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Background: Parasitic diseases were some of the leading causes of global mortality with higher burdens of prevalence in developing countries, especially regions of the world where the contaminated water and poor personal hygiene. The purpose of this study to determine the prevalence rate of intestinal and urinary parasites among Alkhalawi students in Rabak city, White Nile State, Sudan. Materials and methods: In this study, 150 stool and 150 urine samples were collected from Alkhalawi students (all were males). The stool samples were processed by wet preparation, formal ether concentration technique and the urine samples were processed by the sedimentation technique. Results: The results revealed that out of the 150 stool and 150 urine samples, 37 were found positive for intestinal and urinary parasites, this constituted an overall prevalence rate of 12.3%. The highest prevalence rate (28%) was reported among the 11-15 years age groups, while the lowest prevalence rate (0%) was reported among the 21-25 years age groups. The prevalence rate of different parasites was as follow: Giardia lamblia (11.3%), Entamoeba histolytica (8%), Hymenolepis nana (2.7%), Schistosoma haematobium (3.3%). The prevalence of intestinal parasites (21.3%) was higher than urinary parasites (3.3%). The study showed that 24% were infected with single infection and 0.6% were infected with mixed infection. Conclusion: From the result we concluded the intestinal and urinary parasites are highly prevalent among the Alkhalawi students in Rabak city. Giardia lamblia is more likely to occur among the Alkhalawi students followed by Entamoeba histolytica. The highest infection rate was reported among the 11-15 years age groups. Formal ether concentration technique proved to be as efficient more than the wet preparation technique.

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 Background Climate changes have led to health and environmental risks, so it has become essential to measure climate change literacy among the entire population, especially nursing students. The significant role of nursing students in raising public awareness and future healthcare roles emphasizes assessing the predictors of climate change literacy among nursing students. Aims This study seeks to identify the predictors of climate change literacy among nursing students in A Multi-Site Survey. Design A multi-site descriptive cross-sectional study adheres to the guidelines outlined in A Consensus-Based Checklist for Reporting Survey Studies collected for five months, from the 1st of July 2023 to November 2023. The study participants comprise 10,084 nursing students from all 27 governments in Egypt. The researcher used the Predictors of Nursing Students’ Climate Change Literacy scale in this study. Data was collected, with 25 min average time to complete. Backward multiple linear regression was used to identify these predictors. Results In the current study, nursing students demonstrated a moderate understanding of climate science (mean score 14.38), communication and advocacy skills (mean score 14.41), and knowledge of adaptation and mitigation strategies (mean score 13.33). Climate health impacts (mean score 17.72) emerged as the domain with the highest level of knowledge. No significant differences in climate literacy were observed across diverse student backgrounds (all p-values were > 0.05). Perceived faculty knowledge of climate change positively correlated with all four domains of climate literacy and emerged as a significant predictor in multiple linear regression analyses (all p-values were

Objective The livestock handler attitude and their handling of animals is crucial for improving animal welfare standards, minimizing stress, improving productivity and meat quality. The present study was undertaken to assess the effect of training livestock handlers on behavioral, physiological, and hormonal responses during preslaughter handling in goats. Methods A total of 6 handlers were divided into trained (trained in basic animal handling practices, animal behavior, and animal welfare), contact trained (not trained directly but interacted and saw the working of trained handlers), and untrained groups (no formal training). The handling experiment was conducted on 18 male goats by following a cross-over design. The goats were moved from lairage to slaughter point by trained, contact-trained, and untrained handlers. Various behavioral, physiological, and hormonal parameters were recorded at the lairage before handling and at the slaughter point after handling the goats. Results The training of livestock handlers had a significant effect on behavioral, physiological, and hormonal responses in goats. The goats handled by untrained and contact-trained handlers were recorded with intense vocalization, significant (p

Abstract Background Community-acquired pneumonia (CAP) and its associated complications pose a noteworthy public health apprehension in the pediatric population, leading to considerable morbidity and mortality. The objective of this study was to assess the diagnostic and prognostic value of heparin-binding protein (HBP) as a promising biomarker in children hospitalized with CAP. Methods This prospective, single-center study included 50 children admitted to the Pediatric Pulmonology Unit between April 2023 and January 2024 with a diagnosis of CAP, as well as age-matched 50 healthy children as a control group. Demographic, clinical, and laboratory data were recorded. The measurement of serum HBP was conducted upon admission utilizing the enzyme-linked immunosorbent assay technique. Results Serum HBP was elevated in the CAP group in comparison to the control group (p

Abstract High-density cement slurries used in oil well cementing often face challenges such as particle settling, poor rheological properties, permeability, and compressive strength degradation, which can compromise zonal isolation and well integrity. This study focuses on using kaolinite, a clay mineral, as an additive due to its potential to improve the performance of high-density cement by modifying key properties. Several concentrations of kaolinite were examined to evaluate their influence on several cement properties such as rheology, thickening time, permeability, porosity, and compressive strength. Additionally, it assesses the impact of kaolinite on cement sheath solids settling using both conventional methods and nuclear magnetic resonance (NMR). The results revealed that an optimal concentration of 1% kaolinite by weight of cement (BWOC) significantly reduced particle settling by 74.4%, enhanced compressive strength by 13%, and lowered permeability and porosity by 74% and 7%, respectively. Additionally, kaolinite improved rheological properties by an 8.4% reduction in plastic viscosity, a 19.4% increase in yield point, and a 30% increase in gel strength. Kaolinite also acted as a retarder, increasing thickening time. These improvements contribute to better cement sheath integrity and wellbore stability, highlighting kaolinite’s potential as an effective additive for high-density cement.

Abstract Background The present study aimed to investigate the effects of infrared diode laser irradiation on the proliferation and differentiation capacity of periodontal ligament stem cells (hPDLSCs), which are optimal cell sources for periodontal regeneration. Methods hPDLSCs were isolated and characterized by flow cytometric analysis of mesenchymal stem cell markers, and their trilineage differentiation capacity was tested. hPDLSCs were then cultured and irradiated with infrared diode laser (970 nm) at a power of 200 mW and a fluence of 4 J/cm2 for 3 s. MTT assay was performed to assess cellular proliferation. Cell cycle analysis was performed, and the impact of infrared diode laser irradiation on the stemness and osteogenic differentiation potential of hPDLSCs was evaluated via RT‒PCR. Results Infrared diode laser application enhanced the stemness, viability, proliferation, and differentiation of PDLSCs. Stem cell markers (OCT4, SOX2, and NANOG) were significantly upregulated in hPDLSCs exposed to laser irradiation. There was significant overexpression of RUNX2, ALP, OPN, and OCN on day 14 after laser application. Conclusions These findings provide valuable insights into the specific applications of infrared diode lasers to effectively regenerate periodontal tissues. The results can aid in the development of precise clinical protocols aimed at enhancing osseointegration and promoting tissue regeneration. Ultimately, the combination of infrared diode laser with hPDLSCs is promising for stimulating periodontal regeneration.

Primary biliary cholangitis (PBC) is a rare immune-mediated disease, commonly affecting women in their 40s, and ultimately progressing to liver failure. The incidence and prevalence of the disease are increasing worldwide, possibly due to better diagnostic tools. This review will focus on its epidemiology, pathophysiology, diagnosis, prognosis, and new developments in therapy.

