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A minimum resolving set is a resolving set with the lowest cardinality and its cardinality is a dimension of connected graph , represented by . A dominating set is a set of vertices such that each of is either in or has at least one neighbor in . The dominance number of is the lowest cardinality of such a set. The lowest cardinality of the dominant resolving set is called a dominant metric dimension of , represented by . This paper presents an algorithm for finding the domination resolving number of a graph.

Abstract Background Osteoporosis (OP) is a common finding in diabetic patients especially high-risk populations such as postmenopausal women. Sclerostin is a glycoprotein chiefly secreted by mature osteocytes and is considered a main regulator of bone formation. The C1q/TNF-Related Protein 3 (CTRP3) was found to be significantly associated with OP in postmenopausal women. The effect of type 2 diabetes mellitus (T2DM) on sclerostin and CTRP3 levels in postmenopausal women is rarely investigated. The present study aimed to assess the impact of T2DM on sclerostin and CTRP3 levels and their relation to OP in postmenopausal women. Methods The study included 60 postmenopausal women with T2DM and 60 age-matched postmenopausal non-diabetic women. Bone mineral density (BMD) was assessed using dual energy X-ray absorptiometry (DEXA). Serum levels of sclerostin and CTRP3 were assessed using enzyme-linked immunosorbent assay (ELISA) technique. Results Diabetic group expressed significantly higher serum levels of sclerostin when compared with non-diabetic group (110.0 ± 29.0 versus 51.5 ± 23.2 ng; p

Background: Sleep disruptions impact health, correlating with cardiovascular disease, metabolic syndrome, and higher mortality. Irritable bowel syndrome (IBS) involves abdominal pain, altered stool habits, and gut microbiota dysbiosis. Objectives: To screen for obstructive sleep apnea among patients with irritable bowel syndrome. Patients and methods: This cross-sectional study at Qena University Hospital involved adults diagnosed with irritable bowel syndrome (IBS) per Rome IV criteria. Evaluations included personal data, general examinations for vital signs and BMI, and screening for obstructive sleep apnea (OSA) using the Epworth Sleepiness Scale and STOP-BANG Questionnaire. Results: The mean age of the study population was 46.77±12.24 years, with 45% male (135). Epworth Sleepiness Scale averaged 3.78 ± 6.72, with 14% (42) having excessive sleepiness (score>10). STOP-BANG score averaged [2.49 ± 1.89], classifying 72.33% (217) as low risk, 13% (39) as intermediate risk, and 14.67% (44) as high risk for obstructive sleep apnea (OSA). High-risk patients were older (mean age 56.75 years) and had higher BMI (38.77kg/m²) compared to low and intermediate risk groups (P

Abstract Typically, hydrogels are described as three-dimensional networks of hydrophilic polymers that are able to capture a certain mass of water within their structure. Recently, hydrogels have been widely used as drawing agents in forward osmosis (FO) desalination processes. The major aim of this study is to prepare a novel semi-interpenetrating hydrogel by crosslinking sodium alginate (SA) and polyvinyl alcohol (PVA) by using the epichlorohydrin (ECH) crosslinker and polyethylene glycol (PEG) interpenetrated within the hydrogel’s network as a linear polymer. Based on the optimum composition of SA/PVA composite hydrogel obtained from our earlier research, the effect of various percentages of PEG on the response of the hydrogel was investigated. The optimal composition of SA/PVA/PEG hydrogel was characterized by scanning electron microscopy (SEM), compression strength testing, Fourier transform infrared spectroscopy (FTIR), and X-ray diffraction (XRD). The morphological and mechanical properties of the SA/PVA/PEG semi-interpenetrating hydrogel were also compared to those of the SA/PVA composite hydrogel. Moreover, the performance of the optimal SA/PVA/PEG hydrogel in a FO batch unit as a drawing agent was investigated based on the optimal operation conditions from our previous experiments. The results showed that the optimal PEG/polymer blend mass ratio was 0.25, which increased the swelling ratio (SR) (%) of the hydrogel from 645.42 (of the neat SA/PVA hydrogel) to 2683. The SA/PVA/PEG semi-interpenetrating hydrogel was superior to the SA/PVA copolymer hydrogel in pore structure and mechanical properties. Additionally, in terms of FO desalination, the achieved water flux by SA/PVA/PEG hydrogel is higher than that accomplished by SA/PVA hydrogel.

