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Lizy Sonia Benjamin,1 Eddieson Pasay-an,2 Petelyne Pangket,3 Aidah Sanad Alqarni,4 Ferdinand Gonzales,4 Lailani Sacgaca,5 Dawlat Ahmed Mahmoud,1 Maysa M Mohsen,4 Yahya Showkan Ali Hamdi,6 Sumathi Robert Shanmugam7 1Department of Medical-Surgical Nursing, College of Nursing, King Khalid University, Abha, Saudi Arabia; 2Department of Nursing Administration, College of Nursing, King Khalid University, Abha, Saudi Arabia; 3Department of Medical Surgical Nursing, University of Hail, Hail City, Saudi Arabia; 4Department of Fundamental of Nursing, College of Nursing, King Khalid University, Abha, Saudi Arabia; 5Department of Nursing, Prince Sultan Military College of Health Sciences, Dhahran, Saudi Arabia; 6Nursing Service, Aseer Central Hospital, Aseer, Saudi Arabia; 7Department of Maternity and Pediatric Nursing, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi ArabiaCorrespondence: Sumathi Robert Shanmugam, Department of Maternity and Pediatric Nursing, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia, Email srshanmugm@pnu.edu.saIntroduction: Nursing students frequently encounter the challenge of balancing their studies with the demanding requirements of hands-on practice and this can greatly affect their mental wellbeing. This study aimed to investigate the impact of sleep and psychological well-being on the academic and clinical performance of nursing students in Saudi Arabia.Methods: This study used a cross-sectional approach with 218 student nurses selected through convenience sampling from King Khalid University, Abha, Saudi Arabia. The sleep quality, psychological wellbeing, academic performance and clinical performance questionnaires were adopted to measure the variables. The Google Forms survey was used to gather the data, which were collected in August through October 2023. t-test and chi-square were used to analyze the data.Results: The sleep quality was higher with good/very good performers (p < 0.001). There was a significant difference with academic performance on positive relations (p < 0.007) and purpose in life (p < 0.004). Additionally, there was a significant difference in autonomy (p < 0.01), environmental mastery (p < 0.026), positive relations (p < 0.001), and purpose in life (p < 0.001) with clinical performance. Among students with good academic performance, those who were older than 25 years of age (p < 0.043) and level 3 students (p < 0.001) were found to have a significant correlation. Furthermore, those who were 25 years of age (p < 0.012) and level 3 students (p < 0.001) were also found to have a significant correlation with clinical performance.Conclusion: The sleep quality, positive relations, purpose in life, autonomy, and environmental mastery are all important factors for academic and clinical success. Moreover, older students and level 3 students may be more likely to have the skills and knowledge necessary to succeed in these areas. Further research exploring factors influencing academic and clinical success must be conducted.Keywords: sleep quality, psychological well-being, academic performance, clinical performance, nursing students, Saudi Arabia

Abstract Understanding the history of Iran during the Seljuk period is very important because of the presence and influence of a new role player called the Turkmen tribes. They have played an important role in the formation and fate of this government. Since the establishment of this government, the conflict between the two forms of policies about running the country led to challenges and conflicts between them. On the one hand, the Iranian bureaucrats demanded a centralized government, and on the other hand, the military and tribal chiefs and the pro-power clerics claimed the decentralization of power. The death of Nizam al-Mulk, the architect of the centralized sovereignty theory in the Seljuks, provided a good opportunity for the military to attempt to seek power, and the first victim of such an attempt was Amir Oner. The present study aimed to elucidate the nature and causes of Oner's revolt against Sultan Barkyaruq and to determine what factors influenced Oner’s action. The method of this research was descriptive-analytical based on library resources. The findings of the present study indicated that Amir Oner represented a group of military officials who sought to increase their power in factions formed after King Malik Shah and Khajeh Nizam al-Mulk’s death. Although Oner’s did not enjoy a good fortune and fate, his uprising began to bring about major changes in the structure of the Seljuk power and sovereignty. Introduction The arrival of Seljuk Turkmen to Iranian territory during early 5th AH exerted a great influence on the political structure of the Iranian society. The new invaders dominated a large territory, but from the very beginning, they found that they cannot govern such a large territory. Therefore, they appointed Iranian bureaucrats to govern the territories. But, the main concern for the Iranian bureaucrats was to persuade the Seljuk Sultans to use centralized methods of government. However, Seljuk Turkmen were inclined to exercise some other methods of government which they had tried before, such as the division of the country to different parts to be ruled by different persons from among dominating Turkmen. Gradually, there appeared a wide gap between the supporters of these two methods of government. Khajeh Nizam al-Mulk Toosi in his new system of government dismissed army top officials, which in turn, brought about reactions from the army top officials Nizam al-Mulk’s death and subsequently Malik Shah’s death and fights over the succession to the throne provided the army top officials with the opportunity to gain more power in the government. Oner, one of the top army officials at the later years of Malik Shah’s reign attained a top rank. The most important topic that the present research aimed to investigate is the unknown aspects and reasons of Amir Oner’s uprising against sultan Barkyaruq. The research sought to introduce some of the causes and reasons which lead to the mutiny and possible outcomes and trends resulting from it in the Seljuk era. The hypothesis of the research is that the open and hidden quarrels in the Seljuk (Majd al-Mulk or Muayyied al-Mulk) bureaucratic system structure had a great role in Oner’s mutiny. Materials & Methods The present study was conducted using the descriptive-analytical method based on main documents, evidence and resources of the Seljuk era. Taking advantage of documents and resources and comparing the available data and reports, the research shed more light on the real causes of the uprising. Discussion of Results & Conclusions Regarding Oner’s uprising, the present study takes a few matters into consideration. First, it studies Turkmen commanders’ status and their position in top ranks of government in Malik Shah’s reign. Seljuk Turkmen depending on tribal power and top military officials succeeded in establishing a magnificent and powerful government in Iranian plateau. At first, Seljuks mainly depended on tribal forces and military officials, but after the formation of the government, Seljuks needed ministers to govern the territory and establish a centralized government. Hence, they gradually dismissed military officials from ranks of power. Nizam al-Mulk played a decisive role in controlling top military officials power during his term of office. His approach to power was to centralize it instead of putting it at the hands of many. In other words, actions taken by him lead to reducing aristocrats and wealthy tribal people’s influence in the government structure. When the power was monopolized by him, mutual trust between the powerful elites and him was reduced to the minimum. After the death of Nizam al-Mulk and Malik Shah, there was a quarrel over their substitution, and this provided a chance for the military officials to get the power in their own grasp. The commander Oner was one of these military commanders. The Seljuk historical documents has mentioned his name for the first time after the episodes leading to Sultan Malik Shah’s death and the skirmishes between forces trying to capture Isfahan in 485 AH. Oner was one of the powerful commanders of the government. When Sultan Barkyaruq attained the power, Amir Oner became one of the most important commanders of sultan Barkyaruq. Nonetheless, in 492 AH, exactly when Sultan Barkyaruq left the capital Isfahan to suppress Arslan Argun’s rebellion in Khorasan, Amir Oner started his uprising. In the present study, by studying the resources and document of this era, some reasons effective in Oner’s uprising was found: 1. The policy of Majd al-Mulk, a minister of Sultan Barkyaruq, as military commanders in financial affairs which initiated the opposition of the commanders especially Oner to Majd- al Mulk. Consequently one of the Oner’s purposes was to eliminate this minister. 2. The role of Muayyied al-Mulk in Oner’s uprising. After the deposition of Muayyied al-Mulk as a minister in 488 AH, Barkyaruq tried to make a party of opponents and played an important role in instigating Oner. 3. Majd al- Mulk’s, as the common enemy of military commanders, and Muayyied al-Mulk, as a primary target, had a great role in their union against Sultan Barkyaruq and Oner’s uprising. The vacuum of power in central Iran and the absence of Sultan Barkyaruq provided Oner with the opportunity to make a background for an uprising against Sultan Barkyaruq. The uprising of Commander Oner very soon came to an end. When Oner went from Isfahan to Rey, according to one of the narratives, he was killed by three Kharazmi Turkmen. But, still according to some other narratives, he was killed by some Ismaili self-sacrificers in Muharram month of 492 AH. Khajeh Nizam al-Mulk’s death and conflicts over his substitution after Malik Shah’s death, provided the military commanders with the opportunity to actively get involved in gaining the power. The Commander Oner was one of these military commanders who got a position in political divisions for power and succeeded in playing an active role in Turkan Khatun, and later on in Sultan Barkyaruq policies. Oner’s increased level of ambitions led to an uprising with the conspiracy of Muayyied al-Mulk to oust of Barkyaruq. Although the uprising did not succeed, it was an indication of an era in which the main role players in politics and power gaining in the Seljuk society were the military commanders. Bureaucrats and the Seljuk sultan were disempowered. Subsequently, the role of the military commanders in the government and power structure of the Seljuk dynasty increased to a prominent level. Oner was one the escape goats in a rivalry between Khorasani or Iraqi elites. But his uprising against sultan and his collaboration with Korasani party was the beginning of an era in which the Seljuk commanders revitalized their power.

