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Presented here is a compelling case of a patient with a history of untreated hypertension, highlighting symptoms indicative of Wallenberg syndrome, including acute-onset dizziness, visual disturbances, continuous vomiting, difficulty walking, and an altered level of consciousness. This case's significance lies in its clinical presentation and in the diagnostic journey undertaken to elucidate its underlying pathology.Throughout the patient's hospitalization, a comprehensive assessment incorporating clinical, laboratory, and imaging techniques was conducted to delineate the extent of their condition. Of particular significance were the findings derived from MRI and MRA examinations of the endocranium, which provided crucial insights into the underlying pathophysiology.The MRI revealed multifocal ischemic lesions, pointing towards basilar artery thrombosis affecting both vertebral branches and displaying characteristic features associated with Wallenberg syndrome. Notably, the patient's lack of antihypertensive, anticoagulant, or antiplatelet therapy underscores the importance of addressing modifiable risk factors early in the disease course.This case serves as a poignant reminder of the complexities inherent in cerebrovascular diseases, highlighting the imperative of prompt recognition and management of predisposing factors. By presenting this case, we aim to underscore the clinical significance of timely intervention in mitigating potential complications of hypertension, such as cerebral artery thrombosis, thereby emphasizing the importance of proactive patient care and risk factor modification in clinical practice.

Priapism is defined as a form of erectile dysfunction characterized by a prolonged and involuntary penile erection, either partial or complete, occurring without sexual stimulation and lasting for more than 4 hours. Its incidence is estimated to be 0.5-0.9 cases per 100,000 people per year.The most frequent form is ischemic priapism, results from paralysis of the cavernous smooth muscles, which are unable to contract, leading to the stagnation of hypoxic blood within the sinusoidal spaces. Characterized by a painful rigid and sustainable erection.Non-ischemic priapism constitutes a rare entity, unlike the former, this type is typically painless. It is caused by an excessive influx of blood into the penis without a concomitant increase in outgoing blood flow. Blunt trauma is the most commonly reported etiology.And finally, recurrent priapism is characterized by recurrent episodes of prolonged erection and can be challenging to treat, often requiring long-term management to prevent recurrences.We report a case of high-flow priapism in a 10-year old child, secondary to a cavernous arterial fistula following a straddle injury during sports activity. It was suspected clinically and confirmed by ultrasound-Doppler, then successfully treated radiologically with highly selective embolization, with very satisfactory postoperative outcomes.

The paper examines the correlation between patriarchal attitudes, women's asset ownership, participation in household decision-making and women's educational attainment across 27 post-communist countries. It hypothesizes that patriarchal attitudes hinder women's educational achievements while women's asset ownership and participation in household decision-making facilitate them. Utilizing regression analysis, marginal effects, post-regression simulation, the study tests and confirms these hypotheses. Results show that for every unit increase in women's asset ownership and participation in decision-making, the odds of achieving higher educational attainment increase by approximately 35.7% and 16.5%, respectively. Conversely, a unit increase in patriarchal attitudes decreases these odds by 15.8%. The findings underscore the importance of state and civil society commitment to addressing gender disparities in education.

Introduction:Colocasia affinis Schott (Family: Araceae), found in the Asian region, is a traditional root vegetable consumed by the locals and well-known as Dwarf Elephant Ear.Methods: For the pharmacological exploration of this root vegetable, four kupchan fractions (i.e. HSF, DCMSF, EASF, and AQSF) from ethanolic extract of C. affinis were employed to in vitro i.e. antioxidant, cytotoxicity, and antimicrobial and in vivo i.e. antidiarrheal and analgesic assays, followed by phytochemical screening and GC-MS protocol.Result and Discussion: In the antioxidant assay, the AQSF showed promising potential with an IC50 value of 29.4 μg/mL and additionally, it exhibited the greatest overall phenolic content, measuring 57.23 mg GAE/gm. of extract among other fractions. The AQSF also revealed promising cytotoxic activity in brine shrimp lethality assay with an LC50 value of 1.36 μg/mL. Both AQSF and EASF exhibited substantial antimicrobial efficacy against both gram-positive and gram-negative bacteria as well as various fungus species with a remarkable zone of inhibitions compared to standards. Whereas, during both the castor oil-induced antidiarrheal and acetic acid-induced writhing assay, the DCMSF at 400 mg/kg dose exhibited the highest 51.16% reduction of diarrhea and 52.33% reduction of writhing. Phytochemical screening revealed several chemical groups while GC-MS study of different fractions of dwarf elephant ear ethanolic extract revealed 48 different bioactive phytochemicals in total. Several targets such as KAS, DHFR for anti-microbial activities, GLR, URO for antioxidant activities, EGFR, BCL-2 for cytotoxicity, KOR, DOR for antidiarrheal activities and COX-2, TNF-α for analgesic activities are considered for molecular docking against identified phytocompounds and standards along with ADME/T studies to ascertain their safety, efficacy and drug likeliness profiles.Conclusion: To recapitulate, our study revealed that vegetables such as dwarf elephant ear can be considered as a prospective source of therapeutics and drug development besides their nutritive food values.

In this article, we find the Randić spectrum of the weakly zero-divisor graph of a finite commutative ring [Formula: see text] with identity [Formula: see text], denoted as [Formula: see text], where [Formula: see text] is taken as the ring of integers modulo [Formula: see text]. The weakly zero-divisor graph of the ring [Formula: see text] is a simple undirected graph with vertices representing non-zero zero-divisors in [Formula: see text]. Two vertices, denoted as a and b, are connected if there are elements x in the annihilator of a and y in the annihilator of b such that their product xy equals zero. In particular, we examine the Randić spectrum of [Formula: see text] for specific values of [Formula: see text], which are products of prime numbers and their powers.

Abstract Ribosome-inactivating proteins (RIPs) are highly active N-glycosidases that depurinate both bacterial and eukaryotic rRNAs, halting protein synthesis during translation. Found in a diverse spectrum of plant species and tissues, RIPs possess antifungal, antibacterial, antiviral, and insecticidal properties linked to plant defense. In this study, we investigated the physiochemical properties of RIP peptides from the Cucurbitaceae family through bioinformatics approaches. Molecular weight, isoelectric point, aliphatic index, extinction coefficient, and secondary structures were analyzed, revealing their hydrophobic nature. The novelty of this work lies in the comprehensive examination of RIPs from the Cucurbitaceae family and their potential therapeutic applications. The study also elucidated the binding interactions of Cucurbitaceae RIPs with key biological targets, including Interleukin-6 (IL-6). Strong hydrogen bond interactions between RIPs and these targets suggest potential for innovative insilico drug design and therapeutic applications, particularly in cancer treatment. Comprehensive analysis of bond lengths using Ligpolt + software provides insights for optimizing molecular interactions, offering a valuable tool for drug design and structural biology studies.

