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This study investigates the impact of Knowledge Management (KM) practices, enhanced by smart technologies, on organizational performance within public pharmaceutical organizations in Cairo Governorate, Egypt. Using a descriptive-analytical approach, the study targeted employees from five public pharmaceutical companies in Cairo Governorate, including Memphis Pharmaceuticals, Arab Pharmaceuticals, Cairo Pharmaceuticals, Nile Pharmaceuticals, and EIPICO. These companies were selected based on their public listing and accessible workforce data. Respondents included administrative and technical staff, ensuring a representative sample of the sector. The sample size of 372 was calculated using a 95% confidence level and a 5% margin of error, proportionally distributed across organizations and roles. The results of the study reveal that KM practices significantly enhance operational efficiency and foster innovation, with quantitative evidence showing that KM positively influences operational efficiency (β = 0.42, p < 0.01) and innovation (β = 0.35, p < 0.05). The analysis also indicates that strategic leadership plays a moderating role in the relationship between KM practices and organizational performance. Specifically, the moderation effect of leadership strengthens the impact of KM on operational efficiency (interaction term: β = 0.18, p < 0.05) and innovation (interaction term: β = 0.21, p < 0.05). These findings underscore the critical role of leadership in aligning KM practices with strategic goals, highlighting the potential for public pharmaceutical organizations to achieve higher efficiency and innovation. Organizations operating in highly regulated sectors can drive continuous improvement and achieve sustainable performance outcomes by integrating KM frameworks with advanced technologies and strategic leadership. Acknowledgment The authors are thankful to the Deanship of Graduate Studies and Scientific Research at the University of Bisha for supporting this work through the Fast-Track Research Support Program.

Abstract The present study applied a combined analytical quality-by-design and green analytical chemistry approach to develop an HPLC method for the determination of four cephalosporin pharmaceuticals in both their formulations and water samples. These drugs include ceftriaxone, cefotaxime, ceftazidime and cefoperazone. A Box–Behnken experimental design was employed to optimize three chromatographic parameters: mobile phase composition, flow rate and buffer pH. The predicted optimal conditions involved using a mobile phase of acetonitrile and 0.04 M phosphate buffer at pH 6 in a 7:93 (v/v) ratio, pumped at 1.3 mL/min through a Nucleosil C18 (4.6 × 250 mm, 5 μm) column with UV detection at 240 nm. Under these optimum conditions, the developed HPLC method successfully separated the four drugs with good resolution in less than 6 min. Linearity was established across the concentration ranges of 5–300 µg/mL for ceftriaxone and cefotaxime, 5–400 µg/mL for ceftazidime and 5–100 µg/mL for cefoperazone. Furthermore, full validation of the method in terms of accuracy, precision, specificity and robustness was carried out as per ICH guidelines. The greenness profile of the optimized HPLC method was also evaluated using the Analytical GREEnness (AGREE) tool and found to be environmentally friendly with AGREE score of 0.75, making it a greener alternative for quality control and routine analysis of the investigated cephalosporins in their pharmaceutical formulations and tap water samples. Furthermore, the blueness assessment of the proposed HPLC method using the blue applicability grade index (BAGI) tool yielded a value of 77.5, indicating its high analytical practicality and substantial potential for routine analysis applications.

Abstract Hepatocellular carcinoma (HCC) is a leading cause of cancer mortality globally due to HCC late diagnosis and limited treatment options. MiRNAs (miRNAs) emerged as potential biomarkers for various diseases, including HCC. However, the value of miRNA-101 as a serum biomarker for HCV-induced HCC has not been fully investigated. Our study aims to investigate the miRNA-101 differential expression in Egyptian HCV-induced HCC patients’ serum versus HCV liver cirrhosis (LC) as prospective diagnostic biomarkers compared to alpha-fetoprotein (AFP). Blood samples were collected for clinical chemistry profile, liver function, and serum AFP investigations. The serum miR-101 expression levels were evaluated using real-time quantitative PCR (RT-qPCR) in 100 Egyptian subjects: 40 HCV-induced HCC, 40 HCV-induced cirrhosis, and 20 healthy controls. HCC patients showed significantly higher TB, DB, and AFP levels than those cirrhosis and control groups, whereas ALB and Total Protein exhibited significantly reduced levels. AFP sensitivity and specificity in differentiating HCC reported 60 and 67%, respectively, at the cut-off values of 7ng/dl. miR-101 shows fold change upregulation in HCC patients (P

Purpose: Non-obstructive azoospermia (NOA) is a common, but complex problem, with multiple therapeutic options and a lack of clear guidelines. Hence, there is considerable controversy and marked variation in the management of NOA. This survey evaluates contemporary global practices related to medical and surgical management for patients with NOA. Materials and Methods: A 56-question online survey covering various aspects of the evaluation and management of NOA was sent to specialists around the globe. This paper analyzes the results of the second half of the survey dealing with the management of NOA. Results have been compared to current guidelines, and expert recommendations have been provided using a Delphi process. Results: Participants from 49 countries submitted 336 valid responses. Hormonal therapy for 3 to 6 months was suggested before surgical sperm retrieval (SSR) by 29.6% and 23.6% of participants for normogonadotropic hypogonadism and hypergonadotropic hypogonadism respectively. The SSR rate was reported as 50.0% by 26.0% to 50.0% of participants. Interestingly, 46.0% reported successful SSR in

Abstract This study focuses on the use of machine learning (ML) models to predict the biodistribution of nanoparticles in various organs, using a dataset derived from research on nanoparticle behavior for cancer treatment. The dataset includes both categorical and numerical variables related to nanoparticle properties, with a focus on their distribution across organs such as the tumor, heart, liver, spleen, lung, and kidney tissues. In order to address the complex and non-linear nature of the data, three machine learning models were utilized: Bayesian Ridge Regression (BRR), Kernel Ridge Regression (KRR), and K-Nearest Neighbors (KNN). The selection of these models was based on their wide range of capabilities in dealing with non-linear relationships and data complexity. To further model performance and strength, the study also applied cutting-edge methods including the Firefly Algorithm for hyperparameter tuning and Recursive Feature Elimination (RFE) for feature selection. Based on higher R² and lower RMSE values for most output parameters, the study concluded that Kernel Ridge Regression (KRR) did better compared to other models in predicting biodistribution outcomes. The study revealed that machine learning models, particularly KRR, exhibit a high level of efficiency in accurately representing the non-linear characteristics of nanoparticle biodistribution. The results obtained provide valuable insights into the optimization of predictive models for the behavior of nanoparticles. These models can be further enhanced by the use of advanced feature selection and hyperparameter tuning techniques.

Abstract Background Fibromyalgia Syndrome (FMS) is a chronic disabling musculoskeletal condition of unknown aetiology characterized by generalized musculoskeletal pain, extreme fatigue, mood disturbance, impaired cognition, and lack of refreshing sleep. Middle East pain syndrome (MEPS) is a newly described pollution-induced syndrome of hyperparathyroidism and fibromyalgia mimicking rheumatoid arthritis, characterized by the radiological presence of spur-like excrescences in terminal phalanges. This study aimed to explore the inflammatory nature of Middle East pain and Fibromyalgia syndromes. Methods Eighty primary fibromyalgia patients were included in this study. They were divided into two groups, group [1] 1 of 40 FMS patients with low vitamin D levels and secondary hyperparathyroidism, which were diagnosed as MEPS, and group [2] of 40 primary FMS patients. They were subjected to full medical history taking, clinical examination and laboratory assessment including serum IL-17 by enzyme-linked immunosorbent assay technique, as well as assessment of Madrid Sonographic Enthesitis Index (MASEI) using musculoskeletal ultrasound and nailfold capillaroscopic pattern assessment. Plain X-ray films for hands were done on all patients. Results There was a statistically significant elevation of serum IL17 in the MEPS group (median = 58.3 ng/L) compared to the FMS group (median = 45.7 ng/L) as the p-value is

Abstract The invasion of Anopheles stephensi in Africa warrants investigation of neighboring countries. In this study, genetic analysis was applied to determine the status of An. stephensi in southern Yemen. Cytochrome c oxidase subunit I (COI) and internal transcribed spacer 2 (ITS2) were sequenced in An. stephensi collected in Dar Sa’ad (Aden City), Tuban, Rodoom, Al Mukalla, and Sayhut, and phylogenetic analysis confirmed An. stephensi identity. Our analyses revealed that the ITS2 sequences were identical in all An. stephensi, while COI analysis revealed two haplotypes, one previously reported in northern Horn of Africa and one identified in this study for the first time. Overall, these findings revealed low levels of mitochondrial DNA diversity, which is consistent with a more recent population introduction in parts of southern Yemen relative to the Horn of Africa. Further, whole genomic analysis is needed to elucidate the original connection with invasive populations of An. stephensi in the Horn of Africa. Graphical Abstract

Abstract Smart Traffic Light Systems play an important role in urban traffic management. They often rely on cameras and sensors to collect traffic data. However, these methods are limited in terms of vehicle occupancy and queuing. Effective traffic management remains a challenge in urban areas owing to traffic congestion and emergencies. A new system called ADSTLS (Adaptive and Dynamic Smart Traffic Light System) is proposed, which handles traffic management at an intersection and effectively solves the cumbersome problem of traffic congestion while ensuring priority for emergency vehicles. ADSTLS provides fault tolerance to its components and works reliably in most failure situations. Therefore, traffic data is collected from cameras, and useful traffic information is extracted using computer vision and image processing. The proposed system also uses the Weight Chicken Swarm Optimisation algorithm for decision‐making to reduce congestion and average vehicle waiting time significantly. ADSTLS was applied to a real case study of EL‐Hidhab Setif city intersection. The approach's effectiveness was confirmed by thorough experiments, resulting in a noteworthy decrease in the average vehicle waiting time (31 s) and queue occupation rate (33.82%) across all simulated traffic scenarios. Furthermore, compared to other car types, emergency vehicles usually had much shorter wait times.

