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Mohamed T El-Saadony,1,* Guihong Fang,2,3,* Si Yan,3 Samar Sami Alkafaas,4 Mahmoud A El Nasharty,5 Sohila A Khedr,6 Aya Misbah Hussien,7 Soumya Ghosh,8 Mthokozisi Dladla,9 Sara Samy Elkafas,10,11 Essam H Ibrahim,12,13 Heba Mohammed Salem,14 Walid FA Mosa,15 Ahmed Ezzat Ahmed,12 Dina Mostafa Mohammed,16 Sameh A Korma,17 Marawan K El-Tarabily,18 Ahmed M Saad,19 Khaled A El-Tarabily,20 Synan F AbuQamar20 1Department of Agricultural Microbiology, Faculty of Agriculture, Zagazig University, Zagazig, 44511, Egypt; 2School of Public Health, Heinz Mehlhorn Academician Workstation, Hainan Medical University, Haikou, Hainan, 571199, People’s Republic of China; 3Qionghai People’s Hospital, Qionghai, Hainan, 571400, People’s Republic of China; 4Molecular Cell Biology Unit, Division of Biochemistry, Department of Chemistry, Faculty of Science, Tanta University, Tanta, 31527, Egypt; 5Department of Chemistry, Faculty of Science, Ain Shams University, Cairo, 11566, Egypt; 6Industrial Biotechnology Department, Faculty of Science, Tanta University, Tanta, 31733, Egypt; 7Biotechnology Department at Institute of Graduate Studies and Research, Alexandria University, Alexandria, 21531, Egypt; 8Natural and Medical Sciences Research Center, University of Nizwa, Nizwa, 616, Oman; 9Human Molecular Biology Unit (School of Biomedical Sciences), Faculty of Health Sciences, University of the Free State, Bloemfontein, 9300, South Africa; 10Production Engineering and Mechanical Design Department, Faculty of Engineering, Menofia University, Shebin El Kom, Menofia, 32511, Egypt; 11Faculty of Control System and Robotics, ITMO University, Saint-Petersburg, 197101, Russia; 12Biology Department, Faculty of Science, King Khalid University, Abha, 61413, Saudi Arabia; 13Blood Products Quality Control and Research Department, National Organization for Research and Control of Biologicals, Cairo, 12611, Egypt; 14Department of Poultry Diseases, Faculty of Veterinary Medicine, Cairo University, Giza, 12211, Egypt; 15Plant Production Department (Horticulture-Pomology), Faculty of Agriculture, Saba Basha, Alexandria University, Alexandria, 21531, Egypt; 16Nutrition and Food Sciences Department, National Research Centre, Dokki, Giza, 12622, Egypt; 17Department of Food Science, Faculty of Agriculture, Zagazig University, Zagazig, 44511, Egypt; 18Faculty of Medicine, University of Debrecen, Debrecen, 4032, Hungary; 19Department of Biochemistry, Faculty of Agriculture, Zagazig University, Zagazig, 44511, Egypt; 20Department of Biology, College of Science, United Arab Emirates University, Al Ain, 15551, United Arab Emirates*These authors contributed equally to this workCorrespondence: Si Yan, Qionghai People’s Hospital, Qionghai, Hainan, 571400, People’s Republic of China, Email yansi9928@163.com Synan F AbuQamar, Department of Biology, College of Science, United Arab Emirates University, Al Ain, 15551, United Arab Emirates, Tel +971 3 713 6733, Fax +971 3 713 4927, Email sabuqamar@uaeu.ac.aeAbstract: Over the last decade, biomedical nanomaterials have garnered significant attention due to their remarkable biological properties and diverse applications in biomedicine. Metal oxide nanoparticles (NPs) are particularly notable for their wide range of medicinal uses, including antibacterial, anticancer, biosensing, cell imaging, and drug/gene delivery. Among these, zinc oxide (ZnO) NPs stand out for their versatility and effectiveness. Recently, ZnO NPs have become a primary material in various sectors, such as pharmaceutical, cosmetic, antimicrobials, construction, textile, and automotive industries. ZnO NPs can generate reactive oxygen species and induce cellular apoptosis, thus underpinning their potent anticancer and antibacterial properties. To meet the growing demand, numerous synthetic approaches have been developed to produce ZnO NPs. However, traditional manufacturing processes often involve significant economic and environmental costs, prompting a search for more sustainable alternatives. Intriguingly, biological synthesis methods utilizing plants, plant extracts, or microorganisms have emerged as ideal for producing ZnO NPs. These green production techniques offer numerous medicinal, economic, environmental, and health benefits. This review highlights the latest advancements in the green synthesis of ZnO NPs and their biomedical applications, showcasing their potential to revolutionize the field with eco-friendly and cost-effective solutions.Keywords: antimicrobial, antioxidant, green synthesis, nanomedicine, nanoparticle, zinc oxide

Accurate crop yield forecasting is vital for ensuring food security and making informed decisions. With the increasing population and global warming, addressing food security has become a priority, so accurate yield forecasting is very important. Artificial Intelligence (AI) has increased the yield accuracy significantly. The existing Machine Learning (ML) methods are using statistical measures as regression, correlation and chi square test for predicting crop yield, all such model's leads to low accuracy when the number of factors (variables) such as the weather and soil conditions, the wind, fertilizer quantity, and the seed quality and climate are increased. The proposed methodology consists of different stages, like Data Collection, Preprocessing, Feature Extraction with Support Vector Machine (SVM), correlation with Normalized Google Distance (NGD), feature ranking with rising star. This study combines Bidirectional Gated Recurrent Unit (Bi-GRU) and Time Series CNN to predict crop yield and then recommendation for further improvement. The proposed model showed very good results in all datasets and showed significant improvement compared to baseline models. The ECP-IEM achieved an accuracy 96.34%, precision 94.56% and recall 95.23% on different datasets. Moreover, the proposed model was also evaluated based on MAE, MSE, and RMSE, which produced values of 0.191, 0.0674, and 0.238, respectively. This will help in improving production of crops by giving an early look about the yield of crops which will than help the farmer in improving the crops yield., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2025 Mustafa et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

The proposed study uses a special procedure to verify that an analyte assessment operation is sustainable and environmentally friendly. When the targeted analyte molecule (alogliptin drug, ALT) lacks chromophoric or fluorogenic groups, it cannot be analyzed without marking or structural amendment. The obeyed phenomenon (marking process) could be achieved via fluorescence probing or marking using tagging agents. An innovative reagent pair consisting of trioxosulfate ion and o-Phthaldialdehyde (OPD) is used in the described analytical approach. This reagent is used to build a novel fluorescent nucleus and can be detected using the developed fluorimetric approach. ALT's amino moiety could condense trioxosulfate/OPD. This study presents a new, facile, green, sustainable fluorometric assay of the ALT drug. The product's response is linear at 50.00-800.00 ng mL -1 concentration range (LOD = 15.74 and LOQ = 47.69 ng mL -1 ). The method validation was considered following the International Council for Harmonisation (ICH) recommendations. The planned probe was applied to the crude powder and dose forms, and excipients had no influence. The planned analytical procedure is identified as sustainable and white by the WAC (White Analytical Chemistry) indications following the Green/Red/Blue (RGB 12) pattern. Additionally, new tools (BAGI and GSST) were applied to the current work., (© 2025 John Wiley & Sons Ltd.)

This study assessed the effects of high-fiber olive pomace (OP) and exogenous multi-enzymes (phytase, cellulase and xylanase) on broiler chickens' growth performance, internal organs, intestinal morphology, blood traits, serum lipid profile and health. A total of three hundred one-day-old Ross 308 chicks were randomly allocated into six treatments using a 2 × 3 factorial design involving 0 and 0.5 g/kg multi-enzymes and 0, 5, and 10% olive pomace. The diet was primarily based on corn and soybean meal. The experiment was carried out in three stages: starter, grower and finisher. The results indicated that including OP at 5% and 10% levels did not negatively impact broilers' performance (P > 0.05). However, supplementing the diet with multi-enzymes significantly increased feed consumption, body weight, and weight gain (P < 0.05). Furthermore, chickens offered with 10% OP + multi-enzymes exhibited the best performance compared to other experimental groups. The mortality rate also showed a non-significant decline of almost 5% (P > 0.05). Additionally, administration of OP and multi-enzymes or a combination of them to the broilers' diet improved serum lipid profile and liver enzyme activity (P < 0.05) and did not affect the relative weight and length of internal organs and intestinal histomorphology (P > 0.05). In conclusion, using multi-enzymes and a diet containing olive pomace could improve the serum lipid profile, liver enzyme activity, and overall health without adversely affecting broiler performance., Competing Interests: Declarations. Ethics approval: This study was performed in accordance with the principles of the Declaration of FASS (2012). The Ethics Committee of the University of Raparin granted approval (15/7/2023: 756–26). Competing interests: The authors have no relevant financial or non-financial interests to disclose., (© 2025. The Author(s), under exclusive licence to Springer Nature B.V.)