One factor influencing the outcome of care may be the nursing staffs experience of organizational work climate. We compared organizational climate and nurse's empowerment in specialty units at 2 hospitals in Egypt. Data were collected from 164 diploma school staff nurses using 2 tools: the situational outlook questionnaire to assess organizational climate and the psychological empowerment in the workplace questionnaire. There was no statistically significant difference in the level of organizational climate between the 2 hospitals, which the majority of nurses classified as moderate. Most nurses reported a moderate level of empowerment in both hospitals and there was a statistically significant positive correlation between organizational climate and nurse's empowerment. [ABSTRACT FROM AUTHOR]

Background: Psoriasis is a common chronic systemic disease affecting the skin, nails, and joints. Nails are commonly associated with a greater severity of the disease. Radiofrequency (RF) is a nonionizing radiation that provides energy originating from electric current to generate heat inside the dermis with anti-inflammatory effects., Objective: To assess the efficacy of nonablative bipolar radiofrequency in treating fingernail psoriasis., Methods: Forty-three affected fingernails were treated with nonablative bipolar RF. Sessions were performed every 2 weeks for 2 months, with a maximum of 5 sessions. The 32-point target nail psoriasis severity index (tNAPSI), ultrasonography, and the physicians' global assessment were used for assessment at baseline, 1 month, and 3 months from the last treatment session., Results: One month after the last RF session, a significant reduction in median tNAPSI score from baseline was recorded (p = .002), with a 58.33% reduction in pit count. The median thickness of subungual hyperkeratosis decreased significantly from baseline (p = .024), and the median score of onycholysis was also significantly reduced (p = .005). Ultrasonography revealed a significant reduction in the median nail matrix, bed thickness, and nail vascularity (p = .020, p < .001, and p = .013, respectively)., Conclusion: Radiofrequency may offer a safe and effective treatment modality for fingernail psoriasis., (Copyright © 2024 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.)

Non-alcoholic fatty liver disease is a prevalent liver condition that can progress to fibrosis and cirrhosis. It also poses a risk for hepatocellular carcinoma, underscoring the importance of identifying effective treatments. N-acetylcysteine, an inhibitor of glutathione depletion, shows promise in modulating intracellular glutathione biosynthesis and combating oxidative stress, making it a potentially beneficial therapy for liver fibrosis in non-alcoholic fatty liver disease. This study assesses the impact of N-acetylcysteine on HepG2 cells which were induced into fatty liver cells was evaluated. HepG2 cells were cultured in DMEM and seeded onto six-well plates at a density of 5 × 10 5 cells. Following a 24-h incubation period, the cells were exposed to a medium inducing fat accumulation. Subsequently, the cells were treated with varying concentrations of N-acetylcysteine for 48 h. Some plates were utilized for Real-Time-PCR tests, while others underwent Oil Red staining. The findings indicated a significant increase in the expression of fatty acid β-oxidation genes in the group treated with 10mM N-acetylcysteine (p < 0.05), along with reduced expression of lipogenesis-related genes (p < 0.05) in N-acetylcysteine-treated groups. Analysis of apoptotic gene expression revealed decreased BAX expression but increased BCL2 expression in the N-acetylcysteine-treated groups. Oil Red staining demonstrated a dose-dependent reduction in lipid droplets compared to the control group. This study's results suggest that N-acetylcysteine has the potential to decrease lipid droplets and modulate lipid metabolism effectively., Competing Interests: Declarations. Conflict of interest: The authors declare no competing interests., (© 2024. The Author(s), under exclusive licence to Springer Nature B.V.)

This study presents an innovative approach to integrated energy systems by combining solar energy harvesting and electrochemical charge storage in a single modular platform. By strategically incorporating a MoS 2 /NaTaO 3 heterostructure material, we have developed a photo-rechargeable zinc-ion capacitor (PR-ZIC) that utilises the synergistic benefits of this unique configuration. The photoactive MoS 2 /NaTaO 3 cathode effectively absorbs light and charges the capacitor, enabling continuous light-driven operation. Experimental studies show that the MoS 2 /NaTaO 3 -based photo-rechargeable zinc-ion capacitor (PR-ZIC) exhibits a significant increase in capacitance when irradiated with light, with a 2.76-fold increase (93.94 mF cm -2 ) compared to dark conditions (33.95 mF cm -2 ) at a 10 mV s -1 scan rate. In addition, these capacitors show a photocharge voltage response of about 860 mV and excellent cyclability, retaining about 96% of their capacity over 4000 charge-discharge cycles. The results of this study highlight the potential of the MoS 2 /NaTaO 3 heterostructure as a high-performance photoactive material for advanced photo-rechargeable zinc-ion energy storage devices. This integrated approach offers innovative off-grid energy solutions by optimizing device footprint, minimizing energy transfer losses and providing sustainable energy storage options.

Background/objectives: Acne is the most prevalent dermatological condition among humans, affecting approximately 80% of adolescents during puberty. To date, numerous compounds have been used for acne treatment, including erythromycin ointments and antiseptics, with varying degrees of success. The emergence of erythromycin-resistant C. acnes strains has spurred the search for new antimicrobial agents, particularly from natural sources., Methods: Propolis collected in Rwanda was extracted and fractionated by flash chromatography and tested against C. acnes growth by using NCLSI recommendations., Results: In our research, we identified a molecule, 2,4-Di- tert -butylphenol (2,4-DTBP) which inhivbited the C. acnes growth at a concentration of 16 µg/mL. Based on these results, we formulated an ointment (1%) using OFAP18 and petroleum jelly for the potential treatment of acne using a mouse model., Conclusions: In vitro and in vivo evidence suggests that 2,4-DTBP has anti-inflammatory properties and could effectively manage the overgrowth of C. acnes as well as serve as a potent alternative for the formulation of an active propolis ointment for acne treatment.

Purpose: The objective of this randomized controlled trial was to investigate the impact of manual therapy (friction massage) and pelvic floor muscle (PFM) training on erectile dysfunction (ED), pelvic floor muscle thickness, and blood flow in the penile arteries and veins in men who have undergone prostatic adenectomy (PA)., Materials and Methods: This study employed a randomized, double-blinded, controlled trial design. Forty patients participated and were divided into two groups: intervention and control (n=20 per group). The intervention group received 10 sessions of pelvic floor muscle training and manual therapy, while the control group solely underwent pelvic floor muscle training. The recovery rate was measured using the International Index of Erectile Function 15 (IIEF-15) questionnaire and Erection Hardness Score (EHS). Sonographic factors were assessed using simple and Doppler ultrasound., Results: The intervention group exhibited significantly higher erectile function scores (F(1,37)=158.04, P < 0.001, η2 P = 0.810) and a higher average total (IIEF-15) score (20.52) (F(1,37)=136.76, P < 0.001, η2 P = 0.787) compared to the control group in the post-test assessment. Comparison between the two groups revealed an increase in ultrasonic parameters such as the thickness of the ischiocavernosus and bulbospongiosus muscles, maximum systolic velocity, and minimum diastolic velocity of the cavernosal artery in the intervention group. However, the maximum blood flow velocity in the posterior vein decreased., Conclusion: PFM training and friction massage play a significant role in managing ED following PA, positioning them as the primary treatment approach for men experiencing ED post-prostatectomy.

Background and Aims: Several studies have highlighted the potent antioxidant properties of N-acetyl cysteine (NAC). This review aimed to assess the impact of NAC on oxidative stress biomarkers in patients with β-thalassemia., Methods: The review included articles published before 2024 that investigated the effects of NAC on oxidative stress in individuals with β-thalassemia. A comprehensive search was conducted across various databases, including Scopus, PubMed, Web of Science, Trip, and CENTRAL. Only English-language clinical trials were considered for inclusion in this review. Besides, the number needed to treat (NNT) was calculated based on the included studies., Results: Ninety-nine articles were retrieved from electronic databases, and after a thorough review, eight articles were selected for comprehensive text analysis. The highest dose of NAC administered was 10 mg/kg/day (equivalent to 600 mg/day) over a period of 3-6 months. All the studies assessing the impact of NAC on oxidative stress indicators in β-thalassemia patients demonstrated positive effects during the 3-month follow-up period. Most estimated NNTs fell into 1-5, suggesting significant clinical therapeutic value in this context., Conclusion: The current potency of NAC alone appears to be effective in ameliorating oxidative stress in patients with β-thalassemia major. While a 3-month duration seems adequate to demonstrate the antioxidant properties of NAC in this population, larger and well-designed clinical trials are warranted. Current clinical evidence possesses a high risk of bias., Competing Interests: The authors declare no conflict of interest., (© 2024 The Author(s). Health Science Reports published by Wiley Periodicals LLC.)