Abstract Recently, hydrogels have been widely applied as draw agents in forward osmosis (FO) desalination. This work aims to synthesize bioartificial hydrogel from a blend of sodium alginate (SA) and polyvinyl alcohol (PVA) using epichlorohydrin (ECH) as a crosslinker. Then this prepared hydrogel was applied as a draw agent with cellulose triacetate membrane in a batch (FO) cell. The effects of the PVA content in the polymer blend and the crosslinker dose on the hydrogel’s swelling capacity were investigated to optimize the hydrogel’s composition. Furthermore, the water flux and the reverse solute flux of the optimum SA/PVA hydrogel were evaluated in a batch (FO) unit under the effect of the hydrogel’s particle size, feed solution (FS) temperature, FS concentration, and membrane orientation. Fourier transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM), X-ray diffraction (XRD) and compression strength tests were used to characterize the prepared hydrogel. Results revealed that the equilibrium swelling ratio (%) of 5228 was achieved with a hydrogel that had 25% PVA and a crosslinking ratio of 0.8. FO experiments revealed that the maximum water flux of 0.845 LMH achieved, when distilled water was used as FS, average hydrogel’s particle size was 60 µm, and the FS temperature was 40 °C.

Abstract Recently, fresh water resources have been limited globally. Thus, desalination has been the most recommended solution to overcome this issue. Forward osmosis (FO) is an affordable and developing desalination technique. In this current study, a cutting-edge green hydrogel was prepared from a polymer blend of flaxseed gum (FG) and sodium alginate using epichlorohydrin (ECH) as a crosslinker and polyethylene glycol (PEG) as a semi-interpenetrating network polymer. The impact of PEG incorporation on the hydrogel’s response was investigated, and the influence of different mass contents of FG and ECH on the swelling measurements of the hydrogel was studied to optimize the composition of the hydrogel. The optimum hydrogel was characterized by Fourier transform infrared spectroscopy, scanning electron microscopy, and X-ray diffraction and the compressive strength test. Furthermore, the behavior of the present hydrogel was examined as a draw agent in a batch FO unit. The water flux and the reverse solute flux were measured at various values of average hydrogel particle size and feed solution (FS) temperature and concentration. The optimal hydrogel of 0.3 PEG/polymer blend mass ratio, 12% FG, and 0.95 ECH/polymer blend mass ratio exhibits a swelling ratio (%) of 1800 after an hour and an equilibrium swelling ratio (ESR) (%) of 5300. The results of the FO experiments revealed that raising FS temperature and reducing FS concentration and average hydrogel particle size enhance water flux.

AbstractEmergent records propose that Aspergillus niger endophytic fungus is a vital source for various bioactive molecules possessing many biological properties. The current study was designed to inspect the antibacterial and anti-Toxoplasma potentials of Ficus retusa-derived endophytic fungi. After isolation and identification (using 18S rRNA gene sequencing) of A. niger endophytic fungus, LC/MS was utilized for identification and authentication of the chemical profile of the A. niger endophyte extract. Then, the fungal extract was assessed for its antibacterial and antibiofilm activities against Klebsiella pneumoniae clinical isolates. Additionally, its efficacy against Toxoplasma gondii was elucidated in vivo. The fungal extract displayed antibacterial activity against K. pneumoniae isolates with minimum inhibitory concentration values of 64–512 µg/mL. It also possessed a membrane potential dissipating effect using flow cytometry. Moreover, it formed distorted cells with rough surfaces and deformed shapes using a scanning electron microscope (SEM). Regarding its antibiofilm activity, it resulted in a dysregulation of the genes encoding biofilm formation (fimH, mrkA and mrkD) using qRT-PCR in nine K. pneumoniae isolates. The in vivo anti-Toxoplasma potential was demonstrated by decreasing the mortality rate of mice and reducing the tachyzoites’ count in the peritoneal fluids and liver impression smears of mice. In addition, the deformities of the parasite decreased, as revealed by SEM and the inflammation in tissues diminished. Thus, A. niger endophytic fungi could be a valuable source of antibacterial and anti-Toxoplasma compounds.

