Towards dental diagnostic systems: Synergizing wavelet transform with generative adversarial networks for enhanced image data fusion.

The advent of precision diagnostics in pediatric dentistry is shifting towards ensuring early detection of dental diseases, a critical factor in safeguarding the oral health of the younger population. In this study, an innovative approach is introduced, wherein Discrete Wavelet Transform (DWT) and Generative Adversarial Networks (GANs) are synergized within an Image Data Fusion (IDF) framework to enhance the accuracy of dental disease diagnosis through dental diagnostic systems. Dental panoramic radiographs from pediatric patients were utilized to demonstrate how the integration of DWT and GANs can significantly improve the informativeness of dental images. In the IDF process, the original images, GAN-augmented images, and wavelet-transformed images are combined to create a comprehensive dataset. DWT was employed for the decomposition of images into frequency components to enhance the visibility of subtle pathological features. Simultaneously, GANs were used to augment the dataset with high-quality, synthetic radiographic images indistinguishable from real ones, to provide robust data training. These integrated images are then fed into an Artificial Neural Network (ANN) for the classification of dental diseases. The utilization of the ANN in this context demonstrates the system's robustness and culminates in achieving an unprecedented accuracy rate of 0.897, 0.905 precision, recall of 0.897, and specificity of 0.968. Additionally, this study explores the feasibility of embedding the diagnostic system into dental X-ray scanners by leveraging lightweight models and cloud-based solutions to minimize resource constraints. Such integration is posited to revolutionize dental care by providing real-time, accurate disease detection capabilities, which significantly reduces diagnostical delays and enhances treatment outcomes.

Physio-biochemical mechanism of melatonin seed priming in stimulating growth and drought tolerance in bread wheat.

Drought stress (DS) adversely affects a plant's development and growth by negatively altering the plant's physio-biochemical functions. Previous investigations have illustrated that seed priming with growth regulators is an accessible, affordable, and effective practice to elevate a plant's tolerance to drought stress. Melatonin (MT) is derived from the precursor tryptophan and can improve germination, biomass, and photosynthesis under stress conditions. The current study examined the effect of melatonin seed priming on two wheat cultivars (Fakhar-e-Bhakkar and Akber-19) cultivated under severe drought conditions (35% FC). There were 6 levels of melatonin (i.e., M0 = control, M1 = 1 mg L- 1, M2 = 2 mg L- 1, M3 = 3 mg L- 1, M4 = 4 mg L- 1 and M5 = mg L- 1) which were used for seed priming. Our results confirmed that seed priming with M2 = 2 mgL- 1 concentration of MT alleviates the negative effects of DS by boosting the germination rate by 54.84% in Akber-19 and 33.33% in Fakhar-e-Bhakkar. Similarly, leaf-relative water contents were enhanced by 22.38% and 13.28% in Akber-19 and Fakhar-e-Bhakkar, respectively. Melatonin pre-treatment with 2 mgL- 1 significantly enhanced fresh and dry biomass of shoot and root, leaf area, photosynthetic pigments, osmoprotectants accumulation [total soluble proteins (TSP), total free amino acids (TFAA), proline, soluble sugars, glycine betaine (GB)] and lowered the amount of malondialdehyde (MDA) and hydrogen peroxide (H2O2) production by elevating antioxidants [Ascorbic acid, catalase (CAT), Phenolics, peroxidase (POD) and superoxide dismutase (SOD)] activity under drought stress (DS). Meanwhile, under control conditions (NoDS), the melatonin treatment M1 = 1 mgL- 1 effectively enhanced all the growth-related physio-biochemical attributes in both wheat cultivars. In the future, more investigations are suggested on different crops under variable agroclimatic conditions to declare 2 mgL- 1 melatonin as an efficacious amendment to alleviate drought stress.

Partial replacement of inorganic fertilizer with organic inputs for enhanced nitrogen use efficiency, grain yield, and decreased nitrogen losses under rice-based systems of mid-latitudes.