To assess micro-tensile bond strength (μTBS), degree of conversion (DC), microleakage (ML) antibacterial efficacy, and adhesive remnant index (ARI) of orthodontic brackets to enamel with different concentrations of photoactivated riboflavin-doped hydroxyapatite (HA) nanospheres (NS) (0%,1%,5% and 10%) and 0.5 wt% RF alone in orthodontic adhesive. Samples were included on the predefined inclusion criteria and positioned up to the cementoenamel junction (CEJ). Hydroxy apatite nanospheres (HANS) commercially bought were doped with RF. Surface characterization of HANS and RF-doped HANS were assessed along with EDX analysis. Samples were grouped based on experimental orthodontic adhesive modification. Group 1: Transbond XT no modification, Group 2: experimental Transbond XT 0.5 wt% RF, Group 3: experimental Transbond XT 0.5 wt% RF-doped 1% HANS, Group 4: experimental Transbond XT 0.5 wt % RF-doped 5% HANS and Group 5: Experimental Transbond XT 0.5 wt% RF-doped 10% HANS. Brackets were placed based on different adhesive modifications and samples underwent thermocycling. Samples were evaluated for μTBS, DC, and ML. The type of failure was assessed using ARI. Adhesive modified and un-modified in four different concentrations (0%, 1%, 5%, and 10%) and 0.5 wt% RF only were used to test efficacy against Streptococcus mutans (S.mutans). The survival rate of S.mutans and ML was determined using the Kruskal-Wallis Test. For the analysis of μTBS, ANOVA was employed, followed by a post-hoc Tukey HSD multiple comparisons test. The highest μTBS and lowest ML were observed in Group 2 experimental Transbond XT 0.5 wt% RF only. The lowest μTBS, highest ML, and lowest DC was seen in Group 5 experimental Transbond XT 0.5 wt% RF-doped 10% HANS. Samples in Group 1 in which Transbond XT was used as adhesive demonstrated significantly the highest microbial count of S.mutans and DC. Photoactivated RF-doped HANS in 1% and 0.5 wt% Riboflavin alone in orthodontic adhesive for metallic bracket bonding improved micro tensile bond strength, ML, DC, and antibacterial scores. RESEARCH HIGHLIGHTS: The highest μTBS and lowest ML were observed in Group 2 experimental Transbond XT 0.5 wt% RF only. The lowest μTBS, highest ML, and lowest DC was seen in Group 5 experimental Transbond XT 0.5 wt% RF-doped 10% HA-NS. Samples in Group 1 in which Transbond XT was used as adhesive demonstrated significantly the highest microbial count of S.mutans and DC., (© 2024 Wiley Periodicals LLC.)

In this study, 3D model of a hollow glycerin droplet impacting on a cylindrical cross-section was numerically analyzed to coat the lateral surface of the cylinder. The hollow droplets had exterior diameters of 5.5 mm, 5.25 mm, and 5 mm, and the impact velocity was 1 m/s. To model, the influence of droplets on OpenFoam software, the Volume Of Fluid technique was utilized (VOF). The Newtonian, incompressible, and laminar fluid phase of a glycerin droplet was investigated using air with a diameter of 4 mm as the gas phase. The hydrodynamic behavior of droplet collisions as well as fluid properties were investigated. As a result, when can be observed in the simple cylinder, as the outer diameter increased, the spread diameter shrank. The least amount distributed diameter in Case 3 was 1.404, whereas the highest amount in Case 4 was 1.625. The situations with a simple lateral surface, uniform spread occurred, while in cases with a spiral lateral surface, non-uniform spread occurred. Observed the maximum length in Case 3 was 4.12 mm and the minimum was 1.83 mm in Case 4., 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.)

Background and Objectives : Caregiving for geriatric patients is essential for ensuring the well-being and quality of life of older adults. Family caregivers play a crucial role, but they often face a significant burden that can lead to adverse mental health outcomes, including depression. This study aimed to estimate the prevalence of depression among caregivers of geriatric patients in Jeddah, Saudi Arabia, and to analyze its association with caregiver burden and various socio-demographic and caregiving parameters. Methods : A cross-sectional study was conducted in Jeddah, Saudi Arabia, between January and March 2024. Adult caregivers of geriatric patients were recruited through various social media platforms. Data were collected via an electronic questionnaire that included demographic information, caregiving parameters, the Patient Health Questionnaire-9 (PHQ-9) for depression screening, and the Zarit Burden Interview (ZBI-12) for caregiver burden assessment. Data were analyzed using descriptive statistics, chi-square tests, and multivariate logistic regression. Results : Of the 269 participants, the average age was 32 years, and the gender distribution was nearly balanced. The prevalence of depression (PHQ-9 score ≥ 10) among caregivers was 45.4% (95% CI: 39.3, 51.5%). Significant factors associated with higher depression scores included younger age, female gender, single status, being a student, low income, and caregiving burden. In the multivariate analysis, female gender (OR 2.50, 95% CI 1.30-4.80) and caregiving burden (mild-to-moderate burden: OR 6.18, 95% CI 2.94-13.00; high burden: OR 22.75, 95% CI 8.75-59.13) were independent predictors of depression. Conclusions : The study highlights the high prevalence of depression among caregivers of geriatric patients in Jeddah and underscores the significant impact of caregiving burden on mental health. These findings emphasize the need for targeted interventions, such as mental health support, respite care programs, and culturally sensitive educational training, to mitigate caregiver burden and enhance the well-being of caregivers.

This review highlights the need for therapeutic guidelines for syringomyelia associated with tethered cord syndrome (TCS) caused by spinal dysraphism (SD). A comprehensive literature review was conducted, selecting twelve articles to analyze common therapeutic strategies. Surgical cord untethering alone has recently become a preferred treatment, with 45 ± 21.1% of patients experiencing remission or improvement, 47 ± 20.4% unchanged and asymptomatic, and 4 ± 8% worsened. Untethering with direct surgical drainage for the syrinx had better outcomes than untethering alone (78% vs. 45%, p = 0.05). Terminal syringostomy was beneficial for syrinxes extending to the filum terminale but not for asymptomatic small syrinxes with a syrinx index < 0.4. Syrinx shunting was recommended for symptomatic large syrinxes (>2 cm in length and syrinx index > 0.5). Various shunt procedures for syrinxes are still advocated, mainly for refractory syringomyelia in Chiari malformation, posttraumatic cases, SD, or other causes. Personalized surgical methods that address the root cause of syringomyelia, particularly those improving cerebrospinal fluid flow, offer promising results with minimized complications. Ongoing studies are required to enhance management strategies for syringomyelia associated with TCS, optimize patient outcomes, and reduce the risk of recurrent symptoms.

The aim of this study was to assess the effect of ibuprofen sustained release (SR) oral premedication on the efficacy of buccal infiltration (BI) with intraoperative and postoperative pain after single-visit root canal treatment. Sixty patients diagnosed with symptomatic irreversible pulpitis and apical periodontitis in mandibular molar were divided into two groups. Group SR received ibuprofen SR 800 mg and group PL received placebo capsule 1 h before 3.6 mL articaine BI injection. Pain was recorded using a modified visual analogue scale and postoperatively at intervals 6, 24 and 48 h. Group SR showed a significantly higher anaesthetic success rate (73.3%) compared to group PL (46.7%) (p < 0.05). Intraoperative and postoperative pain was significantly higher in group PL compared to group SR (p < 0.05). Premedication of ibuprofen SR improved the efficacy of primary BI in mandibular molars with symptomatic irreversible pulpitis and decreased postoperative pain at 6 and 48 h., (© 2024 Australian Society of Endodontology Inc.)

Background and Aims: Recognizing the ability to adapt coping mechanisms in response to the unique issues present in various Iranian societies underscores the importance of considering culture and religion when interacting with diverse groups of individuals. The objective of this study was to assess the reliability and validity of the fear of progression questionnaire-short form (FoP-Q-SF) in Iranian breast cancer patients., Methods: In this methodological cross-sectional research design, 400 Iranian breast cancer patients completed the FoP-Q-SF in 2023. We assessed the characteristics, content, and both exploratory and confirmatory construct validity of the measures. To evaluate the reliability and construct validity of the FoP-Q-SF, we calculated Cronbach's α , McDonald's omega, and the Intraclass Correlation Coefficient., Results: The average age of the patients was 49.18 (standard deviation = 16.14) years. The results of exploratory factor analysis revealed that a single-factor structure, specifically the self-efficacy scale, accounted for 65.045% of the total variance. The findings from the confirmatory factor analysis indicated a satisfactory model fit. The reliability analysis indicated that the internal consistency and stability of the measures were acceptable., Conclusion: The short Persian version of the FoP-Q-SF exhibits satisfactory validity and reliability. Thus, we recommend using this questionnaire to assess the fear of disease progression among breast cancer patients in Iran., Competing Interests: The authors declare no conflict of interest., (© 2024 The Author(s). Health Science Reports published by Wiley Periodicals LLC.)

