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The Inverse Gaussian distribution finds application in various fields, such as finance, survival analysis, psychology, engineering, physics, and quality control. Its capability to model skewed distributions and non-constant hazard rates makes it a valuable tool for understanding a wide range of phenomena. In this paper, we present a goodness-of-fit test specifically designed for the Inverse Gaussian distribution. Our test uses an estimate of the Gini index, a statistical measure of inequality. We provide comprehensive details on the exact and asymptotic distributions of the newly developed test statistic. To facilitate the application of the test, we estimate the unknown parameters of the Inverse Gaussian distribution using maximum likelihood estimators. Monte Carlo methods are utilized to determine the critical points and assess the actual sizes of the test. A power comparison study is conducted to evaluate the performance of existing tests. Comparing its powers with those of other tests, we demonstrate that the Gini index-based test performs favorably. Finally, we present a real data analysis for illustrative purposes.

Abstract Background Improving the germination performance of bread wheat is an important breeding target in many wheat-growing countries where seedlings are often established in soils with high salinity levels. This study sought to characterize the molecular mechanisms underlying germination performance in salt-stressed wheat. To achieve this goal, a genome-wide association study (GWAS) was performed on 292 Iranian bread wheat accessions, including 202 landraces and 90 cultivars. Results A total of 10 and 15 functional marker-trait associations (MTAs) were detected under moderate (60 mM NaCl) and severe (120 mM NaCl) salinity, respectively. From genomic annotation, 17 candidate genes were identified that were functionally annotated to be involved in the germination performance of salt-stressed wheat, such as CHX2, PK2, PUBs, and NTP10. Most of these genes play key roles in DNA/RNA/ATP/protein binding, transferase activity, transportation, phosphorylation, or ubiquitination and some harbored unknown functions that collectively may respond to salinity as a complex network. Conclusion These findings, including the candidate genes, respective pathways, marker-trait associations (MTAs), and in-depth phenotyping of wheat accessions, improve knowledge of the mechanisms responsible for better germination performance of wheat seedlings under salinity conditions.

This study aims to develop assessment-focused teaching materials for dual-dimensional visual works in the form of valid, practical, and effective p-books and e-books for the Department of Fine Arts. Employing the R&D method with the 4D model (define, design, develop, and disseminate), the research used a Likert scale questionnaire as the instrument, with data analysis techniques covering validity, practicality, and effectiveness assessments. The study results indicated that the teaching materials, both p-books and e-books, were highly valid with an average score of 87.8%. Furthermore, these materials proved to be highly practical for students in Shape Drawing, Illustration Drawing, Visual Communication Design (DKV), Graphic Arts, and Sketching courses, with a practicality score of 84.16%. They were also deemed effective, as students’ activities (such as reading modules, asking and answering questions, and completing assignments) resulted in an effectiveness score of 85.41%. Thus, the teaching materials are confirmed to be valid, practical, and effective for application in the specified Fine Arts courses.

Abstract In this study, screening of the collected 70 Salvia nemorosa L. populations from 54 habitats from West Azerbaijan province, Iran was evaluated by analyzing the content of phytochemical compounds, antioxidant activity, and UHPLC-HRMS profiling in different populations. The aerial parts of the plants were analyzed based on total phenolic (TPC) and flavonoid (TFC), total tannin (TTC), ascorbic acid (AAC), chlorophylls (Cla, and Clb), total carotenoid (TCC), β-carotene, antioxidant activity (by DPPH and FRAP assays), and 40 polyphenolic compounds by UHPLC-HRMS (phenolic acids, flavonoids and fatty acyl glicosides). Significant variations in phytochemical compositions and antioxidant activity were observed among S. nemorosa samples from different habitats. Rosmarinic acid, sagerinic acid, and caffeoylquinic acids (notable polyphenolic compounds with significant pharmacological properties, particularly in the context of their antioxidant, anti-inflammatory, and enzyme inhibitory activities) were identified as the major compounds in S. nemorosa populations. According to hierarchical cluster analysis (HCA) three groups of species were identified based on phytochemical compounds and antioxidant activity. Data analysis indicated that the quality and quantity of the chemical compounds, as well as their antioxidant functions, varied depending on habitat diversity. Overall, the results showed that each population exhibited a unique class of polyphenols, highlighting diverse potential applications across various industries. These findings suggest that the S. nemorosa populations studied here have significant potential for the development of innovative nutraceuticals, addressing the current scarcity of S. nemorosa-derived products in the market.

Abstract In this study, we present the synthesis of a silver nanocomposite by utilizing a β-cyclodextrin (βCD) polymer anchored onto the surface of magnetic g-C3N4 (referred to as g-C3N4-Fe3O4/βCD-Ag). The structure and composition of the g-C3N4-Fe3O4/βCD-Ag nanocomposite were thoroughly characterized using various techniques, including FT-IR, FE-SEM-EDS, TEM, TGA, XRD, ICP, and VSM. This catalytic system exhibited excellent selectivity in reducing nitro groups, even in the presence of other reactive functional groups, resulting in high yields ranging from 85 to 98%. Moreover, the organometallic nanocatalyst could be easily recovered from the solution using an external magnet and demonstrated consistent catalytic activity over six consecutive runs with a slight decrease.

Introduction: In the nursing profession, a suitable level of moral reasoning increases the quality of care for patients and boosts job satisfaction among nurses. Professional identity increases self-confidence, the feeling of belonging to the profession, and establishing interpersonal communication in people. This study was conducted to determine the relationship between Kohlberg's level of ethical reasoning and the professional identity of nursing students. Method: In this correlation study, 231 undergraduate nursing students of nursing faculties affiliated with Birjand University of Medical Sciences were selected by stratified random sampling based on ratio. Data were collected using a Demographic profile form, Hao et al.'s professional identity questionnaire, and Kohlberg's moral reasoning. Data were analyzed using statistical tests of Pearson correlation, regression, independent t-test, and one-way analysis of variance at a significance level of 0.05. Result: The average score of moral reasoning and professional identity in nursing students was 47.04 ± 5.21 and 61.98 ± 11.16, respectively. The results showed a positive and significant relationship between moral reasoning and professional identity in nursing students (r = 0.55, P < 0.001). Conclusion: Based on the results, moral reasoning has a positive and significant relationship with professional identity in nursing students. Therefore, teaching ethical concepts to nursing students, enhances their ethical reasoning. As a result, their professional identity can be improved.

Background: Since brain temperature fluctuations are related to cognitive disorders, regulating brain temperature has become a key focus in cognitive studies. This study examined the effect of frontopolar cortical cooling on working memory using a cortical thermal stimulation device (CTSD). Methods: This phase II, randomized, controlled trial included twenty participants randomly divided into two groups to receive 30 minutes of frontopolar cortical cooling across four sessions. The control group received sham cooling, while the intervention group received real cooling. Spatial working memory tests were recorded from both groups before and after the first and after the fourth sessions. The cortical thermal stimulation device used for cooling operates through the flow of water and alcohol in a closed loop.Results: After four sessions of frontopolar cortical cooling, a significant improvement in working memory was observed. The analysis of working memory results, based on an ANCOVA test, showed an improvement in the Spatial Working Memory (SWM) test in the intervention group compared to the control group (p < 0.05).Conclusion: Considering the positive effect of frontopolar cortical cooling on working memory capacity, the results suggest that using an appropriate tool for cooling the cerebral cortex could become a practical approach in cognitive rehabilitation.

