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Background: Pelvic floor dysfunction (PFD) in women is attributed to several disorders that affect the supporting structures of the female pelvic organs and cause urinary incontinence, pelvic pain, and sexual dysfunction. Studies indicate a significant global prevalence of pelvic floor dysfunction, affecting almost half of the women worldwide. At the same time, the complex underlying mechanisms and specific risk factors remain complex. Methods and Results: The cross-sectional study involved 427 women in the Qassim region. The study utilized a convenience sampling technique to recruit participants. The questionnaire, covering socio-demographic data, clinical characteristics, and risk factors, was distributed online through social media platforms like Telegram and WhatsApp. The data collected was analyzed using SPSS version 27.0. The four components of PFD (sexual function, bowel function, prolapse symptoms, and bladder function) were analyzed. The prevalence of sexual function, bowel function, prolapse symptoms, and bladder function were 42.5%, 42.8%, 58.2%, and 63.3%, respectively. In each group, there were statistically significant differences (P

Background: Testicular cancer (TC) is one of the most prevalent malignancies that develops in young adult males aged 15–40 years. This study aimed to assess and evaluate the prevalence, incidence, clinical symptoms, and management of TC in the Qassim region of Saudi Arabia. Methods and Results: This retrospective study was conducted at King Fahad Specialist Hospital in Buraidah, Qasim Region, Saudi Arabia. The study population comprised 14 patients diagnosed with TC between October 2017 and July 2024, with complete medical records. Most patients (64.3%) were aged between 20 and 30 years. All patients exhibited symptoms, primarily testicular swelling (42.9%) or a combination of testicular swelling and pain (28.6%). Seminoma was the most prevalent histological type (64.3%), with lesions more frequently located in the right testicle (57.1%) and most tumors measuring ≤4 cm (85.7%). Concerning tumor markers, half of the patients exhibited elevated beta-human chorionic gonadotropin (ß-hCG) levels (50%). In contrast, alpha-fetoprotein (AFP) and lactate dehydrogenase (LDH) levels were elevated in fewer cases (21.4% and 35.7%, respectively). Most patients presented with early-stage tumors—T1a (28.6%), T1b (35.7%), and T2 (28.6%), the predominant stages observed. Lymph node involvement was minimal, with a significant portion classified as N0 (71.4%), while a smaller group exhibited N2 involvement (21.4%). Notably, none of the patients demonstrated distant metastasis (M0). A substantial proportion of patients received adjuvant treatment (92.9%), and the primary surgical approach employed was open radical inguinal orchiectomy (78.6%). Nearly all patients completed their therapy (92.9%), with follow-up durations predominantly within one year (57.1%) or extending to 1–3 years (35.7%). There were no recorded cases of recurrence. Sperm cryopreservation was done for 5(36.7%) patients. Conclusion: The study findings highlighted testicular swelling as the most common presenting symptom, with seminoma being the predominant subtype. Notably, the right testicle was more frequently affected, and elevated ß-hCG levels were observed as a common biomarker for TC.

Klippel-Feil syndrome (KFS) is a rare congenital disorder characterized by the fusion of cervical vertebrae, with a clinical presentation that can vary widely due to genetic and phenotypic diversity. While KFS can occur as an isolated anomaly, it is often associated with other congenital conditions, such as Sprengel deformity, which may present with or without an omovertebral bone, complicating diagnosis and management. This particular case also involves diffuse large B-cell lymphoma (DLBCL), the most common subtype of non-Hodgkin lymphoma. We hereby present a complex case of a 60-year-old male with the co-occurrence of KFS, Sprengel deformity, and DLBCL. Diagnostic imaging revealed an ill-defined right neck mass on ultrasound which was confirmed on neck CT. The CT also demonstrated an elevated left scapula and a left omovertebral bone, indicative of Sprengel deformity. There was fusion of the C5 and C6 vertebrae consistent with KFS. A whole-body F-18 FDG PET scan demonstrated significant uptake in the neck mass, leading to a biopsy that confirmed DLBCL. This case highlights the importance of comprehensive medical and imaging evaluations in diagnosing and managing the complexities associated with these disorders. In particular, awareness of the potential co-existence of congenital abnormalities and aggressive malignancies is critical in such cases.

Abstract Background This study examines the effectiveness of arbuscular mycorrhizal fungi (AMF, Rhizophagus irregularis) as a bioprotection strategy to improve wheat’s physiological and biochemical responses. This study utilized soil inoculation with AMF and plant-controlled infestation with aphids, conducted over four weeks with three replicates per treatment. Results Although aphid infestation reduced root colonization by 26.8% and hyphal length by 30.7%, with no effect on arbuscular numbers (p

Osteoid osteoma (OO), a benign bone-forming tumor estimated to account for 3% of all primary bone tumors, rarely occurs in the finger. This case report presents an unusual instance of osteoid osteoma in the finger of a 15-year-old male patient. The lesion was discovered following an initial patient visit for left middle finger pain and swelling for one year without any identifiable injuries.

Non-orthogonal multiple access (NOMA) is well known for enhancing the spectral and energy efficiency by allowing multiple users to share the network resources more effectively. While most existing studies focus on downlink NOMA, this paper shifts the focus to uplink NOMA, presenting novel generalized closed-form bit error rate (BER) performance analysis for imperfect successive interference cancellation (SIC) receivers under fading channels. To accommodate various scenarios, the derived expressions are generalized for any arbitrary rectangular/square M-ary quadrature amplitude modulation order, number of NOMA users, and number of base station antennas. It is shown that these expressions are essential for designing optimal uplink power allocation (PA) strategies and mitigating SIC error floors, as evidenced by the proposed PA algorithm which achieves significant performance gains. The results also show that the BER performance of uplink NOMA can surpass that of its orthogonal multiple access counterpart under certain operating conditions and equivalent transmission rates and powers.

BACKGROUND: Patient satisfaction is a paramount measure of the quality of healthcare system, particularly in the practice of family medicine. The study aimed to assess patients’ satisfaction with services provided by family physicians (FPs) at Comprehensive Healthcare Centers (CHCCs) in Northern Jordan. MATERIALS AND METHODS: A cross-sectional study was conducted at 11 CHCCs in Northern Jordan between July and October 2023. A convenient sample of 367 patients, both males and females over the age of 18 years, was selected. Participants were requested to complete the Arabic version of the Consultation Satisfaction Questionnaire (CSQ). Mean and standard deviation calculated for continuous variables, and frequencies and percentages for categorical variables. Multivariable logistic regression analysis yielded factors related to patients’ satisfaction with family physician. RESULTS: The mean score of patients’ satisfaction was 55.63 ± 12.15. The highest mean satisfaction scores were reported for the “professional care” provided by the FP (72.41 ± 15.9), followed by the “depth of relationship and the length of consultation” with the FP, respectively. Patients who had a reference health center if needed (P < 0.002), had health insurance (P < 0.05), patient’s privacy (P < 0.027), and waiting time < 20 min to see the FP (P < 0.001) were all positively associated with the status of patients’ satisfaction. Logistic regression final model included only two factors, waiting time < 20 minutes and having a reference health center. CONCLUSION: The study reveals moderate patient satisfaction with care provided by FP. The moderate satisfaction is attributed to good care provided by FP and the least to the length of consultation. The predictors of satisfaction are the waiting time to see FP and the availability of a reference health center. Study has implications for the health care system in Jordan, as regards the strengthening of the health information system to incorporate policies on appointments, quality of consultation times, and waiting times.