Background and Aim: One of the leading reasons that patients, particularly older persons, are brought to the orthopedic emergency room is a fracture at the end of the radius. In this study, a new traction method for distal radius fractures was compared with manual reduction., Methods: The census method was used in this clinical trial to study 45 patients (46 hands) who were referred to Hamedan Besat Hospital in 2021. Patients were randomly assigned to two groups. The manual reduction (pressure and traction by an assistant and a doctor) method was implemented in Group A, and the new traction procedure (pressure and traction by hardware or a device) was performed in Group B. The radiographic results of reduction in both groups were investigated and compared immediately and in the first and 6 weeks after surgery., Results: The following results were observed in the new and manual groups in the sixth week after surgery: average volar tilt: 4.19 ± 3.79 and 4.08 ± 3.88 ( p  = 0.926), radial angulation: 2.18 ± 1.27 and 2.21 ± 1.35 ( p  = 0.934), radial shortening: 10.52 ± 0.65 and 10.56 ± 0.68 ( p  = 0.828), radial inclination: 22.52 ± 2.46 and 22.71 ± 2.01 ( p  = 0.787), dorsal angulation: -5.89 ± 0.33 and 5.22 ± -1.91 ( p  = 1.00), ulnar variance: 1.66 ± 0.90 and 1.67 ± 0.81 ( p  = 0.958), and average pain score: 2.40 ± 0.68 and 2.47 ± 0.73 ( p  = 0.737)., Conclusion: The new reduction procedure with hardware in patients with distal radius fractures showed the same effect as the traditional method based on pressure and traction by the assistant and doctor in terms of radiographic changes and pain score of the fracture site., Competing Interests: The authors declare no conflict of interest., (© 2024 The Authors. Health Science Reports published by Wiley Periodicals LLC.)

Introduction: Trapped fourth ventricle (TFV), which is a rare neurosurgical condition with multifactorial etiology, requires a prompt diagnosis and appropriate therapeutic method selection. We report a case of post-hemorrhagic hydrocephalus and TFV incited/worsened by prematurity, sepsis, acute respiratory distress syndrome (ARDS), mechanical ventilation, and concomitant fourth ventricle outlets stenosis; which displayed a delayed onset. This article addresses the proposed pathophysiology and the clinical importance of appropriate therapeutic strategies with a mini-review of the literature., Case Presentation: We encountered a case involving a premature Asian male newborn with sepsis and posthemorrhagic hydrocephalus who required ventriculoperitoneal shunt surgery. However, after three years, the baby was diagnosed with a trapped fourth ventricle and subsequently underwent retrograde endoscopic surgery with stent insertion., Discussion: TFV is traditionally known as a complication of lateral ventricle shunting. However, in rare cases such as our neonate patient, it develops as a consequence of multiple pathophysiological processes including ventricular system inflammation along with associated anatomic and physiologic alterations, which necessitates prompt diagnosis and a case-specific therapeutic strategy., Conclusion: Understanding the multifactorial pathophysiological mechanisms leading to the development of TFV is crucial. The presence of comorbidities such as prematurity, neonatal sepsis, and ARDS increased the risk of intraventricular hemorrhage and subsequent inflammation and further exacerbated obstructions in cerebrospinal fluid pathways. When posthemorrhagic TFV is accompanied by collapsed lateral ventricles, the optimal treatment approach is retrograde endoscopic fenestration with stent insertion. This treatment option has proven effective in alleviating the condition and restoring proper cerebrospinal fluid flow., Competing Interests: Declaration of competing interest The authors have no conflicts of interest to declare., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Nail psoriasis is a chronic, inflammatory condition which is difficult to treat, linked with greater psoriasis severity, and may be associated with anxiety and significant functional impairment of the quality of life. The 1064 nm Nd: YAG laser was reported to yield satisfactory results in the treatment of nail psoriasis.The aim of the study was to assess the clinical and ultrasonographic efficacy of long-pulsed 1064 nm Nd: YAG laser in the treatment of fingernail psoriasis and compare its effect to control fingernails.This intra-patient randomized controlled trial analyzed 86 fingernails collected from 13 patients suffering from cutaneous and nail psoriasis. The nails were randomized into two groups. Group A was treated with Nd: YAG laser once monthly for three sessions while group B served as control. Assessment took place at baseline, 1 and 3 months after the last treatment session. For scoring, the 32-points target NAPSI scoring systems was used. Additionally, two blinded dermatologists' score of improvement, patients' pain assessment by visual analogue score and ultrasonographic assessment were all performed.At the end of follow up, the medians of tNAPSI score, plate definition, matrix thickness, bed thickness and bed vascularity decreased significantly in the Nd: YAG laser treated group in comparison to baseline (p = 0.001, 0.006, 0.039, < 0.001 and 0.010, respectively). While, there was a non-significant reduction in median tNAPSI score in the control group at last follow up, however, ultrasonography recorded a significant reduction in the medians of plate definition, bed thickness and vascularity (p = 0.002, 0.011 and 0.033, respectively) from the baseline. Comparison of the Nd: YAG laser and the control groups showed no significant difference from baseline regarding the medians of tNAPSI, tNAPSI percentile improvement, pits count, blinded evaluation of photographs and ultrasonographic assessments.In conclusion, Nd: YAG laser showed clinical and ultrasonographic improvement in fingernail psoriasis. Ultrasonography is a useful noninvasive tool in diagnosing and monitoring the clinical and even the subclinical changes in nail psoriasis. Nail psoriasis although difficult to treat, may show spontaneous improvement., (© 2024. The Author(s).)

Background: Acute peripheral neuropathy, also known as Parsonage-Turner syndrome or neuralgic amyotrophy, mostly affects the upper brachial plexus trunks, which include the shoulder girdle. It is typically accompanied by abrupt, intense pain, weakness, and sensory disruption. The etiology and causes of this disease are still unknown because of its low prevalence, however viral reactions-induced inflammation is one of its frequent causes., Case Presentation: Here, we introduce a professional wrestler patient who was diagnosed with PTS after vaccination and was treated, and we review some articles in this field., Conclusion: When it comes to shoulder-girdle complaints and pain, Parsonage-Turner syndrome can be a differential diagnosis. Corticosteroids during the acute period, followed by physical therapy, appear to be an efficient way to manage pain, inflammation, muscular atrophy, and the process of recovering to full nerve regeneration., (© 2024. The Author(s).)

Zirconium dioxide silver-doped nanoparticles (ZrO 2 AgDNPs) impacts the adhesive material in terms of its physical characteristics, antimicrobial properties, degree of conversion (DC), and micro-tensile bond strength (μTBS) of orthodontic brackets to the enamel surface. A comprehensive methodological analysis utilizing a range of analytical techniques, including scanning electron microscopy coupled with energy-dispersive x-ray spectroscopy (EDX), Fourier-transform infrared (FTIR) spectroscopy, DC analysis, and μTBS testing. A light-curable orthodontic adhesive, specifically Transbond XT, was combined with ZrO 2 AgDNPs at 2.5% and 5%. As a control, an adhesive with no incorporation of ZrO 2 AgDNPs was also prepared. The tooth samples were divided into three groups based on the weightage of NPs: group 1: 0% ZrO 2 AgDNPs (control), group 2: 2.5 wt% ZrO 2 AgDNPs, and group 3: 5 wt% ZrO 2 AgDNPs. EDX graph demonstrated silver (Ag), Zirconium (Zr), and Oxygen (O 2 ), The antibacterial efficacy of adhesives with different concentrations of NPs (0%, 2.5%, and 5%) was assessed using the pour plate method. The FTIR spectra were analyzed to identify peaks at 1607 cm -1 corresponding to aromatic CC bonds and the peaks at 1638 cm -1 indicating the presence of aliphatic CC bonds. The μTBS was assessed using universal testing machine (UTM) and bond failure of orthodontic brackets was seen using adhesive remanent index (ARI) analysis. Kruskal-Wallis test assessed the disparities in survival rates of Streptococcus mutans. Analysis of variance (ANOVA) and post hoc Tukey multiple comparisons test calculated μTBS values. The lowest μTBS was observed in group 1 adhesive loaded with 0% ZrO 2 AgDNPs (21.25 ± 1.22 MPa). Whereas, the highest μTBS was found in group 3 (26.19 ± 1.07 MPa) adhesive loaded with 5% ZrO 2 AgDNPs. ZrO 2 AgDNPs in orthodontic adhesive improved μTBS and has acceptable antibacterial activity against S mutans. ZrO 2 AgDNPs at 5% by weight can be used in orthodontic adhesive alternative to the conventional method of orthodontic adhesive for bracket bonding. RESEARCH HIGHLIGHTS: The highest μTBS was found in orthodontic adhesive loaded with 5% ZrO 2 AgDNPs. ARI analysis indicates that the majority of the failures fell between 0 and 1 among all investigated groups. The colony-forming unit count of S. mutans was significantly less in orthodontic adhesive loaded with nanoparticles compared with control. The 0% ZrO 2 AgDNPs adhesive showed the highest DC., (© 2024 Wiley Periodicals LLC.)