Background: Emergence agitation EA is a state of confusion and harmful aggressiveness during recovery. It is a common complication after rhinoplasty, with risk of trauma, bleeding, and hemodynamic instability. Dexmedetomidine and gabapentin premedication could improve the quality of recovery after rhinoplasty., Methods: One hundred fifty-three participants (ASA I-II, both sexes and age 18-40 years) scheduled for rhinoplasty were randomized into three groups. Group C didn't receive premedication, Group D received intramuscular (IM) dexmedetomidine, and Group G received oral gabapentin. The degree of EA by Riker sedation-agitation scale (RSAS) during recovery, pain severity, and adverse events recorded., Results: The results showed statistically significant differences in EA scores with the lowest values in group D (p-value 0.002). Moreover, the incidence of EA was 17.6% (9/51) in Group D, 41.2% (21/51) in Group G, and 56.9% (29/51) in Group C with P value < 0.001 and significant differences in VAS score at 4, 8, and 12 h with the highest median (range) values in group C 4(3-6) in comparison to group D 2(1-3) and group G 2(1-3) and p-value < 0.001; no significant differences in adverse events., Conclusions: IM dexmedetomidine premedication was more efficient than gabapentin in the reduction of the emergence agitation incidence, severity, and postoperative pain scores after rhinoplasty in adults., Clinical Trial Registration Number Id: NCT05626998 on 25/11/2022., Competing Interests: Declarations. Ethics approval and consent to participate: Were registered and approved by the Ethics Committee of Ain Shams University Hospital (FMASU R 164/ 2022) on 31/10/2022 and conducted according to the Consolidated Standards of Reporting Trials (CONSORT) guidelines. Written informed consent to participate was obtained from all participants. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2025. The Author(s).)

Background: Migraine is a common primary headache disorder that significantly affects academic life and is often associated with stress, depression, anxiety, and irregular sleep patterns among university students. This study aimed to assess the prevalence of migraine among King Khalid University (KKU) students, identify its determinants, and evaluate the impact of migraine and other headaches on academic life and performance., Methods: An analytical cross-sectional study was conducted among 732 students from Colleges of Medicine, Pharmacy, Engineering, and Computer science. We used a self-administered questionnaire, including the ID Migraine™ screening tool, which was administered either through an online survey or face-to-face. Convenience and snowball sampling methods were adopted to recruit participants between June 1 and August 31, 2024., Results: The median [interquartile range (IQR)] age was 21(2.0) years, 58.2 % were female, 97.5 % were Saudi, and 93.0 % were non-smokers. The prevalence of migraine was 44.1%. The key predictors of migraine were female gender (adjusted odds ratio (AOR) = 1.78 (1.29 - 2.46), P < 0.001), family history AOR = 2.39 (1.75- 3.27), P < 0.001], working alongside education (AOR = 1.95 (1.19 - 3.18), P = 0.007), family debt (AOR = 1.86 (1.06 - 3.29), P = 0.03), and having chronic diseases like bronchial asthma (AOR = 2.16 (1.11 - 4.20), P = 0.02) and hypertension AOR = 6.23 (1.34 - 28.84), P = 0.01). Over 90 % reported migraines affected concentration, sleep, and exam preparation, and 65 % indicated an impact on university attendance., Conclusions: Migraines are highly prevalent among KKU students, affecting academic daily life. Early detection and lifestyle changes are essential, and universities should plan and implement coping strategies to support affected students., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2025 Elsevier Ltd. All rights reserved.)

Introduction: With the incorporation of artificial intelligence (AI), significant advancements have occurred in the field of fetal medicine, holding the potential to transform prenatal care and diagnostics, promising to revolutionize prenatal care and diagnostics. This scoping review aims to explore the recent updates in the prospective application of AI in fetal medicine, evaluating its current uses, potential benefits, and limitations., Methods: Compiling literature concerning the utilization of AI in fetal medicine does not appear to modify the subject or provide an exhaustive exploration of electronic databases. Relevant studies, reviews, and articles published in recent years were incorporated to ensure up-to-date data. The selected works were analyzed for common themes, AI methodologies applied, and the scope of AI's integration into fetal medicine practice., Results: The review identified several key areas where AI applications are making strides in fetal medicine, including prenatal screening, diagnosis of congenital anomalies, and predicting pregnancy complications. AI-driven algorithms have been developed to analyze complex fetal ultrasound data, enhancing image quality and interpretative accuracy. The integration of AI in fetal monitoring has also been explored, with systems designed to identify patterns indicative of fetal distress. Despite these advancements, challenges related to the ethical use of AI, data privacy, and the need for extensive validation of AI tools in diverse populations were noted., Conclusion: The potential benefits of AI in fetal medicine are immense, offering a brighter future for our field. AI equips us with tools for enhanced diagnosis, monitoring, and prognostic capabilities, promising to revolutionize the way we approach prenatal care and diagnostics. This optimistic outlook underscores the need for further research and interdisciplinary partnerships to fully leverage AI's potential in driving forward the practice of fetal medicine., Competing Interests: The authors report no conflicts of interest in this work., (© 2025 Miskeen et al.)

Over the past two decades, cloud computing has experienced exponential growth, becoming a critical resource for organizations and individuals alike. However, this rapid adoption has introduced significant security challenges, particularly in intrusion detection, where traditional systems often struggle with low detection accuracy and high processing times. To address these limitations, this research proposes an optimized Intrusion Detection System (IDS) that leverages Graph Neural Networks and the Leader K-means clustering algorithm. The primary aim of the study is to enhance both the accuracy and efficiency of intrusion detection within cloud environments. Key contributions of this work include the integration of the Leader K-means algorithm for effective data clustering, improving the IDS's ability to differentiate between normal and malicious activities. Additionally, the study introduces an optimized Grasshopper Optimization algorithm, which enhances the performance of the Optimal Neural Network, further refining detection accuracy. For added data security, the system incorporates Advanced Encryption Standard encryption and steganography, ensuring robust protection of sensitive information. The proposed solution has been implemented on the Java platform with CloudSim support, and the findings demonstrate a significant improvement in both detection accuracy and processing efficiency compared to existing methods. This research presents a comprehensive solution to the ongoing security challenges in cloud computing, offering a valuable contribution to the field., Competing Interests: Declarations. Competing interests: The authors declare no conflict of interest. Consent to participate: Not Applicable. Consent to publish: Not Applicable., (© 2024. The Author(s).)

Cadmium (Cd) is a potent environmental pollutant that causes functional and structural damage to the salivary glands. Tempol (TEM) has powerful antioxidant activity that can potentially preserve organ function., Aims: This study was designed to investigate the protective effects of TEM on Cd-induced toxicity in rat parotid salivary glands., Materials and Methods: Twenty-four adult Wistar male rats were randomly assigned to four equal groups: control, TEM (27.5 g/100 ml), Cd (0.6 g/100 ml), and TEM plus Cd (at the same doses). All treatments were dissolved in distilled water and administered subcutaneously four times a week for four weeks. Parotid gland tissues were isolated and subjected to molecular and histo-biochemical assessments., Key Findings: TEM exerted a prophylactic effect against Cd-induced toxicity in the parotid glands by controlling inflammation through the downregulation of toll-like receptor 4/myeloid differentiation primary response 88/nuclear factor kappa B/ interleukin-1 beta mRNA expression, upregulation of aquaporin-5 mRNA expression, improvement of the oxidant/antioxidant status in the parotid gland, mitigation of endoplasmic reticulum stress, and repair of the associated histological and ultrastructural abnormalities., Significance: TEM protects against Cd-induced toxicity in the parotid glands of rats, attributable at least in part to its anti-inflammatory and antioxidant properties, as well as its ability to inhibit ER stress and facilitate glandular repair. However, the protective effects of TEM did not reach the levels observed in the control group. TEM could be a promising clinical candidate for protecting the salivary glands, particularly in high-risk groups such as workers exposed to Cd and cigarette smokers., Competing Interests: Declaration of competing interest The authors report no declaration of competing interest. The authors confirm they did not receive any funding to do this work., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Objectives: Minor ailments are a significant burden on primary care services globally. In Saudi Arabia's evolving healthcare landscape, pharmacists play a crucial informal role, but no coordinated national approach exists. Understanding pharmacists' preparedness is thus vital to optimize successful integration. This study evaluated Saudi community pharmacists' perceptions, barriers, and facilitators related to minor ailment services (MAS) for capacity-building strategies., Methods: A cross-sectional survey was conducted from April to July 2023. Data were collected from participants using a self-administered, anonymous questionnaire with 48 questions. The data were analyzed using descriptive and inferential statistics in SPSS v.27., Key Findings: Of the 720 pharmacists invited to participate, 442 completed the questionnaire, yielding an overall response rate of 61.4% (442/720). Most pharmacists recognized the value of accessible self-care support using their skills (92.6%), but 26.9% feared misdiagnosis risks. Most (93.9%) emphasized prudent triage and history-taking, and yet 22.2% were ambivalent on referrals. Key barriers that were identified included the lack of patient information (71.5%), lack of reimbursement for MAS (61.8%), lack of a private/counseling area (59.5%), and lack of knowledge for minor ailment management (48.2%). Pharmacists who work in rural areas, work part-time, and have not attended any training or education programs also tend to display a more uncertain attitude toward delivering services for minor ailments., Conclusions: Pharmacists in Saudi Arabia can play a significant role in managing minor ailments, but the identified barriers must be addressed to integrate their services thoroughly. That can be done through comprehensive training, allocating resources, and establishing structured communication and referral pathways. This integration can improve healthcare accessibility, reduce costs, and better utilize pharmacists' expertise for delivering patient care., (© The Author(s) 2024. Published by Oxford University Press on behalf of the Royal Pharmaceutical Society.)