Abstract The purpose of this paper is to examine the effect of contextual (community) level social trust on women’s empowerment. The specific knowledge gap explored in this study is that the previous studies theorized that community trust has a positive impact on women’s empowerment. Thus, an increase in trust in the community will empower women. However, such an assumption has been never empirically tested and confirmed. Against this backdrop, the present paper develops a theoretical argument on why the increase in community trust should lead to a higher level of women empowerment. Then, a cross-country survey was used as a data source to test the effect of community trust on women’s empowerment. A traditional single-stage OLS and instrumental variable regressions are estimated to test the effect of community trust on women’s empowerment and quantify the magnitude of such impact. The key finding of this paper is that community trust indeed significantly strengthens the empowerment of women by increasing women’s ownership of assets and improving the decision-making authority of women in the family. Importantly, our findings are robust for the separate rural and urban samples, as well as the samples of younger and older women. Equally, our findings are robust for an alternative set of instruments. The main implication of these findings is that policymakers, social administrators, and government authorities who are working on promoting gender equality should give priority to promoting community-based interventions that nurture and maintain women’s trust.

Abstract The standard of care for brain tumors is maximal safe surgical resection. Neuronavigation augments the surgeon’s ability to achieve this but loses validity as surgery progresses due to brain shift. Moreover, gliomas are often indistinguishable from surrounding healthy brain tissue. Intraoperative magnetic resonance imaging (iMRI) and ultrasound (iUS) help visualize the tumor and brain shift. iUS is faster and easier to incorporate into surgical workflows but offers a lower contrast between tumorous and healthy tissues than iMRI. With the success of data-hungry Artificial Intelligence algorithms in medical image analysis, the benefits of sharing well-curated data cannot be overstated. To this end, we provide the largest publicly available MRI and iUS database of surgically treated brain tumors, including gliomas (n = 92), metastases (n = 11), and others (n = 11). This collection contains 369 preoperative MRI series, 320 3D iUS series, 301 iMRI series, and 356 segmentations collected from 114 consecutive patients at a single institution. This database is expected to help brain shift and image analysis research and neurosurgical training in interpreting iUS and iMRI.

Abstract The use of saline water under drought conditions is critical for sustainable agricultural development in arid regions. Biochar is used as a soil amendment to enhance soil properties such as water-holding capacity and the source of nutrition elements of plants. Thus, the research was carried out to assess the impact of biochar treatment on the morphological and physiological characteristics and production of Solanum lycopersicum in greenhouses exposed to drought and saline stresses. The study was structured as a three-factorial in split-split-plot design. There were 16 treatments across three variables: (i) water quality, with freshwater and saline water, with electrical conductivities of 0.9 and 2.4 dS m− 1, respectively; (ii) irrigation level, with 40%, 60%, 80%, and 100% of total evapotranspiration (ETC); (iii) and biochar application, with the addition of biochar at a 3% dosage by (w/w) (BC3%), and a control (BC0%). The findings demonstrated that salt and water deficiency hurt physiological, morphological, and yield characteristics. Conversely, the biochar addition enhanced all characteristics. Growth-related parameters, such as plant height, stem diameter, leaf area, and dry and wet weight, and leaf gas exchange attributes, such rate of transpiration and photosynthesis, conductivity, as well as leaf relative water content were decreased by drought and salt stresses, especially when the irrigation was 60% ETc or 40% ETc. The biochar addition resulted in a substantial enhancement in vegetative growth-related parameters, physiological characteristics, efficiency of water use, yield, as well as reduced proline levels. Tomato yield enhanced by 4%, 16%, 8%, and 3% when irrigation with freshwater at different levels of water deficit (100% ETc, 80% ETc, 60% ETc, and 40% ETc) than control (BC0%). Overall, the use of biochar (3%) combined with freshwater shows the potential to enhance morpho-physiological characteristics, support the development of tomato plants, and improve yield with higher WUE in semi-arid and arid areas.

Postpartum hemorrhage caused by a pseudoaneurysm of the uterine artery is suspected clinically in the case of abundant metrorrhagia. An ultrasound is performed, followed by further imaging modalities to confirm the diagnosis: CT scan, MRI, and angiography, the latter would also allow embolization. This is admittedly rare, however, since the pseudo aneurysm of the uterine artery is potentially fatal, it must be taken into account in the differential diagnosis of secondary postpartum hemorrhage, allowing adequate and rapid management. We report a case of pseudo aneurysm of the uterine artery, suspected clinically and confirmed by a CT scan, presenting as a secondary postpartum hemorrhage a few hours after delivery by cesarean section. It was eventually managed by embolization with excellent results several days after its onset when the cause was revealed. Angiographic embolization is an effective treatment for postpartum hemorrhage caused by pseudoaneurysm in stable patients. It should be considered before surgery in suitable cases.

Purpose: Varicoceles can be a source of elevated seminal oxidative stress (OS) and sperm DNA fragmentation (SDF). However, it remains unclear whether varicocele repair (VR) could reduce these parameters. This systematic review and metaanalysis (SRMA) aims to investigate the impact of VR on SDF and seminal malondialdehyde (MDA). Materials and Methods: A literature search was performed in Scopus, PubMed, Ovid, Embase, and Cochrane databases. This SRMA included randomized controlled trials and observational studies reporting the pre- and postoperative levels of SDF and seminal OS in infertile men with clinical varicocele that underwent VR. Subgroup analyses included techniques of VR and SDF testing. The effect size was expressed as standardized mean difference (SMD). Results: Out of 1,632 abstracts assessed for eligibility, 29 studies with 1,491 infertile men were included. The analysis showed a significant reduction in SDF after VR, compared to preoperative values (SMD –1.125, 95% confidence interval [CI] –1.410, –0.840; p

Background: The advent of Deep Learning initiated a new era in which neural networks relying solely on Whole-Slide Images can estimate the survival time of cancer patients. Remarkably, despite deep learning’s potential in this domain, no prior research has been conducted on image-based survival analysis specifically for peritoneal mesothelioma. Prior studies performed statistical analysis to identify disease factors impacting patients’ survival time. Methods: Therefore, we introduce MPeMSupervisedSurv, a Convolutional Neural Network designed to predict the survival time of patients diagnosed with this disease. We subsequently perform patient stratification based on factors such as their Peritoneal Cancer Index and on whether patients received chemotherapy treatment. Results: MPeMSupervisedSurv demonstrates improvements over comparable methods. Using our proposed model, we performed patient stratification to assess the impact of clinical variables on survival time. Notably, the inclusion of information regarding adjuvant chemotherapy significantly enhances the model’s predictive prowess. Conversely, repeating the process for other factors did not yield significant performance improvements. Conclusions: Overall, MPeMSupervisedSurv is an effective neural network which can predict the survival time of peritoneal mesothelioma patients. Our findings also indicate that treatment by adjuvant chemotherapy could be a factor affecting survival time.

Abstract Background Postural instability and gait abnormalities are frequently observed after an ankle sprain. A modified Four Square Step Test (mFSST) was developed to assess dynamic balance during gait. The aim of this study was to evaluate the reliability and validity of the mFSST in individuals with ankle sprains. Methods The study included 39 individuals with grade 1 and 2 ankle sprains with a mean age of 30.36 ± 6.21 years. The dynamic balance of the participants was assessed with the mFSST and Timed Up & Go test (TUG). To determine the test-retest reliability of the mFSST, the test was repeated approximately 1 h apart. Results The test-retest reliability of the mFSST was excellent (ICC = 0.85). Furthermore, when the concurrent validity of the mFSST was examined, a high correlation was found between with the TUG (r = 0.78, p

Logistics and transport-production processes are critical components in the management of supply chains for enterprises. Increasing demands for the accessibility and efficiency of these processes necessitate further refinement of logistics theory and practice. The primary objective of this research was to establish the interrelationship between the structure and functioning of transport operations within manufacturing enterprises. The application of cluster analysis methods revealed the unique structure of each cluster, reflecting the specificity of transport operations. The obtained results determine the stability of the logistic cluster for a specific type of transport and its impact on overall efficiency. The research also emphasizes the importance of improving the quality of transport-production processes to ensure efficiency in supply chains. Quality and logistics service analysis identified factors that can be enhanced, such as service complexity, responsiveness to unforeseen orders, professionalism of the personnel, and fulfillment of order-related commitments. The conclusions drawn contribute to the development of logistics science and theory, providing practical insights by urging manufacturing companies to implement recommendations for optimizing their transport-production processes and selecting the most effective partners in this context. Thus, the originality of the article lies in expanding theoretical concepts of logistics and defining the specifics of transport-production processes.

