Search

A combination of science is a way to accommodate various effective phenomena that could influence the entire life cycle. Recently, emphasis has been placed on the electrochemical polymerization mechanism that is involved in numerous technological applications, including sensors and detectors. Accordingly, daily promises were raised to eliminate life disasters and alleviate the challenges such as water floods as a part of weather changes, which could cause severe damage to life health explicitly, infrastructure, economic productivity, and much more. The proposal considers the matter via compromising the water overflow as well as eliminating the disaster that would come in no warning time and tackling the climate emergency flooding with the potential of water reclamation and offers scholarly suggestions by the requirements of the scientific approach. The investigation clarified the electromagnetic absorber beside the electrochemical polymerization through engagement in the flooded water track stations and the calculation result shows that 19.73% could be absorbed when using 300 grams of polymer gel capacity in 240 grams of water. Generally, the paper explores the electromagnetic flood disaster and how to address it to build a more secure forthcoming.

ABSTRACTObjective To evaluate the impact as well as safety of trimanual vitrectomy versus bimanual vitrectomy in cases with complicated proliferative diabetic retinopathy (PDR) necessitating surgical intervention.Methods We designed a randomized, interventional, prospective study on 40 pseudophakic eyes suffering from tractional retinal detachment (TRD). 20 eyes of 16 cases with trimanual 23-gauge Parsplana vitrectomy (PPV) were categorized as Group A ”trimanual group.” Twenty eyes of 18 cases with bimanual 23-gauge PPV were categorized as Group B” bimanual group” in the duration between May 2021 and December 2022. All cases were under continual observation for ≥ 6 months postoperatively.Results A total of 40 eyes out of 34 cases with the mean age of cases 50.5 years (ranged between 29–69 y) in group A and 47.9 (ranged between 33–60 y) old in group B were assessed. Retinal attachment, total elimination of the pre-retinal proliferation attained in all cases of the two groups. Surgical time was statistically significant shorter in the trimanual group compared to bimanual group (p value

ABSTRACTThe carrot is a root vegetable well-known for its high nutritional content and health advantages. It is well known for its strong antioxidant content, particularly carotenoids, which have been linked to cancer-fighting effects. Carotenoids, polyphenols, and vitamins in carrots have been demonstrated to have anticarcinogenic, antioxidant, and immune-boosting qualities, lending credence to the long-held concept that carrots are good for eye health. Numerous in-vivo and in-vitro research have revealed carrots’ numerous health benefits, including cholesterol-lowering, anti-diabetic, anti-hypertensive, renoprotective, hepatoprotective, and facilitate the excretion of fats and bile by the liver. Carrot seed extracts have also been shown to have antibacterial, antifungal, anti-inflammatory, cardioprotective, and hepatoprotective effects. Carrot pomace, which contains about 50% -carotene, has been recognized as a valuable byproduct that can be economically helpful for boosting culinary products such as biscuits, bread, and cakes, as well as preparing various functional goods. Carrot pomace powder is used to create bread and extruded items, demonstrating this waste’s variety and prospective applications. This comprehensive review focuses on the nutritional composition, phytonutrients, functional properties, product development, and utilization of carrots and their byproducts. This review aims to provide valuable insights into the diverse uses and advantages of incorporating carrots into various food and health products by highlighting the potential health benefits and applications of carrots and their derivatives.

Abstract Background Instantaneous wave-free ratio (iwFR) is a well-validated method for functional evaluation of intermediate coronary lesions. A recently developed Murray law-based QFR (µQFR) allows wire-free FFR estimation using a high-quality single angiographic projection. We aim to determine the diagnostic accuracy of µQFR as compared to wire-based iwFR for physiological assessment of coronary lesions in a sample of Egyptian patients. Results Over a one-year period, patients who previously underwent iwFR assessment of an intermediate coronary stenosis (40–90%) were retrospectively included. μQFR analysis was then performed offline using a dedicated artificial intelligence (AI)-aided computation software. All the measurements were performed blinded to iwFR results, and the agreement between iwFR and μQFR values was tested. Forty-nine patients (mean age 57.9 ± 9 years, 72.9% males) were included. Mean value of iwFR and μQFR was 0.90 ± 0.075 and 0.79 ± 0.129, respectively. There was a significant moderate positive linear correlation between μQFR and iwFR (r = 0.47, p = 0.001; 95% CI 0.22–0.68) with moderate-to-substantial agreement between the two methods (Kappa 0.6). In assessing the diagnostic accuracy of μQFR, the receiver operating characteristic (ROC) curve yielded an area under the curve (AUC) of 0.84 (95% CI 0.717–0.962) for predicting functionally significant lesions defined as iwFR

Abstract To investigate the association between parenting style and child’s dental caries. Parents presenting with their children to the Department of Pediatric Dentistry at Tufts University School of Dental Medicine for an initial exam or re-care appointment completed a demographic survey and the parenting styles and dimensions questionnaire. Recruitment of subjects started in May 2019 and ended in February of 2020. Child’s decayed, missing, and filled teeth (dmft) index, diet score, sex, and age were recorded, as were parent’s race, education level, and form of payment. Adjustment for confounders was done using multivariable negative binomial regression. The sample size was 210 parent/child dyads. In the multivariable analysis, parenting style and child’s dmft were not significantly associated (p > 0.05). Parents with an education level less than high school (p = 0.02) and at the high school graduate level (p = 0.008) were significantly associated with children who had higher dmft, compared to parents with a college degree or higher. Children with excellent diet scores had significantly lower dmft than children with a diet score in the “needs improvement” category (p = 0.003). There was no significant evidence that parenting style is associated with child’s dental caries. Parent’s education level and child’s diet score were significantly associated with child’s dmft, less than high school (p = 0.02) and at the level of high school graduate (p = 0.008). Pediatric dental professionals should be aware of these risk indicators.

Abstract Background Esophagitis dissecans superficialis (EDS) is a rare desquamative esophageal condition with a wide range of presentations, from asymptomatic cases to those with severe, life-threatening symptoms. EDS has a strong association with several conditions, such as autoimmune diseases, smoking, and certain medications, although it can also occur without any apparent cause (idiopathic). Diagnosis involves a comprehensive approach, including clinical assessment (history and examination), endoscopic examination, histopathological analysis, and the exclusion of other potential causes. There is still no established standard treatment for EDS, as many cases resolve spontaneously without long-term complications. Case presentation. We present a case of a 73-year-old female with an episode of upper gastrointestinal bleeding (UGIB) due to Esophagitis dissecans superficialis, which had a favorable outcome after therapy with a proton pump inhibitor (PPI). Conclusion Although EDS is a rare condition, it should be considered a cause of UGIB in patients with risk factors.

Abstract Background Colorectal cancer (CRC) is ranked as the third most commonly diagnosed cancer and the third cause of cancer related deaths. CRC is greatly attributed to genetic and epigenetic mutations and immune dysregulation. Tumor aberrant expression of Toll-like Receptors (TLRs) can contribute to tumorigenesis. Recent studies suggested that microRNAs act as direct ligands of TLRs altering their expression and signaling pathways. Aim To prove our concept that specific miRNA mimics may act as antagonists of their specific toll like receptors inhibiting their expression that could limit the release of pro-inflammatory and pro-tumorigenic cytokines leading to apoptosis of tumor cells. Methods From public microarray databases, we retrieved TLRs and miRNAs related to CRC followed by in silico docking of the selected miRNA ligands into the TLRs. Clinical validation after co-immunoprecipitation of TLRs and their interacting miRNA ligands was done. Expression of TLRs 1, 7,8 was determined by ELISA while miRNAs was measured by RT-qPCR. In addition, microRNA mimics of the down regulated miRNAs were transfected into human CRC cell lines. Results Our data demonstrate that TLRs 1, 7, 8 are up regulated in CRC compared to controls. Further, three miRNAs (-122, -29b and -15b) are relatively downregulated, while 4 miRNAs (-202, miRNA-98, -21 and -let7i) are upregulated in CRC patients compared to those with benign tumor and healthy controls. Transfection of down regulated miRNA mimics into CRC cell lines resulted in a significant reduction of the number and viability of cells as well as down regulating the expression of TLRs 1, 7 and 8 with ultimate reduction of downstream effector IL6 protein, suggesting that these miRNAs are negative regulators of carcinogenesis. Conclusion MicroRNAs could act as antagonistic ligands of TLRs limiting the inflammatory tumor microenvironment.