Abstract Objective Multisystem inflammatory syndrome in children (MIS-C) is a critical childhood disease that is associated with coronavirus disease (COVID-19). We aimed to describe the clinical, laboratory, and echocardiographic characteristics and outcome of critical MIS-C cases in Egyptian children during the first wave of the COVID-19 pandemic. Design A retrospective, observational study. Setting A single-center tertiary pediatric intensive care unit (PICU).In Ain Shams university hospitals Cairo Egypt Methods Children admitted to the PICU diagnosed with severe MIS-C as per the Centers for Disease Control’s definition from June 23, 2020, to August 22, 2020, were included. Results The patient’s mean age was 7.45 (interquartile range [IQR], 4.23) years, and the cause of PICU admission was hypotension and shock. All patients had a fever for 4.8 (IQR, 2.5) days before shock developed. Overall, 68% had a gastrointestinal manifestation, and 55.6% had a rash. Thirty-five of 45 patients had ≥ 4 elevated inflammatory markers. The cardiac troponin I level was elevated in 35 of 45 patients. The most common cardiac condition was valvulitis (tricuspid regurgitation, 29/45; mitral valve regurgitation, 28/45; pulmonary valve regurgitation, 5/45; atrial valve regurgitation, 4/45). Twenty-one patients had an impaired ejection fraction

Abstract To evaluate the effect of combining different bioactive root-end filling materials with composite bone graft (xenogeneic mixed with autogenous bone fragments) on the healing process of periapical tissues after endodontic micro-surgery procedure. In this triple-blinded clinical trial, 56 patients were divided into 2 main groups (28 each) according to the root-end filling material and 2 subgroups according to the presence or absence of the composite bone graft material. Group I: MTA root-end filling (n = 28) in which there are Sub-group A: without bone graft (n = 14) and Sub-group B: with composite bone graft (n = 14). Group II: TotalFill root-end filling (n = 28) in which there are Sub-group A: without bone graft (n = 14) and Sub-group B: with composite bone graft (n = 14). Healthy patients whose ages range from 20 to 50 years with small-to-medium size radiolucency in CBCT related to single-rooted maxillary teeth were included in this study. Patients were assigned a number starting from 1 to 56 and were randomly allocated to four test groups (2 main groups and 2 sub-groups) following simple randomization procedure guidelines described by IBM SPSS V23 (IBM USA) statistical analysis software. This trial was triple-blind where the patient, the outcome assessors, and the main operator were blinded to the applied intervention. Every patient was evaluated clinically and by CBCT at two main observation periods: presurgical and 12-month post-operative. They were also examined and evaluated clinically and radiographically through periapical x-rays after one week, three, and six months. Statistical analysis was performed with IBM SPSS Statistics for Windows Version 23.0. Armonk, NY: IBM Corp. Of the 56 patients enrolled in the study, 49 patients were available for the final analysis. All groups showed no statistically significant differences with regard to healing or success rates at the 12-month follow-up mark. No adverse effects were encountered. Results showed that high success rates were achieved using MTA and TotalFill in the healing of periapical lesions after endodontic surgery. The addition of bone graft in small-to-medium size lesions did not affect the success rate of endodontic surgeries.

Abstract Soil electrokinetics (SEK) research has been widely used in various fields such as soil remediation, dewatering, land restoration, geophysics, sedimentation, pollution prevention, consolidation, and seed germination. According to our most recent published research on SEK process design modifications during the last 30 years (1993–2022), more than 150 designs have been introduced to assure SEK’s maximum performance. Incorporating lateral electrodes/anodes was not documented in the existing literature, which motivated us to investigate the output of this design. In this study, we aimed to enhance the performance of the perforated cathode pipe soil electrokinetic remediation (SEKR) system (PCPSS) for removing inorganic pollutants by installing lateral anodes (LA-PCPSS) using two approaches. In the first approach, the LA-PCPSS was connected to different sources of applied voltages (DSAV) from different power supplies, while in the second approach, the entire operation system was connected to the same source of applied voltage (SSAV). We used the Taguchi approach (L9OA) to determine the optimal levels of applied voltages for the DSAV system. The results indicated that the DSAV-(LA-PCPSS) could be optimized at an applied voltage of 1 V cm−1 for the surface and the first and second lateral anodes. The indigenous Sr (elements found in the tested soil without artificial pollution) in kaolinite showed the best response among other elements (Ni and other indigenous elements) when optimizing the DSAV-(LA-PCPSS) using the Taguchi approach. Installing lateral anodes (position B) supplied to low applied voltage (0.5 V cm−1) improved the electroosmosis (EO) rate/dewatering. Reverse migration of ions was observed during the remediation of real contaminated soil using the SSAV-(LA-PCPSS). The DSAV-(LA-PCPSS) is considered an appropriate design for the SEKR of inorganic pollutants, and increases the EO flow/dewatering. Additionally, the increased energy consumption employing the DSAV-(LA-PCPSS) was extremely minimal compared to the traditional PCPSS, which is an economic advantage for SEKR research. The DSAV-(LA-PCPSS) is still under optimization/intensification process, and subsequent processes will be examined to achieve high efficiency.

Abstract Chronic demyelination and oligodendrocyte loss deprive neurons of crucial support. It is the degeneration of neurons and their connections that drives progressive disability in demyelinating disease. However, whether chronic demyelination triggers neurodegeneration and how it may do so remain unclear. We characterize two genetic mouse models of inducible demyelination, one distinguished by effective remyelination and the other by remyelination failure and chronic demyelination. While both demyelinating lines feature axonal damage, mice with blocked remyelination have elevated neuronal apoptosis and altered microglial inflammation, whereas mice with efficient remyelination do not feature neuronal apoptosis and have improved functional recovery. Remyelination incapable mice show increased activation of kinases downstream of dual leucine zipper kinase (DLK) and phosphorylation of c-Jun in neuronal nuclei. Pharmacological inhibition or genetic disruption of DLK block c-Jun phosphorylation and the apoptosis of demyelinated neurons. Together, we demonstrate that remyelination is associated with neuroprotection and identify DLK inhibition as protective strategy for chronically demyelinated neurons.

Abstract Background Male reproductive performance is an essential part of sheep production; therefore, the use of natural antioxidants to improve sperm quality and maintain reproductive performance in males is very important. Hence, oral administration of rosemary essential oil (REO) was investigated to improve the fertility rate, including the ultrasonographic testes, epididymal tail and genital glands, as well as semen parameters and testosterone concentration. Sixty animals were splitted into two groups, each with 30 rams; the rosemary group (C + REO) received 2 mg/kg/bw and the control group (C-REO). Ultrasound images and blood samples were collected at 15, 30 and 45 days of the REO treatment. Results The testis and epididymal tail ultrasonographic assessments demonstrated a significant enhancement in the C + REO group compared to the C-REO group. However, the rams in the C + REO group showed significant improvements in the pampini-form plexus, seminal vesicle, Cowper's and prostate genital glands compared to the C-REO group. The data showed that the sperm cell concentration (× 109/ml) and individual motility (%) were significantly improved in the C + REO group. Furthermore, ejaculate volume (ml) in the C + REO group was significantly higher than that in the C-REO group. While the animals treated with REO did not improve live spermatozoa (%), it reduced the abnormalities of spermatozoa (%) compared to the C-REO group. Also, the C + REO group significantly increased the testosterone concentration more than the C-REO group. Conclusion It can be concluded that supplementation with 2 mg/kg/bw REO improves genital characteristics, semen parameters and testosterone concentration in Barki rams.

