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Most renewable energy sources are intermittent and seasonal, making energy storage and consumption problematic. Hydrogen gas can save and convey chemical energy, making it a promising sustainable energy source. Electrochemical water electrolysis technology’s sustainable and efficient hydrogen gas production attracts global attention. Higher hydrogen production rates enhance hydrogen volumetric energy capacity by storing intermittent hydrogen gas in high-pressure tanks. Pressurized storage tanks are cost-effective and efficient. Hydrogen gas may be stored economically and efficiently in pressurized tanks, making electrochemical water electrolysis a sustainable energy source. This paper introduced hydrogen as an alternative to natural gas, detailed water electrolysis technologies for hydrogen production, and highlighted how they can manufacture hydrogen efficiently and cost-effectively. The theoretical volume of gaseous hydrogen and oxygen that could be produced by electrolyzing water under typical temperature and pressure (STP) circumstances, assuming a 100% efficiency rate of the process. Since there are always two moles of hydrogen produced by electrolysis and one mole of gas occupies the same volume, the volume of hydrogen developed from water is twice that of oxygen. The volume of liberated oxygen is 0.21 (L/min), and the volume of liberated hydrogen is 0.42 (L/min) with a current density of 30 A, for instance, the tracer’s diffusion coefficient for all conceivable flow rates. A maximum value of 90 liters per hour was determined to be the threshold at which the diffusion coefficient increased with increasing flow rate. It would appear that the diffusion coefficient remains unchanged at flow rates greater than 90 liters per hour.

Introduction: The primary objective of this study was to assess the effectiveness of the clinical decision tool (CDT) in trauma patients, providing a comparable ability to rule out thoracolumbar (TL) fractures as traditional imaging methods. The goal is to facilitate early clearance of the TL spine without an immediate requirement for radiological tests, thereby minimizing unnecessary utilization of TL-spine imaging. Methods: A prospective, observational study was conducted on trauma patients with suspected TL injury. To achieve early TL clearance, the CDT assessed criteria such as absence of pain, tenderness, and pain-free axial movement and flexion. The study enrolled alert trauma patients with thoracic and/or lumbar spine injuries, defined by the Glasgow Coma Scale of 15. The study excluded patients not aligning with CDT criteria, such as those who received intravenous opioid analgesia within 4 h and those unable to stand due to suspected pelvic or lower limb injuries. Results: Following the completion of the CDT steps, there were 31 true negative cases, signifying the absence of TL fractures according to both CDT and imaging studies. The sensitivity of the CDT was 99.38% (95% confidence interval [CI]: 96.59%–99.98%), specificity 9.1% (95% CI: 6.30%–12.73%), negative predictive value (NPV) 96.87% (95% CI: 81.02%–99.56%), positive predictive value (PPV) 34.19% (95% CI: 33.38%–35.00%), negative likelihood ratio (LHR) 0.07 (95% CI: 0.01–0.49), and positive LHR 1.09 (95% CI: 1.06–1.13). The sensitivity, specificity, NPV, PPV, negative LHR, and positive LHR varied with each step in the CDT. Notably, the overall sensitivity was high; however, the stepwise sensitivity decreased, albeit with an improvement in specificity with each further step in the tool. The overall sensitivity in the study cohort (n = 500) was high; however, the stepwise sensitivity decreased, albeit with an improvement in the specificity. Conclusions: The CDT to rule out TL fracture is a feasible bedside stepwise tool in fully awake trauma patients after a thorough clinical neurological examination on arrival. The tool could help Level II or III trauma centers avoid secondary triage to the higher center.