Abstract Background The reported prevalence of patent foramen ovale (PFO) in the general population is variable. It ranges between 8.6 and 42% according to the population studied and the imaging technique used. We aim to prospectively assess the prevalence and characteristics of PFO and interatrial septum (IAS) abnormalities as well as the related clinical manifestations in a sample of Egyptian population. Results This study comprised 1000 patients who were referred for CT coronary angiography (CTCA). Mean age was 52.5 ± 10.9 years. The prevalence of PFO among the studied population was 16.3%; closed PFO (grade I) 44.2%, open PFO (grade II) 50.9%, and open PFO with jet (grade III) 4.9%. Anatomical high-risk PFO features—defined as the presence of at least 2 or more of the following (diameter ≥ 2 mm, length ≥ 10 mm, septal aneurysm “ASA”, or redundant septum)—were found in 51.5% of PFOs’ population. Other IAS abnormalities as redundant septum (8.6%), ASA (5.3%), Bachmann’s bundle (4.5%), microaneurysm (2.6%), and atrial septal defect (ASD) (0.4%) were detected. There was a lower rate of coexistence of ASA with PFO (p = 0.031). Syncope was significantly higher in patients with PFO compared to those without PFO (6.7% vs. 1.6%, p = 0.001). Stroke, transient ischaemic attacks (TIA), and dizziness were similar in both groups. TIA, dizziness, and syncope were significantly higher in patients with IAS abnormalities including PFO compared to those without IAS abnormalities. Syncope was also significantly higher in PFO with high-risk anatomical features compared to those with non-high-risk PFO population (p = 0.02). Conclusion The prevalence of PFO in our study was approximately 16.3%, almost half of them showed anatomical high-risk features for stroke. Dizziness, syncope and TIA were significantly higher in patients with IAS abnormalities including PFO.

Key Clinical Message Stone heart syndrome has a complex interaction with digoxin toxicity, where, theoretically, the administration of intravenous calcium can worsen a patient's condition. Research on this subject is conflicting, so it is imperative to approach it cautiously.

Background: Immunoglobulin G (IgG) subclasses play a crucial role in the immune response to viral infections. While total IgG levels can generally provide an indication on the immune response, specific IgG subclasses can offer more detailed information about nature of the immune response and stage of the infection. Herein, we addressed the value of both total (t) and SARS-CoV-2-specific (s) IgG-subclasses in distinguishing between infection-confirmed virus-qRT-PCR-positive (IC; V-qRT-PCR-P) and infection-unconfirmed virus-qRT-PCR-unchecked (IU; V-qRT-PCR-UC) Egyptians. Results: Both the t-IgG2 and 4 means were significantly higher (SH) among the IU subjects, whereas, the s-IgG1 and 3 means were SH among the IC ones. On the gender levels, both the t-IgG2 and 4 means were SH among the IU females, whereas, the mean of the s-IgG1 was SH among the IC females. The t-IgG4 mean was SH among the IU males, whereas, both means of the s-IgG1 and 3 were SH among the IC males. Significant positive correlations (SPC) were recorded between both the t-IgG1 and 3 with the symptom grades (SG) among the IU humans (r2 = 0.200 and 0.253, respectively). Also, SPC was noticed between the s-IgG2 and the SG among the IU females (r2 = 0.6782). SPC was recorded between both the t-IgG1 and the s-IgG2 with the SG among the IU males (r2 = 0.794 and 0.373, respectively). SPC was noticed between the t-IgG3 and the age among the IC males (r2 = 0.779). Conclusion: Although the limitation of the small studied sample size, our results suggest some total and SARS-CoV-2-specific IgG-subclasses as both supplemental and gender-specific immune markers to distinguish between confirmed and unconfirmed SARS-CoV-2 infections.

Introduction: The role of Acetyl -11-keto-β-boswellic acid (AKBA) in regulating osteoblast differentiation was recently brought to light. Therefore, the current study was designed to explore the osteogenic differentiation capability of AKBA on bone marrow mesenchymal stem cells (BMMSCs) as a potential therapeutic agent to accelerate the healing process in apicoectomy. Materials and Methods: BMMSCs were characterized by flow cytometry. Cellular viability and proliferation assays were used with different concentrations of AKBA. Cells were divided into 5 groups to test osteogenic differentiation: Group I: negative control, Group II: positive control, Group III: BMMSCs were treated with 1 μM AKBA, Group IV: BMMSCs were treated with 0.1 μM AKBA, and Group V: BMMSCs were treated with 0.01 μM AKBA. Mineralization assays and gene expression analysis were assessed, and the significance difference between groups was established at P < 0.05. Results: The flow cytometry analysis demonstrated that BMMSCs had positive expression for mesenchymal stem cell marker and negative expression for hematopoietic markers. The concentration of 0.01 μM gave significantly higher cell density than the untreated cells after 7 days (P < 0.05). Cells treated with 0.1 and 0.01 μM AKBA revealed a significantly higher ALP activity, alizarin red, and von Kossa staining than control groups (P < 0.05). High expression of osteogenic genes was detected in BMMSCs treated with 0.1 μM AKBA (P < 0.05). Conclusions: It was declared that the concentration of 0.1 μM AKBA has no toxicity on BMMSC viability and proliferation with an impact on BMMSC osteogenic differentiation. Therefore, AKBA (0.01 μM) could be used in bone regeneration during periradicular surgery.

Abstract Background & Aim Teacher engagement can be defined as the teachers’ effort and attention to teaching professional tasks, adequate emotions and commitment to relationships with students and colleagues in classroom and school. The Engaged Teacher Scale (ETS) is the frequently used scale, measuring teacher engagement developed by Klassen et al., 2013 in the UK, and consists of four dimensions: cognitive engagement (CE), emotional engagement (EE), social engagement with students (SES), and social engagement with colleagues (SEC). Therefore, the aim of this study was to measure the psychometric properties of the Persian version of the Engaged Teachers Scale (ETS). Materials & methods A total of 123 teachers who worked at Shahid Beheshti University of Medical Sciences, Tehran, Iran, were included in this study. The study participants were selected using the convenience sampling. The Persian version of a 16-item scale developed by Klassen et al. was validated by this study. Face and Content validity index and reliability were assessed after translation and cultural adaptation, and also construct validity was calculated by confirmatory factor analysis using the PLS22. Results Of the 123 study participants, 74 (60.01%) were females and 49 (39.9%) were males. The mean age of the subjects was about 30–40 years. The majority of the study participants were general practitioners (n = 75; 60.9%) and others were from different specialists. Content validity among 15 experts was 0.88. Confirmatory factor analysis for all 16 items loaded across four factors, and this four-factor scale showed a good fit in the Iranian community. Reliability using Cronbach’s alpha was 0.79. The value of root mean square error of approximation (RMSEA) was 0.0094 with the 99% confidence interval, and also the goodness of fit index GFI value was 0.98. Conclusion The Persian version of ETS had good validity and reliability in Iran and could be a useful tool for measuring the teacher engagement factors of faculty members that can be used by teachers and educational administrators.

Abstract Background Medical students face significant psychological stress, impacting their academic performance and well-being. The Systematic Assessment for Resilience (SAR) framework is designed to enhance resilience and mitigate stress among medical students, addressing the need for interventions within the assessment system in medical education. The aim of this study was to evaluate the implementation of SAR framework on medical students’ resilience, anxiety, depression, burnout, and academic stress. Methods This study employed a quasi-experimental design with pre- and post-testing. It involved the training of course coordinators in implementing the SAR framework and its integration into the daily learning activities. Fourth-year medical students were assessed before and after the intervention using standardized measures of resilience, anxiety, depression, burnout, and academic stress. Data were analyzed using quantitative methods and thematic analysis for qualitative feedback. Results Post-intervention, students demonstrated a significant increase in resilience scores (p 0.05). Qualitative feedback of the course coordinators highlighted an improved learning environment, increased coping strategies, and a more supportive academic culture. Conclusion The SAR framework significantly contributes to enhancing medical students’ resilience and reducing psychological distress. Its implementation suggests a promising approach to fostering a supportive educational environment that not only addresses the psychological challenges faced by medical students but also enhances their academic performance and overall well-being. Further research is warranted to explore the long-term impacts of SAR across different medical education contexts.

