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Abstract Background Acute coronary syndrome (ACS) patients are vulnerable to anxiety and depression. This study aimed to assess the mental health burden among Egyptian ACS patients by assessing the prevalence and associates of these conditions. This study enrolled 212 patients who underwent coronary angiogram. Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale (HADS). Demographic, psychosocial, and clinical data were collected. Univariate and multivariate logistic regression analyses identified factors associated with anxiety and depression. Results The mean age of the participants was 54.1 years, and 80.7% were males. More than half (58.1%) exhibited anxiety, depression, or both, with depression being more prevalent than anxiety (48.1% vs 38.2%). Past major depressive disorder was strongly correlated with both anxiety and depression. Higher anxiety scores increased the odds of depression (OR = 1.234, p

Focus on form through oral corrective feedback has been the center of many L2 learning investigations in recent decades. Although research has been abundantly done on the impact of different single-feedback types, not many studies have included combinational feedback strategy, especially as regards the mastery of both explicit and implicit knowledge of morpheme ‘s’ by EFL students in Iran. Therefore, the present work attempted to compare the effectiveness of unmarked recast, explicit correction with metalinguistic explanation, and mixed feedback in the expansion of knowledge of third-person marker ‘s’ in Iranian task-based language teaching context, employing a pretest/posttest design. To this end, forty-eight lower-intermediate learners of EFL were selected as participants. Every feedback type was supplied to an experimental group through story retelling and picture description tasks. Control group, however, was not provided with any intervention and feedback. Untimed grammaticality judgment and elicited oral imitation tests were used as measurement tools. Results of Descriptive Statistics, One-Way Between Groups ANCOVA and Tukey’s Multiple Comparison Post-Hoc Test illustrated that all types of feedback were relatively effective. Nevertheless, mixed feedback and explicit correction with metalinguistic explanation lead to overall acquisition. The insights provided might benefit EFL instructors in Iran in employing the best way(s) of corrective feedback to foster language learning in task-based teaching approach, which can promote Iranian English learners’ acquisition of third person singular‘s’.

Abstract Tumor immune microenvironmental alterations occur early in multiple myeloma (MM) development. In this study, we aim to systematically characterize the tumor immune microenvironment (TME) and the tumor-immune interactions from precursor stages, i.e., monoclonal gammopathy of undetermined significance (MGUS) and smoldering MM (SMM), to newly diagnosed MM, comparing these to healthy donors. Using CIBERSORT, mass cytometry (CyTOF), and single-cell RNA sequencing (scRNA-Seq), we examined innate and adaptive immune changes across these stages. We found a decrease in granulocytes in the TME predicts MM outcomes. HLA-DR is reduced in CD16+ monocytes and plasmacytoid dendritic cells, while myeloid dendritic cells show decreased expression of stress and immune-response genes. NK cells and CD8+ T cells shift from a GZMK+ to a GZMB+ cytotoxic phenotype in the TME, with increased inhibitory markers TIM3 and TIGIT. In paired samples, the proportion and gene expression pattern in patient-specific GZMB+CD8+ T cells remain largely unchanged despite MM progression. Our findings provide a comprehensive immune landscape of MM and its precursors, offering insights into therapeutic strategies. Enhancing neutrophil and NK cell cytotoxicity, tumor antigen presentation, and CD8+ T cell versatility in precursor stages may prevent MM progression.

Background and purpose: The process by which family physicians refer patients to specialized levels of the healthcare system is presented. In other words, the referral system can assure us that the clients of health care services are optimally allocated at the specialized level of services. In addition to providing proper time and providing proper health care for health benefits. The referral process is a specialized outpatient consulting process that determines the course and communication of the individual in three levels of the health system to provide the integrity and continuity of services this study aimed to determine the quality of referral and feedback forms in the medical family physician of Mazandaran province in 2019. Materials and methods: This descriptive cross-sectional study was conducted to examine the form of insurance referral of social security insurance by physicians of urban families and feedback from experts. After receiving the code of ethics and obtaining permission from the relevant organization the researcher paid the social security organization 1397 issued by the physicians in the province. The statistical population consisted of all forms of reference and the feedback from experts to the social security insurance organization to get the right According the report of the department of medical record department of the social security insurance organization of Mazandaran province in1397 has been handed over to that organization in a total of 151075 reference sheets completed to obtain the right of the specialists. the collected data were entered into Excel software for statistical analysis was performed in descriptive statistics using central dices (mean, median, mode) and dispersion index(variance, standard deviation, range of changes, coefficients of variation ) for quantitative variables, and index, percentage, and prevalence for qualitative data. The data were analyzed by using spss-25 software. Results: The study of 3200 cases of referral and referral forms of family physicians and specialists showed that among the Physicians 2321(72.5) were male and 879(27.5) were female. The patient's records in 586(%18.3) were incomplete. Clinical findings Were found in 98(2.7%) cases and paraclinical findings were incomplete in 22 cases (0.7%) and complete in 171 cases (5.3%). in 884 cases (27.6%) the papers were illegible the cause of referral was written in 560(17.5%). the reason for further referral in 187 cases (5.8%) was written by experts. In addition, 1454 cases (45.4%) of the return sheets completed by specialists were illegible. Conclusion: The results obtained in this study show that the status of the quality of completion of the referral form by the family doctors and also the status of providing feedback by the specialist doctors are not suitable. to improve this situation the implementation of face-to-face and non-face-to-face training programs for both groups and using electronic referral forms can be put on the agenda.

