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Jamil MAS Obaid,1,2 Khawla AAS Sakran,2 Shaima AH Mohammed,1 Shifa`a LA Al-Salahi,1 Nawal AN Mahdi,1 Mohammed AM AL-Sharabi,1 Asadaddin SM AL-Gaadi,2 Mohammed NM AL-Fatahi2 1Department of Medical Laboratory Sciences, Faculty of Medicine and Health Sciences, Ibb University, Ibb, Yemen; 2Department of Medical Microbiology, Faculty of Science, Ibb University, Ibb, YemenCorrespondence: Jamil MAS Obaid, Ibb University, Assalaba, Ibb, Yemen, Email Jamilobaid@yahoo.com; Jamilobaid@ibbuniv.edu.yeObjective: Hemolysis is the most severe change that occurs in stored blood and can cause severe consequences in patients after transfusion. This study examines the potential role of IgG and complement, exampled by C4, in the hemolysis of stored CPDA-1 blood under poor storage conditions in low-income countries.Methods: The study was performed on 30 whole blood units (250 mL) drawn from convenience healthy volunteer donors with CPDA-1 anticoagulant and stored at 2– 6 °C for 35 days. Each well-mixed blood bag was sampled at 0, 7, 21 and 35 days and examined for CBC, plasma hemoglobin, hemolysis percent and determination of IgG and C4.Results: The plasma hemoglobin level and hemolysis percent increased continuously to reach 1.56 g/dl and 7.05% at the end of storage time. Hemolysis increased alongside the mean IgG concentration that was increased significantly from day 0 of storage (7.68± 1.75 g/L) and peaked on day 7 (11.55± 1.57 g/L), then declined to reach 8.33± 2.09 g/L on day 35. Also, the mean concentration of C4 increased from day 0 of storage (0.15± 0.06 g/L) to a peaked on day 21 (0.18± 0.04) then declined on day 35 (0.17± 0.06 g/L). The coordinated action of IgG and C4 is reflected by the positive correlation of their delta changes (r=0.616, p< 0.0001).Conclusion: Elevated hemolysis percent in whole CPDA-1 stored blood in Yemen was accompanied by initial increase of IgG and C4 followed by final decline, which indicate their activation and consumption during hemolysis. Further studies for other hemolysis markers and analyses will give a full idea about that.Keywords: IgG, complements, hemolysis, CPDA-1 blood, transfusion

Wudneh Simegn,1 Solomon Ahmed Mohammed,2 Getachew Moges2 1Department of Social and Administrative Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; 2Department of Pharmacy, College of Medicine and Health Sciences, Wollo University, Dessie, EthiopiaCorrespondence: Wudneh Simegn, Email wudusim@gmail.comBackground: Diabetes mellitus is one of the major public health problems that requires appropriate self-care practices to reduce complications. The current study assessed adherence to self-care practices and associated factors using the theory of planned behavior and the health belief model among type 2 diabetes mellitus patients.Methods: A facility-based, sequential explanatory mixed-method was undertaken at comprehensive specialized hospitals in the Amhara region of Ethiopia. A single population proportion formula was used to calculate sample size. Proportional allocation to the three study settings and systematic random sampling techniques were used to select 846 study participants. Logistic regression analysis was used to identify associated factors. Variables with a P-value less than 0.05 were declared statistically significant. For the qualitative study, purposive sampling was used to select sixteen key informants, and thematic analysis was performed.Results: About 42.4% of the study participants had good adherence to self-care practices. Being a member of a diabetes association (AOR = 2.57, 95% CI: 1.51, 4.38), having a home glucometer (AOR = 2.52, 95% CI: 1.59, 4.02), having good glycemic control (AOR = 4.07, 95% CI: 2.53, 6.53), having low perceived barriers (AOR = 8.65, 95% CI: 4.65, 16.07), and having middle perceived barriers (AOR = 3.26, 95% CI: 1.88, 5.66) were significantly associated with good adherence to self-care practice. On the other hand, poor wealth index (AOR = 0.27, 95% CI: 0.16, 0.46), poor behavioral control (AOR = 0.59, 95% CI: 0.36, 0.97), poor behavioral intention (AOR = 0.36, 95% CI: 0.21, 0.64), low perceived benefits (AOR = 0.20, 95% CI: 0.08, 0.51), and middle perceived benefits (AOR = 0.57, 95% CI: 0.31, 0.83) were significantly associated with poor adherence to self-care practice. The key informants explored the influence of patients’ beliefs, self-efficacy, social support, and barriers on their self-care practices.Conclusion: Less than half of type 2 diabetes mellitus patients had good adherence to self-care practices. This was more evident for patients who are members of a diabetes association, having a high wealth index, having a home glucometer, good behavioral control, good behavioral intentions, high perceived benefit, and poor perceived barriers. Appropriate intervention should be designed based on the aforementioned factors.Keywords: adherence, health belief model, self-care practice, theory of planned behavior, type 2 diabetes mellitus

Sadek Mostafa,1 Shaymaa A Mohammed,2 Salwa I Elshennawy,2 Doaa Mohammed Zakaria,1 Sammar Ahmed Kasim Mahmoud,1 Amira Mohammed Alsadek,3 Inass Hassan Ahmad,4 Doaa Sayed Mohammed,4 Marwa Abdelmonim Mohammed,1 Heba H Eltrawy3 1Internal Medicine Department, Al-Azhar University, Cairo, Egypt; 2Clinical Pathology Department, Al-Azhar University, Cairo, Egypt; 3Chest Diseases Department, Al-Azhar University, Cairo, Egypt; 4Endocrinology and Metabolism Department, Al-Azhar University, Cairo, EgyptCorrespondence: Heba H Eltrawy, Chest Diseases Department, Al-Azhar University, Cairo, Egypt, Tel +201006381297, Email hebahamed182@gmail.comBackground and Aim: Vitamin D is a hormone with essential roles in both cellular metabolism and immunity. It controls calcium homeostasis and modulates innate and adaptive immune system responses. Many studies suggested an association between vitamin D deficiency and clinical outcomes of covid-19 infection, while others failed to document such a relation. The present study aimed to evaluate the clinical and prognostic significance of baseline vitamin D levels in hospitalized Egyptian covid-19 patients.Patients and Methods: The present retrospective study included 300 hospitalized covid-19 patients. Patients were submitted to standard clinical, laboratory, and radiological assessment. According to vitamin D levels, patients were classified to have normal levels (≥ 30), insufficient levels (20– 29) or deficient levels (< 20).Results: According to their vitamin D levels, patients were classified into those with normal vitamin D (n=135), others with vitamin D insufficiency (n=114), and a third group with vitamin D deficiency (n=51). Patients with normal vitamin D levels and vitamin D insufficiency are significantly younger [median (IQR): 49.0 (39.0– 57.0) versus 51.0 (40.0– 61.0) and 55.0 (43.0– 62.0) years, respectively, p=0.012] and had less frequency of severe disease (24.4% versus 40.4% and 51.0%, respectively) when compared with those with vitamin D deficiency. Moreover, they had significantly lower levels of D dimer [median (IQR): 1.5 (0.9– 2.5) versus 1.8 (0.9– 3.1) and 2.0 (1.0– 3.2)], CRP [median (IQR): 58.0 (30.0– 120.0) versus 76.0 (42.5– 160.0) and 105.0 (74.0– 208.0), respectively, p< 0.001], ferritin [median (IQR): 458.0 (240.0– 759.0) versus 606.0 (433.8– 897.8) and 820.0 (552.0– 1087.0), respectively, p< 0.001], and procalcitonin [median (IQR): 290.0 (152.0– 394.0) versus 372.5 (227.0– 530.5) and 443.0 (272.0– 575.0), respectively, p< 0.001]. Only lower vitamin D levels were significant predictors of mortality in multivariate analysis [OR (95% CI): 0.88 (0.84– 0.92), p< 0.001].Conclusion: Low vitamin D levels are related to exaggerated inflammatory response, disease severity, and poor clinical outcome in hospitalized covid-19 patients.Keywords: covid-19, vitamin D, vitamin D deficiency