Abstract Background Sodium butyrate (SB) is a short-chain fatty acid and a safe antibiotic alternative. During 35 days, this study compared the impact of coated SB (Butirex C4) and lincomycin (Lincomix) on broiler growth, gut health, and litter hygiene in 1200 one-day-old Ross-308 broiler chicks that were randomly assigned into 5-dietary groups with 5-replications each. Groups divided as follows: T1: Basal diet (control), T2: Basal diet with buffered SB (1 kg/ton starter feed, 0.5 kg/ton grower-finisher feeds), T3: Basal diet with 100 g/ton lincomycin, T4: Basal diet with buffered SB (0.5 kg/ton starter feed, 0.25 kg/ton grower-finisher feeds) + 50 g/ton lincomycin, and T5: Basal diet with buffered SB (1 kg/ton starter feed, 0.5 kg/ton grower-finisher feeds) + 50 g/ton lincomycin. Birds were housed in a semi-closed deep litter house, where feed and water were available ad libitum. Results were statistically analyzed using ANOVA and Tukey’s post hoc tests. Results Combined dietary supplementation with SB and lincomycin (T4 and T5) significantly enhanced body weights, weight gains, feed conversion ratio, and profitability index. Also, carcasses in T4 and T5 exhibited the highest dressing, breast, thigh, and liver yields. T5 revealed the best blood biochemical indices, while T3 showed significantly elevated liver and kidney function indices. T4 and T5 exhibited the highest expression levels of IGF-1 and TLR4 genes, the greatest villi length of the intestinal mucosa, and the lowest levels of litter moisture and nitrogen. Clostridia perfringens type A alpha-toxin gene was confirmed in birds’ caeca, with the lowest clostridial counts defined in T4. Conclusions Replacing half the dose of lincomycin (50 g/ton) with 0.5 or 1 kg/ton coated SB as a dietary supplement mixture showed the most efficient privileges concerning birds’ performance and health.

Dental care accessibility is subject to a dentist’s qualification, practice and intention to treat patients, regardless of whether those patients have special healthcare needs (SCN) and should receive treatment in a dental setting. This multicentre study aimed to evaluate the characteristics of patients with SCN, their access to dental care and behaviour towards dental care from their caregiver’s perspective. In addition, the perspective of dental care providers who care for patients with SCN and the factors affecting the provision of treatment was also appraised. The Eastern Province of Saudi Arabia served as the site of this cross-sectional study from 1 February 2020 to 31 January 2022. Caregivers of 272 patients with SCN, regardless of age and gender, were recruited in the study. The caregiver’s proforma sought information on the demographic characteristics, type of disability, cooperation, medical history, occupation of the parent and patient’s behaviour towards oral hygiene and dental healthcare. The second proforma had the dental care provider’s perspective about the common disabilities, factors that affect the decision to provide treatment, difficulties patients face in getting their dental treatment and, from the dentist’s experience, recommendations to improve the access to dental care for patients with SCN. Statistical analysis was carried out by using SPSS version 22.0. The demographic features, caregiver’s perception about oral healthcare accessibility and dental professional’s point of view were presented as frequencies and percentages. Chi-square test was applied to compare the proportions. The majority of the caregivers were satisfied with the dental service providers (91.9%) for their patients with SCN. The dental care provider’s survey results indicated a shortage of dentists (54.7%) in the region and other factors that pose challenges to special care, like the severity of the disability of patients with SCN (50%), family structure (46.7%), treatment cost (35.6%) and transportation (32.8%). Patients with SCN in Saudi Arabia had a high appraisal of access to dental care and were very satisfied with dental treatment results. However, the presence of a dental care provider in the same rehabilitation centre was a major concern. The severity of the disability and the patient’s cooperation were the major factors that may have affected the decision of the dental care provider.