Abstract Background Tuberculosis-associated hemophagocytic lymphohistiocytosis (TB-HLH) presents significant challenges in diagnosis and treatment due to its complex interplay between TB and HLH. This systematic review aims to provide comprehensive insights into the epidemiology, clinical characteristics, and treatment outcomes of TB-HLH patients. Methods We performed a systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, searching PubMed, Scopus, Web of Science, and Embase up to May 16, 2023, without language restrictions. We included case reports and cases series on patients with both TB and HLH with documented treatment outcomes. Data were analyzed using descriptive statistics, chi-square or Fisher’s exact tests, t-tests, and mortality rates. Significant variables (p

Abstract Alkalinity is a significant environmental factor affecting crop production, which is exacerbated by the current climate change scenario. In alkaline soils, iron availability is severely reduced due to its low solubility at high pH levels and bicarbonate concentrations, which hinders plant iron absorption by rendering it inactive. In modern agriculture, green-synthesized nanoparticles have attracted considerable attention due to their environmental compatibility, cost-effectiveness, and enhanced potential for foliar uptake. This study explores the effects of various iron sources and concentrations, including FeSO4.7H2O, Fe-EDDHA, Nano-Fe, and green-synthesized nano-Fe, at three concentrations (0, 0.25, and 0.5 g L− 1) on the growth, physiological, biochemical parameters, and nutrient uptake of goji berry. The evaluated parameters included leaf area, fresh and dry weight of leaves and fruits, chlorophyll a, b, and a/b ratio, carotenoids, total soluble sugar in leaves and fruits, catalase, guaiacol peroxidase, ascorbate peroxidase enzymes, and the concentrations of nutrient elements (N, P, K, Ca, Mg, Cu, Mn, Zn, and Fe). Results demonstrated that increasing iron concentrations led to enhanced fresh and dry weights of leaves and fruits, with the highest values recorded at 0.5 g L⁻¹ of all iron sources. Nano-Fe significantly boosted fresh and dry weight of leaves, resulting in a 4.95 to 4.84-fold increase compared to the control. The highest fresh (1.267 g) and dry (0.815 g) fruit weights were observed at 0.5 g L⁻¹ of green-synthesized nano-Fe. Regarding photosynthetic pigments, the chlorophyll a/b ratio peaked at 1.62 mg g⁻¹ FW under the 0.5 g L⁻¹ green-synthesized nano-Fe treatment, while the control exhibited the lowest ratio (1.31 mg g⁻¹ FW). A similar trend was observed in nutrient uptake, with the highest leaf iron content (0.189 mg g⁻¹ DW) recorded in the 0.5 g L⁻¹ nano-Fe treatment, and the lowest (0.116 mg g⁻¹ DW) in the control. Although iron concentration positively influenced most traits, it led to a decline in zinc and manganese levels. Overall, these results highlight the potential of green-synthesized nano-Fe as an efficient, cost-effective iron source for improving vegetative growth, photosynthetic pigment levels, and nutrient uptake in goji berries grown in alkaline soils.

Abstract The increasing demand for integrating renewable energy sources necessitates inverter topologies with boosting capabilities. Using inverters with boosting capability and a low number of components to integrate renewable energy sources can reduce costs. This study describes a three‐phase multilevel inverter based on extendable switching capacitors. The use of voltage‐doubling modules permits the development of the inverter's capability. By increasing the number of doubling modules, the number of output voltage levels and boost factor are increased. Furthermore, the study introduces and implements a line voltage‐based pulse width modulation approach developed for the proposed inverter. The operation of the proposed multilevel inverter, along with the pulse width modulation scheme, common mode voltage, and power loss analysis are thoroughly discussed. Additionally, a comparative analysis is provided; highlighting the advantage of reducing the number of power switches in the proposed three‐phase inverter compared to other existing topologies. Finally, a laboratory prototype is developed, operating at a 4 kHz switching frequency and with a 120 V DC‐link voltage. The experimental results corroborate the efficiency and performance of the proposed multilevel inverter, thereby validating its practical applicability.

Background: The consumption of unhealthy food is increasing among both children and adults, which can have detrimental effects on their overall health. The present study aimed to investigate the relationship between the consumption of junk foods with standard physical fitness tests and academic grade point average among 13-15-year-old girls’ students in Kangavar County, Kermanshah Province, Iran.Methods: This was a descriptive-correlation study. From 380 girl’s students aged 13-15 years in Kangavar County, Kermanshah Province, Iran, 181 individuals voluntarily participated in the study. The schools were selected using the multi-stage cluster sampling method. Height, weight, and body mass index were evaluated based on the defined Body Mass Index (BMI) cutoffs in the National Health and Nutrition Survey. To check the amount of junk food consumption, Junk Food Frequency Questionnaire of Kamangar and colleagues (2023) was used. In order to assess the cardio-respiratory endurance of students, a 540-meter test was conducted. Additionally, a modified supine pull-up test was used to measure the endurance and strength of the shoulder muscles, sit-up tests were performed to measure abdominal muscle endurance, and a flexibility box was used to evaluate the flexibility of lower and posterior muscles (thighs). The grade point average of the students at the end of the year was used to measure the academic grade point average. The data were analyzed using descriptive statistics in order to calculate mean and standard deviation. Variables were examined for correlation using the Spearman correlation method.Results: Consuming junk food was found to have a considerable negative correlation with physical fitness factors related to health, such as cardio-respiratory endurance (r=0.371, P=0.04), muscle strength (r=-0.241, P=0.002), muscle endurance (r=-0.249, P=0.01), and flexibility (r=-0.134, P=0.01), but there was a direct and significant correlation between junk foods consumption and body mass index (r=0.18, P=0.04). Also, there was no significant correlation between the consumption of junk foods and the academic grade point average of the subjects (r=-0.06, P=0.12).Conclusions: Our results indicated that increased consumption of junk food has an inverse correlation with physical fitness and a direct correlation with the body mass index of the students. It is recommended to pay more attention and support parents and policymakers regarding nutrition and physical activities in society and schools.

Abstract Background The ability of skeletal muscle to respond adequately to changes in nutrient availability, known as metabolic flexibility, is essential for the maintenance of metabolic health and loss of flexibility contributes to the development of diabetes and obesity. The tumour suppressor protein, p53, has been linked to the control of energy metabolism. We assessed its role in the acute control of nutrient allocation in skeletal muscle in the context of limited nutrient availability. Methods A mouse model with inducible deletion of the p53‐encoding gene, Trp53, in skeletal muscle was generated using the Cre‐loxP‐system. A detailed analysis of nutrient metabolism in mice with control and knockout genotypes was performed under ad libitum fed and fasting conditions and in exercised mice. Results Acute deletion of p53 in myofibres of mice activated catabolic nutrient usage pathways even under ad libitum fed conditions, resulting in significantly increased overall energy expenditure (+10.6%; P = 0.0385) and a severe nutrient deficit in muscle characterized by depleted intramuscular glucose and glycogen levels (−62,0%; P

Abstract This paper introduces a novel high-voltage gain topology for a solid-state transformer, integrating a DC-DC converter and dual active bridge converters. The proposed design features three DC links operating at different voltage levels. The first DC link connects to a single-switch high step-up DC-DC converter, while the second DC link interfaces with an AC source via a rectifier, allowing the use of both DC and AC inputs. A high-frequency transformer ensures galvanic isolation between the sources and the third DC link. The DC-DC converter employs coupled inductors and voltage multiplier cells, offering distinct advantages such as a high voltage gain, reduced voltage stress on semiconductors, and minimized current ripple. These features make the topology highly suitable for transferring power from renewable energy sources, such as photovoltaic panels, to a high-voltage DC link in microgrid or nanogrid applications. The novelty lies in the combination of multiple voltage levels, high-frequency isolation, and the ability to handle both DC and AC inputs efficiently. An experimental prototype, delivering 620 W with a 25 V DC input and 110 V AC input, is built, and the results validate the converter’s effectiveness.

Abstract Diabetes and its complications pose a significant threat to global health. Various factors contribute to the development of diabetes, with diet being an important trigger. The Dietary Quality Index-International (DQI-I) serves as an indicator of changes in diet and its association with chronic diseases, including diabetes. The aim of this study is to examine the association between DQI-I and diabetes in adults. Data from the first phase of the Ravansar Non-Communicable Disease Cohort Study (RaNCD) were used for this cross-sectional study. The study included individuals from western Iran aged between 35 and 65 years. The DQI-I was used to assess diet quality and the essential aspects of a healthy diet. Multiple logistic regression analyses were performed to compare DQI-I total score and diabetes. A total of 7,079 individuals were included, including 608 diabetic and 6,471 healthy individuals. The mean DQI-I score was 60.51 ± 8.47 in healthy individuals and 63.12 ± 8.64 in diabetics. The odds of developing diabetes were higher in individuals with a higher DQI-I (adjusted odds ratio: 1.49, 95% CI: 1.30–1.73). The variety was 13.43 ± 4.47 in diabetics and 12.59 ± 4.79 in healthy individuals. Adequacy was 33.23 ± 3.71 in diabetics and 33.79 ± 3.37 in healthy individuals. Moderation was 13.27 ± 6.05 in diabetics and 11.79 ± 5.47 in healthy individuals. The overall balance was 2.88 ± 2.21 in the healthy group and 2.61 ± 2.13 in the diabetics. The macronutrient ratio was 2.15 ± 1.88 in the healthy group and 2.04 ± 1.84 in the diabetics. The fatty acid ratio was 0.72 ± 1.29 in the healthy group and 0.56 ± 1.17 in the diabetic group. The overall balance score was higher in the healthy subjects. The DQI-I total score was higher in diabetics, indicating a positive association between diabetes and the DQI-I. Therefore, the importance of continuous dietary management and education of diabetic patients should be emphasized.