Abstract Talquetamab is an approved therapy for relapsed multiple myeloma. This study examined dysgeusia and weight loss occurrences, alongside investigating symptom reversibility post‐treatment cessation. Dysgeusia was prevalent, persisting in 15% of patients. On average, patients lost 6% of their weight during treatment, with weight loss persisting in about half of the patients post‐discontinuation. Weight loss and dysgeusia are important adverse events to consider while on talquetamab treatment. Extending dose intervals can potentially prevent such adverse events and should be studied in future prospective clinical trials.

Abstract Background Hepatocellular carcinoma (HCC) is the most common primary liver cancer. Chronic hepatitis and liver cirrhosis lead to accumulation of genetic alterations driving HCC pathogenesis. This study is designed to explore genomic landscape of HCC in Egyptian patients by whole exome sequencing. Methods Whole exome sequencing using Ion Torrent was done on 13 HCC patients, who underwent surgical intervention (7 patients underwent living donor liver transplantation (LDLT) and 6 patients had surgical resection}. Results Mutational signature was mostly S1, S5, S6, and S12 in HCC. Analysis of highly mutated genes in both HCC and Non-HCC revealed the presence of highly mutated genes in HCC (AHNAK2, MUC6, MUC16, TTN, ZNF17, FLG, MUC12, OBSCN, PDE4DIP, MUC5b, and HYDIN). Among the 26 significantly mutated HCC genes—identified across 10 genome sequencing studies—in addition to TCGA, APOB and RP1L1 showed the highest number of mutations in both HCC and Non-HCC tissues. Tier 1, Tier 2 variants in TCGA SMGs in HCC and Non-HCC (TP53, PIK3CA, CDKN2A, and BAP1). Cancer Genome Landscape analysis revealed Tier 1 and Tier 2 variants in HCC (MSH2) and in Non-HCC (KMT2D and ATM). For KEGG analysis, the significantly annotated clusters in HCC were Notch signaling, Wnt signaling, PI3K-AKT pathway, Hippo signaling, Apelin signaling, Hedgehog (Hh) signaling, and MAPK signaling, in addition to ECM-receptor interaction, focal adhesion, and calcium signaling. Tier 1 and Tier 2 variants KIT, KMT2D, NOTCH1, KMT2C, PIK3CA, KIT, SMARCA4, ATM, PTEN, MSH2, and PTCH1 were low frequency variants in both HCC and Non-HCC. Conclusion Our results are in accordance with previous studies in HCC regarding highly mutated genes, TCGA and specifically enriched pathways in HCC. Analysis for clinical interpretation of variants revealed the presence of Tier 1 and Tier 2 variants that represent potential clinically actionable targets. The use of sequencing techniques to detect structural variants and novel techniques as single cell sequencing together with multiomics transcriptomics, metagenomics will integrate the molecular pathogenesis of HCC in Egyptian patients.

The present work is dedicated to the study of the inverse kinematics solution of a humanoid bipedal robot with 30 degrees of freedom using a newly approach based on vectors that generated from the geometric space of the robot. The solutions of the inverse kinematics problem for all joints articulations are carried out through a simple and linear equations. Finally, simulations of results are performed through harmonization of trajectories of end effectors of the robot's members.