Let G = (V, E) be a connected, basic, and finite graph. A subset T=u1,u2,…,uk of V(G) is said to be a resolving set if for any y ∈ V(G), the code of y with regards to T, represented by CTy, which is defined as CTy=du1,y,du2,y,…,duk,y, is different for various y. The dimension of G is the smallest cardinality of a resolving set and is denoted by dim(G). If, for any t ∈ V – S, there exists r ∈ S such that S–r∪t is a resolving set, then the resolving set S is secure. The secure metric dimension of 𝐺 is the cardinal number of the minimum secure resolving set. Determining the secure metric dimension of any given graph is an NP-complete problem. In addition, there are several uses for the metric dimension in a variety of fields, including image processing, pattern recognition, network discovery and verification, geographic routing protocols, and combinatorial optimization. In this paper, we determine the secure metric dimension of special graphs such as a globe graph Gln, flag graph Fln, H- graph of path Pn, a bistar graph Bn,n2, and tadpole graph T3,m. Finally, we derive the explicit formulas for the secure metric dimension of tadpole graph Tn,m, subdivision of tadpole graph ST3,m, and subdivision of tadpole graph STn,m.

Abstract Heritage buildings are considered a source of pride for countries, and their preservation is an important pursuit. Different techniques have been adopted in this regard, and many review papers have addressed them either qualitatively or quantitatively through bibliometric analysis. Nevertheless, none of these review studies conducted a general dynamic quantitative analysis of the vast amount of scientific literature about heritage buildings preservation (HBP) research domain over time. Therefore, the current study performs a bibliometric analysis of the relevant literature considering a time of two decades (2002–2022). A total of 863 peer-reviewed journal articles were extracted from the Web of Science Core Collection database. A five-step methodology was followed employing VOSviewer, CiteSpace, and Biblioshiny as the bibliometric software tools. The main findings revealed the annual publication trends and the most prominent articles. It was also found that 60% of the literature publications were published in journals, and only 2.4% corresponded to review studies. The scientific collaboration networks showed the most prolific researchers and countries. Further, the citation analysis of journals identified the most reliable information sources for academic researchers. Finally, the conceptual and intellectual knowledge structures were visualised and studied via science mapping analysis to map the research domain evolution and determine its trending patterns and promising areas for future exploration. The conducted review provides fellow researchers with a systematic summarised database to be familiarized with the HBP literature and identify potential research opportunities to conduct state-of-the-art research with the top contributors in the field (researchers, journals, and countries). In addition, policymakers can utilize the results from this research to find expert authors and academic support to facilitate forming partnerships to plan and fund relevant research and address the practical implications of preserving valuable heritage buildings.

Objective: This study aimed to assess the public's perspectives and the health institutions' readiness for telehealth utilization in Egypt. Methods: A cross-sectional study design was employed, and data were collected from a convenient sample of 800 Egyptian citizens and 26 nursing administrators and information technology personnel from 16 governmental hospitals and 10 private hospitals between January and March 2022. The Egyptian community utilization of telehealth questionnaire and the telemedicine hospital readiness assessment were used to collect the data. Results: The results revealed that 35.1% of the general Egyptian population used telehealth services and 43% expressed willingness to use them in future. As perceived by the general Egyptian population, the most prevalent barriers to telehealth utilization were communication barriers (97.6%), lack of confidence in health professionals (77.6%), technological limitations (72.5%), the need for physical examination (25%), and privacy concerns (10%). Regarding hospital readiness, 42% of governmental hospitals were not taking any initiative to implement telehealth services, and 15.4% were at the beginner level, meaning that some steps had been taken. However, the hospital was still far from being able to implement telehealth services. In contrast, private hospitals were either at the beginner or advanced level. Conclusion: Although the use of telehealth services in Egypt has increased, there is a need to address the barriers to public utilization and improve hospitals' readiness to implement telehealth services to enhance public usage.