The accurate determination of acid/base constants (proton dissociation constants-p K a , or equivalently protonation constants-log K ) is essential for the physicochemical characterization of new molecules, especially in drug design and development, as these parameters thoroughly influence the pharmacokinetics and pharmacodynamics of drug action. While pH/potentiometric titration remains the gold standard method for determining acid/base constants, spectroscopic techniques-particularly nuclear magnetic resonance spectroscopy (as NMR/pH titrations)-have emerged as powerful alternatives for specific challenges in analytical chemistry, providing also information on the structure and site of protonation. In this study, we performed a comprehensive meta-analysis of protonation constants reported in the literature, measured using both potentiometry and NMR titrations. Our analysis compiled the available literature data and assessed the agreement between the two methods, taking into consideration various experimental conditions, such as temperature and ionic strength. The results provide insights into the reliability and applicability of NMR titrations compared with potentiometry, offering guidance for selecting appropriate methodologies in drug design.

Motivated by the pivotal role of routing in Wireless Sensor Networks (WSNs) and the prevalent security vulnerabilities arising from existing protocols, this research tackles the inherent challenges of securing WSNs. Many current WSN routing protocols prioritize computational efficiency but lack robust security measures, making them susceptible to exploitation by malicious actors. The prevalence of reactive protocols, chosen for their lower bandwidth consumption, exacerbates security concerns, as proactive alternatives require more resources for maintaining network routes. Additionally, the ad hoc nature and energy constraints of WSNs render conventional security models designed for wired and wireless networks unsuitable. In response to these limitations, this paper introduces the Secured Energy-Efficient Opportunistic Routing Scheme for Sustainable WSNs (EDSSR). EDSSR is designed to enhance security in WSNs by continuously updating neighbor information and validating the legitimacy of standard routing parameters. Critically, the protocol is power-aware, recognizing the vital importance of energy considerations in the constrained environment of WSNs. To assess the efficacy of EDSSR in mitigating WSN vulnerabilities, simulation experiments were conducted, evaluating the protocol's performance on key metrics such as throughput, average End-to-End delay ([Formula: see text] delay), energy consumption (EC), network lifetime (alive nodes), and malware detection rate. The results demonstrate that the EDSSR protocol significantly improves performance. It shows substantial gains in sum goodput relative to throughput, average [Formula: see text] delay, EC, and alive nodes. Specifically, the EDSSR protocol is 2-3% faster than DLAMD and 10-13% faster than EEFCR. Additionally, the malware detection rate increases by 23%., Competing Interests: Declarations Competing interests The authors declare no conflict of interest., (© 2024. The Author(s).)

Polyphenols, including phenolics, alkaloids, and terpenes, are secondary metabolites that are commonly found in fruits, vegetables, and beverages, such as tea, coffee, wine, chocolate, and beer. These compounds have gained considerable attention and market demand because of their potential health benefits. However, their application is limited due to their low absorption rates and reduced tissue distribution efficiency. Engineering polyphenol-protein complexes or conjugates can enhance the antioxidant properties, bioavailability, and stability of polyphenols and improve digestive enzyme hydrolysis, target-specific delivery, and overall biological functions. Complex polyphenols, such as melanin, tannins, and ellagitannins, can promote gut microbiota balance, bolster antioxidant defense, and improve overall human health. Despite these benefits, the safety of polyphenol complexes must be thoroughly evaluated before their use as functional food additives or supplements. This review provides a detailed overview of the types of macromolecular polyphenols, their chemical composition, and their role in food enrichment. The mechanisms by which complex polyphenols act as antioxidative, anti-inflammatory, and anticancer agents have also been discussed., Competing Interests: Declaration of competing interest The authors declare that they have no conflicts of interest., (Copyright © 2024 Elsevier B.V. All rights reserved.)

In cases of brain tumors, some brain cells experience abnormal and rapid growth, leading to the development of tumors. Brain tumors represent a significant source of illness affecting the brain. Magnetic Resonance Imaging (MRI) stands as a well-established and coherent diagnostic method for brain cancer detection. However, the resulting MRI scans produce a vast number of images, which require thorough examination by radiologists. Manual assessment of these images consumes considerable time and may result in inaccuracies in cancer detection. Recently, deep learning has emerged as a reliable tool for decision-making tasks across various domains, including finance, medicine, cybersecurity, agriculture, and forensics. In the context of brain cancer diagnosis, Deep Learning and Machine Learning algorithms applied to MRI data enable rapid prognosis. However, achieving higher accuracy is crucial for providing appropriate treatment to patients and facilitating prompt decision-making by radiologists. To address this, we propose the use of Convolutional Neural Networks (CNN) for brain tumor detection. Our approach utilizes a dataset consisting of two classes: three representing different tumor types and one representing non-tumor samples. We present a model that leverages pre-trained CNNs to categorize brain cancer cases. Additionally, data augmentation techniques are employed to augment the dataset size. The effectiveness of our proposed CNN model is evaluated through various metrics, including validation loss, confusion matrix, and overall loss. The proposed approach employing ResNet50 and EfficientNet demonstrated higher levels of accuracy, precision, and recall in detecting brain tumors., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Author(s).)

Human activity recognition (HAR) is a crucial task in various applications, including healthcare, fitness, and the military. Deep learning models have revolutionized HAR, however, their computational complexity, particularly those involving BiLSTMs, poses significant challenges for deployment on resource-constrained devices like smartphones. While BiLSTMs effectively capture long-term dependencies by processing inputs bidirectionally, their high parameter count and computational demands hinder practical applications in real-time HAR. This study investigates the approximation of the computationally intensive BiLSTM component in a HAR model by using a combination of alternative model components and data flipping augmentation. The proposed modifications to an existing hybrid model architecture replace the BiLSTM with standard and residual LSTM, along with convolutional networks, supplemented by data flipping augmentation to replicate the context awareness typically provided by BiLSTM networks. The results demonstrate that the residual LSTM (ResLSTM) model achieves superior performance while maintaining a lower computational complexity compared to the traditional BiLSTM model. Specifically, on the UCI-HAR dataset, the ResLSTM model attains an accuracy of 96.34% with 576,702 parameters, outperforming the BiLSTM model's accuracy of 95.22% with 849,534 parameters. On the WISDM dataset, the ResLSTM achieves an accuracy of 97.20% with 192,238 parameters, compared to the BiLSTM's 97.23% accuracy with 283,182 parameters, demonstrating a more efficient architecture with minimal performance trade-off. For the KU-HAR dataset, the ResLSTM model achieves an accuracy of 97.05% with 386,038 parameters, showing comparable performance to the BiLSTM model's 98.63% accuracy with 569,462 parameters, but with significantly fewer parameters.

Liver cancer is the sixth most commonly diagnosed cancer and the third leading cause of cancer death in the world, and hepatocellular carcinoma (HCC) is the most common form of liver cancer. More than half of the HCC patients are diagnosed at an advanced stage and often require systemic therapy. Dysregulation of the activity of receptor tyrosine kinases (RTKs) is involved in the development and progress of HCC, RTKs are therefore the potential targets for systemic therapy of advanced HCC (aHCC). Currently, a total of six small molecule tyrosine kinase inhibitors (TKIs) have been approved for aHCC, including first-line sorafenib, lenvatinib, and donafenib, and second-line regorafenib, cabozantinib, and apatinib. These TKIs improved patients survival, which are associated with disease stage, etiology, liver function, tumor burden, baseline levels of alpha-fetoprotein, and treatment history. This review focuses on the clinical outcomes of these TKIs in key clinical trials, retrospective and real-world studies and discusses the future perspectives of TKIs for aHCC, with an aim to provide up-to-date evidence for decision-making in the treatment of aHCC., (© 2024. The Author(s).)

Substituting sugar with noncaloric sweeteners prevents overweight and diabetes development. They come in two types: artificial, like aspartame and sucralose, and natural, such as sorbitol. This research aimed to assess the effects of sucrose and these sweeteners on nutritional parameters, hematological parameters, hormones, and anti- and pro-inflammatory cytokines in male rats. Thirty rats had been separated into five groups. The results showed the highest significant increase in body weight gain, total food intake, and feed efficiency noticed in the aspartame group followed by sucralose, sucrose, and sorbitol, respectively. In contrast to RBCs and platelets, all sweeteners significantly reduced the hemoglobin level, Hct %, and WBC count. The aspartame group showed the highest decline in glycoproteins, steroids, and T3, and T4 hormones and a dramatic elevation in thyroid stimulating hormone, eicosanoid, and amine hormones compared with the control group. A vigorous elevation in anti- and proinflammatory cytokine levels was observed in the aspartame group, followed by sucralose, sucrose, and sorbitol groups. Aspartame has the highest docking scores when studying the interactions of sweeteners and a target protein associated with hormones or cytokines using in silico molecular docking, with the best absorption, distribution, metabolism, elimination, and toxicity properties compared to the remaining sweeteners., Competing Interests: The authors declare no competing financial interest., (© 2024 The Authors. Published by American Chemical Society.)