Abstract Aim The purpose of this study was to evaluate the performance of polyethylene fiber reinforced resin composite fillings compared to bulk fill resin composite fillings in endodontically treated teeth over a two-year monitoring period. Method A total of 240 individuals with endodontically treated lower molars and a moderate amount of tooth structure were divided into two equal groups of 120 each. One group received polyethylene fiber reinforced bulk fill resin composite restorations while the other group received only bulk fill resin composite restorations, both applied as per manufacturer guidelines. Two proficient experienced blinded assessors assessed the restorations using modified USPHS criteria at baseline, 6, 12, and 24 months. Statistical analysis used Data analysis involved the utilization of Mann-Whitney U, Friedman’s test, and Nemenyi post hoc test, with age data being displayed as mean and standard deviation. The significance level was established as p

Abstract Background While substantial research has explored rhizosphere and phyllosphere microbiomes, knowledge on flower microbiome, particularly in wild plants remains limited. This study explores into the diversity, abundance, and composition of bacterial and fungal communities on leaves and flowers of wild flowering plants in their natural alpine habitat, considering the influence of environmental factors. Methods We investigated 50 wild flowering plants representing 22 families across seven locations in Austria. Sampling sites encompassed varied soil types (carbonate/silicate) and altitudes (450–2760 m). Amplicon sequencing to characterize bacterial and fungal communities and quantitative PCR to assess microbial abundance was applied, and the influence of biotic and abiotic factors assessed. Results Our study revealed distinct bacterial and fungal communities on leaves and flowers, with higher diversity and richness on leaves (228 fungal and 91 bacterial ASVs) than on flowers (163 fungal and 55 bacterial ASVs). In addition, Gammaproteobacteria on flowers and Alphaproteobacteria on leaves suggests niche specialization for plant compartments. Location significantly shaped both community composition and fungal diversity on both plant parts. Notably, soil type influenced community composition but not diversity. Altitude was associated with increased fungal species diversity on leaves and flowers. Furthermore, significant effects of plant family identity emerged within a subset of seven families, impacting bacterial and fungal abundance, fungal Shannon diversity, and bacterial species richness, particularly on flowers. Conclusion This study provides novel insights into the specific microbiome of wild flowering plants, highlighting adaptations to local environments and plant–microbe coevolution. The observed specificity indicates a potential role in plant health and resilience, which is crucial for predicting how microbiomes respond to changing environments, ultimately aiding in the conservation of natural ecosystems facing climate change pressures.

Abstract Introduction Kuwait has a large expatriate community who experience both restricted access to public health services and lower income than Kuwaiti citizens. Given these conditions, we examined differences in characteristics and management of chronic kidney disease (CKD) between Kuwaitis and expatriates. Methods Clinical and laboratory data for adult CKD Stages 3–5 not on dialysis (CKD 3–5 ND) patients with native kidneys attending nephrology clinics in all Ministry of Health hospitals collected from January 1, 2022, to December 31, 2022. Cohort was then divided into Kuwaiti patients and expatriates patients for comparison. Results We collected data from 2,610 patients (eGFR: 30.8 ml/min/1.73m2; age: 62.6 years; males: 56.7%; Kuwaitis: 62.1%). Kuwaitis were older (63.94 vs. 60.3 years, p

Abstract Parboiling improves rice grain hardness and reduces susceptibility to Sitophilus oryzae infestation by gelatinizing the starch and enhancing resistance.A newly designed electric machine was used to parboil four Egyptian rice cultivars—Sakha 108, Giza 178, Super 300, and Egyptian Yasmin—at 70, 75, and 80 °C and determine their susceptibility to Sitophilus oryzae L. (Coleoptera: Curculionidae) infestation. Results indicated that heating affected most traits in all four rice cultivars during both study seasons 2021 and 2022. Super 300 rice cultivar exhibited the highest hulling values (81.23 and 81.42%) when heated to 80 °C, while the Yasmin rice cultivar showed the lowest values for hulling (77.66 and 77.45%) at 70 °C. while Giza 178 cultivar showed a significant decrease in broken percentage (90.85 and 94.02%) compared to control when heated to 80 °C. The results also indicated that the Yasmin rice cultivar had the highest values for white belly, hardness, and gel consistency at 80 °C, while the Sakha 108 cultivar showed the lowest values for these traits at 70 °C. Furthermore, the protein, elongation, and water uptake characters significantly responded to the different investigated treatments. Yasmin cultivar at 80 °C showed the highest significant values for protein (9.26 and 9.47%), elongation (65.02 and 65.44%), and water uptake (453.2 and 455.1 ml water/100 g milled grains) in both seasons. Sakha 108 cultivar had the lowest values for these traits at 70 °C. The S. oryzae insects responded differently to the rice cultivars. Using Dobie’s Index of Susceptibility, all cultivars were classified as resistant to S. oryzae infestation. Super 300 was moderately resistant before parboiling but resistant after heat treatment. In conclusion, the study underscores the influence of pre-storage parboiling on rice weevil infestation, suggesting that heat treatment could serve as an effective control measure. These findings emphasize the importance of parboiling conditions in enhancing rice grain quality and bolstering resistance to insect infestation.

Abstract Emission trajectories produced by integrated assessment models increasingly suggest that gigatonnes of carbon removal will be required to stabilize atmospheric greenhouse gas concentrations at safe levels. This can be accomplished using the direct air capture of carbon dioxide, among other technologies. Process models of these systems assume that they would operate at standard ambient temperature and pressure, when capture rates vary with ambient conditions, including temperature, relative humidity, and other factors. Here, we build an open-source model of a liquid solvent direct air capture technology and analyze its capture performance as a function of hourly varying ambient environmental conditions across Canada. We find that, in the cool climate considered, capture performance is degraded due to both varying environmental conditions and the intermittent operation that could result. Our findings can be used to calibrate policy and investment decisions, and to support engineers in making operational design choices.

Abstract. Schistosomiasis is a prevalent health issue in numerous countries in Africa, Asia, and South America. Data regarding the coinfection of schistosomiasis with hepatitis C virus (HCV) is limited, yet this coinfection is prevalent in regions where schistosomiasis is endemic. The extent of the coinfection issue is evident in countries with a high prevalence of both diseases, such as Egypt. Coinfections with schistosomiasis result in more pronounced liver damage compared with an HCV infection alone. Schistosomiasis has been found to disrupt HCV-specific T-cell responses, resulting in high viral load, increased likelihood of HCV chronicity, and accelerated development of comorbidities in individuals with coinfection. Introducing new, directly acting antivirals for HCV treatment resulted in a marked shift in the disease landscape. This shift may have an impact on the incidence of coinfection with schistosomiasis. This review emphasizes the notable influence of schistosomiasis on the vulnerability to HCV coinfection, the gravity of the consequent liver pathology, and the effectiveness of HCV antiviral therapy.