Abstract Background Adherence to preventive control measures is influenced by perception, attitudes, and practices toward the disease prevention. Aim To assess the perceptions, attitude, and practices of university students in three health sector faculties (Medicine, Nursing, and Pharmacy) from six Egyptian universities towards COVID-19 pandemic prevention. Methods An electronic online survey was distributed to students of 3 faculties (Medicine, Pharmacy, and Nursing) in six Egyptian universities from March to July 2021. The questionnaire consists of the following parts: socio-demographic data of participants, student perception and attitude towards the COVID-19 pandemic and its consequences, as well as practices of preventive measures in the community. Results The study included 1990 participants. Most respondents perceived the seriousness of the COVID-19 pandemic (88.2%). The rates of practicing precautionary measures were mostly high (approximately 90% or above). Significantly high attitude scores toward the pandemic were detected in people with quite-to-extremely concerned, very good/excellent status, aware of infection risk, willing to report positive cases and avoiding contact with them, and seeking medical advice regarding infection. The attitude to protective measures followed a similar pattern along with average health status, female students, and avoidance of contact when experiencing flu symptoms. Significantly higher practice scores were observed in those with bad health status, rural areas, perceiving the risk of infection, willing to report positive cases, and avoiding contact with positive cases. Conclusion The effectiveness of precautionary measures should be stressed to promote positive student practices.

Introduction Diabetes mellitus (DM) is a main, highly prevalent, and challenging public health issue. Suboptimal self-care for type II diabetes can lead to poor glycemic control, complications, and even death. Objective This study investigated the incidence of distress and its link with self-care habits of patients with diabetes type II. Methods A correlational, cross-sectional design with a convenient sample of 200 patients was used to conduct this study. Three questionnaires were administered: (A) the demographic and medical data questionnaire; (B) diabetes self-care activities in brief; and (C) the diabetes distress scale in Arabic language. Results The patients’ mean age was 51.78 ± 11.34; 80% of patients practiced lower levels of diabetes self-care, and 37% of them had a high level of diabetes distress. Self-care is associated with diabetes distress ( R = −0.152, p -value = .032). Conclusion Self-care activities can help in the early detection and management of diabetes distress. Sustained self-care education is promising to minimize diabetes distress. The potential advantages of association between diabetes distress and self-care can offer self-care programs that enhance diabetes distress management.

هدف البحث الى معرفة دلالة الفرق بين طلبة عينة البحث على اختبار حل المشكلات الكيميائية ككل وعلى كل مجال من مجالاته، تالفت عينة البحث من (200) طالب وطالبة من طلبة المرحلة الرابعة من جامعة بغداد كلية التربية للعلوم الصرفة/ ابن الهيثم/ قسم الكيمياء في الدراستين الصباحية والمسائية أي بنسبة (50%) من مجتمع البحث كانت أداة البحث اختبار حل المشكلات الكيميائية من (25 ( فقرة بواقع ستة مجالات باعتماد تصنيف هايز Hayes لحل المشكلات تمثلت ب (تحديد المشكلة، تمثيل المشكلة، اختيار خطة الحل، ايضاح خطة الحل، الأستنتاج، التحقق والتقويم)، تم التحقق من صدقه وثباته أظهرت النتائج الأحصائية للبحث انه يوجد فرق دال احصائيا بين طلبة عينة البحث في اختبار حل المشكلات العلمية ككل بدرجة مقبول كما أظهرت النتائج وجود فرق ذو دلالة إحصائية في كل مجال من مجالات حل المشكلات الكيميائية بين طلبة عينة البحث لمجالات (تحديد المشكلة، تمثيل المشكلة، اختيار خطة الحل، ايضاح خطة الحل، الاستنتاج) بدرجة مقبول، اما مجال التحقق والتقويم لم يكن دال احصائيا، وأوصى البحث ضرورة اهتمام كليات التربية بحل المشكلات الكيميائية على كافة مجالاته ودمجها في مقررات المواد الدراسية النظري والعملي.