Objective: Parents have a profound influence on their children's dietary habits. Parents' perspectives, attitudes, and behaviors regarding feeding their children a nutritious diet can have a significant impact on their children's health. The objective of this study was to examine the attitudes, beliefs, and feeding practices of parents in relation to nutrition for their children and to determine how these factors influence strategies for preventing obesity., Subjects and Methods: A total of 446 Saudi mothers with children aged 2-12 years were recruited for this study. The Child Feeding Questionnaire (CFQ) was administered to mothers via an instant messaging application., Results: Mothers' age showed a significant difference in perceived responsibility (p < 0.004), perceived parental weight (p = 0.000), perceived child's weight (p = 0.000), and concern about the child's weight (p = 0.000). Mothers with postgraduate degrees exhibited a significant difference in perceived child weight (p < 0.003); occupational status showed a significant difference in perceived parental weight (p < 0.004), perceived child weight (p < 0.001), and residence, particularly in Riyadh, which showed a significant difference in perceived parental weight (p < 0.026). There were also significant differences in body mass index (BMI) (p = 0.000) and perceived parental weight in relation to the mother's age. Mothers' age was significantly related to food restrictions (p = 0.000), pressure to eat (p = 0.000), and monitoring (p < 0.009). Mothers with only one child displayed significance in relation to pressure to eat (p < 0.019), while government-employee mothers showed a significant relationship with food restrictions (p < 0.005). There was a noteworthy association between the age of the mothers and perceived responsibility (p < 0.001), occupation (p < 0.22), residence (p = 0.000), and the mother's BMI (p = 0.000) with perceived parental weight. Finally, occupation (p < 0.006) was found to significantly influence food restriction, while the mother's age was significantly related to the pressure to eat (p < 0.002)., Conclusions: Parental attitudes, practices, and beliefs regarding child feeding were strongly associated with maternal age, occupation, and BMI. Targeted interventions should be developed to assist mothers exhibiting these characteristics in establishing healthier and more effective feeding routines for their children. For example, interventions could be designed to educate parents on the latest findings regarding child-feeding habits and help them develop a greater sense of responsibility for their children's nutrition.

A novel mesoporous magnetic biochar (MBC) was prepared, using a randomly growing plant, i.e., common reed, as an exporter of carbon, and applied for removal of methylene blue (MB) from aqueous solutions. The prepared sorbent was characterized by nitrogen adsorption/desorption isotherm, saturation magnetization, pH of point of zero charges (pH PZC ), Fourier-transform infrared spectroscopy (FT-IR), and scanning electron microscopy (SEM). The obtained MBC has a specific surface area of 94.2 m 2  g -1 and a pore radius of 4.1 nm, a pore volume of 0.252 cm 3  g -1 , a saturation magnetization of 0.786 emu g -1 , and a pH PZC of 6.2. Batch adsorption experiments were used to study the impact of the physicochemical factors involved in the adsorption process. The findings revealed that MB removal by MBC was achieved optimally at pH 8.0, sorbent dosage of 1.0 g L -1 , and contact time of 30 min. At these conditions, the maximum adsorption was 353.4 mg g -1 . Furthermore, the adsorption isotherm indicated that the Langmuir pattern matched well with the experimental data, compared to the Freindlich model. The ∆G was - 6.7, - 7.1, and - 7.5 kJ mol -1 , at 298, 308, and 318 K, respectively, indicating a spontaneous process. The values of ∆H and ∆S were 5.71 kJ mol -1 and 41.6 J mol -1  K -1 , respectively, suggesting endothermic and the interaction between MB and MBC is van der Waals type. The absorbent was regenerated and reused for four cycles after elution with 0.1 mol L -1 of HCl. This study concluded that the magnetic biochar generated from common reed has tremendous promise in the practical use of removing MB from wastewater., (© 2024. The Author(s).)

Competing Interests: Conflict of Interest: The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

Introduction: Stroke is one of the most debilitating diseases among adults worldwide and leads to persistent rehabilitation needs even at the chronic stage. Achieving good postural control is a critical requirement for daily activities which enhances quality of life (QoL) in patients with stroke. There is increasing evidence that transcranial direct current stimulation (tDCS) can be considered a promising adjunct technique to improve motor recovery after stroke. Evidence of augmented neuroplasticity after tDCS suggests that paired rehabilitation followed by consecutive use of tDCS may optimize recovery outcomes. Although a few randomized controlled trials have been conducted on upper limb rehabilitation in chronic stroke using tDCS, no study focused on balance training in chronic stroke patients. The present randomized, sham-controlled, double-blinded clinical study addresses brain stimulation targeting postural control using tDCS in chronic stroke., Methods: The study participants included chronic ischemic stroke individuals with postural control impairments who passed the exclusion criteria. Active or sham anodal tDCS was delivered to the lesioned leg motor cortex combined with balance training. The experimental group received active anodal tDCS stimulation (2 mA) for 20 min, daily for 5 days paired with balance training. Linear and nonlinear approaches were used to analyze postural sway changes pre-and post-intervention. Postural sway fluctuation, functional balance assessment using the Berg balance scale, and timed up-and-go test were conducted to compare the active and sham groups., Conclusion: This trial could have significant implications for balance rehabilitation after stroke in the ambulatory setting. If effective, this novel approach may improve rehabilitation protocol in this population., (Copyright© 2024 Iranian Neuroscience Society.)

One field of study in microfluidics is the control, trapping, and separation of microparticles suspended in fluid. Some of its applications are related to cell handling, virus detection, and so on. One of the new methods in this field is using ICEK phenomena and dielectrophoresis forces. In the present study, considering the ICEK phenomena, the microparticles inside the fluid are deviated in the desired ratio using a novel ICEK microchip. The deviation is such that after the microparticles reach the floating electrode, they are trapped in the ICEK flow vortex and deviated through a secondary channel that was placed crosswise and noncoplanar above the main channel. For simulation verification, an experimental test is done. The method used for making two noncoplanar channels and separating the particles in the desired ratio with a simple ICEK microchip is an innovation of the present study. Moreover, the adjustment of the percentage of separation of microparticles by adjusting the parameters of the applied voltage and fluid inlet velocity is one of the other innovations of the present experimental study. We observed that for input velocities of 150-1200 µm/s with applied voltages of 10-33 V, 100% of the particles can be directed toward the secondary-channel., (© 2023 Wiley‐VCH GmbH.)

Aim: To acquire a thorough comprehension of the photoactivated Cur-doped ZnONPs at different concentrations 0%, 2.5%, and 5% on the physical qualities, antibacterial efficacy, degree of conversion, and μshear bond strength between orthodontic brackets and the enamel surface., Material and Methods: An extensive investigation was carried out utilizing a range of analytical methods, scanning electron microscopy (SEM) combined with energy-dispersive X-ray spectroscopy (EDX), Fourier-transform infrared (FTIR) spectroscopy, micro tensile bond strength (μTBS) testing, and evaluation of antibacterial effectiveness. Cur-doped ZnONPs at concentrations of 2.5% and 5% were blended with Transbond XT, a light-curable orthodontic adhesive. A control group without the addition of Cur-doped ZnONPs was also prepared. The tooth samples were categorized into three groups based on the weight percentage of NPs: Group 1 (control) with 0% Cur-doped ZnONPs, Group 2 with 2.5 wt% Cur-doped ZnONPs, and Group 3 with 5 wt% Cur-doped ZnONPs. The SEM technique was employed to analyze the morphological characteristics of Cur-doped ZnONPs and ZnONPs. The composition and elemental distribution of the modified Cur-doped ZnONPs were assessed using energy-dispersive X-ray spectroscopy. The effectiveness of NPs at various concentrations against S.Mutans was gauged through the pour plate method. DC of Cur-doped ZnONPs at a region of 1608 cm -1 to 1636 cm -1 for the cured area, whereas the uncured area spanned the same range of 1608 cm -1 to 1636 cm -1 was assessed. The Adhesive Remnant Index (ARI) approach was utilized to investigate the bond failure of orthodontic brackets, while a Universal Testing Machine (UTM) was utilized to test μTBS. The Kruskal-Wallis test was employed to investigate variations in S.mutans survival rates. To determine the μTBS values, analysis of variance (ANOVA) and the post hoc Tukey multiple comparisons test were used., Results: The maximum μTBS was given and documented in group 3: 5 wt% Cur-doped ZnONPs (21.21 ± 1.53 MPa). The lowest μTBS was given in group 2: 2.5 wt% Cur-doped ZnONPs (19.58 ± 1.27 MPa). The highest efficacy against S.mutans was documented in group 3 in which 5 wt% Cur-doped ZnONPs (0.39 ± 0.15). The lowest efficacy was seen in group 1 in which no Cur-doped ZnONPs were used (6.47 ± 1.23). The ARI analysis indicated that the predominant failure was between scores 0 and 1 among all experimental groups. Control group 1 which was not modified showed the highest DC (73.11 ± 4.19)., Conclusion: Orthodontic adhesive, containing 5% Cur-doped ZnONPs photoactivated with visible light exhibited a favorable impact on μTBS and indicated enhanced antibacterial efficacy against S.mutans. Nevertheless, it was observed that the addition of Cur-doped ZnONPs at different concentrations (2.5%,5%) resulted in a decrease in the monomer-to-polymer ratio compromising DC., Competing Interests: Declaration of competing interest The authors declare no conflict of Interest in the present study., (Copyright © 2023. Published by Elsevier B.V.)