Introduction Biochemical exploration of effusion fluids plays a crucial role in the diagnosis of underlying pathologies. This study aimed to evaluate the performance of biochemical ratios and the albumin gradients in the diagnostic process of ascitic fluids. Methods The study was prospective, involving 56 samples from ascitic patients. For each patient, five biochemical parameters (glucose, protein, albumin, LDH, and total amylase) were performed in ascites and plasma samples. The ascites/plasma protein, LDH ratios, and serum-ascites albumin gradients (SAAG), were calculated to evaluate their diagnostic relevance. Results Twenty-eight adult patients presenting ascites were included in this study,18 women (64.28%) and 10 men (35.71%) with an M/F sex ratio of 0.55. The most efficient parameters to distinguish the transudate/exudate concept were: Ascitic proteins (p =0.01), ascitic/plasma proteins (p =0.004), ascitic LDH (p =0.011), ascitic/plasma LDH ratio (p =0.013), ascitic albumin (p = 0.012), ascitic albumin/plasma ratio (p = 0.002) and ascitic glucose/plasma ratio (p = 0.02). A threshold of 14 g/L of Albumine had a better positive predictive value than a threshold set at 20 g/L (73 vs 46%). The sensitivity, specificity, diagnostic efficiency, and positive and negative predictive values for SAAG were 100%, 64%, 78%, 64%, and 100% respectively, and for the modified Light’s criteria 78%, 86%, 82%, 80%, and 82% which had better diagnostic efficiency and specificity than the classic Light’s criteria with the respective comparative value 82 vs 78% and 86 vs 57% but less sensitivity (78 vs 100%). The criteria H20-30, H25, and TAL had good diagnostic efficiency with 75%, 75%, and 78% respectively. Conclusion The integration of biochemical ratios and the albumin’s gradient significantly improves the differential diagnosis of ascites. It is essential to promote the use of these parameters in clinical practice to improve the treatment of patients with ascites

Zinc (Zn) malnutrition is a major concern to many crops and human health in terms of food security. In addition to the Zn deficiency, there was also a serious climate threat to wheat cultivation with global warming causing severe droughts. There is a dire need to develop the synergistic use of organic and inorganic stimulants in enhancing tolerance and nutrient uptake under arid zone agricultural environments. Recently, moringa leaf extract (MLE30) obtained prominence emerging as an organic bio-stimulant and its combined ue with zinc solution (ZnSO4·7H2O) may have potential results in producing the Zn biofortified wheat grains. Two years of field research trials were planned for improving the tolerance with Zn bio-fortified grains by inducing the Zn application via MLE30 as a novel agronomic biofortification approach in Cholistan's arid environment. The experiments laid out by following the various factors including Zn application techniques having treatments control (dry seed), hydro-priming, Zn-priming MLE30, Zn-foliar MLE30, Zn-soil MLE30; wheat cultivars having Ghazi-2019, Zincol-2016; terminal drought stress having treatments normalCondition (irrigation was applied at tillering, booting, grain formation, milking stages), terminal droughtTillering, terminal droughtMilking in experimental research area, Arid Zone Research Institute, Bahawalpur, Pakistan during the winter season 2021–2022 and 2022–2023. A randomized complete block design was used with three factorial designs and replicated thrice. Data revealed the significant interaction of applied various treatments of Zn with MLE30 in wheat cultivars under terminal drought conditions during both years of trials. It was observed that Zn-priming MLE30 improved the morphological growth and yield attributes of the Zincol-16 cultivar under the induced terminal droughtTillering and Milking after normalCondition during year-II as per year-I. Seed Zn-priming MLE30 achieved the maximum results in anti-oxidant contents production against terminal droughtMilking following Tillering as compared to normalCondition in Zincol-16 as per Ghazi-19 wheat plants during the second year of the experiment. Observation illustrated that grains Zn contents obtained the highest values by the applied treatment of seed Zn-priming MLE30 followed by Zn-foliar MLE30, Zn-soil MLE30, hydropriming under the induced terminal droughtTillering as compared to normalCondition during both years of trials. Average economic analysis depicted the best benefit-cost ratio of seed Zn-priming MLE30 treatment under normalCondition followed by terminal droughtMilking in Zincol-16 as compared to Ghazi-19 wheat cultivar. So, the findings of this project research suggested that seed Zn-priming MLE30 with wheat Zincol-16 is the most cost-effective and easily adaptable approach for healthy Zn biofortified grains production during unfavorable terminal drought conditions.

Abstract The escalating presence of heavy metals (HMs) in the Panjkora River water and their impact on fish pose a significant challenge to both the ecological community and human health. Consequently, a study was conducted with the primary aim of elucidating their influence on human health-related issues. To address this, the concentrations of heavy metals, including arsenic (As), cadmium (Cd), iron (Fe), manganese (Mn), lead (Pb), and zinc (Zn), in both water and the fish species Crossocheilus diplocheilus were investigated across various locations within the study area. The quantification of HMs concentration was carried out utilizing an atomic absorption spectrophotometer. The highest concentration in water was found as 0.060 mg/L for Pb and lowest for Fe, whereas the highest concentration in fish was 2.028 mg/kg for Pb and lowest for As. Human health risk associated with fish eating was evaluated by using health risk indices (HRI) for non-carcinogenic health risks and targeted cancer risk (TR) for carcinogenic health risks. The values of the health risk index (HRI) were found greater than 1 except Fe (0.0792), Zn (0.782), and Mn (0.541). The highest mean HRI > 1 was recorded for As (62.99), Cd (26.85), and Pb (10.56). This implies that fish consumption from river Panjkora is not safe up to some extent. Similarly, the TR value for As, Cd, and Pb was found 2.8 $$\times {10}^{-2}$$ × 10 - 2 , 1.6 $$\times {10}^{-2}$$ × 10 - 2 , 2.8 × $${10}^{-3}$$ 10 - 3 which showed cancer risk. There is a detected risk to human health associated with the consumption of fish from the Panjkora River. The government must implement adaptive measures to address this significant issue of water pollution in the study area. Additionally, there is a need for further extensive and prolonged research studies in this context.