الملخص: أهداف البحث: يهدف البحث إلى تقييم تاثير تصميمات خط النهاية المختلفة وسماكات فجوة الاسمنت على مقاومة الكسر لتيجان الزركونيا المتدرجة. طرق البحث: تم تصنيع ستين تاجا على قوالب من الفولاذ المقاوم للصد باستخدام زركونيا اليتريا متعددة الطبقات وتصنيفها في ثلاث مجموعات رئيسية بناء على نوع خط النهاية (حد السكين، والشطف، والكتف المدور). تم تصنيف كل مجموعة لمجموعتين فرعيتين (العدد=10) على حسب سماكة فراغ الاسمنت (خمسون ميكرومتر، ثمانون ميكرومتر). تم الحصول على طبعات بصرية للقوالب باستخدام ماسح مختبري غير مباشر، وتم تحديد فراغات الاسمنت (خمسون وثمانون ميكرومتر) لكل نوع من خطوط النهاية من خلال استخدام برنامج اكسوكاد. بعد ذلك، تم تصنيع تيجان الزركونيا وتلبيدها ولصقها على قوالبها المعنية، وتم تعريضها للتقادم الحراري الميكانيكي، ثم تعريضها للتحميل حتى الكسر. خضعت البيانات المجمعة للتحليل الاحصائي من خلال استخدام تحليل التباين وحيد الاتجاه واختبارات المقارنات الزوجية. علاوة على ذلك، تم استخدام اختبار تحليل التباين ثنائي الاتجاه لدراسة تفاعل المتغيرين. النتائج: لم تلاحظ فروق مهمة بين نمطي الشطف وحد السكين. مع ذلك، سجلت مجموعة الكتف المدور قيم حمل فشل مرتفعة بشكل ملحوظ. وبالمثل، لم يكن هناك فرق مهم بين فراغ الاسمنت خمسين وثمانين ميكرومتر. الاستنتاجات: تمثل حواف حد السكين مع تيجان زركونيا اليتريا متعددة الطبقات المتدرجة بديلا موثوقا لحواف الكتف، خاصة في التحضيرات قليلة التدخل. يفضل فراغ الاسمنت ثمانين ميكرومتر على خمسين ميكرومتر لتصميمات خط النهاية المختلفة. Abstract: Objective: This study was aimed at assessing the effects of various finish line designs and cement gap thicknesses on the fracture resistance of gradient zirconia crowns. Methods: Sixty crowns were fabricated on stainless-steel dies with yttria multi-layered (YML) zirconia and categorized into three primary groups according to finish line type (knife-edge, chamfer, and rounded shoulder). Each group was further classified into two subgroups (n = 10) according to cement space thickness (50 or 80 μm). Optical impressions of the dies were acquired with an indirect laboratory scanner, and cement spaces (50 or 80 μm) were established for each finish line type in Exocad software. Subsequently, the zirconia crowns were milled, sintered, cemented onto their respective dies, thermomechanically aged, and subjected to loading until fracture. The data were statistically analyzed with one-way ANOVA and post hoc tests for pairwise comparisons. Additionally, two-way ANOVA was used to investigate interactions between two study variables. Results: No significant differences between chamfer and knife-edge patterns were observed, whereas the rounded shoulder pattern exhibited significantly higher failure load values. Similarly, no significant difference was observed between 50 μm and 80 μm cement space. Conclusions: Knife-edge margins with YML gradient zirconia crowns provide a reliable alternative to shoulder margins, particularly in minimally invasive preparations. A cement space of 80 μm rather than 50 μm is preferred for various finish line designs.

Linguistic variables (LVs) provide a reliable expression of cognitive information. By inheriting the advantages of LVs, we can express uncertain and incomplete cognitive information in multiple attribute decision-making (MADM), and they do so better than existing methods. In the decision-making process, we can consider decision experts’ (DEs’) bounded rationality, such as cognition toward loss caused by the DEs’ cognitive limitations during the decision process. Therefore, it is necessary to propose a novel cognitive decision approach to handle MADM problems in which the cognitive information is expressed by LVs. In this paper, we employ LVs to represent uncertain and hesitant cognitive information. Then, we propose a mathematical programming approach to solve the MADM problems where attributes or cognitive preferences are not independent. Moreover, the validity and superiority of the presented approach are verified by dealing with a practical problem.

Abstract The increasing integration of AI technologies such as ChatGPT in educational systems calls for an in-depth understanding of the factors influencing students’ intentions to use these tools. This study explores the factors shaping university students’ intentions to use ChatGPT by analysing three key dimensions: task characteristics, technology characteristics and individual characteristics. Using the task-technology fit (TTF) framework, the research examined how these elements impact the alignment between educational tasks and ChatGPT’s capabilities, ultimately driving students’ behavioural intentions. A survey of 393 students from a Saudi Arabian university was conducted, and structural equation modelling was applied to assess the relationships among the variables. Results indicated that all three characteristics significantly influenced TTF, which in turn had a positive impact on students’ intentions to use ChatGPT. The study highlighted the importance of achieving a strong TTF to encourage the effective use of AI tools in academic settings. The implications of this research suggest that educational institutions should focus on aligning AI technologies with students’ learning tasks to enhance their intent to use these tools, thereby improving academic performance. Furthermore, this study extended the TTF model to the context of AI-powered educational tools, particularly in line with Saudi Arabia’s Vision 2030. This research is one of the first to investigate the factors influencing students’ intentions to use ChatGPT within the unique cultural and technological context of Saudi Arabia’s higher education system. By integrating the TTF framework with local and regional factors, the study provides novel insights into the drivers of AI usage in education, offering guidance for regional policy and broad educational practices.

Abstract Serpentine minerals, either polymorphs or polytypes (mostly chrysotile, lizardite and antigorite), are hardly distinguished in ophiolitic serpentinites and serpentinized peridotite unless sophisticated mineralogical tools are applied. Among them, chrysotile has special chemical and structural characteristics, which can be used to identify and classify different modes, and accordingly as significant petrographic indicators of serpentinization in ophiolite sequences. Generally, chrysotile characterizes low-grade metamorphism and it occurs in massive serpentinites as well as asbestos veinlets traversing them. The present paper aims to characterize the different modes of chrysotile in serpenitinite and serpentinized peridotite from the Semail ophiolite at the Daftah area in the United Arab Emirates (UAE). The objectives include microscopic and chemical separation of three chrysotile modes; namely slip-fiber (most common), mass fiber (common) and cross-fiber (less common). The cross-fiber mode is considered a “spinning type” in sheared serpentinite with asbestos veinlets whereas the other two belong to “non-spinning type” in massive serpentinite being formed by a contact volume metasomatic process by replacement of olivine and pyroxene. Excess Mg from the transformation of ferromagnesian minerals into chrysotile, in the presence of additional SiO2, results in an association of cryptocrystalline talc with the chrysotile fibers. Differential thermal analysis (DTA) and thermogravimetry (TG) indicate that the process of thermal decomposition of chrysotile leads to the formation of olivine (forsterite). The infra-red (IR) absorption technique for end products of some selected samples appear to indicate that the spectra of the end products are similar and the absorption bands are assigned in the range of (1100–800 cm−1) and (700–200 cm−1) corresponding to Si–O and Mg–O vibration modes. Based on the findings of the present paper, the chrysotile serpentinization process is due to metasomatic replacement of peridotite during the ocean floor early episode and later an episode of ophiolite obduction. The chemical data focalize that the similarity in chemical behaviour of chrysotile veins implies that a close cogenetic relationship among three modes of chrysotile and removal of such major elements occurred during serpentinization; Mg, Fe and Si were removal in solution from the peridotite and precipitated in tension and shear fractures to form fibrous chrysotile and magnetite. Also, it can be concluded that the mode of occurrence and timing of chrysotile vein formation can be fitted according to the type of chrysotile mode. Cross-fiber type develops along tension fractures whereas mass-fiber type is finally developed via CO2 metasomatism. Finally, the slip-fiber type forms by a volume-for volume metasomatic process due to the replacement of olivine and/or pyroxene. In terms of time and tectonism, the different mode witnessed different metamorphic/metasomatic events and structures. Shear deformation is more likely connected to the formation of cross-fibers in NW- and NE-trending asbestos veins and veinlets.