Reham Hammad,1 Asmaa A Elmadbouly,1 Inass Hassan Ahmad,2 Shaymaa A Mohammed,1 Nehal Farouk,3 Zahraa Futooh,4 Mohamed Omar Alfy,5 Sarah Abozaid,1 Eman F Mohamed,6 Fatma M Kotb,6 Alzahra Abdelbadea,7 Nora Seliem,7 Ahmed Elshafei,8 Alya Mashaal9 1Clinical Pathology Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt; 2Endocrinology Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt; 3Vascular Surgery Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt; 4General Surgery Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt; 5General Surgery Department, Al Zahraa University Hospital, Al-Azhar University, Cairo, Egypt; 6Internal Medicine Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt; 7Biochemistry Department, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt; 8Biochemistry and Molecular Biology Department, Faculty of Pharmacy for Boys, Al-Azhar University, Cairo, Egypt; 9Immunology, Zoology & Entomology Department, Faculty of Science for Girls, Al-Azhar University, Cairo, EgyptCorrespondence: Asmaa A Elmadbouly Tel +20 1011504476Email asmaaelmadbouly@azhar.edu.egBackground: The link between immune system and type 2 diabetes mellitus (T2DM) pathogenesis attracted attention to demonstrate the role of immune cells and their secreted cytokines in T2DM development and its subsequent foot complications.Objective: To investigate the relation between T Natural killer cell (TNK) %, Interleukin 4 (IL4) and Interferon gamma (IFN-γ) and diabetic foot infection (DFI) development in patients with diabetic foot ulcer (DFU).Patients and Methods: Ninety patients with diabetes were included in this work, divided as T2DM group (n=30), DFU group (n=30), and DFI group (n=30). TNK% was detected using flow cytometry. Serum IL4 and IFN-γ were measured by ELISA. Diabetes biochemical parameters were also analyzed.Results: Significant decrease was detected in TNK% and IFN-γ in DFI group compared to other 2 groups (P< 0.001). Significant decrease was detected in serum levels of IL4 in DFI group compared to T2DM group (P=0.006). IFN-γ/IL4 was significantly decreased in DFI compared to DFU group (P=0.020). There was a significant correlation of TNK% with both IL4 and IFN-γ (r=0.385, P< 0.001; r=0.534, P< 0.001, respectively). Significant negative correlation of TNK% with HbA1c and LDL was revealed (r=− 0.631, P< 0.001; and r=− 0.261, P=0.013, respectively), while a positive correlation was seen with HDL (r=0.287, P=0.006). A significant negative correlation of IL4 with HbA1c was found (r=− 0.514, P< 0.001;. As for IFN-γ, a significant negative correlation with HbA1c and LDL was detected (r=− 0.369, P< 0.001; r=− 0.229, P=0.030). TNK % and IFN-γ level showed negative correlations with disease duration/year (r=− 0.546, P< 0.001; r=− 0.338, P=0.001,respectively).Conclusion: Decline in TNK frequency has essential role in T2DM pathogenesis and subsequent foot complications. Downregulation of TNK% and IFN-γ level have potential roles in predicting infection of diabetic ulcer and are correlated with disease duration.Keywords: diabetic foot ulcer, diabetic foot infection, natural killer cell, interferon gamma, interleukin 4

Yohannes Shumet,1 Solomon Ahmed Mohammed,2 Mesfin Haile Kahissay,2 Birhanu Demeke2 1Department of Pharmacy, College of Medicine and Health Science, Debre Tabor University, Debre Tabor, Ethiopia; 2Department of Pharmacy, College of Medicine and Health Science, Wollo University, Dessie, EthiopiaCorrespondence: Solomon Ahmed Mohammed Tel +251-91-050-4378Email ahmedsolomon21@gmail.comBackground: Catastrophic health expenditure is health spending that is not covered by a health-care plan. These costs tend to escalate over time, due to chronic illnesses. Catastrophic health expenditure leads to decreased use of health services and poorer treatment outcomes. This study measured the extent of and factors associated with catastrophic health expenditure among chronically ill patients attending Dessie Referral Hospital in northeast Ethiopia.Methods: An institution-based cross-sectional study design was used to quantify catastrophic health expenditure among 302 chronically ill patients from May 25, 2018 to June 30, 2018. A stratified sampling technique was used to select the study participants. Descriptive and inferential statistics were computed using SPSS 20.Results: Catastrophic health expenditure was found in 194 (64.2%, 95% CI 58.8%– 70.5%) of chronic patients. Costly service (151, 50%), transport (104, 34.4%), and pharmaceuticals (189, 62.6%) were the reasons for catastrophic health expenditure among chronic patients. Factors associated with catastrophic health expenditure were age < 30 years (AOR 7.74, CI 0.94– 63.62; P=0.01), patient monthly income

Solomon Ahmed Mohammed,1 Gashaw Tsega,2 Abel Demerew Hailu3 1Department of Pharmacy, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia; 2Department of Pharmacy, Finote Selam General Hospital, Finote Selam, Ethiopia; 3Department of Pharmacy, Dessie Health Science College, Dessie, EthiopiaCorrespondence: Solomon Ahmed Mohammed Tel +251910504378Email ahmedsolomon21@gmail.comIntroduction: Despite self-medication empowers patients in making decisions about the management of minor illnesses independently, the prevalence among health care professionals has sharply increased throughout the world. Self-medication has negative consequences on both the health care professionals themselves and health care delivery. Hence, this study assessed self-medication practices and associated factors among health care professionals at Debre Markos Comprehensive Specialized Hospital.Methods: A facility-based cross-sectional study was conducted using a structured questionnaire among health care professionals working at Debre Markos Comprehensive Specialized Hospital from October 10 to 25, 2020. A systematic random sampling technique was employed to select 227 study participants. Multivariate logistic regression was computed using the statistical package for social sciences version 20 and variables with a p-value less than 0.05 were taken as statistically significant. Results were presented in the form of tables and graphs.Results: Among 227 health professional, 164 (72.2%; 95% CI: 66.0%, 77.7%) practiced self-medication. Of these, 107 (65.2%; 95% CI: 57.3%, 71.8%) stated the negative consequence of self-medication. Drug resistance 96 (89.7%) and adverse drug reaction 95 (88.8%) were reported as a consequence. The predictor of self-medication among health professionals was the pharmacy profession (AOR: 11.88, 95% CI (1.38– 102.38)). The most common disease conditions for practicing self-medication were headache 153 (93.3%), respiratory tract infection 116 (70.7%) and gastrointestinal symptoms 103 (62.8%). Pain killers 154 (93.9%), antibiotics 122 (74.4%), and antacid 101 (61.6%) were frequently used for self-medication and health professionals got the medicines from drug retail shops 130 (79.3%) and workplace 104 (63.4%). Mild disease condition 128 (78%), time-saving 124 (75.6%), and accessibility 97 (59.1%) were the reasons for self-medication.Conclusion: More than two-thirds of health professionals practiced self-medication and reported the negative consequence of self-medication. The predictor of self-medication was the pharmacy profession. The provision of appropriate health education was recommended for promoting rational medication use.Keywords: self-medication, health professionals, Ethiopia