Background: The aim of this scoping review was to understand the development of robotics and its accuracy in placing dental implants when compared to other forms of guided surgery., Methods: An electronic search was conducted on the electronic databases of PubMed, Cochrane, and Science direct with the following queries: ((robotics) AND (dental implant)) AND (accuracy). The search timeline was between 2017 and 2022., Results: A total of 54 articles were screened for title and abstract, of which 16 were deemed eligible for inclusion. Thirty-one articles were excluded mainly because they were out of topic (not relevant) or not in English. In total, 16 articles were included for analysis., Conclusions: This review thoroughly analyses 5 years of literature concerning the evolution of robotics in dental implant surgery, underscoring the necessity for additional research on nascent technologies reported and a comparative study with static and dynamic systems for clinical efficacy evaluation., (© 2024 John Wiley & Sons Ltd.)

Radiation therapy results in radiation-induced vasculopathy, characterized by alterations in the vascular architecture stemming from radiation exposure. The exact molecular pathways and associated pathologies of this condition have yet to be comprehensively understood. This study aimed to identify specific markers' roles in cerebral vascular endothelial injury pathogenesis after radiosurgery and explore their unique expression patterns in diverse pathologies post-stereotactic radiosurgery. A retrospective cohort study was conducted to assess the expression profiles of endothelial markers via immunohistochemical analysis in 25 adult patients (13 males and 12 females) who had undergone neurosurgical resection for various central nervous system pathologies following stereotactic radiosurgery or radiotherapy from 2001 to 2015. Our findings revealed strong immunohistochemical expression of ICAM-1 and E-selectin across various disease states, while MMP-9, PAI-1, and eNOS exhibited moderate expression levels. In contrast, VCAM-1 and P-Selectin had the weakest expression across all groups. Notably, while individual markers showed significant variations in expression levels when comparing different diseases (P < .001), no substantial differences were found in the overall immunohistochemical expression patterns across the 5 distinct pathologies studied (P = .407, via 2-way ANOVA). Despite the varied long-term effects of radiotherapy on the vascular endothelium, a common thread of inflammation runs through the pathology of these conditions. The distinct patterns of marker expression identified in our study suggest that different markers play unique roles in the development of radiation-induced vasculopathy. These findings offer insights that could lead to the development of novel preventive strategies and treatments., Competing Interests: The authors have no funding and conflicts of interest to disclose., (Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.)

Background and Aims: Chronic obstructive respiratory diseases (COPD) not only cause damage to the respiratory system as well as the heart and blood vessels of the patient but also have a direct effect on the condition of the musculoskeletal system. The risk of falling is increasing due to dysfunction of the joints as well as aging, which occurs frequently in this population. Gait deficits are known as an important risk factor for falls. This research aimed to investigate the gait of COPD patients compared to healthy people to gain a better understanding of the reasons for falls., Methods: Twenty patients with COPD and 20 age and BMI-matched healthy individuals were included in this study. Sixteen markers were applied to the lower body of the subjects. Spatio-temporal, kinematic, and maximum moment parameters were measured in different phases in three lower body joints, including the hip, knee, and ankle., Results: The results showed that all spatio-temporal parameters in patients were significantly lower than in healthy people. The ankle angle in the sagittal plane at initial contact was significantly difference ( p  = 0.03). As well as, in the frontal plane the hip angle in the mid-stance showed a significant difference ( p  = 0.02). There was also a significant difference in maximum hip moment in the sagittal plane between the two groups ( p  = 0.01)., Conclusion: The larger hip angle of the patients can be related to the balance problems in the mediolateral direction. The moment showed a significant difference in the hip joint. Since the hip muscles are directly in a synergistic relationship with the trunk muscles, it seems the performance of these muscles is likely to be seriously damaged due to respiratory diseases., Competing Interests: The authors declare no conflict of interest., (© 2024 The Authors. Health Science Reports published by Wiley Periodicals LLC.)

Leishmaniasis is a vector-borne disease, one of the most important neglected tropical diseases. Existing anti-leishmanial treatments are not effective for a long time and associated with toxic side effects so searching for a new, effective and safe alternative treatments against infectious diseases is greatly needed. This study is aimed to assess the leishmaniacidal effects of methanolic extracts of Eryngium planum (E. planum) and Ecbilliun elaterum (E. elaterum) on Leishmania major (L. major), In vitro. The selected plants were collected from northern areas of Iran. The methanolic extract from the aerial parts of plants were prepared using maceration methods. GC- Mass analysis was used to determine the compounds of the plants. Promastigotes of L. major was cultured in RPMI-1640 medium and the anti-leishmanial and cytotoxicity effects of extracts at concentrations of 100, 200, 400 and 800 µg/ml were assessed using MTT assay. The data obtained from gas chromatography revealed that α-Pinene, Caryophyllene oxide, β-Caryophyllene, Bicyclogermacrene and α-Bisabolol are the main compounds extracted from E. planum and α-Pinene, Germacrene D, Caryophyllene oxide, γ-Eudesmol and α-Bisabolol are the main components of E. elaterum. The results of MTT Assay revealed that E. planum at concentrations of 800 µg/ml after 24 h at 400 µg/ml after 48 h and the E. elaterium at concentrations of 800 µg/ml after 48 h at 400 µg/ml after 72 h had similar anti-leishmanial effects to the positive control. These results indicated that E. planum and E. elaterum are the potential sources for the discovery of novel anti-leishmanial treatments., (© 2023. The Author(s).)

Background: Para-testicular Rhabdomyosarcoma (PT-RMS) has a favorable treatment outcome adopting multidisciplinary management; resection, namely high inguinal orchiectomy ± retro-peritoneal lymph node dissection (RPLND) followed by standard or intensive chemotherapy ± adjuvant radiation therapy., Patients and Methods: This is a retrospective study including all patients with pathologically proven PT-RMS, presented to the National Cancer Institute, Cairo University, during the period from 2005 to 2020. Endpoints included overall survival, disease free survival and patterns of failure of different treatment modalities., Results: Forty one patients were identified. Median age in our cohort was 15 years (range: 2-54 years). After a median follow up of 26 months (range, 3-75 months) ,two and five years OS were 100% and 91.7% respectively and median survival was not reached. Patients who underwent retro-peritoneal nodal dissection had a 5-year DFS rate of 100% versus 73% for those who received radiation to para-aortic nodes (p = 0.185). Limitations include retrospective nature and deviation from COG protocol., Conclusions: This study shows promising results suggesting that less aggressive local treatment modalities including radiation to para-aortic chain could be an option in PT-RMS, given the excellent results of this subtype. However further validation in a prospective study is warranted.

Objectives: To evaluate the efficacy of preoperative glutamine infusion in reducing insulin requirements in patients with uncontrolled type 2 diabetes, defined as glycated hemoglobin (HbA1c) >7%, undergoing urgent coronary artery bypass graft (CABG) surgery., Design: A randomized controlled trial., Setting: At Ain Shams University Hospital, Cardiothoracic Academy., Participants: Ninety-three patients (of both sexes) with uncontrolled diabetes presenting for urgent CABG were categorized into 2 groups., Interventions: The dipeptiven group (n = 46) was given an infusion of dipeptiven 1.5 mL/kg body weight dissolved in normal saline (200 mL) over 3 hours before surgery. The control group (n = 47) received a normal saline infusion (200 mL)., Measurements and Main Results: The dipeptiven group demonstrated statistically significant lower intraoperative (173.74 ± 19.97 mg/dL v 198.22 ±14.64 mg/dL) and postoperative (162.36 ±13.11 mg/dL v 176.13 ±14.86 mg/dL) mean blood glucose levels. In addition, dipeptiven infusion was found to reduce mean total insulin requirements intraoperatively by 3.64 ± 0.56 units/h and postoperatively by 37.109 ± 4.30 units/24 h in comparison to placebo (50.98 ± 16.55 units/24 h and 5.10 ± 2.28 units/h, respectively)., Conclusion: A preoperative infusion of dipeptiven can contribute to ameliorating stress hyperglycemia in uncontrolled diabetic patients undergoing urgent CABG., 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 Inc. All rights reserved.)

Objectives: This study aimed to compare the effect of flexi-bar and stabilization exercises on static and dynamic postural control in patients with chronic nonspecific low back pain., Patients and Methods: In this randomized controlled study conducted between November 2019 and March 2020, 38 patients (19 males, 19 females; mean age: 33.8±6.2 years; range, 20 to 45 years) were randomly assigned into flexi-bar (n=19) and stabilization (n=19) groups. Both groups received general physiotherapy for three sessions per week, a total of 10 sessions. Besides, the flexi-bar group received flexi-bar exercises, and the stabilization group received stabilization exercises. Postural sway was assessed with a force platform in three difficult conditions, including open eye, close eye, and one-leg standing and dynamic posture with the modified Star Excursion Balance Test., Results: After the intervention, both groups showed a significant improvement in static and dynamic postural control (p<0.05). However, no significant differences were found between groups after treatment, while only the phase-plane portrait of opened eyes condition was significantly improved (p=0.03), in the flexi-bar group compared to the stabilization group., Conclusion: Both flexi-bar and stabilization exercises effectively improved static and dynamic postural control, but none of the exercises was superior to the other. Flexi-bar is recommended as an effective tool in low back pain rehabilitation., Competing Interests: Conflict of Interest: The authors declared no conflicts of interest with respect to the authorship and/or publication of this article., (Copyright © 2023, Turkish Society of Physical Medicine and Rehabilitation.)