Work on digital transformation is one of the main features of the fourth economic revolution, which tends to benefit from technology in various aspects of life. The Machine Learning (ML), Semantic Learning (SL), and Deep learning (DL) and dealing with robots are the most prominent features and widespread aspects. This study focuses on taking advantage of Chatbot through SL to provide a wide-knowledge and multi-tasking communication environment by using chat-applications to find typical answers commensurate with customers' questions and reach with them to detail and appropriate answer stage, as well as providing various types of files such as audio, images, video, and documents. After the spread of the Corona pandemic and the transition of education from face-to-face to distance education approach, a number of algorithms were developed that deal with the method of Chatbot to answer the cognitive required aspects to assist the instructors and students what are the necessary features to maximize benefit from the distance education style. Thus, the shifting to digital educational approach represented a major challenge, especially in communities that depend their groups on physical education and their schools do not have any infrastructure for distance education. Therefore, these groups need more technical support to clearly and quickly understand how they can use technology. The experience of King Abdulaziz University (KAU) offers multiple solutions to support instructors and students to fill the shortage of transformation and take advantage of Chatbot to increase the opportunity for ML and SL to develop the technical support operations in professional manner. The number of KAU members is 100,000 users who should be helped and develop through Chatbot solution based to understating the main concept from the clients and providing supporting materials including documents, images, audio and video files to beneficiaries from various sources and supporting databases before reaching the human technical team, that has a good effect on participants and learning services. This study presents the infrastructure and algorithms implemented in Chatbot services, and what are the implications for the emergence of the service.

Zinner syndrome (ZS) is a rare congenital urological condition characterized by a triad of ipsilateral seminal vesicle cysts, unilateral renal agenesis, and ejaculatory duct obstruction, first described in 1914. This case report details the presentation and management of a 27-year-old male diagnosed with ZS following a 2-month history of urinary frequency, hesitancy, dysuria, and painful ejaculation. Physical examination revealed a left lower abdominal mass, and imaging confirmed the classic findings of ZS, including unilateral renal agenesis, an enlarged seminal vesicle cyst, and an ectopic ureter. Conservative treatment with tamsulosin initially improved symptoms, but due to the cyst's large size and the risk of complications, laparoscopic excision was recommended for definitive management. ZS is often diagnosed late due to nonspecific symptoms, with an average diagnosis age of 29.35 years. MRI is the gold standard for diagnosis, revealing seminal vesicle cysts, renal agenesis, and ejaculatory duct obstruction. Conservative management is reserved for asymptomatic cases, while symptomatic patients benefit from surgical intervention. This case emphasizes the importance of timely imaging, particularly in patients with nonspecific lower urinary tract symptoms, and highlights the role of tamsulosin as an effective interim therapy before definitive surgical treatment. The case underscores the need for clear diagnostic criteria and treatment pathways to improve outcomes in this rare condition, which can lead to infertility if not managed appropriately.

Cell-based therapy is a new direction of treatment of diseases such as type 1 diabetes mellitus (T1DM); but unfortunately, its severe side effects include immunogenicity and tumor development. Using Mesenchymal stem cells conditioned medium (MSCs-CM) may be an alternative therapy to avoid stem cell risks, preserving effectiveness and demonstrating noticeably increased levels of cytokines, angiogenic factors, and growth factors that encourage and support regenerative processes. In the current work, we examined the effects of MSCs-CM injected in tail vein and pancreas directly compared with the standard antidiabetic drug, glimepiride in streptozotocin-induced type 1 diabetic rats. Fifty adults Male Wistar rats were allocated equally into five groups: normal, diabetic control and three diabetic groups treated respectively with glimepiride, MSCs-CM injected daily into tail vein (MSCs-CMT) and MSCs-CM injected directly in pancreas (MSCs-CMP); all treatments continued for 28 days. The treatments produced a significant improvement in blood glucose level and glycosylated hemoglobin A1c (HbA1c), serum insulin level and lipid panel, and pancreas apoptosis-related markers including B cell lymphoma-2 (Bcl-2) and vimentin. In addition, the treatments resulted in suppression in the oxidation stress and enhancement in the antioxidant, which were manifested by the suppressed lipid peroxidation and the increased antioxidant markers (glutathione, catalase and superoxide dismutase) in the pancreas. In association with the significant decrease in tumour necrosis factor-alpha (TNF-α) and interleukin-1beta (IL-1β) and a significant increase in interleukin-10 (IL-10) levels, the inflammatory mediator nuclear factor-kappa B (NF-κB) expression was significantly decreased by MSCs-CMT and MSCs-CMP. The histological amelioration of the pancreatic islet cells assured our study especially in MSCs-CMP group than MSCs-CMT which supports islet regeneration and elevated circulating insulin. These results imply that MSCs-CM infusion has therapeutic benefits in T1DM rats and may be a viable novel therapeutic approach; MSCs-CMP was shown to be more effective than glimepiride and MSCs-CMT. The mechanisms of antidiabtic actions may be mediated via the antioxidant, anti-apoptotic and anti-inflammatory effects.

In reliability engineering or medical studies, more information about the life expectancy of products or materials is needed. This information under use conditions is more difficult to collect especially under highly reliable case. In this paper, the problem of statistical inference when the lifetime of a product or material has the power failure rate distribution is developed. To save the cost and time induced by units the experiment is designed with respect to partially step-stress accelerated life tests (ALTs) with type-I generalized hybrid censoring scheme (GHCS). The point estimate of the model parameters as well as the accelerated factor are obtained with respect to the maximum likelihood (ML) and Bayes methods. Also, the asymptotic normal properties of ML estimates, two bootstrap techniques and Markov Chain Monte Carlo techniques are used to formulate interval estimators. A real lifetime data set is used to illustrate the application of the proposed model. Finally, a Monte Carlo simulation study is constructed to discuss and assess, the proposed model and estimation methods.

Salinity, resulting from climate change and excessive mineral fertilization, burdens farmers and negatively impacts soil and water ecosystems in the Northeastern Nile Delta. Organic and biological approaches are crucial for addressing these issues. This study examined the effects of individual and combined inoculations with cyanobacteria, yeast, and Arbuscular Mycorrhizal Fungi (AMF), with or without K-Humate and reducing Nitrogen, phosphorus and potassium (NPK) mineral fertilizers application rates to crop quality of wheat and faba bean. In preliminary laboratory experiments, the interactive effects of these microbiomes on plant antioxidant and soil enzyme production were examined under salinity stress. Results showed that co-inoculation, especially with K-Humate, yielded superior outcomes compared to individual inoculations. These findings were validated by a field trial conducted in saline-alkaline soil in the Northeastern Nile Delta region. All biological treatments 25% of recommended doses, and enhancing salinity tolerance, increasing yield, and improving enhanced rhizosphere microbial activity, including soil enzyme activity, AMF colonization, spore density, and the total numbers of bacteria, cyanobacteria, and yeast. These effects were further amplified by K-Humate and were more pronounced with combined inoculations than with individual ones, leading to improved soil fertility and significant increases in both crop quantity and quality compared to control treatments. The triple treatment, combining cyanobacteria, yeast, and mycorrhizae in the presence of K-Humate while reducing the mineral NPK rate by 75%, achieved superior increases in the productivity of wheat grains and faba bean seeds, reaching 54.72% and 128.92%, respectively, compared to the 100% NPK mineral control. This treatment also significantly improved crop quality, with notable increases in nitrogen, potassium, phosphorus, and protein percentages in wheat grains and faba bean seeds. Microbiomes-interaction increased potassium uptake over sodium, enhancing the plant’s potassium/sodium ratio and improving salt stress tolerance. This approach reduces reliance on costly mineral fertilizers, enabling bio-organic farming in marginal lands, optimizing resource utilization, and preserving natural resources.

