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Abstract This study investigated the green synthesis of Zn-MnO nanocomposites via the fungus Penicillium rubens. Herein, the synthesized Zn-MnO nanocomposites were confirmed by UV-spectrophotometry with a top peak (370 nm). Transmission electron microscopy confirmed irregular particles with a spherical-like shape ranging from 25.13 to 36.21 nm. Numerous functional groups were detected on the surface of Zn-MnO nanocomposite via Fourier-transform infrared spectroscopy. X-Ray diffraction assay appeared that the synthesized Zn-MnO nanocomposites contained two different components, MnO (JCPDS 81-2261) and ZnO (JCPDS 36-1451), while energy dispersive X-ray spectra confirmed the occurrence of manganese, zinc, oxygen, and carbon in Zn-MnO nanocomposites. Zn-MnO nanocomposites demonstrated excellent suppress effect versus the growth of various bacteria namely Staphylococcus aureus, Methicillin-resistant S. aureus (MRSA), Salmonella typhi, and Klebsiella pneumoniae via agar well diffusion assays with inhibition areas of 36 ± 0.1, 25 ± 0.1, 27 ± 0.2, and 23 ± 0.2 mm, correspondingly. Alterations in the ultrastructure of the treated K. pneumoniae by Zn-MnO nanocomposite were recorded. Both the values of minimum inhibitory concentration (MIC) and minimum bactericidal concentration of Zn-MnO nanocomposite extended from 15.62 to 125 µg/mL employing the examined bacteria. The antibiofilm activity of Zn-MnO nanocomposites was 82.07, 75.43, 43.65, and 41.35% at 25% MIC, and 96.54, 93.0, 94.53, and 91.11% at 75% MIC against S. aureus, MRSA, K. pneumoniae, and S. typhi, respectively. At 25 to 75% MIC, Zn-MnO nanocomposites exhibited antihemolytic activity with the maximum activity of 96.3% at 75% MIC in the presence of MRSA. Extensive molecular docking studies were performed to identify the optimal location for manganese oxide and zinc oxide nanoclusters binding to MRSA. MnO-NPs and ZnO-NPs demonstrated inhibitory activity against the crystal structure of putative minohydrolase (PDB ID: 4EWT), methicillin acyl-penicillin binding protein 2a structure (PDB ID: 1MWU) and K2U bound crystal structure of class II peptide deformylase from MRSA (PDB ID: 6JFQ). The minimum binding energy was utilized to estimate the receptor’s binding site with NPs, providing additional understanding of the ways of action. Anti-inflammatory activity of Zn-MnO nanocomposites via cyclooxygenase-1 and cyclooxygenase-2 enzymes inhibition was documented with IC50 doses of 20.81 ± 0.68 µg/mL and 35.87 ± 1.35 µg/mL, respectively. Based on these outcomes, it was concluded that Zn-MnO nanocomposites could be useful agents for the management of multidrug resistant bacterial pathogens and inflammation.

Abstract Fear of progression (FoP) is a stressful psychosocial condition that affects health and quality of life. Breast cancer is recognized as the most prevalent cancer among women globally. This study aims to determine the prevalence of FoP, coping strategies, and associated factors among Malaysian female breast cancer survivors. A cross-sectional survey was conducted among 242 female breast cancer patients recruited from the south of Malaysia using simple random sampling method. The questionnaire captured sociodemographic characteristics, clinical factors, coping strategies and FoP level. Factors associated with FoP were investigated using multiple logistic regression analysis. The mean age was 55.1 (± 10.9) years. Majority of them were Malays, attained secondary ducation and above, married, unemployed, and in advanced cancer stages. Most patients had low FoP levels, with a smaller proportion having moderate-to-high FoP levels (10.7%). Higher education (AOR = 5.10, P = 0.050), being employed (AOR = 3.85, P = 0.020), advanced can cer stage (AOR = 4.23, P = 0.030), and adoption of avoidant coping strategy (AOR = 1.19, P = 0.009), were associated with higher FoP level. The level of FoP is low among Malaysian females with breast cancer. Higher levels of FoP were associated with higher educational levels, employment status, advanced cancer stage, and utilization of avoidant coping strategies. The fundamental cognitive process mainly affects FoP, rather than disease-related factors.