In the rice-based system of mid-latitudes, mineral nitrogen (N) fertilizer serves as the largest source of the N cycle due to an insufficient supply of N from organic sources causing higher N losses due to varying soil and environmental factors. However, aiming to improve soil organic matter (OM) and nutrients availability using the best environmentally, socially, and economically sustainable cultural and agronomic management practices are necessary. This study aimed to enhance nitrogen use efficiency (NUE) and grain yield in rice-based systems of mid-latitudes by partially replacing inorganic N fertilizer with organic inputs. A randomized complete block design (RCBD) was employed to evaluate the effects of sole mineral N fertilizer (urea) and its combinations with organic sources-farmyard manure (FYM) and poultry compost-on different elite green super rice (GSR) genotypes and were named as NUYT-1, NUYT-2, NUYT-3, NUYT-4, NUYT-5, and NUYT-6. The study was conducted during the 2022 and 2023 rice growing seasons at the Rice Research Program, Crop Sciences Institute (CSI), National Agricultural Research Centre (NARC), Islamabad, one of the mid-latitudes of Pakistan. The key objective was to determine the most effective N management strategy for optimizing plant growth, N content in soil and plants, and overall crop productivity. The results revealed that the combined application of poultry compost and mineral urea significantly enhanced soil and leaf N content (1.36 g kg- 1 and 3.06 mg cm- 2, respectively) and plant morphophysiological traits compared to sole urea application. Maximum shoot dry weight (SDW) and root dry weight (RDW) were observed in compost-applied treatment with the values of 77.62 g hill- 1 and 8.36 g hill- 1, respectively. The two-year mean data indicated that applying 150 kg N ha⁻1, with half provided by organic sources (10 tons ha⁻1 FYM or poultry compost) and the remainder by mineral urea, resulted in the highest N uptake, utilization, and plant productivity. Thus, integrated management of organic carbon sources and inorganic fertilizers may sustain the productivity of rice-based systems more eco-efficiently. Further research is recommended to explore root and shoot morphophysiological, molecular, and biochemical responses under varying N regimes, aiming to develop N-efficient rice varieties through advanced breeding programs.

Impact of iron deficiency anemia on academic achievement among female university students in Saudi Arabia.

Anemia, particularly iron deficiency anemia (IDA), is a prevalent health issue globally and in Saudi Arabia, especially among young adult females. This study investigates the association between anemia and academic achievement among female students at the Female Health Campus of Jazan University, Jazan, Saudi Arabia. This cross-sectional study included 118 randomly selected participants aged 18-22. A validated questionnaire was administered to the study participants. The participants underwent blood tests for complete blood count (CBC) parameters and iron profile analysis. The study reported that 52.5% of the female students had anemia and low serum iron levels. Regarding academic performance, significant positive correlations were found between various CBC parameters including white cell count, hemoglobin, hematocrit, mean cell volume, mean cell hemoglobin, mean cell hemoglobin concentration, and serum iron. However, no significant correlations were observed between red blood cell count and platelet count with academic performance. Demographic variables were also associated with a higher odds ratio of anemia. The study highlights the prevalence of anemia among female students and its potential impact on academic achievement. The current study underscores the importance of addressing anemia in young adult females and implementing appropriate interventions to improve their educational outcomes.

L'anémie, en particulier l'anémie ferriprive (IDA), est un problème de santé répandu dans le monde et en Arabie Saoudite, en particulier chez les jeunes femmes adultes. Cette étude examine l'association entre l'anémie et la réussite scolaire chez les étudiantes du Campus de santé féminine de l'Université de Jazan, Jazan, Arabie Saoudite. Cette étude transversale a inclus 118 participants sélectionnés au hasard âgés de 18 à 22 ans. Un questionnaire validé a été administré aux participants à l'étude. Les participants ont subi des analyses de sang pour les paramètres de la formule sanguine complète (CBC) et une analyse du profil en fer. L'étude a révélé que 52,5 % des étudiantes souffraient d'anémie et de faibles taux de fer sérique. En ce qui concerne les résultats scolaires, des corrélations positives significatives ont été trouvées entre divers paramètres de CBC, notamment le nombre de globules blancs, l'hémoglobine, l'hématocrite, le volume cellulaire moyen, l'hémoglobine cellulaire moyenne, la concentration moyenne d'hémoglobine cellulaire et le fer sérique. Cependant, aucune corrélation significative n'a été observée entre le nombre de globules rouges et le nombre de plaquettes avec les résultats scolaires. Les variables démographiques étaient également associées à un rapport de cotes plus élevé d'anémie. L'étude met en évidence la prévalence de l'anémie chez les étudiantes et son impact potentiel sur la réussite scolaire. L'étude actuelle souligne l'importance de lutter contre l'anémie chez les jeunes femmes adultes et de mettre en œuvre des interventions appropriées pour améliorer leurs résultats scolaires.