Abstract Cancer cells exhibit altered metabolism, often relying on glutamine (Gln) for growth. Breast cancer (BC) is a heterogeneous disease with varying clinical outcomes. We investigated the role of the amino acid transporter SLC1A5 (ASCT2) and its association with BC subtypes and patient outcomes. In large BC cohorts, SLC1A5 mRNA (n = 9488) and SLC1A5 protein (n = 1274) levels were assessed and correlated their expression with clinicopathological features, molecular subtypes, and patient outcomes. In vitro SLC1A5 knockdown and inhibition studies in luminal BC cell lines (ZR-75-1 and HCC1500) were used to further explore the role of SLC1A5 in Gln metabolism. Statistical analysis was performed using chi-squared tests, ANOVA, Spearman’s correlation, Kaplan–Meier analysis, and Cox regression. SLC1A5 mRNA and SLC1A5 protein expression were strongly correlated in luminal B, HER2 + and triple-negative BC (TNBC). Both high SLC1A5 mRNA and SLC1A5 protein expression were associated with larger tumour size, higher grade, and positive axillary lymph node metastases (P

Background: Surgeons generally avoid compromising tendon insertions during fracture fixation; however, it is a common practice to violate the triceps tendon insertion during olecranon plate fixation. The assumption in these procedures is that minimal triceps insertion is disrupted. The purpose of this study was to quantify the degree of triceps insertion that is violated, intentionally peeled off, by commonly utilized olecranon plating systems. The secondary objectives are to measure the surface area of the triceps insertion and olecranon using a 3-dimensional (3D) technique and compare them to 2 similar papers that were done using 2-dimensional (2D) measurements. Evaluating the amount of olecranon plates’ violation to the triceps insertion was not one of the objectives of those papers. It was hypothesized that olecranon plate fixation violates a larger portion of the triceps footprint than previously thought. Methods: Six olecranon plate designs and 12 cadaveric upper-extremity specimens were used. Olecranon plates, triceps insertion footprints, and olecranon surface areas were digitized as 3D surface models with a laser scanner (SG100; ShapeGrabber Inc., Ottawa, Canada). The violated triceps insertion footprint area, required to accommodate the plate surface on the olecranon, was calculated using 3D modeling software (MeshLab; ISTI - CNR Research Center, Pisa, Italy). Results were compared with both 2D and 3D measurements and the 2D surface area measurements of 2 previous studies. Results: The median triceps insertion footprint violation for 6 common olecranon plates was 46% (range, 40%-62%) using 3D analysis, and 47% (range, 41%-64%) using 2D analysis. The greatest footprint violations were observed with Synthes – Wide VA at 62% and Smith-Nephew Peri-LOC (Smith & Nephew, Andover, MA, USA) plates at 58%, while the least violation was seen with Wright Medical EPS (Wright Medical, Memphis, TN, USA) and Synthes – Extended (DePuy Synthes, Raynham, MA, USA) plates at 40%. The median triceps insertion surface area was 254 mm2 (range, 193-348 mm2) and 260 mm2 (range, 171-364 mm2) using 2D and 3D methods, respectively. Median olecranon surface area was 645 mm2 (range, 478-775 mm2) and 573 mm2 (range, 411-722 mm2) by 2D and 3D methods, respectively. Conclusions: Many commonly used olecranon plating systems violate a large portion of the triceps insertion footprint which is up to 62% in this study. A better understanding of the triceps insertion footprint, olecranon anatomy, and clinical implications of triceps footprint disruption may lead to improvements in olecranon plate design and postoperative outcomes. Future studies should assess the possibility of any clinical implications of triceps insertion disruption.

Abstract Background Immune checkpoint inhibitors (ICIs) have revolutionized the management of cancer patients, but the emergence of ICI-related endocrinopathies (IREs) has introduced new clinical challenges. Despite worldwide recognition of these adverse effects, data from the Middle East is scarce. Methods This retrospective-observational study included adult cancer patients who received at least one dose of ICI between January 2015 and January 2023. Descriptive statistics and multivariable regression (MVR) models were applied to delineate the incidence and clinical impact of IREs. Results The median age of 649 included patients was 55 years, with male preponderance (70.7%). The incidence of IREs was 26.7%, dominated by primary hypothyroidism (62.4%), insulin deficiency (15%), and primary hyperthyroidism (13.9%). Pembrolizumab (62%) was the most utilized ICI among the study cohort, followed by nivolumab (23.7%), atezolizumab (12.5%), durvalumab (0.9%), avelumab (0.6%) and ipilimumab (0.1%). The mortality rates in the cohort and the IRE subgroup were 43.4% and 42.2%. MVR revealed age (OR 1.02, 95% CI (1.003–1.03), P = 0.02), pre-ICI white-cell (WBC) count (OR 0.94, 95% CI (0.89–0.99), P = 0.04), pembrolizumab (OR 2.6, 95% CI (1.05–6.3), P = 0.04), and nivolumab use (OR 2.6, 95% CI (1.04–6.6), P = 0.04) as significant predictors of IREs. After MVR, factors influencing mortality in the subgroup with IREs included a higher age (OR 1.1, 95% CI 1.04–1.2, P = 0.001) and platelet-to-lymphocyte ratio (OR 1.004, 95% CI 0.7–1.4, P = 0.006). Conclusions This first extensive Middle Eastern and South Asian cohort reported a higher-than-previously known incidence of IREs. Hypothyroidism, insulin deficiency, and hyperthyroidism were the commonest IREs, with pembrolizumab being the commonest ICI. IRE development was associated with higher age, a low WBC count, pembrolizumab, and nivolumab use. The development of IREs did not seem to influence mortality. Further research on IREs is imperative to optimize management guidelines in the era of precision medicine.

The research explores the complexities and challenges of preserving and developing historic towns, focusing on sustainable urban development in Jerash. The study emphasizes the significance of maintaining and restoring historic buildings and urban spaces to yield benefits in aesthetics, tourism, local economy, and property values. It highlights the urgency of integrating conservation measures into development strategies to promote cultural heritage planning, adaptive reuse, and overall revitalization. The rapid urbanization in Jordan has led to increased pressure on historic resources, necessitating the preservation of cultural heritage as essential capital. The study outlines the importance of sustainable urban development in historic towns, considering the diverse values they offer, including architectural accomplishments, historical significance, economic return, environmental quality, and social functions. A case study of Jerash illustrates the historic and cultural significance of the town, showcasing its unique urban setting with Roman architectural remains and a rich history spanning over 6500 years. The research discusses current urban development initiatives in Jerash, addressing the challenges posed by socioeconomic factors, population growth, and the transformation from a colonial to a tourist urban economy. The study underscores the need for an integrated approach to sustainable urban development that balances growth and conservation, leveraging the town's cultural, social, and physical components. The research provides strategies for sustainable urban development, focusing on the preservation and conservation of cultural heritage, innovative urban planning and design approaches, community engagement, and participation. Through comprehensive analysis and evaluation, the research aims to contribute valuable insights for future urban development projects in historic towns, ensuring their sustainability and continued significance as cultural and historical treasures.

Summary: Friction stir lap welding (FSLW) of dissimilar Aluminum alloys (AA1100 with AA6061) is ‎investigated using a 3 ‎mm sheet’s thick. These alloys are difference in physical characteristics, strength, and melting temperatures, at different tool ‎rotation speeds (560,900 and 1400) rpm and various feed rate (16, 40 and ‎‎125) mm/min, with ‎cylindrical pin geometry having two tilt angle: 0°, 3° was used. Copper particles were added ‎to ‎the weld zone to make composite friction stir welded joints using the best welding ‎conditions. Many tests and ‎inspections were carried out to evaluate the joint quality and the ‎soundness of weldments. The highest value of tensile strength and efficiency at (1400, 40, 3̊) while hardness recorded (97.5HV) at stir zone of FSLW and it go downs along the HAZ and base metals of AA1100 and AA6061.

Abstract Objectives Sialendoscopy has become the standard treatment for sialolithiasis; however, larger submandibular calculi may require an incisional technique. This study describes and evaluates an intraoral microscopic‐assisted sialolithotomy (IMAS) as a refined submandibular stone extraction technique. Methods Retrospective case series of 64 submandibular IMAS procedures operated at a tertiary university center and private hospital from 2015 to 2021 were evaluated. Preoperative radiological assessment included noncontrast computed tomography scan ± magnetic resonance sialography. Stone characteristics (side, number, size, and location), operative findings, complications, and postoperative follow‐up were reviewed. Success was defined as successful intraoral stone extraction with no symptoms or stone recurrence for at least 12 months postoperatively. Results The study included 43 males and 19 females, mean age 38 ± 12 years. Two patients had bilateral stones. All but one operated gland had stones extracted (98.4%), however the true success was 93.8% (60/64) as three patients had recurrent/residual stones within a year. Biggest stone longest diameter was 9.8 ± 4.6 mm (range, 5–30 mm). Hilar and intraglandular stone locations were 73.4% and 6.3%, respectively. Median operative time was 55 min. Adjunctive sialendoscopy was performed in 42.2%. Its use is significantly correlated with having ˃3 stones (mean 3.4 vs. 1.2 stones) [P