Introduction: Hepatitis B and C are viral infections causing chronic liver inflammation and, when left untreated, lead to cirrhosis and a risk for hepatocellular carcinoma, the most common type of primary liver cancer with high mortality. The hepatitis B virus-hepatitis C virus (HBV-HCV) coinfection leads to a faster progression to advanced liver diseases and higher hepatocellular carcinoma (HCC) risk than monoinfection. Unlike the relative risk for HCC due to either HBV or HCV, no recent analysis of the risk for HBV-HCV coinfection exists. Methods: Based on PRISMA recommendations and guidelines, we developed a search strategy by combining the keywords (“hepatitis B”) and (“hepatitis C”) and (“hepatocellular carcinoma” or “liver cancer”). First, we performed a title and abstract screening and, later, a full-text screening. We extracted the demographic characteristics, such as gender, age, study design, sample size, country, and biomarkers of hepatitis B surface antigen (HBsAg), HBV DNA, HBeAg, anti-HCV, and HCV RNA. The data were assessed for quality, and the Review Manager software was used for the meta-analysis. Results: We included 63 studies. The pooled analysis showed that the risk of HCC was significantly higher in the case-cohort who were positive for HBsAg (odds ratio [OR] = 9.70 [3.75, 25.12], P = 0.0001), HBV DNA or HBeAg (OR = 22.77 [10.00, 51.88], P = 0.0001), HBV and HCV coinfection (OR = 46.07 [26.33, 80.60], P = 0.0001) than the control cohort. Conclusion: Chronic HBV and HCV infections are major risk factors for HCC, and their coinfection was significantly associated with an increased risk of HCC than monoinfection.

Objective: Making appropriate referrals for patients with complex restorative needs can be challenging. The NHS Restorative Dentistry Index of Treatment Need (IOTN) is an important guideline and tool that helps to ensure that patients receive the appropriate level of restorative dental care for their needs. The objective of this study was to test, via structured training, the usability and utility of the IOTN as a screening tool for referral and management of patients attending [King Abdulaziz University Faculty of Dentistry (KAUFD)], Saudi Arabia. Methods: In this prospective, interventional study, one hundred and fourteen participants (38 sixth-year dental students, 44 interns, and 32 general dentists) were equally and randomly assigned to either receive training on the IOTN or no training. Then, participants were provided with clinical and radiographic records for six cases and asked to make management and referral decisions recorded on a questionnaire. Results: The group receiving training on the IOTN more accurately classified cases into different levels of complexity and specialty and more frequently made correct management and referral decisions for complexity levels 2 and 3 cases than the untrained group. There was no difference between the trained and untrained groups for complexity level 1 cases. Conclusion: Training general dentists to use the NHS IOTN improved referral and management decision skills.

Forcibly displaced Muslims, including refugees, internally displaced persons, and asylum seekers who have fled their homes to escape violence, conflict, and persecution, often have inequitable access to quality mental health services, despite substantial trauma exposure and high rates of posttraumatic stress disorder (PTSD). Understanding factors associated with domains of perceived need (i.e. community, individual, friends/family) for culturally responsive, trauma-focused mental health interventions among forcibly displaced Muslims may provide insight into those most likely to seek psychological treatment. A sample of 108 forcibly displaced Muslims endorsed moderate to high perceived need across all three domains for a trauma healing group tailored for Muslim refugees. PTSD severity related to perceived individual need, regardless of locus of displacement. Among participants with minimal PTSD symptoms, those who were externally displaced had higher perceived community and friends or family need than those who were internally displaced. Findings highlight a need for culturally responsive, trauma-focused mental health services to facilitate access to mental health care for forcibly displaced Muslims.

This study presents a numerical analysis of natural convection heat transfer within inclined square cavities featuring sinusoidal heating elements. The analysis, conducted using a finite volume approach implemented in ANSYS 16.0, aims to estimate flow and heat regimes under steady-state conditions. Grid-independent analyses were performed to ensure numerical accuracy. The vertical walls of the enclosure were maintained at a cold temperature, while the other two walls were perfectly insulated. Key parameters investigated include Rayleigh numbers (104, 105, 106), corrugation numbers (3, 5, and 7), amplitude values (0.1, 0.3 and 0.5), and enclosure inclination angles (δ = 0°, 15°, 30°, 45°, 60°, 75°). The sinusoidal element’s diameter to enclosure length ratio was set at 0.4, and fluid properties were assumed constant with a Prandtl number of 7.0. Results were illustrated using isothermal and flow lines, with heat transfer discussed in terms of local and average Nusselt numbers. Findings indicate that at Ra = 106, local Nusselt numbers exhibited a sinusoidal distribution influenced by corrugation and amplitude, with a 50% increase in local Nusselt number as amplitude increased from 0.1 to 0.5. Average Nusselt number enhancements were observed with higher corrugation numbers and wave amplitudes, while the number and size of eddies were sensitive to Rayleigh numbers. Enclosure inclination significantly affected the formation of vortices, particularly at angles of 60° and 75°.