Abdu Tuha, Abebe Getie Faris, Solomon Ahmed Mohammed, Mengistie Yirsaw Gobezie Department of Pharmacy, College of Medicine and Health Science, Wollo University, Dessie, EthiopiaCorrespondence: Solomon Ahmed MohammedDepartment of Pharmacy, College of Medicine and Health Science, Wollo University, Dessie 1145, EthiopiaTel +251910504378Email solomon.ahmed@wu.edu.etIntroduction: Self-medication is an important part of daily self-care, without the supervision of health professionals. It is commonly practiced by pregnant women all over the world and may result in maternal and fetal risks. Hence, this study assessed self-medication practices and associated factors among pregnant women attending Kemisie General Hospital.Methods: A facility-based cross-sectional study was conducted using a structured questionnaire on pregnant women who were attending antenatal care at Kemisie General Hospital. A simple random sampling technique was employed to select the study participants. Descriptive and inferential statistics were computed using the Statistical Package for Social Sciences version 20.Results: Among 223 pregnant women, 60 (26.9%; 95% CI: 20.9%, 32.9%) and 111 (48.9%; 95% CI: 43%, 58%) practiced self-medication on conventional and herbal medicine, respectively. The predictors of self-medication of conventional medicine among pregnant women were prior experience to the drug (P-value: 0.00, AOR=126.04, 95% CI: 32.55– 488.04) and no pervious history of abortion (P-value: 0.00, AOR=0.01,95% CI:0.002– 0.04), while college educational level (P-value: 0.00, AOR=13.45,95%, CI: 3.58– 50.5), history prior herbal medicine use (P-value: 0.00, AOR=9, 95% CI: 3.32– 24.39), Ruta chalepensis (P-value:0.001,AOR=193.7,95% CI:8.64– 4342.1) and Ocimum lamiifolium type of herb use (P-value: 0.004, AOR=12.72, 95% CI: 2.27– 71.38), and 5– 10km health facility distance (P-value:0.022, AOR=0.1, 95% CI: 0.01– 0.73) were predictors for self-medication practice of herbal medicines among pregnant women.Conclusion: Nearly one-third and two-third of pregnant women practiced self-medication on conventional and herbal medicine, respectively. Prior experience to the drug and no previous history of abortion associated with self-medication of conventional medicine, while college educational level, history prior herbal medicine use, Ruta chalepensis and, Ocimum lamiifolium type of herb use, and 5– 10km distance were predictors for self-medication practice of herbal medicines. Improving health service coverage and awareness creation on rational medication use is recommended to prevent fetal and maternal risks.Keywords: self-medication, conventional medicine, herbal medicine, pregnant women

Solomon Ahmed Mohammed, Birhanu Demeke Workneh Department of Pharmacy, College of Medicine and Health Science, Wollo University, Dessie, EthiopiaCorrespondence: Solomon Ahmed Mohammed Tel +251910504378Email ahmedsolomon21@gmail.comIntroduction: Inventory management is a complex process that accelerates the probability of stock-out and overstocking if not tracked properly. Classification of drugs based on their criticality, cost burden, and in combination is important to make inventory decisions and optimize the quality use of scarce resources. This study analyzed the pharmaceutical inventory management systems of Dessie Referral Hospital using the ABC-VEN matrix for the years 2013 to 2017.Methodology: Cross-sectional study design was used to review logistic data retrospectively from health commodity management information system and manual records. Data were collected from January 1– 20, 2018 in Dessie Referral Hospital.Results: In the five-year ABC-VEN analysis, 310 (17%), 368 (20.18%), and 1146 (62.83%) items were class A, B, and C, while 610 (34.56%), 1125 (63.74%), and 30 (1.7%) of pharmaceuticals were V, E, and N, respectively. Among these, 139 (7.88%) and 339 (19.21%) of AV and CV pharmaceuticals utilized 43.52% and 2.89% of annual drug expenditures, respectively. Category I, II, and III pharmaceuticals also accounted for 43.68%, 54.79%, and 1.53% of items with their respective USD drug expenditure of 2,268,405.64 (84.49%), 411,961.18 (15.34%), and 4483.97 (0.17%). The pharmaceutical inventory cost projected to be 1,619,351.79 USD in 2025 and total cost (β= 10.68, p = 0.001), class A (β= 8.68, p = 0.001), class B (β= 1.27, p = 0.007), class C (β= 0.72, p = 0.03), and E items (β= 6.08, p = 0.01) were statistically significant with inventory cost.Conclusion: A huge amount of budget is invested in class A and category I, which pinpoints the need for strict inventory control to prevent wastage and accumulation of capital in buffer stocks. ABC-VEN analysis should be routinely performed before initiation of any new procurement for efficient use of scarce resources.Keywords: inventory management, ABC analysis, VEN analysis, ABC-VEN matrix

Mulate Belete Demessie,1 Birhanu Demeke Workneh,1 Solomon Ahmed Mohammed,1 Abel Demerew Hailu2 1Department of Pharmacy, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia; 2Department of Pharmacy, Dessie Health Science College, Dessie, EthiopiaCorrespondence: Solomon Ahmed MohammedDepartment of Pharmacy, College of Medicine and Health Science, Wollo University, P.O. Box: 1145, Dessie, EthiopiaTel +251 91 050 4378Email ahmedsolomon21@gmail.comBackground: Tracer drugs are the representative of essential medicines and satisfy the priority healthcare needs of the population. Managing tracer drugs through logistics management information systems is a strategy to enhance their smooth flow for continuous provision of quality health service. This study assessed the availability of tracer drugs and implementation of their logistic management information system in public health facilities of Dessie, North-East Ethiopia.Methods: Cross-sectional study was conducted from September 15– 30, 2017, in all public health facilities of Dessie. The data were collected by reviewing tracer drugs logistic formats and conducting physical inventory. Key informant interview was employed to all pharmacy heads and store managers. Data analysis was done using statistical package for social science version 20 and Microsoft Excel 2010.Results: Twelve tracer drugs were managed by health facilities. The overall mean availability, mean duration, and average frequency of stock out of tracer drugs (last 6 months) were 74.7%, 48.8 days, and 1.43, respectively. In eight health facilities, logistic records were available, but all health facilities did not use stock cards. Also, 3 out of 9 used the health commodity management information system. On average, 77.8% of the tracer drugs had bin cards, of which, 86% were updated. The discrepancy between physical count and stock keeping records was ranged from 0% to 100%. The causes of stock out were inadequate supply, lack of recording forms, and their inconsistent use.Conclusion and Recommendations: The availability of tracer drugs was less than the recommended percent, and inadequate supply, poor availability and use of recording forms were the reasons for stock out. Thus, health facility managers and pharmacy heads should work in harmony to ensure uninterrupted supply and implement a logistic management information system.Keywords: logistic management information system, overstock, public health facility, stockouts, tracer drugs

Yohannes Shumet Yimer,1 Solomon Ahmed Mohammed,2 Abel Demerew Hailu3 1Department of Pharmacy, College of Medicine and Health Science, Debre Tabor University, Debre Tabor, Ethiopia; 2Department of Pharmacy, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia; 3Department of Pharmacy, Dessie Health Science Collage, Dessie, EthiopiaCorrespondence: Solomon Ahmed Mohammed Tel +251910504378Email solomon.ahmed@wu.edu.etAbstract: Despite the fact that pharmaceutical care has been expanding simultaneously with the increasing role of pharmacists and the number of prescriptions dispensed, the extended role of community pharmacists is largely confined to the dispensing of medications. This advancement in pharmacy services demands competent pharmacists and patient-centered communication. The objective of this review was to explore the barriers to patient–pharmacy interaction. Relevant kinds of literature were searched from Google Scholar, PubMed, Hinari, We of Science, Scopus, and Science Direct. A total of 3025 kinds of literature were searched. After excluding redundant and irrelevant literature, 13 kinds of literature were reviewed. Lack of adequate knowledge of drugs, lack of updated drug information, work experience, poor job satisfaction, lack of good communication skills, shortage of time, and clearness of pharmacist’s voice and tone were barriers to communication from the side of pharmacy professionals. Factors like not wanting to talk much, bad attitude toward the pharmacy, being in a rush to leave, lack of willingness, language and educational status of the patient were patients’ communication obstacles while high patient load, the suitability of dispensing area, and waiting time for service were associated challenges for patient-centered communication faced by health facilities. Barriers to patient–pharmacist interactions were related to patients, pharmacy professionals, and health institutions. These factors are not independent and the presence of one factor may trigger others and further compromise the patient–pharmacist interaction and result in poor medication outcomes.Keywords: patient, pharmacist, communication and Ethiopia