Abstract Terminal irrigation drought stress is one of the most drastic abiotic stress to diminish the wheat crop development and grains yield in arid regions of the world. The use of moringa leaf extract (MLE30) via seed priming technique is investigated as an organic and sustainable approach for the mitigation of drought stress along with curtailed seed rate in wheat crop. The study investigated the interaction of organic seed priming: control (dry seeds), hydro-priming, MLE30-priming, seed rate: recommended @ 125 kg ha−1, curtailed @ 25 kg ha−1, and terminal irrigation drought (TID): normal irrigation, mild-TID, severe-TID in wheat crop at agronomic research station, Bahawalpur, Pakistan during the wheat winter season of 2021–2022 and 2022–2023. The application of organic MLE30-priming with curtailed seed rate enhanced antioxidant enzyme activity especially total soluble proteins by 15%, superoxide dismutase by 68%, peroxidase by 16%, catalase by 70%, ascorbic acid by 17% and total protein contents by 91% under severe-TID. Yield and yield-related morphological attributes performed better in MLE30-priming as compared to hydro-priming. An effective trend was observed in the plant's chlorophyll contents, K+, and water use efficiency after being treated with MLE30-priming followed by hydro-priming under curtailed seed rate. The higher benefit–cost ratio and net income return were observed with the application of MLE30-priming with curtailed seed rate under mild-TID and severe-TID. So, it is suggested to adopt the MLE30-priming technique along with a curtailed seed rate for improving the crop establishment, stress regulation, and economic return under limited availability of irrigation water. The project findings recommended that the application of exogenous application of organic MLE30-seed priming favored and compensated the maximum wheat grains production under curtailed seed rate @ 25 kg ha−1 and induced terminal drought stress at flowering and milking conditions.

Purpose: Sperm DNA fragmentation (SDF) is a functional sperm abnormality that can impact reproductive potential, for which four assays have been described in the recently published sixth edition of the WHO laboratory manual for the examination and processing of human semen. The purpose of this study was to examine the global practices related to the use of SDF assays and investigate the barriers and limitations that clinicians face in incorporating these tests into their practice. Materials and Methods: Clinicians managing male infertility were invited to complete an online survey on practices related to SDF diagnostic and treatment approaches. Their responses related to the technical aspects of SDF testing, current professional society guidelines, and the literature were used to generate expert recommendations via the Delphi method. Finally, challenges related to SDF that the clinicians encounter in their daily practice were captured. Results: The survey was completed by 436 reproductive clinicians. Overall, terminal deoxynucleotidyl transferase deoxyuridine triphosphate Nick-End Labeling (TUNEL) is the most commonly used assay chosen by 28.6%, followed by the sperm chromatin structure assay (24.1%), and the sperm chromatin dispersion (19.1%). The choice of the assay was largely influenced by availability (70% of respondents). A threshold of 30% was the most selected cut-off value for elevated SDF by 33.7% of clinicians. Of respondents, 53.6% recommend SDF testing after 3 to 5 days of abstinence. Although 75.3% believe SDF testing can provide an explanation for many unknown causes of infertility, the main limiting factors selected by respondents are a lack of professional society guideline recommendations (62.7%) and an absence of globally accepted references for SDF interpretation (50.3%). Conclusions: This study represents the largest global survey on the technical aspects of SDF testing as well as the barriers encountered by clinicians. Unified global recommendations regarding clinician implementation and standard laboratory interpretation of SDF testing are crucial.

Background: Chronic anal fissure is recognized for its profound impact on quality of life and the propensity for treatment relapse, underscoring the need to explore safe and alternative clinical interventions. Unani medicine offers a wealth of therapeutic approaches for anal fissures, yet empirical evidence remains limited. Objective: This study aimed to assess the efficacy of the Unani formulation Marham Safeda Kafoori in treating chronic anal fissures. Methods: Seven patients with chronic anal fissures underwent a 14-day treatment with Marham Safeda Kafoori. Concurrently, two Unani interventions, namely Habb-e-Bawaseer Amya and Habb-e-Muqil, were administered for the management of constipation. Therapeutic response was assessed using a 100mm Visual Analog Scale for anal pain and burning sensations, alongside evaluating non-hemorrhoidal rectal bleeding and fissure healing status. Results: Following a two-week follow-up, pain and burning decreased significantly. Similarly, all the cases were healed completely with no instances of rectal bleeding. Conclusion: The trial formulation demonstrated promising efficacy in the management of anal fissures, with no observed adverse effects. Nevertheless, it is prudent to recommend rigorous prospective clinical investigations to validate its scientific soundness.

Abstract Heavy metals like Cadmium, Lead, and Chromium are the pollutants emitted into the environment through industrial development. In this work, a new diphenylamine coordinated cobalt complex (Co-DPA) has been synthesized and tested for its efficiency in removing heavy metals from wastewater, and its adsorption capacity was investigated. The effectiveness of heavy metals removal by Co-DPA was evaluated by adjusting the adsorption parameters, such as adsorbent dose, pH, initial metals concentration, and adsorption period. Heavy metal concentrations in real sample were 0.267, 0.075, and 0.125 mg/L for Cd2+, Pb2+, and Cr3+ before using as-synthesized Co-DPA to treat wastewater. After being treated with synthesized Co-DPA the concentration of heavy metals was reduced to 0.0129, 0.00028, 0.00054 mg/L for Cd2+, Pb2+, and Cr3+, respectively, in 80 min. The removal efficiency was 95.6%, 99.5%, and 99.5% for the respective metals. The adsorption process fitted satisfactorily with Freundlich isotherm with R2(0.999, 0.997, 0.995) for Cd2+, Pb2+, and Cr3+, respectively. The kinetic data obeyed the pseudo-second order for Cd2+ and Cr2+ and the pseudo-first order for Pb2+. Based on the results obtained within the framework of this study, it is concluded that the as-synthesized Co-DPA is a good adsorbent to eliminate heavy metal ions like Cd2+, Pb2+, and Cr3+from wastewater solution. In general, Co-DPA is a promising new material for the removal of heavy metal ions from water. Graphical Abstract

Abstract In soilless cultivation, plants are grown with nutrient solutions prepared with mineral nutrients. Beneficial microorganisms are very important in plant nutrition. However, they are not present in soilless culture systems. In this study we investigated the impact of introducing Plant Growth Promoting Rhizobacteria (PGPR) as an alternative to traditional mineral fertilizer in hydroponic floating lettuce cultivation. By reducing mineral fertilizers at various ratios (20%, 40%, 60%, and 80%), and replacing them with PGPR, we observed remarkable improvements in multiple growth parameters. Applying PGPR led to significant enhancements in plant weight, leaf number, leaf area, leaf dry matter, chlorophyll content, yield, and nutrient uptake in soilles grown lettuce. Combining 80% mineral fertilizers with PGPR demonstrated a lettuce yield that did not significantly differ from the control treatment with 100% mineral fertilizers. Moreover, PGPR application improved the essential mineral concentrations and enhanced human nutritional quality, including higher levels of phenols, flavonoids, vitamin C, and total soluble solids. PGPR has potential as a sustainable substitute for synthetic mineral fertilizers in hydroponic floating lettuce cultivation, leading to environmentally friendly and nutritionally enriched farming.

Artificial intelligence (AI) in medicine has gained a lot of momentum in the last decades and has been applied to various fields of medicine. Advances in computer science, medical informatics, robotics, and the need for personalized medicine have facilitated the role of AI in modern healthcare. Similarly, as in other fields, AI applications, such as machine learning, artificial neural networks, and deep learning, have shown great potential in andrology and reproductive medicine. AI-based tools are poised to become valuable assets with abilities to support and aid in diagnosing and treating male infertility, and in improving the accuracy of patient care. These automated, AI-based predictions may offer consistency and efficiency in terms of time and cost in infertility research and clinical management. In andrology and reproductive medicine, AI has been used for objective sperm, oocyte, and embryo selection, prediction of surgical outcomes, cost-effective assessment, development of robotic surgery, and clinical decision-making systems. In the future, better integration and implementation of AI into medicine will undoubtedly lead to pioneering evidence-based breakthroughs and the reshaping of andrology and reproductive medicine.

