funding, capacity and resources. Unfortunately, the air quality in the museum cannot be considered satisfactory and specific measures need to be taken to improve the level of air quality and museum and building management. The results enabled an assessment of indoor air quality and provided information on potential risks to the museum building and collections, including variations in temperature (T) and relative humidity (RH), concentrations of NO2, SO2, O3, CO2, acetic and formic acid and lighting conditions, as well as the location and management of the museum. The results necessitate the development of a preventive conservation plan to address the challenges associated with high T/RH fluctuations and pollution pressure. This requires more regular use of the HVAC system within certain T/RH set points as well as minimising light exposure and the use of UV-filtering glazing. Care should be taken to ensure that housekeeping and emergency preparedness reduce the damping and salt florescence in the museum building. However, dealing with the impact of climate change on indoor and outdoor environments and museum collections in Mediterranean museums requires a holistic and adaptive approach that includes joint collaboration, research, training and strategic planning to ensure the long-term preservation of valuable cultural heritage collections in different climates with customised adaptations based on local environmental conditions, resources and needs. Resilience planning should be region-specific and take into account the potential impacts of extreme weather events, sea level rise and other climate-related challenges.

Abstract Introduction Premenstrual symptoms encompass a range of physical, emotional, and behavioral changes that cyclically occur before menstruation. Childhood abuse has been associated with subsequent mental health challenges, yet its relationship with exacerbating premenstrual symptoms remains an understudied area. Furthermore, suicidal ideation often emerges from traumatic backgrounds such as child abuse, creating another layer of complexity. Given the rising suicide rates in Lebanon, and the concurrent increase in reported child abuse cases, this research focuses on the role of suicidal ideation as a mediator between child abuse and premenstrual syndrome. Methods This cross-sectional study involved 915 female university students in Lebanon. Participants completed an online questionnaire encompassing demographic details, health lifestyle, the Premenstrual Symptoms Screening Tool (PSST), Columbia-Suicide Severity Rating Scale (C-SSRS), and Child Abuse Self Report Scale (CASRS-12). The mediation analysis was conducted using PROCESS MACRO v3.4 model 4; three pathways derived from this analysis: pathway A from the independent variable to the mediator, pathway B from the mediator to the dependent variable, Pathway C indicating the direct effect from the independent to the dependent variable. Results The results of the mediation analysis showed that suicidal ideation mediated the association between all types of child abuse and the presence of PMS. Higher psychological (Beta = 0.21; p

Objectives: Deep venous thrombosis (DVT) is a known surgical complication that can lead to pulmonary embolism with subsequent morbidity and mortality. The incidence of DVT following coronary artery bypass grafting is unclear. Prophylaxis regimens vary and some guidelines advocate against use of routine chemoprophylaxis in patients at low-moderate risk for venous thromboembolism. We utilized postoperative lower extremity venous ultrasound to determine the incidence of DVT following coronary artery bypass grafting in patients with low- to moderate-risk of venous thromboembolism receiving aggressive postoperative DVT prophylaxis. Methods: This is a single-center, retrospective study of all patients who underwent coronary artery bypass grafting between April 2022 and January 2023. All patients who completed postoperative venous ultrasound of the bilateral lower extremities were initially included. Patients who underwent concurrent valve or aortic surgery, were at high risk of venous thromboembolism, or were receiving anticoagulation therapy for nonvenous thromboembolism indications were excluded. The primary outcome was in-hospital incidence of DVT. Secondary outcomes were rates of mortality, postoperative bleeding, and thromboembolic events from discharge to 30 days postoperatively and from 30 days to 3 months postoperatively. Results: No DVTs were observed in 211 included patients. In hospital, there were 3 significant bleeding events and 1 stroke. Following discharge there were 3 additional bleeding events, 1 death, 1 transient ischemic attack, and 1 pulmonary embolism. Conclusions: We observed a 0% rate of DVT in low- to moderate-risk patients undergoing isolated coronary artery bypass grafting and receiving a comprehensive DVT prophylaxis regimen. In hospital bleeding and other thromboembolic event rates were 2.84% and 0.47% respectively.