Abstract Background Tympanic membrane perforations are among the most common indications for otological surgery. Surgeons from all around the world have made accidental and intentional contributions to find the perfect graft material and the best approach to perform tympanoplasty. Platelet-rich fibrin (PRF) use in myringoplasty has been popular in the last decade among many surgeons. We aimed to evaluate the efficacy of using PRF only as a graft material in myringoplasty. Methods We conducted a prospective study including 20 patients with dry central tympanic membrane perforations. The patients underwent endoscopic transcanal myringoplasty using a platelet-rich fibrin membrane by underlay technique. Follow-up was done 3 months postoperatively regarding graft uptake and hearing outcome by audiological assessment using pure tone audiometry. Results Sixty percent of patients were surgically successful with complete healing of the tympanic membrane, 10% were partially successful with partial healing of the tympanic membrane, and 30% failed with complete loss of graft. The mean air-bone gap closure was 3.5 dB. No major complications were reported. Conclusion Endoscopic myringoplasty using platelet-rich fibrin alone can be performed in cases with tympanic membrane perforations as an alternative to using other autologous grafts. It is a new reliable method for myringoplasty, as well as being an easy, time-saving procedure that avoids the need for any skin incision.

Background: The objective of our study to analyze the data of the prenatal diagnosis of congenital malformations at the maternity and reproductive health hospital "Les Orangers" in Rabat and to identify the main anomalies detected, their percentage and their short-term outcome.Methods: This is a cross-sectional study conducted at the maternity and reproductive health hospital "Les Orangers" in Rabat, Morocco. The data was collected and reported on pre-established sheets and on the register of malformations of the hospital.Results: A total of 245 cases of congenital malformations comprising 470 types of congenital malformations were recorded out of a total of 43,923 births over a period of five and a half years, giving a prevalence of 5.58 per thousand.Prenatal diagnosis was made in a third of cases (33%), essentially during the 2nd-3rd trimester of pregnancy. The anomalies revealed by this antenatal diagnosis were dominated by urinary malformations in 70% and central nervous system anomalies in 67%, followed by other types of congenital anomalies in less than 40% of cases, while genetic problems were detected in 2.5%; this rate is underestimated since chromosomal abnormalities sometimes appear as syndromes, so that in some diseases, genetic changes are not separated from other abnormalities, and since more than half (50.7%) of cases presenting polymalformative syndromes not survived 77% of cases i.e. (48.5% of deaths and 28.5% of FDIU) and an etiological study was not carried out.Conclusion: Antenatal ultrasound allows early detection and monitoring of the evolution of congenital malformations, and thus the possibility of ensuring early and adequate management of these anomalies from birth. In our context, it is necessary to develop a prenatal screening program for congenital anomalies and a network of reference centers for the management of these anomalies in order to improve their prognosis.

Introduction: Infection prevention and control (IPC) is a crucial component of the healthcare system that demands adherence to standards to avoid and reduce the risk of infectious diseases spreading among patients, staff members, and visitors to healthcare institutions. The aim of this study was to assess IPC knowledge among undergraduate health sciences students and to identify the critical IPC components that need to be addressed. Methods: A cross-sectional online survey was conducted among 235 final-year health science students at International Islamic University Malaysia (IIUM), involving five faculties: the Faculty of Medicine, Dentistry, Pharmacy, Nursing, and Allied Health Science. A 45-item questionnaire was used to collect participants’ sociodemographics (5 items) and explore their knowledge about IPC across six aspects (40 items). A score of > 24 (62%) indicates satisfactory knowledge. Results: The majority of the participants were female (74.9%), and 34% were from the Faculty of Pharmacy. Medicine students had the highest level of IPC knowledge with a mean score of 29.3 (n = 52), which was significantly different from Allied Health Science students (M = 25.6, n =55, p < 0.001). Other faculties students had similar IPC knowledge with no significant differences (Pharmacy: M = 27.5, n = 80; Nursing: M = 27.4, n = 29; Dentistry: M = 27.2, n = 19). IPC components that need to be improved are knowledge about sharp disposals and sharp injuries, as well as respiratory hygiene and cough etiquette. Conclusion: IPC knowledge was adequate among health science students at IIUM, although certain IPC components still require improvement. Additional IPC educational materials and workshops should be added to all faculties' syllabi to address this issue.

Introduction: Polymyalgia rheumatica (PMR) is a chronic inflammatory disorder that causes stiffness and pain in the proximal joints, including the shoulders, hips and neck. The exact cause of polymyalgia rheumatica is yet to be fully understood, but research suggests that both genetic and environmental factors may contribute to it. Studies have previously linked the onset and relapse of polymyalgia rheumatica symptoms to the influenza and COVID-19 vaccines. The Food and Drug Administration approved the respiratory syncytial virus (RSV) vaccine, which is a recombinant protein vaccine for adults over 60, in May 2023. No previous reports of polymyalgia rheumatica onset or relapse have been linked to the RSV vaccine. The human proteome shares some peptides with the RSV F antigen, suggesting a high risk of cross-reactivity when using that antigen in vaccination formulations. Case description: A 72-year-old man experienced a new onset of bilateral shoulder pain and stiffness three days after receiving the Abrysvo® RSV vaccine. The symptoms lasted more than an hour (up until noon) and interfered with his activities of daily living. Inflammatory markers such as C-reactive protein were elevated. The patient’s symptoms and inflammatory marker levels significantly improved with prednisone therapy. Conclusion: In patients with typical PMR symptoms, it is important for clinicians to carefully review immunisation history to rule out any potentially related adverse effects.

To perform a condition monitoring for rotating machines with variable running speed, order tracking is considered as an effective technique suitable for their non-stationary vibration signals. A tachometer signal is necessary to perform a computed order tracking (COT) technique; however, in some applications it's not possible to add tachometer hardware due to its complexity or shortage of power. To improve the applicability of order tracking techniques, some tacho-less order tracking techniques have been introduced in the last few years. These techniques are working off-line by inspecting the vibration signals in time-frequency domain to extract the machine rotating speed. In this paper, a new tacho-less technique suitable for continuous structural health monitoring applications of railway vehicles, is proposed. In the presented approach, a coarse angular speed of the railway axle is estimated firstly using estimation train speed. Then this coarse angular speed is used to improve the applicability of the traditional tacho-less techniques to be able to work online. The train speed is estimated from two acceleration signals obtained from vertical vibration of axle-boxes from same side of train. The sequential properties of the two signals are used to estimate the delay time of one signal with respect to the other one by means of cross-correlation function. By knowing the horizontal distance between the two sensors collected the vibration signals, the train speed can be estimated. This modification of tacho-less technique improves the effectiveness and robustness of the traditional maxima tracking strategy to be performed automatically. Thereafter, signal processing technique based on the computed order tracking as well as averaging technique can be applied to extract the useful information from noisy and non-stationary signals. This technique has been proposed in a framework of a project investigating crack detection using vibration measurements, therefore, vibration signals of cracked axle have been processed using tacho-based method and using the proposed tacho-less technique and a good agreement has been found between the two techniques.

Abstract Background By 2030, approximately 22.6 million individuals in Egypt will be older than 50 years and prone to develop osteoporosis and are at risk of sustaining a fragility fracture. Osteoporotic fragility fractures, and in particular hip fractures, are associated with enduring pain, physical disability, poor quality of life, and loss of independence. Mortality rates are also high in this cohort of patients. Over the coming years, the potential preventable burden is likely to surge, particularly with the aging of the Egyptian population. The aim of this work was to determine the age onset of screening for risk of fragility fracture among Egyptians. Results A convincing evidence was found that fracture risk assessments are accurate and can be applicable in standard practice to identify individuals at high/very high risk of developing fragility fractures. A tremendous increase in the risk of fragility fracture at the age of 60 (RR = 33.5 for men and 20.2 for women). As interventions to either treat osteoporosis or to modify behavioral risk factors in terms of healthy eating and physical exercise would take years to change this risk, it was recommended to start screening for fragility fracture at the age of 50 for both men and women. Conclusion All Egyptian men and postmenopausal women 50 years of age or older should be evaluated/screened for their risk of sustaining a fragility fracture risk. The consequences of failing to identify and treat women and men who are prone to sustain a fragility fracture are considerable. In contrast to DXA scanning, screening with FRAX is cost-effective (time and effort required by patients and the health care system).