Flavonoids are organic compounds characterized by a range of phenolic structures, which are abundantly present in various natural sources such as fruits, vegetables, cereals, bark, roots, stems, flowers, tea, and wine. The health advantages of these natural substances are renowned, and initiatives are being taken to extract the flavonoids. Apigenin, galangin, hesperetin, kaempferol, myricetin, naringenin, and quercetin are the seven most common compounds belonging to this class. A thorough analysis of bibliographic records from reliable sources including Google Scholar, Web of Science, PubMed, ScienceDirect, MEDLINE, and others was done to learn more about the biological activities of these flavonoids. These flavonoids appear to have promising anti-diabetic, anti-inflammatory, antibacterial, antioxidant, antiviral, cytotoxic, and lipid-lowering activities, according to evidence from in vitro, in vivo, and clinical research. The review contains recent trends, therapeutical interventions, and futuristic aspects of flavonoids to treat several diseases like diabetes, inflammation, bacterial and viral infections, cancers, and cardiovascular diseases. However, this manuscript should be handy in future drug discovery. Despite these encouraging findings, a notable gap exists in clinical research, hindering a comprehensive understanding of the effects of flavonoids at both high and low concentrations on human health. Future investigations should prioritize exploring bioavailability, given the potential for high inter-individual variation. As a starting point for further study on these flavonoids, this review paper may promote identifying and creating innovative therapeutic uses.

To understand the effect of different natural and chemical admixtures on the properties of conventional and high strength concrete, an extensive literature review was done. It is known that chemical admixtures are composed of substances that are added to concrete to improve different aspects in fresh and hardened states and polycarboxylate PCE is one of the admixtures that have significantly contributed to the development of conventional concrete. Since the effect of different types of chemical admixtures can arise when concrete particles containing admixtures is dumped after a building has been demolished or when they are thrown out into the surroundings, Therefore, it is required to identify alternative admixtures that improve the qualities of concrete without negatively impacting the environment. Various natural organic elements have been studied incorporated in concrete and mortar in the past and recently. There are Organic admixtures such as molasses, black gram, potato starch, egg white, and cactus adhesive juice etc. are among the organic substances that enhance the workability, compressive strength, tensile strength, plasticity, and durability, etc. throughout this work the behaviour of natural plant extracts used as admixtures and fibres in concrete with and without the combination of certain types of other admixtures have been explored.

Current study aims to explore the relationship among cognitive flexibility variables (alternative and control) and effective problem solving variables (impulsive, reflective, avoidant, monitoring, problem solving confidence, and planfulness) in school principals’ sample. The population of the research consists of 564 school administrators working in public schools in Siirt, Turkey, in the 2020-2021 academic year. Research data were collected from 50 female and 261 male administrators who volunteered to participate in the research among school administrators. "Cognitive Flexibility Inventory" and "Problem Solving Inventory" were used as data collection tools in the study. Two independent t-tests were conducted to examine gender differences in participants' both cognitive flexibility and overall problem-solving scores. According to the research findings, it was determined that school administrators' cognitive flexibility levels and problem solving skills did not differ significantly according to gender. The canonical correlation analyze was utilized to test interrelationship between two set of variables. The canonical correlation analyze revealed two significant canonical functions. The findings of first canonical function indicated that, when both alternative and control sub-dimension of cognitive flexibility and total cognitive flexibility scores increase impulsive and avoidant scores decrease, while reflective, monitoring, problem solving confidence, and planfulness sub-dimensions of effective problem solving and total problem solving scores increase. The results also showed that there was a high and a positive correlation between overall cognitive flexibility level of school administrations and their effective problem solving skills. The findings of second canonical function also indicated that when alternative scores increase and control scores decrease, reflecting, monitoring, and impulsive problem solving scores decrease. Overall, the results suggest that the cognitive flexibility and effective problem solving nicely complement each other. In these respect, in order to be equipped to effectively solve problems, school principals need to be also equipped with cognitive flexibility skills.

Researchers have been interested in honey bee, Apis mellifera L., venom for many years, but the previous studies focused mainly on its pharmacological properties and the factors affecting its production and chemical content were less well evaluated. This research aims to investigate the potential effect of the method of collecting bee venom on its chemical content. To achieve this, brass, steel, aluminium and copper wire conductors were used. This research was carried out at Van YYU Beekeeping Application and Research Centre, where the venom was collected dry on glass plates from 16 Caucasian F1 honey bee colonies. The quantity produced and its composition in terms of melittin, apamin and phospholipase A2 were determined after storage. Duncan and LSD Multiple Comparison tests on the amounts of venom collected using aluminium, copper, steel and brass wires for conducting electricity, revealed it was 21.03 ± 3.50, 15.08 ± 0.32, 22.38 ± 6.35 and 30.35 ± 3.66 mg, respectively. Although these values differed significantly (p < 0.05), the chemical content of the bee venom was the same. The colour of the venom was associated with the material of the electrical conductor used. It was concluded that it would be beneficial to carry out further studies using more colonies along with using residue analysis.

Background-The high mortality of cirrhosis is a global public health problem. For predicting the outcome of patients with cirrhosis, many prognostic models were proposed.The new Model for End-Stage Liver Disease including serum sodium (MELD-Na) has been proposed as an alternative to the original MELD, to increase the accuracy of the score in predicting short-term mortality. The purpose of this study was to assess the ability of MELD-Na scoring system to predict three-month mortality among cirrhotic patients, and comparing it to the MELD score. Methods-An observational study was carried out, at the Hepato-Gastro-Enterology De­partment of the University Hospital Center of Oran. A retrospective review of the medical records of all patients with cirrhosis, between 1st January 2019 and 31st December 2021, was performed. Among 103 patients, 47 were selected after excluding the patients who were lost to follow-up after three months or with missing data. The information collected included demographic data, clinical characteristics and laboratory values of: bilirubin, creatinine, international normalized ratio (INR) of prothrombin and sodium. The MELD-Na and MELD scores were calculated using online calculators, then the ability of the mo­dels to predict the risk of mortality at three months was assessed, using the area under the receiver operating characteristic curve (AUC). Results - : Eight (17%) patients died at three months. The MELD-Na and MELD both had significantly high area under the curve (AUC): MELD-Na: 0.952, 95% confidence interval [CI]: 0.885–1.00, MELD: 0.931, 95% confidence interval [CI]: 0.834–1.000. The MELD-Na score was slightly better than the MELD, with a sensitivity and a specificity of 87.5% and 87.2%, respectively, for a cut-off value = 21. Conclusion -The MELD-Na score seems to be a good predictor of mortality at three mon­ths among patients with cirrhosis..