Abstract Purpose The aim was to investigate the effect of surgeon handedness on acetabular cup positioning, functional outcomes, and dislocation incidence during primary THA. Methods A systematic review was conducted according to the PRISMA guidelines. Studies published in English were searched in three databases (PubMed, Embase, and Scopus). A dominant side is a right-handed (RHD) or left-handed (LHD) surgeon who operates on the right or left hip, respectively. The opposite is considered to be the non-dominant side. We used odds ratios for dichotomous data and mean differences for continuous data, with 95% confidence intervals for quantitative data synthesis. Heterogeneity was assessed using the I² test, with outcomes graphically represented in a forest plot and a p-value of . Result Four observational studies were included out of 98 articles. Ten experienced surgeons participated (8 RHD and 2 LHD) and operated on 822 patients (1484 hips), divided equally between dominant and non-dominant sides, and the posterolateral approach was utilized in 80.9% of THAs. RHD surgeons operated on 1404 (94.6%) THAs. The pooled synthesis for inclination indicated no significant difference between either side [MD: 0.10 (95% CI -2.10 to 2.30, P = 0.93, I² = 91%)]. While the difference was significant for anteversion [MD: -2.37 (95% CI -3.82 to -0.93, P = 0.001, I² = 31%)]. The functional outcome was better on the dominant side [MD: 1.44 (95% CI 0.41 to 2.48, P = 0.006, I² = 0%)], and the dislocation incidence was significantly higher on the non-dominant side [OR: 0.45 (95% CI 0.25 to 0.81, P = 0.008, I² = 0%)]. Conclusion Surgeon handedness and whether operating on the dominant or non-dominant side could affect the acetabular cup positioning and outcomes during primary THAs, even in the hands of high-volume surgeons.

Abstract Background Intracellular hydroperoxides are harmful reactive oxygen species that can cause damage. Cells depend on antioxidant enzymes such as glutathione peroxidase (GPx) to prevent their accumulation. GPx is present in all cell compartments, including the cytosol, mitochondria, and peroxisomes. This article will present a rapid and reliable method for measuring GPx activity, which has been rigorously tested and proven dependable. Results The enzyme samples are incubated in a phosphate buffer containing specific concentrations of glutathione (GSH) and peroxide and then incubated for a suitable time to react before Ellman's reagent (5,5′-dithiobis-(2-nitrobenzoic acid) (DTNB) is added. This method, designed for ease of use, is effective and straightforward. When GSH reacts with DTNB, mixed disulfides (GS-S-DTNB) are formed, where the thiol group replaces one of the nitrobenzoic acid moieties in DTNB. The release of the nitrobenzoic acid group as nitro-2-thiobenzoate anion (TNB−) creates a yellow anion that can be measured spectrophotometrically at a wavelength of 412 nm. The intensity of the yellow color is directly proportional to the unreacted glutathione concentration. GPx activity was linked to decreased absorbance of the TNB− anion, providing a sensitive and relatively specific method for detecting thiol groups in various biological samples. Conclusion This study utilized a Box–Behnken design (BBD) to apply to response surface modeling (RSM) to determine the best conditions for measuring GPx activity. The efficiency of the new protocol was validated by comparing GPx activity in matched samples using the Bland–Altman plot analysis and reference methods. The new protocol was just as accurate as the reference one, with a correlation coefficient of 0.9991. Graphical abstract

Abstract Background We evaluated the noncontrast MRA as an alternate method to CT angiography in assessment of patients with lower limb ischemia, 30 patients were included in a prospective cohort study; they underwent quiescent interval slice selective magnetic resonance angiography (QISS-MRA) and computed tomographic angiography (CTA). The assessment of images was evaluated by two independent consultants. The overall subjective image quality, interobserver and intermodality concordance were calculated. Results The median acquisition time in QISS-MRA was 20 min (range 18–30 min), The overall subjective image quality was rated similarly with QISS-MRA (3.13 [95% CI 2.84–3.42]) and CTA (3.23 [95% CI 2.94–3.52]; p = 0.08) with interobserver concordance for lesion ratings in QISS-MRA reached (κ = 0.987 (SD 0.006)), while for CTA it was (κ = 0.99 (SD 0.006)), while the intermodality concordance between QISS-MRA and CTA in lesion ratings were calculated on a per segment basis and was (κ = 0.944 (SD 0.013)) for reader 1 and (κ = 0.947 (SD 0.013)) for reader 2, with sensitivity 100% and specificity 97.6% Conclusions QISS-MRA is a reliable modality for assessment of patients with critical limb ischemia.

Abstract Background Pleuropulmonary Blastoma (PPB) is an extremely uncommon, highly aggressive tumor that arises from either the lungs or pleura. According to Dehner, PPB was classified into three groups: type I (cystic), type II (mixed), and type III (solid). Type I tends to occur more commonly in infants and has a more favorable prognosis compared to types II and III. This tumor is very rare in pediatric age group; hence, there is no consensus on the optimal treatment regimen for it to date. Type I tumors, which resemble congenital lung cysts, can eventually progress to more aggressive type II and type III tumors. This article aims to increase general awareness of this pathology, clinical presentation, and differential diagnosis in order to identify this rare entity early in its course. By presenting 4 such cases, we highlight that PPB can be missed early in diagnosis and it is important to be alert when putting this rare tumor in differential diagnosis of cystic lung lesions. Methods A retrospective study was conducted between 2015 and 2020 involving patients who had a definitive diagnosis of PPB with emphasis on clinical presentation, preoperative imaging studies, intra-operative findings, pathological reports, ancillary treatment, and outcomes. All patients were followed up every 6 months to monitor local recurrence and distant metastasis by undergoing physical exam and non-contrast enhanced CT of the chest. The primary outcome is to identify the mortality and morbidity (recurrence and distant metastasis) of PPB for cases admitted in our institute. Results Four children were diagnosed with PPB during the study period. Clinically, patients presented with manifestations ranging from respiratory distress, fever to obstructive shock and radiologically, 2 cases were presented with mediastinal mass and the other 2 presented with pneumothorax. Regrettably, none of the cases were diagnosed pre-operatively. One lesion proved to be type I, 2 were type II and one was type III. All cases underwent chemotherapy using the combination of vincristine, Adriamycin and cyclophosphamide (VAC regimen). Recurrence was detected in a type II case, around 2 years after operation, and the other type II case developed brain metastasis that was discovered 3 years after operation. Type I case showed no local or distant metastasis. Conclusion A prompt preoperative diagnosis and workup of cases of PPB is crucial to enable optimal intervention intraoperatively and early postoperative treatment. Though it is uncommon, PPB should be considered in the differential diagnosis of cystic lung lesions.

This paper presents a theory of audience-resistance and speaker-denial. The paper commences with the problem of definition, encompassing an analysis of the scope and nature of denial and resistance. The data for this study were primarily obtained from mainstream and social media postings in two languages: English and Arabic. The article primarily draws on discourse and socio-cognitive frameworks. The paper’s principal question is how and why Arab and English speakers may resist or deny a remark. Previous research on resistance to figurative language has focused predominantly on the rhetorical trope of metaphor and on what drives the English political and media elite to reject a metaphoric expression. However, this raises an important question that is rarely asked: how and why do members of the general public resist verbal metaphors, and what about other tropes such as hyperbole and metonymy, other languages such as Arabic, and other modalities such as images and art forms? The paper argues that the existing literature on meaning negotiation and/or human dialogic action and behavior is riddled with fundamental theoretical, methodological, and analytical flaws. The paper aims to fill in this gap and has significant implications both for conceptual metaphor theory and for (non-)deliberate language use.