Abstract Background Obstructive left main disease (LMD) is a challenging entity of coronary artery disease with variable patterns among different studies. We aimed to evaluate the prevalence, demographic, clinical, and angiographic profiles of LMD. We conducted a single-center retrospective study over a period of 10 years to screen all patients who underwent elective cardiac catheterization for chronic coronary syndrome. Of the 19,336 screened cases, 944 obstructive LMD patients were included as the patients' group. Age and sex-matched control groups included patients with normal coronary angiography and non-LMD. Results Obstructive LMD had a prevalence of 4.9%, a mean age of around 60 years, and a male to female ratio of approximately 3:1. About 9.8% of LMD patients were 70 years. LMD versus non-LMD patients had a significantly higher prevalence of diabetes mellitus, dyslipidemia, and number of stenotic coronary segments and arteries, and nonsignificant differences regarding smoking, hypertension, previous myocardial infarction, and ejection fraction. Ostial LMD had a prevalence of 2%, a mean age of around 58 years and 21% were females. In LMD patients, the most affected sites were the ostial/proximal left anterior descending artery and distal left main bifurcation. Bypass grafting surgery was the standard angiographic decision in LMD in 75.8% of cases, which was significantly higher than non-LMD. LMD patients revascularized surgically versus percutaneous treatment had significantly lower ejection fraction, significantly higher multivessel disease, and no significant differences regarding age, sex, hypertension, and diabetes mellitus. Conclusion Obstructive LMD is a relatively common angiographic finding, with a higher prevalence among males around 60 years. In LMD, bypass grafting was the main revascularization strategy. We recommend integrating clinical characteristics, and noninvasive investigations as a predictive model of LMD.

Background: Prevalence of seropositivity following SARS-CoV-2 infection is vital in evaluating herd immunity. However, depending on illness severity, it remains unclear whether the breadth and magnitude of immune response to SARS-CoV-2 infection is for short or long term. Objective: To test the persistence of humoral antibody responses after SARS-CoV-2 exposure in patients with different illness severity and among volunteers who had been vaccinated. Methods: This study was conducted in two Saudi Arabian tertiary hospitals. Participants were categorized as critically ill COVID-19 patients, non-critically ill COVID-19 patients, or vaccinated volunteers. We collected demographic data, COVID-19 exposure history, symptoms, vaccination details, and serum samples to analyze antibody persistence. We evaluated SARS-CoV-2 antibody concentrations in COVID-19 patients with varying disease severity and age groups, as well as in BNT162b2-vaccinated individuals, focusing on IgG levels against the S.FL and S1 domains of the spike protein. Results: The study included 172 adults: 92 unvaccinated hospitalized COVID-19 patients and 80 vaccinated volunteers. All vaccinated subjects demonstrated seropositivity to the SARS-CoV-2 spike protein, with nearly 80% having a median antibody titer of 13,500 AU/mL. Notably, vaccinated subjects exhibited significantly higher IgG levels than naturally infected patients (P < 0.001), including higher S.FL and S1 titers, regardless of severity. Age, comorbidities, and previous infections influenced S-specific antibody levels. Among hospitalized patients, 58% required intensive care, with 28- and 90-day mortality rates of 23% and 43%, respectively. Conclusion: These findings shed light on the immune response dynamics following SARS-CoV-2 infection compared to vaccinated individuals, where the latter showed significantly higher level of antibodies response, providing crucial insights for evaluating short-term herd immunity and the effectiveness of natural infection-induced immunity.

Abstract In this paper, the transfer matrix method is used to study the dispersion of acoustic waves in a finite periodic expansion chambers system with a defect. Two kinds of structures are studied. The first one is formed by expansion chambers, which are symmetrical concerning a defect, and the second one is asymmetrical with a defect. Studying the properties of consistent peak (defective mode) at normal incidence is the objective of these calculations. Consistent peaks arise in the forbidden frequency intervals when a fault in the perfectly periodic structure is present. Concerning the defected asymmetrical configuration, there is a consistent peak located inside acoustic band gap. On the other hand, in the symmetrical structure, two consistent peaks appear in the band gap. In the asymmetrical structure, the consistent peak height depends on the variance in the cross-section of the defect guide. Moreover, the impact of the defect guide’s length on the number of consistent peaks that appear in the band gap will be examined. These results can be used in several applications, such as the design of new kinds of acoustic filters.

Abstract Colorectal cancer (CRC) is a major health problem the world face currently and one of the leading causes of death worldwide. CRC is genetically heterogeneous and multiple genetic aberrations may appear on course of the disease throughout patient’s lifetime. Genetic biomarkers such as BRAF, KRAS, and NRAS may provide early precision treatment options that are crucial for patient survival and well-being. The aim of this study was to identify pathogenic mutations in the NRAS gene causing colorectal cancer in the Saudi population. We enrolled 80 CRC tumor tissue samples and performed molecular analyses to establish the mutation spectrum status in the western region of Saudi Arabia. We identified 5 different mutations in 10 patients, 4 of whom were reported previously (G10R, E37K, Q61K, and Q61*) in the literature while we discovered one novel lethal insertion mutation (E49R). A novel identified insertion mutation was present in the third codon of the NRAS gene [c.145 insA (p.Glu49ArgTer85)], causing a frameshift in the amino acid sequence of the protein, and leading to an aberrant and truncated protein of 85 amino acids. Subsequent bioinformatics analysis showed that the mutation was highly deleterious and affected protein function to a greater extent. This identification may further improve the prognosis of CRC and benefit subsequent treatment choices.

Maize (Zea mays) is a critical crop for global food security and economic stability. However, it is highly vulnerable to various diseases such as northern leaf blight, common rust, and maize lethal necrosis, which can lead to significant crop losses if not detected early. Traditional CNN-based models, while effective in extracting spatial features, often fail to capture subtle multi-scale variations necessary for distinguishing between disease symptoms. These models also suffer from high computational complexity when deeper layers are introduced to handle fine-grained details. Transformer-based models, on the other hand, provide long-range dependencies but come with significant computational overhead, limiting their use in real-time agricultural applications. To overcome these challenges, we propose MSCPNet, a novel architecture that combines a truncated MobileNetV2 backbone with a Multi-Scale Convolutional PoolFormer block. The truncated backbone ensures that only essential layers for general feature extraction are retained, enhancing the model’s adaptability across domains. The Multi-Scale Convolutional PoolFormer block captures both local and global dependencies through parallel convolutional branches of varying kernel sizes, while the PoolFormer module efficiently handles feature aggregation without the heavy computational cost associated with traditional attention mechanisms. This design allows the model to balance computational efficiency and high accuracy, making it highly suitable for real-time maize disease detection. Extensive evaluations on the maize leaf disease classification task yielded outstanding results, with the proposed MSCPNet achieving an accuracy of 97.44%, precision of 96.76%, recall of 97.37%, F1-score of 97.04%, and an MCC of 0.9653, with a model size of 998,084 parameters and 315,258,752 FLOPs. Furthermore, the model was evaluated on the PlantVillage dataset for tomato leaf disease classification, where it achieved an accuracy of 99.32%, precision of 99.32%, recall of 99.33%, F1-score of 99.32%, and an MCC of 0.9925. These results demonstrate the effectiveness and efficiency of MSCPNet in disease classification across different domains.

Infectious diseases are a major global public health concern. Precise modeling and prediction methods are essential to develop effective strategies for disease control. However, data imbalance and the presence of noise and intensity inhomogeneity make disease detection more challenging. Goal: In this article, a novel infectious disease pattern prediction system is proposed by integrating deterministic and stochastic model benefits with the benefits of the deep learning model. Results: The combined benefits yield improvement in the performance of solution prediction. Moreover, the objective is also to investigate the influence of time delay on infection rates and rates associated with vaccination. Conclusions: In this proposed framework, at first, the global stability at disease free equilibrium is effectively analysed using Routh-Haurwitz criteria and Lyapunov method, and the endemic equilibrium is analysed using non-linear Volterra integral equations in the infectious disease model. Unlike the existing model, emphasis is given to suggesting a model that is capable of investigating stability while considering the effect of vaccination and migration rate. Next, the influence of vaccination on the rate of infection is effectively predicted using an efficient deep learning model by employing the long-term dependencies in sequential data. Thus making the prediction more accurate.