Background:Gestational diabetes mellitus (GDM) is defined as the development of carbohydrate intolerance during pregnancy, excluding overt diabetes. GDM poses a risk of short-term adverse perinatal outcomes and long-term metabolic morbidity to women and their newborns. Objectives:The aim of this study was to determine the role of first trimester glycosylated haemoglobin as a predictor of gestational diabetes mellitus. Patients and methods: The study was carried out at Qena University Hospital, Department of Obstetrics and Gynecology. The glcosylated hemoglobin investigation included 200 high risk pregnant ladies from the start trimester taking care of our outpatient facility and in tolerant from May 2019 to May 2020. Results: Patients who developed gestational diabetes mellitus with HA1c < 5.7% were 12.4% while with HA1c ≥ 5.7% were 47.3%. Also, there is significant statistically difference between both groups (p value= 0.015).ROC curve for HbA1c in 1st trimester as a predictor of gestational diabetes mellitus showed that the cut-off point was ≥6.2%, sensitivity was 93.3% and specificity was 90.0%. Conclusion: The detection of glycosylated hemoglobin in the first trimester is a promising predictor biomarker for diagnosis of GDM and in the future may replace other basic investigations.

Wildfires in boreal forests release large quantities of greenhouse gases to the atmosphere, exacerbating climate change. Here, we characterize the magnitude of recent and projected gross and net boreal North American wildfire carbon dioxide emissions, evaluate fire management as an emissions reduction strategy, and quantify the associated costs. Our results show that wildfires in boreal North America could, by mid-century, contribute to a cumulative net source of nearly 12 gigatonnes of carbon dioxide, about 3% of remaining global carbon dioxide emissions associated with keeping temperatures within the Paris Agreement's 1.5°C limit. With observations from Alaska, we show that current fire management practices limit the burned area. Further, the costs of avoiding carbon dioxide emissions by means of increasing investment in fire management are comparable to or lower than those of other mitigation strategies. Together, our findings highlight the climate risk that boreal wildfires pose and point to fire management as a cost-effective way to limit emissions.

Abstract Background Considerable improvements in the prognosis of pediatric cancer patients have been achieved over recent decades due to advances in treatment. Nevertheless, as the most common and distressing health issue for pediatrics with cancer, cancer-related pain is still a significant hurdle that impedes patients’ journey to recovery, compromises their quality of life, and delays the positive outcome and effectiveness of their treatments. Purpose Taking into consideration that acceptability studies are imperative for the design, evaluation, and implementation of healthcare interventions, this study aims to explore pediatric oncology patients’ readiness to use a mobile health application that emphasizes social assistance and peer support in addition to conventional pain management methods. Design and methods This study followed the Qualitative description approach. Twelve participants were chosen based on purposive sampling and maximum variation sampling. Interviews were analyzed using the conventional content analysis. Results Analysis of the interviews revealed four major categories: (A) The need for connectedness; (B) An innovative way to connect yet fearful; (C) A 3D approach; (D) Fears of the unfamiliar. Conclusions This study is the first in Lebanon and the region to undertake an initiative towards introducing technology for pain assessment and management of children with cancer through a dedicated digital platform. The study results attested to the acceptability and potential utilization of this platform by children with cancer. Practice implications Nurses need to be trained to play an essential role in teaching children with cancer about the significance of social support and assisting them to establish their social support network. Children with cancer are encouraged to voice out their need for help. Our proposed application can create an enabling environment to harness the power of social support and provide children with cancer the opportunity to connect on a deeper level in a supportive and pity-free space.

BackgroundChronic Kidney Disease (CKD) patients encounter many obstacles that affect their physical and psychological well-being. The primary objective of the present study was to investigate potential correlates of optimism/pessimism in a sample of patients with CKD, including socio-demographics, body appreciation and disordered eating symptoms. As a secondary objective, we proposed to examine the psychometric properties of an Arabic translation of the Optimism-Pessimism Short Scale-2 (SOP2) before its use in our sample.MethodsA cross-sectional study was carried out between April and May 2023, enrolling 108 participants from three hospitals in Lebanon providing insights into their sociodemographic characteristics, physical activity levels, body appreciation, optimism, pessimism, and eating attitudes.ResultsResults indicated that the Arabic-language adaptation of the SOP2 has good reliability coefficients. The two facets of the scale displayed a strong correlation to each other, and highly similar correlations with external study variables (i.e., household crowding index, physical activity, body appreciation, disordered eating), suggesting that the SOP2 can be interpreted as a unidimensional measure for the psychological dispositional optimism as proposed by the developers. Furthermore, findings revealed a strong positive correlation between body appreciation and optimism, suggesting that CKD patients who appreciate their bodies tend to exhibit a more optimistic outlook on life. Conversely, higher body appreciation is associated with lower pessimism, indicating that a positive body image may mitigate feelings of hopelessness and despair in CKD patients.ConclusionThis study contributes to the literature in two ways. First, it offers the Arabic SOP2 as an brief tool to administer, and psychometrically sound instrument that can be useful for clinical and research purposes. Second, it unveils a clear correlation between higher body appreciation and a more optimistic, less pessimistic mindset in patients with CKD.