Abstract Improper solid waste management in urban and semi-urban areas has led to adverse impacts on the environment, public health, and the economic well-being of communities. Therefore, this study analyzes the status of household solid waste management practices and their effects in Logia Town, Afar, Ethiopia. To achieve this objective, the study utilizes both descriptive and econometric models (binary logistic regression model). The descriptive results of the study revealed that there is general awareness of the importance of solid waste management (SWM) and its impact on the environment, economy, and human health among the respondents. Regarding respondents’ attitudes, the majority of households understand the responsibility of proper waste disposal and its impact. However, in terms of solid waste management practices, 80% of households do not properly segregate their waste, 59.3% do not separate solid waste (SW) before disposal, and 74% of households engage in improper disposal practices. About 95.9% of respondents were aware that improper waste management can lead to diseases such as diarrhea, typhoid, and cholera. Around 65% of the sampled households considered solid waste as a source of wealth, and, as a result, 56% of them reuse, recycle, and reduce waste. This indicates that solid waste has economic value for society. Regarding the environmental impact of SW, about 89% of respondents argued that SW adversely affects the environment by polluting rivers, lakes, wells, and air. This environmental impact negatively affects the well-being and economic status of the community. The binary logistic regression model found that having adequate solid waste landfills, access to door-to-door solid waste collection, knowledge of SWM rules and regulations, treating waste as a resource, and understanding the 3Rs (recycle, reuse, reduce) had positive and significant effects on the adoption of proper solid waste management practices in the study area. Therefore, to reduce undesirable effects and improve the value of SW, the relevant authorities should provide adequate solid waste landfills and door-to-door collection services, create awareness about SWM rules and regulations, and promote knowledge of the 3Rs.

Abstract This study addresses the inherent challenges associated with the limited flexibility of power systems, specifically emphasizing uncertainties in solar power due to dynamic regional and seasonal fluctuations in photovoltaic (PV) potential. The research introduces a novel supervised machine learning model that focuses on regression methods specifically tailored for advanced microgrid energy management within a 100% PV microgrid, i.e. a microgrid system that is powered entirely by solar energy, with no reliance on other energy sources such as fossil fuels or grid electricity. In this context, “PV” specifically denotes photovoltaic solar panels that convert sunlight into electricity. A distinctive feature of the model is its exclusive reliance on current solar radiation as an input parameter to minimize prediction errors, justified by the unique advantages of supervised learning. The performance of four well-established supervised machine learning models—Neural Networks (NN), Gaussian Process Regression (GPR), Support Vector Machines (SVM), and Linear Regression (LR)—known for effectively addressing short-term uncertainty in solar radiation, is thoroughly evaluated. Results underscore the superiority of the NN approach in accurately predicting solar irradiance across diverse geographical sites, including Cairo, Egypt; Riyadh, Saudi Arabia; Yuseong-gu, Daejeon, South Korea; and Berlin, Germany. The comprehensive analysis covers both Global Horizontal Irradiance (GHI) and Direct Normal Irradiance (DNI), demonstrating the model’s efficacy in various solar environments. Additionally, the study emphasizes the practical implementation of the model within an Energy Management System (EMS) using Hybrid Optimization of Multiple Electric Renewables (HOMER) software, showcasing high accuracy in microgrid energy management. This validation attests to the economic efficiency and reliability of the proposed model. The calculated range of error, as the median error for cost analysis, varies from 2 to 6%, affirming the high accuracy of the proposed model.

Abstract Alzheimer’s disease (AD) is associated with heterogeneous atrophy patterns. We employed a semi-supervised representation learning technique known as Surreal-GAN, through which we identified two latent dimensional representations of brain atrophy in symptomatic mild cognitive impairment (MCI) and AD patients: the “diffuse-AD” (R1) dimension shows widespread brain atrophy, and the “MTL-AD” (R2) dimension displays focal medial temporal lobe (MTL) atrophy. Critically, only R2 was associated with widely known sporadic AD genetic risk factors (e.g., APOE ε4) in MCI and AD patients at baseline. We then independently detected the presence of the two dimensions in the early stages by deploying the trained model in the general population and two cognitively unimpaired cohorts of asymptomatic participants. In the general population, genome-wide association studies found 77 genes unrelated to APOE differentially associated with R1 and R2. Functional analyses revealed that these genes were overrepresented in differentially expressed gene sets in organs beyond the brain (R1 and R2), including the heart (R1) and the pituitary gland, muscle, and kidney (R2). These genes were enriched in biological pathways implicated in dendritic cells (R2), macrophage functions (R1), and cancer (R1 and R2). Several of them were “druggable genes” for cancer (R1), inflammation (R1), cardiovascular diseases (R1), and diseases of the nervous system (R2). The longitudinal progression showed that APOE ε4, amyloid, and tau were associated with R2 at early asymptomatic stages, but this longitudinal association occurs only at late symptomatic stages in R1. Our findings deepen our understanding of the multifaceted pathogenesis of AD beyond the brain. In early asymptomatic stages, the two dimensions are associated with diverse pathological mechanisms, including cardiovascular diseases, inflammation, and hormonal dysfunction—driven by genes different from APOE—which may collectively contribute to the early pathogenesis of AD. All results are publicly available at https://labs-laboratory.com/medicine/ .

تواجه المناطق التاريخية تحديات كبيرة عالمياً ومحلياً، حيث التحضر السريع وتزايد معدلات الهجرة والتنمية غير الواعية بأهمية التراث، وقصور الخطاب الكلاسيكي للتراث، وبالتالي، دعا مركز التراث العالمي إلى تطبيق "توصية نهج المناظر الحضرية التاريخية"، وبالتالي تحاول هذه الورقة في الجزء النظري مراجعة ومناقشة تطور هذا النهج وعلاقته بالمناهج المعاصرة، ومناقشة وتأطير خطوات وأدوات تطبيقه، ثم تتناول في الجزء التطبيقي دراسة وتحليل حالة "مدينة بالارات – أستراليا" وحالة " شبه جزيرة إسطنبول التاريخية – تركيا"، وهي حالات عالمية رائدة لتطبيق هذا النهج، وحالة محلية وهي " إعادة إحياء سوق السلاح كمركز مجتمعي- مصر"، لرصد مدى إمكانية تطبيق هذا النهج في ظروف مختلفة، ومدى فاعليته في الحفاظ المستدام والتوفيق بين عمليات الحفاظ والتنمية، بما يحقق جودة العيش لمجتمع التراث، ثم تتوصل هذه الورقة في الجزء الثالث إلى استنتاج أن هذا النهج يحقق التكامل والاستدامة والمرونة كأداة فاعلة لإدارة عمليات الحفاظ، والتوفيق بين الحفاظ والتنمية وإدارة التغير، في إطار عملية محورها مشاركة مجتمع التراث، وبالتالي توصى الورقة بملاءمة هذا النهج كآلية فاعلة لإدارة واستدامة عمليات الحفاظ على المناطق التاريخية بمصر. Historic areas face great challenges globally and locally, with rapid urbanization, increasing rates of migration, development that is unaware of the importance of heritage, and the shortcomings of the classical discourse of heritage. Therefore, the World Heritage Center called for the application of the “Recommendation of Historic Urban Landscape Approach” and thus this paper attempts, in the theoretical part, to review and discuss the development of this approach and its relationship to contemporary approaches, and a discussion and framing of the steps and tools for its application. Then, in the applied part, it deals with studying and analysing the case of “Ballarat - Australia” and the case of “Historic Istanbul Peninsula - Turkey”, which are pioneering global cases of applying this approach, and a local case, which is “Community-centered revitalization of Souq al-Silah in Cairo- Egypt” to monitor the extent to which this approach can be applied in different circumstances, and the extent of its effectiveness in sustainable conservation and reconciliation between conservation and development processes, in order to achieve quality of life for the heritage community. Then this paper, in the third part, comes to the conclusion that this approach achieves Integration, sustainability, and flexibility as an effective tool for managing conservation operations, and reconciling conservation, development, and change management, within the framework of a process focused on the participation of the heritage community. Therefore, the paper recommends the suitability of this approach as an effective mechanism for managing and sustaining conservation processes for historical areas in Egypt.