Background: Emergency and primary health care (PHC) are critical settings for addressing urological health problems and related emerging complaints. Therefore, physicians in these fields must possess the knowledge, skills, and competencies to diagnose and manage common urologic presentations accurately. This study aimed to evaluate the general level of knowledge about common urological problems among PHC and emergency room physicians in Qassim province, Saudi Arabia. Methods and Results: A cross-sectional questionnaire-based study included 82 PHC and emergency room physicians. The study was mainly a descriptive study utilizing non-probability convenience sampling of all participants who completed online or hardcopy surveys. As for the urological knowledge, it was found that 40.2% of the participants knew correctly that prostate-specific antigen (PSA) screening should be performed on a 60-year-old man who presents with urinary retention. In addition, 40.2% knew that patients should be referred for further urological evaluation of hematuria if they have a single episode of gross hematuria, a finding of microhematuria on 3 successive urine analyses, or when persistent microhematuria after treatment with antibiotics is present. Only 23.2% knew that when inserting a Foley catheter in a man, it is appropriate to inflate the balloon after the catheter has been inserted at its full length or when urine return is noted. More than half (58.5%) knew that patients should be referred to a urologist if they have a nodular prostate. Only 24.4% knew that the best test to evaluate for the presence of a kidney stone is a CT abdomen/pelvis, and 63.4% correctly defined microscopic hematuria. As for the participants’ urological skills, 70.7% agreed that they were proficient in performing a digital rectal examination and 76.9% said they performed male genitourinary examinations; 87.8% agreed that they are proficient in taking sexual history, 23.2% performed digital rectal examination >20 times, and 31.7% performed male genitourinary examination >20 times; 79.3% agreed they were proficient in performing male urinary catheterization, while 79.3% were proficient in performing female urinary catheterization. Only 24.4% were proficient in the insertion of a suprapubic catheter. As for the practice frequency, 37.8% performed male urinary catheterization more than 20 times, while only 12.2% performed it for females at the same frequency. Conclusion: The general knowledge of emergency and PHC physicians in the Qassim region appears insufficient. The study identified significant gaps in urological knowledge among these physicians, highlighting the need for adequate training programs to bridge these gaps.

Background: Urethral stricture (UrS), a narrowing of the urethra, is caused by many etiologies and can vary in severity. This condition can lead to various urinary symptoms and complications, resulting in emergency room visits and hospital admissions. This study aimed to assess the demographics, clinical characteristics, management, and outcomes of people with urethral stricture in the Qassim Region of Saudi Arabia. Methods and Results: This retrospective study included all cases of urethral stricture treated at King Fahd Specialist Hospital (KFSH), Buraydah, Saudi Arabia, between October 2017 and July 2024. The complete records of 90 UrS patients of all ages were analyzed. The study recorded the age, clinical characteristics, management, and outcomes of UrS patients. All patients were male. The mean age of the patients was 41.13±16.61 years, with 55.6% under 41. In most of the cases (95.6%), urethral strictures were symptomatic, commonly presenting lower urinary tract symptoms (LUTS) (87.2%), followed by urinary tract infection (UTI) (3.4%), acute urine retention (2.3%), and dysuria (2.3%). Regarding the cause, most cases were found to be idiopathic (81.1%), followed by post-infectious causes (6.7%) and traumatic causes (5.6%). Iatrogenic causes were identified in only two patients (2.2%), as well as urethral stones in 2(2.2%) patients. Most strictures occurred in the bulbomembranous region of the urethra (83.5%). Regarding treatment modalities, visual internal urethrotomy was done for 82(91.2%) patients and follow-up for 3(3.3%) patients. In most cases, 64.4% of strictures were successfully treated, while the strictures recurred in 35.6% of patients. Conclusion: Urethral stricture disease was common among males under 41 who presented with LUTS and UTI to King Fahd Specialized Hospital. Most of the cases were idiopathic, followed by post-infectious causes and traumatic causes, and most of the strictures occurred in the bulbomembranous urethra. Visual internal urethrotomy is commonly used for both visualization and treatment of urethral stricture. The study highlights the importance of using modern technology to facilitate a comprehensive and systematic approach to understanding the underlying pathology of urethral stricture. It is particularly important to rule out other potential causes, especially when there was no apparent cause initially.

Background: Urinary bladder cancer (UBC) is one of the most common cancers worldwide. According to the 2020 Cancer Incidence Report in Saudi Arabia, there were 348 cases of UBC recorded among Saudi nationals in 2020, with 291 cases (83.62%) occurring in males and 57 cases (16.38%) in females. This study aims to assess and evaluate the prevalence, incidence, clinical symptoms, and management of UBC in the Qassim Region. Methods and Results: This retrospective study was conducted over 12 months at King Fahad Specialist Hospital in Buraidah, Saudi Arabia. The study population comprised all patients diagnosed with UBC between October 2017 and July 2024, with complete medical records, irrespective of age, gender, or nationality. Of 75 UBC patients, 81.3% were males, most participants (68.0%) were above 60, and Saudis comprised 85.3%. Hematuria was the most common symptom, reported in 57.3% alone and in 10.7% of cases with other symptoms. Most patients underwent TURBT (89.3%), while 8.0% underwent radical cystectomy. Surgical margins were negative in 96.0% of patients, and recurrence was noted in 37.3%. Histopathological analysis revealed that 97.3% of the tumors were classified as TCC. Squamous cell carcinoma and urothelial carcinoma with squamous differentiation accounted for 1.3% in each case. Most of the tumors were low-grade and non-muscle invasive. The most frequent stage was TaN0M0, reported in 44% of cases, followed by T1N0M0 at 37%. Less common stages included T1N1M0 and T2aN0M0, each accounted for 2% of the cases. Rarer stages, including TisN0M0, T2N2M0, and T3N0M0, each accounted for 1%. Conclusion: This study reports the predominance of UBC in males and older populations, with TCC as the most common histological type. Hematuria is the primary symptom, reported in more than half of the patients, indicating its critical role in early diagnosis. A significant recurrence rate necessitates rigorous surveillance post-treatment.

Abstract Endothelial cells (ECs) form a tissue-specific barrier for disseminating cancer cells in distant organs. However, the molecular regulation of the ECs in the metastatic niche remains unclear. Here, we analyze using scRNA-Seq, the transcriptional reprogramming of lung ECs six hours after the arrival of melanoma cells in mouse lungs. We discover a reactive capillary EC cluster (rCap) that increases from general capillary ECs in response to infiltrating cancer cells. rCap is enriched for angiogenic and inflammatory pathways and is also found in human lung datasets. The JAK-STAT activated oncogenic Pim3 kinase is a marker of rCap, being upregulated in spontaneous metastasis models. Notably, PIM inhibition increases vascular leakage and metastatic colonization and impairs the EC barrier by decreasing the junctional cadherin-5 and catenins α, β and δ. These results highlight the pulmonary endothelium’s plasticity and its protection by PIM3, which may impair the efficacy of PIM inhibitors in cancer therapies.

Background Enhanced Recovery After Surgery (ERAS) has been established in various surgical specialties. This prospective controlled randomized study was intended to assess the efficacy of implementing intravenous lidocaine infusion with enhanced recovery after pancreatic surgery (ERAPS) program on postoperative patients’ outcomes.Methods Thirty patients aged 30 to 70 years, of ASA class II who underwent elective pancreatic cancer surgery under general anesthesia were divided into two equal groups, Group L received IV lidocaine infusion, and Group S received IV saline. Postoperative pain intensity was our primary outcome, total postoperative epidural bupivacaine consumption, hospital stay, gastro-intestinal recovery, time to first ambulation, hospital stay duration, effect on immune response and perioperative complications were secondary outcomes.Results The visual analog scale (VAS) scores for pain were significantly lower in Group L compared with those in Groups S (p 0.05). Natural killer cell isolation and cytotoxic lymphocytes count decreased in both studied groups postoperatively in comparison to preoperative value and this reduction was significantly detected in Group S when compared with Group L (p = 0.001). The function of natural killer cell and cytotoxic lymphocytes with or without stimulation enhanced in Group L while it suppressed in Group S postoperatively in comparison to preoperative reading and significant difference was recorded between the two groups (p = 0.001).Conclusion Implementation of lidocaine in ERAS protocol in patients with cancer pancreas undergoing pancreatic surgery decreased pain score, reduced post-operative epidural bupivacaine consumption, shortened time to return of bowel sound, and enhanced patient ambulation and the patient’s immunity.