Background There are no evidence‐based resources guiding the perioperative management of patients with moyamoya syndrome who are undergoing revascularization surgery. We investigated practice patterns among a transdisciplinary group aiming at identifying possible heterogeneity of practices on key components of care that warrant prospective studies. Methods We disseminated a web‐based Qualtrics survey internationally to physician members of the following: Neurocritical Care Society, Society of Critical Care Medicine, American Academy of Neurology, Society for Neuroscience in Anesthesiology and Critical Care, American Association of Neurological Surgeons, Asian Society of Neuroanesthesia and Critical Care, Indian Society of Neuroanesthesia and Critical Care, Japanese Society for Neuroscience in Anesthesiology and Critical Care, and World Federation of Neurosurgical Societies. The survey contained questions on demographics and aspects of preoperative, intraoperative, and postoperative care. Results Among the 175 physicians who managed at least 1 adult (aged ≥18 years) undergoing moyamoya revascularization in the preceding 24 months, 18 countries (United States, 84.6%) and 4 disciplines (anesthesiology [44.7%, 76/170], critical care medicine [30.6%, 52/170], neurology [32.4%, 55/170], and neurosurgery [15.3%, 26/170]) were represented. Anesthesiologists preferred total intravenous over volatile anesthesia (56.3%, 40/71 versus 42.3%, 30/71) and arterial line zeroing at the circle of Willis/tragus over the phlebostatic axis/right atrium intraoperatively (84.3%, 59/70 versus 11.4%, 8/70) and postoperatively (68.9%, 42/61 versus 24.6%, 15/61). Intraoperative blood pressure goals were primarily targeted to baseline blood pressure (34.8%, 48/138), whereas postoperative blood pressure goals were mainly determined by neurosurgeon preference (48.9%, 65/133). The predominant hemodynamic target was mean arterial pressure intraoperatively (50.4%, 68/135) and systolic blood pressure postoperatively (48.5%, 63/130). Crystalloid infusion was the preferred method to achieve perioperative hemodynamic goals (median rank, 1.0), followed by colloid infusion (median rank, 2.0) and phenylephrine (median rank, 2.0); however, colloid infusion and phenylephrine were considered contraindicated by 18.2% (10/55) and 20.0% (11/55), respectively. Conclusions We demonstrate perioperative practice heterogeneity for moyamoya syndrome revascularization among physicians for both methods and targets of hemodynamic management, constituting equipoise for prospective studies targeting optimal management strategies.

Two decades ago, nanotechnologies demonstrated various applications in different fields. As a result, exposure to such particles has been risen dramatically within the last century due to anthropogenic sources of nanoparticles. The wide application of nanomaterials in industry, consumer, and products have raised concerns regarding the potential toxicity of nanoparticles to humans. For this Engineered nano technology, materials have been proved to be with a great risk on human health and environment. For that reason, we now try to find solutions to mange this risks that many scientific studies prove it to be with a great dangerous impact. As an alternative solution, scientists work hard to extract natural nanomaterials from different sources of nature even from (agricultural crops – soil- sand ……..etc).The aim of the research is to focus on the potential uses of these extracted natural nanomaterials and study their physical and mechanical properties and application in interior design and furniture field, in a way to find Sustainable interior design using design principles such as functionality, and aesthetics and expands the focus to include environmental considerations by choosing materials with low environmental impacts.The research manipulated three components (Nano cellulose fibers sheets, nano clays and shellac) together structural properties and studied The advantages of those green nano materials and future trends and applications in the field of interior design.Two properties were examined on the prepared samples on this paper contact angle and water absorption For the purpose of mating between green nano-materials and interior design for use in creating a comfortable environment for humans and environment friendly.

The interactive inner space has become an integral part of the internal spaces that aim to spread culture and learning, to facilitate the delivery of thought and culture to all groups of the interacting society within the vacuum in all its age groups and also urges them to be creative and innovative. The interior designer aims to integrate the interior space with interactive technology, To discover every new result of technological progress, it may start by trying to employ new materials that technology has produced.And the research study here touched on to highlight the user's behavior inside the vacuum taking into consideration the type of activity taking place, and how to interact with the user by studying his behavior within the interactive activity environment to reach the highest efficiency and benefit from the interaction and integration between reality and imagination taking into account the requirements of functional, aesthetic, human and technological internal design.The interactive activity environment is a virtual environment in which reality and imagination are combined using modern methods and techniques, in which different forms of interaction between the user and the user occur, and between the user and another and finally between the user and interactive space tools and design elements. The interaction environment is an integrated continuous interactive circle through the compatibility of internal design elements such as walls, floors, roofs and work surfaces to serve the activity in the internal space with a study of the age group of users and their requirements and psychological and technological factors during the interaction; hence, that system is activated by choosing the appropriate interactive system to serve and enhance the requirements of the internal space Interactive.Thus, the circle of interaction within the vacuum is closed by the presence of an integrated vacuum in terms of the interactive system and communication between it and the user under the supervision of the specialist, and that the system includes methods for learning and innovation and obtaining new information related to the activity, the presence of specialists and educating those in work in the activity halls how to deal with and facilitate the interactive system On users.With clarification by mentioning an application of interactive activity within the space of a digital interactive museum for children.