Purpose: Non-obstructive azoospermia (NOA) represents the persistent absence of sperm in ejaculate without obstruction, stemming from diverse disease processes. This survey explores global practices in NOA diagnosis, comparing them with guidelines and offering expert recommendations. Materials and Methods:Materials and Methods: A 56-item questionnaire survey on NOA diagnosis and management was conducted globally from July to September 2022. This paper focuses on part 1, evaluating NOA diagnosis. Data from 367 participants across 49 coun-tries were analyzed descriptively, with a Delphi process used for expert recommendations. Results:Results: Of 336 eligible responses, most participants were experienced attending physicians (70.93%). To diagnose azoosper-mia definitively, 81.7% requested two semen samples. Commonly ordered hormone tests included serum follicle-stimulating hormone (FSH) (97.0%), total testosterone (92.9%), and luteinizing hormone (86.9%). Genetic testing was requested by 66.6%, with karyotype analysis (86.2%) and Y chromosome microdeletions (88.3%) prevalent. Diagnostic testicular biopsy, distinguishing obstructive azoospermia (OA) from NOA, was not performed by 45.1%, while 34.6% did it selectively. Differ-entiation relied on physical examination (76.1%), serum hormone profiles (69.6%), and semen tests (68.1%). Expectations of finding sperm surgically were higher in men with normal FSH, larger testes, and a history of sperm in ejaculate. Conclusions:Conclusions: This expert survey, encompassing 367 participants from 49 countries, unveils congruence with recommended guidelines in NOA diagnosis. However, noteworthy disparities in practices suggest a need for evidence-based, international consensus guidelines to standardize NOA evaluation, addressing existing gaps in professional recommendations.

Abstract Background Hoarding disorder (HD) is characterized by a compulsion to collect belongings, and to experience significant distress when parting from them. HD is often misdiagnosed for several reasons. These include patient and family lack of recognition that it is a psychiatric disorder and professionals’ lack of relevant expertise with it. This study evaluates the ability of a supervised machine learning (ML) model to match the diagnostic skills of psychiatrists when presented with equivalent information pertinent to symptoms of HD. Methods Five hundred online participants were randomly recruited and completed the Hoarding Rating Scale-Self Report (HRS-SR) and the Generalized Anxiety Disorder 7-item (GAD-7) scale. Responses to the questionnaires were read by an ML model. Responses to the HRS-SR were then converted into anonymized, random-equivalent texts. Each of these individual texts was presented in random order to two experienced psychiatrists who were independently asked for a provisional diagnosis - e.g.; the presence or absence of HD. In case of disagreement between the two assessors, a third psychiatrist broke the tie. A decision tree classification model was employed to predict clinical HD using self-report data from two psychological tests, the HRS-SR and GAD-7. The target variable was whether a participant had clinical HD, while the predictive variables were the continuous scores from the HRS-SR and GAD-7 tests. The model’s performance was evaluated using a confusion matrix, which compared the observed diagnoses with the predicted diagnoses to assess accuracy. Results According to the psychiatrists, approximately 10% of the participants fulfilled DSM-5 diagnostic criteria for HD. 93% of the clinician-identified cases were identified by the ML model based on HRS-SR and GAD-7 scores. A decision tree plot model demonstrated that about 60% of the cases could be detected by the HRS-SR alone while the rest required a combination of HRS-SR and GAD-7 scores. ML evaluation metrics showed satisfactory performance, with a Matthews Correlation Coefficient of 55%; Area Under Curve (AUC), 79%; a Negative Predictive Value of 76%; and a False Negative Rate of 24%. Conclusions Study findings strongly suggest that ML can, in the future, play a significant role in the risk assessment of psychiatric disorders prior to face-to-face consultation. By using AI to scan big data questionnaire responses, wait time for seriously ill patients can be substantially cut, and prognoses substantially improved.

Abstract The toxicity that was caused by the developed medications for anticancer treatment is, unfortunately, an earnest problem stemming from the various involved targets, and accordingly, intense research for overcoming such a phenomenon remains indispensable. In the current inquiry, an innovative category of substituted quinazoline-based glycosides incorporating a core of 1,2,3-triazole and attached to distinct acetylated likewise deprotected sugar segments are created and produced synthetically. The resulted 1,2,3-triazolyl-glycosides products were investigated for their ability to cause cytotoxicity to several human cancer cell lines. The quinazoline based glycosyl-1,2,3-triazoles 10–13 with free hydroxy sugar moiety revealed excellent potency against (IC50 range = 5.70–8.10 µM, IC50 Doxorubicin = 5.6 ± 0.30 µM, IC50 Erlotinib = 4.3 ± 0.1 µM). against MCF-7 cancer cell line. In addition, the derived glycosides incorporating quinazolinone and triazole core 6–13 with acetylated and deprotected sugar parts showed excellent and superior potency against HCT-116 (IC50 range = 2.90–6.40 µM). The potent products were revealed as safe cytotoxic agents as indicated by their studied safety profiles. Additional research of promising candidates inhibitory analysis performed against EGFR and VEGFR-2. The hydroxylated glycosides incorporating triazole and quinazoline system 11 and 13 with N-methyl substitution of quinazolinone, gave excellent potency against EGFR (IC50 = 0.35 ± 0.11 and 0.31 ± 0.06 µM, correspondingly) since glycoside 13 revealed comparable IC50 (3.20 ± 0.15 µM) to sorafenib against VEGFR-2. For more understanding of its action mode, it was analyzed how the 1,2,3-triazolyl glycoside 13 made an effect on the apoptosis induction and the arrest of the cell cycle. It was revealed that it had the ability to stop HCT-116 cells in their cell cycle’s G1 stage. Moreover, the influence of quinazolinone-1,2,3-triazole-glycoside 13 upon p53, Bax, and Bcl-2 levels in HCT-116 units was also studied for future approaches toward its behavior. Additionally, the latter derivative may trigger apoptosis, as indicated by a significant increase in apoptotic cells. Furthermore, molecular docking was simulated to make an obvious validation and comprehension acquirement of the binding’s characteristics also attractions among the most forceful compounds side by side with their aimed enzymes.

Abstract Background The prostaglandin E1 analog “misoprostol” is a drug that has powerful ecbolic effects and can be beneficial in the prevention and treatment of postpartum hemorrhage, which is the leading cause of maternal mortality worldwide. Objectives To assess the value of adding intrauterine misoprostol together with intravenous oxytocin injection compared with sublingual misoprostol together with intravenous oxytocin injection during elective cesarean section to reduce blood loss intraoperatively and prevent postpartum hemorrhage. Methods A total of 192 pregnant women were counseled and recruited from the labor and delivery unit at Kasr Al Aini Hospital, Cairo University, and equally randomized into two groups. Group (A) included 96 women who received intrauterine misoprostol (400 mg) + oxytocin. Group (B) included 96 women who received sublingual misoprostol (400 mg) + oxytocin. The primary outcome of our study was estimation of the amount of blood loss during and after cesarean delivery. The secondary outcomes were the incidence of PPH within the first 6 h after labor, the need for blood transfusion, the need for any supplementary ecbolic drugs, the need for additional surgical intervention for PPH, changes in hematocrit and hemoglobin in both groups after delivery, and the incidence of side effects of the study medications. Results We observed a significant discrepancy between the two groups in terms of postoperative Hb and Hct, postoperative differences (pre- and post-Hb and post-Hct) and EBL favoring the intrauterine group. However, no significant difference was observed between the groups with respect to excessive blood loss > 1000 ml in the 1st six hours, the need for supplementary ecbolics, the necessity for blood or blood prod, the need for additional surgical intervention (for PPH) or side effects. Conclusion Intrauterine misoprostol combined with oxytocin intravenous infusion is more effective than sublingual misoprostol combined with oxytocin intravenous infusion in lowering intraoperative blood loss and preventing postpartum hemorrhage in elective cesarean section. Trial registration This trial was retrospectively registered with the ClinicalTrials.gov Registry on 12-April-2024 (registration number: NCT06364098).

Background The evaluation of genetic markers in the gingival crevicular fluid (GCF) and their connection to tooth movement can be helpful. Aim The objective of this research is to assess the relationship involving leptin levels and orthodontic tooth movement (OTM). Study Setting and Design Thirty individuals reporting to the Department of Orthodontics participated in an observational prospective study. Material and Method Thirty orthodontic patients (15 male and 15 female) were included in the current study. The association of leptin concentration (GCF) was measured before and after orthodontic force was applied to move the mesially impacted canine distally (tooth movement distance on dental cast). Statistical Analysis With the help of SPSS software version 21, the data were statistically examined using the “t” test, one-way ANOVA, and Bonferroni correction in Chicago. The average degree of tooth movement was calculated using Pearson’s correlation coefficient, and it was connected to the average leptin levels. Results Average leptin levels in GCF elevated from baseline (T0, 285.315 picograms/micro litre) to 1 h after force application (T1, 384.683 pg/μL), then raised to a maximum at after 24 h (T2, 927.64 pg/μL), and decreased to the least amount after 15 days (T3, 29.26 pg/μL) and another time increase after two months (242.31 pg/μL). The degree of OTM was significantly correlated with the levels of leptin. Conclusion While OTM was occurring, a biphasic fluctuation in the leptin level was noted. The amount of tooth movement was significantly correlated with the GCF leptin level.