The aim of this study is to estimate the normal cross-sectional area and diameter of the stellate ganglion (SG) by ultrasound (US) in healthy adults. The study sample included 80 stellate ganglia in 40 participants (15 males, 25 females), mean age 38 years, mean height 162.5 cm, mean weight 67.8 kg, mean body mass index 25.4 kg/m2. Two radiologists separately obtained US images of the bilateral SG. Each participant was scanned 3 times bilaterally to assess for intra-observer reliability. The mean diameter of the SG was 1 mm (range: 0.1-2). The mean CSA of the bilateral SG was 1.3 mm2 (range: 0.6-3.9). The SG diameter positively correlated with age. Our study demonstrates the ability of US to image the SG and estimate its normal diameter and CSA. Knowledge of how to identify and measure the SG during ultrasound-guided procedures would be expected to decrease the risk of associated complications and help establish normal reference values., Competing Interests: The authors have no funding and conflicts of interest to disclose., (Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.)

Purpose: To evaluate the efficacy of vestibular rehabilitation therapy (VRT) for management of patients with persistent postural perceptual dizziness (PPPD) utilizing subjective and objectives outcome measures and to study the effect of degree of both anxiety and depression in patients on the response of vestibular rehabilitation therapy., Methods: Thirty-three PPPD patients participated in this study. Selection of patients was based on the diagnostic criteria for PPPD stated by Barany society in the International Classification of Vestibular Disorders (2017). Every patient was subjected to history taking, anxiety and depression assessment, Arabic version of Dizziness Handicap Inventory (DHI), and sensory organization test (SOT). All patients received vestibular rehabilitations therapy. Assessment of VRT outcome was conducted after 6 weeks of VRT., Results: The mean patients' age was 40.9 ± 16.3 years, and nearly equal gender distribution. Vestibular migraine was the most precipitating condition (24.2%) in patients with PPPD. (39.4%) of patients had abnormal scores of anxiety and depression tests, all patients had from moderate to severe degrees of handicap caused by dizziness as measured by DHI, most of patients had abnormal findings in all conditions of SOT. After vestibular rehabilitation therapy, DHI and SOT scores showed significant improvement after VRT. More improvement was found among the group with no anxiety and depression., Conclusion: VRT were effective in improving balance abnormalities in patients with PPPD evidenced by subjectively by DHI scores and objectively by SOT results. PPPD patients with concomitant psychiatric disorders; anxiety and depression experienced the least degree of improvement., (© 2023. The Author(s).)

The present study investigated the relationship between single nucleotide polymorphisms in the interleukin (IL)-15 gene located (exon 8) on the chromosomal location 4q31.21 and acute lymphoblastic leukaemia (ALL) risk in Iraqi patients. A total of 78 (49 male -29 female) primary ALL (62B-cell, 16 T-cells lineages cases and 30 healthy control subjects (median age 11, age range were 4-21.5), were enrolled at the Nanakaly Hospital of Erbil Province between February 2021 and January 2022. The genotype analysis was performed using polymerase chain reaction (PCR) and Sanger DNA sequencing. The IL15 homozygous rs10833 (100%) and rs2291596 (63.6%) genotypes indicated high frequencies and were associated with a risk of developing ALL, while the remaining 16 novel mutations indicated in low frequency (9.1%) except for the 97270G>GT genotype (18.2%). High expression levels were noted for different clusters of differentiation (CD) biomarkers between both subtypes of ALL, including, CD10, CD19, CD22, CD79a, CD99,  terminal deoxynucleotidyl transferase (TdT), and human leukocyte antigen DR (HLA-DR) isotype in B-cells lineages, while, CD2, CD3, CD5, CD7, CD13, CD117 and TdT are more specific to T-cells lineages. On the other hand,  significant changes were noted in certain hematological parameters including red blood cells (RBCs), haemoglobin (g/dl), haematocrite (HCt %), red blood cell distribution width (RDW %), and platelet counts (PLT- 109/L) compared with those of healthy subjects. Finally, it was concluded that various novel mutations were recorded with different subtypes of ALL diseases, and mild anemia was observed among patients. Future studies will be towered to associate these mutations with prognosis and therapeutic response of diseases.

Background: Sleeve gastrectomy (SG) is an effective method for managing obesity. While opioids are used for their hemodynamic stability and their ability to reduce intraoperative stress, they also have reported side effects. Dexmedetomidine (DEX), an α2 adrenergic receptor agonist, is noted for its analgesic and anesthetic-sparing effects, leading to a higher quality of recovery., Objectives: The study aims to compare the effects of fentanyl and dexmedetomidine (DEX) on the recovery of morbidly obese patients following laparoscopic sleeve gastrectomy (SG)., Methods: This randomized, double-blind study involved 64 patients, equally divided into two groups. The Dexmedetomidine group (Group D) received an intravenous (IV) loading dose of dexmedetomidine (1 μg/kg) over 15 minutes before anesthesia induction, followed by a 10 mL saline 0.9% infusion over 60 seconds during induction. Post-intubation, dexmedetomidine was administered at 0.5 μg/kg/h. The Fentanyl group (Group F) received a volume-matched saline 0.9% IV over 15 minutes pre-induction and fentanyl (1 μg/kg) diluted in 10 ml saline 0.9% IV over 60 seconds during induction. After intubation, a continuous fentanyl infusion was maintained at a rate of 1 μg/kg/hr., Results: Extubation time was significantly shorter in the Dexmedetomidine group (Group D) at 8.25 ± 2.7 minutes compared to the Fentanyl group (Group F) at 10.47 ± 2.17 minutes, with a P-value of 0.001. Intraoperative heart rate and mean arterial blood pressure were also significantly lower in Group D than in Group F. Visual analogue scale (VAS) pain scores were significantly lower in Group D compared to Group F upon arrival at the post-anesthesia care unit and at 2 hours postoperatively (P-value < 0.05). Additionally, the morphine dose consumed in the first 12 hours after surgery was significantly lower in Group D (5.75 ± 2.20 mg) compared to Group F (8 ± 2.38 mg), with a P-value of 0.001., Conclusions: For morbidly obese patients undergoing laparoscopic sleeve gastrectomy, dexmedetomidine (DEX) proves to be an effective anesthetic choice. It not only reduces extubation time but also lowers early postoperative visual analogue scale (VAS) pain scores and opioid consumption within the first 12 hours following surgery., Competing Interests: Authors declared no conflict of interests., (Copyright © 2024, Bakr et al.)

Background and Objective: Patients with Type 2 Diabetes (T2D) are at substantial risk for developing erectile dysfunction (ED). The primary goal of this study was to assess the prevalence of ED and depression among T2D patients and the associated risk factors., Methods: A cross-sectional study was conducted for adult T2D patients who had a routine clinic visit between January-August 2023. Structured questionnaires formed with two validated questionnaires - the International Index of Erectile Function short form (IIEF-5) and Patient Health Questionnaire (PHQ-9) - were used to screen for ED and depression, respectively., Results: A total of 478 male patients with T2D with a mean age of 59.2 ± 10.8 years, mostly married, with long standing T2D were included. Hyperlipidemia followed by hypertension were the most reported comorbidities. Of the patients, 61.3% had reported no depression and were less likely to have ED or severe ED ( p <0.001) and more likely to be physically active and to report no smoking ( p <0.0001) when compared to those with depression. Fifty-two percent of the patients reported moderate and severe ED and those were older in age ( p = 0.031), had longer duration of T2D diagnosis ( p = 0.005), were more likely to have any comorbidities ( p <0.05), were less likely to have a university degree and higher income (both p <0.001), were less likely to be on oral hypoglycemic agents (OHA) ( p <0.001), had worse glycemic control parameters ( p = 0.463), were more likely to have positive urine microalbuminuria ( p = 0.019), and were less likely to be physically active ( p = 0.048) when compared to patients with no or milder degree of ED., Conclusion: ED is highly prevalent in our study sample, with half of the patients having moderate to severe ED and being more likely to have depression. Older age, long-standing T2D, comorbidities, socioeconomic disadvantage, and sedentary lifestyle were all significantly associated with ED., Competing Interests: The authors report no conflicts of interest in this work., (© 2024 Alswat et al.)