Unexpected positive cultures in conversion hip and knee arthroplasty.

PURPOSE: Total hip and knee arthroplasty in patients with previous history of periarticular surgery, such as osteosynthesis, can be surprisingly complex. This type of procedure is known as conversion arthroplasty (cTHA or cTKA) and has a higher risk of complications. The rates of unexpected positive cultures (UPC) and the risk of periprosthetic joint infection (PJI) compared to primary arthroplasty is unclear. The main purpose of this study was to evaluate rates of Unexpected Positive Cultures (UPC) in a series of conversion arthroplasty patients. The main questions to answer are: 1. Are the patients with conversion arthroplasties more susceptible to UPC than other causes of revision arthroplasties? 2. Are the conversion patients with UPC more susceptible to developing PJI? METHODS: This was a retrospective review of patients submitted to cTHA and cTKA from January 2012 to September 2018. Patients with history of previous infection or with missing intraoperative cultures were excluded. The UPC was defined as a single positive culture obtained during a procedure previously considered aseptic and PJI was defined according to the 2018 ICM criteria. After excluding 141 cases, 205 patients were analyzed, 160 hips and 45 knees. RESULTS: Nine (4.4%) UPC were identified, five (3.1%) in the hip group and four (8,9%) in the knee group. Staphylococcal species were the most common isolated bacteria (n = 7, 77.7%). During the study period, four (1,9%) patients were diagnosed with PJI. Only one case had an UPC and a different germ was identified during revision arthroplasty workup. CONCLUSIONS: While UPC are more prevalent in conversion knee arthroplasties compared to conversion hip arthroplasties, the rates are similar to those observed in revision arthroplasty for other indications. Importantly, the presence of a UPC in conversion arthroplasty does not appear to elevate the risk of subsequent periprosthetic joint infection, provided a thorough PJI workup has been conducted preoperatively. Therefore, in such cases, UPCs may be safely disregarded.

Corrigendum: Performance evaluation of Moringa oleifera seeds aqueous extract for removing Microcystis aeruginosa and microcystins from municipal treated-water.

[This corrects the article DOI: 10.3389/fbioe.2023.1329431.].

The association of anatomical renal mass complexity with surgical approach, Hb drop, and the rate of blood transfusion.

INTRODUCTION: The third most prevalent malignant neoplasm involving the urinary tract is renal cell carcinoma (RCC), encompassing nearly 3.5% of the entire cancers afflicting the body. The aim of this research was to explore how the R.E.N.A.L. nephrometry score relates to the decisions made regarding surgery in individuals with localized RCC. METHODS: This prospective study, assessed patients with localized parenchymal renal masses (stages I and II) tentatively diagnosed as RCC. Utilizing preoperative multiphasic renal CT scans and MRI, the R.E.N.A.L. score categorized masses for nephrometry values. Inclusion criteria involved collecting patient data, and data collection utilizing a structured format focusing on the nephrometry grading system. RESULTS: The study included 64 patients aged (mean ± SD) 49.78 ± 12.35 yrs. Undergoing renal mass surgery, there were 17 (26.5%) low, 28 (43.8%) moderate and 19 (29.7%) high-complexity lesions. All patients with a low Nephrometry score (n = 17) underwent partial nephrectomy, and all cases with a high score (n = 19) underwent radical nephrectomy. For those with a moderate Nephrometry score (n = 28), 13 (46.4%) underwent partial nephrectomy, while the remaining 15 (53.6%) cases underwent radical nephrectomy. Morbidity was low, and no mortality occurred at 180 days. Patients who had lesions fully above or below polar lines were less likely to need blood transfusions. A trend towards higher Fuhrman grades in patients receiving transfusions suggests a potential link between tumor aggressiveness and bleeding risk. CONCLUSIONS: Our findings provide insight on the utilization of the R.E.N.A.L. nephrometry score in forecasting perioperative, post-surgical, and oncological results. Such data might help optimize surgical methods and pre-operative patient counseling.