Abstract Background The use of electronic nicotine delivery systems (ENDS), including e-cigarettes, vape pens, hookah pens, e-cigars, and e-pipes, has grown in popularity worldwide, particularly among young individuals. However, these products are not without risks, as their emissions may contain harmful substances such as diacetyl (a flavoring agent linked to specific pulmonary problems in high concentrations), tobacco-specific nitrosamines, and volatile organic compounds with unknown long-term effects on lung health. Objective This systematic review and meta-analysis aimed to assess the prevalence of ENDS use among school and college students on a global scale. Methods A comprehensive search was conducted in PubMed, Scopus, Cochrane Library, and Web of Science databases. Two researchers independently selected and extracted data from the identified studies. The pooled prevalence of ENDS use among school or college students was calculated using a random-effect meta-analysis. Results The systematic review encompassed 146 studies with 4,189,145 subjects from 53 countries and six continents. The overall current prevalence of ENDS use was 10.2%, indicating a significant presence of this behavior among students. Moreover, ENDS current use was higher among males (10.2%) than females (7.5%). In comparison, the lifetime prevalence was 22.0%, indicating that a substantial portion of students have tried these products but do not continue to use them regularly. Conclusion Our meta-analysis reveals a significant prevalence of ENDS use among school and college students globally, with higher rates observed among males than females. The lifetime prevalence of ENDS indicates that many students have tried or are currently using these products. The current prevalence of ENDS use was 10.2%, with notable variations across different continents.

Little is known about granite outcrops in arid regions. The current study sought to determine if granite outcrops generate wetter islands compared to their arid surroundings. Forty independent phytosociological stands dealing with granite outcrops (25 stands) and nearby matrix (15 stands) vegetation were sampled. A total of 146 species of vascular plants were identified, categorised into 39 families and 106 genera. Results recorded more taxa in granite outcrops than in their matrix; specifically, there were 29.2% more species, 33.8% more genera and 26.6% more families in the granite outcrops than in their matrix. Only 16 species were reported in the matrix area that are not present in the granite outcrops, compared to 46 species found in the granite outcrops that are absent from the matrix area. The ratios of therophytes and phanerophytes in granite outcrops were 5% and 11.1% greater, respectively, than those observed in their matrices. The proportions of Sudano-Zambasian elements were higher in granite outcrops than those in the matrix and, in contrast, the Sudano-Arabian and tropical elements proportions were higher in the matrix than those in the granite outcrops. The current results concluded that granite outcrops form wetter island-like habitats as compared to their surroundings.

Abstract Decoding locomotor tasks is crucial in cognitive neuroscience for understanding brain responses to physical tasks. Traditional methods like EEG offer brain activity insights but may require additional modalities for enhanced interpretative precision and depth. The integration of EEG with ocular metrics, particularly eye blinks, presents a promising avenue for understanding cognitive processes by combining neural and ocular behaviors. However, synchronizing EEG and eye blink activities poses a significant challenge due to their frequently inconsistent alignment. Our study with 35 participants performing various locomotor tasks such as standing, walking, and transversing obstacles introduced a novel methodology, pcEEG+, which fuses EEG principal components (pcEEG) with aligned eye blink data (syncBlink). The results demonstrated that pcEEG+ significantly improved decoding accuracy in locomotor tasks, reaching 78% in some conditions, and surpassed standalone pcEEG and syncBlink methods by 7.6% and 22.7%, respectively. The temporal generalization matrix confirmed the consistency of pcEEG+ across tasks and times. The results were replicated using two driving simulator datasets, thereby confirming the validity of our method. This study demonstrates the efficacy of the pcEEG+ method in decoding locomotor tasks, underscoring the importance of temporal synchronization for accuracy and offering a deeper insight into brain activity during complex movements.

Mid-gut volvulus (MGV) frequently occurs in infancy and childhood and is rarely seen in adults. Here, we present a 23-year-old male who presented with abdominal pain and vomiting for one-week duration.The patient gave a long history of similar attacks in the past since the age of 16 years old, at a rate of 2-3/ attacks per year, which become more frequent in the last year. A laboratory workup was carried out, and an imaging study demonstrated a twisting of bowel loops around mesenteric vessels on ultrasound and intravenous-enhanced contrast computed tomography (CT scan). Whirlpool sign of midgut volvulus was seen on contrast CT scan. The patient underwent laparoscopic Ladd’sprocedure, where the diagnosis was confirmed, bands were resolved, and the bowel blood supply was restored. The surgery and postoperative period were uneventful. The patient became pain-free and was discharged home on the fourth postoperative day. To improve patient outcomes, physicians should practice a high suspicion index to confirmMGV in adult cases.

Abstract Background The prevalence of Helicobacter pylori (H. pylori) infection and its potential relationship to various diseases is currently a focus of attention. The aim of this study is to investigate the association between current and past H. pylori infections and elevated levels of microalbuminuria in type 2 diabetic patients. Methods Two hundred patients with type 2 diabetes mellitus were tested for the presence of H. pylori infection. They were divided into three groups: 52 had a current H. pylori infection, 38 had a past H. pylori infection, and 110 had no H. pylori infection. All study participants underwent assessments of plasma glucose levels, glycated hemoglobin (HbA1c), albuminuria levels, inflammatory markers such as erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), as well as other relevant investigations. Results The prevalence of H. pylori infection (current and past) was detected in 90 out of 200 diabetic patients (45%). There was no statistically significant difference between the three groups in terms of age, diabetes duration, family history of DM, family history of hypertension, residence, or dyspeptic symptoms, indicating that current or past infection with H. pylori has no association with these variables. The current H. pylori infection group showed the highest levels of inflammatory markers, ESR and CRP, which were significantly different from those in the non-infected group (p = 0.013 and p

Abstract Water scarcity and soil carbon dioxide elevation in arid regions are considered the most serious factors affecting crop growth and productivity. This study aimed to investigate the impacts of elevated CO2 levels (eCO2 at rates of 700 and 1000 ppm) on agro-physiological attributes to induce drought tolerance in cucumbers by activating the expression of genes related to aquaporin and stress response, which improved the yield of cucumber under two levels of irrigation water conditions [75% and 100% crop evapotranspiration (ETc)]. Therefore, two field experiments were conducted in a greenhouse with controlled internal climate conditions, at the Mohamed Naguib sector of the national company for protected agriculture, during the winter seasons of 2021–2022 and 2022–2023. The treatments included eCO2 in soil under normal and partial root zoon drying (PRD, 100% ETc Full irrigations, and 75% ETc). All the applied treatments were organized as a randomized complete block design (RCBD) and each treatment was replicated six times. Untreated plants were designed as control treatment (CO2 concentration was 400 ppm). The results of this study showed that elevating CO2 at 700 and 1000 ppm in soil significantly increased plant growth parameters, photosynthesis measurements, and phytohormones [indole acetic acid (IAA) and gibberellic acid (GA3)], under partial root-zone drying (75% ETc) and full irrigation conditions (100% ETc). Under PRD condition, eCO2 at 700 ppm significantly improved plant height (13.68%), number of shoots (19.88%), Leaf greenness index (SPAD value, 16.60%), root length (24.88%), fresh weight (64.77%) and dry weight (61.25%) of cucumber plant, when compared to untreated plants. The pervious treatment also increased photosynthesis rate, stomatal conductance, and intercellular CO2 concentration by 50.65%, 15.30% and 12.18%; respectively, compared to the control treatment. Similar findings were observed in nutrient concentration, carbohydrate content, Proline, total antioxidants in the leaf, and nutrients. In contrast, eCO2 at 700 ppm in the soil reduced the values of transpiration rate (6.33%) and Abscisic acid (ABA, 34.03%) content in cucumber leaves compared to untreated plants under both water levels. Furthermore, the results revealed that the gene transcript levels of the aquaporin-related genes (CsPIP1-2 and CsTIP4) significantly increased compared with a well-watered condition. The transcript levels of CsPIP improved the contribution rate of cell water transportation (intermediated by aquaporin’s genes) and root or leaf hydraulic conductivity. The quantitative real-time PCR expression results revealed the upregulation of CsAGO1 stress-response genes in plants exposed to 700 ppm CO2. In conclusion, elevating CO2 at 700 ppm in the soil might be a promising technique to enhance the growth and productivity of cucumber plants in addition to alleviating the adverse effects of drought stresses.

Background Ankle injuries are some of the most common injuries among footballers and can prevent players from participating in sport. The Fédération Internationale de Football Association (FIFA) developed FIFA injury prevention programs to reduce overall football injuries, but their effectiveness on a particular joint, such as the ankle, was not assessed. Therefore, this project aims to investigate if these FIFA injury prevention programs are particularly effective in reducing ankle injuries. Method A systematic review was conducted with the following criteria for study selection: Randomized controlled trials (RTCs) comparing the FIFA programs (FIFA 11 the old version and FIFA 11+) with the usual training for the teams. Other studies that included the number or percentage of ankle injuries as an outcome. Sample: Male and female footballers aged between 13 and 40 years old and without any restriction on particular skill levels. The Physiotherapy Evidence Database scale (PEDro) was used to assess the methodological quality of the included studies. Results The search strategy identified five RCTs that used the FIFA programs. The included studies had a good-to-excellent methodological quality according to the PEDro scale (ranging from 5 to 7 out of 10). The pooled data from all the included studies indicated that the FIFA 11 and FIFA 11+ programs were effective in reducing the ankle injury rate by 14%, while pooled results from the studies that used the FIFA 11+ program significantly reduced ankle injury rate by 32%. However, the FIFA 11 program was not effective in reducing the ankle injury rate. Conclusion The FIFA programs, and especially the FIFA 11+ program, appear to be more effective than the usual training in preventing ankle injuries among footballers.