Abstract Background One of the most prevalent musculoskeletal issues in dentistry is forward head posture (FHP). Proprioception and core endurance are crucial for maintaining proper posture. Objective The aim of this study was to compare dental students with and without FHP in terms of their core endurance and shoulder proprioception. Methods Using kinovea software, a cross-sectional study was conducted on 30 dental students who had FHP with a craniovertebral angle less than 49 degrees. The control group consisted of 30 additional dental students without FHP. Trunk anterior flexor, posterior extensor, right and left flexors were tested using the McGill method to determine core endurance. The isokinetic Biodex system was used to measure shoulder proprioception. Results Independent t-test results revealed that core endurance was significantly lower in the group with forward head posture compared to the control group (p 0.05), while shoulder proprioception did not differ significantly between groups (p > 0.05). Conclusion In comparison to dental students without forward head posture, male dental students with FHP have normal shoulder joint proprioception and impaired core endurance holding time. This could be a risk factor for a variety of musculoskeletal issues in dentists.

Tundra environments are experiencing elevated levels of wildfire, and the frequency is expected to keep increasing due to rapid climate change in the Arctic. Tundra wildfires can release globally significant amounts of greenhouse gasses that influence the Earth's radiative balance. Here we develop a novel method for estimating carbon loss and the resulting radiative forcings of gaseous and aerosol emissions from the 2015 tundra wildfires in the Yukon–Kuskokwim Delta (YKD), Alaska. We paired burn depth measurements using two vegetative reference points that survived the fire event – Sphagnum fuscum and Dicranum spp. – with measurements of local organic matter and soil carbon properties to estimate total ecosystem organic matter and carbon loss. We used remotely sensed data on fire severity from Landsat 8 to scale our measured losses to the entire fire-affected area, with an estimated total loss of 2.04 Tg of organic matter and 0.91 Tg of carbon and an average loss of 3.76 kg m−2 of organic matter and 1.68 kg m−2 of carbon in the 2015 YKD wildfires. To demonstrate the impact of these fires on the Earth's radiation budget, we developed a simple but comprehensive framework to estimate the radiative forcing from Arctic wildfires. We synthesized existing research on the lifetime and radiative forcings of gaseous and aerosol emissions of CO2, N2O, CH4, O3 and its precursors, and fire aerosols. The model shows a net positive cumulative mean radiative forcing of 3.67 W m−2 using representative concentration pathway (RCP) 4.5 and 3.37 W m−2 using RCP 8.5 at 80 years post-fire, which was dominated by CO2 emissions. Our results highlight the climate impact of tundra wildfires, which positively reinforce climate warming and increased fire frequency through the radiative forcings of their gaseous emissions.

Numerous deep beam design models have been proposed; however, even the most recent design manuals provide limited guidance for deep beam design, especially when the beams have complicated features such as web openings. The openings cause a geometric discontinuity, which makes the distribution of nonlinear stress along the depth of the beam more complicated. In this paper, the structural behavior of the deep beams with openings was investigated experimentally via a total of twenty concrete beam specimens and analytically in four themes. In the first theme, eleven concrete beam specimens with circular and rectangular openings, including the reference solid specimen, were tested to examine how the shape, size, and position of the openings affected the structural behavior of the deep beams. According to earlier studies, the crack patterns and modes of failure for the specimens were discussed in the first theme, and various techniques for strengthening the openings, whether circular or rectangular, were suggested in the second theme. Six concrete beam specimens with rectangular openings were strengthened; three of them were internally strengthened using various thickness plates around the openings, and the other three were strengthened using external fasteners subjected to torque moments. As for the concrete beam specimens with circular openings, these openings were strengthened with three different reinforcement techniques in the three tested beams. The load capacity, deflection, and crack patterns for the strengthened and unstrengthened specimens were recorded and discussed. The experimental results indicated that the load capacity and stiffness of the tested beams were significantly reduced by the presence of openings. Additionally, there was a distinct variety in how the size, position, and shape of the openings affected the beams performance. The results also demonstrated that concrete beam specimens with rectangular openings that were strengthened externally by the fasteners were the best, whereas the efficiency of the remaining strengthening was lower than expected. In the third theme, a numerical study using the nonlinear finite element model (NLFE), the program ANSYS V-19.2, 2018 was conducted on some of the tested strengthened and unstrengthened specimens. The analytical study's findings demonstrated the effectiveness of the NLFE model by comparing with load carrying capacity and load-deflection curve of the tested specimens. In the fourth theme, based on Bi-directional Evolutionary Structural Optimization (BESO), an algorithm developed in MATLAB and integrated with the FEA solver SAP software was used to build the optimal strut and tie model (OSTM) for two concrete beam specimens with rectangular and circular openings. This was undertaken with the objective of seeking and finding a strengthening technique that is more effective and is dependent on a clear methodology, not on trial and expectation. In agreement with the final obtained OSTM, new alternative strengthening techniques were proposed and evaluated using NLFE. In comparison to the other techniques that were described in this research, the proposed strengthening techniques based on BESO was the best and most effective, they increased the ultimate load in some cases by 72.7 %. BESO can be used efficiency for strengthening the deep beams with openings.