The potential of plant-based diets and drugs to prevent and control obesity has been attributed to the presence of several biologically active phytochemicals. The study aimed to assess herb consumption's impact on alleviating the risks and hazards associated with obesity induced by a high-fat diet (HFD) and the promotion of fertility. Eighty rats were allocated into four distinct groups. Group 1 (G1) was provided with a basal diet and acted as the control group. Group 2 (G2) was provided with an HFD. Group 3 (G3) was provided with HFD supplemented with chia seeds and Hibiscus sabdariffa L. The fourth group of subjects was provided with HFD supplemented with Foeniculum vulgare (fennel) and Coriandrum sativum L. (coriander). The feeding session was sustained for 10 weeks, and the biochemical parameters were evaluated. The administration of Foeniculum vulgare (fennel) and Coriandrum sativum L. (coriander) (G4) resulted in a more significant reduction in all biochemical parameters compared to G3, which received a diet consisting of chia seeds and Hibiscus sabdariffa L. Additionally, the average number of embryonic lobes and the average number of offspring after birth were found to be considerably more significant in the normal control group (G1) and group (G4) compared to the HFD group (G2) and group (G3) (P < 0.01). Group 4 (G4) was administered a diet enriched with Foeniculum vulgare (fennel) and Coriandrum sativum L. (coriander), which demonstrated superior outcomes in many biochemical indicators and the promotion of fertility in obese female rats., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)

Latest studies indicated that agro-food wastes are considered renewable sources of bioactive compounds. This investigation aimed to utilize natural extracts of citrus peels as antimicrobial and anti-aflatoxigenic agents for food safety. The bioactivity of two citrus peels was assessed by total phenolic, flavonoids, and antioxidant activity. Nanoemulsions were manufactured using high-speed homogenization. The mean particle size of the nanoemulsions ranged from 29.41 to 66.41 nm with a polydispersity index of 0.11-0.16. The zeta potential values ranged from -14.27 to -26.74 mV, indicating stability between 81.44% and 99.26%. The orange peel extract showed the highest contents of total phenolic and flavonoids compared to the other extracts and nanoemulsions (39.54 mg GAE/g and 79.54 mg CE/100 g, respectively), which agreed with its potential antioxidant activity performed by DPPH free radical-scavenging and ABTS assays. Chlorogenic, caffeic, ferulic, and catechin were the dominant phenolic acids in the extracts and nanoemulsions, while quercitrin, rutin, and hesperidin were the most abundant flavonoids. Limonene was the major volatile component in both oils; however, it was reduced dramatically from 92.52% to 76.62% in orange peel oil and from 91.79 to 79.12% in tangerine peel oil. Consistent with the differences in phenolics, flavonoids, and volatiles between orange and tangerine peel extracts, the antibacterial properties of orange extracts had more potential than tangerine ones. Gram-positive bacteria were more affected by all the examined extracts than Gram-negative ones. The antifungal activity of orange extract and nanoemulsion on seven fungal strains from Aspergillus spp had more potential than tangerine extracts. Additionally, using a simulated media, the orange peel extract and its nanoemulsion had a more anti-aflatoxigenic influence. Molecular docking confirmed the high inhibitory action of flavonoids, especially hesperidin, on the polyketide synthase (-9.3 kcal/mol) and cytochrome P450 monooxygenase (-10.1 kcal/mol) key enzymes of the aflatoxin biosynthetic mechanism., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)

Purpose: Examining the association of breast cancer (BC) symptom awareness with time to help seeking and exploring barriers to timely presentation may enhance the effectiveness of BC awareness campaigns and early detection efforts. This study aimed to assess the anticipated time for seeking medical advice when experiencing a potential BC symptom among women in Palestine and to identify their barriers to early presentation., Materials and Methods: A convenience sampling method was used to recruit adult women from hospitals, primary health care facilities, and public areas across 11 governorates in Palestine. A translated-into-Arabic version of the validated BC Awareness Measure was used. The questionnaire consisted of three sections: sociodemographic information, recognition of 13 BC symptoms and reporting time for seeking medical advice, and barriers to early presentation., Results: A total of 5,257 questionnaires were included. The proportion of participants who would seek medical advice immediately varied on the basis of the nature of BC symptoms. For symptoms related to the breast, the proportion ranged from 25.7% for redness of the breast skin to 53.5% for a lump or thickening in the breast. For symptoms related to the nipple, the proportion ranged from 30.7% for nipple rash to 48.0% for discharge or bleeding from the nipple. Exhibiting good BC symptom awareness was associated with a higher likelihood of seeking medical advice within a week for all BC symptoms. Emotional barriers were the most frequently reported barriers. There was no association between increasing levels of BC awareness and reporting fewer or more barriers., Conclusion: The nature of BC symptoms had an impact on help-seeking behaviors. Participants with good BC symptom awareness were more likely to seek medical advice earlier.

Background: Cholestasis is an important predisposing factor for hepatocyte damage, liver fibrosis, primary biliary cirrhosis, and even liver failure. Silybum marianum L. (SM) plant is used in teas or eaten in some countries due to its antioxidant and hepatoprotective properties. Because of its low and poor oral bioavailability, so we improve the therapeutic activity of Silybum marianum L. extract (SM) by studying the potential effects of nanoformulation of Silybum marianium L. extract (nano-SM) on 17α-ethinylestradiol (EE)-induced intrahepatic cholestasis., Methods: Thirty female Sprague-Dawley rats were divided into 5 groups (6 rats/group). Group I: Rats were received the treatment vehicle and served as normal group. Group II:Rats were injected daily with EE (10 mg/kg) for five successive days. Group III-V: Rats were injected daily with EE (10 mg/kg) and treated with either Ursodeoxycholic acid (UDCA) (40 mg/kg), SM (100 mg/kg) and nano-SM (100 mg/kg) orally once/day throughout the trialfor five successive days, respectively., Results: Nano-SM greatly dampened the increase in serum levels of total and direct bilirubin, alanine aminotransaminase, aspartate aminotransaminase, and alkaline phosphatase caused by EE. Furthermore, nano-SM increased the hepatic contents of reduced glutathione (GSH) and catalase (CAT) and also upregulated the relative hepatic gene expressions of Rho-kinase (ROCK-1), myosin light chain kinase (MLCK), and myosin phosphatase target subunit (MYPT1) compared to the EE-induced group. Administration of nano-SM reduced hepatic lipid peroxidation and downregulated the relative hepatic expressions of the nuclear factor-kappa B (NF-ҡB) and interleukin-1β (IL-1β). In addition, nano-SM improved the histopathological changes induced by EE., Conclusion: Nano-SM possessed a superior effect over SM, which can be considered an effective protective modality against EE-induced cholestatic liver injury through its antioxidant, anti-inflammatory activities, and enhancing bile acid (BA) efflux., (© 2024. The Author(s).)

Functional materials are required to meet the needs of society, such as environmental protection, energy storage and conversion, integrated product production, biological and medical processing. bulk nanostructured materials are a research concept that combines nanotechnology with other research fields such as supramolecular chemistry, materials science, and life science to develop logically functional materials from nanodevices. In this review article, nanostructures are synthetized by different methods based on the types and nature of the nanomaterials. In a broad sense "top-down" and "bottom-up" are the two foremost methods to synthesize nanomaterials. In top-down method bulk materials have been reduced to nanomaterials, and in case of bottom-up method, the nanomaterials are synthesized from elementary level. The different methods which are being used to synthesize nanomaterials are chemical vapor deposition method, thermal decomposition, hydrothermal synthesis, solvothermal method, pulsed laser ablation, templating method, combustion method, microwave synthesis, gas phase method, and conventional Sol-Gel method. We also briefly discuss the various physical and chemical methods for producing nanomaterials. We then discuss the applications of functional materials in many areas such as energy storage, supercapacitors, sensors, wastewater treatment, and other biological applications such as drug delivery and drug nanocrystals. Finally, future challenges in materials nanoarchitecture and concepts for further development of functional nanomaterials are briefly discussed., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Background: The sympatholytic property of dexmedetomidine (DEX) makes it suitable as a hypotensive drug during functional endoscopic sinus surgery (FESS); however, delayed emergence from anesthesia and high postoperative sedation have been reported., Objectives: Delayed emergence from anesthesia and high postoperative sedation are associated with a prolonged length of stay in the operating room and the postanesthesia care unit (PACU), which increases health care costs. This study aimed to overcome the negative impact of DEX on recovery by using aminophylline., Methods: This randomized, double-blind, placebo-controlled study was conducted on 52 patients planned for elective FESS under general anesthesia with DEX infusion for controlled hypotension during surgery. Patients were equally divided into 2 groups. The aminophylline group received 4 mg/kg aminophylline diluted in 50 mL saline 0.9% over 30 minutes after positioning in a 20-degree reverse Trendelenburg position. The control group received 50 mL saline 0.9% with a similar volume and period as the aminophylline group., Results: The extubation time was significantly shorter in the aminophylline group (6.5 (5.25 - 7.75) minutes) than in the control group (9 (7.25 - 10) minutes) (P-value < 0.001). The PACU discharge time was significantly shorter in the aminophylline group (15 (10 - 20) minutes) compared to the control group (20 (15 - 28.75) minutes) (P-value = 0.036). Intraoperative heart rate and mean arterial pressure were nonsignificantly different between the 2 groups. Ramsay sedation score measurements at 15 min, 30 min, and 60 min after extubation were significantly lower in the aminophylline than in the control group (P-value < 0.05). Complications were nonsignificantly different between the 2 groups., Conclusions: Intraoperative aminophylline infusion enhances the recovery of patients undergoing FESS under DEX hypotensive anesthesia without intraoperative hemodynamic alterations and decreases their postoperative sedation without significant postoperative side effects., Competing Interests: The authors declare no conflict of interest., (Copyright © 2023, Rehab et al.)