الأهداف: بيان حكم رجوع الزوجة على زوجها بما أنفقت على نفسها من مالها الخاص، أو استدانت في الفقه الإسلامي، وقانوني الأحوال الشخصية الأردني، والإماراتي. المنهجية: دُرست المسألة من خلال المنهجين؛ المنهج التحليلي بتحليل أقوال الفقهاء، وأدلتهم في المسألة، والمنهج المقارن؛ للمقارنة بين المذاهب الفقهاء، والنصوص القانونية الخاصة بالمسألة. النتائج: توصلت الدراسة إلى أنه يجب على الزوج الإنفاق على زوجته في حال يسره وإعساره، وإذا لم يقم بذلك، وأدت زوجته عنه هذا الواجب، فلها الرجوع عليه في حال أنهما تراضيا على ذلك، أو قضى القاضي بالنفقة، على أن يكون رجوعها بما أنفقت بعد التراضي، أو التقاضي، وليس لها الرجوع قبل ذلك. الخلاصة: اتفقت المذاهب الفقهية على حق الزوجة الرجوع على زوجها بما أنفقت على نفسها، واختلفت في الحالات التي يثبت لها هذا الحق، ومتى يمتنع عليها الرجوع، ونتيجة لذلك اختلفت قوانين الأحوال الشخصية في تفصيلات المسألة كل حسب المذهب الذي اعتمده، وتوصي الدراسة بإجراء الدراسات الفقهية المقارنة بقوانين الأحوال الشخصية في الفروع الدقيقة المتعلقة بالأسرة.

Many sectors in aerial transportation use unmanned aircraft vehicles (UAVs) extensively. This becomes even more challenging in complex environments where not only it is required to avoid obstacles, but it also must be maintained for a prolonged period of time. This paper presents a novel approach to increase UAV autonomy through safe and efficient flight trajectory design. An optimization problem is formulated with external and internal safety constraints, and traversing collision free paths. The proposed work offers an energy efficient RRT algorithm, which is used to assess multiple trajectory alternatives. The simulation results confirm the achieved performance in finding the optimal energy path while obeying to the safety constraint. The data and performance metrics, show the system operated in a safe and energy efficient manner. This work provides a unified framework for UAV trajectory planning that guarantees a trade-off between safety and energy efficiency.

This paper addresses the increasing complexity and evolving challenges in recent power systems management, particularly under the integration of diverse renewable energy sources (RESs) and advanced control technologies. With the rising unpredictability of power generation due to RESs and the diminishing system inertia, robust load frequency control (LFC) solutions are desperately needed to maintain network stability and manage frequency variations. This work proposes improved FOCs for achieving load frequency control (LFC) and the virtual inertia control (VIC) provision of electric vehicles (EVs) batteries. The proposed method includes a twofold contribution using a new fractional-order LFC method. The proposed technique is innovative by merging the characteristics of cascaded 2-degree of freedom (2DOF) configuration, incorporating both tilt-integral-derivative-filter (FOTIDN) and tilt-derivative-filter (FOTDN) controllers. This method is designed to enhance the robustness of interconnected multi-microgrid systems against disturbances from RESs and load demand fluctuations. Moreover, this paper presents the application of the Marine Predators Algorithm (MPA) for optimizing the proposed controller's parameters across various interconnected systems. Through simulation and time-domain analysis, the efficacy of the proposed technique is assessed in a range of load scenarios and uncertainty levels, exhibiting superior performance in contrast to current LFC methodologies such as TID, FOTID, TID-FOPIDN, and 2DOF TIDN-TDN. The results indicate that the advanced 2DOF FOTIDN-FOTDN controller based on the MPA significantly improves system response and stability, marking a pivotal advancement in power system control strategies. Moreover, the employing of MPA optimizer is compared with the widely-used optimizers in the literature, including the MRFO, ABC, and PSO optimizers at the different objective functions of IAE, ISE, ITAE, and ITSE. For instance, the MPA method has a minimized ITAE after 30 iterations of 0.027 compared to 0.0276 with MRFO, 0.0282 with ABC, and 0.034 with PSO optimizer. Thence, fast and better minimization of objective functions are achieved using the proposed MPA.

IntroductionPrecision farming is an agricultural management practice that addresses various challenges by observing and measuring the variability of field crops, utilizing accurate and timely information about agricultural resources. A fundamental aspect of precision farming is the use of site-specific management zones (SSMZs). SSMZs improve agricultural management by customizing treatments for specific production zones, thereby conserving resources while enhancing crop productivity and quality. This research aimed to investigate the application of magnesium fertilizer in SSMZs for Allium cepa, as opposed to traditional methods based on soil and plant attributes.MethodsTo achieve this, a 10-meter grid-sampling scheme was implemented across the field, comprising 12 points where soil samples were collected from the top 20 cm before planting green onions in June 2021. Normalized Difference Vegetative Index (NDVI) data during the harvest stage of the green onion growth cycle were sourced from Sentinel-2 satellite imagery at each sampling point. Yield mapping was performed at harvest. Key yieldlimiting factors were identified through stepwise multiple analyses, which included soil properties (such as organic matter) and canopy parameters (such as bulb diameter, phosphorus, magnesium, and NDVI).ResultsOverlay maps illustrated soil parameters, growth, and biochemical measurements, and evaluated the effect of foliar spraying with different magnesium sources on the growth, productivity, and quality of green onions, indicating three distinct SSMZs: zone (I), zone (II), and zone (III), with areas of 1.97 ha, 1.35 ha, and 2.79 ha, respectively. The use of magnesium oxide nanoparticles (nMgO) in a site-specific management zone resulted in a remarkable green onion yield of 152.14 tons/ha. The assessed soil properties and plant characteristics revealed that foliar applications of (nMgO) significantly improved the nutritional status, growth, and quality of green onions (Allium cepa L.).DiscussionThe modeling process effectively classified the study area into three management zones for soil treatments and three additional management zones for plant treatments. Implementing such a process will lower the costs of soil analysis and enhance overall agricultural income.

Nanoparticles show superior potential for enhancing thermal properties compared to conventional particle–liquid suspensions. This investigation delves into magnetohydrodynamics (MHD) drift, heat, and mass transfer effects within a Jeffery nanoparticle liquid. The study includes transference equations that consider the influences of thermophoresis and Brownian motion on particle deposition. The analysis examines the impact of a nanofluid through a porous, exponentially elongating sheet, focusing on the double-stratification effects on heat and mass transference. The primary emphasis is on the formulated thermal energy equation, which incorporates Joule heating, heat generation, and ohmic dissipation terms. The initial step involves transforming the non-linear primary equations and their related boundary conditions into non-dimensional forms using similarity variables. The homotopy analysis method is then applied to obtain analytical results for the equations. Graphical representations of the impacts of various parameters on velocity and temperature values are presented, along with a detailed discussion of these impacts. A comprehensive analysis of specific parameters on the drag force factor-reduced Nusselt number and Sherwood number is provided and illustrated. Additionally, this research is applicable in environmental engineering, particularly in managing thermal pollution in water bodies, by aiding in predicting temperature distribution and the mixing behavior of effluents.