Applying soil electrokinetic remediation (SEKR) is considered a valuable technique to remediate contaminants-containing low permeability soils with the advantage of integration with other remediation approaches (e.g., chemical, physical, and biological). The basics and principles of electrokinetic remediation (EKR) were utilized in different fields of interest; for example, sedimentation, seed germination, consolidation, dewatering, etc. The present review is focused on the role of the electrode approaching/movement technique (EAMT) in improving the effectiveness of the SEKR. Based on our search in the collected literature, the influence of the EAMT on soil electrokinetic efficiency yielded no pertinent reviews. We looked for articles relevant to the EAMT in six search engines, and articles collected for the present review were chosen based on the data mentioned in the materials and methods section. Our objective was to illustrate the proper applicability of the EAMT from different perspectives to overcome some obstacles reported with the traditional SEKR. The effect of the EAMT is discussed/illustrated from four perspectives including a) the approaching/moving anode technique (AMAT), b) the approaching/moving cathode technique (AMCT), c) electrodes placement/gap, and d) continuously reoriented/rotating, reciprocating, and rotational electric fields. Several advantages could be gained from the EAMT application including a) improving the current passing, b) soil pH reduction, c) increasing heavy metals desorption, d) elevating the redox potential, e) reducing the energy consumption, f) increasing the removal percentages of contaminants, g) reducing extra chemical additives or pH modifications, h) enhancing electroosmotic flow, i) installing auxiliary electrodes presents a more stable current and uniform electric field, and j) ultimately reducing the environmental risks of heavy metals. Two methods were proposed for the practical applications of the EAMT (in-situ and ex-situ). Although there are various advantages were achieved from the application of the EMAT, the published research during the past 31 years (1993–2023) is few compared to other enhancement approaches.

Background: Several investigations suggested correlation between microscopic colitis (MC) and celiac disease (CD). This study aimed to examine this relationship using large-sized, population-based data with adequate control for confounding factors. Methods: This study employed the National Inpatient Sample (NIS) database over 4 years (2016–2019). Patients with/without MC in the presence/absence of CD were identified through ICD-10 codes. Univariate and multi-variate analyses involving odds ratios (OR) and 95% confidence intervals (CI) were performed. Results: Overall, 26,836,118 patients were analyzed. Of whom, 6,836 patients had MC (n = 179 with CD and n = 6,657 without CD). The mean hospital stay was not significantly different between both groups (5.42 ± 5.44 days vs. 4.95 ± 4.66 days, P = 0.202). The univariate analysis revealed a significant association between MC and CD (OR = 22.69, 95% [19.55, 26.33], P < 0.0001). In the multi-variate analysis, which adjusted for potential confounders including age, race, hospital region, hospital teaching status, ZIP income, smoking status, alcohol overuse, hypertension, diabetes mellitus, lipidemia-related disorders, non-steroidal anti-inflammatory drug use, and selected auto-immune diseases, the association remained significant (OR = 15.71, 95% CI [13.52, 18.25], P < 0.0001). Moreover, in patients with MC, the presence of CD emerged as a significant, independent variable of in-hospital mortality in univariate (OR = 2.87, 95% [1.14, 7.21], P = 0.025) and multi-variate (OR = 3.37, 95% CI [1.32, 8.60], P = 0.011) analyses. Conclusion: This study establishes a probable link between MC and CD, backed by both univariate and multi-variate analyses, while also identifying CD as an independent risk factor for increased mortality among MC patients. These findings need to be validated in real-world clinical studies.

Background. Children infected with COVID-19 may experience a variety of neurological symptoms. During the outbreak of COVID-19, doctors should consider SARS-CoV-2 infection as a differential diagnosis when meeting patients with neurological symptoms. This study aims to investigate the neurological symptoms of COVID-19 infection. Materials and methods. A cross-sectional study enrolled 100 patients (age range from 1 month to 12 years) admitted to the emergency room with neurological symptoms between October 1, 2020, and August 1, 2021. Results. Sixty out of 100 patients were positive for COVID-19 that was confirmed by polymerase chain reaction. Eighteen (30 %) children had lower limb weakness and abnormal gait, fit was detected in 12 (20 %) cases, a disturbed level of consciousness — in 18 (30 %), and Guillain-Barre-like syndrome — in 12 (20 %); the outcome was favorable in almost all patients. Overall, neurological manifestations were more common in school-age children than in other age groups (p-value of 0.01). Conclusions. We presented these cases to highlight the link between COVID-19 and neurological manifestations, as it was found that while a disturbed state of consciousness is common among school-age children, convulsions are more common in infancy.

Cryptococcus neoformans is the highest‐ranked fungal pathogen in the Fungal Priority Pathogens List (FPPL) released by the World Health Organization (WHO). In this study, through in silico simulations, a multi‐epitope vaccine against Cryptococcus neoformans was developed using the mannoprotein antigen (MP88) as a vaccine candidate. Following the retrieval of the MP88 protein sequences, these were used to predict antigenic B‐cell and T‐cell epitopes via the bepipred tool and the artificial neural network, respectively. Conserved B‐cell epitopes AYSTPA, AYSTPAS, PASSNCK, and DSAYPP were identified as the most promising B‐cell epitopes. While YMAADQFCL, VSYEEWMNY, and FQQRYTGTF were identified as the best candidates for CD8+ T‐cell epitopes; and YARLLSLNA, ISYGTAMAV, and INQTSYARL were identified as the most promising CD4+ T‐cell epitopes. The vaccine construct was modeled along with adjuvant and peptide linkers and the expasy protparam tool was used to predict the physiochemical properties. According to this, the construct vaccine was predicted to be antigenic, nontoxic, nonallergenic, soluble, stable, hydrophilic, and thermostable. Furthermore, the three‐dimensional structure was also used in docking analyses with Toll‐like receptor (TLR4). Finally, the cDNA of vaccine was successfully cloned into the E. coli pET‐28a (+) expression vector. The results presented here could contribute towards the design of an effective vaccine against Cryptococcus neoformans.

Aims: To compare the extraoral and intraoral scanners' accuracy in obtaining implant impressions using an in-vitro reference model. Materials and methods: An upper master model was fabricated with two parallel dental implants at the first and second premolars missing regions in size (4.0mm in diameter and 10mm in length); twenty impressions were made using the intraoral and extraoral scanners to produce twenty digital impressions (10 for each one), which will result in twenty digital casts. The linear distance measurements were performed using (Medit Design) digital measurement by using Medit Intraoral Scanner. Results: In the digital part there was a highly significant difference between measurements for the oral scanner (MeditI500) and extraoral scanner Rainbow using Medit design, the intra-oral scanner (MeditI500) is the highest value which is at a level of significance p≤0.01. Conclusion: The Medit I500 Intra Oral Scanner is a more accurate impression technique than the Rainbow extraoral scanner in transferring implant position.