Abstract This is an interim analysis of the Beta-blocker (Propranolol) use in traumatic brain injury (TBI) based on the high-sensitive troponin status (BBTBBT) study. The BBTBBT is an ongoing double-blind placebo-controlled randomized clinical trial with a target sample size of 771 patients with TBI. We sought, after attaining 50% of the sample size, to explore the impact of early administration of beta-blockers (BBs) on the adrenergic surge, pro-inflammatory cytokines, and the TBI biomarkers linked to the status of high-sensitivity troponin T (HsTnT). Patients were stratified based on the severity of TBI using the Glasgow coma scale (GCS) and HsTnT status (positive vs negative) before randomization. Patients with positive HsTnT (non-randomized) received propranolol (Group-1; n = 110), and those with negative test were randomized to receive propranolol (Group-2; n = 129) or placebo (Group-3; n = 111). Propranolol was administered within 24 h of injury for 6 days, guided by the heart rate (> 60 bpm), systolic blood pressure (≥ 100 mmHg), or mean arterial pressure (> 70 mmHg). Luminex and ELISA-based immunoassays were used to quantify the serum levels of pro-inflammatory cytokines (Interleukin (IL)-1β, IL-6, IL-8, and IL-18), TBI biomarkers [S100B, Neuron-Specific Enolase (NSE), and epinephrine]. Three hundred and fifty patients with comparable age (mean 34.8 ± 9.9 years) and gender were enrolled in the interim analysis. Group 1 had significantly higher baseline levels of IL-6, IL-1B, S100B, lactate, and base deficit than the randomized groups (p = 0.001). Group 1 showed a significant temporal reduction in serum IL-6, IL-1β, epinephrine, and NSE levels from baseline to 48 h post-injury (p = 0.001). Patients with severe head injuries had higher baseline levels of IL-6, IL-1B, S100B, and HsTnT than mild and moderate TBI (p = 0.01). HsTnT levels significantly correlated with the Injury Severity Score (ISS) (r = 0.275, p = 0.001), GCS (r = − 0.125, p = 0.02), and serum S100B (r = 0.205, p = 0.001). Early Propranolol administration showed a significant reduction in cytokine levels and TBI biomarkers from baseline to 48 h post-injury, particularly among patients with positive HsTnT, indicating the potential role in modulating inflammation post-TBI. Trial registration: ClinicalTrials.gov NCT04508244. It was registered first on 11/08/2020. Recruitment started on 29 December 2020 and is ongoing. The study was partly presented at the 23rd European Congress of Trauma and Emergency Surgery (ECTES), April 28–30, 2024, in Estoril, Lisbon, Portugal.

Intrapulmonary miliary metastasis is a rare presentation of adenocarcinoma of the lung, characterized by the dissemination of cancer cells throughout the lung parenchyma in different patterns. This case report highlights an unusual presentation of adenocarcinoma of the lung with intrapulmonary miliary metastasis, emphasizing the diagnostic challenges and management considerations. Here, we report a case of a 51-year-old female who presented to the emergency department (ED) with a 2-month history of dry cough, which started after a flu illness and was associated with mild shortness of breath, left-sided chest pain, and miliary nodules on chest imaging. During bronchoscopy, a transbronchial biopsy was taken for further pathological assessment. The results showed histopathological evidence of lung adenocarcinoma.

Abstract Background Hearing loss is a common problem worldwide with a global prevalence of 20%. There is no local relevant study from Iraq about the prevalence of hearing loss. Objective To assess the prevalence of hearing loss among patients attending the otolaryngology clinic, Ramadi city, Iraq. Method This retrospective study was conducted at the otolaryngology clinic, Ramadi city, Anbar government, Iraq. Patients with hearing loss were enrolled in the current study. Data were gathered from patients record regarding the age, sex, type, side, and severity of hearing loss. Additionally, the number of cases were registered for each month during the study period. Results Out of 8497, there were 2165 (25.48%) patients with hearing loss. The highest number of cases was registered in April (n = 246, 11.4%). The highest age group affected was 18–60 years (n = 1125) with slight male predominance (51.64%). The main cause of hearing loss was secretary otitis media (n = 762, 35.19/5). The vast majority of cases were with conductive hearing impairment (n = 2051, 94.73%). Unilateral hearing loss (50.76%) was slightly more than bilateral one. Mild hearing loss has outnumbered (n = 1905, 88%) the other severities. Conclusion The prevalence of hearing loss was 25.48%. Hearing loss could affect any age with slight male predominance. The majority of the cases were with conductive type and mild severity.

Sometimes the researcher faces a problem in obtaining data, or there may be difficulty in obtaining it due to cost, effort, or other reasons related to the time. In this case, sampling methods are used that ensure the researcher achieves his desired goal with a short time, effort, and cost, by using Ranked Set Sampling (RSS). In this paper, the reliability function of the Lomax Distribution was estimated under the (RSS) using four estimation methods, which are the Maximum Likelihood Estimators (MLE), the Maximum Product of Spacings (MPS), the Least Squares (LS) method, and Weighted Least Squares (WLS). The Monte Carlo simulation method was also used to determine the best method, and the best estimate was chosen using the Mean Square Error (MSE) criterion, and the results were applied in the theoretical aspect using the R-program, as the simulation results showed that the most efficient method among the methods used to estimate the reliability function of the Lomax distribution under (RSS) is the (MPS) method. The experimental aspect was applied to real data representing the times of the beginning of complete recovery (times of disease remission) in months for bladder cancer patients for a sample consisting of 96 patients drawn using the (RSS) method.