Internet of Things (IoT) security is paramount for enterprises, as it includes several strategies, techniques, actions, and protocols that aim to alleviate the high vulnerability of cutting-edge businesses. IoT consumer devices, from smart home appliances to wearable gadgets, have become ubiquitous daily, facilitating automation and seamless connectivity. However, ensuring their reliability and security presents a tremendous challenge. Anomaly detection methods offer a promising solution, especially those powered by TinyML (Machine Learning (ML) on Tiny Devices). These IoT devices can autonomously identify unusual behaviours or patterns that diverge from regular operation by leveraging the proficiencies of deep learning (DL) techniques enhanced for resource-constraint environments, like neural networks. Incorporating DL, anomaly detection, and TinyML allows real-time monitoring and proactive mitigation of malfunctions or security breaches in IoT devices. This advanced technology ensures improved reliability, privacy, and overall user experience in the dynamic landscape of connected devices, whether identifying irregular health data or detecting unauthorized access attempts on a smart door lock from the wearable fitness tracker. Therefore, this study develops a new Deep Learning technique to secure IoT consumer devices with TinyML Driven Real-time Anomaly Detection for Predictive Maintenance (DLTML-RTADPM). The DLTML-RTADPM technique aims to recognize and categorize the anomalies in IoT consumer devices. At the primary phase, the DLTML-RTADPM model normalizes the input data using Z-score normalization. In the DLTML-RTADPM method, the Fennec Fox Optimization Algorithm (FFA) is used for a high dimensionality reduction process where the optimal feature set is chosen. The DLTML-RTADPM technique implements gradient least mean squares with a bidirectional long short-term memory (GLMS-BiLSTM) approach for anomaly detection. To further improve the detection results of the DLTML-RTADPM technique, the Jaya optimization algorithm (JOA)-based hyperparameter tuning process is utilized. A series of simulations are performed on the benchmark dataset to ensure better detection outcomes of the DLTML-RTADPM model. The investigational validation of the DLTML-RTADPM method portrayed a superior accuracy value of 98.11% over other techniques.

This research presents a novel approach to fault diagnosis for CNC hobbing cutters using machine learning techniques, leveraging three-axis vibration data to ensure machining precision and tool reliability. Traditional methods of tool monitoring are insufficient for real-time and complex machining environments, prompting the integration of automated machine learning models. A robust dataset was collected from a CNC hobbing machine, capturing vibration signals under healthy and faulty tool conditions. Statistical features, including Root Mean Square (RMS), Crest Factor, and Kurtosis, were extracted from the vibration data for model training. Various machine learning algorithms, including Decision Trees, Efficient Linear models, Neural Networks, and Ensemble methods, were evaluated for their classification accuracy. Among these, the Ensemble model achieved perfect classification accuracy (100 %) with minimal computational cost, making it optimal for real-time applications. Explainable AI techniques, such as LIME and Shapley values, were employed to interpret model predictions, enhancing the system's transparency and reliability. The proposed framework demonstrated superior performance compared to existing methodologies in the literature, addressing key gaps such as overfitting, data quality, and model explainability. Real-world deployment challenges, including diverse operating conditions and generalizability across machines, were also discussed, with recommendations for incorporating multi-sensor data and transfer learning approaches in future research. This study establishes a foundation for predictive maintenance in CNC machining, significantly reducing downtime and improving operational efficiency through precise fault diagnosis in hobbing cutters.

This study investigates the significance of single-walled (SWCNTs) and multi-walled (MWCNTs) carbon nanotubes with a convectional fluid (water) over a vertical cone under the influences of chemical reaction, magnetic field, thermal radiation and saturated porous media. The impact of heat sources is also examined. Based on the flow assumptions, the fundamental flow equations are modeled as partial differential equations (PDEs). Using the appropriate transformation, the PDEs are converted to ordinary differential equations and then solved via RK4 in MATLAB. To confirm the results, a comparison is made with a previously investigated problem, finding good agreement. The emerging dimensionless physical parameters impact on the flow problem is determined through graphs and tables. Analysis reveals a dual solution for the suction and injection parameter. Therefore, stability examination is implemented to confirm a stable solution. The aim of the study is to analyze SWCTs and MWCTs in a vertical cone with stability to establish that only the first solution is reliable. The analysis here signifies that large volume fractions can be substituted to increase the nanofluid movement. The mathematical model and graphical demonstration indicate that the velocity of MWCNTs is higher than SWCNTs. Moreover, the local skin friction, rate of heat transfer, and Nusselt and Sherwood numbers improve with Biot number.

BackgroundCOVID-19 poses a significant threat to global public health. As the severity of SARS-CoV-2 infection varies among individuals, elucidating risk factors for severe COVID-19 is important for predicting and preventing illness progression, as well as lowering case fatality rates. This work aimed to explore risk factors for developing severe COVID-19 to enhance the quality of care provided to patients and to prevent complications.MethodsA retrospective study was conducted in Saudi Arabia’s eastern province, including all COVID-19 patients aged 18 years or older who were hospitalized at Prince Saud Bin Jalawi Hospital in July 2020. Comparative tests as well as both univariate and multivariate logistic regression analyses were performed to identify risk factors for developing severe COVID-19 and poor outcomes.ResultsBased on the comparative statistical tests patients with severe COVID-19 were statistically significantly associated with older age and had higher respiratory rate, longer hospital stay, and higher prevalence of diabetes than non-severe cases. They also exhibited statistically significant association with high levels of potassium, urea, creatinine, lactate dehydrogenase (LDH), D-dimer, and aspartate aminotransferase (AST). The univariate analysis shows that having diabetes, having high severe acute respiratory infection chest X-ray scores, old age, prolong hospitalization, high potassium and lactate dehydrogenase, as well as using insulin, heparin, corticosteroids, favipiravir or azithromycin were all statistically significant associated with severe COVID-19. However, after adjustments in the multivariate analysis, the sole predictor was serum LDH (p = 0.002; OR 1.005; 95% CI 1.002–1.009). In addition, severe COVID-19 patients had higher odds of being prescribed azithromycin than non-severe patients (p = 0.001; OR 13.725; 95% CI 3.620–52.043). Regarding the outcomes, the median hospital stay duration was statistically significantly associated with death, intensive care unit admission (ICU), and mechanical ventilation. On the other hand, using insulin, azithromycin, beta-agonists, corticosteroids, or favipiravir were statistically significantly associated with reduced mortality, ICU admission, and need of mechanical ventilation.ConclusionThis study sheds light on numerous parameters that may be utilized to construct a prediction model for evaluating the risk of severe COVID-19. However, no protective factors were included in this prediction model.

Driving is a complex task that requires effective neural processing and coordination, which degrade with aging. Previous studies suggest that age-related changes in cognitive and motor functions can influence driving performance. Herein, we investigated age-related differences and differences between reactive and proactive driving in blink behavior-related potentials, and source-level functional connectivity. Seventy-six subjects participated in two experiments with reactive (19 young, 28 older) and proactive (16 young, 13 older) driving scenarios, consisting of a lane-keeping task with either varying levels of crosswind or curve road, respectively. While blink rate analysis revealed no significant age or driving condition effects, blink duration was notably longer in younger participants. Also, significant age effects were observed in blink-related potentials, mainly in the frontal N2 and occipital P0 and P2 components, with higher amplitudes in younger participants, signifying more efficient neural processing. The parietal N2 component showed significant age and interaction effects, with older individuals showing higher amplitudes in reactive conditions, potentially due to increased cognitive effort and attentional demands. Furthermore, functional connectivity analysis revealed that aging most significantly affects the visual network in the beta band. More specifically, younger participants showed an increase in the clustering coefficient and degrees of the networks, reflecting more robust neural network integration. This pattern of higher connectivity measures in younger participants was also observed in the default mode, control, and limbic networks. Conversely, the dorsal attention network in the theta band showed an increased degree and clustering coefficient in older adults, which could indicate a compensatory mechanism for maintaining cognitive demands. This study highlights the impact of aging on neural activity and connectivity characteristics during driving and emphasizes the requirement of age-tailored interventions, aimed to improve driving safety.

This work aims to investigate the Cuckoo search-active set algorithm (CS-ASA), which is based on the artificial neural network (ANN) approach to the nonlinear partial differential equations (PDEs). CS-ASA technique modifies the Cuckoo search best possible solution to the next stage. This best solution is considered from all the best-chosen sets of Cuckoo search. This technique is applied to 1D and higher-order nonlinear PDEs that work as benchmark problems (heat, forced heat, Burger's, and Allen-Cahn). The results are obtained in the form of graphs by applying the CS-ASA algorithm. The state variables are plotted for a single hidden layer to reduce the computational cost. For the overall performance of CS-ASA, the fitness function is plotted against the number of iterations. It is clear that the fitness function minimizes with higher iterations, and hence achieve an optimal solution. The error in each case is presented at the grid points. Also, the fitness function for the description of the objective function is plotted. For best possible output, CS-ASA has chosen weight functions and its range in each case study accordingly. The obtained results (L2 error) are presented in the form of a table and compared with PSO, PSO-BP, and PSO-BP-CD. It is clear that CS-ASA perform better with a minimum L2 error for each problem under consideration.