Aims: This study aimed to compare the accuracy of implant position transfer using three impression materials with two techniques. Materials and methods: A master model was fabricated with two parallel dental implants at the first and second premolars missing regions in size (4.0mm in diameter and 10mm in length); Two traditional impression techniques (open and closed tray); Three silicone impression materials were used which are: Condensation, Additional (heavy and low) and Additional (medium) consistencies. Sixty conventional impressions were taken, ten impressions for each material and each technique. The linear distance measurements were performed using two methods: Digital Vernier and Digital measurement by using Medit Intraoral Scanner. Results: The open tray technique showed significantly fewer changes (P≤ 0.05) with linear distance measurements when compared to the control, while the closed tray technique showed significantly more changes (P≤ 0.05) with linear distance measurements when compared to the control. In comparing Medit Design and digital vernier as methods of measurement for both open and closed tray techniques; there was no significant difference in the accuracy of measurements for both of these two methods of measurement at a level of(P≤ 0.05). Conclusion: The additional silicone material is the best in its accuracy in transferring implant position for the (open and closed tray) conventional impression technique. The condensation silicone material is the worst in accuracy in transferring implant position for (open and closed tray) conventional impression technique. The open tray technique showed significantly more accuracy than the closed tray technique in transferring implant position in the traditional impression technique.

Background: To end the COVID-19 pandemic, we need to reach herd immunity. A successful pediatric COVID-19 immunization program is the only way to achieve this goal. The objective of this study was to determine the views of parents in Saudi Arabia on the COVID-19 vaccine in children. MATERIALS AND METHODS: This cross-sectional study took place within the Family Medicine Pediatric clinics at the King Faisal Specialist Hospital and Research Center (KFSH and RC). All parents of patients of Family Medicine Pediatric Clinics at KFSH and RC, Riyadh, were invited to participate in this study between January 2022 and June 2022. A culturally sensitive and specially designed questionnaire was administered using an interview-based model. Results: Safety concerns were the primary reason for vaccine hesitancy among parents, with 29.7% of parents expressing concerns about side effects and 25.1% not knowing where to get reliable information about vaccines. Negative information and lack of perceived need were also important factors, with 17.1% and 18.3% of parents citing these reasons, respectively. Poor knowledge about vaccines was a significant predictor of parental vaccine hesitancy. Mothers had more concerns about the efficacy and safety of vaccines than fathers. Conclusion: Our study demonstrated a negative attitude toward the pediatric COVID-19 vaccine among parents in Saudi Arabia. A higher level of awareness about the vaccine was significantly associated with planning on having the vaccine. There is a need for effective awareness programs for better pediatric COVID-19 vaccine-related education to increase the acceptance of the vaccine among parents in Saudi Arabia.

Abstract Introduction Unexpandable lung is a complication by which the lung does not expand to the chest wall with pleural space drainage, which will result in adverse events or intervention failure if not well recognized prior to the intervention. Aim of the work This study aimed to assess the role of pleural manometry and transthoracic ultrasonography in predicting abnormal lung expansion during pleural drainage. Patients and methods This was a prospective observational analytical study involving 50 patients that aims to predict abnormal lung expansion during pleural drainage using pleural manometry and transthoracic ultrasound. Results Regarding pleural manometry (pleural elastance), all patients in the entrapped lung group (100%) had pleural elastance > 14.5 cmH2o/L, while in the non-entrapped lung group, all patients (100%) had pleural elastance ≤ 14.5 cmH2o/L. Regarding ultrasonography, pleural thickening > 0.5 cm was found in all patients with entrapped lung (100%) and 50% of patients with non-entrapped lung with statistically significant difference. In the entrapped lung group, 20%, 35%, and 45% of patients had simple, complex non-septated, and complex septated pleural effusion, respectively, while in the non-entrapped lung group, 63.35%, 33.33%, and 3.32% of patients had simple, complex non-septated, and complex septated effusion, respectively, with statistically significant difference (p-value 0.0005). Conclusion Pleural manometry and transthoracic ultrasound can guide decision-making regarding the timing of pleural interventions and management of cases with entrapped lung.

Abstract Background The etiological diversity of pulmonary hypertension and its association with other accompanying unrelated symptoms is why this disease may be primarily diagnosed by physicians of different medical specialties. In this study, we sought to evaluate the awareness of physicians regarding pulmonary hypertension across different regions in Egypt and among different medical specialties this is because we believed that pulmonary hypertension disease awareness differed among different specialties. Methodology The survey is conducted from January 2023 to April 2023 targeting certified physicians of different medical specialties in Egypt. A self-administered questionnaire is designed to evaluate and capture information on the awareness of physicians of different medical specialties regarding the diagnosis and management of disease. The questionnaire is offered through an online Google form link, that is made available in two languages English and Arabic for dissemination. Results A total number of 177 physicians of different medical specialties participated in the questionnaire, 97 (54.8%) participants were males, and 80 (45.2%) participants were females with a mean age of 36.88 ± 7.18. Among different medical specialties, 89.4% (n = 76) of the pulmonologists and 91.9% (n = 34) of the cardiologists participating in the survey have satisfactory PH disease knowledge above 75% with a statistically high significant difference of 0.000, in addition, 87.1% (n = 74) of the pulmonologists and 94.6% (n = 35) of the cardiologists have satisfactory PH disease management knowledge above 75% with a statistically significant difference of 0.000. Coincidentally most participants encountering PH patients in their daily clinical practice have satisfactory PH disease knowledge above 75% and satisfactory PH disease management knowledge above 75% with percentages of 84.8% and 82.3% respectively with statistically significant differences of 0.000 and 0.043 respectively. Conclusions Our research highlights the importance of appropriate awareness of the healthcare providers of different medical specialties regarding PH disease essential to abide by the current guidelines in management as well as prioritizing the establishment of geographically available designated expert centers enforcing proper clinical practice. Thus, aiming at reducing the prereferral malpractice noted as the prescription of targeted therapy based on the clinical and imaging assessment only without hemodynamic study.

Abstract Background Acute coronary syndrome (ACS) is responsible for one-third of total deaths in people older than 35 years old. Number of prognostic models aims to estimate the future risk of mortality, or the combined risk of all-cause mortality or MI has been developed, such as GRACE score. Objective The aim of our study is to assess the utility of GA and CHA2DS2-VASc score in predicting outcomes in patients admitted with acute coronary syndromes. Patients and methods This study was conducted on 90 patients diagnosed with acute coronary syndrome who were admitted receiving PCI, CHA2DS2-VASc score was calculated on admission, and a serum sample for GA was withdrawn within 24 h from admission. Results Combined GA and CHA2DS2-VASc score could significantly predict MACCE with sensitivity 100%, specificity 79%, and diagnostic accuracy 80.9% and significantly predict hospital mortality with sensitivity 100%, specificity 75.3%, and diagnostic accuracy 76.7%; on the other hand, GRACE score can predict MACCE using cutoff point 112.5 with sensitivity 75% and specificity 66%. Conclusion It was concluded that GA and CHADSVASC score can significantly predict major adverse cardiovascular events, in-hospital mortality, and poor clinical outcomes.

Abstract The insulators of overhead power lines play a crucial role in maintaining the reliability of transmission and distribution networks. Because they are exposed to harsh and dynamic environmental conditions, it is essential to investigate the impact of environmental parameters such as pollution, inclined angle with the cross arm, and temperature on the dielectric performance of the insulators of overhead lines. Conventionally, the effect of such parameters can be investigated through experimental measurements of the insulator flashover voltage. However, this approach is costly and time-consuming and calls for the isolation of the lines to conduct the test, causing interruption to the entire grid. As such, there is an essential need to develop a new methodology to quantify the flashover voltage of overhead insulators operating under various environmental conditions, which is the main aim of this paper. The Central Composite Design is employed to develop a mathematical correlation between the insulator flash over voltage as a dependent variable and three environmental parameters: pollution level, inclined angle, and temperature as independent variables. The robustness of the developed equation is validated through extensive experimental measurements of the insulator’s flash overvoltage under various conditions. Results reveal a good agreement between the actual and predicted flashover voltage using the developed correlation, as the absolute error for all investigated samples is less than 6%.