Abstract The effect of kneading wheat flour with aqueous cladode extracts on the dough's rheological and pan bread quality characteristics was investigated. Cladodes aqueous extract solutions of 5% and 7.5% positively and significantly (P

Abstract Background Mucocutaneous leishmaniasis (MCL) is a severe form of leishmaniasis causing chronic and destructive lesions. Accurate diagnosis is crucial for effective treatment. Traditional methods, such as the Montenegro skin test is delayed hypersensitivity test. Polymerase chain reaction (PCR) has emerged as a superior diagnostic tool for detecting Leishmania DNA, offering higher sensitivity and specificity. Methodology This meta-analysis adhered to PRISMA guidelines and included studies focusing exclusively on the diagnostic accuracy of PCR for MCL. A comprehensive literature search was conducted across multiple databases. Inclusion criteria mandated studies with relevant diagnostic accuracy metrics, while those mixing other forms of leishmaniasis or lacking a control group were excluded. Quality was assessed using the STARD checklist, and ensuring a low risk of bias assessed through QUADAS-2 tool. Results Eight studies were included, showing PCR sensitivity ranging from 50% to 97.1% and consistently high specificity, often reaching 100%. The studies demonstrated a low risk of bias and applicability concerns, supporting the robustness of the findings. Heterogeneity was substantial, necessitating a random-effects model for pooled estimates. Interpretations This analysis confirms PCR's high specificity for MCL diagnosis, despite variable sensitivity. Compared to previous meta-analyses, this study's focus on MCL exclusively provides a more targeted evaluation. Future research should aim to standardize PCR protocols and explore non-invasive sampling techniques to enhance diagnostic accuracy and patient comfort, ultimately improving clinical outcomes for MCL patients.

Abstract The fourth industrial revolution witnessed significant advancements in automating numerous aircraft inspection tasks. Still, certain critical procedures continue to rely on manual execution, including the aero-engine blade weighing process. This task is of paramount importance for blade mass inspection and engine dynamic balancing. Yet, automation of aero-engine blade weighing remains a challenge due to the intricate geometry of engine blades, and the stringent requirements on precision. To address this gap, this paper introduces, for the first time, a vision-guided robotic system for autonomous aero-engine blade weighing. The proposed system presents a novel end-effector design incorporating a high-precision load cell for accurate and rapid weighing coupled with an imaging sensor for autonomous robotic perception capabilities. The system is tested in industrial settings, and the results show a high weighing precision and accuracy of 0.0404 g and of 0.0252 g, respectively. Our system offers the advantage of seamless integration into existing industrial setups without the need for facility reconfiguration. Video Link

Abstract In the twenty-first century, maritime routes are crucial for geographical and financial reasons in riverine countries. Compared to the available technology abroad, Bangladesh has insufficient monitoring of water vessels to tackle any possible disaster, such as vessel collisions for inland water transportation. One of the frequent outcomes of this architecture is regular capsizing, which sometimes leads to loss of lives. These accidents bear physical and economic costs, which are detrimental for a third-world country like Bangladesh. Considering this important issue, we attempted to develop an effective system to make river travel safe. In this study, our focus was on Bangladesh’s inland waterway transportation, particularly at night. We proposed a system with the help of laser technology that tracks both the host ship and its surrounding vessels and provides real-time tracking positions. Cameras are used to monitor the vessel’s movement. The diameter of the laser sphere is the primary source of data to work on for our proposed model, which is annotated using image processing. The control room will monitor data in the real-time setup, and data will be updated automatically. This proposal was presented through modeling and simulation based on laser detection and identification.

Asmalarda gövde hastalıkları (AGH) arasında, Esca sendromu (Phaeomoniella chlamydospora ve Phaeoacremonium oleophilum, Botryosphaeria spp., Eutypa lata, Phomopsis viticola, Cylindrocarpon spp.), Petri hastalığı (Phaeomoniella chlamydospora, Phaeoacremonium spp., Cadophora luteo-olivacea ve Pleurostoma richardsiae), Siyah ayak (Dactylonectria, Ilyonectria, Campylocarpon, Cylindrocladiella veya Neonectria), Botryosphaeriae dieback (Lasiodiplodia theobromae, Neofusicoccum parvum ve Botryosphaeria dothidea) Eutypa dieback, (Eutypa lata ve Diatrypaceae spp.) Phomopsis dieback, (Phomopsis viticola) yer almaktadır. AGH enfeksiyonları kısa veya uzun vadede asmaların ölümüne neden olur. Global ölçekte, bağcılığın sürdürülebilirliğini etkidiğinden ve tüm bağcı ülkelerde hızla yayıldığından, son otuz yıldır asmanın en yıkıcı hastalıkları olarak kabul edilmektedir. AGH’nın kontrolünde sıcak su uygulaması (SSU), tarım kimyasalları ve dezenfektanlar kullanılmaktadır. SSU′na genç asmalar, dinlenme halindeki aşı gözü veya anaç çelikleri, köklü veya aşılı köklü asma fidanları ve Vitis vinifera çeşitleri farklı düzeyde hassasiyet gösterebilirler. Bu hassasiyet çeliklerin veya fidanların büyüdüğü mevsim sıcaklıklarından etkilenebilir ve uygulanacak sıcaklık aralığı, kontrol edilecek patojenlere göre değişebilir. Asma çeliklerindeki AGH′nı baskılamak için çeşidine göre değişen aralıklarda SSU′ları (30-45 dakika süreyle 45-54°C) önerilmektedir. SSU, asma çoğaltma materyalleri ile taşınabilecek filoksera, nematod ve fitoplazma patojenleri için etkin bir kontrol yöntemidir. Kaliteli bir asma fidanı, sağlıklı, ismine doğru, iyi bir bitki formuna sahip, iyi kaynaşmış, virüsler ve patojenlerden arındırılmış, çevresel strese maruz kalmamış olmalıdır. Bu derlemede, asma çoğaltma materyallerinin patojenik bakteri, mantar, nematod, fitoplazma ve filoksera enfeksiyonlarının kontrolünde kullanılan SSU çalışmalarının bir özeti sunulmuştur.

The “Vertical Drop” is a hydraulic structure widely utilized in irrigation and wastewater collection systems to equalize height differences between channel slopes and the natural terrain. Previous studies of vertical drops primarily focused on experimental investigations of their hydraulic properties. This study numerically analyzes the hydraulic features of vertical drops with inverse aprons using FLOW3D software and the finite volume method. The volume of fluid (VOF) technique was employed to simulate the free surface. Key flow parameters, such as downstream depth, pool depth, and energy loss, were calculated and validated against experimental data. Various turbulence models and grid configurations were assessed. The numerical results, achieved with a grid size of 20,000 nodes, a downstream channel length of 2 meters, the standard k-ε turbulence model, and a standard wall function, exhibited excellent agreement with theoretical equations. Downstream depth, pool depth, and energy loss closely matched experimental findings. Additionally, numerical impact velocities were compared with empirical equations across different scenarios, demonstrating minimal deviation. These findings confirm that the velocity characteristics of the falling jet can be reliably estimated numerically.

Construction companies frequently struggle with poor cash flow management of their projects. Financial terms, including retainage, advance payments, and interest rates, significantly impact the project’s cash flow. This study investigates the financial aspects of projects with close beginnings. In addition, considers how to deal with financial deficits by suggesting a multi-project scheduling optimization model to minimize maximum negative cash flow while maintaining maximum profit. Sequential quadratic programming algorithms (SQP) generate workable schedules that optimally use available resources. Several scenarios have been used to test and examine the model. The outcomes indicate a decrease in negative cash flow for company 1 from (-1,852,096) to (-1,817,485) and for company 2 from (-484,524) to (-459,769) in scenario 1. Furthermore, a decrease in negative cash flow to (-1,661,660) alongside a profit of (776,593) for company 1 and a decrease to (-434,970) alongside a profit of (141,228) for company 2 in scenario 2. On the other hand, a decrease in negative cash flow to (-1,698,992) alongside a profit of (786,243) for company 1 and a decrease to (-370,815) alongside a profit of (209,363) for company 2 in scenario 3.