Smart grid represents an advanced and interconnected system that incorporates modern technologies to enhance efficiency, reliability and sustainability. In comparison to the conventional grid, the smart grid (SG) uses many cutting-edge technologies. This research introduces a fog computing encryption-based model for privacy preservation in the smart grid model. By using different advanced technologies, our model addresses the balance between privacy, security, effectiveness and functionality. The model facilitates efficient communication and function inquiry while mitigating challenges posed by massive Internet of Things (IoT) systems in the smart grid environment. Specifically, it tackles the secure data consolidation challenge by employing encryption-based techniques for transmitting private data from smart meters to fog devices. These devices consolidate the data before updating to cloud. Conventional data consolidation approaches for SGs have high computation and communication costs and suffer from high storage requirement. The proposed model resolves these issues; algorithms for data consolidation and extraction of data at fog device and cloud respectively to obtain the secure communication has also been included. The performance of the developed mechanism has been computed against existing data consolidation mechanisms GCEDA (Grouping of Clusters for Efficient Data Aggregation), SPPDA (Secure Privacy-Preserving Data Aggregation) and LPDA (Lightweight Privacy-preserving Data Aggregation) for numerous performance parameters. And the results proves that the performance of developed mechanism with respect to bytes of storage, communication cost and ratio of transmission is better than the existing ones.

Buildings in some conditions suffer from structural issues caused by foundation soilinhomogeneity. The main cause of an inhomogeneity in soil profile is the presence of voidsor very weak large pockets. The present paper deals with the structural behavior of concretebuildings, exposed to transverse loading such as seismic loads, when constructed on claysoil with predefined weak zones (voids). The finite element program ANSYS was used tostudy the effect of an underground void of different sizes and locations. A comprehensivestudy of various parameters was conducted on six structures of different widths and heights,considering the underground void diameter and void location. The effects of undergroundvoids on building natural periods and structural response to static lateral loads wereinvestigated. According to the studied cases, it was found that the void effect in increasingthe differential settlement almost fades at void eccentricity equals 1 to 3 times the structurewidth from the foundation center. Although the void effect in increasing lateraldisplacements at structure floor levels fades at void eccentricity equals 1 to 1.75 timesstructure width. The void effect approximately vanishes at void depth equals 1 to 3.5 timesthe structure width from the foundation level.

Abstract Background Research on incidence and characteristics of Out-of-Hospital Cardiac Arrest (OHCA) in the Middle East is limited. We assessed the incidence, prehospital characteristics, and outcomes of OHCA in Qatar, a Middle Eastern country. Subsequently, we performed gender-specific analysis. Methods This was a retrospective examination of data obtained from the OHCA registry at Hamad Medical Corporation (HMC) in Qatar from 2017 to 2022. We included adults, non-traumatic, EMS-treatment OHCA. We calculated the incidence of adult OHCA and conducted descriptive analyses for prehospital characteristics, and prehospital outcomes presented by return of spontaneous circulation (ROSC). We evaluated gender differences in prehospital characteristics and ROSC using Student’s t-test and the Chi-Square test as appropriate. Furthermore, we conducted a multivariable logistic regression analysis to investigate the correlation between gender and achieving ROSC. Results We included 4,306 adult OHCA patients, with 869 (20.2%) being females. The mean annual incidence of adult OHCA was 27.4 per 100,000 population-year. Males had a higher annual incidence of OHCA than females. Among all cases, 36.3% occurred in a public location, 25.8% had an initial shockable rhythm, and 28.8% achieved ROSC. Males had a higher proportion of bystander CPR, arrests in public locations, and initial shockable rhythms. While unadjusted analysis showed no significant gender differences in achieving ROSC, adjusted analysis revealed that male gender was associated with higher odds of achieving ROSC (adjusted OR male vs. female 1.38, 95% CI 1.15–1.66, p

Abstract Ovarian insufficiency is one of the common reproductive disorders affecting women with limited therapeutic aids. Mesenchymal stem cells have been investigated in such disorders before yet, the exact mechanism of MSCs in ovarian regeneration regarding their epigenetic regulation remains elusive. The current study is to investigate the role of the bone marrow-derived mesenchymal stem cells (BM-MSCs) lncRNA (Neat-1 and Hotair1) and miRNA (mir-21-5p, mir-144-5p, and mir-664-5p) in mitigating ovarian granulosa cell apoptosis as well as searching BM-MSCs in altering the expression of ovarian and hypothalamic IGF-1 – kisspeptin system in connection to HPG axis in a cyclophosphamide-induced ovarian failure rat model. Sixty mature female Sprague Dawley rats were divided into 3 equal groups; control group, premature ovarian insufficiency (POI) group, and POI + BM-MSCs. POI female rat model was established with cyclophosphamide. The result revealed that BM-MSCs and their conditioned media displayed a significant expression level of Neat-1, Hotair-1, mir-21-5p, mir-144-5p, and mir-664-5p. Moreover, BM-MSCs transplantation in POI rats improves; the ovarian and hypothalamic IGF-1 – kisspeptin, HPG axis, ovarian granulosa cell apoptosis, steroidogenesis, angiogenesis, energy balance, and oxidative stress. BM-MSCs expressed higher levels of antiapoptotic lncRNAs and microRNAs that mitigate ovarian insufficiency.

Abstract Background Kidneys have been one of the different organs affected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) since its discovery, Acute kidney injury was the most common presentation. A pooled data from different kidney centers or hospitals in Egypt who sent their renal biopsy specimens from patients with renal trouble, up to 4 months after catching SARS-CoV-2, to PATH LAB for diagnosis, were analyzed. Results Beside acute kidney injury, a variety of different presentations was found, such as accidentally discovered impaired kidney function, varying degrees of proteinuria, and nephrotic syndrome. Not only acute tubular injury, acute tubulointerstitial nephritis, or thrombotic microangiopathy, but the extent of observation for 4 months revealed, unexpected pathologies, such as podocytopathies, membranous glomerulonephritis, proliferative and necrotizing glomerulonephritis, and lupus nephritis. Conclusion This virus has been incriminated in a chain of different kidney disease presentations and pathologies, although, a causal relationship is difficult to prove.

A treasure trove of naturally occurring biomolecules can be obtained from sea living organisms to be used as potential antioxidant and anti-inflammatory agents. These bioactive molecules can target signaling molecules involved in the severity of chronic autoimmune diseases such as rheumatoid arthritis (RA). The intracellular tyrosine kinases family, Janus kinases (JAKs, includes JAK1, JAK2, and JAK3), is implicated in the pathogenesis of RA through regulating several cytokines and inflammatory processes. In the present study, we conducted molecular docking and structural analysis investigations to explore the role of a set of bioactive molecules from marine sources that can be used as JAKs’ specific inhibitors. Around 200 antioxidants and anti-inflammatory molecules out of thousands of marine molecules found at the Comprehensive Marine Natural Products Database (CMNPD) website, were used in that analysis. The details of the interacting residues were compared to the recent FDA approved inhibitors tofacitinib and baricitinib for data validation. The shortlisted critical amino acids residues of our pharmacophore-based virtual screening were LYS905, GLU957, LEU959, and ASP1003 at JAK1, GLU930 and LEU932 at JAK2, and GLU905 and CYS909 of JAK3. Interestingly, marine biomolecules such as Sargachromanol G, Isopseudopterosin E, Seco-Pseudopterosin, and CID 10071610 showed specific binding and significantly higher binding energy to JAK1 active/potential sites when being compared with the approved inhibitors. In addition, Zoanthoxanthin and Fuscoside E bind to JAK2′s critical residues, GLU930 and LEU932. Moreover, Phorbaketal and Fuscoside E appear to be potential candidates that can inhibit JAK3 activity. These results were validated using molecular dynamics simulation for the docked complexes, JAK1(6sm8)/SG, JAK2 (3jy9)/ZAX, and JAK3 (6pjc)/Fuscoside E, where stable and lower binding energy were found based on analyzing set of parameters, discussed below (videos are attached). A promising role of these marine bioactive molecules can be confirmed in prospective preclinical/clinical investigations using rheumatoid arthritis models.