Abstract Background Non-communicable diseases (NCDs) are the leading cause of death around the world. The Dietary Quality Index-International (DQI-I) is one of the indicators that shows changes in diet and its association with NCDs. The aim of this study is to measure the association between the DQI-I and major metabolic risk factors. Methods This study is a cross-sectional study based on data collected in the first phase of the prospective cohort study on Ravansar non-communicable diseases (RaNCD). To perform clinical and biochemical tests such as lipid profile, blood glucose and liver enzymes, blood samples were collected using standard vacutainer blood collection techniques. Information from the food frequency questionnaire containing 118 food items was used to score each person’s DQI-I. Binary logistic regression was used to determine the association between the DQI-I tertile and the metabolic risk factors. Linear regression was also used for the association between subgroups of DQI-I score and the metabolic risk factors. Results The total number of subjects in this study was 7,115, with a mean age of 47.14 ± 8.29 years. Dietary quality was generally poor, with 37.03% in the lowest tertile. Men had better dietary quality than women. Anthropometric measures, blood pressure, triglycerides and blood glucose were lower in the lowest tertile of dietary quality. A one-unit increase in the total DQI-I resulted in a 0.19 decrease in total cholesterol. Higher dietary quality was associated with a 22% increased risk of high triglycerides, a 19% increased risk of low high-density density lipoprotein, a 5% decreased risk of elevated low-density lipoprotein, a 42% increased risk of high blood pressure, and a 99% increased risk of high fasting blood glucose. Higher dietary quality was also associated with a 33% increased risk of overweight/obesity. Conclusion The study found that participants had poor dietary quality, with some favorable metabolic outcomes in the lowest tertile, but concerning associations in the highest tertile, including increased risk for high triglycerides, blood pressure, and obesity. The complex associations suggest that balanced, multifaceted interventions are needed.

Extended Abstract Background: In arid and semi-arid regions, biotic and abiotic stresses can directly or indirectly lead to restrictions and decreased growth of different plants. In these areas, salinity stress is one of the major challenges facing agriculture and crop production that causes huge damage to crop yields annually. The amount of salinity in the soil results in plant growth limitation, and increased soil salinity disrupts water and essential nutrient absorption for the plant and reduces plant growth, which can then lead to plant death. Reduced root growth and development, decreased nutrient absorption, increased likelihood of allergies to diseases and pests, decreased yield, and final product quality (e.g., nutrient deficiency), and increased toxic elements, are among the negative effects of salinity on plants. Various factors are involved in the creation of salinity, the most important of which can be climate change, source rock weathering, improper irrigation, drought, excessive consumption of fertilizers, and reduced seawater levels. Following climate change, these damages are on the rise every year. Due to the increase in population growth, demand for food production is increasing day by day. Wheat is known as the major grain in the supply of nutritional needs in the world, hence its sustainable production is of paramount importance. Salinity is recognized as an important factor in reducing wheat yield, and it may increase the accumulation of harmful salts in the plant tissue, which can lead to physiological damage and decreased plant growth. The effects of soil salinity vary depending on the amount of salinity, the type of salinity, and the type of wheat. One way to prevent the negative effects of salinity is to use salinity-resistant wheat cultivars. The range of diversity in relation to salt stress tolerance in different plants, especially the wheat plant, depends on various factors such as plant genotype, duration of stress, and plant growth stage. The seedling stage in wheat is one of the important stages regarding tolerance to salt stress. This study aims to investigate the response of spring wheat cultivars in the seedling stage to salinity stress. Methods: In the present study, the reaction of 64 Iranian spring wheat genotypes at the seedling stage under normal conditions and 12 dS/m salinity stress was investigated in two replications in a simple lattice design at the research greenhouse of the Faculty of Agriculture, Urmia University in 2021-2022. In this study, in the four-leaf stage, salinity stress was applied gradually for two days. The measured traits were chlorophyll (SPAD), canopy temperature, shoot length (SL), root length (RL), seedling length (PL), shoot potassium content (KS) ), root potassium content (KR), shoot sodium content (NaS), root sodium content (NaR), shoot potassium to sodium ratio (KNaS), root potassium to sodium ratio (KNaR), root volume (RV), leaf area index (LAI), radicle fresh weight (FWR), radicle dry weight (DWR), relative leaf water content (RWC), shoot fresh weight (FWS), shoot dry weight (DWS), seedling fresh weight (FWP), weight dry matter of seedlings (DWP). The data of the studied traits were obtained in a random complete block design. PROC GLM was used for the analysis of variance (ANOVA) in SAS 9.4 software. The correlation was examined using PROC CORR and decomposition into factors using PROC FACTOR. The figures were grouped using the gplots software package and the biplot diagram was drawn with the factoextra software package in the R 4.1 environment. The MANOVA statement in PROC GLM was used in SAS 9.4 software for multivariate variance analysis. Results: Based on the results of ANOVA, statistically significant differences were observed between the tested cultivars based on the traits studied in the seedling stage, including FWP, DWP, FWR, DWR, FWS, RWS, and (PL). In both normal and salt stress conditions, DWP showed the most significant correlation with FWP, DWS, and DWR. Under the salinity stress conditions, FWS was significantly correlated with DWS, FWP, and DWP. Based on factor analysis, the studied traits in both normal and salinity stress conditions were grouped into seven factors, which explained 77.93% and 76.44% of the total changes in normal and salinity stress conditions, respectively. Using cluster analysis, cultivars under both normal and salt stress conditions were grouped into three clusters. Conclusion: Based on the biplot results of factor analysis and cluster analysis, Maron, Darya, Shiroodi, Moghan 3, Darab 2, Roshan, Pishgam, and Pishtaz cultivars are introduced as favorable cultivars. Chamran, Bam, Alborz, and Maroodasht cultivars are categorized as unfavorable cultivars that can be used in further wheat breeding programs.

Coordination polymers (CPs) are synthesized using bridging organic ligands and metal ions, depending on the geometric coordination of the metal, the bridging ligands, and the donor atoms present in these ligands, various one-, two-, or three-dimensional polymeric structures can form. To investigate the effect of the position of the pyridine nitrogen atom in the tridentate NN'O Schiff base ligand on the type of coordination polymers, two copper complexes were prepared. The ligand HL2 was characterized using IR, NMR, and elemental analysis, while the complexes were analyzed and identified using IR, elemental analysis, and X-ray diffraction techniques. The structural data of the copper complexes indicated that changing the pyridine nitrogen from position 3 to position 4 in the Schiff base ligand altered the structure of the copper complex from two-dimensional to three-dimensional. Analysis of inter- and intramolecular interactions using the NCI program shows that the interactions in both molecules are of the hydrogen bonding, halogen bonding, CH…π, π…π stacking, metal…π, and lone-pair…π type.

Abstract This paper aims to analyze the levelized cost of energy (LCOE) of floating offshore wind farms from a probabilistic point of view. Understanding and addressing the uncertainty associated with the main parameters that influence the wind energy generated by a wind farm during its lifetime is crucial for the economic evaluation of offshore wind energy in the broader energy landscape. The methodology for probabilistic assessment of LCOE is introduced, and the uncertainty in input parameters are discussed. In a base case study, an assumed Floating Offshore Wind Farm (FOWT) consisting of 250 5-MW wind turbines is considered. The use of bias and randomness in key random variables is discussed and studied in detail. Results indicate that LCOE estimates of 15 EURc/kWh for offshore wind turbines are achievable with reasonable confidence, while estimates of 5 EURc/kWh require careful consideration of uncertainty in the wind farm’s parameters. The feasibility analysis showed that techno-economic parameters are more influenced by wind characteristics and efficient use of wind turbines than by the cost of the wind farm. This paper provides general guidance on how to carry out early-stage techno-economic analysis of FOWFs.

Abstract Background Genetic testing for persons with a heightened likelihood of harboring a germline mutation permits early identification and appropriate management. This study aimed to identify the proportion of breast cancer (BC) patients who were offered genetic testing and the prevalence of BRCA mutations among them. Additionally, we assessed the demographic and clinical features of BC patients in the Eastern Region of Saudi Arabia. Materials and Methods Data from 2535 patients with BC were retrieved from the registry between 2017 and 2021. The data were analyzed and presented using univariate and bivariate statistics. Odds ratios and 95% confidence intervals using logistic regression analysis were computed to identify the predictors of BRCA testing. Results Patients with BC ranged in age from 18 to 103 years, and the mean age was 49.60 ± 12.14 years. BC was detected in men in 29 (1.1%) cases. Among diagnosed patients with BC, a total of 96 (3.7%) patients underwent testing for BRCA gene mutations. Of them, 36 (37.5%) patients had a BRCA gene mutation. The likelihood of undergoing BRCA testing was higher for those who were diagnosed with the condition before the age of 50, patients who were referred from private institutions, and patients with a history of previously diagnosed cancer. The likelihood of conducting BRCA testing was significantly lower among those with distant metastases. Conclusion The proportion of BRCA testing among BC patients was found to be relatively low. The development of a cost-effective, locally developed risk assessment tool that incorporates genetic counseling and testing for those with a familial predisposition to BC is imperative.