All-organic, heavy-atom-free photosensitizers based on thionation of nucleobases are receiving increased attention because they are easy to make, noncytotoxic, work both in the presence and absence of molecular oxygen, and can be readily incorporated into DNA and RNA. In this contribution, the DNA and RNA fluorescent probe, thieno[3,4-d]pyrimidin-4(1H)-one, has been thionated to develop thieno[3,4-d]pyrimidin-4(3H)-thione, which is nonfluorescent and absorbs near-visible radiation with about 60% higher efficiency. Steady-state absorption and emission spectra are combined with transient absorption spectroscopy and CASPT2 calculations to delineate the electronic relaxation mechanisms of both pyrimidine derivatives in aqueous and acetonitrile solutions. It is demonstrated that thieno[3,4-d]pyrimidin-4(3H)-thione efficiently populates the long-lived and reactive triplet state generating singlet oxygen with a quantum yield of about 80% independent of solvent. It is further shown that thieno[3,4-d]pyrimidin-4(3H)-thione exhibits high photodynamic efficacy against monolayer melanoma cells and cervical cancer cells both under normoxic and hypoxic conditions. Our combined spectroscopic, computational, and in vitro data demonstrate the excellent potential of thieno[3,4-d]pyrimidin-4(1H)-thione as a heavy-atom-free PDT agent and paves the way for further development of photosensitizers based on the thionation of thieno[3,4-d]pyrimidine derivatives. Collectively, the experimental and computational results demonstrate that thieno[3,4-d]pyrimidine-4(3H)-thione stands out as the most promising thiobase photosensitizer developed to this date.

(Charcot-Marie-Tooth disease (CMT) is a genetic disorder affecting peripheral nerves. The human induced pluripotent stem cell (iPSC) line JUCTCi018-A was created using dermal fibroblasts from a Charcot-Marie-Tooth disease type 2EE (CMT2EE) patient with a homozygous missense mutation in the MPV17 gene (c. 122G > A, p.Arg41Gln). These fibroblasts were reprogrammed using Sendai viruses that encoded OCT4, SOX2, KLF4, and c-MYC reprogramming factors. The iPSCs demonstrated normal morphology and karyotype, expressed pluripotency markers, and the ability to differentiate into the three germ layers. This iPSC line is valuable for investigating the mechanisms underlying CMT2EE.

A novel mechanism is proposed to simultaneous recovery and storage of energy for use in the natural gas depressurization process. The main idea of this proposal is to use a compressor and a pump coupled with the turbo-expander to directly store the mechanical power produced by the expansion turbine in the energy storage system based on the pumped hydro combined with compressed gas. The compressor is used to create preset pressure in the vessel of the energy storage system, and the pump is used to inject water into the vessel. In this way, the density of energy storage in the system increases. In the discharge stage, electricity is produced by passing water through the turbo-generator during peak consumption hours or when energy prices are higher. The capability of the presented new method has been tested in a natural gas pressure reducing station with a nominal capacity of 50,000 Nm3/h, and the effect of different factors within the energy storage system on its performance, including the preset pressure and the volumetric ratio of water to gas in the pressurized tank, has been studied. By using the proposed plan, due to the elimination of unnecessary energy conversions the efficiency of recovery, storage and release of energy enhances. The results showed that by employing the proposed system, about 1.3 (GWh) of energy can be harvested annually; while this amount of energy is currently wasted. Also, the overall energy conversion efficiency of 48.64 %.

In this paper a new renewable energy source was proposed based on rain power. Rain energy was not used as an energy source up to now; so, in this research its applicability was investigated as a green large scale power source. Hence, three innovative mechanisms were presented to harvest the energy of rain. Firstly, the kinetic energy of rain drops was converted to electricity using piezoelectric harvesters designed and named as Pizo-panel collectors. Secondly, potential energy of collected rainwater was enhanced by utilizing designed towers and converted to electricity using a water turbine. Thirdly, collected water was used in osmotic power units to generate electricity from the salinity gradient of that rain water and brine. The results show that generated power in the presented power plant named as rain power plant, was considerable and can be used for diversifying of energy basket. In addition to power generation, collected water in the rain power plant can be used for supplying urban and agricultural need for water. The presented power source not only does not have destructive impacts on the environment, but also helps the soil to prevent it from splash and crusting erosion. The results showed that total global annual rain energy potential amount was estimated to be 3.44 × 108 GW h which is comparable with global potential of solar energy. Also, the results showed that for rainy areas with an annual rainfall of 200 cm, 2.59 kW h/m2 could be produced, which is equal to 51.7 MW h for an area of 200,000 m2.