Cybercrime is considered one of the most significant crimes effecting people and society. Computer network are involved in this type of crime, with various hackers participating. Through such crime, identities and much information of the victims are stolen. Many students, especially international students and young individuals, fall victim to this fraud. This study focuses on raising awareness among people to avoid scammer’s link or unknown websites that seek to obtain their information. This will be achieved by organizing different questionnaires by teaching staff at one of the Iraqi Universities in this field, to be answered by undergraduate and postgraduate students. The statistical analysis conducted on this group showed that students are more educated and aware, making them less likely to fall victim to these types of crime. This is a result of the knowledge and skills these students acquired through technology and various sessions and training at universities or other resources.

BACKGROUND: Despite prolonged life expectancy in patients with beta-thalassemia due to modern chelation therapy and planned blood transfusions, they still suffer from multisystem complications of this chronic hemolytic anemia, including endocrine system dysfunction. Under-recognized parathyroid hormone (PTH) dysfunction in these patients can manifest as bone pain and fractures. OBJECTIVE: The objective of the study was to evaluate PTH in patients with beta-thalassemia >10 years of age. METHODS: A cross-sectional study was performed on 76 randomly selected patients >10 years old with beta-thalassemia (including both thalassemia major and thalassemia intermedia) in the Al-Kut Hereditary Blood Disease Center in Wasit province, Iraq. The study covered the period from November 2021 to April 2022. Data were collected from patients’ files after written consent, including sex, age, ferritin level, mean hemoglobin level, type of chelation therapy, frequency of transfusion, mean calcium level, and whether the patients were splenectomized or not. RESULTS: Of the 76 patients enrolled in the study, 39 (51.3%) were males. There were 63 (82.9%) who had thalassemia major. The majority of cases (n = 55, 71%) were from the age group >15 years. Fifteen (19.7%) patients had low PTH levels. The age group >15 years had a higher frequency of having low PTH levels (P = 0.01 and Pearson factor - 0.29). The study found a positive correlation between low calcium and low PTH levels (P = 0.001, Pearson factor = 0.1). High ferritin levels had no significant correlation with PTH levels (P = 0.4). CONCLUSIONS: Beta-thalassemia patients can have a low PTH level. It can occur more often in patients >15 years old, which necessitates close monitoring for older thalassemia patients. A declining calcium level in these patients can correlate with a low PTH level.

Strong coupling between resonantly matched surface plasmons of metals and excitons of quantum emitters results in the formation of new plasmon-exciton hybridized energy states. In plasmon-exciton strong coupling, plasmonic nanocavities play a significant role due to their ability to confine light in an ultrasmall volume. Additionally, two-dimensional transition metal dichalcogenides (TMDCs) have a significant exciton binding energy and remain stable at ambient conditions, making them an excellent alternative for investigating light-matter interactions. As a result, strong plasmon-exciton coupling has been reported by introducing a single metallic cavity. However, single nanoparticles have lower spatial confinement of electromagnetic fields and limited tunability to match the excitonic resonance. Here, we introduce the concept of catenary-shaped optical fields induced by plasmonic metamaterial cavities to scale the strength of plasmon-exciton coupling. The demonstrated plasmon modes of metallic metamaterial cavities offer high confinement and tunability and can match with the excitons of TMDCs to exhibit a strong coupling regime by tuning either the size of the cavity gap or thickness. The calculated Rabi splitting of Au-MoSe2 and Au-WSe2 heterostructures strongly depends on the catenary-like field enhancement induced by the Au cavity, resulting in room-temperature Rabi splitting ranging between 77.86 and 320 meV. These plasmonic metamaterial cavities can pave the way for manipulating excitons in TMDCs and operating active nanophotonic devices at ambient temperature.

Abstract Necroptosis is a lytic form of regulated cell death reported to contribute to inflammatory diseases of the gut, skin and lung, as well as ischemic-reperfusion injuries of the kidney, heart and brain. However, precise identification of the cells and tissues that undergo necroptotic cell death in vivo has proven challenging in the absence of robust protocols for immunohistochemical detection. Here, we provide automated immunohistochemistry protocols to detect core necroptosis regulators – Caspase-8, RIPK1, RIPK3 and MLKL – in formalin-fixed mouse and human tissues. We observed surprising heterogeneity in protein expression within tissues, whereby short-lived immune barrier cells were replete with necroptotic effectors, whereas long-lived cells lacked RIPK3 or MLKL expression. Local changes in the expression of necroptotic effectors occurred in response to insults such as inflammation, dysbiosis or immune challenge, consistent with necroptosis being dysregulated in disease contexts. These methods will facilitate the precise localisation and evaluation of necroptotic signaling in vivo.