"Necessity" is a well-known principle in both jurisprudence and law, categorized as a secondary rule and applied across various legal and jurisprudential domains. When its conditions are met, this principle inevitably influences legislation, interpretation, and adjudication. Its impact is particularly significant in criminal law, where, due to public order concerns, sensitivity, and vulnerability, as well as its unique methodology, it occupies a critical role within the broader legal framework. Since criminal law typically embraces minimalism due to its severe, person-centered sanctions, the occurrence of necessity within the criminal sphere limits the expansion of criminal sanctions and must be interpreted within the framework of the principle of minimization in criminal law. Therefore, given the importance of this issue, the present study adopts a descriptive-analytical approach based on library research to examine the boundaries, criteria, and governing conditions of the necessity principle in the new Islamic Penal Code. This analysis demonstrates that reliance on this principle aligns with the logic and essence of criminal law, facilitating its application in this field far more effectively than in other legal areas, such as civil liability. Accordingly, it is recommended that the impact of necessity on civil liability be approached with greater caution, restricting its application to explicitly defined legal cases, particularly those based on fault-based liability.

Abstract Objectives Injury to the recurrent laryngeal nerve (RLNI) is a known possible morbidity after thyroid surgery. The clinical presentation varied in severity, from changes in voice quality and swallowing in unilateral cases to airway compromise in bilateral cases. In minor cases, vocal fold paralysis (VFP) may occur unnoticed. Although many intraoperative measures have been implemented to minimize nerve injury, the risk remains, either transient or permanent. This study evaluated the incidence and potential risk factors of recurrent laryngeal nerve injury after thyroidectomy. Methods Retrospective data analysis was conducted on 1368 patients who underwent thyroidectomy at the National Guard Hospital, King Abdul-Aziz Medical City, Jeddah, Saudi Arabia, between January 2008 and December 2021. Evaluations were conducted on the pathological features, surgical procedure type, and state of the recurrent laryngeal nerve during surgery as contributing to recurrent laryngeal nerve injury. All patients underwent preoperative and postoperative indirect laryngoscopy examinations with or without videostroboscopy. Physiological testing of the RLN using neurostimulation and laryngeal palpation (NSLP) or intraoperative neuromonitoring (IONM) was performed in all cases. VFP was considered present when vocal fold mobility was absent or significantly reduced. Results A total of 1368 patients (2177 nerves at risk) who underwent thyroidectomy and fulfilled the inclusive criteria (809 bilateral, 559 unilateral) were evaluated. A total of 62% of patients were more than 45 years old, and the mean age was 48.36 ± 13.03 with a male-to-female ratio of 1:3.6. Eight-hundred one (58.6%) patients underwent total or subtotal thyroidectomies (1602 nerves at risk). Two-hundred seventy-six patients underwent hemithyroidectomy (276 nerves at risk), and 291 patients underwent completion or redo surgeries (299 nerves at risk). Of these 1368 patients, post-surgery laryngoscopy showed reduced or absent vocal fold mobility in 47 (3.4%) patients. Forty-three out of 47 patients had unilateral vocal fold paralysis, and 4 had bilateral VFP. When we analyzed the three risk factors statistically significant for postoperative RLN palsy, age (OR, 1.01; 95% CI, 0.98–1.05; p = 0.365) became non-significant. The other risk factors (extent of surgery and histopathological diagnosis) remained statistically significant (p = 0.004 and 0.031). After adjustment, the extent of surgery, including total thyroidectomy and revision surgery, was strongly associated with a higher risk of odds of postoperative RLN palsy. Physiological RLN stimulation was performed in all cases with NSLP or INOM, and no significant association was observed in the incidence of VFP (p = 0.365). In most cases, symptoms were spontaneously resolved with recovery of vocal fold movement within a few months. Conclusion In this study, 3.4% of the recurrent laryngeal nerve showed postoperative dysfunction either transient or permanent VFP. Intraoperative identification of the nerve remains the gold standard of care during thyroidectomy. Neuromonitoring aids in detecting the nerve, particularly in severe cases, but does not reduce the nerve injury compared to NSLP.

Recently, Alizadeh and Shafaei (2023) introduced some estimators for varentropy of a continuous random variable. The present article applies these estimators and construct some tests of fit for Inverse Gaussian distribution. Percentage points and type I error of the new tests are obtained and then power values of the proposed tests against various alternatives are computed. The results of a simulation study show that the tests have a good performance in terms of power. Finally, a real data set is used to illustrate the application of the proposed tests.

Understanding the differences in respiratory functions and isometric strength between recreational athletes and non-athletes has a significant importance in the fields of Sports science, exercise physiology, and performance enhancement. The purpose of this study was to determine the respiratory functions and isometric strength differences among recreational athletes and non-athletes. A cross-sectional design was selected for this research with 16 recreational athletes and 16 non-athletes. Respiratory functions were assessed using spirometry tests, measuring parameters such as forced vital capacity (FVC), peak expiratory flow rate (PEFR), and forced expiratory volume in one second (FEV1). Isometric strength was measured by a handheld dynamometer for dominant and non-dominant hands. The results of the study showed a significant difference between recreational athletes and non-athletes for respiratory function parameters (FVC = t-3.00, p-.006 & FEV1= t-2.221, p-.011), whereas PEFR is insignificant (t-218, p-.219). The isometric strength is also significant between recreational athletes and non-athletes (Dominant arm = t—3.039, p-.005 & non-dominant arm= t-.255, p-.001). The study findings revealed significant differences in respiratory functions and isometric strength between recreational athletes and non-athletes, and there was a significant relationship between parameters. Athletes typically exhibit remarkable isometric strength due to their consistent engagement in activities designed to enhance muscle function. Future research should give priority to conducting long term studies that directly compare the effects of different sports disciplines on respiratory functions and isometric strength. Keywords: Isometric Strength, Pulmonary Functions, Forced Vital Capacity, Peak Expiratory Flow Rate, FEV1, Recreational Athletes.

Although low dose of X-rays are widely used in medical radiology, the harmful effects of exposure to low dose of X-rays during diagnostic radiological examination is still a commonly discussed topic. Objective of the current study was to investigate the effects of exposing low dose of X-rays on human parameters, like the white blood cell (WBC), red blood (RBC), hemoglobin (HGB), and platelet counts (PLT) . znn We exposed a human blood into 60kv and 100mA for 80ms of medical diagnostic X-rays. Non-irradiated cells represented as the control group. The results showed there are no changes in the percentage in the RBC , WBC ,PLT , and HGB that were exposed to low dose X-rays, comparing to the corresponding non-irradiated blood cells, control samples, at all the harvest time-points. These finding suggested that there were no harmful effects of the diagnostic low dose X-rays in an in vitro exposure of RBC, WBC , PLT , and HGB.

In this research, zein/basil seed gum (BSG) electrospun active nanofibers (NFs) incorporated with thyme essential oil (TEO) were prepared to extend the oxidative stability of flaxseed oil. TEO was used in two forms free and encapsulated with nanostructured lipid carriers (NLCs). According to Field Scanning electron microscopy (FE-SEM), the NFs with a Zein/BSG ratio of 85:15 was a desirable sample with the best morphology and the lowest fiber diameter (569 nm). According to Fourier transform infrared (FT-IR), no new chemical interaction was confirmed during the electrospinning process. According to X-ray diffraction (XRD) analysis, the pure and active zein NFs didn't have a crystalline structure and were amorphous. The antioxidant activity of NFs estimated by DPPH scavenging analysis, was found to be in the range of 30–40 %. The fabricated NFs were placed in contact with flaxseed oil. Peroxide value (PV), DPPH scavenging activity, and oxidative stability index (OSI) were calculated over 45 days. The PV increased with increasing storage time (p < 0.05), but this change was lower in oil in contact with NFs. A significant increment in DPPH scavenging activity and OSI was observed during the storage of flaxseed oil by active NFs. The results of the study indicate that the zein/BSG NFs incorporated with TEO-loaded NLC has the potential to extend the shelf life of fatty food products such as flaxseed oil.