The current COVID-19 pandemic is caused by the novel SARS-CoV-2 coronavirus strain. Although SARS-CoV-2 infection can affect everyone, the kind and degree of infection and sickness vary widely between individuals and populations. It has been crucial since reported disease loads and case fatality rates vary greatly among countries. However, there are still uncertainties about the severity of the illness in certain people and, in other cases, the aetiology of a more severe illness. Various chronic conditions, such as diabetes, cardiovascular diseases, respiratory ailments, and immunodeficiency disorders, have been identified as significant risk factors for COVID-19. These comorbidities not only increase the susceptibility to contracting the virus but also exacerbate the severity of symptoms and the likelihood of adverse outcomes, including hospitalization, intensive care unit admission, and mortality. The objective of this article is to point out the proliferation of COVID-19 in relation to different diseases affecting the clinical outcome of COVID-19. The study included 1500 patients with various diseases such as HCV, HBV, kidney disease, heart disease, asthma, T.B., arthritis, smokers, and vaccinated or unvaccinated. Results showed that 22% of diabetic patients, 40% of heart patients, 40% of asthma patients, 26% of kidney patients, 25% of T.B patients, and 41% of smokers had high corona positive. Coronavirus positivity was found in 34% of vaccinated patients and 72% of non-vaccinated patients, with an overall calculated p-value of 0.0001 by ANOVA statistical analysis. The overall outcome of the results showed that the severity of Corona disease increased in relation to different diseases.

Abstract During the seasons with limited light intensity, reductions in growth, yield, and quality are challenging for commercial cut rose production in greenhouses. Using artificial supplemental light is recommended for maintaining commercial production in regions with limited light intensity. Nowadays, replacing traditional lighting sources with LEDs attracted lots of attention. Since red (R) and blue (B) light spectra present the important wavelengths for photosynthesis and growth, in the present study, different ratios of supplemental R and B lights, including 90% R: B 10% (R90B10), 80% R: 20% B (R80B20), 70% R: 30% B (R70B30) with an intensity of 150 µmol m−2 s−1 together with natural light and without supplemental light (control) were applied on two commercial rose cultivars. According to the obtained results, supplemental light improved growth, carbohydrate levels, photosynthesis capacity, and yield compared to the control. R90B10 in both cultivars reduced the time required for flowering compared to the control treatment. R90B10 and R80B20 obtained the highest number of harvested flower stems in both cultivars. Chlorophyll and carotenoid levels were the highest under control. They had a higher ratio of B light, while carbohydrate and anthocyanin contents increased by having a high ratio of R light in the supplemental light. Analysis of chlorophyll fluorescence was indicative of better photosynthetic performance under a high ratio of R light in the supplemental light. In conclusion, the R90B10 light regime is recommended as a suitable supplemental light recipe to improve growth and photosynthesis, accelerate flowering, and improve the yield and quality of cut roses.

Background: Anemia, “a hidden hunger” is among one the major nutritional public health problems across the globe affecting both developed and developing countries. In children, it results in impaired cognitive performance, behavioral, linguistic development and scholastic achievement. The study aimed to estimate the frequency and new risk factors of anemia in school-going children of Peshawar. Methods: A cross-sectional study was conducted from February 2020 to January 2022. A sample of 240 children between the ages of 5-15 years from eight different schools, were selected. The data was analyzed using SPSS version 20 for windows. Chi-square test was used to see association between different variables. p≤0.05 was taken as a minimum level of significance. Results: Among a total of 240 school-going children, 93 (38.75%) were anemic and 147 (61.2%) were non-anemic. The anemia prevalence was higher in female children and younger age groups. The percentage of anemic children was significantly higher who don’t take nutritional supplements (19.7%) compared to those who do (47.5%) (p˂0.001). The anemic children with worm infestation history, were significantly higher (51.6%) in number compared to (25.4%) without infestation (p˂0.001). Majority (66.6%) of children from lower socioeconomic groups were anemic (p˂0.001). Conclusion: Children, school-going, and vegetarian were found significantly anemic (p

The increasing instability within the global oil sector poses a challenge for contemporary companies to devise and implement effective financial stability strategies. The aim of this study is to analyse the financial stability strategies employed by oil companies, explore alternative approaches amidst the global volatility of the oil market, and develop a methodological framework for evaluating financial strategies, utilising an alternative options matrix. The author's methodological approach is proposed: a matrix of the company's alternative financial strategies is created. In this study, data from the top 10 largest oil companies in the world for the years 2015–2019 were utilised. Exxon Mobil and CNPC exhibit the lowest level of financial stability. A sustainable growth strategy is necessary for Aramco, Rosneft, and ADNOK. Kazmunaigas should adopt a strategy focused on ensuring financial stability in the event of adverse external conditions. For Exxon Mobil, maintaining financial stability is a relevant strategy. CNPC should consider implementing a financial stabilisation strategy contingent upon favourable market dynamics. The practical significance of the research results lies in providing specific conclusions and recommendations regarding optimal financial stability strategies for oil companies and stakeholders amidst global market volatility conditions. The analysis of the alternative financial strategies matrix may serve as a foundation for managerial decision-making aimed at ensuring company resilience in fluctuating economic environments and enhancing their competitiveness.

Objective: Deep neck space abscess (DNSA) is a serious infection associated with immune response. Magnesium has fundamental multifunctions in the body. Its insufficiency is involved in immüne weakness and susceptibility to infectious diseases. The present study addressed serum magnesium status in patients with DNSA. Herein, we hypothesized that patients with DNSA may have decreased serum magnesium concentration. Materials and Methods: In the study, 23 patients with DNSA and 23 matched healthy individuals were included. The atomic absorption spectrometry was used to measure serum magnesium concentration. The groups were compared statistically for demographics and serum magnesium concentration. Results: Patients with DNSA and healthy controls were statistically similar in age ( p = .625), gender ( p = 1.0), and smoking status ( p = 1.0). However, patients with DNSA had significantly decreased serum magnesium concentration (µg/dL) than healthy controls [25.23 ± 4.98 (19.9-42.2) versus 31.98 ± 5.36 (26.8-40.8)], ( p < .001). Conclusion: This study demonstrated that decreased serum magnesium concentration is associated with DNSA. It is the first report on the research topic, and may inspire future studies.

Ocimum basilicum L. is one of the most important medicinal and vegetable crops due to its essential oil, pleasant aroma and taste. In this study, we evaluated the impact of different light intensities, including 100 %, 50 %, and 30 % of natural sunlight, on the growth, phytochemical compositions, and antioxidant activity of green and purple basil cultivars at two different harvest times: early morning and noon. The height of the plant, number of leaves per plant, length of the petiole, diameter of the stem, and fresh and dry weight of the shoot were all reduced by decreasing light intensity in both basil cultivars. When the plants of both cultivars were grown under full light intensity and were sampled at noon, they showed the highest phenolic and flavonoid contents. The highest antioxidant activity was detected in purple basil cultivars grown under 30 and 50 % of sunlight in both harvests. The green basil cultivar showed the highest antioxidant activity when exposed to 30 % sunlight and harvested in the early morning. The highest essential oil content and yield in both basil cultivars were obtained under full sunlight in the early morning harvests. In summary, light intensity and harvest time influence the phytochemical yield, composition, and growth of two studied basil cultivars. Optimal results, particularly for medicinal purposes, were achieved by morning harvesting to maximize the essential oil yield of basils.