Background: Undesirable injuries during the intraoperative period, such as pressure injuries caused by improper positioning, medical devices, or adhesive tapes, can lead to patient harm and decreased satisfaction. This study aims to identify the risk factors of pressure injuries during the intraoperative period and the characteristics of these injuries. Methods: A retrospective case-control study was conducted at King Khaled University Hospital in Riyadh, Saudi Arabia. Data were collected from the hospital incident reporting system and electronic medical records for incidents reported from January 1, 2022 to December 31, 2022. Inclusion criteria consisted of all patients with a reported pressure injury, including pressure ulcers, medical adhesive-related skin injuries, or medical device-related pressure injuries, occurring at least once during surgery. Results: Among the 113 patients, 57 (50.44%) had intraoperative pressure injuries (cases), while 56 (49.56%) did not (controls). The most common locations for pressure injuries were the lips (33.33%). Most of these injuries were classified as Medical Adhesive-Related Skin Injury (61.40%). Stage 1 injuries were observed in 47 cases (82.46%), while Stage 2 injuries were observed in 10 cases (17.54%). Duration of surgery and device tightness were identified as significant risk factors (P < 0.001). Conclusion: This case-control study identified the duration of surgery and device tightness as significant risk factors for intraoperative pressure injuries. The findings emphasize the importance of implementing evidence-based prevention strategies. Healthcare professionals should prioritize staff education and training, while future research should focus on conducting prospective, multicenter studies and developing risk assessment tools and innovative medical devices.

The ID10 beamline of the SESAME (Synchrotron-light for Experimental Science and Applications in the Middle East) synchrotron light source in Jordan was inaugurated in June 2023 and is now open to scientific users. The beamline, which was designed and installed within the European Horizon 2020 project BEAmline for Tomography at SESAME (BEATS), provides full-field X-ray radiography and microtomography imaging with monochromatic or polychromatic X-rays up to photon energies of 100 keV. The photon source generated by a 2.9 T wavelength shifter with variable gap, and a double-multilayer monochromator system allow versatile application for experiments requiring either an X-ray beam with high intensity and flux, and/or a partially spatial coherent beam for phase-contrast applications. Sample manipulation and X-ray detection systems are designed to allow scanning samples with different size, weight and material, providing image voxel sizes from 13 µm down to 0.33 µm. A state-of-the-art computing infrastructure for data collection, three-dimensional (3D) image reconstruction and data analysis allows the visualization and exploration of results online within a few seconds from the completion of a scan. Insights from 3D X-ray imaging are key to the investigation of specimens from archaeology and cultural heritage, biology and health sciences, materials science and engineering, earth, environmental sciences and more. Microtomography scans and preliminary results obtained at the beamline demonstrate that the new beamline ID10-BEATS expands significantly the range of scientific applications that can be targeted at SESAME.

Abstract Introduction MicroRNAs (miRNAs) are single RNA molecules that act as global regulators of gene expression in mammalian cells and thus constitute attractive targets in treating cancer. Here we aimed to investigate the possible involvement of miRNA-141 (miR-141) in cervical cancer and to identify its potential targets in cervical cancer cell lines. Methods The level of miR-141 in HeLa and C-33A cells has been assessed using the quantitative real-time PCR (qRT-PCR). A new miR-141 construct has been performed in a CMV promoter vector tagged with GFP. Using microarray analysis, we identified the potentially regulated genes by miR-141 in transfected HeLa cells. The protein profile of killer-like receptor C1 (KLRC1), KLRC3, carcinoembryonic antigen‐related cell adhesion molecule 3 (CAM3), and CAM6 was investigated in HeLa cells transfected with either an inhibitor, antagonist miR-141, or miR-141 overexpression vector using immunoblotting and flow cytometry assay. Finally, ELISA assay has been used to monitor the produced cytokines from transfected HeLa cells. Results The expression of miR-141 significantly increased in HeLa and C-33A cells compared to the normal cervical HCK1T cell line. Transfection of HeLa cells with an inhibitor, antagonist miR-141, showed a potent effect on cancer cell viability, unlike the transfection of miR-141 overexpression vector. The microarray data of HeLa cells overexpressed miR-141 provided a hundred of downregulated genes, including KLRC1, KLRC3, CAM3, and CAM6. KLRC1 and KLRC3 expression profiles markedly depleted in HeLa cells transfected with miR-141 overexpression accompanied by decreasing interleukin 8 (IL-8), indicating the role of miR-141 in avoiding programmed cells death in HeLa cells. Likewise, CAM3 and CAM6 expression reduced markedly in miR-141 transduced cells accompanied by an increasing level of transforming growth factor beta (TGF-β), indicating the impact of miR-141 in cancer cell migration. The IntaRNA program and miRWalk were used to check the direct interaction and potential binding sites between miR-141 and identified genes. Based on this, the seeding regions of each potential target was cloned upstream of the luciferase reporter gene in the pGL3 control vector. Interestingly, the luciferase activities of constructed vectors were significantly decreased in HeLa cells pre-transfected with miR-141 overexpression vector, while increasing enormously in cells pre-transfected with miR-141 specific inhibitor. Conclusion Together, these data uncover an efficient miR-141-based mechanism that supports cervical cancer progression and identifies miR-141 as a credible therapeutic target.

Abstract Background Rheumatoid arthritis (RA) is a chronic systemic autoimmune inflammatory disorder characterized by synovial inflammation that leads to joint damage, bony erosions, and related deformities. Between 30 and 70% of RA patients will experience anemia. Early detection of anemia is of great importance. This study aimed to evaluate the serum level of hepcidin (HEP) in RA patients and to assess its relation to disease activity and anemia. The current cross-sectional study included 44 cases with RA in addition to 44 healthy controls. The disease activity in the RA patient was assessed by using the disease activity score (DAS) 28 score-CRP. The serum levels of HEP and ferritin were assessed in both groups using enzyme-linked immunosorbent assay (ELISA) technique. Results Hepcidin level in the RA group was statistically significantly higher as compared to the control group (p = 0.001). The prevalence of Anemia of chronic disease (ACD) was 40.9%, and iron deficiency anemia (IDA) was 27.3% which accounted for 68.2% of the total anemia cases. The HEP level was statistically significantly higher in the RA patients with ACD than those without anemia (P = 0.028), RA patients with IDA (P 355.5 Pg/ml. This point showed moderate sensitivity (70.5%) with moderate specificity (63.6%) with a statistically significant value. Conclusions We found the anemia, and particularly ACD, is more common in RA patients. In RA patients with ACD, serum HEP levels were considerably higher. Although serum HEP showed no diagnostic significance when it came to evaluating disease activity, it could be a dependable non-invasive biomarker for the diagnosis of various forms of anemia in RA patients.

Abstract Herein, a novel UV spectrophotometric method coupled with chemometric tools was developed for the simultaneous determination of three fluoroquinolone antibiotics: ciprofloxacin, lomefloxacin, and enrofloxacin. Such integration of UV spectroscopy and chemometric analysis proved to be a simple, rapid, and cost-effective approach for the quantification of these clinically important pharmaceutical compounds and aid in their quality control analysis. The method employed firefly algorithm for variable selection and partial least squares (PLS) regression for model calibration. The developed method was validated by independent test set in addition the accuracy, intra and inter-day precision as per ICH guidelines which showed a satisfactory performance with mean recovery ranged between 98.18 and 101.83 with %RSD

Abstract The welfare of donkeys remains a compelling subject for researchers, with limited literature available on the response of the donkey cardiovascular system during strenuous exercise. The study aimed to address two primary objectives. Firstly, to assess the reliability of wearable devices in detecting heart rate (HR) and ECG readings. Secondly, to determine HR, locomotor and cardiac troponin 1 (cTnI) levels in donkeys during exercise. A total of seven donkeys were outfitted with two systems for ECG measurements, namely Equimetre and the Standard base apex, to enable a comparison between the two. Additionally, fifteen apparently healthy donkeys equipped with Equimetre were divided into two groups: the race group (R), consisting of donkeys trained for racing, and the non-race group (NR), comprising donkeys used for regular riding. The results indicated a level of agreement between the two devices in intervals R-R (P =

Aim: Acute appendicitis is a frequent surgical emergency which affects the lower right quadrant of the abdomen. Failure to diagnose this condition might result in perforation, abscess development, or peritonitis if not tackled. Hyponatremia was the focus of our retrospective cohort investigation because it may serve as a biochemical indicator for spotting serious forms of acute appendicitis in our patient group. Materials and Methods: All pediatric patients aged up to 14 years who were admitted to the Prince Sultan Military Medical City, under our service between 2020 and 2023 were retrospectively reviewed. Data of interest were retrieved from the medical files of our study subjects and entered into Excel sheets, including medical history, age, sex, type of referral, and associated comorbidities, as well as clinical data such as abdominal pain, nausea/vomiting, anorexia, fever, changes in bowel movement, dysuria, and any recent histories of upper respiratory tract infection. Results: Thirty-one (19%) patients were found to have a complicated acute appendicitis, confirmed by the presence of gross or micro-perforation and segmental gangrenous segment on histopathological analysis. Statistically significant differences were observed in those patients with the complicated form, compared to others with the non-complicated form of acute appendicitis in terms of preoperative sodium levels, along with intra-operative findings of perforated appendices. Compared to the non-complicated patients, those with complicated acute appendicitis had a much lower mean blood sodium level. Conclusion: This study suggests the use of hyponatremia as a potential biomarker for complicated cases. Early diagnosis and appropriate response can assist medical and surgical practitioners in providing more focused and effective management plans for complicated cases, which would improve patient outcomes.