Activation of specific brain areas and synchrony between them has a major role in process of emotions. Nevertheless, impact of anti-synchrony (negative links) in this process still requires to be understood. In this study, we hypothesized that quantity and topology of negative links could influence a network stability by changing of quality of its triadic associations. Therefore, a group of healthy participants were exposed to pleasant and unpleasant images while their brain responses were recorded. Subsequently, functional connectivity networks were estimated and quantity of negative links, balanced and imbalanced triads, tendency to make negative hubs, and balance energy levels of two conditions were compared. The findings indicated that perception of pleasant stimuli was associated with higher amount of negative links with a lower tendency to make a hub in theta band; while the opposite scenario was observed in beta band. It was accompanied with smaller number of imbalanced triads and more stable network in theta band, and smaller number of balanced triads and less stable network in beta band. The findings highlighted that inter regional communications require less changes to receive new information from unpleasant stimuli, although by decrement in beta band stability prepares the network for the upcoming events., (© 2023. Springer Nature Limited.)

Aim The current study assessed the efficiency of buccal infiltration (BI) and inferior alveolar nerve block (IANB) during the extraction of deciduous mandibular molars.Subjects and method A total of 112 children aged between 5-8 years with mandibular molar indicated for extraction were divided into two groups at random. The BI group was injected with 4% articaine using BI, while the IANB group was injected with 2% lidocaine using IANB. The effectiveness of both techniques was examined using the Wong-Baker FACES Pain Rating Scale (W-BFPRS); Faces, Legs, Activity, Cry, and Consolability (FLACC) scale; and pulse oximetry.Results Using the W-BFPRS scale, success rates were 83.9% and 75.0% for the BI group and 82.1% and 71.4% for the IANB group during the injection and extraction, respectively, while using the FLACC scale, success rates were 83.9% and 92.9% for the BI group and 78.6% and 89.3% for the IANB group. In terms of pulse rate and oxygen saturation, there was no significant difference between the two groups.Conclusions BI with articaine is as efficient as IANB with lidocaine in the extraction of deciduous mandibular molars., (© 2023. The Author(s), under exclusive licence to the British Dental Association.)

Background: We aimed to evaluate the safety and efficacy of single anastomosis sleeve ileal (SASI) bypass surgery on obese patients with type II diabetes mellitus during a one-year follow-up period., Methods: We included patients with a body mass index (BMI) more than 35 kg/m 2 and at least one-year history of type II diabetes mellitus. We excluded patients aged under 25 or above 66 years, those who were not candidates for surgery, needed another bariatric surgery, and those not willing to participate in the study. All the patients were visited in the outpatient office on the 10 th and 45 th days as well as the 3 rd month of the post-operative period until the end of the first year., Results: in this study, we investigated 14 male (23.0%) and 47 female (77.0%) morbidly obese patients with type II diabetes mellitus who underwent SASI bypass. The mean excess weight loss (%EWL) was 60.99±15.69 and the mean total weight loss (%TWL) was 30.39±6.52 at the end of the one-year follow up. Finally, 44 patients (72.1%) had a complete and 15 patients (24.6%) had partial remission of type II diabetes mellitus. Of note, severe complications were recorded in two patients (3.2%). Paired t test analysis demonstrated a significant decrease for fasting plasma sugar (FBS) after one-year follow-up in comparison with FBS before surgery ( P <0.0001). Furthermore, this difference was observed in HbA1c ( P <0.0001)., Conclusion: SASI bypass is an effective method for weight loss and controlling type II diabetes mellitus., (© 2023 The Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.)

Objective: To explore effect of cupping and Kinesio-taping techniques on clinical and ultrasound outcomes of carpal tunnel syndrome (CTS) during pregnancy., Methods: Thirty pregnant women suffering from CTS were randomly assigned into Kinesio-taping (n = 15) and cupping (n = 15) groups. In Kinesio-taping group, individuals underwent Kinesio-taping for three days, one day with no treatment, and three days with Kinesio-taping, continuing this procedure for four weeks. In cupping group, cupping was moved for 5 min with pressure of 50 mm-Hg on the carpal tunnel area. This procedure continued longitudinally in forearm area for 2 min. The therapeutic intervention of cupping group continued with eight sessions, two days a week for 4 weeks. Ultrasound outcomes including median nerve cross-sectional area through ultrasonography, and clinical outcomes including pain through visual analog scale and severity of symptoms and functional status through Boston questionnaire were measured in both groups before and after therapeutic program., Results: In both groups, a significant reduction was observed in all variables after treatment compared to pre-treatment (P < 0.001). In inter-group comparison, a significant improvement was found in outcomes of Boston questionnaire and ultrasound results about median nerve cross-sectional area at pisiform and hook of hamate in cupping group compared to Kinesio-taping at end of four weeks (P < 0.001)., Conclusion: Both cupping and Kinesio-taping improved clinical and ultrasound outcomes of CTS. However, efficacy of cupping compared to Kinesio-taping was better in improvement of median nerve cross-sectional area at hamate hook and pisiform levels, symptoms severity scale, and functional status scale, which makes the results clinically more applicable., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Introduction: Studies on the mid and long-term outcomes of thoracic endovascular aortic repair (TEVAR) are scarce. This study aimed to investigate the long-term outcomes of TEVAR for all-comers patients with various types of thoracic aortic pathologies, predominantly thoracic aortic dissections and thoracic aortic aneurysms., Methods: Between January 2005 and December 2015, 123 consecutive patients with thoracic aortic pathologies underwent TEVAR. The patients were divided into groups based on aortic pathologies (dissections or aneurysms) and the type of procedure (hybrid TEVAR or non-hybrid TEVAR). Mortality, complications, and reintervention rates were compared between these four groups. The Kaplan-Meier curve and the Cox regression analysis were employed to estimate survivals and factors associated with 5-year mortality., Results: One hundred twenty-three consecutive patients with various aortic pathologies undergoing TEVAR were evaluated. Hypertension (79.7 %) and smoking (39 %) were the most common comorbidities in the study population. The patients were followed up for a mean duration of 58.1 ± 7.1 months to evaluate the postprocedural surveillance. Most complications occurred in the dissection and hybrid groups; however, these differences were nonsignificant. The overall 5-year surveillance and reintervention rates were 65 % and 12.1 %, respectively. A significant difference existed in 5-year survival between the patients with aneurysmal and aortic dissection pathologies based on the log-rank test (P = 0.01). On the other hand, no significant differences were observed in 5-year survival between the patients who underwent hybrid and non-hybrid TEVAR. The Cox regression analysis confirmed that chronic kidney disease, previous coronary artery bypass grafting, age >65 years, platelet counts <150∗ 10 3 /μL, aneurysmal aortic pathology, and ejection fraction ≤ 50 % were predictors of 5-year mortality., Conclusions: The long-term outcomes of TEVAR for various aortic pathologies disclosed that this procedure was well-tolerated in a group of patients with high comorbid conditions. The five-year survival rate of TEVAR for thoracic aortic dissections was more favorable than that for thoracic aortic aneurysms, but there were no significant differences between hybrid and non-hybrid procedures regarding the mortality rate., Competing Interests: Conflict of interest The authors declare that they have no conflict of interest., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Statement of Problem: The accuracy of different virtual cement gap parameters in designing a single crown in a computer-aided design (CAD) software program is still unclear., Purpose: The purpose of this in vitro study was to evaluate and compare the virtual cement gap settings of 3 different CAD software programs used to design a single crown restoration., Material and Methods: Three different CAD software programs (exocad, Dental System, and B4D) were evaluated for designing single crowns with similar virtual cement gap settings. Three experimental groups were created based on the CAD software program used (n=10). Three-dimensional analysis software program was used to assess the virtual cement gap in the CAD restoration. The Shapiro-Wilk test of normality was used. Comparisons were carried out by using 1-way ANOVA and the Scheffé post hoc test (α=.05)., Results: The Dental System software program had the lowest statistical mean error values at both tooth margin (4.6 μm) and axial wall (1.5 μm), followed by B4D then exocad. At the occlusal surface, the lowest statistical mean error value of 5 μm was achieved by the Dental System followed by exocad then B4D., Conclusions: Accuracy of the virtual cement gap parameter in single crown design varies based on the CAD software used. The highest accuracy was attained by the Dental System software program at all tooth surfaces, followed by B4D at the tooth margin and axial wall and by exocad at the occlusal surface., (Copyright © 2023 Editorial Council for The Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.)