Introduction: The consumption of dairy products, including soft cheese, has been associated with numerous health benefits due to their high nutritional value. However, the phenolic compounds bioaccessibility present in soft cheese is limited due to their poor solubility and stability during digestion. So, this study aimed to develop an innovative soft cheese enriched with date seed phenolic compounds (DSP) extracted ultrasonically and incorporated into homogeneous liposomes and study its attenuation effect on testosterone-induced benign prostatic hyperplasia (BPH) in rats., Methods: Date seed phenolic compounds were extracted using 98 and 50% ethanol along with water as solvents, employing ultrasonication at 10, 20, and 30-min intervals. The primary and secondary DSP-liposomes were prepared and dehydrated. The particle size, zeta potential, encapsulation efficiency, and morphology were measured. Incorporating dehydrated liposomes (1-3% w/w) into soft cheese and their impact on BPH using male Sprague-Dawley rats was assessed. After inducing BPH, rats were fed a cheese diet with dehydrated DSP-liposomes. Over 8 weeks, parameters including nutrition parameters, prostate enlargement analysis, biochemical parameters, hormones level, oxidative stress, and cytokines were analyzed., Results and Discussion: The results showed that ultrasound-assisted extraction effectively reduced the extraction time and 30 min extraction EtOH 50% was enough to extract high yield of phenolic compounds (558 mg GA/g) and flavonoids (55 mg qu/g) with high antioxidant activity (74%). The biological results indicate that prostate weight and prostate index% were diminished in the treatment groups (1 and 2) compared to the BPH control group. The high antioxidant content present in the DSP-liposomes acted as the catalyst for suppressing the responses of the inflammatory cytokines, inhibiting the anti-inflammatory IL-10 production, and suppressing the elevated levels of lipid peroxidation products compared to the BPH group., Conclusion: The treatment group (2) supplemented with dehydrated secondary DSP-liposomes exhibited the most significant variance ( p < 0.05) as opposed to the BPH group. Liposomal encapsulation was proved to be a feasible approach for administering DSP in soft cheese, thereby establishing new functional food category possessing prophylactic properties against the advancement of BPH in rats., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Mohammed, El-Messery, Baranenko, Hashim, Boulkrane and El-Said.)

Background: The discussion about breast cancer (BC) causation continues to be surrounded by a number of myths and misbeliefs. If efforts are misdirected towards reducing risk from false mythical causes, individuals might be less likely to consider and adopt risk-reducing behaviors for evidence-based BC causes. This national study aimed to assess the awareness of BC causation myths and misbeliefs among Palestinian women, and examine the factors associated with having good awareness., Methods: This national cross-sectional study recruited adult women from government hospitals, primary healthcare centers, and public spaces in 11 governorates in Palestine. A modified version of the Cancer Awareness Measure-Mythical Causes Scale was used to collect data. The level of awareness of BC causation myths was determined based on the number of myths recognized to be incorrect: poor (0-5), fair (6-10), or good (11-15)., Results: A total of 5,257 questionnaires were included. Only 269 participants (5.1%) demonstrated good awareness (i.e., recognizing more than 10 out of 15 BC mythical causes). There were no notable differences in displaying good awareness between the main areas of Palestine, the Gaza Strip and the West Bank and Jerusalem (5.1% vs. 5.1%). Having chronic disease as well as visiting hospitals and primary healthcare centers were associated with a decrease in the likelihood of displaying good awareness. Myths related to food were less frequently recognized as incorrect than food-unrelated myths. 'Eating burnt food' was the most recognized food-related myth (n = 1414, 26.9%), while 'eating food containing additives' was the least recognized (n = 599, 11.4%). 'Having a physical trauma' was the most recognized food-unrelated myth (n = 2795, 53.2%), whereas the least recognized was 'wearing tight bra' (n = 1018, 19.4%)., Conclusions: A very small proportion of Palestinian women could recognize 10 or more myths around BC causation. There is a substantial need to include clear information about BC causation in future educational interventions besides focusing on BC screening, signs and symptoms, and risk factors., (© 2023. The Author(s).)

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Flavors and aromas are widely used in food and pharmaceutical industries to enhance food palatability. However, it is worth noting that they may also have bioactivity. This study aims to examine the potential impact of key flavors and their nanocapsules on health and diseases, such as type 2 diabetes mellitus (T2DM). The 36 nanocapsules of key flavorings were prepared by high shear homogenization (HSH). Seventy-two male Sprague-Dawley rats received a single dosage of streptozotocin (35 mg kg -1 body weight) intraperitoneally. All of the nutritional and biochemical parameters were statistically analyzed. A virtual docking study was conducted. Linalool nanoemulsion results showed the highest encapsulation efficiency (86.76%), while isoamyl acetate nanoparticles showed the lowest (69.99%). According to GC-MS analysis, encapsulation did not affect the flavoring structure with particle size distributions ranging from 277.3 to 628.8 nm. Using TEM, nanoemulsion particles appeared spherical with a desired nanometric diameter size. In the oral glucose tolerance test, flavorings in oil and nanoforms had no discernible hypoglycemia effects in normal rats. The nutritional and biochemical parameters confirmed that both normal and nanoencapsulation forms demonstrated a potential anti-hyperglycemic effect, and enhanced the rat health compared to the raw flavorings. The studied flavorings and their nanocapsules seem to have the potential double effect of a flavor compound as a food palatability enhancer with a potential beneficial effect on type 2 diabetes mellitus without any health drawbacks.

Colon cancer is the third most common cancer type worldwide in 2020, almost two million cases were diagnosed. As a result, providing new, highly accurate techniques in detecting colon cancer leads to early and successful treatment of this disease. This paper aims to propose a heterogenic stacking deep learning model to predict colon cancer. Stacking deep learning is integrated with pretrained convolutional neural network (CNN) models with a metalearner to enhance colon cancer prediction performance. The proposed model is compared with VGG16, InceptionV3, Resnet50, and DenseNet121 using different evaluation metrics. Furthermore, the proposed models are evaluated using the LC25000 and WCE binary and muticlassified colon cancer image datasets. The results show that the stacking models recorded the highest performance for the two datasets. For the LC25000 dataset, the stacked model recorded the highest performance accuracy, recall, precision, and F1 score (100). For the WCE colon image dataset, the stacked model recorded the highest performance accuracy, recall, precision, and F1 score (98). Stacking-SVM achieved the highest performed compared to existing models (VGG16, InceptionV3, Resnet50, and DenseNet121) because it combines the output of multiple single models and trains and evaluates a metalearner using the output to produce better predictive results than any single model. Black-box deep learning models are represented using explainable AI (XAI).

Aflatoxins are an unavoidable contaminant of foods. The current work aimed to study the ameliorating effect of Lawsonia inermis L. extract and its nano-formulation versus aflatoxin ingestion in ulcerative rats. Lawsonia inermis L. bioactivity was evaluated by both antioxidant & antimicrobial assays. The nanoparticles characterization measurements were evaluated. Different parameters in the fortified milk beverage were assessed. Seventy two Sprague-Dawley male rats were randomized into 12 groups (6 rats/group) where peptic ulcer was induced with a single aspirin dose (500 mg/kg BW) orally. The nutritional and biochemical parameters were evaluated. The results showed that antioxidant activity and total phenolic content increased with increasing nano-formulation ratio. A remarkable improvements in all the treated groups, either for ulcer alone or for aflatoxin exposed ulcerative groups in normal and nano-formulation. Conclusively, Lawsonia inermis L. & its nano-formulation could act as dual therapy for ulcer treatment and the hazardous effects of aflatoxin exposure., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 The Authors.)

Diacetyl is a common ingredient that creates a buttery flavor in baked goods and other food products. The cytotoxic impact of diacetyl on a normal human liver cell line (THLE2) indicated an IC 50 value of 41.29 mg/ml through MTT assay and a cell cycle arrest in the G 0 /G 1 phase relative to the control. Administration of diacetyl at two-time points (acute-chronic) led to a significant increase in DNA damage indicated by the increase in tail length, tail DNA%, and tail moment. The mRNA and protein expression levels of genes in the rats' livers were then measured using real-time PCR and western blotting. The results showed an activation of the apoptotic and necrosis mechanism, with an upregulation of p53, Caspase 3, and RIP1 and a downregulation of Bcl-2 at the mRNA level. The ingestion of diacetyl disrupted the liver's oxidant/antioxidant balance, as evidenced by alterations in levels of GSH, SOD, CAT, GPx, GR, MDA, NO, and peroxynitrite. Additionally, heightened levels of inflammatory cytokines were shown. Histopathological examinations revealed necrotic foci and congested portal areas in the rats' liver cells after treatment with diacetyl. Diacetyl may interact moderately with Caspase, RIP1, and p53 core domain through In-silico, possibly resulting in upregulated gene expression., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

The aim of this study is to utilize ultrasound to evaluate the normal cross-sectional area (CSA) of the phrenic nerve (PN), at the level of the anterior scalene muscle. The study included 62 PNs in 31 healthy subjects (13 men, 18 women); mean age, 36.6 years; mean height, 161.1 cm; mean weight, 69.6 kg; and mean body mass index 25.8 kg/m2. High-resolution ultrasound images of the bilateral PNs were obtained by a radiologist with 15 years of experience in neuromusculoskeletal ultrasound. Three separate CSA measurements for the bilateral PNs bilaterally were obtained. Images were also reviewed by an experienced neurologist to evaluate for inter-rater variability. The mean CSA of the right PN was 0.54 mm2 ± 0.16. The mean CSA of the left PN was 0.53 mm2 ± 0.18. We believe that the reference values for the normal CSA of the PNs obtained in our study could help in the sonographic evaluation of PN enlargement, as it relates to the diagnosis of various diseases affecting the PN. Furthermore, knowledge of its location and size, at the level of the scalene muscle, could help prevent PN-related complications during interventional procedures in that area. Additionally, for each participant, demographic information of age and gender as well as body mass index, weight, and height were documented., Competing Interests: The authors have no funding and conflicts of interest to disclose., (Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.)