Bacterial nanocellulose (BNC) is a sustainable antimicrobial material for food packaging. To enhance its antimicrobial properties, basil (Ocimum basilicum L.) essential oil (BEO) was incorporated into the BNC porous foam. A spray method was used with low BEO concentrations (1 and 2 μL/cm2) based on foam surface to optimize BEO usage while maintaining its antimicrobial effectiveness. BNC was synthesized using Komagataeibacter xylinus. The minimum inhibitory concentrations were 128 and 64 μg/mL for Pseudomonas aeruginosa and Listeria monocytogenes, respectively, demonstrating greater sensitivity of Gram-positive bacteria compared to Gram-negative bacteria. The use of BEO in spray form increased the antimicrobial and antioxidant activities (as measured by DPPH and ABTS methods) of foams. The absorption bands related to BEO in Fourier transform infrared spectroscopy analysis of the BNC-BEO foam confirmed the incorporation of BEO into the BNC foam. Impregnation with BEO at 1 and 2 μL/cm2 significantly increased the water contact angle to 31.62° and 33.19°, respectively, thereby enhancing the hydrophobicity of the foam, but reduced the mechanical strength of the BNC-BEO foams. Foams were used in active packaging of ground beef to improve shelf life by controlling microbial and oxidative processes. The BNC-BEO foam showed a slower microbial growth rate, with bacterial populations about 1–2 log₁₀ CFU/g lower than control. Meat samples packaged with BNC-BEO foams scored higher in terms of taste and odor. A significantly lower amount of BEO was used in the foam form of BNC, which is favorable for improving sensory parameters. Therefore, BNC-BEO can be applied to the active packaging of meat.

Background: Large language models (LLMs) such as ChatGPT-4 (CG4) are proving to be valuable tools in the medical field, not only in facilitating administrative tasks, but in augmenting medical decision-making. LLMs have previously been tested for diagnostic accuracy with expert-generated questions and standardized test data. Among those studies, CG4 consistently outperformed alternative LLMs, including ChatGPT-3.5 (now no longer publicly available for use) and Google Bard (now known as “Google Gemini”). The next logical step was to begin to explore CG4’s accuracy within a specific clinical domain. Our study evaluated the diagnostic accuracy of CG4 within an inpatient neurology consultation service. Methods: We conducted a review of all patients listed on the daily neurology consultation roster at Arrowhead Regional Medical Center in Colton, CA, for all days surveyed until we reached a total of 51 patients, ensuring a complete and representative sample of the patient population. ChatGPT-4, using HIPAA-compliant methodology, received patient data from the Epic EHR as input and was asked to provide an initial differential diagnoses list, investigations and recommended actions, a final diagnosis, and a treatment plan for each patient. A comprehensiveness scale (an ordinal scale between 0 and 3) was then used to rate match accuracy between consultant and CG4 initial diagnoses and the consultants’ final diagnoses. In this proof-of-concept study, we assumed that the neurology consultants’ final diagnoses were accurate. We employed a non-parametric bootstrap resampling method to create 95 % confidence intervals around mean scores, a Fisher’s Exact test, a Wilcoxon Rank Sum test, and ordinal logistic regression models to compare the performance between consultant and CG4 groups. Findings: Our study found that CG4 demonstrated diagnostic accuracy comparable to that of consultant neurologists. The most frequent comprehensiveness score achieved by both groups was ''3,'' with consultant neurologists achieving this score 43 times and CG4 achieving it 31 times. The mean comprehensiveness scores were 2.75 (95 % CI: 2.49–2.90) for the consultant group and 2.57 (95 % CI: 2.31–2.67) for the CG4 group. The success rate for comprehensive diagnoses (a score of ''2″ or ''3″) was 94.1 % (95 % CI: 84.1%–98.0 %) for consultants and 96.1 % (95 % CI: 86.8%–98.9 %) for CG4, with no statistically significant difference in success rates (p = 1.00). The Wilcoxon Rank Sum Test indicated that the consultant group had a higher likelihood of providing more comprehensive diagnoses (W = 1583, p = 0.02). Ordinal logistic regression models identified significant predictors of diagnostic accuracy, with the consultant diagnosis group showing an odds ratio of 3.68 (CI 95 %: 1.28–10.55) for higher value outcomes. Notably, integrating CG4’s initial diagnoses with those from consultants could achieve comprehensive diagnostics in all cases, indicating a number needed to treat (NNT) of 17 to attain one additional comprehensive diagnosis. Interpretation: Our findings suggest that CG4 can serve as a valuable diagnostic tool within the domain of inpatient neurology, providing comprehensive and accurate initial diagnoses comparable to those of consultant neurologists. The use of CG4 might contribute to better patient outcomes by serving as an aid in diagnosis and treatment recommendations, potentially leading to reduced missed diagnoses and quicker diagnostic processes. Continuous strategies and evaluations to improve LLMs' accuracy remain crucial. Further studies with larger sample sizes and independent third-party evaluations are recommended to confirm these findings and assess the impact of LLMs on patient health.

Summary: Background: High-intensity interval training (HIIT) has been shown to improve cardiorespiratory fitness (V˙O2 max) but may ameliorate insulin sensitivity only in insulin-resistant humans. It is yet unclear whether these benefits persist after detraining and to which extent duration and effectiveness of metabolic improvements differ between individuals without and with prediabetes or type 2 diabetes (T2D). Understanding these differences is relevant for developing targeted exercise training modes for individuals with different stages of dysglycemia. Methods: Men with (20 T2D) and without T2D (12 insulin-sensitive, IS-NDM; 10 insulin-resistant, IR-NDM) underwent hyperinsulinemic-euglycemic clamps, spiroergometry, ectopic lipid quantification and muscle biopsies at baseline, after 12-week HIIT and after 4-week detraining. Findings: After detraining, the HIIT-stimulated V˙O2 max declined in T2D and IR-NDM, but remained higher compared to baseline in all groups. The HIIT-induced changes in hepatic insulin sensitivity and ectopic lipid content were sustained after detraining in T2D and IR-NDM, whereas improvements of whole-body insulin sensitivity were abolished in T2D. T2D and IR-NDM showed persistent increases in the number of small extracellular vesicles, which carry among others antioxidant proteins. The ratio of reduced-to-oxidized glutathione further decreased after detraining in all groups, whereas changes in proteins involved in mitochondrial turnover were dependent on insulin sensitivity, with some evidence for upregulation of fusion and mitophagy in T2D and IR-NDM and upregulation of fission in IS-NDM. Levels of different lipolytic proteins were reduced in all participants after detraining. Interpretation: HIIT offers sustained improvement of energy metabolism and hepatic insulin sensitivity in insulin-resistant humans, but long-term adherence is required to maintain these benefits. Funding: Funding bodies that contributed to this study are listed in the Acknowledgements section.

Chemical stabilization is a commonly used technique for ground improvement. Traditional methods of chemical soil stabilization rely on additives such as cement and lime, which are relatively expensive and not environmentally friendly. Therefore, using accessible natural pozzolans, such as zeolite, in soil stabilization is an effective and economical option. This study investigated the effect of zeolite and nano-magnetite on the geomechanical behavior of fine-grained clayey soil. Unconfined compressive strength (UCS), ultrasonic pulse velocity (UPV), and electrical conductivity (EC) tests were performed on both stabilized and unstabilized samples. The samples were cured under standard curing conditions (SCC) and accelerated curing conditions (ACC). The UCS and UPV results for the clay sample containing 5% zeolite and 1% nano-magnetite showed significant increases of 85% and 48% under SCC and 174% and 59% under ACC, respectively, compared to untreated clayey soil. Additionally, the clay mixture containing 5% zeolite and 1% nano-magnetite, which achieved the highest UCS and UPV values under ACC, exhibited increases of 166 kPa and 100 m/s, respectively, compared to SCC. Moreover, the EC value decreased by approximately 51% and 60% for the samples with the highest strength in SCC and ACC, respectively. Based on Scanning Electron Microscope (SEM) imaging and Energy Dispersive Spectroscopy (EDS) analysis, the impact of zeolite and nano-magnetite on improving compaction and promoting hydrothermal reactions was evident, supporting the higher geomechanical results obtained. Overall, the findings suggest that using zeolite and nano-magnetite offers a cost-effective and eco-friendly solution for stabilizing clayey soil in civil engineering projects.