Angiotensin-Converting Enzyme Inhibitor-Induced Psoriasis: A Case Report on Plaque Exacerbation.

Psoriasis is a chronic inflammatory skin condition characterized by well-demarcated, erythematous plaques. Certain medications, including Angiotensin-Converting Enzyme (ACE) inhibitors, have been implicated as potential triggers for psoriasis flare-ups. We report the case of a 48-year-old Indian male with a history of well-controlled plaque psoriasis who experienced severe flare-ups after initiating ACE inhibitor therapy for hypertension. Within two weeks, the patient developed widespread psoriatic plaques accompanied by intense pruritus and discomfort, strongly suggesting a drug-induced reaction. Discontinuation of the ACE inhibitor led to a gradual improvement in symptoms, managed with topical corticosteroids and emollients, and switching to an alternative antihypertensive medication resulted in no further exacerbation of psoriasis. This case underscores the potential for ACE inhibitors to trigger psoriasis flare-ups in susceptible individuals, highlighting the need for clinicians to be vigilant when prescribing these medications to patients with a history of psoriasis. Further studies are needed to elucidate the underlying mechanisms and identify patients at risk.

Gallstones in a Looking-Glass: A Case Report on the Successful Laparoscopic Management of Cholelithiasis in Situs Inversus Totalis.

Situs inversus is an uncommon congenital condition where the internal organs are arranged in a mirrored or reversed orientation within the body. In this unique anatomical variation, the placement of visceral organs is flipped, presenting a mirror-image configuration relative to their standard positions. While situs inversus itself does not predispose an individual to gallbladder disorders, the anatomical variation poses unique challenges for healthcare professionals in managing abdominal pathologies. This case report describes the successful management of a 52-year-old male patient with situs inversus totalis who presented with gallstone-induced obstructive jaundice and underwent endoscopic retrograde cholangiopancreatography (ERCP) with stenting, followed by a laparoscopic cholecystectomy. The surgical procedure required exceptional visual-motor skills and extensive reorientation to accurately identify and navigate the left upper quadrant anatomy, which is the mirror image of the typical surgical approach. The case highlights the importance of thorough preoperative planning, comprehensive anatomical knowledge, and a multidisciplinary team approach to ensure favorable outcomes for patients with this rare condition.

Iptacopan Efficacy and Safety to Treat Paroxysmal Nocturnal Hemoglobinuria (PNH): A Systematic Review and Meta-Analysis.

Paroxysmal nocturnal hemoglobinuria (PNH) is an uncommon blood condition caused by complement-mediated hemolysis. In early clinical studies, iptacopan, an oral factor B inhibitor, showed promise in treating PNH. This systematic review aimed to compile information on the effectiveness and safety of iptacopan for PNH. A systematic review was performed using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards. The Medline, Embase, PubMed, and Cochrane Central databases were searched for randomized controlled trials (RCTs) and observational studies that evaluated iptacopan for PNH. The primary efficacy outcomes were hemoglobin and lactate dehydrogenase (LDH) changes. A fixed-effects model was used for the meta-analysis. Six studies (three prospective cohorts, two RCTs, and one non-randomized trial) were included, comprising 197 patients. Iptacopan therapy significantly increased hemoglobin levels (mean differences (MD) = 12.98 g/L; 95% CI: 11.82-14.13; p < 0.0001) and decreased LDH (MD = -83.55 IU/L; 95% CI: -83.77 to -83.34; p < 0.0001). Subgroup analyses revealed more significant hemoglobin increases in European vs. Asian populations, studies with baseline Hb > 10 g/dL vs. < 10 g/dL, and studies lasting > 24 weeks vs. ≤ 24 weeks. LDH decreases were more pronounced in studies with baseline LDH > 500 IU/L vs. < 500 IU/L. The incidence of adverse events ranged from 66% to 90%, with the most common being headache, nasopharyngitis, and diarrhea. Serious adverse events occurred in 0-20% of patients across studies. Only one patient withdrew because adverse effects were reported across all studies. Preliminary data support iptacopan's effectiveness in improving hemoglobin levels and lowering hemolysis in PNH, both as a monotherapy and in combination with usual treatment. The safety profile appears to be excellent, with a minimal incidence of major adverse events and treatment discontinuation. Further studies are needed to validate the effectiveness and safety of larger, longer-term trials. Iptacopan is a viable oral therapy option for PNH.