Introduction: Birth weight is vital to an infant’s long-term health and development. This study aims to assess the birth weight of babies born to Saudi women in the Jazan region and to determine the maternal risks influencing it. Materials and Methods: A cross-sectional study covered all the women who delivered babies in three hospitals. Data were gathered from the participants using a semi-structured questionnaire administered during a face-to-face interview, and the birth weight was measured immediately after the baby’s delivery. Results: Of 403 delivered women, 62% were between 21 and 34 years old, with 63% coming from the rural coastal part of the region. About 86% had regular antenatal care visits, ranging between 5 and 9 visits in more than half of the women. Among the participants women, 2.7% were smokers, 4.7% had hypertension, 4.7% had diabetes mellitus, and 27.5% had anemia. Regarding the neonatal outcomes, 55% gave birth to male newborns, and the mode of delivery was normal vaginal in about 69%. The gestational age was a term completing more than 37 weeks in about 92% of women, and the birth weight was 2.961 ± .51; however, 13.4% were low birth-weight newborns (35 years is associated with low birth weight (LBW; odds ratio = 1.86, 95% confidence interval = 1.00–3.46). Conclusion: Although overall birth weight showed normal distribution, the mother’s occupation, smoking, and increased maternal age were all linked to LBW. Therefore, we recommend further studies that include more maternal risk factors.

BACKGROUND: One of the complications of blood transfusion is the development of red cell alloimmunization. Little published literature on the prevalence and actual significance of red cell alloantibodies among nonregularly transfused patients and the general population. OBJECTIVES: This study aimed to estimate red cell alloantibodies’ prevalence, specificity, and clinical significance in obstetric and medical practice in Iraq. MATERIALS AND METHODS: A cross-sectional hospital-based study involving internal medicine patients and ladies in obstetric wards of Baghdad Teaching Hospital in Baghdad/Iraq, from January 2022 to May 2022. Demographic data were collected along with detailed medical, obstetric, and transfusion history. Alloantibody screening was performed, and samples with positive results were subjected to antibody titration and identification. RESULTS: A total of 200 patients were enrolled. Indirect antiglobulin test was positive in 15% of patients in internal medicine wards and 23% of ladies in obstetric wards, with most of the identified alloantibodies being clinically significant, against Kidd and Duffy antigen groups. Blood transfusion of more than four units to patients at internal medical wards showed a significant association as a risk for developing red cell alloantibodies (P = 0.025). For ladies in obstetric wards, there was a significant association between pregnancy loss at the time of screening and alloimmunization (P = 0.0164). CONCLUSION: High prevalence of red cell alloantibodies in comparison to what is published worldwide. Transfusion of more than four units of blood and pregnancy loss at the time of screening were statistically significant risks for alloimmunization of the medical and obstetric populations, respectively.

Abstract Despite the increased adoption of Artificial Intelligence in Education (AIED), several concerns are still associated with it. This has motivated researchers to conduct (systematic) reviews aiming at synthesizing the AIED findings in the literature. However, these AIED reviews are diversified in terms of focus, stakeholders, educational level and region, and so on. This has made the understanding of the overall landscape of AIED challenging. To address this research gap, this study proceeds one step forward by systematically meta-synthesizing the AIED literature reviews. Specifically, 143 literature reviews were included and analyzed according to the technology-based learning model. It is worth noting that most of the AIED research has been from China and the U.S. Additionally, when discussing AIED, strong focus was on higher education, where less attention is paid to special education. The results also reveal that AI is used mostly to support teachers and students in education with less focus on other educational stakeholders (e.g. school leaders or administrators). The study provides a possible roadmap for future research agenda on AIED, facilitating the implementation of effective and safe AIED.

Purpose The present study aimed to determine the serum level of asprosin, a novel glucogenic and orexigenic hormone, in NAFLD and hypothyroidism patients.Methods This is a case–control study that included three groups of age and sex-matched subjects: hypothyroid patients with NAFLD (n = 26), hypothyroid patients without NAFLD (n = 25) and normal control subjects (n = 27). A detailed clinical history was obtained, and an examination was performed. Laboratory tests included fasting plasma glucose and insulin, lipid profile, TSH, free T4, AST, ALT, albumin, and asprosin. The homeostatic model assessment of insulin resistance (HOMA-IR) score was calculated. Abdominal ultrasonography was performed to calculate the hepatorenal index and define participants with NAFLD. The data were statistically analyzed.Results There was a statistically significant difference between the three groups regarding serum asprosin concentration (p

Classification of disease and healthy volunteer cohorts provides a useful clinical alternative to traditional group statistics due to individualized, personalized predictions. Classifiers for neurodegenerative disease can be trained on structural MRI morphometry, but require large multi-scanner datasets, introducing confounding batch effects. We test ComBat, a common harmonization model, in an example application to classify subjects with Parkinson’s disease from healthy volunteers and identify common pitfalls, including data leakage. We used a multi-dataset cohort of 372 subjects (216 with Parkinson’s disease, 156 healthy volunteers) from 11 identified scanners. We extracted both FreeSurfer and the determinant of Jacobian morphometry to compare single-scanner and multi-scanner classification pipelines. We confirm the presence of batch effects by running single scanner classifiers which could achieve wildly divergent AUCs on scanner-specific datasets (mean:0.651 ± 0.144). Multi-scanner classifiers that considered neurobiological batch effects between sites could easily achieve a test AUC of 0.902, though pipelines that prevented data leakage could only achieve a test AUC of 0.550. We conclude that batch effects remain a major issue for classification problems, such that even impressive single-scanner classifiers are unlikely to generalize to multiple scanners, and that solving for batch effects in a classifier problem must avoid circularity and reporting overly optimistic results.

The quantity of waste generated during construction and demolition keeps rising annually. Refractory bricks are wastes that have a detrimental effect on the environment. This paper investigates the reuse of refractory brick wastes to create environmentally friendly refractory concrete. To accomplish this goal, two percentages 10 and 25% of alumina cement will be substituted for bauxite powder, and alumina brick as the aggregate will be used instead of the natural aggregates. For each of the six types, a mix of refractory concrete (RFC), 14% water content, and a 1:3 cement/ aggregate ratio. The cast samples were stored at laboratory temperature for a full day while still in their molds. The cast samples were left for (24) hours at laboratory temperature in 100% relative humidity. After that, they were opened and placed in water for 7 days to cure. The specimens were placed in an oven to dry at 110 ℃ for 24 hours after seven days of curing in water. The samples were burned for two hours at temperatures between 1000–1100 ℃ at a rate of 3.33 ℃/min. After that, they were cooled to 25 ℃ before being tested. Then, the cast samples were tested to determine the bulk density, shrinkage, compressive strength, modulus of rupture, and weight change. The produced RFC performed almost comparably to those obtained on conventional RFC. This implies that waste alumina bricks as aggregate, with bauxite powder, can be used to manufacture RFC.