Abstract Background This work aims to develop clinical practice recommendations for the management of systemic sclerosis (SSc). Results Fourteen expert panels had completed the two rounds of surveys. After the end of round 2, recommendations were released and distributed on 11 domains. The percentage of the agreement on the recommendations was 92.3% to 100%. All 11 key questions were answered at the end of the second round with agreement. Conclusion This guideline tried to tackle the gaps in research that limit treatment options. Stratifying the patients according to their disease domains has helped to set up sequential management pathways for each domain.

Introduction Adaptive radiotherapy (ART) is an essential approach to account for anatomical and biological uncertainties. Adaptive radiotherapy is, however, time-consuming, and it is unclear which patients are eligible or when is the best time to start ART. Methods This prospective study was conducted at Kasr El-Aini Center of Clinical Oncology and Nuclear Medicine, Cairo, Egypt from January 2019 to December 2020. Thirty patients with pathologically proven, limited-stage small cell or stage I-II non–small cell lung cancer who were either not fit for or refused surgery or had stage III disease were recruited and underwent treatment planning to receive 60 Gy on a conventional 3D conformal radiation schedule with platinum-based chemotherapy. All patients underwent computed tomography (CT) planning within 2 and 4 weeks of starting radiation therapy to assess the need for adaptation. Pulmonary function test and echocardiography findings were assessed at the end of treatment and at 3 and 6 months after treatment, and were compared to the baseline. Results We found a significant reduction in mean value of the planning target volume (PTV) in the CT scans at the second (331 cm3) and fourth (257 cm3) weeks of treatment as compared to baseline (342 cm3) (p-value < 0.0001). Adaptation decreased the dose to the organ at risk with statistical significance and with improvement of the target coverage. At week 2 of radiotherapy, the need for adaptation was correlated to the conformity index (p = 0.0473), esophageal V35 (p = 0.0488), esophageal V50 (p = 0.0295), and its mean dose (p = 0.0087). At week 4 it was correlated to forced expiratory volume in 1 second (FEV1) (p = 0.0303), ratio between the forced expiratory volume in 1 second and the forced vital capacity (FEV1/FVC) (p = 0.0024), and echocardiography (p = 0.0183). Conclusion Conformity index and esophageal dose constraints can predict the need for adaptation at week 2, whereas baseline pulmonary function parameters and echocardiography can predict the need for adaptation at week 4 of radiotherapy.

Abstract Hydrothermal alteration processes are connected to many mineral formations, particularly auriferous deposits. In this study, airborne gamma-ray spectrometry (GRS) data and the analysis of radioactive materials (eU, eTh, and K) are applied to search for regions with hydrothermal alteration activity. An example is presented from Wadi Al-Allaqi, South Eastern Desert, Egypt. GRS was used to analyse various radiometric data to address potential mineral deposit areas, to map regions potentially showing metallic ore mineralisation, and to point out new geological mineral resources. The Kd (potassium deviation), “F” parameter and Th-normalisation of the K and eU anomalies were calculated, and locating new exploratory targets in the study area that exhibit high F-parameter, Kd, and K/eTh values was recommended. Additionally, the research region has a few isolated enriched spots of (K). Therefore, GRS data was used to characterise and estimate potential metallic ores, nonmetallic deposits, and gold ore zones associated with the alteration zones. Results show that most of the known mineral deposits and gold occurrences in the area, according to the metallogenic map of Egypt, are located in zones with a ratio value of (0.25–0.30) (K%/(U or Th ppm)) maps which may suggest a moderate degree of alteration. Also, most mineral deposits and gold occurrences are found in intermediate altered zones, or K-enriched sites, with a Kd% of (0.2. The work represents an attempt to map hydrothermal alteration zones associated with mineral deposits in the Wadi Al-Allaqi area. Generally, natural radiation characteristics and attributes suggest criteria that can be used globally for regional mineral exploration.

Abstract Background Regardless of a proliferation of interest in reducing unsafe practices in healthcare, threats to patient safety (PS) remain high. Moreover, little attention has been paid towards the role of interprofessional education (IPE) in enhancing PS. This qualitative study was conducted to unfold the insights of the senior medical, dental and health sciences students at the University of Sharjah (UoS) in the United Arab Emirates (UAE) about PS in an online IPE-based workshop. Methods This inductive thematic analysis study was conducted on senior medical and health students at the Colleges of Medicine, Dental Medicine, Health Sciences, and Pharmacy of UoS. During an online workshop, students discussed plausible solutions for four real practice-based clinical scenarios with elements of unsafe healthcare practices. During the breakout rooms, the students exhibited high level of articulation and proactively participated in discussions. The data from the online workshop were transcribed and then coding, categorizing, and labelling of recurrent themes were carried out. Multiple individual deliberations, consolidation, incorporation of the identified preliminary themes, and merging and reorganizing sub-themes led to a final thematic framework. Results This work delved into the perspectives of 248 students regarding teamwork, communication, problem-solving, and other aspects concerning PS in interprofessional settings in an online workshop. The iterative process of data transcription, curating and qualitative analysis surfaced 32 codes. Later, the inductive themaric analysis yielded five themes with distinct yet interconnected nested subthemes in the context of PS in IPE settings. These themes of information sharing and grounding (problem-solving, social skills), maintaining communication (clinical reasoning, shared mental model), executing interprofessional activities (collaborative practice, collaboration scripts), professional cognitive abilities (cognitive maturity, metacognition), and negotiating professional identities (systematic change, socio-economic scaffolding) emerged as fundamental pillars for enhancing PS in healthcare. Conclusion Our study demonstrated the outcome of an innovative and team-based workshop which embedded PS within a scaffold of IPE environment. This research calls for incorporation of the emerging areas of clinical reasoning, problem solving, collaborative practice, and shared mental model into medical curricula for structured IPE in improving PS domains in medical education. These findings underscore the need for multifaceted dimensions of IPE imperatives for cultivating collaborative competence.

Background: Administration of trastuzumab (TRA) in resource-limited settings (RLS) is associated with significant deviations from per-label recommendations such as fixed-dose instead of weight-based, interruptions, and a reduced number of cycles. The impact of these deviations on the clinical outcomes of HER2-positive non-metastatic breast cancer is unclear. Methods: We retrospectively reviewed the records of patients with operable HER2-positive breast cancer treated at our center from 2013 to 2018 for TRA dose deviations. The standard protocol for TRA administration includes a one-year course of TRA with one intravenous dose every three weeks for 17 cycles. We assessed the number of cycles, underdosing based on body weight calculation, and low relative dose intensity (RDI). Cox regression analysis was used to identify predictors of survival and was adjusted for baseline clinical variables. Results: This analysis included 208 patients with a median age of 45 years. A total of 175 (84%) patients showed at least one per label deviation. Fifty-four patients (26%) were underdosed with a mean maintenance dose defect of 54 ±107 mg, 64 (31%) received a reduced number of courses (≤ 9 cycles), and 103 patients (49.5%) received TRA at low RDI. Reduced number of cycles was the only factor associated with a worse hazard of recurrence-free survival and overall survival (HR: 2.25, 95% CI: 1.35–3.75, adjusted p =0.002) and (HR: 2.48, 95% CI: 1.36-4.52, adjusted p =0.003), respectively. Conclusion: In our cohort, not all the deviations had adverse impacts on clinical outcomes. Only a reduced number of cycles was associated with a worse recurrence-free and overall survival hazard. Improving access to anti-HER2 therapies in RLS is crucial. Ensuring the full course of TRA in RLS is needed.