Synthesis and Biological Evaluation of Novel Imidazole Derivatives as Antimicrobial Agents.

Imidazole derivatives are considered potential chemical compounds that could be therapeutically effective against several harmful pathogenic microbes. The chemical structure of imidazole, with a five-membered heterocycle, three carbon atoms, and two double bonds, tends to show antibacterial activities. In the present study, novel imidazole derivatives were designed and synthesized to be evaluated as antimicrobial agents owing to the low number of attempts to discover new antimicrobial agents and the emerging cases of antimicrobial resistance. Two imidazole compounds were prepared and evaluated as promising candidates regarding in vitro cytotoxicity against human skin fibroblast cells and antimicrobial activity against several bacterial strains. The synthesized imidazole derivatives were chemically identified using nuclear magnetic resonance (NMR) and Fourier-transform infrared spectroscopy (FTIR). The results demonstrated a relatively high cell viability of one of the imidazole derivatives, i.e., HL2, upon 24 and 48 h cell exposure. Both derivatives were able to inhibit the growth of the tested bacterial strains. This study provides valuable insight into the potential application of imidazole derivatives for treating microbial infections; however, further in vitro and in vivo studies are required to confirm their safety and effectiveness.

Correction: Khan et al. The Extraction and Impact of Essential Oils on Bioactive Films and Food Preservation, with Emphasis on Antioxidant and Antibacterial Activities-A Review. Foods 2023, 12, 4169.

There was an error in the original publication [...].

Chemical Composition, Antioxidant Capacity, and Anticancerous Effects against Human Lung Cancer Cells of a Terpenoid-Rich Fraction of Inula viscosa.

Inula viscosa is a widely used plant in traditional Mediterranean and Middle Eastern medicine for various illnesses. I. viscosa has been shown to have anticancer effects against various cancers, but its effects against lung cancer have been under limited investigation. At the same time, I. viscosa is rich in terpenoids whose anti-lung cancer effects have been poorly investigated. This study aimed to examine the potential anticancer properties of methanolic and aqueous extracts of stems and leaves of I. viscosa and its terpenoid-rich fraction against human lung cancer A549 cells. Results showed that the methanolic extracts of I. viscosa had significantly higher polyphenol and flavonoid content and radical scavenging capacity than the aqueous extracts. In addition, leaves methanolic extracts (IVLM) caused the highest reduction in viability of A549 cells among all the extracts. IVLM also reduced the viability of human ovarian SK-OV-3, breast MCF-7, liver HepG2, and colorectal HCT116 cancer cells. A terpenoid-rich I. viscosa fraction (IVL DCM), prepared by liquid-liquid separation of IVLM in dichloromethane (DCM), displayed a substantial reduction in the viability of A549 cells (IC50 = 27.8 ± 1.5 µg/mL at 48 h) and the panel of tested cancerous cell lines but was not cytotoxic to normal human embryonic fibroblasts (HDFn). The assessment of IVL DCM phytochemical constituents using GC-MS analysis revealed 21 metabolites, highlighting an enrichment in terpenoids, such as lupeol and its derivatives, caryophyllene oxide, betulin, and isopulegol, known to exhibit proapoptotic and antimetastatic functions. IVL DCM also showed robust antioxidant capacity and decent polyphenol and flavonoid contents. Furthermore, Western blotting analysis indicated that IVL DCM reduced proliferation (reduction of proliferation marker Ki67 and induction of proliferation inhibitor proteins P21 and P27), contaminant with P38 MAP kinase activation, and induced the intrinsic apoptotic pathway (P53/BCL2/BAX/Caspase3/PARP) in A549 cells. IVL DCM also reduced the migration of A549 cells, potentially by reducing FAK activation. Future identification of anticancer metabolites of IVL DCM, especially terpenoids, is recommended. These data place I. viscosa as a new resource of herbal anticancer agents.