Background Proximal radial artery (pRA) access for cardiac catheterization is safe but can jeopardize subsequent use of the artery because of occlusion. Distal radial artery (dRA) access in the anatomical snuffbox preserves the radial artery, but safety and potential detrimental effects on hand function are unknown. Methods and Results In the DIPRA (Distal Versus Proximal Radial Artery Access for Cardiac Catheterization and Intervention) study, a single‐center trial, 300 patients were randomized 1:1 to cardiac catheterization through dRA or pRA. The primary end point of change in hand function from baseline to 30 days was a composite of the QuickDASH (Quick Disabilities of the Arm, Shoulder and Hand) questionnaire, hand‐grip test, and thumb forefinger pinch test. Secondary end points included access feasibility and complications; 254 of 300 patients completed follow‐up at 30 days; of these, 128 were randomized to dRA and 126 to pRA with balanced demographic and procedural characteristics. Both groups had similar rates of access site bleeding (dRA 0% versus pRA 1.4%; P=0.25). Six patients with dRA failed access compared with 2 patients with pRA. Radial artery occlusion occurred in 2 pRA versus none in dRA. There were no significant differences in change in hand function, median hand‐grip (dRA 0 [−3.2, 3.3] versus pRA 0.7 [−2.3, 3.3] kg; P=0.21), pinch‐grip (dRA −0.3 [−1.2, 0.5] versus pRA 0 [−0.9, 0.9] kg; P=0.09), and QuickDASH (dRA 0 [−4.6, 2.3] versus pRA 0 [−4.6, 2.3] points, P=0.96). There was no significant difference in the composite of hand function between pRA and dRA. Conclusions dRA is a safe strategy for cardiac catheterization with a low complication rate. Compared with pRA, there is no increased risk of hand dysfunction at 30 days. Registration URL: https://www.ClinicalTrials.gov. Unique identifier: NCT04318990.

Plain English Summary Muscle dysmorphic disorder (MDD) refers to an important muscularity-oriented dimension related to eating disorder (ED) symptoms and body image disturbances. One widely used self-report measure to assess the MDD construct is the Muscle Dysmorphic Disorder Inventory (MDDI). Despite its high clinical relevance, MDD has not been previously investigated in the Lebanese context and among the Arabic-speaking communities in general. Indeed, the multiple scales assessing ED symptomatology that have previously been translated to the Arabic language and adapted to the Lebanese population have been mainly focused on thinness-oriented ED; and no Arabic validation of muscularity-oriented body image and disordered eating symptoms measures, including the MDDI, exists so far to the best of our knowledge. To overcome this gap, the present study aimed to validate the Arabic version of the MDDI (Ar-MDDI) in a sample of Lebanese men university students. The findings showed that the AR-MDDI is robust in terms of reliability, factor structure, convergent and divergent validity. We, therefore, preliminarily recommend its use in clinical practice, preventive interventions and future research in Arab settings.

Abstract Background The literature highly concentrates on disorders related to body image among women but only minimally when it comes to the male population; hence, in order to provide general practitioners, and primary care physicians in general, and psychiatrists in particular, with additional information concerning muscle dysmorphia among male university students in Lebanon, this study seemed essential, and was therefore conducted to (1) identify the prevalence of MDD, and (2) evaluate the indirect effect of eating attitudes in general and orthorexia nervosa in particular, in the association between perfectionism and muscle dysmorphic disorder (MDD) among a sample of male university students. Methods In this cross-sectional study conducted between September 2021 and May 2022, 396 male university students from multiple universities in Lebanon filled the online Arabic questionnaire. Results The results showed that 26 (6.6%) of the participants had MDD. Orthorexia nervosa and eating attitudes mediated the association between perfectionism and MDD; higher perfectionism was significantly associated with higher ON and more inappropriate eating; higher ON and more inappropriate eating were significantly associated with higher MDD, whereas perfectionism had a significant total direct effect on MDD. The high prevalence of MDD among male university students in Lebanon implies further investigation on the national level in the country. Conclusion Awareness campaigns among the university students could be adopted at the national level to increase the level of knowledge on the concepts of obsessive self-destructive perfectionism, orthorexia nervosa and muscle dysmorphia.