The study investigates the comparative toxicity of three widely used insecticides-fenitrothion, malathion, and deltamethrin-on Blattella germanica, a major urban pest.Using bioassay tests based on World Health Organization (WHO) protocols, we determined the lethal doses 50 (LD50) for each insecticide. 2.5 mL of each insecticide in acetone was placed in glass jars. Ten adult male cockroaches were tested per dilution, with three to four replicates. Acetone alone served as the control. After 1 h of exposure, the cockroaches were moved to containers with food and water, and mortality was recorded after 72 h. Probit regression analysis was employed to analyze the mortality rates at various doses, and statistical significance was confirmed for all tested insecticides.Results showed that malathion had the lowest lethal dose, with an LD50 of 4.29 ppm, making it more potent at lower concentrations. Fenitrothion followed with an LD50 of 5.11 ppm, while deltamethrin exhibited the highest LD50 of 8.56 ppm, indicating lower toxicity at standard concentrations.The study also emphasized the importance of understanding sublethal doses, which, though not immediately fatal, could induce behavioral and physiological changes leading to pesticide resistance. The findings provide critical insights for pest management strategies, highlighting the need for appropriate dosing to balance efficacy with safety concerns. This research establishes baseline data for future studies on B. germanica and its resistance mechanisms, contributing to improved pest control measures with minimal environmental impact.

The increasing demand to replace chemical antimicrobial agents with natural compounds leads to the use of some plant extracts and essential oils (EOs) as natural preservatives. Nanoemulsion (NE) with Tween 80 as wall material and Pickering emulsions (PE) stabilized with carbohydrate (Arabic gum (AG)) or protein (sodium caseinate (SC)) wall materials. First of all, the PEO was obtained from two parts of plant: flowers and leave, and characterized by GC-MS and the IC50 index measurement. The Prangos ferulacea essential oil (PEO) extracted from leave was selected for the next tests due to slightly higher antioxidant activity compared to the flower's EO. The leave's PEO was encapsulated in three forms: nanoemulsion (NE) with Tween 80 as wall material and Pickering emulsions (PE) stabilized with carbohydrate (gum Arabic (GA)) or protein (sodium caseinate (SC)) wall materials. The NE had the smallest particle size and the highest antioxidant and antimicrobial (S. aureus and E. coli) activity. AG-stabilized PE recorded the highest encapsulation efficiency (85.37 ± 1.97 %). The occurring of new chemical interactions between PEO and wall materials and uniformly shaped PE microcapsules were approved by FT-IR and FE-SEM tests, respectively. Free and encapsulated PEO were added to the mayonnaise, and the samples were analyzed during storage at 4 °C for 60 days. Peroxide value and TBA index gradually increased for all mayonnaise samples, but this increase was lower for samples containing NE and SC-stabilized PEO capsules. In general, carriers stabilized with the simultaneous application of protein and carbohydrate performed better compared to their single application in sensory tests in mayonnaise.

Inherent (fabric) anisotropy is one of the most important properties of earthen materials that significantly influences their strength and stiffness characteristics. In this study, a comprehensive series of unconfined and constrained compression tests is performed on normally consolidated (NC) clay samples with different plasticity indices to examine the effect of inherent anisotropy on their mechanical characteristics. Accordingly, several cylindrical clay samples with different proportions of kaolinite and bentonite are reconstituted at a wide range of deposition angles, and then subjected to both unconfined and constrained compressive loadings. The experimental results reveal that, for a clay sample with a particular plasticity index, the highest and lowest values of unconfined compressive strength (UCS), secant modulus (E50), and constrained Young's modulus (Eoed) are associated with deposition angles of 0° and 90°, respectively. The results also show that at a certain bedding plane angle, the sample containing 30 % bentonite (PI = 110 %) exhibits the highest UCS, E50, and Eoed values. Several practical empirical correlations are developed to estimate the strength and stiffness properties of NC clays based on their plasticity indices and bedding plane directions. Furthermore, Scanning Electron Microscopy (SEM) analysis is conducted to explore the microstructure of samples containing varying percentages of kaolinite and bentonite.

The main aim of this study was to investigate the potential of encouraging intention to use conservation agriculture technologies to create sustainable social and psychological changes in agricultural communities. The study was carried out using a cross-sectional survey using 384 Iranian landowner farmers as the sample. The research instrument was a researcher-made questionnaire. Furthermore, its validity and reliability were evaluated using different quantitative and qualitative indices. The results revealed that the basic variables of Theory of Planned Behavior including attitude towards conservation agriculture (ACA), subjective norms of conservation agriculture (SNCA), and perceived behavioral control on conservation agriculture (PBCCA) positively and significantly affected the intention towards application of conservation agriculture technologies and practices (IACATP). Comparison of the original and extended versions of Theory of Planned Behavior showed that the inclusion of the variables perceived risk conventional agriculture (PRCA), knowledge about conservation agriculture (KCA), level of education, farm size, and income level in the original Theory of Planned Behavior could increase its explanatory power from 66.4% to 77.3%. This result was one of the most important contributions of the present study that can be considered a turning point for social change interventions in rural and agricultural communities. The study also led to new insights into the mechanisms of encouraging IACATP and social-psychological changes in agricultural communities. These innovative insights can be used by different users such as governmental policy-makers, technology developers, social change interventionists, environmental decision-makers, and researchers.

Patient-reported outcome measurements (PROMs) are important to evaluate the impact of clinical practice in athletes with Achilles tendinopathy (AT). The TENDINopathy Severity assessment-Achilles (TENDINS-A) is a PROM that measures the pain, symptoms and physical function associated with AT. This study aims to translate, cross-culturally adapt and measure the properties of the Persian language version of the TENDINS-A (Persian-TENDINS-A) in athletes with AT.According to the COnsensus-based Standards for selecting health Measurement INstruments guidelines, 100 athletes with AT will be required for test-retest reliability, construct validity and internal consistency. Analyses will include confirmatory factor analysis, internal consistency, construct validity, SE of measurement, agreement, smallest detectable change, and floor and ceiling effects. Test-retest reliability of the Persian-TENDINS-A will be evaluated within 2–3 days for the Persian-TENDINS-A. Hypothesis testing of the Persian-TENDINS-A will be determined using a Pearson correlation of a single point in time between Persian-TENDINS-A scores with the Victorian Institute of Sports Assessment-Achilles and Pain Self-Efficacy Questionnaires.The study protocol was approved by the Ethics Committee of the University of Zabol (approval ID: IR.UOZ. REC.1403.004) based on the Declaration of Helsinki. Findings from this study will be disseminated to the athletes, clinicians and researchers through peer-reviewed journals and national and international conferences.

ABSTRACT The present case report aims to describe the successful management of pulp canal obliteration (PCO) in mandibular incisors using static‐guided endodontics. A healthy 74‐year‐old man was referred by a prosthodontist for root canal treatment on teeth #31, #32, and #41. Periapical radiographs revealed the presence of periapical lesions as well as PCOs in teeth #31 and #41. After cone‐beam computed tomography (CBCT) evaluation, guided endodontics was selected as the treatment approach. The intraoral scan of the lower jaw and CBCT datasets were aligned and processed through image processing software to design and create a 3D‐printed guide. A virtual drill was superimposed on the scans to ensure proper access to the identified root canals. Finally, the virtually designed guide was printed using a 3D printer and accurately positioned on the teeth. The access cavities were prepared using a Munce Discovery bur. After detecting the canals, the working length was determined. Root canal preparation was performed using rotary files up to F2, followed by obturation with gutta‐percha and a bioceramic sealer. After a six‐month follow‐up, the teeth remained completely asymptomatic and functional, and the periapical radiograph showed a normal periodontal ligament space, demonstrating the effectiveness of the treatment. These results indicate that static‐guided endodontics can be an effective and predictable approach for managing PCO in mandibular incisors with some consideration. Furthermore, these results highlight the clinical implications of this approach, particularly in elderly patients or teeth with severe obliterations.

Background Heart failure (HF) is a complex cardiovascular disease. Effective management typically involves four main medications: angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, beta-blockers, angiotensin receptor-neprilysin inhibitors, and mineralocorticoid receptor antagonists, along with sodium-glucose co-transporter-2 inhibitors (SGLT2i). The primary objective of this article is to assess and identify the utilization of four-pillar regimen for HF managment and explore the characteristics of the patients being on the four-pillar regimen in Jordan. Methods Data from the Jordanian HF registry (JoHFR) was analyzed, encompassing records of HF patients treated in various cardiology centers from 2021 to 2023. Results The medical records of 2,151 patients with HF who were admitted to cardiology centers throughout Jordan were collected. Males comprised 58.0% of the included patients. Moreover, 71.0% of patients had chronic HF, whereas the rest, 29.0%, had acute HF. Of these, only 0.6% received the complete four-pillar treatment of HF. Beta-blockers were the most frequently used medication, prescribed to 74% of patients, while SGLT2i were the least common, used by only 9%. Notably, patients with type 2 diabetes were more likely to be on the four-pillar regimen (P-value = 0.016). Additionally, patients with a glomerular filtration rate (GFR) below 60 were more likely to be treated using the four-pillar (P-values = 0.044). The analysis revealed no significant difference in mortality rates between the two groups (P-value = 0.475). Conclusion Our study demonstrated an overall low utilization of the four-pillar regimen for HF treatment in Jordan with several patients’ characteristics associated with it. This highlight the need for enhanced collaborative effort and governmental initiatives to address the challenges of the low utilization of these medications.