Abstract Background Polycystic ovarian syndrome (PCOS) is a common endocrine disorder affecting one in five women of reproductive age. Polycystic appearance of the ovaries in ultrasonography is associated with oligomenorrhea, and clinical and or biochemical hyperandrogenism. PCOS has been associated with voice alterations for many years. However, there is insufficient research on voice analysis in PCOS patients. Objectives This research aimed to examine the voice characteristics among women with PCOS. Patients and methods Our study included 25 women confirmed with PCOS and 25 control. A complete voice assessment was performed for all participants using primary demographic data, vocal symptoms, auditory perceptual evaluation of the voice, Arabic version of the Voice Handicap Index, acoustic analysis, and video laryngoscopic examination of the larynx. Results Our study revealed statistically significant differences between PCOS and control groups in phonasthenic symptoms, auditory perceptual assessment of the voice, acoustic parameters, and laryngoscopic examination. Conclusion PCOS women with hirsutism are complaining of vocal symptoms, changes in vocal characters, and deterioration of the acoustic parameters of the voice. High serum levels of androgen can cause the deepening of the voice, which is essential for the early detection of vocal symptoms in PCOS patients to prevent virilization of their voice. Trial registration NCT06085170. Registered 20 August 2023—retrospectively registered, https://www.google.com/url?sa=t&source=web&rct=j&opi=89978449&url=https://classic.clinicaltrials.gov/ct2/show/NCT06085170&ved=2ahUKEwjEyLqUq6KGAxWxRPEDHb57DIQQFnoECBQQAQ&usg=AOvVaw1xTurnA6mJEZ9PK0vQS8VL .

Abstract Background Dry eye syndrome (DES) is a widespread ocular condition affecting the general population. It is a complex disorder affecting the eye surface, characterized by a tear film imbalance and ocular symptoms such as eye ache, burning, irritation, dryness, blurred vision, and foreign body sensation. DES can reduce visual acuity, increase the risk of ocular infection, and significantly impact daily activities and quality of life. Aim Determine the impact of nursing-led educational program on the management of DES and patients’ health outcomes including the intensity of DES symptoms and their influence on visual-related functions. Methods The study was conducted with a quasi-experimental design. Sixty adult patients diagnosed with DES were selected using a convenience sampling method. Two tools were employed for the collection of data. Tool I: Precipitating factors of DES structured interview schedule. Tool II: Ocular surface disease index (OSDI) to assess ocular irritation symptoms associated with DES and their effect on functions related to vision. Results A statistically significant decrease in the mean scores of OSDI in the study group two weeks after the implementation of the educational program regarding the ocular symptoms, functions associated with vision, environmental triggers, and overall score of OSDI. Conclusion Implementing an educational program for DES is effective in relieving symptoms, boosting patients’ understanding of managing symptoms effectively, and maintaining eye health. Therefore, patients must be instructed on dry eye early detection and management to enhance health-related outcomes and self-care practices. Registration ClinicalTrials.gov: NCT06288945.

Abstract Enterprise risk management (ERM) frameworks convey vital principles that help create a consistent risk management culture, irrespective of employee turnover or industry standards. Enterprise Management System (EMS) are becoming a popular research area for assuring a company’s long-term success. Statistical pattern recognition, federated learning, database administration, visualization technology, and social networking are all used in this field, which includes artificial intelligence (AI), data science, and statistics. Risk assessment in EMS is critical for enterprise decision-making to be effective. Recent advancements in AI, machine learning (ML), and deep learning (DL) concepts have enabled the development of effective risk assessment models for EMS. This special issue seeks groundbreaking research articles that showcase the application of applied probability and statistics to interdisciplinary studies. This study offers Improved Metaheuristics with a Deep Learning Enabled Risk Assessment Model (IMDLRA-SES) for Smart Enterprise Systems. Using feature selection (FS) and DL models, the provided IMDLRA-SES technique estimates business risks. Preprocessing is used in the IMDLRA-SES technique to change the original financial data into a usable format. In addition, an FS technique based on oppositional lion swarm optimization (OLSO) is utilized to find the best subset of features. In addition, the presence or absence of financial hazards in firms is classified using the triple tree seed algorithm (TTSA) with a probabilistic neural network (PNN) model. The TTSA is used as a hyperparameter optimizer to improve the efficiency of the PNN-based categorization. An extensive set of experimental evaluations is performed on German and Australian credit datasets to illustrate the IMDLRA-SES model’s improved performance. The performance validation of the IMDLRA-SES model portrayed a superior accuracy value of 95.70% and 96.09% over existing techniques.

A paraganglioma is a neuroendocrine tumor that may secrete catecholamines and present with symptoms of sympathetic overload such as hypertension and diaphoresis. It is important that paragangliomas are identified, as they must often be treated by surgical excision. IgG4-related retroperitoneal fibrosis (IgG4-RPF) is a systemic inflammatory disease that results in the infiltration of IgG4-positive plasma cells in the retroperitoneum. Such fibrosis may adversely affect nearby organs and tissues. Here, we describe a case of combined paraganglioma and IgG4-RPF in a 47-year-old female patient. This case demonstrates the deleterious effect of these two conditions when they occur simultaneously.

Background: Calcific tendonitis is a painful shoulder disorder characterized by calcium deposits (CDs) in the rotator cuff tendon. This systematic review and meta-analysis examined the most efficient surgical procedure for calcific tendonitis. This includes the comparison between the three main surgical techniques: CD removal, CD removal with subacromial decompression (SAD) and CD removal with tendon repair with respect to functional outcomes and pain control scores. Methods: Four electronic databases (MEDLINE, EMBASE, CINAHL, and Cochrane Central Register of Controlled Trials) were searched in February 2023. Studies were eligible for inclusion if they were peer-reviewed, and participants were patients diagnosed with calcific tendonitis of one or more rotator cuff tendon based on diagnostic imaging who underwent shoulder calcific tendonitis surgery. Other shoulder pathology diagnoses were excluded. Meta-analyses were conducted for results that were sufficiently homogeneous in terms of statistical, clinical, and methodological characteristics. Subgroup analyses were performed to determine if effect sizes differed based on the patient’s position during the surgery, physiotherapy, and follow-up time. Results: All surgical interventions resulted in significant improvements in shoulder function and pain control. There were no significant differences between CD removal vs. CD removal with SAD or CD removal vs. CD removal with tendon repair. However, there was a trend in favor of CD removal alone or CD removal with SAD approaches, as they provided better outcome scores than CD removal with tendon repair in terms of shoulder function and pain control. Conclusions: All surgical interventions provide substantial improvement in shoulder functions and pain control scores with no significant difference between these surgical techniques.

Abstract Background N6-methyladenosine (m6A) is the most common internal RNA modification and is involved in regulation of RNA and protein expression. AlkB family member 5 (ALKBH5) is a m6A demethylase. Given the important role of m6A in biological mechanisms, m6A and its regulators, have been implicated in many disease processes, including cancer. However, the contribution of ALKBH5 to invasive breast cancer (BC) remains poorly understood. The aim of this study was to evaluate the clinicopathological value of ALKBH5 in BC. Methods Publicly available data were used to investigate ALKBH5 mRNA alterations, prognostic significance, and association with clinical parameters at the genomic and transcriptomic level. Differentially expressed genes (DEGs) and enriched pathways with low or high ALKBH5 expression were investigated. Immunohistochemistry (IHC) was used to assess ALKBH5 protein expression in a large well-characterised BC series (n = 1327) to determine the clinical significance and association of ALKBH5 expression. Results Reduced ALKBH5 mRNA expression was significantly associated with poor prognosis and unfavourable clinical parameters. ALKBH5 gene harboured few mutations and/or copy number alternations, but low ALKBH5 mRNA expression was seen. Patients with low ALKBH5 mRNA expression had a number of differentially expressed genes and enriched pathways, including the cytokine-cytokine receptor interaction pathway. Low ALKBH5 protein expression was significantly associated with unfavourable clinical parameters associated with tumour progression including larger tumour size and worse Nottingham Prognostic Index group. Conclusion This study implicates ALKBH5 in BC and highlights the need for further functional studies to decipher the role of ALKBH5 and RNA m6A methylation in BC progression.

One of the routine tasks of local, regional, and global seismic networks is to calculate the earthquake magnitude using one or more scales. This study aims to derive a duration magnitude equation using the earthquake data recorded by the local Mesopotamian Seismological Network (MPSN) in Iraq. The seismic waveform data were collected from 13 broadband seismic stations of the local MPSN for the period June 2014 to October 2023 years. The source parameters of these earthquakes were extracted from the International Seismological Centre (ISC). To establish a coda duration magnitude scale, 476 events were used and 100 events were employed to test the derived equation. Coda-duration magnitude equations were derived using linear regression analysis. To ensure the applicability of the magnitude equation for the network, the station correction coefficient (Sc) was estimated. The established coda duration magnitude scales are as follows: (4 ≤ ML ≤ 6) (4 ≤ ML ≤ 5) There is a good agreement between the MD values calculated using the above equation with those estimated for the same events using coda-duration magnitude equation derived in previous study from data of the Iraqi Meteorological Organization and Seismology (IMOS). The significant strong scaling relationships derived between MD–ML, MD–mb, MD–Ms, and MD–MW can be used quickly and reliably in MD calculation for earthquakes recorded by the MPNS stations and vice versa.