Background: Pest des petits ruminants (PPR) and Foot and Mouth Disease (FMD) are two viral infectious diseases affecting sheep dramatically causing great economic losses. So, attention should be directed toward their control specially through application of well-designed vaccination schedule with specific potent vaccines. Aim: Determination of the possibility of sheep vaccination with PPR and FMD vaccines in mutual schedule. Methods: Different groups of sheep were vaccinated with Live attenuated PPR vaccine and inactivated polyvalent FMD vaccine in mutual manner (one before the other on week interval or simultaneously) followed by monitoring of the induced immunity to both vaccines using serum neutralization test (SNT) and enzyme linked immune sorbent assay (ELISA). Results: SNT and ELISA revealed that there was no antagonizing effect of any vaccine on the immune response to the mutual vaccination of sheep to the other where the obtained antibody titers in single vaccinated sheep groups were similar to those in simultaneous vaccinated group. Conclusion: Simultaneous vaccination of sheep with PPR and polyvalent FMD vaccine is of applicable benefit saving time, effort and stress factors on the animals. [Open Vet J 2023; 13(12.000): 1669-1682]

ABSTRACTThis study was designed to investigate the amino acid profile, vitamin B complex, and bioactive properties present in recently cultivated rye variants in Pakistan. The four rye variants, named as Gp 1, Gp-2, Gp-3, and Gp-4, were procured from the Forage and Pulses section of AARI Faisalabad. The rye samples were ground into flour using a hammer-type 120-ton laboratory mill. For the analysis of amino acids, vitamin B complex, phenolic constituents, alkylresorcinols, and lignin, standard HPLC and GC-MS methods were employed following the extraction with appropriate reagents. The results revealed that among the rye variants, Gp-2 showed the highest content of vitamin B complex, with thiamin at 252.33 μg/100 g, niacin at 397 μg/100 g, and pyridoxine at 99 μg/100 g. Pantothenic acid (246.70 μg/100 g) and ascorbic acid (470 μg/100 g) were found in the highest concentrations in Gp-3. The riboflavin content of Gp-1 was 84.40 g/100 g, while the folate content of Gp-4 was 24.40 g/100 g. In terms of phenolic compounds, the range of chlorogenic acid content ranged from 86.70 to 92.43 mg/kg, p-coumaric acid from 2.70 to 5.40 mg/kg, gallic acid from 64.70 to 97.10 mg/kg, caffeic acid from 16.90 to 25.90 mg/kg, and coumaric acid from 218.10 to 228.40 mg/kg. In conclusion, Gp-2 observed as the most nutritionally rich and bioactive variant, distinguished by its high essential amino acids, vitamins, and other bioactive components.

ABSTRACTBackground Application of supraclavicular block generally comprises elbow, forearm, and hand surgery. Tramadol and dexamethasone were tested and compared in the current study as adjuvants to levobupivacaine in the supraclavicular block.Patients and Methods 60 ASA Grade I and II patients of either sex, older than 18, participated in the current study. Two groups of patients were created: Group D (n = 30), who received 30 ml of 0.5% levobupivacaine and 2 ml of dexamethasone (8 mg). 30 ml of 0.5% levobupivacaine and 2 ml of 5% tramadol (100 mg) were given to Group T (n = 30). Statistics were used to compare the two groups.Results The tramadol group required substantially less time (13.4 ± 2.6 h) than the dexamethasone group (15.3 ± 2.8 h) for the first rescue analgesia request (P-value = 0.009). Within the first 24 hours following surgery, the mean total dose of rescue analgesia was considerably lower in group D (36 ± 12.2 mg) than in group T (44 ± 15.2 mg, P-value = 0.029). Group D had no side effects and considerably higher patient satisfaction (P = 0.042).Conclusion When levobupivacaine was used with dexamethasone in a supraclavicular brachial plexus block for forearm fractures, it worked better as an adjuvant than tramadol. Sensory and motor blockage, a quicker onset and longer duration of analgesia, and higher satisfaction levels were all present.

Background: This study aims to compare resource utilization and staff satisfaction between the point-of-care (POC) activated system and the traditional intravenous piggyback (PB) system in hospital pharmacy settings. Methods: Employing a pre-post quasi-experimental design from November 2019 to April 2020, the study assessed resource requirements for both the POC activated system and the traditional PB system. Additionally, a staff satisfaction survey was conducted, focusing on staff experiences related to the pharmacy preparation process and the subsequent activation of the system by nurses. Results: The POC activated system required significantly fewer full-time equivalents (FTEs) per month compared to the PB system (0.36 ± 0.05 vs. 1.56 ± 0.07; p < 0.0001). Using POC in automated dispensing cabinets (ADCs) reduced medication administration time and returns (6.41% vs. 1.75%; p < 0.0001). The staff satisfaction survey revealed greater satisfaction with the POC activated system. A subsequent analysis showed the POC activated system had a low expiration rate of 0.1% and a cost of 39 Saudi riyal, while the traditional system had higher expiration rates and cost of 46,260 SR. Conclusions: The POC activated system reduced FTEs, decreased returned medications, and enhanced staff satisfaction compared to the PB system.

Escitalopram is widely prescribed for the treatment of major depressive disorder and generalized anxiety disorder with a well-documented side effects profile. Peripheral edema, however, is a rarely reported adverse reaction that warrants further work up. This paper summarizes the case of a 58-year female patient who developed transient bilateral peripheral edema following the administration of low dose escitalopram. This case underscores the necessity for clinicians to be familiar with even rare potential side effects of commonly prescribed medications. It also suggests a need for patient education regarding the importance of reporting new symptoms promptly.

IntroductionBurnout, resilience, and thriving significantly impact academics, particularly in health professions, where responsibilities are extensive. This study aimed to explore these constructs among academic health professionals, examining sociodemographic and work-related factors influencing these outcomes.MethodsA cross-sectional study was conducted among academic health professionals via web-based professional networks from August 2022 to February 2023. Validated tools were used, and descriptive and inferential statistics were applied.Results505 participants were included, predominantly female (63%), with a mean age of 38.15 ± 9.6 years. High burnout was reported by 10.9%, 13.7% experienced exhaustion, and 6.3% were disengaged. Resilience and thriving were moderate at 59.2 and 51.9%, respectively. Age correlated negatively with burnout (r = −0.131, p = 0.003) but positively with resilience (r = 0.178, p

Gabal El Urf region is located in the northern Egyptian Eastern Desert and overlain essentially by older and younger granitoids of Late Proterozoic age. These granitoids contain numerous outcrops of pegmatites, mostly occurring as dikes and veins or huge separated masses. In the contrary, pegmatites form lens-like bodies enclosed within the younger granites along their margins. Previous radiometric surveys showed anomalous concentrations of radioactivity on pegmatite body, located to the south of the study region. The younger granites and the associated radioactive pegmatite are studied in details with the aim to describe this pegmatite, petrogenesis and its relation with the encolsing granite. The younger granites are monzogranite and syenogranite according to mineralogical and chemical classification. Petrographically, the two younger granitic phases are strikingly similar. Both consist of potash feldspar, plagioclase and biotite with some hornblende in the earlier phase. Gabal El Urf younger granites are categorized as highly fractionated I-type granites with metaluminous to mildly peraluminous characters, which emplaced at 600 ± 11 Ma in post-collisional environment. The radioactive pegmatite is located within the syenogranite and enriched with Zr, Nb, Ta, Y, Th, U and REEs; accordingly it was classified as NYF-type rare-elements pegmatite. Metal-bearing generations of minerals within the rare-elements pegmatite include zircon, uranothorite, betafite, aeschynite, fluorite, pyrite and ilmenite.

Purpose: This study aimed to examine the effects of a multi-component mobile health intervention (wearable, apps, and social media) on cancer survivors’ (CS') physical activity (PA), quality of life, and PA determinants compared to exercise prescription only, social media only, and attention control conditions. Methods: A total of 126 CS (age = 60.37 ± 7.41 years, mean ± SD) were recruited from the United States. The study duration was 6 months and participants were randomly placed into 4 groups. All participants received a Fitbit tracker and were instructed to install its companion app to monitor their daily PA. They (1) received previously established weekly personalized exercise prescriptions via email, (2) received weekly Facebook health education and interacted with one another, (3) received both Conditions 1 and 2, or (4) were part of the control condition, meaning they adopted usual care. CS PA daily steps, quality of life (i.e., physical health and mental health), and PA determinants (e.g., self-efficacy, social support) were measured at baseline, 3 months, and 6 months. Results: The final sample size included 123 CS. The results revealed only the multi-component condition had greater improvements in PA daily steps than the control condition post-intervention (95% confidence interval (95%CI): 368–2951; p < 0.05). Similarly, those in the multi-component condition had significantly greater increased physical health than the control condition (95%CI: –0.41 to –0.01; p < 0.05) over time. In addition, the social media condition had significantly greater increased perceived social support than the control condition (95%CI: 0.01–0.93; p < 0.05). No other significant differences on outcomes were identified. Conclusion: The study findings suggest that the implementation of a multi-component mobile health intervention had positive effects on CS PA steps and physical health. Also, offering social media intervention has the potential to improve CS perceived social support.