Abstract This study involved synthesis of a novel antibacterial heterocyclic compound, sodium 2-(2-(3-phenyl-1, 2, 4-oxadiazol-5-yl) phenoxy) acetate abbreviated as Na-POPA. Further development of a biocompatible, pH-responsive hydrogel drug carrier prepared utilizing the natural polymers gelatin and sodium alginate. The compound loaded on the hydrogel represented new drug delivery system. Comprehensive characterization of Na-POPA was performed using Fourier-transform infrared spectroscopy (FT-IR), proton nuclear magnetic resonance (¹H NMR), carbon-13 nuclear magnetic resonance (¹³C NMR), and high-resolution mass spectrometry (HRMS). The compound was loaded onto the sodium alginate/gelatin hydrogel carrier under feasible experimental conditions. The successful incorporation of Na-POPA into the hydrogel matrix was confirmed via scanning electron microscopy (SEM), powder X-ray diffraction (pXRD) analysis and FT-IR spectroscopy. Cytotoxicity assays revealed that the all the loaded and unloaded compound induced cell toxicity at large concentration much lower than many reported results. The hydrogel reduced the inherent cytotoxicity of Na-POPA and enhanced its biocompatibility. The release kinetics of Na-POPA from the hydrogel were evaluated spectrophotometrically at different pH conditions simulating biological fluids. The release rate at pH 1.2 was greater than the release at pH 6.8, with a higher cumulative release observed at pH 6.8. The release kinetics obeyed the pseudo-second-order kinetic model, indicating a controlled release mechanism influenced by the hydrogel’s physicochemical properties. Electrochemical impedance spectroscopy and cyclic voltammetry further confirmed that the compound release was pH-dependent. The high swelling and solubility at pH 6.8 enhance the release. The larger amount released at 6.8 (target intestine) because of more solubility, leaching and swelling rather than shrinking.

Abstract Pyridine and urea derivatives have emerged as valuable corrosion platforms ascribed to exceptional coordination potential, and environmental friendliness. Two novel structures of pyridine-carbamides (MS30 & MS31) were synthesized and used as green corrosion inhibitors for the carbon steel in 1M HCl. Electrochemical measurements determined the increase in efficiency with concentrations, reaching 95.3% and 97.1% at 200 mg L −1 and 298 K for MS30 and MS31. Despite the reduced performance with increasing temperature to 303 and 313 K, results revealed improved inhibition at 323 K. At the highest temperature of 323 K, MS30 and MS31 proved their influence in maintaining 97.6% and 93.4% efficiency, highlighting their suitability for treatments in oilfield downhole regions. The adsorption of both inhibitors fitted the Langmuir model and was attributed to chemisorption, as inferred from thermodynamics. Corrosion kinetics and activation energy also verified the chemical interaction of the Fe–inhibitor complex. Spectroscopic surface evaluation interpreted the surpassed metallic dissolution by MS30 and MS31 through protective barrier formation, and X-ray photoelectron spectroscopy (XPS) determined the existence of the Fe–N bond. The sustained viability of human cells affirmed the nontoxic nature of MS30 and MS31 after treatment with 0.2 mg mL−1 of MS30 and MS31 compounds. DFT calculations revealed that both inhibitors exhibited strong adsorption on the metal surface (− 9.5 eV), classified as chemisorption. Overall, the experimental findings are well supported with surface and computational studies. These pioneering compounds are introduced herein to advance state-of-the-art inhibitors, providing high efficiency under challenging environments.

Abstract In learning analytics and in education at large, AI explanations are always computed from aggregate data of all the students to offer the “average” picture. Whereas the average may work for most students, it does not reflect or capture the individual differences or the variability among students. Therefore, instance-level predictions—where explanations for each particular student are presented according to their own data—may help understand how and why predictions were estimated and how a student or teacher may act or make decisions. This study aims to examine the utility of individualized instance-level AI, its value in informing decision-making, and—more importantly—how they can be used to offer personalized feedback. Furthermore, the study examines mispredictions, their explanations and how they offer explanations or affect decision making. Using data from a full course with 126 students, five ML algorithms were implemented with explanatory mechanisms, compared and the best performing algorithm (Random Forest) was therefore selected. The results show that AI explanations, while useful, cannot achieve their full potential without a nuanced human involvement (i.e., hybrid human AI collaboration). Instance-level explainability may allow us to understand individual algorithmic decisions but may not very helpful for personalization or individualized support. In case of mispredictions, the explanations show that algorithms decide based on the “wrong predictors” which underscores the fact that a full data-driven approach cannot be fully trusted with generating plausible recommendations completely on its own and may require human assistance.

Abstract This study investigates stress-deformation behavior in Himalayan tunnels, focusing on how geological features impact stability. The objective is to enhance the understanding of displacement phenomena, particularly in tunnels traversing jointed rocks. A modified support system, to specific rock mass classifications, is employed to address the unique challenges posed by geological discontinuities. Kinematic analysis reveals a 20% probability of wedge failure due to these discontinuities. Numerical analysis using Hoek–Brown parameters identifies significant stress concentrations at the tunnel crown, especially in jointed sections, where increased convergence and displacement (1.2 mm at the crown compared to 0.25 mm at the walls) highlight the susceptibility to deformation. The study indicates the critical need for specialized support in jointed regions to mitigate stability risks.

Abstract Emergency computed tomography (CT) often does not allow for comprehensive coronary artery assessment. However, CT may reveal pathological myocardial hypoperfusion suggestive of acute myocardial infarction (AMI), especially in patients presenting with a different diagnostic hypothesis. CT hypoperfusion is known to be associated with myocardial infarction, however the diagnostic value of CT hypoperfusion for the detection of AMI is still not well evaluated. This was a single-centre retrospective study including patients who underwent invasive coronary angiography (ICA) due to suspected AMI based on incidental perfusion defects upon emergency CT imaging between 2018 and 2023. A total of 22 patients (mean age 66.3 ± 10.8 years, 11 female) were included in this analysis. The diagnosis of AMI was established in all cases leading to ICA. Culprit coronary artery lesions with an indication of percutaneous coronary intervention were detected in all patients who underwent ICA. Spearmann correlation for hypoperfused segments on CT imaging and the corresponding vascular territory upon ICA was significantly substantial (ρ = 0.73, p =

Abstract Bone scintigraphy is recognized as an efficient diagnostic method for whole-body screening for bone metastases. At the moment, whole-body bone scan image analysis is primarily dependent on manual reading by nuclear medicine doctors. However, manual analysis needs substantial experience and is both stressful and time-consuming. To address the aforementioned issues, this work proposed a machine-learning technique that uses phases to detect Bone scintigraphy. The first phase in the proposed model is the feature extraction and it was conducted based on integrating the Mobile Vision Transformer (MobileViT) model in our framework to capture highly complex representations from raw medical imagery using two primary components including ViT and lightweight CNN featuring a limited number of parameters. In addition, the second phase is named feature selection, and it is dependent on the Arithmetic Optimization Algorithm (AOA) being used to improve the Growth Optimizer (GO). We evaluate the performance of the proposed FS model, named GOAOA using a set of 18 UCI datasets. Additionally, the applicability of Bone scintigraphy for real-world application is evaluated using 2800 bone scan images (1400 normal and 1400 abnormal). The results and statistical analysis revealed that the proposed GOAOA algorithm as an FS technique outperforms the other FS algorithms employed in this study.

Abstract This study investigates noise reduction using a periodic arrangement of dual Helmholtz resonators and explores the introduction of defects within this periodic structure. The transfer matrix method was employed to carry out theoretical research. The computations of the interface response function approach results are verified, and consistent outcomes are demonstrated. The simulation results highlight the distinctive dual resonance frequencies of dual Helmholtz resonators. By differentiating dual Helmholtz resonators from traditional Helmholtz resonators, prospective applications for low-frequency noise reduction are envisioned. In this contribution, introducing defects in the middle of perfect dual Helmholtz resonators adds more value to the acoustic filter. In particular, the first neck and cavity of the defective dual Helmholtz resonator. This study shows that introducing a 2D-defect into identical dual Helmholtz resonators can improve the transmission of defect modes by taking advantage of the advantageous interaction of the resonant modes. In such arrangements, the entire structure functioned as a potent selective filter.

In the present work, we have established some new fractional integral inequalities for functions whose $ k $th-derivatives are generalized modified $ h $-convex and symmetric about the midpoint involving the Caputo fractional derivatives. Many particular cases are obtained by using the findings.