Background: Anti-N-methyl-d-aspartate "anti-NMDA" receptor encephalitis is one of the most common autoimmune encephalitis for which first- and second-line therapies have been recommended following international consensus. However, some refractory cases do not respond to the first- and second-line therapy and require further immune-modulatory therapies such as intra-thecal methotrexate. In this study, we reviewed six confirmed cases of refractory anti-NMDA receptor encephalitis from two tertiary centers in Saudi Arabia that required escalation of treatment and received a six-month course of intra-thecal methotrexate. The aim of this study was to evaluate the effectiveness of intra-thecal methotrexate as immunomodulatory therapy for refractory anti-NMDA receptor encephalitis., Methods: We retrospectively evaluated six confirmed cases of refractory anti-NMDA receptor encephalitis who did not improve after first- and second-line therapy and received monthly intra-thecal methotrexate treatment course for six consecutive months. We reviewed patient demography, underlying etiologies, and compared their modified Rankin score prior to receiving intra-thecal methotrexate and six months after completing the treatment., Results: Three of the six patients showed a marked response to intra-thecal methotrexate with a modified Rankin scale of 0-1 at 6-month follow-up. None of the patients experienced any side effects during or after intra-thecal methotrexate treatment, and no flareups were observed., Conclusion: Intra-thecal methotrexate may be a potentially effective and relatively safe escalation option for immunomodulatory therapy of refractory anti-NMDA receptor encephalitis. Future studies on intra-thecal methotrexate -specific treatment regimens may further support its utility, efficacy, and safety in treating refractory anti-NMDA receptor encephalitis., (© 2023. The Author(s).)

The aim of this article is to utilize ultrasound to evaluate the normal cross-sectional area (CSA)of the vagus nerve (VN) in the carotid sheath. This study included 86 VNs in 43 healthy subjects (15 men, 28 women); mean age 42.1 years and mean body mass index 26.2 kg/m2. For each subject, the bilateral VNs were identified by US at the anterolateral neck within the common carotid sheaths. One radiologist obtained 3 separate CSA measurements for each of the bilateral VNs with complete transducer removal between each measurement. Additionally, for each participant, demographic information of age and gender as well as body mass index, weight, and height were documented. The mean CSA of the right VN in the carotid sheath was 2.1 and 1.9 mm2 for the left VN. The right VN CSA was significantly larger than the left VN (P < .012). No statistically significant correlation was noted in relation to height, weight, and age. We believe that the reference values for the normal CSA of the VN obtained in our study, could help in the sonographic evaluation of VN enlargement, as it relates to the diagnosis of various diseases affecting the VN., Competing Interests: The authors have no funding and conflicts of interest to disclose., (Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.)

Opioids have dominated the management of perioperative pain in recent decades with higher doses than ever before used in some circumstances. Through the expanding use of opioids, growing research has highlighted their associated side-effects and the intertwined phenomena of acute withdrawal syndrome, opioid tolerance, and opioid-induced hyperalgesia. With multiple clinical guidelines now endorsing multimodal analgesia, a diverse array of opioid-sparing agents emerges and has been studied to variable degrees, including techniques of opioid-free anaesthesia. It remains unclear to what extent such methods should be adopted, yet current evidence does suggest dependence on opioids as the primary perioperative analgesic might not meet the principles of 'rational prescribing' as described by Maxwell. In this narrative review we describe how, using current evidence, a patient-centred rational-prescribing approach can be applied to opioids in the perioperative period. To contextualise this approach, we discuss the historical adoption of opioids in anaesthesia, our growing understanding of associated side-effects and emerging strategies of opioid-sparing and opioid-free anaesthesia. We discuss avenues and challenges for improving opioid prescribing to limit persistent postoperative opioid use and how these may be incorporated into a rational-prescribing approach., (Copyright © 2023 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.)

Objective: To identify and examine the available studies regarding adult perceptions and experiences of postoperative opioid pain management., Introduction: The opioid crisis has been acknowledged as a significant clinical and social problem in many countries. Opioids are often initiated after surgery and may be continued on hospital discharge. There is no consensus on the optimal strategy for integrating patients' views in postoperative opioid prescribing. The aim of this review is to explore the literature on adults' experiences with postoperative opioid pain management., Inclusion Criteria: This review will consider all qualitative studies and mixed-method studies with qualitative approaches that explored adults' opinions or concerns on opioids and/or opioid reduction, and adults' satisfaction with pain control in this context. Participants in the studies should be adults who had undertaken any type of surgery and have had opioid prescriptions for pain management., Methods: This scoping review will be carried out in accordance with the Joanna Briggs Institute (JBI) methodology and will utilise the Preferred Reporting Items for Systematic Reviews and Meta Analyses extension for scoping reviews (PRISMA-ScR) reporting guideline and checklist. Searches will be conducted in Ovid MEDLINE, PsycInfo, EMBASE and CINAHL (EBSCO). Studies published in the English language will be included with no time limit. The screening and selection of studies will be carried out independently by three reviewers. Then data extraction process will be conducted by the main reviewer and the reviewer's supervisors independently. A descriptive qualitative content analysis will be utilised for data synthesis. The final report will contain a methodological quality assessment, with the findings being presented, including the knowledge gaps and recommendations for research., Competing Interests: Conflicts of interest: PF received advisory board/speaker fees from Oncomfort/Grunenthal. The other authors have no other conflict of interest to disclose., (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the European Society of Anaesthesiology and Intensive Care.)

In the past three decades, a significant progress has been made in the prevention and treatment of gastric ulcers. The incidence of the disease has decreased, but gastric ulcer is still a medical problem. Currently, the available drugs for gastric ulcer treatment have many side effects; therefore, searching for new and safe therapeutic agents is mandatory. The present study aims to investigate the gastroprotective potential of Cornu aspersum ( C. aspersum ) mucin against gastric ulcers, and the mechanisms related to oxidative stress and inflammation. C. aspersum mucin was collected from 50 snails. The characteristics of C. aspersum mucin (chemical and microbiological) were evaluated. Mice were pretreated with famotidine and C. aspersum mucin (7.5 and 15 ml/kg b.w.) for 5 days, and then gastric ulcers were induced by indomethacin. Macroscopic examination, biochemical estimations, and Quantitative real-time PCR were carried out. Also, histopathological and immunohistopathological examinations were evaluated. We found that the high dose of the mucin significantly decreased the gastric mucosal malondialdehyde (MDA) and nitric oxide (NO) contents as well as interleukin 1β (IL-1β) and nuclear factor kappa β (NF-ҡB) expression, and inducible nitric oxide synthase (iNOS) immunostaining. It also increased the gastric mucosal GSH and catalase contents as well as hemoxygenase-1 (HO-1) and nuclear factor-erythroid 2-related factor 2 (Nrf2) expressions with regressions in gastric mucosal lesions. In conclusion, C. aspersum mucin could be a potential therapeutic candidate to protect against gastric ulceration., Competing Interests: The authors declare no conflict of interest., (© 2023 The Authors.)

Aluminum, one of the most abundant metallic elements, is known to be toxic to multiple organs including the kidneys. This study aimed to investigate the pleiotropic nephroprotective effects of Hesperidin in aluminum chloride (ALCL3)-induced renal injury, highlighting the potential molecular mechanisms underlying. Twenty-four male albino rats were divided into four groups: control, Hesperidin (80 mg/kg BW, orally), ALCL3 (10 mg/kg BW, IP), and ALCL3 + Hesperidin groups. By the end of the study, blood samples were collected, and tissue samples were harvested at sacrifice. ALCL3 rats showed dramatically declined renal function, enhanced intrarenal oxidative stress, inflammation, apoptosis, and extravagant renal histopathological damage with interstitial fibrosis as shown by a higher Endothelial, Glomerular, Tubular, and Interstitial (EGTI) score. Hesperidin significantly reversed all the aforementioned detrimental effects in ALCL3-treated rats. The study verified the nephroprotective effects of Hesperidin on ALCL3-induced renal damage and confirmed the critical role of extracellular matrix (ECM) remodeling and apoptosis inhibition., (© 2022. The Author(s).)

Background: Children with chronic kidney disease (CKD), particularly those who require hemodialysis (HD), are at high risk of hepatitis B virus (HBV) infection. The HBV vaccine non-/hypo-response rate among HD children remains high, and it is critical to investigate the influencing factors and their linkages. The aim of this study was to identify the pattern of HB vaccination response in HD children and to analyze the interference of various clinical and biomedical factors with the immunological response to HB vaccination. Methods: This cross-sectional study included 74 children on maintenance hemodialysis, aged between 3 and 18 years. These children were subjected to complete clinical examination and laboratory investigations. Results: Out of a total of 74 children with HD, 25 (33.8%) were positive for the HCV antibody. Regarding the immunological response to hepatitis B vaccine, 70% were non-/hypo-responders (≤100 IU/mL) and only 30% mounted a high-level response (more than 100 IU/mL). There was a significant relation between non-/hypo-response and sex, dialysis duration, and HCV infection. Being on dialysis for more than 5 years and being HCV Ab-positive were independent variables for non-/hypo-response to HB vaccine. Conclusions: Children with CKD on regular HD have poor seroconversion rates in response to the HBV vaccine, which were influenced by dialysis duration and HCV infection.