Advancements in computing and data from the near universal acceptance and implementation of electronic health records has been formative for the growth of personalized, automated, and immediate patient care models that were not previously possible. Artificial intelligence (AI) and its subfields of machine learning, reinforcement learning, and deep learning are well-suited to deal with such data. The authors in this paper review current applications of AI in clinical medicine and discuss the most likely future contributions that AI will provide to the healthcare industry. For instance, in response to the need to risk stratify patients, appropriately cultivated and curated data can assist decision-makers in stratifying preoperative patients into risk categories, as well as categorizing the severity of ailments and health for non-operative patients admitted to hospitals. Previous overt, traditional vital signs and laboratory values that are used to signal alarms for an acutely decompensating patient may be replaced by continuously monitoring and updating AI tools that can pick up early imperceptible patterns predicting subtle health deterioration. Furthermore, AI may help overcome challenges with multiple outcome optimization limitations or sequential decision-making protocols that limit individualized patient care. Despite these tremendously helpful advancements, the data sets that AI models train on and develop have the potential for misapplication and thereby create concerns for application bias. Subsequently, the mechanisms governing this disruptive innovation must be understood by clinical decision-makers to prevent unnecessary harm. This need will force physicians to change their educational infrastructure to facilitate understanding AI platforms, modeling, and limitations to best acclimate practice in the age of AI. By performing a thorough narrative review, this paper examines these specific AI applications, limitations, and requisites while reviewing a few examples of major data sets that are being cultivated and curated in the US.

Cerebral Vasospasm is a common complication of aneurysmal subarachnoid hemorrhage (aSAH) which results in delayed cerebral ischemia. Cerebral vasospasm in elective endovascular management of intracranial aneurysms rarely has been reported, and the vasospasm in this situation results from irritation by the endovascular catheter. The choice of intra-arterial (IA) vasodilators is variable among clinicians. Many studies describe the use of intra-arterial vasodilators in the neurosurgery and neuroradiology literature and comment that it is safe without major complications. Calcium-channel blockers are reported to be safe in regards to hemodynamics and potential complications. Nimodipine is considered the only calcium channel blocker that has neuroprotective effect and the only vasodilator that proved to improve outcome. The use of Intra-arterial verapamil has been reported in the last 2 decades, and with the frequent and safe use, the doses are reported to be higher in the recent reports with no major complications. We report the first case series where the use of high dose Intra-arterial verapamil resulted in postoperative pulmonary edema. Neurosurgeons and neuroanesthesiologists need to be aware of the potential complications from the use of verapamil as a negative inotropic agent in this patient population. Keywords: Cerebral vasospasm, Endovascular treatment of cerebral vasospasm, Intra-arterial vasodilators, Intra-arterial verapamil, Verapamil induced pulmonary edema