Abstract The red palm weevil (RPW), Rhynchophorus ferrugineus Olivier, is a devastating insect-pest of 29 plants including date palm. It feeds inside the tree bark thus it is difficult to manage using insecticides. Only a few insecticides have been found effective against RPW. Among these insecticide, emamectin benzoate (EMB) is widely used. This insecticide can pose threat human and environmental health as it is used in the form of tree injection. Thus, keeping in view its possible, its sublethal effect on RPW was studied using Age-stage, two sex life table. Life table parameters of the progeny of exposed larvae to LC10, LC25, and LC50 of EMB were computed. Statistically higher fecundity (161.12 per female) was observed in control treatment, while less fecundity was observed in LC50 treatment. Significantly higher values for intrinsic rate of increase (r), finite rate of increase (λ), and net reproductive rate (R o ) (0.0376, 1.0383, and 67.13 per day, respectively) were recorded for the control treatment. Contrarily, lower values for r, R o , and λ i.e. 0.0318, 23.82, and 1.0324 per day, respectively were recorded in the LC50 treatment. Decreased population parameters suggest that EMB can be successfully used in for the management of RPW.

Abstract Background: Total hip arthroplasty (THA) by using ceramic-on-ceramic (CoC) implants has emerged as a promising solution to mitigate wear debris-related complications, such as osteolysis, specifically in younger patients. This study aims to investigate the functional outcomes after total hip replacement by CoC in patients less than 30 years old, conducted within the hospitals of Khartoum, Sudan. Methods: A descriptive, cross-sectional, hospital-based study was carried out across the major healthcare institutions in Khartoum state from October 2021 to April 2022. A cohort of 32 patients, all aged 30 or below, who underwent total hip replacement were included. Thorough data analysis was conducted using advanced statistical techniques. Results: The average age of included patients was 25.69 ± 2.7 years, among them, males had a slight predominance (56.3%) with a male-to-female ratio of 1.3:1. Most patients had a secondary school level of education (37.5%), while workers constituted the largest group (34.4%). The included patients were followed-up for more than six months. The mean visual analog scale (VAS) score was 7.91 ± 0.893. Additionally, the mean modified Harris hip score was 83.03 ± 4.9 (range: 72–91), highlighting the enhanced hip function achieved through the procedure. The majority of patients (65.6%) reported good functional outcomes, followed by 28.1% who attained fair outcomes and 25.8% who reported excellent outcomes. Conclusion: The study demonstrates that CoC THA yields optimal functional outcomes among patients aged 30 years and below. The procedure exhibits remarkable potential to improve hip function and alleviate pain in this specific patient population. These findings highlight the efficacy and viability of CoC implants in younger patients, contributing to the advancement of hip arthroplasty techniques.

Abstract Activated sludge has a high diversity of infectious agents. However, many of these microorganisms contribute greatly to the biological treatment process due to the enzyme production and capability for degrading a wide range of organic compounds in wastewater. The present review discusses the potential of aerobic granular sludge as a bio-startup (AGS-BS-up) for new wastewater treatment plants. The complex microbial community in activated sludge was investigated using 16S metagenomic analysis. The potential of aerobic granular sludge prepared from activated sludge to be used as a bio-starting medium for food wastewater treatment plants (FWWTP) was discussed. AGS-BS-up appears to have high applicability to enhance the biological treatment of food wastewater (FWW). The hypothesis behind using aerobic granular sludge as a bio-startup for FWWTP lies in the high microbial biodiversity in the aerobic granular sludge, which contributes effectively to the biological treatment of food wastewater. Based on the previous studies, the AGS-BS-up is efficient in improving the quality of FWW to meet international standards required for safe disposal into the environment.

The early treatment and detection of plant diseases are important processes, as many diseases affecting crops are highly contagious. Recent advancements in deep learning have helped to provide innovative tools that have not only assisted early detection, but also significantly improved the performance and accuracy of Coffee Leaf Disease (CLD) classification and treatment. However, training a deep learning model from scratch can be both resource and time-consuming. To overcome this challenge, the transfer learning technique can take full advantage of pre-trained models for more general tasks on extensive datasets o ameliorate the performance of a new, related task using few-shot training. This paper proposes a deep learning model, coupled with transfer learning, for CLD detection that aims to provide high accuracy forecasting of diseases that could affect coffee leaves. Our method involves 195 different pre-trained deep learning models, including real-time models like MobileNet and dense ones like EfficientNet and ResNet for the detection of four different diseases. The findings suggest that the EfficientNetB0 model, with transfer learning, has the most relevent accuracy (99.99%), and thus offers an effective solution for coffee leaf diseases classification of. This result could be used to develop applications that help coffee growers to improve the productivity and quality of their crops through early and accurate detection of coffee plant leaf diseases. Such an Artificial Intelligence based application would provide growers with timely control measures, preventing the spread of disease, and minimizing crop damage.

Abstract Background Measures of patient safety culture and patient experience are both commonly utilised to evaluate the quality of healthcare services, including hospitals, but the relationship between these two domains remains uncertain. In this study, we aimed to explore and synthesise published literature regarding the relationships between these topics in hospital settings. Methods This study was performed using the five stages of Arksey and O’Malley’s Framework, refined by the Joanna Briggs Institute. Searches were conducted in the CINAHL, Cochrane Library, ProQuest, MEDLINE, PsycINFO, SciELO and Scopus databases. Further online search on the websites of pertinent organisations in Australia and globally was conducted. Data were extracted against predetermined criteria. Results 4512 studies were initially identified; 15 studies met the inclusion criteria. Several positive statistical relationships between patient safety culture and patient experience domains were identified. Communication and teamwork were the most influential factors in the relationship between patient safety culture and patient experience. Managers and clinicians had a positive view of safety and a positive relationship with patient experience, but this was not the case when managers alone held such views. Qualitative methods offered further insights into patient safety culture from patients’ and families’ perspectives. Conclusion The findings indicate that the patient can recognise safety-related issues that the hospital team may miss. However, studies mostly measured staff perspectives on patient safety culture and did not always include patient experiences of patient safety culture. Further, the relationship between patient safety culture and patient experience is generally identified as a statistical relationship, using quantitative methods. Further research assessing patient safety culture alongside patient experience is essential for providing a more comprehensive picture of safety. This will help to uncover issues and other factors that may have an indirect effect on patient safety culture and patient experience.

Abstract Background The American Society of Anesthesiologists (ASA) classification is the most used system to assess patient health status before surgery, ranging from I to V levels. This study aims to explore the impact of different ASA risk classes (ASA II [mild risk] and ASA III [severe risk]) on clinical outcomes following hip fracture surgery, including all-cause mortality and postoperative complications. Methods A retrospective analysis from 2019 to 2021 across three Jordanian centers was conducted. The study included patients aged 65 and above who underwent hip fracture repair surgeries. Preoperative measures, intraoperative management protocols, and postoperative care were collected. Clinical data were extracted from electronic medical records, including demographics, fracture type, intraoperative data, and postoperative outcomes. Results The analysis included 1033 patients, with 501 (48.5%) in the mild anesthetic risk group (ASA I-II) and 532 (51.5%) in the severe anesthetic risk group (ASA III-V). The mean age was 73 years, with a higher prevalence of males in the severe risk group. Patients in the severe risk group had more comorbidities, higher ICU admissions (15.23% vs. 6.18%), longer hospital stays (median 7 vs. 6 days), and higher rates of postoperative thromboembolic complications (3.39% vs. 1.39%) compared to the mild risk group. Additionally, the severe risk group showed higher mortality rates both in-hospital mortality (3.38% vs. 1.39%) and all-cause mortality (16.92% vs. 10.36%). Multivariate analysis identified higher ASA score as independent risk factors for increased all-cause mortality (HR = 1.64 95%CI 1.51–2.34) and thromboembolic complications (OR = 2.85 95%CI 1.16-7). Length of hospital stay was significantly associated with higher ASA score (OR = 1.04 95%CI 0.96–1.11). Conclusion The study underscores the significant impact of anesthetic risk on the outcomes of hip fracture surgeries. Patients with higher ASA scores associated with severe systemic diseases may have at increased risk of adverse outcomes.