This study evaluated the long-term effects of mesophilic (MAD) and thermophilic (TAD) anaerobic digestion on the fate and evolution of antimicrobial resistance genes (ARGs) and mobile genetic elements (MGEs) in cattle manure following a metagenomic approach. The results indicated that MAD and TAD lowered ARG levels in fresh cattle manure by over 50 % and MGEs by over 65 %. However, no statistically significant difference was observed between the MAD and TAD processes in terms of their ability to reduce ARG and MGE. Co-occurrence analysis suggested facultative anaerobic species belonging to the Bacillota and Actinomycetota phyla as the primary potential hosts of ARGs and MGEs. Analyses of co-assembled contigs revealed the presence of transposon and toxin-antitoxin systems in close proximity to ARGs typically found in anaerobic digesters. The identification of these systems near ARGs is particularly significant, as it highlights a potential mechanism for the persistence and spread of ARGs in such environments. Overall, the results indicated that digested cattle manure (whether under mesophilic or thermophilic conditions) would pose a much lower risk of dissemination of antimicrobial resistance than untreated manures. Since TAD did not outperform MAD at reducing ARGs and MGEs, thermophilic temperatures may not be necessary to improve ARG reduction rates in cattle manure AD. These valuable insights could help develop strategies to reduce the dissemination of antibiotic resistance due to manure treatment and disposal.

The study was aimed to assess the impact of adding eggshells as calcium sources in broiler diets on carcass traits, meat quality, and chemical composition ,three hundred one-day-old broiler chicks were randomly designed CRD . Each treatment included five replications and each replicate containing twenty birds. The dietary of first treatment was control (0% eggshell) the second and the third treatments were eggshell powder as a replacement for limestone at 50% and 100%, respectively. .The chickens were fed a basal diet during the starting and finished periods. Ten broilers were chosen randomly from each treatment group and slaughtered at age 42 days to evaluate meat quality. The results showed that no significant differences (p< 0.05) between treatments regarding pre-slaughter in live body weight, carcass weight, and percentage of each carcass cuts weight, as well as immunological organs such as the spleen and bursa. However, a substantial difference in dressing percentage was observed. Except for pH, yellowness, and chroma, no significant differences were noticed in drip loss, cooking loss, lightness, redness, color ,tenderness. Meanwhile, the bird chemical composition treatments had no significant differences in moisture, protein, and ash percentages. However, there was a considerable change in fat %. Except for broilers' pH, yellowness, and chroma, the substitution of eggshell powder for limestone resulted in comparable carcass characteristics, chemical composition, and meat quality. However, there was a significantly differ in fat %. Except for broilers' pH, yellowness, and chroma, the substitution of eggshell powder for limestone resulted in comparable of some carcass characteristics, chemical composition, and meat quality.

Abstract In this article, by using the notion of quantum calculus, we define a new type Szász–Mirakjan operators based on the q-integers. We derive a recurrence formula and calculate the moments Φ n , q ( t m ; x ) $\Phi _{n,q}(t^{m};x)$ for m = 0 , 1 , 2 $m=0,1,2$ and the central moments Φ n , q ( ( t − x ) m ; x ) $\Phi _{n,q}((t-x)^{m};x)$ for m = 1 , 2 $m=1,2$ . We give estimation for the first and second-order central moments. We present a Korovkin type approximation theorem and give a local approximation theorem by using modulus of continuity. We obtain a local direct estimate for the new Szász–Mirakjan operators in terms of Lipschitz-type maximal function of order α. Finally, we prove a Korovkin type weighted approximation theorem.

Abstract Hereditary hearing loss (HL) is a genetically heterogeneous disorder affecting people worldwide. The implementation of advanced sequencing technologies has significantly contributed to the identification of novel genes involved in HL. In this study, probands of two Turkish families with non-syndromic moderate HL were subjected to exome sequencing. The data analysis identified the c.600G > A (p.Thr200Thr) and c.1863dupG (p.His622fs) variants in GPR156, which co-segregated with the phenotype as an autosomal recessive trait in the respective families. The in silico predictions and a minigene assay showed that the c.600G > A variant disrupts mRNA splicing. This gene belongs to the family of G protein-coupled receptors whose function is not well established in the inner ear. GPR156 variants have very recently been reported to cause HL in three families. Our study from a different ethnic background confirms GPR156 as a bona fide gene involved in HL in humans. Further investigation towards the understanding of the role of GPCRs in the inner ear is warranted.

Abstract Background Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized by impaired social and communication skills, restricted interests, and repetitive behaviors. The prevalence of ASD among children in Qatar was recently estimated to be 1.1%, though the genetic architecture underlying ASD both in Qatar and the greater Middle East has been largely unexplored. Here, we describe the first genomic data release from the BARAKA-Qatar Study—a nationwide program building a broadly consented biorepository of individuals with ASD and their families available for sample and data sharing and multi-omics research. Methods In this first release, we present a comprehensive analysis of whole-genome sequencing (WGS) data of the first 100 families (372 individuals), investigating the genetic architecture, including single-nucleotide variants (SNVs), copy number variants (CNVs), tandem repeat expansions (TREs), as well as mitochondrial DNA variants (mtDNA) segregating with ASD in local families. Results Overall, we identify potentially pathogenic variants in known genes or regions in 27 out of 100 families (27%), of which 11 variants (40.7%) were classified as pathogenic or likely-pathogenic based on American College of Medical Genetics (ACMG) guidelines. Dominant variants, including de novo and inherited, contributed to 15 (55.6%) of these families, consisting of SNVs/indels (66.7%), CNVs (13.3%), TREs (13.3%), and mtDNA variants (6.7%). Moreover, homozygous variants were found in 7 families (25.9%), with a sixfold increase in homozygous burden in consanguineous versus non-consanguineous families (13.6% and 1.8%, respectively). Furthermore, 28 novel ASD candidate genes were identified in 20 families, 23 of which had recurrent hits in MSSNG and SSC cohorts. Conclusions This study illustrates the value of ASD studies in under-represented populations and the importance of WGS as a comprehensive tool for establishing a molecular diagnosis for families with ASD. Moreover, it uncovers a significant role for recessive variation in ASD architecture in consanguineous settings and provides a unique resource of Middle Eastern genomes for future research to the global ASD community.

Purpose: Sperm DNA fragmentation (SDF) has been associated with male infertility and poor outcomes of assisted reproductive technology (ART). The purpose of this study was to investigate global practices related to the management of elevated SDF in infertile men, summarize the relevant professional society recommendations, and provide expert recommendations for managing this condition. Materials and Methods: An online global survey on clinical practices related to SDF was disseminated to reproductive clinicians, according to the CHERRIES checklist criteria. Management protocols for various conditions associated with SDF were captured and compared to the relevant recommendations in professional society guidelines and the appropriate available evidence. Expert recommendations and consensus on the management of infertile men with elevated SDF were then formulated and adapted using the Delphi method.Results: A total of 436 experts from 55 different countries submitted responses. As an initial approach, 79.1% of reproductive experts recommend lifestyle modifications for infertile men with elevated SDF, and 76.9% prescribe empiric antioxidants. Regarding antioxidant duration, 39.3% recommend 4–6 months and 38.1% recommend 3 months. For men with unexplained or idiopathic infertility, and couples experiencing recurrent miscarriages associated with elevated SDF, most respondents refer to ART 6 months after failure of conservative and empiric medical management. Infertile men with clinical varicocele, normal conventional semen parameters, and elevated SDF are offered varicocele repair immediately after diagnosis by 31.4%, and after failure of antioxidants and conservative measures by 40.9%. Sperm selection techniques and testicular sperm extraction are also management options for couples undergoing ART. For most questions, heterogenous practices were demonstrated. Conclusions: This paper presents the results of a large global survey on the management of infertile men with elevated SDF and reveals a lack of consensus among clinicians. Furthermore, it demonstrates the scarcity of professional society guidelines in this regard and attempts to highlight the relevant evidence. Expert recommendations are proposed to help guide clinicians.