Abstract Heart failure (HF) represents one of the greatest healthcare burdens worldwide, and Egypt is no exception. HF healthcare programmes in Egypt still require further optimization to enhance diagnosis and management of the disease. Development of specialized HF clinics (HFCs) and their incorporation in the healthcare system is expected to reduce HF hospitalization and mortality rates and improve quality of care in Egypt. We conducted a literature search on PubMed on the requirements and essential infrastructure of HFCs. Retrieved articles deemed relevant were discussed by a panel of 10 expert cardiologists from Egypt and a basic HFC model for the Egyptian settings was proposed. A multidisciplinary team managing the HFC should essentially be composed of specialized HF cardiologists and nurses, clinical pharmacists, registered nutritionists, physiotherapists, and psychologists. Other clinical specialists should be included according to patients' needs and size and structure of individual clinics. HFCs should receive patients referred from primary care settings, emergency care units, and physicians from different specialties. A basic HFC should have the following fundamental investigations available: resting electrocardiogram, basic transthoracic echocardiogram, and testing for N‐terminal pro‐B‐type natriuretic peptide. Fundamental patients' functional assessments are assessing the New York Heart Association functional classification and quality of life and conducting the 6 min walking test. guideline‐directed medical therapy should be implemented, and device therapy should be utilized when available. In the first visit, once HF is diagnosed and co‐morbidities assessed, guideline‐directed medical therapy should be started immediately. Comprehensive patient education sessions should be delivered by HF nurses or clinical pharmacists. The follow‐up visit should be scheduled during the initial visit rather than over the phone, and time from the initial visit to the first follow‐up visit should be determined based on the patient's health status and needs. Home and virtual visits are only recommended in limited and emergency situations. In this paper, we provide a practical and detailed review on the essential components of HFCs and propose a preliminary model of HFCs as part of a comprehensive HF programme model in Egypt. We believe that other low‐to‐middle income countries could also benefit from our proposed model.

Enhancing the handling and ride comfort is the main objective in the off-road vehicles.Ride dynamics studies. To augment the control authority on the handling and the ride comfort for such vehicles, a soft suspension system should exist. The main drawback of the soft suspension is the high probability of rolling-over especially in sudden maneuver cases. Anti-roll bar is a classical mechanical linkage that has been used to increase the rolling stiffness without affecting the vertical stiffness of the vehicle. The main drawback of the antiroll bar is the increase of the load transfer between the vehicle sides and increases the rolling acceleration, which negatively affects the ride comfort. In the current study, we investigate the effect of adding torsional dynamic absorber beside the antiroll bar on improving the handling and the ride comfort of the vehicle. More over the structural integrity of this kind of vehicles is expected to be maintained for longer service life compared with the same vehicles without the torsional dynamic absorber. A model of 4 DOF vibrating system that represent the suspension system of the half rear of the off-road vehicle is adopted and the mathematical model is derived. The frequency responses of the model were studied statistically as well as the time domain response. The results reveal that, to a large extent, the augmented antiroll suspension system succeeded to damp the system quickly and reducing all vibration frequency levels. The simulation results show that the vehicle rolling settling time has been reduced by 30% approximately. Also the rolling acceleration mean value among the resonance band in the frequency response curve was reduced by 60%.

The continuity of power supply is affected by many factors; the weather conditions to which power system components are exposed are considered the most effect. A new methodology to assess the reliability of distribution system considering the impact of different weather conditions is presented in this paper. The proposed method considers possible future changes in the weather patterns that might occur differently from what it was in the past. Modified sets of reliability indices are presented for mathematically predicting reliability performance based on historical reliability data under specific past weather conditions combined with forecasted future weather conditions. The proposed method is applied to the distribution system components of RBTS; the results demonstrate the significance of considering the forecast of weather conditions in reliability assessment.

Blood transfusion is a common therapeutic intervention in hospitalized patients. There are numerous indications for transfusion, including anemia and coagulopathy with deficiency of single or multiple coagulation components such as platelets or coagulation factors. Nevertheless, the practice of transfusion in critically ill patients has been controversial mainly due to a lack of evidence and the need to consider the appropriate clinical context for transfusion. Further, transfusion carries many risk factors that must be balanced with benefits. Therefore, transfusion practice in ICU patients has constantly evolved, and we endeavor to present a contemporary review of transfusion practices in this population guided by clinical trials and expert guidelines.

Strong epigenetic pan-cancer biomarkers are required to meet several current, urgent clinical needs and to further improve the present chemotherapeutic standard. We have concentrated on the investigation of epigenetic alteration of the hTERT gene, which is frequently epigenetically dysregulated in a number of cancers in specific developmental stages. Distinct DNA methylation profiles were identified in our data on early urothelial cancer. An efficient EpihTERT assay could be developed utilizing suitable combinations with sequence-dependent thermodynamic parameters to distinguish between differentially methylated states. We infer from this data set, the epigenetic context, and the related literature that a CpG-rich, 2800 bp region, a prominent CpG island, surrounding the transcription start of the hTERT gene is the crucial epigenetic zone for the development of a potent biomarker. In order to accurately describe this region, we have named it “Acheron” (Ἀχέρων). In Greek mythology, this is the river of woe and misery and the path to the underworld. Exploitation of the DNA methylation profiles focused on this region, e.g., idiolocal normalized Methylation Specific PCR (IDLN-MSP), opens up a wide range of new possibilities for diagnosis, determination of prognosis, follow-up, and detection of residual disease. It may also have broad implications for the choice of chemotherapy.

Abstract The harmful influences of global warming on rabbit reproduction and industry attract global attention. Zinc (Zn) is an important trace element with a wide list of functions in the male reproductive system. The aim of this study was to estimate the effects of different forms of zinc supplementation, as organic (Zn methionine), nano (nano Zn oxide) as indirect way to minimized it impact on environment, and inorganic (Zn sulphate) on physiological parameters, semen quality, anti-oxidative status, hormonal profiles of male rabbits subjected to server heat stress. Thirty-six V-line bucks (6–7 months old, 2842.29 ± 34.46 g weight) were randomly distributed to 4 groups, bucks in 1st group (control group, Con) fed basal diet without Zn supplementation, the 2nd, 3rd and 4th groups fed basial diet with 30 mg/kg of zinc methionine (Zn-Met), nano zinc oxide (ZnO-NPs), and zinc sulphate (Zn-S), respectively for a period of 10 weeks suffered from severe heat stress of environmental ambient temperature (over 32 of temperature humidity index, THI). Semen samples were collected and evaluated for volume, pH, motility, concentration, viability, initial fructose, and seminal plasma antioxidant concentration. Liver, kidney function, hormonal and antioxidant profile were measured in blood serum. The results revealed that, compared to control, all forms of Zn supplementation used significantly improved kidney function (creatinine), serum antioxidant (SOD and CAT), physiological parameters, especially on 1st month of the experiment, and seminal plasma antioxidant (SOD and CAT) of heat stressed bucks. Likewise, semen quality in terms of sperm concentration, sperm viability, and initial fructose enhanced significantly (P ≤ 0.05) by ZnO-NPs supplementation. Zinc methionine supplementation significantly improved liver function and decreased seminal plasma TBARs. Treatments with Zn-Met and ZnO-NPs increased seminal TAC and blood testosterone levels with reduced blood cortisol levels compared to other groups. Severe heat stress could be counteract by inclusion Zn with studied forms Zn-Met and ZnO-NPs at recommended dose (30 mg/kg diet) to improve semen quality and antioxidant status.