Background and aim: Group B Streptococcus (GBS) has emerged as a leading cause of illness and death among neonates. The study was conducted to estimate the prevalence of recto-vaginal carriage of GBS among pregnant women at 35–37 weeks, gestation, to describe GBS antimicrobial susceptibility profile and to investigate selected virulence genes by PCR. Subjects and methods: Two-hundred pregnant women at 35–37 weeks of gestation attending antenatal clinic at Al-Shatby University Hospital were enrolled in the study. Both vaginal and rectal swabs were collected from each subject. Swabs were inoculated onto CHROMagar™ StrepB and sheep blood agar plates. All GBS isolates were subjected to antimicrobial susceptibility testing using disc diffusion. Disc approximation test was performed to detect erythromycin resistance phenotype (MLSB). GBS virulence genes scpB, bac, bca, and rib were identified by PCR. Results: Among the 200 pregnant women, 53 (26.5%) were identified as GBS carriers. All carriers had vaginal colonization (100%), four (7.5%) had combined recto-vaginal colonization. None of the carriers had rectal colonization alone. All isolates (100%) were susceptible to penicillin, ampicillin, ceftriaxone, cefotaxime, cefepime, vancomycin, and linezolid. On the other hand, 43.4%, 28.3%, 22.6%, and 15% of isolates were resistant to levofloxacin, azithromycin, erythromycin, and clindamycin respectively. Out of 12 erythromycin resistant isolates, six isolates had constitutive while two had inducible MLSB resistance. scpB was identified in 100%, rib in 79.2%, and bac in 35.8% of GBS isolates. None of the isolates possessed the bca gene. Conclusion: Introduction of GBS screening in Egyptian pregnant women is recommended. Penicillin or ampicillin is still the antibiotic of choice for intrapartum prophylaxis.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

The objective of this study is to evaluate the effect of various filler types on the fresh and hardened properties of self-compacting concrete (SCC) and Flow-able concrete. For this purpose, two groups of fillers were selected. The first group was pozzolanic fillers (silica fume and metakaolin) while the second group was non-pozzolanic fillers (limestone powder, granite dust and marble dust). Cement contents of 400 kg/m3 and 500 kg/m3 were considered while the used filler material was 7.5%, 10% and 15%. Slump and slump flow, T50, sieve stability and bleeding tests were performed on fresh concrete. The studied hardened properties included unit weight, voids ratio, porosity, and water absorption and cube compressive strength. In addition, thermo-gravimetric analysis, X-ray diffraction analysis and scanning electronic microscope were performed. The test results showed that filler type and content have significant effect on fresh concrete properties where non-pozzolanic fillers improve segregation and bleeding resistance. Generally, filler type and content have significant effect on unit weight, water absorption and voids ratio. In addition, non-pozzolanic fillers have insignificant negative effect on concrete compressive strength. Finally, there was a good correlation between fresh concrete properties and hardened concrete properties for SCC and Flow-able concrete.

Dental care accessibility is subject to a dentist's qualification, practice and intention to treat patients, regardless of whether those patients have special healthcare needs (SCN) and should receive treatment in a dental setting. This multicentre study aimed to evaluate the characteristics of patients with SCN, their access to dental care and behaviour towards dental care from their caregiver's perspective. In addition, the perspective of dental care providers who care for patients with SCN and the factors affecting the provision of treatment was also appraised. The Eastern Province of Saudi Arabia served as the site of this cross‐sectional study from 1 February 2020 to 31 January 2022. Caregivers of 272 patients with SCN, regardless of age and gender, were recruited in the study. The caregiver's proforma sought information on the demographic characteristics, type of disability, cooperation, medical history, occupation of the parent and patient's behaviour towards oral hygiene and dental healthcare. The second proforma had the dental care provider's perspective about the common disabilities, factors that affect the decision to provide treatment, difficulties patients face in getting their dental treatment and, from the dentist's experience, recommendations to improve the access to dental care for patients with SCN. Statistical analysis was carried out by using SPSS version 22.0. The demographic features, caregiver's perception about oral healthcare accessibility and dental professional's point of view were presented as frequencies and percentages. Chi‐square test was applied to compare the proportions. The majority of the caregivers were satisfied with the dental service providers (91.9%) for their patients with SCN. The dental care provider's survey results indicated a shortage of dentists (54.7%) in the region and other factors that pose challenges to special care, like the severity of the disability of patients with SCN (50%), family structure (46.7%), treatment cost (35.6%) and transportation (32.8%). Patients with SCN in Saudi Arabia had a high appraisal of access to dental care and were very satisfied with dental treatment results. However, the presence of a dental care provider in the same rehabilitation centre was a major concern. The severity of the disability and the patient's cooperation were the major factors that may have affected the decision of the dental care provider. [ABSTRACT FROM AUTHOR]