The variation in the seepage under hydraulic structures significantly impacts their stability and effective water management, especially considering recent water scarcity challenges. This paper aims to calculate seepage and investigate the hydraulic performance of the Al-Hilla canal regulator's foundation. The methodology involves constructing a model (SEEP/W) and comparing its results with one-site piezometer readings. Using a mixed-methods approach, this study integrates software modelling and statistical analysis techniques. This study integrates software modelling and statistical analysis techniques. The Geo-studio program facilities modelling of seepage flow, while JASP software is used for statistical analysis and predictive equation development. The methodology consists of data collection, Geo-Studio modelling, JASP analysis, and validation of equation accuracy. After verifying the models’ efficiency, the data for the seepage equation was established under various upstream and downstream conditions, incorporating artificial intelligence algorithms. This data was analyzed to drive a predictive equation for seepage with a high coefficient of determination (R2) OF 97%. Additionally, another equation was formulated to determine the total water pressure head, achieving an R2 value of 95 %. These equations are invaluable tools for predicting the total water pressure head and seepage and enhancing the management of hydraulic structure.

To accurately model the consequences of accidental dust explosions, numerical simulations of the flame propagation process are required. A key parameter in these models is the burning velocity ( ?? ?? ), which represents the consumption rate of the reactants by the flame front. Experiments are therefore needed to determine the burning velocity, and the influence of turbulence on this velocity; as well as to validate these models of flame propagation. In this article, aluminum flame propagation inside a vertical duct with obstacles is studied. The aim of the obstacles is first to increase the turbulence just in front of the flame front, in order to quantify its influence on the burning velocity. The second objective of the implementation of the obstacles is to obtain experimental data in a more complex geometry in order to validate the models. During these experiments, the flame propagation is recorded and the unburned flow velocity is measured using the TR-PIV (Time-Resolved Particle Image Velocimetry) technique. This innovative measurement of the unburned flow velocity is important not only for the accurate determination of the burning velocity, but also to validate these numerical simulations. An increase in the propagation velocity and the burning velocity is observed as the flame propagates toward the obstacles.

Although mesenchymal stem cells (MSCs) are extensively applied in the regenerative field, the majority of MSCs die after a few weeks of transplantation. Therefore, hypoxia pre-conditioning is a crucial step in increasing the MSCs' tolerance to physiological conditions. Meanwhile, induced pluripotent stem cell-derived MSCs (iMSCs) were proposed as a possible alternative to MSCs, and recently, the interest is growing in applying iMSCs in the regenerative field. This study examined the effect of hypoxia pre-conditioning on the proliferation, viability, and differentiation of iMSCs. Both iMSCs and MSCs were subjected to two rounds of severe short-term hypoxia (1 % O2 for 24h). After that, iMSCs and MSCs were characterized by testing their surface markers' expression, proliferation, viability, oxidative stress, and differentiation potential. Our findings revealed that hypoxia did not have a consistent effect among all the analyzed lines: the severe short-term hypoxia (1 % O2) reduced iMSCs proliferation, cell viability, and MMP while showing a benign effect on surface markers expression, colony formation, ROS accumulation, and osteogenic and adipogenic differentiation. Though hypoxia adversely affected iMSCs’ proliferation, this does not necessarily mean that hypoxia is harmful to iMSCs; on the contrary, our results suggest that short-term hypoxia might have a beneficial long-term effect on the proliferation of iMSCs. Thus, the effect of hypoxia on proliferation, viability, and differentiation should also be tested after a long recovery period from iMSCs. Our next step will be to test the effect of hypoxia for a longer period besides uncovering the changes in the expression profile of hypoxic iMSCs.

Microwave-assisted hydrothermal extraction (MAHE) was optimized using a Box-Behnken design (BBD) of the response surface methodology (RSM) for optimal recovery of pectin from tangerine peel (TPP). The effects of three factors (pH, irradiation time and temperature) on extraction yield (EY), galacturonic acid content (GAC) and degree of esterification (DE) of pectin were investigated. The optimal extraction conditions were as follows: pH 1.7, irradiation time 12 min and temperature 109 °C. Under these conditions, the EY, GAC and DE were 30.4, 72.3 and 45.2%, respectively. The low methoxyl content of MHAE (45.2%) compared to CE is confirmed by the 1H NMR and FTIR spectra, and the emulsifying activity is 57.65% and 50.56% for CE and MHAE, respectively. The total phenolic content (TPC) of pectin produced using MAHE is 41.2 mg GAE/g, thus indicating higher antioxidant properties compared to pectin produced with CE, which had a TPC of 38.4 mg GAE/g. In addition, the X-ray diffraction (XRD) and surface morphological analysis (SEM) results showed that TPP had a rough surface and crystalline structure. Overall, our findings show that TTP from MAHE can be used as a natural antioxidant ingredient in the functional food and pharmaceutical industries.