Abstract Marl soil is highly prone to erosion when exposed to water flow, posing a potential threat to structural stability. The common practice of stabilizing soil involves the addition of cement and lime. However, persistent reports of severe ruptures in many stabilized soils, even after extended periods, have raised concerns. In stabilized marls, unexpected ruptures primarily result from the formation of ettringite, which gradually damages the soil structure. This article aims to assess the impact of nanosilica on the formation of ettringite and the nanostructure of calcium silicate hydrate (C-S-H) during the marl soil stabilization process with lime. To achieve this, marl soil was stabilized with varying percentages of lime and nanosilica. X-ray diffraction (XRD) patterns and scanning electron microscopy (SEM) images were collected to observe changes in mineralogy and microstructural properties. Various geotechnical parameters, including granularity, Atterberg limits, compressive strength, and pH, were measured. The results indicate that the uniform distribution of nanosilica in marl-lime soils enhances pozzolanic activities, calcium aluminate hydrate growth (C-A-H), and the nanostructure of calcium silicate hydrate (C-S-H). According to XRD and SEM experiments, the presence of nanosilica reduces the formation of ettringite. Moreover, the compressive strength of modified samples exhibited an upward trend. In the experimental sample manipulated with 1% nanosilica combined with 6% lime, the compressive strength increased by 1.84 MPa during the initial 7 days, representing an approximately 18-fold improvement compared to the control sample.

Abstract This study examines the relationship between family-controlled companies and corporate social responsibility practice disclosure (CSRPD) and examines whether board independence influences this relationship. A self-constructed CSR disclosure index is developed to measure the CSRPD in a sample of 152 publicly listed companies in Saudi Arabia from 2016 to 2021. The findings from the pooled ordinary least squares (POLS) regression reveal that family-controlled companies exhibit lower levels of CSRPD than non-family companies. However, family-controlled companies with a higher number of independent directors on their boards show higher CSRPD, indicating a significant positive interaction effect of board independence. These results remain robust even after applying a variety of econometric techniques, including Newey-West regression, panel corrected standard error (PCSE), logistic regression, and addressing endogeneity problems, along with using different measures for CSRPD and family-controlled companies. These findings suggest that the governance structure of the boards, particularly independent directors, can support the prosocial and positive stimulus of socioemotional wealth (SEW) theory. Therefore, Saudi Arabian capital market regulators need to be aware of the importance of companies’ governance structures.

The integration of multidisciplinary tumor boards (MTBs) is fundamental in delivering state-of-the-art cancer treatment, facilitating collaborative diagnosis and management by a diverse team of specialists. Despite the clear benefits in personalized patient care and improved outcomes, the increasing burden on MTBs due to rising cancer incidence and financial constraints necessitates innovative solutions. The advent of artificial intelligence (AI) in the medical field offers a promising avenue to support clinical decision-making. This review explores the perspectives of clinicians dedicated to the care of cancer patients—surgeons, medical oncologists, and radiation oncologists—on the application of AI within MTBs. Additionally, it examines the role of AI across various clinical specialties involved in cancer diagnosis and treatment. By analyzing both the potential and the challenges, this study underscores how AI can enhance multidisciplinary discussions and optimize treatment plans. The findings highlight the transformative role that AI may play in refining oncology care and sustaining the efficacy of MTBs amidst growing clinical demands.

Post-stroke early activation of neutrophils contributes to intensive neuroinflammation and worsens disease outcomes. Other pre-existing patient conditions can modify the extent of their activation during disease, especially hypercholesterolemia. However, whether and how increased circulating cholesterol amounts can change neutrophil activation responses very early after stroke has not been studied. In this study, we investigated the effect of high-fat diet (HFD) induced hypercholesterolemia on neutrophil activation and stroke outcome. Mice were fed with HFD or normal diet (ND) for six weeks and then induced stroke by transient occlusion of the middle cerebral artery. The activation receptors on immune cells and plasma levels of cytokines were analyzed using flow cytometry. The amount of plasma neutrophil extracellular traps (NETs) was measured using citH3-DNA complex ELISA. We found that HFD-induced cholesterolemia increased the number of circulating and splenic neutrophils in stroke mice but reduced bone marrow neutrophils compared to sham controls. After stroke neutrophils in HFD mice expressed higher levels of activation markers Ly6G and PSGL-1 (CD162) compared to ND mice. In addition, stroke led to an increased expression of the activation markers Ly6C and CD68 on monocyte/macrophages (MΦ) in HFD mice but not in ND mice. Compared to ND, HFD increased plasma levels of the proinflammatory cytokines TNF-α, IL-6, IL-23, and MCP-1 in stroke mice. Remarkably, HFD mice showed higher amounts of circulating NETs, brain-infiltrated neutrophils, and larger infarcts after stroke compared to ND mice. The existence of hypercholesterolemia with a stroke can trigger a stronger activation of neutrophils and MΦ, causing deteriorating disease outcomes.

Monitoring and management engineering technologies, as well as crude oil production, have recently advanced significantly. Technology advancements aside, monitoring, administration, wait times, and emergency response remain quite poor, especially for the crude oil production cycle, where real-time management and monitoring are difficult. Several methodologies and technologies utilized for continuously monitoring and managing crude oil manufacturing are analyzed in light of the integrating of the Industrial Internet of Things (IIoT) and Edge Computing (EC). The ultimate objective is to monitor and manage the whole value chain process to increase production dependability and availability and generate better economic products and services. This study goes over crude oil production guidelines and unresolved research difficulties. The IIOT and EC integration are viewed as a possible approach for establishing domestic services and corporate procedures for increasing crude oil production. One hundred eighty-eight relevant studies published between 2017 and 2023 were indexed in the WOS (Web of Science), SCOPUS, OnePetro, and IEEE Xplore databases. A survey based on a literature review showed 50 studies (selected from those studies through the literature review stages) and their architectures and frameworks to automate crude production to better monitor alerts and production control. This survey aims to provide a comprehensive overview of multiple studies to highlight the deficiencies in recent research and serve as a reference for subsequent endeavors to develop solutions for a straightforward process monitoring system. Such a system would empower process operators to promptly and effortlessly detect any sources of abnormality within the process.

Construction industry is considered one of the most versatile industries characterized by uncertainties and risk. Estimating the steel structure cost of industrial buildings is a challenging task compared with traditional buildings due to the uniqueness of this class of projects. This paper aims to introduce an effective and accurate parametric model for construction cost estimation of industrial steel structures. The paper proposes a regression-based model for estimating the cost of a critical construction component: the industrial steel structure where the is not enough historical data is available. The factors that affect the construction cost of industrial steel structures are initially identified based on the literature and interviews with local experts. The correlation between input factors and model’s output is then investigated. In addition, sensitivity analysis is performed to examine the relative importance of the regression model’s inputs. The model is validated using actual data on industrial steel structure costs in Saudi Arabia. The model adequately predicted the construction costs of actual projects with an accuracy of more than 88%. This indicates that the model is capable of accurately predicting the cost of such structures. The proposed model can be of great assistance to investors and decision-makers looking to invest in the industrial sector. First published online 10 December 2024

BackgroundLittle is known about the relationship between lipoprotein (a) [Lp(a)] and cerebral white matter hyperintensities (WMH). The aim of the study was to examine if elevated Lp(a) levels are associated with higher burden of WMH.MethodsWe retrospectively investigated associations between Lp(a) and the burden of WMH among patients with confirmed diagnosis of acute ischemic stroke or transient ischemic attacks. WMH burden was assessed using 3-Tesla brain MRI and graded according to the Fazekas score. Multivariable models were generated to determine the contribution of Lp(a) to the presence and extent of WMH.ResultsOne hundred and fifty-three patients were included (mean age, 45.9 years; 35.9% women). When the study population was stratified by Lp(a) level into three categories, low (

Despite the reliance of Saudi Arabian government facilities on private contractors for maintenance, there is a persistent rise in disputes between these contractors and government entities. This ongoing issue raises concerns about the efficiency and effectiveness of contract management, ultimately affecting the quality of maintenance services and operational continuity. This study investigates the primary causes of disputes in government building maintenance projects, using both the Frequency Adjusted Importance Index (FAII) and risk mapping methods to analyze and prioritize the causes. A literature review and a designed questionnaire survey were employed to rank dispute causes. Thirty-six responses were analyzed. Cronbach's alpha and coefficient of variation were utilized to assess the collected data's validity and reliability. Three case studies then were utilized as a validation tool, compared against the findings of the survey to integrate practical insights with the theoretical results from the survey. The findings reveal that issues such as (1) the lack of original as-built drawings, (2) constant government interference, (3) delays in decision-making, (4) poorly defined scope of work, and (5) mistakes in bidding or cost estimation are the most critical causes of disputes in these projects. Cross-method validation with real-world case studies further strengthens the reliability of these findings, as these top-ranked causes consistently align with issues encountered in practice. The findings of this study could assist local authorities adopt alternative approaches in managing and executing maintenance contracts, thereby mitigating the causes of disputes.