Background: Toll-like receptors (TLRs) play an important role in activation of innate and adaptive immune responses., Aim: We aimed to detect the association between TLR2 rs5743708 G>A and TLR9 rs5743836 C>T variants and COVID-19 disease susceptibility, severity, and thrombosis by using neutrophil extracellular traps (NETs)., Subjects and Methods: We included 100 adult COVID-19 patients as well as 100 age- and gender-matched normal controls. Participants were genotyped for TLR2 rs5743708 and TLR9 rs5743836. Citrullinated Histone (H3) was detected as an indicator of NETs., Results: The mutant (G/A and C/C) genotypes and (A and C) alleles of TLR2 rs5743708 and TLR9 rs5743836, respectively, have been significantly related to a higher risk of COVID-19 infection, representing a significant risk factor for the severity of COVID-19. There was no significant association between the two variants and citrullinated histone (H3)., Conclusion: TLR2 rs5743708 and TLR9 rs5743836 variants have been significantly related to a higher risk and severity of COVID-19 infection but had no effect on thrombus formation., Competing Interests: The authors report no conflicts of interest in this work., (© 2023 Alhabibi et al.)

Background: Neurological diseases frequently affect sexual activity, and the resulting sexual dysfunction can cause much distress for patients. However, despite the importance of such complaints, neurologists frequently do not ask patients about their sexual symptoms or how their neurological illness and medications are affecting their sexual health. This study aimed to identify these difficulties as well as potential obstructions to conversations for addressing sexual dysfunction in patients with neurological diseases., Methods: This cross-sectional study was performed by sending invitation letters and questionnaires to registered neurologists in Saudi Arabia. The questionnaire was constructed to determine the possibility of discussing sexual activities and function with patients with neurological diseases and the possible obstacles neurologists face in this regard. Statistical analyses were performed using the Statistical Package of Social Sciences (SPSS) program version 25, and p -values of <0.05 were considered statistically significant., Results: A total of 258 of 750 neurologists (34.4%) returned the survey, of which 252 had completed the entire survey; therefore, their responses were considered suitable for further analysis. The majority of the respondents (63.1%) seldom discussed sexuality with their patients, more than half of the participants never discussed sexuality with female patients, and patients aged 60 years or older. The most commonly reported barriers were the lack of spontaneous communication by patients regarding their sexual problems (82.1%), insufficient consultation time (60.7%), and barriers based on language/culture/religion (53.6%). The majority of the respondents (61.9%) expressed the need for training on discussing sexuality as a measure that may enhance the discussion of sexual life with patients. Most of the respondents (92.9%) considered the patients responsible for bringing up problems in their sexual functioning during a patient interview., Conclusion: Sexual dysfunction is rarely discussed with patients showing neurological diseases, particularly with female patients. This is due to the patient's inability to articulate their sexual problems freely as well as a lack of consultation time. Training on discussing sexuality may enhance the discussion of sexual life with patients., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Almalki, Kotb and Albarrak.)

Introduction: Healthcare-associated urinary tract infection (UTI) represents a significant health problem, especially in infants and young children. The most common pathogen associated with this infection is Escherichia coli (E. coli)., Objective: The present study aimed to detect the frequency of virulence genes among clinical isolates of E. coli isolated from healthcare-associated urinary tract infections in children and the correlation between these virulence genes and the presence of the bla CTX gene., Methods: The study included one hundred clinical isolates of E. coli isolated from healthcareassociated urinary tract infections in children in intensive care units. The isolates were subjected to antibiotics sensitivity by disc diffusion method and detection of extended-spectrum beta-lactamase by double disc diffusion method. In addition, multiplex polymerase chain reaction (PCR) was used to detect some virulence genes, and PCR was used to detect the bla CTX-M gene., Results: E. coli producing ESBL by double discs method was identified in 74 isolates. bla CTX-M gene detection by PCR was identified among 38 isolates representing 51.4% of ESBL-producing E. coli. There was a significant association between ESBL and bla CTX-M Gene, P = 0.0001. The frequency of the studied virulence genes by multiplex PCR in the isolated E. coli was 66% for the Fim gene, 75% for the Aer gene, 68% for the FliC gene, 53% for each of IucD gene and Usp gene, 40% for pap gene, 35% for each of AFA and ironN genes and 17% for sfa gene. None of the isolated E. coli had the Cdt gene. There was a significant association between the presence of the FimH gene (P = 0.0001), Pap gene (P = 0.05), sfa (P = 0.026), Afa gene (P = 0.018), and aer gene (P = 0.035) and the presence of the bla CTX-M gene in the isolated E. coli., Conclusion: The present study highlights the presence of virulence genes and bla CTX-M gene in uropathogenic E. coli isolated from pediatric patients with healthcare-associated urinary tract infections. There was an association between the bla CTX-M gene and virulence genes FimH, pap, sfa, Afa, and aer. Various distributions of the studied genes with a high frequency of fimbria are flic genes. Moreover, the ESBL had high frequency in E. coli with the presence of bla CTX-M in about one-third of the isolates., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Diabetes mellitus is a metabolic syndrome affecting millions of people worldwide. Every year, the rate of occurrence rises drastically. Diabetes-related problems across several vital organs of the body can be fatal if left untreated. Diabetes must be detected early to receive proper treatment, preventing the condition from escalating to severe problems. Tremendous health sciences and biotechnology advancements have resulted in massive data that generated massive Electronic Health Records and clinical information. The exponential increase of electronically gathered information has resulted in more complicated, accurate prediction models that can be updated continuously using machine learning techniques. This research mainly emphasizes discovering the best ensemble model for predicting diabetes. A new multistage ensemble model is proposed for diabetes prediction. In this model, accuracy is predicated on the Pima Indian Diabetes dataset. The accuracy of the proposed ensemble model is compared with the existing machine learning model, and the experimental results demonstrate the performance of the proposed model in terms of higher Precision, f-measure, Recall, and area under the curve., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Simaiya, Kaur, Sandhu, Alsafyani, Alroobaea, alsekait, Margala and Chakrabarti.)

Diabetes is a drastic health problem resulting from an endocrine disorder. M. parviflora L. might represent an antioxidant-rich food source and thus applies to pharmaceutical and therapeutic applications in oxidative stress-related degenerative diseases. In the current work, we assessed the antidiabetic activity of M. parviflora L. leaves extract and its nano-formulation in rats. M. parviflora L. bioactivity was evaluated by both antioxidant and antimicrobial assays. The nano-formulation characteristics (Mass, TEM, and Zeta potential) were evaluated. Twenty-four male Sprague-Dawley rats were administered streptozotocin (STZ) intraperitoneally for only one dose (35 mg/kg body weight). All of the nutritional and biochemical parameters were statistically analyzed. The results showed that M. parviflora L. is rich in phenolics and flavonoids with high antioxidant action. The antifungal activity of the extract was evident, especially with Fusarium culmorum and aspergillus flavus . The extract and its nano-formulation have shown antidiabetic properties when tested on diabetic rats as they improved all the biochemical parameters; decreased glucose level in serum, increased insulin production, marked improvement in lipid profile, liver and kidney functions, and that was more proved with the histopathological examinations. Conclusively, M. parviflora L. extract and its nano-formulation could attenuate or effectively help in controlling diabetes through its therapeutic properties exhibited by the action of the plant antioxidant components., Competing Interests: The authors declare no conflict of interest., (© 2022 The Author(s).)

Purpose: This study aimed to assess awareness of Palestinian women about breast cancer (BC) age-related and lifetime risks and its risk factors and to identify factors associated with good awareness., Materials and Methods: Adult women were recruited from government hospitals, primary health care centers, and public spaces in 11 governorates in Palestine. Recognition of 14 BC risk factors was assessed using a translated-into-Arabic version of the validated BC awareness measure. The level of BC risk factor awareness was determined on the basis of the number of risk factors recognized: poor (0-4), fair (5-9), and good (10-14)., Results: Of 6,269 potential participants approached, 5,434 agreed and completed the questionnaire (response rate = 86.7%). A total of 5,257 questionnaires were included: 2,706 from the West Bank and Jerusalem and 2,551 from the Gaza Strip. Only 173 participants (3.3%) recognized the age-related risk of BC. More than one quarter (n = 1,465; 27.9%) recognized the lifetime risk of BC. The most recognized modifiable risk factor was not breastfeeding (n = 4,937; 93.9%), whereas the least recognized was having children later on in life or not at all (n = 1,755; 33.4%). The most recognized nonmodifiable risk factor was radiation exposure (n = 4,579; 87.1%), whereas the least recognized was starting the periods at an early age (n = 1,030; 19.6%). In total, 2,024 participants (38.4%) demonstrated good BC risk factor awareness. Participants from the Gaza Strip had a higher likelihood than participants from the West Bank and Jerusalem to have good awareness (42.0% v 35.2%). Age ≥ 40 years, postsecondary education, and visiting hospitals and primary health care centers were all associated with an increase in the likelihood of having good BC risk factor awareness., Conclusion: The awareness of BC risk factors was suboptimal. These findings highlight the need for implementing health education programs combined with consistent use of ad hoc opportunities to raise awareness by health care providers.