Background: Since the onset of the Covid-19 pandemic, an increase in mucormycosis cases has been observed in many countries, including Iran. However, the role of covid-19 and associated risk factors have not been thoroughly investigated., Objective: This study is designed to identify epidemiologic characteristics, risk factors, and outcome predictors of Covid-19-Associated Rhino-Orbito-Cerebral Mucormycosis (C-ROCM)., Methods: Data of pathology proven Covid Associated ROCM cases were retrospectively obtained from 7 tertiary care centers throughout Iran from February 20, 2021, to July 22, 2021. Univariate and multivariate analyses were performed using binary logistic regression to assess the effects of various factors on the outcome., Results: A total of 132 patients with C-ROCM were included in the study. The mean age of patients was 61.6 ± 13.9 (60.6% male). In 12 patients (9.1%), both eyes were involved. Diabetes was the most common comorbidity (94.7%). The mortality rate was 9.1%, higher in males (12.5%) than females (3.8%). Severe vision impairment was seen in 58 patients (43.9%). Main factors that had a negative impact on the outcome in the univariate analysis include older age (P < 0.001), higher steroid dosage (P < 0.001), higher HbA1c level (P < 0.001), Covid-19 severity (P < 0.001), and brain involvement (P < 0.001). However, in the multivariate analysis, the effects of age (P = 0.062), steroid dosage (P = 0.226), and Covid-19 intensity (P = 0.084) decreased, and the difference was no longer statistically significant. CRAO was a predictor of mortality in the univariate analysis (P = 0.008, OR = 4.50), but in the multivariate analysis, this effect decreased and was no longer significant (P = 0.125)., Conclusion: The risk of C-ROCM and its complications may increase in patients with more severe Covid-19, steroid over-prescription, ICU admission due to Covid-19, and poor glycemic control during and after Covid-19 treatment., (© 2022. The Author(s), under exclusive licence to Springer Nature B.V.)

Measuring and predicting accurate joint angles are important to developing analytical tools to gauge users' progress. Such measurement is usually performed in laboratory settings, which is difficult and expensive. So, the aim of this study was continuous estimation of lower limb joint angles during walking using an accelerometer and random forest (RF). Thus, 73 subjects (26 women and 47 men) voluntarily participated in this study. The subjects walked at the slow, moderate, and fast speeds on a walkway, which was covered with 10 Vicon camera. Acceleration was used as input for a RF to estimate ankle, knee, and hip angles (in transverse, frontal, and sagittal planes). Pearson correlation coefficient (r) and Mean Square Error (MSE) were computed between the experimental and estimated data. Paired statistical parametric mapping (SPM) t-test was used to compare the experimental and estimated data throughout gait cycle. The results of this study showed that the MSE of joint angles between the experimental and estimated data ranged from 0.04 to 24.29 and r > 0.91. Moreover, the findings of SPM indicated that there was no significant difference between the experimental and estimated data of ankle, knee, and hip angles in all three planes throughout gait cycle. The results of our research developed a more accessible, portable procedure to quantifying lower limb joint angles by an accelerometer and RF. So, such wearable-based joint angles have the potential to be used in outside-laboratory settings to measure walking kinematics., 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.)

Substrate-assisted laser desorption/ionization (SALDI) is a kind of soft ionization method that is most suitable for the analysis of low molecular weight analytes when it is coupled with a time-of-flight mass spectrometer. Unlike the conventional matrix-assisted laser desorption/ionization, there is no interference in the SALDI with matrices for the low mass analyte peaks ( m / z < 700). The focus of this work is to develop substrates based on nanomaterials to obtain higher sensitivity, better reproducibility, and easier preparation. The mass spectra of some small molecules (capecitabine, hemin, methadone, noscapine, oxycodone, thebaine, malathion, chlorpyrifos, ethion, permethrin, and phosalone) deposited on the TiO 2 -nanotube (TiO 2 -NTs) plate by the SALDI-TOF-MS technique are reported. The nanotubes are synthesized in different diameter sizes of nanotubes via the anodizing method. The intensity of the analyte peaks and the softness of ionization are optimized by varying the diameter of nanotubes and adding relevant alkali salts to the analytes. In addition, the reproducibility of the signal intensity of analytes is optimized by changing the surface hydrophilicity of the TiO 2 -NT plate.

Background: Overexpression of CD200 in ALL patients indicates that it may be useful in the characterization of leukemia initiating cells (LIC). We aim at investigating the expression pattern of CD200 on leukemic B cells and the correlation of CD200 expression with various clinical and laboratory findings in 62 newly diagnosed acute lymphoblastic leukemia patients., Methods: All patients were subjected to full history taking, a thorough clinical examination, and laboratory investigations, which included complete blood count (CBC), BM aspiration, immunophenotyping of blast cells, and CD200 expression., Results: There is a higher statistically significant mean value of CD200 expression among the cases (66.15 ± 23.08) than the control group (0.37 ± 0.2) ( p value ≤ 0.001). CD200 expression shows a significant correlation with total leucocytic count and hemoglobin level ( p = 0.001, 0.03, respectively)., Conclusions: This study showed that CD200 expression was expressed in 100% of the patients. Correlations between CD200 expression and different laboratory data of patients revealed that there was an impact of CD200 on different diagnostic findings. After the follow-up of the patients, we found that the use of PRISM function of the software could add value to the detection of minimal residual disease.

Purpose: Sacrococcygeal teratoma (SCT) is a rare congenital tumor originating from a variant of extragonadal germ cell neoplasm. Herein, we present three cases of neonatal SCTs undergoing surgical resection and reconstruction. We also review the literature to discuss the importance of proper perinatal management and timely surgical intervention depending on the tumor type and maturity to prevent malignant transformation and recurrence and ensure functional outcomes., Methods and Results: Three cases of SCT were retrospectively analyzed. All infants underwent complete surgical resection of the SCT and coccygectomy during their neonatal/infancy period, followed by pelvic floor and buttock reconstruction while minimizing buttock contour deformity and undesirable skin scar. Two of the cases were histopathologically diagnosed as predominantly cystic mature teratomas of Altman types I and IV, and the third was a mature teratoma of Altman type II. There were no complications or tumor recurrence during the average follow-up period of 5.3 years., Conclusions: This case-based review highlights the role of multidisciplinary team approaches, including prenatal monitoring, oncologic resection, and adequate reconstruction according to the type of tumor and anomaly. Optimal perinatal evaluation allows promising oncologic and functional outcomes in terms of timely intervention to eliminate tumor recurrence and malignant transformation. Complete oncologic surgical resection of SCTs should also include proper functional preservation strategies, such as the reconstruction of the pelvic floor, cosmetic buttock contouring, and preservation of bladder and bowel sphincter function., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: Genetic alterations and high levels of the vascular endothelial growth factor (VEGF) are presumptive risk factors for differentiated thyroid cancer (DTC)., Objective: This work aims to study the presence of - 634G/C polymorphism of vascular endothelial growth factor (rs2010963) and its' serum level in patients with DTC and comparing these results with those of the control subjects., Material and Method: The study was a retrograde case-control study that included seventy patients with DTCin addition to seventy apparently healthy control subjects. Blood sample was taken and subjected to study of - 634G/C VEGF polymorphism (rs2010963) by real time PCR and measurement of its' plasma level by immunoassay kit (ELISA)., Results: Regarding genotyping of VEGFA - 634G/C (rs2010963) polymorphism, there was significant increase in CG and GG genotypes (28.6%, 18.6% respectively) among patients compared to control subjects (20.0%, 4.3% respectively) and significant increase in CC genotype in control subjects (75.7%) compared to patients (52.9%), P = 0.001. The VEGF mean ± SD level was significantly elevated in patients compared to control subjects (1215.81 ± 225.78 versus 307.16 ± 91.81, P = 0.006). Moreover, there was significant increase in VEGF levels in patients with CG and GG genotypes (1295.9 ± 68.74, 1533.08 ± 109.95, respectively) compared to patients with CC genotype (1061 163.25), P = 0.001)., Conclusion: There was significant increase in GG and CG genotypes in patients with DTC compared to control subjects which may suggest a predisposing role for these genotypes in development of DTC. Moreover, there was significant increase in serum level of vascular endothelial growth factor in patients with GG and CG genotypes which may reflect the mechanism of these genotypes in development of DTC., (© 2022. The Author(s).)

This paper utilizes response surface methodology (RSM) design-based analyses to optimize starch-based wound dressings that were characterized based on weight loss (WL%), swelling index (SI%), and mechanical strength (TS). The wound-dressing materials were prepared by employing a modified casting method, using various concentrations of starch (0.5-2 w / w %), polyvinyl alcohol (PVA) (0.5-2 weight%), citric acid (1.5-4 weight%), and glycerol (1.5-4 weight%) to yield wound-dressing films with appropriate combinations of in vitro degradation, swelling index, and tensile strength. As a result of the response surface method-based analysis, the swelling index, in vitro degradation, and tensile strength were linearly related to variations in the formulation of organic components. Based on our experimental investigations, the optimized film (formulation: 1 weight% PVA, 2 weight% starch, 1.5 weight% citric acid, and 1.5 weight% glycerol) exhibited an outstanding swelling index (343.52%), suitable in vitro degradation (53.22%), and excellent tensile strength (8.82 MPa). The response surface plots for the dependent variables, swelling index (SI%), weight loss (WL%), and mechanical strength (TS), showed that in all dual relations, the PVA-starch combination significantly affected all dependent variables; however, the PVA-citric acid interaction showed the most excellent effect on the swelling index. As a result, every component of the resulting film had a lesser amount of all ingredients to achieve better properties at a lower material cost. Starch-based/PVA films have been identified in this paper as optimal and more affordable wound-dressing films.