Abstract In recent years, the exploration of the therapeutic potential of Salvia has gained considerable attention, leading to a growing number of scientific studies emphasizing its pharmacological properties. Despite this, therapeutic applications of Salvia remain underexploited, requiring further investigation. Iran is a major center for sage diversity in Asia, boasting 60 Salvia species, 17 of which are unique to the area. This study aimed to comprehensively explore and compare the extracts of 102 Salvia samples belonging to 20 distinct Salvia species from Iran, providing a deeper understanding of their specific polyphenol content and, consequently, their antioxidant capabilities and potential therapeutic uses. All samples were analyzed to determine the contents of total phenolics, total flavonoids, total tannin, photosynthetic pigments, and ascorbic acid, along with their antioxidant activity. These data were then combined with the forty distinct chemical fingerprints identified by ultrafast high-pressure liquid chromatography coupled with high-resolution mass spectrometry. Multivariate data analysis was employed to find correlations and differences among the huge number of data obtained and to identify Salvia species with similar phytochemical and/or antioxidant properties. The results show that each Salvia species is characterized by a distinct class of polyphenols recognized for their antidiabetic, anti-inflammatory, cardioprotective and neuroprotective properties. Overall, our findings reveal the potential of some Salvia species for targeted therapeutic applications and provide a rational basis for the development of Salvia-derived nutraceuticals, ultimately improving the prospects for the use of Salvia in medicine.

The purpose of this study was to investigate the efficacy of acceptance and commitment therapy matrix training on the communication patterns of married women with an avoidance and anxiety attachment personality style. The investigation included all female students at the University of Bojnourd from 2019 to 2020. The study included 40 subjects who fulfilled the inclusion criteria and were randomly assigned to two experimental groups and two control groups. The subjects completed Christensen and Sullaway'’s Communication Patterns Questionnaire (CPQ) both before and after the intervention. Multivariate analysis of variance was implemented to analyze the data. The results suggested that the acceptance and commitment therapy matrix had an impact on communication patterns by increasing constructive communication patterns (P0.05). According to the research findings, the acceptance and commitment therapy matrix can be implemented to enhance the communication patterns of married women.

Abstract During the COVID-19 pandemic, the Province of Ontario, Canada, launched a wastewater surveillance program to monitor SARS-CoV-2, inspired by the early work and successful forecasts of COVID-19 waves in the city of Ottawa, Ontario. This manuscript presents a dataset from January 1, 2021, to March 31, 2023, with RT-qPCR results for SARS-CoV-2 genes and PMMoV from 107 sites across all 34 public health units in Ontario, covering 72% of the province’s and 26.2% of Canada’s population. Sampling occurred 2–7 times weekly, including geographical coordinates, serviced populations, physico-chemical water characteristics, and flowrates. In doing so, this manuscript ensures data availability and metadata preservation to support future research and epidemic preparedness through detailed analyses and modeling. The dataset has been crucial for public health in tracking disease locally, especially with the rise of the Omicron variant and the decline in clinical testing, highlighting wastewater-based surveillance’s role in estimating disease incidence in Ontario.

Abstract Choosing appropriate tillage methods and applying the right amount of chemical fertilizers are pivotal for optimizing wheat management and enhancing wheat quality. This study investigated the influence of conservation agriculture and phosphorus levels on nutrient content, yield components, and quality traits of wheat in a corn-wheat rotation. Conducted over five years in field conditions, the study employed a randomized complete block design with tillage treatments (conventional tillage, CT; minimum tillage, MT; and no tillage, NT) and phosphorus levels (no fertilizer use, P0; and 100% fertilizer recommendation, PR) as factors. Soil samples were collected during the fourth year (2021–2022). Results revealed significant impacts of tillage methods and phosphorus levels on wheat straw and grain nutrient composition, yield components, and quality traits. Conventional tillage yielded the highest values for protein content (12%), Zeleny sedimentation volume (20.33 mL), hardness index (45), water absorption (64.12%), and wet gluten content (25.83%). Additionally, phosphorus fertilizer application positively influenced protein percentage, gluten weight, and gluten index. The study highlights the potential of strategic soil management, particularly conventional tillage combined with phosphorus fertilization, to enhance wheat quality and yield. By elucidating these relationships, the findings contribute to optimizing wheat cultivation practices and advancing the development of superior wheat cultivars for baking applications.

Abstract Measures such as education, improving knowledge, attitude and taking preventive action to protect against COVID-19 are vital strategies for prevention. The aim of this study was to determine the predictability of Health Belief Model (HBM) constructs in performing preventive behaviors against COVID-19 among secondary school students in Chabahar, Iran. In this cross-sectional-analytical study, 400 secondary school students of Chabahar city were investigated by simple random sampling. The data collection tool was a questionnaire including demographic characteristics, knowledge, behavior, and Health Belief Model constructs’ questions. Exploratory Factor Analysis (EFA) was used to evaluate the validity of HBM constructs, and the structural equation modeling (SEM) method was used to evaluate the direct and indirect effects of the relationship between knowledge, HBM constructs, and preventive behavior against COVID-19 based on the conceptual model. Based on the results of the structural modeling, the direct effect of knowledge on the constructs of the health belief model was positive and significant (β = 0.34, P-value

Knowledge hoarding by knowledge workers deprives the organization of very valuable resources and can have many direct and indirect consequences. This research was conducted with the aim of identifying and validating its. This applied research has been done with a mixed sequential exploratory approach. Factors have been identified with a qualitative approach using thematic analysis method. The participants of this stage were the selected technical experts of Nahaja, and a semi-structured interview was used to survey their views. The quantitative stage was carried out in order to validate the identified factors. For this purpose, a questionnaire distributed among selected thecnical experts. These data were analysed through structural equation modeling (confirmatory factor analysis) and Smart Pls version 3 software. The findings showed that the antecedents of knowledge hoarding include individual factors (tendencies and interests, concerns and worries, motivations, individual traits and characteristics), interpersonal factors (communication factors), organizational factors (occupational factors, culture organizational, managerial factors, and structural factors), extra-organizational factors (social, cultural and economic factors). Also, the consequences of knowledge hoarding were classified into two categories of individual and organizational consequences. Quantitative analyzes also confirmed the significance of the relationship between the desired indicators and components. The results of this research can provide useful knowledge in this field to manage the phenomenon of knowledge hoarding. The simultaneous identification of factors affecting the occurrence of knowledge hoarding in the aforementioned four levels, as well as the consequences of this complication for knowledge workers and the organization, can provide an effective understanding for the management of this destructive organizational behavior. The simultaneous attention to the roots and individual and organizational consequences of this complication is considered the outstanding distinguishing feature of this research.

A paramount determinant in the selection of irrigation canal overflow configurations resides in their flow conveyance capacity. This overflow capacity is contingent upon the effective length and geometric characteristics of the weir. In the present investigation, the hydraulic performance and discharge coefficient (Cd) of circular-crested weir were scrutinized through the utilization of FLUENT software. Specifically, the study delved into the impact of geometric parameters, namely the radius and height of the crest, on these hydraulic aspects. Following the execution of calibration and validation procedures using FLUENT in conjunction with laboratory-derived data, the outcomes of the simulation revealed that augmenting the radius of the crest led to a corresponding escalation of 144.28% in the maximum pressure exerted on the crest and a 6.84% increase in flow depth. Conversely, the maximum velocity and Cd experienced reductions of 6.84% and 7.82%, respectively. The elevation of the weir height exhibited negligible influence on the maximum pressure magnitude at the crest. Contrastingly, a reduction in weir height constricted the range of pressure variations on the crest, indicating a more limited domain of pressure changes. Elevating the weir height induces a notable augmentation in the maximum flow velocity at the crest by 44.36%, concomitant with a reduction in both the depth and Cd by 52.66% and 68.96%, respectively.