Abstract Alzheimer’s disease (AD) is a complex neurodegenerative disorder significantly impairing cognitive faculties, memory, and physical abilities. To characterize the modulation of the gut microbiota in an in vivo AD model, we performed shotgun metagenomics sequencing on 3xTgAD mice at key time points (i.e., 2, 6, and 12 months) of AD progression. Fecal samples from both 3xTgAD and wild-type mice were collected, DNA extracted, and sequenced. Quantitative taxon abundance assessment using MetaPhlAn 4 ensured precise microbial community representation. The analysis focused on species-level genome bins (SGBs) including both known and unknown SGBs (kSGBs and uSGBs, respectively) and also comprised higher taxonomic categories such as family-level genome bins (FGBs), class-level genome bins (CGBs), and order-level genome bins (OGBs). Our bioinformatic results pinpointed the presence of extensive gut microbial diversity in AD mice and showed that the largest proportion of AD- and aging-associated microbiome changes in 3xTgAD mice concern SGBs that belong to the Bacteroidota and Firmicutes phyla, along with a large set of uncharacterized SGBs. Our findings emphasize the need for further advanced bioinformatic studies for accurate classification and functional analysis of these elusive microbial species in relation to their potential bridging role in the gut-brain axis and AD pathogenesis.

Abstract Breast cancer is considered a multifactorial disease, with genetic factors playing an important role in diagnosis and treatment. FCGR3A encodes the receptor for the Fc portion of immunoglobulin G that has been linked to the trastuzumab response. Our study aimed to investigate the association of FCGR3A-V158F gene polymorphism with breast cancer and to evaluate the impact of FCGR3A-V158F gene polymorphism on trastuzumab response in HER2-positive breast cancer patients. The study was conducted on eighty breast cancer patients who were collected from the Department of Oncology at Ain Shams University Hospitals; in addition, twenty age-matched healthy subjects were taken as a healthy control group. Patients were further sub-classified according to their responses. The study showed that there were no statistically significant differences between patients and controls regarding FCGR3A-V158F gene polymorphism genotypes. However, there was a significant association between the concordance of this polymorphism and the response to trastuzumab therapy among the patient’s group. V/V is associated with better treatment response and overall survival (OS) compared to F/V and F/F alleles. Assessment of FCGR3A-V158F gene polymorphism might be useful in making a treatment decision in HER2-positive breast cancer patients.

Abstract Background This study aimed to evaluate the knowledge, awareness, and practice of intraoral scanners (IOS) and the factors affecting their accuracy amongst dental interns and practitioners. Methods This was an observational cross-sectional study in which data was collected from a representative population in Saudi Arabia, with the help of online questionnaires. The forms were distributed to 500 dental interns and practitioners and the questionnaire’s validity and reliability were evaluated for vetting and remarks. The questionnaire consisted of three parts: the participants’ demographic details, questions on the awareness and knowledge of participants regarding IOS, and the factors affecting the accuracy in clinical use of IOS. Questions were to be answered with ‘yes’, ‘no’ and ‘I don’t know’. Descriptive statistical analysis was performed using the control chart technique and the chi-squared test, with statistical significance set at p

Abstract Transalveolar sinus elevation is a minimally invasive technique aimed at augmenting the vertical bone height in the posterior maxilla, facilitating successful implant placement in areas with insufficient bone volume. This study compares the efficacy of osseodensification and piezoelectric internal sinus elevation (PISE) techniques in delayed implant placement. The primary objective was to radiographically assess vertical bone gain and bone density, while secondary objectives included clinical assessment of primary implant stability and post-operative satisfaction of both patients and operators. The study population of a total of 16 patients was randomly divided into two groups. Group 1 underwent osseodensification sinus lift using sticky bone as a graft material, whereas Group 2 received PISE with the same graft material. Results indicated that the osseodensification technique led to greater bone gain, improved bone density, and shorter surgical duration. Additionally, osseodensification was associated with enhanced rapid healing and higher patient satisfaction. Conversely, the PISE technique demonstrated superior primary stability of implants on the day of surgery. These findings suggest that while both techniques are effective, osseodensification may offer advantages in terms of bone gain, density, and patient satisfaction, making it a reliable method for enhancing rapid healing in delayed implant placement. the study was registered on clinicaltrials.gov at 26th September 2023 and clinical trials ID is NCT06055127.

Background: The increasing need for nutrients during adolescence due to growth and menstruation experienced by young women causes young women to be susceptible to anaemia. Anaemia is a condition where the haemoglobin level in the blood is less than the normal value. One of the factors causing anaemia is the lack of knowledge among teenagers about anaemia. Many types of media, both visual and audiovisual, can be used to convey education about anaemia. Purpose: To determine the effectiveness of nutrition education media in increasing teenagers' knowledge of preventing anaemia. Methods: This research uses a literature review design. A literature review study is a method used to collect data or sources related to a particular topic, which can be obtained from various sources such as research articles. Results: From the reviewed articles, five showed an increase in teenagers' average knowledge score after being educated using visual media. There is 1 article that shows an increase in teenagers' average knowledge score after being educated using audiovisual media. Three articles showed an increase in teenagers' average knowledge score after being educated using visual and audiovisual media. Conclusion: Visual and audiovisual media are effective when used together to help increase teenagers' nutrition knowledge and provide nutritional education about anaemia. When delivering nutritional education about anaemia to teenagers, using visual and audiovisual media simultaneously is recommended to get effective results.

Summary: Mycobacterium tuberculosis (Mtb) evades host defense by hijacking and rupturing the phagosome. ESAT-6, a secreted virulence protein of Mtb, is known to be critical for phagosome rupture. However, the mechanism of ESAT-6-mediated disruption of the phagosomal membrane remains unknown. Using in vitro reconstitution, live-cell imaging, and numerical simulations, we discover that ESAT-6 polymerization forces remodeling and vesiculation of the phagosome-like compartment both in vitro and in vivo. Shallow insertion of ESAT-6 leads to tubular and bud-like deformations on the membrane facilitated by a reduction in membrane tension. Growing fibrils generate both radial and tangential forces causing local remodeling and shape transition of the membrane into buds. The ESAT-6-bound tensed membrane undergoes local changes in membrane curvature and lipid phase separation that assist the subsequent fission. Overall, the findings provide mechanistic insights into the long-standing question of phagosome disruption by Mtb for its escape.

Bilateral ureteropelvic junction obstruction resulting from distinct vascular anomalies on each side, with a pre-ureteric vena cava on the right and crossing vessels on the left, has not been previously documented in the literature. Even more intriguing is the association between a grade 3 hydronephrosis and a type 2 circumcaval ureter. This unprecedented report discusses this association and its management.

Background: Mucopolysaccharidoses types I and IIIA are lysosomal storage diseases caused by mutations in the IDUA and SGSH genes, leading to deficiencies in α-L-iduronidase and heparan sulfamidase, respectively. These progressive, autosomal recessive disorders require early diagnosis. Purpose: The study targeted and investigated the p.Pro533Arg mutation, known to cause mucopolysaccharidosis type I, and the p.Arg377Cys mutation, associated with mucopolysaccharidosis IIIA, in newly recruited Moroccan families. In parallel, variants/polymorphisms associated with these mutations were searched for. Methods: Researchers employed RFLP assays for the p.Pro533Arg and p.Arg377Cys mutations and genomic PCR sequencing for variant detection. PolyPhen-2, MutPred2, SIFT, and MutationTaster were used to assess the pathogenicity of these variants, helping to evaluate their potential impact on disease. Results: The p.Pro533Arg mutation was found in newly recruited families with Hurler syndrome, consistent with previous findings. Similarly, the p.Arg377Cys mutation was present in a newly recruited family with Sanfilippo A syndrome. DNA sequencing revealed five SNPs four in the IDUA gene and one in the SGSH gene with three IDUA SNPs and one SGSH SNP being novel. Conclusion: The p.Pro533Arg and p.Arg377Cys mutations are common among Moroccan patients with MPS I and MPS IIIA, respectively. The ability to detect these mutations using restriction endonucleases allows for molecular diagnosis in affected families. Five polymorphisms were identified among them four are novel.