Abstract Background Transplant candidates on the waiting list are increasingly challenged by the lack of organs. Most of the organs can only be kept viable within very limited timeframes (e.g., mere 4–6 h for heart and lungs exposed to refrigeration temperatures ex vivo). Donation after circulatory death (DCD) using extracorporeal membrane oxygenation (ECMO) can significantly enlarge the donor pool, organ yield per donor, and shelf life. Nevertheless, clinical attempts to recover organs for transplantation after uncontrolled DCD are extremely complex and hardly reproducible. Therefore, as a preliminary strategy to fulfill this task, experimental protocols using feasible animal models are highly warranted. The primary aim of the study was to develop a model of ECMO-based cadaver organ recovery in mice. Our model mimics uncontrolled organ donation after an “out-of-hospital” sudden unexpected death with subsequent “in-hospital” cadaver management post-mortem. The secondary aim was to assess blood gas parameters, cardiac activity as well as overall organ state. The study protocol included post-mortem heparin–streptokinase administration 10 min after confirmed death induced by cervical dislocation under full anesthesia. After cannulation, veno-arterial ECMO (V–A ECMO) was started 1 h after death and continued for 2 h under mild hypothermic conditions followed by organ harvest. Pressure- and flow-controlled oxygenated blood-based reperfusion of a cadaver body was accompanied by blood gas analysis (BGA), electrocardiography, and histological evaluation of ischemia–reperfusion injury. For the first time, we designed and implemented, a not yet reported, miniaturized murine hemodialysis circuit for the treatment of severe hyperkalemia and metabolic acidosis post-mortem. Results BGA parameters confirmed profound ischemia typical for cadavers and incompatible with normal physiology, including extremely low blood pH, profound negative base excess, and enormously high levels of lactate. Two hours after ECMO implantation, blood pH values of a cadaver body restored from 130 to 41.7 ± 10.5 mmHg, sO2, base excess, and HCO3 were all elevated from below detection thresholds to 99.5 ± 0.6%, − 4 ± 6.2 and 22.0 ± 6.0 mmol/L, respectively (Student T test, p 20 to 10.5 ± 1.7 mmol/L) and hyperkalemia (from > 9 to 6.9 ± 1.0 mmol/L) was observed when hemodialysis was implemented. On balance, the first signs of regained heart activity appeared on average 10 min after ECMO initiation without cardioplegia or any inotropic and vasopressor support. This was followed by restoration of myocardial contractility with a heart rate of up to 200 beats per minute (bpm) as detected by an electrocardiogram (ECG). Histological examinations revealed no evidence of heart injury 3 h post-mortem, whereas shock-specific morphological changes relevant to acute death and consequent cardiac/circulatory arrest were observed in the lungs, liver, and kidney of both control and ECMO-treated cadaver mice. Conclusions Thus, our model represents a promising approach to facilitate studying perspectives of cadaveric multiorgan recovery for transplantation. Moreover, it opens new possibilities for cadaver organ treatment to extend and potentiate donation and, hence, contribute to solving the organ shortage dilemma.

Background: The target of vaccination is to encourage a strong, covering and long-lasting immune response against antigens. For achieving these objectives; effective adjuvant and new vaccine strategies are demanded to make the vaccine sufficiently immunogenic to instigate a powerful immune response Aim: This study was completed for elaboration and evaluation of freeze-dried combined vaccine against both Rift Valley fever (RVF) and Bovine Ephemeral Fever (BEF) viruses using different stabilizers. Methods: Three formulae were prepared from such vaccine including: formula (1): stabilized with a mixture of 5% Lactalbumin Hydrolysate and 2.5% sucrose, formula (2): stabilized with a mixture of 50% the previous stabilizer and 50% of 1% Carbopol and formula (3): stabilized with 1% Carbopol solution. Samples of the three vaccine formulae were reconstituted on the time of experimental animal vaccination using saponin diluent which acts as an adjuvant for both RVFv and BEFv and as inactivator BEF virus. The ratio between both viruses in all vaccine formulae was 1:1. Results: All vaccine batches were proved to be free of any foreign contaminants and unharmed for experimentally vaccinated animals. Each of three groups of calves was vaccinated S/C with 2ml of a reconstituted vaccine formula and their immune response was evaluated using serum neutralization test (SNT). The gained results revealed that the prepared combined freeze-dried vaccine with Carbopol elicited better humoral immune response than the other two vaccine formulae. Conclusion: It could be recommended to use Carbopol as a stabilizer for preparation of the aimed vaccine. [Open Vet J 2023; 13(7.000): 826-833]

Background: Globally, adverse drug reactions (ADRs) are the foremost cause of morbidity as well as mortality. This necessitates a system of surveillance that can effectively and efficiently monitor the effect of drugs on the general population. The role of pharmacovigilance (PV) is paramount in ensuring drug safety through spontaneous ADR reporting. Methods: Data collection in the current research was carried out by an anonymous, online 36-item self-report questionnaire amongst a sample of 351 working healthcare professionals (HCPs) across different regions of Jazan Province, Kingdom of Saudi Arabia (KSA). The current sample comprised 54.4% males and 45.6% females, having an age range of 26–57 years, and was conducted between August 21 and October 21, 2022. Participants were recruited using the convenience snowball sampling technique. Results: The participants' awareness of PV as well as spontaneous ADR reporting, had a significant association with having

AbstractPeanut is the most important oil seed in the world and is becoming a valuable source of plant protein and other important functional ingredients. The present study was designed to explore the nutritional, microbiological, and sensorial properties of the functional cookies enriched with defatted peanut cake flour (DPCF). Peanut seeds were roasted in a microwave, and oil was extracted using a mechanical extruder. The leftover peanut cake residues were collected and utilized for the development of cookies. The mechanical grinder was used to grind the peanut cake into flour. Afterward, DPCF was added at different levels (0, 3, 7, 10, and 14%) to prepare functional and therapeutic cookies. The cookies were tested for their biochemical (proximate, mineral, and antioxidant), microbiological (Mold count), physical, and sensorial attributes. The results showed that the mineral content i.e. calcium, iron, magnesium, zinc, manganese, phosphorus, and potassium in the wheat and DPCF were 21, 1.21, 23, 0.80, 0.73, 137, 134.62 and 178.5, 3.81, 49.68, 5.28, 4.95, 730, 1266.50 mg/100 g, respectively. The antioxidant profile of functional cookies was found to be best in the T4 (14% peanut cake flour) TPC (4.33 ± 0.08 GAE mg/g) and DPPH (1.11 ± 0.06 AAE mg/g), whereas the Control sample has the lowest TPC (1.04 ± 0.02 GAE mg/g) and DPPH (0.18 ± 0.01 AAE mg/g). The thickness, diameter and spread ratio were 3.94–5.54, 31.09–24.98 and 7.82–5.1 mm, respectively. In conclusion, defatted peanut cake flour (DPCF) is a great option to be added in precise amounts (14% of the total) to fill the nutritional gap in cookies.

The national heritage is considered important pillars of tourism development, Tourism is also considered a mean of spreading mutual cultures between countries, Further, tourism in the Hashemite Kingdom of Jordan represents one of the most important activities that work on development and prosperity. Jordan hosts a number of important tourist archaeological sites,such as the pink city of Petra;Jerash; the Roman amphitheater, these places are considered a destination for all tourists. Tourism facilities are considered one of the components of civilization and a vital element in its constructions, this requires the interior designer to link the surrounding environment with the interior design to maintain its originality and heritage identity Therefore, the interior designer goal is to create a design vision to attract the tourist and push him to interact with the surrounding environment, Moreover, many tourist facilities have appeared in Jordan, but it lacks the local identity in interior design and it are not connected to the surrounding environment,Such facilities also established on architectural models that do not suit the cultural and civilizational richness of Jordan, Therefore This research aims to create a design vision to employ Jordanian heritage in interior design and furniture for tourist facilities to preserve its originality and identity, and creating a distinctive and special character for the interior design stemming from the surrounding environment;as well as supporting the functional, aesthetic and cultural aspects of the design process, Hence the importance of research lies in analyzing the design elements of Jordanian heritage and reviving its design lines to be used in interior design in order to develop aesthetic sense and general taste in the community, which leads to increase the elements of tourist attractions for tourist facilities, The research went on to study and analyze the heritage elements and reduce lines that can be employed in interior design supporting the aesthetic values of the place, this research has reached a design vision to employ Jordanian heritage in interior design in the hotel accommodation room, The researcher also presented a proposal to design a hotel residence room that employed design lines inspired by Jordanian heritage in a reduced style to suit contemporary life and achieve functional and aesthetic aspects in tourist facilities. So, the research leads to a vision of design style for tourist facilities with a heritage identity has been drawn through two main directions:First: studying heritage elements and analyzing its design lines.

This paper proposes a methodology for an alternative history matching process enhanced by the incorporation of a simplified binary interpretation of reservoir saturation logs (RST) as objective function. Incorporating fluids saturation logs during the history matching phase unlocks the possibility to adjust or select models that better represent the near wellbore waterfront movement, which is particularly important for uncertainty mitigation during future well interference assessments in water driven reservoirs. For the purposes of this study, a semi-synthetic open-source reservoir model was used as base case to evaluate the proposed methodology. The reservoir model represents a water driven, highly heterogenous sandstone reservoir from Namorado field in Brazil. To effectively compare the proposed methodology against the conventional methods, a commercial reservoir simulator was used in combination with a state-of-the-art benchmarking workflow based on the Big Loop™ approach. A well-known group of binary metrics were evaluated to be used as the objective function, and the Matthew correlation coefficient (MCC) has been proved to offer the best results when using binary data from water saturation logs. History matching results obtained with the proposed methodology allowed the selection of a more reliable group of reservoir models, especially for cases with high heterogeneity. The methodology also offers additional information and understanding of sweep behaviour behind the well casing at specific production zones, thus revealing full model potential to define new wells and reservoir development opportunities.