INTRODUCTION. Urinary incontinence in children is an interdisciplinary problem. The prevalence of urinary incontinence ranges from3.1% to 8.6% and decreases with age. Urinary incontinence can be caused by both organic (diseases of the genitourinary system,neurological pathology) and functional causes. One of the methods of non-drug correction of urinary incontinence is extracorporealmagnetic stimulation, used in adult patients. At the same time, the effectiveness of the method among the pediatric population hasnot been sufficiently studied. AIM. To study the effectiveness and safety of extracorporeal magnetic stimulation in the comprehensive rehabilitation of children withneurogenic urinary incontinence. MATERIAL AND METHODS. A prospective open randomized controlled clinical study included 75 pediatric patients (from 5 years to 16years and 6 months) with a clinical form of day and night urinary incontinence, who were divided by simple randomization into a maingroup (n=39), who received a standard rehabilitation and extracorporeal magnetic stimulation program for 21 days, and a comparisongroup (n=36), in which the standard rehabilitation program did not include the use of extracorporeal magnetic stimulation. RESULTS AND DISCUSSION. A prospective open randomized comparative study revealed that the clinical effectiveness of theextracorporeal magnetic stimulation method in the comprehensive rehabilitation of children with neurogenic urinary incontinenceis 94.8%, which is 25.4% higher than in the comparison group. After treatment, patients in the main group had a noticeable decreasein urinary incontinence episodes, an increase in the micturition volume, and an improvement in the quality of life. Patients withvarious background neurological pathology responded to treatment, which indicates the common pathogenetic mechanisms of thedevelopment of lower urinary tract symptoms in these conditions and the independence of the final effect from the basic diagnosis. CONCLUSION. The use of the perineal extracorporeal magnetic stimulation method in children with neurogenic urinary incontinenceincreases the effectiveness of rehabilitation and is a promising and safe direction of rehabilitation treatment.

Objective: Circumcision is one of the most common surgical procedures in the world which is performed for various reasons. The aim is to investigate whether people's satisfaction with circumcision, their perspectives on circumcision, and whether there is a connection between circumcision and psychological/urological problems. Materials and Methods: Between 21 March 2023- 10 April 2023, 1009 men aged between 18- 50 who volunteered to participate in the survey were included in the study. Demographic structures of the people (age, education, income status), age of circumcision, by whom, where and with what type of anesthesia; problems during circumcision, satisfaction with circumcision, any sexual and psychological problems and the relationship of this problem with circumcision were investigated. Results: Mean age of 1009 participants was 32.02±9.15 and mean age of circumcision was 6.18±3.10. 269 (26.7%) men stated that they experienced circumcision complications and 145 (14.4%) stated that they were not satisfied with circumcision. 267 men (26.5%) had sexual or urological problems, and 274 (27.2%) had psychological problems, but the relationship of both problems with circumcision was not significant. Both sexual/urological problems and psychological problems were found to be significantly higher in the group satisfied with circumcision (both p:0.000, p

Abstract Background Bangladesh outperforms its Least Developed Country (LDC) status on a range of health measures including life expectancy. Its frontline medical practitioners, however, are not formally trained medical professionals, but instead lightly-trained ‘village doctors’ able to prescribe modern pharmaceuticals. This current study represents the most complete national survey of these practitioners and their informal ‘clinics’. Methods The study is based on a national Computer Assisted Telephone Interviewing (CATI) of 1,000 informal practitioners. Participants were sampled from all eight divisions and all 64 districts of Bangladesh, including 682 participants chosen from the purposively recruited Refresher Training program conducted by the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B), supplemented with 318 additional participants recruited through snowball sampling. Primary and secondary outcome measures In addition to demographics, village doctors were asked about the characteristics of their ‘clinics’ including their equipment, their training, income and referral practices. Results Three quarters of the wholly male sample had not completed an undergraduate program, and none of the sample had received any bachelor-level university training in medicine. Medical training was confined to a range of short-course offerings. Village doctor ‘clinics’ are highly dependent on the sale of pharmaceuticals, with few charging a consultation fee. Income was not related to degree of short-course uptake but was related positively to degree of formal education. Finally, practitioners showed a strong tendency to refer patients to the professional medical care system. Conclusions Bangladesh’s village doctor sector provides an important pathway to professional, trained medical care, and provides some level of care to those who cannot afford or otherwise access the nation’s established healthcare system. However, the degree to which relatively untrained paramedical practitioners are prescribing conventional medicines has concerning health implications.

Red oregano (Origanum vulgare L. subsp. vulgare) is native to the mountainous slopes of Albania, thriving at altitudes ranging from 400 to 1300 m above sea level. The aerial components of oregano have been found to address a spectrum of health concerns. However, this subspecies presents intriguing characteristics that require comprehensive exploration and analysis. This study extensively analyzes the ex −situ collection of various genotype populations of red oregano in Albania. Essential oils were extracted by employing the hydrodistillation method. At the same time, their chemical analyses were carried out using gas chromatography coupled with a flame ionization detector (GC−FID) and gas chromatography coupled with a mass−spectrometer detector (GS−MS). We employed two statistical techniques, namely hierarchical cluster analysis (HCA) and principal component analysis (PCA), which allowed for a comprehensive examination of the relationships within the data set and more profound insights into the compositional patterns and interrelationships within the essential oils to be gained. The results revealed significant qualitative distinctions at the intraspecific level, particularly for sesquiterpenes, of populations originating from seven diverse geographic locations. The study’s findings enhance our understanding of the chemical composition of Albania’s red oregano and its chemical variation among different populations, which will potentially contribute to identifying the most suitable clones for breeding programs within red oregano populations.

Gamma radiation has been suggested to have post-effects on emerging plants when applied to the seeds. In the present study, we aimed to induce alterations in photosynthetic functionality and subsequent modifications in secondary metabolites of summer savory following seed priming with gamma radiation. Savory seeds were treated with 0, 50, 100, 200, and 300 Gy gamma radiation in a completely randomized design with ten replications for morphological and photosynthetic parameters and three for phytochemical assessments. The results showed that gamma radiation on seeds adversely affected photosynthetic performance, especially at the highest doses. It negatively influenced the growth, while increasing the shoot branching, the number of nodes, and the diameter of the stem. Gamma radiation on seeds generally reduced pigmentation in savory leaves, such as chlorophylls, carotenoids, and anthocyanins. However, soluble sugar, starch, total phenolics, and total flavonoid contents were elevated in the leaves of plants that emerged from gamma-primed seeds. Gamma radiation priming reduced essential oil’s percentage and yield. Carvacrol and limonene components of essential oil were diminished, whereas linalool and thymol were increased. In conclusion, due to its inherent stress-inducing effects, and despite some positive effects on phytochemicals, seed priming with gamma radiation adversely influenced growth, photosynthesis, and quantity and quality of savory essential oils. Further research is still needed to target the use of gamma radiations before harvesting the seeds or determine the cytogenetic characteristics of irradiated plants.