ABSTRACT: Milk citrate is regarded as an early biomarker of negative energy balance in dairy cows during early lactation and serves as a suitable candidate phenotype for genomic selection due to its wide availability across a large number of cows through milk mid-infrared spectra prediction. However, its genetic background is not well known. Therefore, the objectives of this study were to (1) analyze the genetic parameters of milk citrate; (2) identify genomic regions associated with milk citrate; and (3) analyze the functional annotation of candidate genes and quantitative trait loci (QTL) related to milk citrate in Walloon Holstein cows. In total, 134,517 test-day milk-citrate phenotypes (mmol/L) collected within the first 50 d in milk on 52,198 Holstein cows were used. These milk-citrate phenotypes, predicted by milk mid-infrared spectra, were divided into 3 traits according to the first (citrate1), second (citrate2), and third to fifth parity (citrate3+). Genomic information for 566,170 SNPs was available for 4,479 animals. A multiple-trait repeatability model was used to estimate genetic parameters. A single-step GWAS was used to identify candidate genes for citrate and post-GWAS analysis was done to investigate the relationship and function of the identified candidate genes. The heritabilities estimated for citrate1, citrate2, and citrate3+ were 0.40, 0.37, and 0.35, respectively. The genetic correlations among the 3 traits ranged from 0.98 to 0.99. The genomic correlations among the 3 traits were also close to 1.00 across the genomic regions (1 Mb) in the whole genome, which means that citrate can be considered as a single trait in the first 5 parities. In total, 603 significant SNPs located on 3 genomic regions (chromosome 7, 68.569–68.575 Mb; chromosome 14, 0.15–1.90 Mb; and chromosome 20, 54.00–64.28 Mb), were identified to be associated with milk citrate. We identified 89 candidate genes including GPT, ANKH, PPP1R16A, and 32 QTL reported in the literature related to the identified significant SNPs. These identified QTL were mainly reported associated with milk fatty acids and metabolic diseases in dairy cows. This study suggests that milk citrate in Holstein cows is highly heritable and has the potential to be used as an early proxy for the negative energy balance of Holstein cows in a breeding objective.

ABSTRACT: The aims of this study were to estimate genetic parameters and to identify genomic regions associated with eating time (ET) and rumination time (RUT) in Holstein dairy cows. Genetic correlations among ET, RUT, and milk yield traits were also estimated. The data were collected from 2019 to 2022 in 6 dairy herds located in the Walloon Region of Belgium. The dataset consisted of daily ET and RUT records on 284 Holstein cows, from which 41 cows had records only for the first parity (P1), 101 cows had records from both the first and second parities, and 142 cows had records only for the second parity (P2). The number of daily ET and RUT records in the P1 and P2 cows were 18,569 (on 142 cows) and 34,464 (on 243 cows), respectively. Data on 28,994 SNPs located on 29 Bos taurus autosomes (BTA) of 747 animals (435 males) were used. Random regression test-day models were used to estimate genetic parameters through the Bayesian Gibbs sampling method. The SNP solutions were estimated using a single-step genomic best linear unbiased prediction approach. The proportion of genetic variance explained by each 20-SNP sliding window (with an average size of 1.52 Mb) was calculated, and regions accounting for at least 1.0% of the total additive genetic variance were used to search for candidate genes. Mean (standard deviation; SD) averaged daily ET and RUT were 327.0 (85.66) and 559.4 (77.69) min/d for cows in P1 and 316.0 (82.24) and 574.2 (75.42) min/d for cows in P2, respectively. Mean (standard deviation; SD) heritability estimates for daily ET and RUT were 0.42 (0.09) and 0.45 (0.06) for cows in P1 and 0.45 (0.04) and 0.43 (0.02) for cows in P2, respectively. Mean (SD) daily genetic correlations between daily ET and RUT were 0.27 (0.07) for P1 and 0.34 (0.08) for P2. Genome-wide association analyses identified 6 genomic regions distributed over 5 chromosomes (BTA1, BTA4, BTA11, 2 regions of BTA14, and BTA17) associated with ET or RUT. The findings of this study increase our preliminary understanding of the genetic background of feeding behavior in dairy cows; however, larger datasets are needed to determine whether ET and RUT might have the potential to be used in selection programs.

Bashayer Farhan Alruwaili,1 Duaa Fahad Bayyumi,1 Ohud Saud Alruwaili,1 Razan Saud Alsadun,1 Amal Sulaiman Alanazi,2 Amal Hadi,2 Nada Kareem S Alruwaili,3 Ashokkumar Thirunavukkarasu,1 Norah Farhan Aldaghmani,4 Aljawharah Abdulrahman Alrayes4 1Department of Family and Community Medicine, College of Medicine, Jouf University, Sakaka, Saudi Arabia; 2Department of Family Medicine, King Abdulaziz Medical City, Riyadh, Saudi Arabia; 3Department of Primary Healthcare, Ministry of Health, Aljouf Health Cluster, Sakaka, Saudi Arabia; 4College of Medicine, Jouf University, Sakaka, Saudi ArabiaCorrespondence: Bashayer Farhan Alruwaili, Department of Family and Community Medicine, College of Medicine, Jouf University, Aljouf, Saudi Arabia, Tel +00966 55 191 3665, Email bfalrwili@ju.edu.saAbstract: In recent years, the countries of the Middle East and North Africa (MENA) region have experienced alarming increases in the prevalence of childhood overweight and obesity. This updated systematic review sought to measure the prevalence and determinants of obesity and overweight among children and adolescents in MENA countries. A literature search for relevant observational studies published in English was conducted using PubMed, Web of Science, Google Scholar, and Saudi Digital Library. The risk of bias was evaluated using the Newcastle-Ottawa Scale. Twenty-one published articles during the past five years were included in the systematic review. Varied approaches were used to diagnose childhood overweight and obesity, including the International Obesity Taskforce (IOTF), Centre for Disease Control (CDC), World Health Organization (WHO), and Saudi Growth Pattern Curves. We found that the combined prevalence of childhood overweight and obesity in the Middle East is up to 49.4%, depending on the methods applied in their studies. Risk factors identified were age, male gender, lack of sufficient physical activity, consumption of fried food, perceived stress level, number of family members, family size, mother’s occupation, education level, family history of obesity, high energy consumption from carbohydrates, ≥ 2 hours spent on watching television on weekend days with overweight, and always eating breakfast while watching television with obesity. The results of this review indicate that the issue of childhood and adolescent overweight and obesity in the Middle East is substantial and concerning. Most of the risk factors identified are modifiable and, if given appropriate attention, could significantly reduce the burden of associated chronic complications.Keywords: childhood obesity, screen time, adolescents, Saudi growth pattern, WHO, CDC

ABSTRACT: Objectives: Plasmid genes, termed mobile colistin resistance-1 (mcr-1) and mobile colistin resistance-2 (mcr-2), are associated with resistance to colistin in Escherichia coli (E. coli). These mcr genes result in a range of protein modifications contributing to colistin resistance. This study aims to discern the proteomic characteristics of E. coli–carrying mcr-1 and mcr-2 genes. Furthermore, it evaluates the expression levels of various proteins under different conditions (with and without colistin). Methods: Plasmid extraction was performed using an alkaline lysis–based plasmid extraction kit, whereas polymerase chain reaction was used to detect the presence of mcr-1 and mcr-2 plasmids. The E. coli DH5α strain served as the competent cell for accepting and transforming mcr-1 and mcr-2 plasmids. We assessed proteomic alterations in the E. coli DH5α strain both with and without colistin in the growth medium. Proteomic data were analysed using mass spectrometry. Results: The findings revealed significant protein changes in the E. coli DH5α strain following cloning of mcr-1 and mcr-2 plasmids. Of the 20 proteins in the DH5α strain, expression in 8 was suppressed following transformation. In the presence of colistin in the culture medium, 39 new proteins were expressed following transformation with mcr-1 and mcr-2 plasmids. The proteins with altered expression play various roles. Conclusion: The results of this study highlight numerous protein alterations in E. coli resulting from mcr-1 and mcr-2–mediated resistance to colistin. This understanding can shed light on the resistance mechanism. Additionally, the proteomic variations observed in the presence and absence of colistin might indicate potential adverse effects of indiscriminate antibiotic exposure on treatment efficacy and heightened pathogenicity of microorganisms.

IntroductionArtificial intelligence has come to be the highlight in almost all fields of science. It uses various models and algorithms to detect patterns and specific findings to diagnose a disease with utmost accuracy. With the increasing need for accurate and precise diagnosis of disease, employing artificial intelligence models and concepts in healthcare setup can be beneficial.MethodologyThe search engines and databases employed in this study are PubMed, ScienceDirect and Medline. Studies published between 1st January 2013 to 1st February 2023 were included in this analysis. The selected articles were screened preliminarily using the Rayyan web tool, after which investigators screened the selected articles individually. The risk of bias for the selected studies was assessed using QUADAS-2 tool specially designed to test bias among studies related to diagnostic test reviews.ResultsIn this review, 17 studies were included from a total of 12,173 studies. These studies were analysed for their sensitivity, accuracy, positive predictive value, specificity and negative predictive value in diagnosing barrette’s neoplasia, cardiac arrest, esophageal adenocarcinoma, sepsis and gastrointestinal stromal tumors. All the studies reported heterogeneity with p-value