Abstract Background Eplerenone and spironolactone, recognized as mineralocorticoid receptor antagonists (MRAs), have been reported to improve clinical prognosis among individuals diagnosed with heart failure (HF). However, the difference in the clinical effects between eplerenone and spironolactone in individuals with HF remains uncertain. We aimed to assess the impact of eplerenone compared to spironolactone on clinical outcomes within the HF population. Methods An extensive search was executed in several databases (PubMed, Web of Science, Scopus, Cochrane Library). All relevant studies evaluating eplerenone compared to spironolactone in patients with HF were included. Dichotomous data were pooled as Hazard ratio (HR) or Risk ratio (RR) with a 95% confidence interval (CI). Our main outcome was all-cause mortality. Secondary outcomes included death from cardiovascular causes, treatment withdrawal, and gynecomastia. Results Ten studies, comprising 21,930 HF individuals, were included in our investigation. Eplerenone showed a lower risk of all-cause mortality (HR = 0.78, 95%CI [0.64 to 0.94], P = 0.009) and cardiovascular mortality (HR = 0.54, 95%CI [0.39, 0.74], P = 0.0001) compared to spironolactone. Furthermore, eplerenone exhibited a reduced risk of treatment withdrawal (RR = 0.69, 95% CI [0.62, 0.78], P = 0.0001) and gynecomastia (RR = 0.07, 95% CI [0.02 to 0.31], P = 0.0001) than spironolactone. Conclusion Eplerenone revealed lower all-cause and cardiovascular mortality events in comparison to spironolactone. Moreover, eplerenone was associated with lower gynecomastia and treatment withdrawal events compared to spironolactone. Further well-designed randomized controlled trials are still warranted better to identify the clinical differences between eplerenone and spironolactone. Trial registration Protocol registration: https://doi.org/10.17605/OSF.IO/VNMGK

Abstract Silver nanowires (AgNWs) have excellent flexibility, unique optical transmittance and high conductivity. The polyol process is appropriate for preparing AgNWs due to its simplicity, effectiveness, low cost, and high yield. This work aims to investigate the effect of preparation parameters of the polyol process on the silver nanowires properties. The parameters include the controlling agent, molecular weight of the polyvinylpyrrolidone (PVP), the temperature, and the reducing agent. The amount of silver nanoparticles formed during preparation was used to determine the optimum preparation conditions. The transmission electron microscope (TEM) images showed minimal amount of Ag nanoparticles when using mixed molecular weight of PVP-40K, and PVP-1.3M at 150 °C with the assistance of copper chloride as a controlling agent. The prepared AgNWs had an average length of 3.7 µm and aspect ratio of 15.3. The fabricated electrodes were characterized using a scanning electron microscope (SEM) and four probe resistivity measurements. The electrical measurement of the AgNWs electrodes indicated that the surfactant thickness is a critical parameter in having low sheet resistance electrodes. Also, the optical transmission was affected by the amount of nanoparticles. The prepared electrode with high concentration of AgNWs and a minimal amount of nanoparticles exhibited 80% optical transmission.

Abstract Climate change stabilization at 1.5 to 2 °C requires a shift in paradigm of industries to transition to low carbon industries. The way forward to decarbonize industries is green manufacturing, as the environmental facet of manufacturing has often been compromised for the sake of economic gains. In order to implicate green manufacturing, it is incumbent upon manufacturing facilities to introduce such measures which ensure that carbon footprint and environmentally detrimental emissions are minimized. In this context, Life-cycle Assessment (LCA) is an excellent tool to record, analyze and critically review the environmental impact of a process. In order to investigate the environmental hotspots, the authors have performed LCA of an auto-parts manufacturing industry in Pakistan by using a unique gate-to-gate approach. ReCiPe Midpoint impact assessment method was utilized to investigate the effects of manufacturing and transportation related emissions of the monthly produce on climate change, fossil depletion, ionizing radiation and human toxicity. Furthermore, the authors discuss three scenarios, which include current state, optimized future state and an energy mix involving hydropower and photovoltaic generation. The results helped in developing a comprehensive framework for green manufacturing which suggests that the prerequisite of a green manufacturing process is an optimized process flow, which significantly reduces the environmental emissions up to 24%. Moreover, the use of photovoltaic cells results in 54% reduction, thus indicating that conventional hydropower systems in developing countries should be mixed with solar power to reduce the environmental burden. A detailed green manufacturing framework based on LCA is proposed by the authors to enhance the functionality and to improvise the carbon burden of the manufacturing sector of Pakistan.

Cross-project defect prediction (CPDP) plays an essential role in identifying potential defects in target projects, especially those with limited historical data, using relevant information from similar source projects. The current studies focused on three main types of software metrics for CPDP: static metrics, code-change metrics, and semantic features. However, these existing CPDP studies encounter two primary challenges: class overlap due to reduced feature dimensions and multicollinearity from integrating various software metrics. To address these challenges, we propose a CPDP model based on both reduction and hybridization techniques (RH-CPDP). The proposed model uses hybrid deep neural networks as a hybridization technique to combine the essential metrics from all metric categories, addressing the issue of class overlap to enhance prediction model efficiency. Principal component analysis (PCA) was used as a reduction method to keep the number of metrics used small, focusing on influential relationships among metrics and fault proneness and avoiding the multicollinearity problem. The experimental analysis conducted using nine open-source projects from the PROMISE dataset demonstrates that RH-CPDP surpasses current CPDP methods (TCSBoost, TPTL, DA-KTSVMO, DBN, and 3SW-MSTL) regarding area under the curve (AUC) and F1-measure. These findings highlight the effectiveness of RH-CPDP in improving the performance of CPDP techniques.

Objective Diffuse large B-cell lymphoma (DLBCL) is an aggressive type of lymphoma. Circulating cell-free DNA (cfDNA) is the promising liquid biopsy in malignancy.Method Assessment of cfDNA concentration and DNA integrity index (DII) in 30 newly diagnosed DLBCL patients and correlating them with the international prognostic index.Results Circulating cfDNA concentration was significantly higher in newly diagnosed DLBCL patients than controls, while DII was significantly lower. There was a significant correlation between cfDNA concentration and adverse prognostic factors.Conclusion cfDNA concentration is potentially strong diagnostic and prognostic marker of DLBCL, however DII is only useful as a diagnostic biomarker.

Objective To evaluate the changes in epithelial mapping using anterior segment OCT-based tomography (MS-39) after 1 week, 1, 3, and 6 months of manual versus transepithelial photorefractive keratectomy in patients with myopia and myopic astigmatism.Methods We designed, prospective, interventional paired eye study on 52 eyes who underwent photorefractive keratectomy to correct myopia and myopic astigmatism. Each eye of a participant was assigned to a different treatment group; 26 eyes underwent transepithelial Photorefractive keratectomy (transPRK) using Stream Light WaveLight E × 500were categorized as Group A “tPRK group” and 26 eyes underwent conventional PRK by manual epithelium removal and wavefront-optimized PRK using WaveLight E × 500excimer were categorized as Group B “mPRK group.” Epithelial mapping was evaluated for all cases preoperatively and postoperative for six months of follow-up.Results The postoperative central epithelial thickness increased in both groups; it was higher in group B (mPRK) with a statistically significant difference between both groups in the 1-week, 1-month (p