Abstract Background Burnout and depression among health professions education (HPE) students continue to rise, leading to unwanted effects that ultimately jeopardise optimal medical care and patient health. Promoting the resilience of medical students is one solution to this issue. Several interventions have been implemented to foster resilience, but they focus on aspects other than the primary cause: the assessment system. The purpose of this study is to develop a framework to promote resilience in assessment planning and practice. Methods We followed the guidelines suggested by Whetten for constructing a theoretical model for framework development. There were four phases in the model development. In the first phase, different literature review methods were used, and additional students’ perspectives were collected through focus group discussions. Then, using the data, we constructed the theoretical model in the second phase. In the third phase, we validated the newly developed model and its related guidelines. Finally, we performed response process validation of the model with a group of medical teachers. Results The developed systematic assessment resilience framework (SAR) promotes four constructs: self-control, management, engagement, and growth, through five phases of assessment: assessment experience, assessment direction, assessment preparation, examiner focus, and student reflection. Each phase contains a number of practical guidelines to promote resilience. We rigorously triangulated each approach with its theoretical foundations and evaluated it on the basis of its content and process. The model showed high levels of content and face validity. Conclusions The SAR model offers a novel guideline for fostering resilience through assessment planning and practice. It includes a number of attainable and practical guidelines for enhancing resilience. In addition, it opens a new horizon for HPE students’ future use of this framework in the new normal condition (post COVID 19).

Purpose: This paper evaluates the benefits of using natural gas in offshore vessels and the challenges faced by using natural gas in offshore vessels.Design/Methodology/Approach: A comprehensive questionnaire was developed and distributed to experts in offshore vessels. The crucial critical factors were selected utilizing an AHP technique from those found common characteristics.Findings: The results found that operational challenges are considered the most important ones as they come in the first place, while technical challenges come in the second place, safety challenges in the third place, and systematic challenges in the fourth place. Received: 21 October 2022Accepted: 13 February 2023 Published: 10 March 2023

Abstract Hyperkalemia is a frequent complication in patients with chronic kidney disease (CKD) or heart failure (HF) and associated with neuromuscular manifestations, changes in the electrocardiogram, and increased risk of mortality. While data on the prevalence and management of hyperkalemia in the gulf region are scarce, risk factors such as preference for potassium‐rich foods (e.g., dates and dried fruits/vegetables), periods of intense fasting (e.g., Ramadan), and diabetes (an ancestor of CKD and HF) are common. Therefore, a panel of nephrologists and cardiologists from countries of the Gulf Cooperation Council (GCC) convened to collate and review available data on the prevalence, regional drivers, and current practice in the management of hyperkalemia in the region. Eventually, this review provides consensus recommendations on a balanced utilization of dietary and pharmacological options including new potassium binders for achieving and sustainably maintaining desirable serum potassium levels in countries of the GCC region. Alignment with regional habits and practice was a key aspect to facilitate the uptake of the recommendations into physicians’ practice and patients’ lives.

Introduction: Grit is proposed as an essential trait for academic achievement. Thus, evaluating its current status and the associated factors could aid academic support planning. Objective: The present study aimed to assess grit level and its related factors among undergraduate pharmacy students from 14 countries amid the COVID-19 pandemic. Methods: A cross-sectional survey-based study was conducted among pharmacy students from 14 countries in Asia and the Middle East. A 31-item questionnaire was developed, validated, and pilot-tested, including the validated short scale for grit assessment. The data was collected between 1 February and 15 April 2022. Descriptive and inferential statistics were employed as appropriate. Results: A total of 2665 responses were received, mainly from females (68.7 %), living in urban areas (69.2 %) and studying at private universities (59.1 %). The average grit score on a scale of 5 was 3.15 ± 0.54. The responses revealed higher favourable responses to items on the perseverance of efforts (34.9 % to 54 %) compared to items on the consistency of interests (26.5 % to 31.1 %). Students who did not exercise (AOR: 0.47, 95 %CI: 0.33–0.67) or exercised irregularly (AOR: 0.64, 95 %CI: 0.45–0.90) were less likely to have higher grit scores than those who exercised regularly. Additionally, students who did not receive COVID-19 vaccination (AOR: 0.50, 95 %CI: 0.36–0.71) or received only one dose (AOR: 0.67, 95 %CI: 0.46–0.99) were less likely to have higher grit scores than those who received their booster vaccination. Interestingly, students who chose the pharmacy program as their only available or reasonable choice (AOR: 0.33, 95 %CI: 0.17–0.62) and students from public universities (AOR: 0.82, 95 %CI: 0.68–0.98) were less likely to have higher grit scores. On the other hand, students who did not face educational challenges with online learning (AOR: 1.19, 95 %CI: 1.003–1.416) and students with excellent (AOR: 2.28, 95 %CI: 1.57–3.31) and very good (AOR: 2.16, 95 %CI: 1.53–3.04) academic performance were more likely to have higher grit scores. Conclusion: The findings revealed moderate grit levels. Higher grit levels were thought to be associated with several personal, lifestyle and academic factors. Further interventions to support students' grit attributes are required, particularly concerning the consistency of interests.

Abstract Background Bacterial wilt caused by Ralstonia solanacearum is considered one of the most important diseases that cause economic losses to many economic crops and spread in many regions around the world, especially in the subtropical tropics and some warm temperate regions of the world. In this study the aqueous plant extract of Rosemarinus officinalis and Pseudomonas fluorescens for their antagonistic activity against bacterial wilt in vitro, greenhouse and population of R, solanacearum in plants was study. Results Following intensive screening studies, aqueous plant extract of R. officinalis and P. fluorescens was selected to study their effectiveness against bacterial wilt of potato plants and their antimicrobial activity or induction of systemic resistance in plants. In greenhouse, all soil drenching treatments on potato plants significantly reduced disease incidence of potato bacterial wilt than infected control. R. officinalis, P. fluorescens mixture between plant extract and endophytic bacteria and streptomycin reduced profoundly the disease severity by 75.51, 65.0 77.9 and 81.00%, respectively, than the infected control (83.71%). The plant extract and microorganism significantly increased fresh and dry weight of potato plants (g) per plant compared to non-treated control plants. R. officinalis, P. fluorescens mixture between plant extract and endophytic bacterium and streptomycin increased fresh weight from 100.1 to 169.9 compared to infected control also increased dry weight from 68.4 in streptomycin to 170.4% in mixture of plant extract and endophytic bacterium. The populations of bacterial pathogen R. solanacearum were lowest in stem of potato plants treated with plant extracts than in inoculated control plants (50%). In general, the total phenols increased in both inoculated and non-inoculated potato plants. Conclusions Ralstonia officinalis and P. fluorescens showed a strong in vitro activity in relation growth limitation of R. solanacearum as well as limiting the development of bacterial wilt disease on potato plants under greenhouse conditions.

This article explores the punching shear behavior of GFRP-RC interior slab–column connections. The parameters tested included the column–aspect ratio (1.0, 2.0, 3.0, 4.0, and 5.0), perimeter-to-depth ratio for square column stubs with side lengths of 0.3, 0.4, 0.5, 0.6, and 0.7 m, and span-to-depth ratios of 4, 6, 8, 10, and 12. A review of the literature revealed that no previous study has investigated the effect of these parameters or their interactions on this type of connection. Numerically, twenty-five slabs were created using finite element (FE) software (V3), each with square dimensions of 2.5 m and a constant thickness of 0.2 m. The central column extended 0.3 m from the top and bottom of the slab. All four sides of the slabs were supported, and the specimens underwent pure static shear load testing. The test results demonstrated that all slabs failed due to punching shear. Increasing any parameter value reduced the punching shear stresses. Additionally, the results indicated that Canadian (CSA-S806-12) and Japanese (JSCE-97) standards for FRP-RC materials generally provided the closest predictions of punching shear capacity compared to the American guideline, ACI 440.1R-22. However, all standards exhibited shortcomings and require enhancement and modifications, particularly to consider the impact of the span-to-depth ratio. Therefore, three equations were developed to predict the shear strength of the connections, yielding better results than those prescribed by the North American and Japanese standards.