This study examined the nutritional, phytochemical, and bioactive profiles of Pulicaria jaubertii and Pulicaria petiolaris to establish their suitability as functional food additives. Generally, P. jaubertii exhibited a significantly higher protein and ash content (14.05 and 18.68 g/100 g DW). Conversely, P. petiolaris had higher fat, fiber, and carbohydrate content (3.9, 21.12, and 59.63 g/100 g DW, respectively). In physical investigation, P. jaubertii showed superior bulk density (0.29 g/cm³), tapped density (0.44 g/cm³), hygroscopicity (6.54%), solubility (14.62%), and water absorption capacity (533.42%). Volatile compound analysis found 267 in P. jaubertii, led by carvotanacetone (7.33%), and 371 in P. petiolaris, led by camphor (4.32%). The primary fatty acid constituents in both plants were palmitic and linoleic acids. Mineral analysis indicated P. jaubertii had greater magnesium, potassium, calcium, and iron (139.06, 437.47, 326.96, and 76.73 mg/100g DW, respectively). Leucine and aspartic acid were the most abundant free amino acids in both plants among the 18 essential and non-essential amino acids. Vitamin analyses revealed that P. petiolaris contained a higher B-complex, while ­P. jaubertii had more vitamin C. Interestingly, P. jaubertii exhibited the highest TPC (89.1 mg gallic acid equivalent/g DW), antioxidant activity (6.08 mg ascorbic acid/g DW), and antioxidant capacity (20.71 mg Trolox equivalent/g DW).

The appealing graphitic phase carbon nitride (g-C3N4) is extensively utilized for environmental remediation; however, some of its intrinsic drawbacks still need to be amended. Herein, the g-C3N4 quality was improved by anchoring to AlCrO3 nanoparticles to acquire a competent ternary AlCrO3@g-C3N4 composite for the cadmium ions elimination. The composite elemental compositions were verified by the EDX and XPS to specify the C, N, Cr, Al, and O as the composing elements, and the XRD structural analysis revealed the development of both the g-C3N4 and AlCrO3. The presence of some functional groups (C–N, CN, –NH–, –NH2, and –OH) as detected by the FTIR and a large surface area of 89.94 m2 g−1 qualified it to successfully eliminate.mg.g−1 of Cd+2 ions from an aqueous solution. The Cd+2 ion adsorption was found to follow the Langmuir isotherm model, while the kinetics matched with the pseudo-second-order style. The high adsorption aptitude of the synthesized adsorbent could be accredited to the numerous adsorption sites, π-π conjugate interactions, and electrostatic attractions with the metal ions in water as publicized by mechanistic study.

The prevalence of Staphylococcus aureus in the circulation (bacteremia) of individuals with sickle cell disease (SCD) may provide a substantial risk for illness and death. Strains of S. aureus exhibit a wide variety of virulence traits, including the ability to generate various toxins and develop treatment resistance. MRSA is characterized by its resistance to a range of beta-lactam antibiotics. This study’s objectives included assessing the frequency of S. aureus infection in SCA patients, analyzing laboratory markers of the CBC test, examining the antibiotic susceptibility pattern, and investigating the mecA gene and heteroresistance, which could potentially link to a higher occurrence of S. aureus infection in SCA patients. The retrospective study was done to gather clinical data on individuals with sickle cell anemia (SCA) who had bloodstream infections. From 2017 to 2021, blood samples and data were gathered by King Saud University Medical City (KSUMC) in Riyadh, Saudi Arabia. The S. aureus strains were re-cultivation, Vitek system and PCR techniques were employed to ascertain the antibiotic resistance patterns. It was confirmed that 2406 patients with SCD had contracted an infection. A total of 138 (5.73 %) patients with SCD were diagnosed with bacteremia. “Of the 138 strains isolated, the MRSA strain revealed as the most prevailing, including 30 isolates (21.7 %), whereas non-MRSA strains constituted 17 isolates (12.3 %).” Males had a higher rate of infection compared to females. The results indicated that all the S. aureus isolates exhibited resistance to ampicillin, while the resistance to penicillin was 98 %. Furthermore, the results indicated that over 65 % of the isolates exhibited resistance to amoxicillin, amoxicillin, cefazolin, imipenem, and oxacillin. The mecA gene was identified in all S. aureus strains obtained from patients with SCD. The current study recognizes the PCR assay as a more dependable technique for assessing antibiotic resistances, in contrast to the Vitek method. A study found strong links between S. aureus infections in individuals with SCD and three different factors: hemoglobin (Hb) level, mean corpuscular volume (RDW), and white blood cell (WBC) count (p

Using diluted seawater for irrigation presents a potential solution to tackle water scarcity and optimize water usage in regions where there is a shortage of freshwater resources. Therefore, the objective of current study was to assess the efficacy of proline and zinc nanoparticles (ZnO-NPs), either alone or in combination, in alleviating adverse impacts of diluted seawater irrigation [2.5% (EC, 1.6) and 5% (EC, 2,3)] on the growth and productivity of pea plants (cv. Master B) during the winter seasons of 2022/2023 and 2023/2024. The results indicated that irrigation with diluted seawater had negative effects on several growth parameters of peas, including plant height, leaf area, plant dry weight, chlorophyll pigment (Ch a, Ch b, and total Ch) content, and seed chemical composition. In contrast, foliar application of ZnO-NPs, proline, or their combination improved plant growth, productivity, oxidative enzyme activities, net photosynthesis, and phenolic compound content under salinity stress. Furthermore, these treatments positively influenced the content of essential nutrients (NPK), vitamin C, carbohydrate percentage, and crude protein in pea seeds. The combination of ZnO-NPs and proline yielded the highest values for most parameters during the experimental seasons. Overall, the interaction between ZnO-NPs and proline showed promise in enhancing pea plant growth and productivity, especially in environments characterized by salt stress.

Purpose: There is limited information about the diagnosis and treatment of hidradenitis suppurativa (HS) in the Kingdom of Saudi Arabia (KSA). This Delphi consensus study was conducted to develop recommendations for the management of HS in the KSA.Methods: The expert panel including 12 dermatologists with extensive experience treating HS patients provided nine consensus statements and recommendations on diagnosis and assessment, management, comorbidities and multidisciplinary approach, and education. The experts also developed clinical questions pertaining to the management of HS and rolled out as a survey to 119 dermatologists practising in the KSA.Results: The topics covered included: referring physicians’ awareness of HS; referral criteria for HS; definition of moderate-to-severe HS; treatment goals; definition of treatment success; treatment and biologic initiation; comorbidities and multidisciplinary approach; patient education and awareness of HS. Full consensus (100%) from the expert dermatologists was received on all the topics except referring physicians’ awareness of HS, definition of treatment success, and treatment and biologic initiation. The survey results resonated with the expert opinion.Conclusion: As HS is a chronic disease with negative impact on quality-of-life, timely diagnosis and treatment, early identification of comorbid conditions and a multidisciplinary care approach are crucial for effective management of HS.

Salinization of water and soil presents a substantial abiotic challenge, hindering plant growth and development, causing physiological imbalances, and threatening global food security. This study aimed to investigate the effects of salinity stress at two levels (1000 and 1500 mg/L) and the potential enhancement of salinity tolerance in peas (cv. Master B) through foliar application of manganese (10 mg/L) and arginine (300 mg/L), both individually and in combination, over two consecutive seasons. Under salinity stress, various growth and yield traits of pea plants, including plant height, leaf area, plant dry weight, number of pods per plant, weight of green pods per plant, and seed dry weight, were significantly reduced compared to unstressed plants in both seasons. Physiological parameters such as chlorophyll content, antioxidant enzyme activity, membrane stability, leaf CO2 and H2O2 content, stomatal conductance, net photosynthesis, and transpiration rate were notably impacted. Biochemical seed analysis revealed significant alterations in total carbohydrate, crude protein, vitamin C, and NPK content under salinity stress. The application of manganese and arginine, either separately or in combination, alleviated the adverse effects of salinity on various parameters across different seasons. The simultaneous application was the most effective, mitigating salinity stress and resulting in improvements in total chlorophyll content (by 41.24%), proline content (17.48%), catalase activity (16.98%), peroxidase activity (22.84%), and fruit number per plant (52.14%) under the highest salinity level (1500 mg/L). Further research, including field trials and molecular studies, is recommended to fully understand the underlying mechanisms of the combined application.