Global citizenship refers to a sense of belonging to a larger culture and humanity in general. It emphasizes the people's political, economical, social, and cultural interdependence and interconnection at the local, national, and global levels. This study explores university students' perceptions toward global citizenship knowledge, skills, and values in the Sultanate of Oman. To achieve this objective, a descriptive approach was followed by developing a questionnaire including 47 items covering three major dimensions of global citizenship education, namely cognitive, socio-emotional, and behavioral (CSeB). The questionnaire was tested to ensure its validity and reliability and applied to a study sample of 299 students (122 males and 177 females). The findings show statistically significant differences at ([alpha]=0.05) between the mean of students' responses who studied Global Citizenship Course (GCC) and those who did not. This reflects the effectiveness of the GCC on students' points of view. Also, the findings show a significant difference between students' points of view regarding the accommodation variable in the cognitive domain in favor of students who live with their families compared with those who live on-campus. GCC plays a significant role in developing student skills and pro-social behavior. The effort to establish a concept of global citizenship is a small step towards a better understanding of its impact and effect.

This study presents the polarization photodetection enhancement in Sb2Se3 nanotube (NT)‐based near‐infrared (NIR) photodetectors through simulation‐based and experimental investigations. High‐quality single‐crystal Sb2Se3 NTs are grown via chemical vapor deposition and characterized by using multiple techniques. The optical simulation reveals a remarkable difference in the light absorption ratio (specifically, absorption along the NT/nanowire (NW) against absorption perpendicular to the NT/NW) between Sb2Se3 NT and NW of the same size in the NIR region. The complementary photodetection experiments present that the fabricated Sb2Se3 NT photodetector demonstrates enhanced polarization photodetection in the NIR range, as indicated by a significantly increased dichroic ratio (3.03 at 850 nm) compared to that of similar‐sized NW counterpart (1.81 at 850 nm). Additionally, the Sb2Se3 NT photodetector exhibits exceptional performance, with a high responsivity of 4.18 A W−1 and specific detectivity of 8.94 × 1010 Jones under 830 nm light illumination. This study provides a comprehensive understanding of the microcavity resonance effect and its role in polarization photodetection enhancement, highlighting the potential of self‐assembled Sb2Se3 NTs in high‐performance near‐infrared polarized photodetection and other relevant applications.

Cardiac allografts suffer diastolic dysfunction early post-heart transplantation (HTx) due to ischemic injury, however the natural course of diastology recovery post HTx remains unknown (Tallaj et al., 2007 [1]). We retrospectively reviewed 60 adult HTx patients between 2015 and 2021 at a single site. Invasive hemodynamics and echocardiograms were obtained at 2 weeks and 1, 3, 6, and 12 months post-HTx. RA strain by 2D feature tracking was compared to intracardiac pressure measurements. In all patients, we observed normalization of RV and RA filling pressures by post-operative week 12 and recovery of diastolic dysfunction by month 6. There was an inverse correlation between RV end-diastolic pressure and RA contractile (r = −0.192, p

Introduction: Diuretics are the mainstay of maintaining and restoring euvolemia in the management of heart failure. Loop diuretics are often preferred, however, combination diuretic therapy (CDT) with a thiazide diuretic is often used to overcome diuretic resistance and increase diuretic effect. We performed an analysis of the GUIDE-IT study to assess all-cause mortality and time to first hospitalizations in patients necessitating CDT. Methods: Patients from the GUIDE-IT dataset were stratified by their requirement for CDT with a thiazide to achieve euvolemia. A total of 894 patients were analyzed, 733 of which were treated with loop diuretics alone vs 161 used either chlorothiazide or metolazone in addition to loop diuretics. Kaplan-Meir curves were derived with log-rank p-values to evaluate for differences between the groups. Results: There was no significant difference in all-cause mortality regardless of CDT utilization status (mean survival of 612.704 days vs 603.326 days, p = 0.083). On subgroup analysis, there was no significant difference in all-cause mortality amongst those using loop diuretics compared to CDT in the BNP-guided therapy group, (mean survival time 576.385 days vs 620.585 days, p = 0.0523), nor the control group (614.1 days vs 588.9 days; p = 0.5728). Time to first hospitalization was reduced in all using CDT compared to loop diuretics alone (280.5 days vs 407.2 days, p