Latent tuberculosis infection and diagnostic performance of the tuberculin skin test among type 2 diabetics in Sana'a city, Yemen.

BACKGROUND: Tuberculosis (TB) is one of the most widespread infectious diseases worldwide, typically persisting in the body as a latent TB infection (LTBI). Patients with type 2 diabetes have an increased risk of LTBI progressing to active TB. Therefore, this study determined the prevalence and predictors of LTBI and assessed the agreement between tuberculin skin test (TST) and interferon-gamma release assay (IGRA) in diagnosing LTBI among type 2 diabetics in Sana'a city, Yemen. METHODS: A cross-sectional study was conducted among 150 type 2 diabetics in private health facilities in Sana'a in 2023. Data about demographics, diabetes-related characteristics, and potential risk factors for LTBI were collected using a structured questionnaire. Patients were then screened for LTBI using TST and IGRA. Univariate analysis was used to identify LTBI-associated risk factors, and multivariable binary logistic regression was used to identify independent predictors of LTBI. The agreement between TST and IGRA for diagnosing LTBI was assessed using Cohen's kappa coefficient (κ). RESULTS: LTBI was prevalent among 29.3% of type 2 diabetics using both types of tests (25.3% with IGRA and 21.3% with TST). Male gender was an independent predictor of LTBI (AOR = 4.4, 95% confidence interval: 1.30-15.08; P = 0.018). However, being employed (AOR = 0.3, 95% CI: 0.09-0.75; P = 0.013) and longer duration since diabetes diagnosis (AOR = 0.3, 95% CI: 0.12-0.98; P = 0.046) were identified as predictors of lower LTBI risk. The agreement between TST and IGRA for the diagnosis of LTBI was 88%, with a good and statistically significant agreement between the two test types (κ = 0.670; P < 0.001). CONCLUSIONS: LTBI is common among type 2 diabetics seeking medical care in Sana'a city, with about one-third of them possibly being latently infected. A higher LTBI risk can be predicted among males, while a lower risk can be predicted among those employed or being diagnosed with diabetes for at least five years. The TST shows good agreement with IGRA in diagnosing LTBI among type 2 diabetics, supporting its continued use as a cost-effective and easily accessible test for diagnosing LTBI in the country.

Photoactivated riboflavin-doped hydroxy apatite nanospheres infiltered in orthodontic adhesives.

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.

Efficacy of Adenoidectomy versus Tympanostomy on the Otitis Media with Effusion: A Systematic Review and Meta-Analysis.

BACKGROUND: This systematic review and meta-analysis aimed to investigate the current evidence on the efficacy of tympanostomy and adenoidectomy in children with otitis media with effusion in comparison with tympanostomy alone following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. MATERIALS AND METHODS: We completed a comprehensive search of PubMed, Web of Science, Scopus and Cochrane Library databases for relevant studies published in the literature with no date restrictions. We collected the results of the databases search and removed duplicated studies by Rayyan QCRI and EndNote Software X8. We used an Excel sheet for screening titles and abstracts, full text and data extraction. For quality assessment, we used Cochrane Handbook of Systematic Reviews of Interventions 5.1.0 using the quality assessment table provided in Part 2 and Chapter 8.5, and quantitative data synthesis was done using Review Manager (RevMan) software version 5.4. RESULTS: The literature search showed 1510 studies, of which five studies were included in data synthesis. The study measured the effect through number of acute otitis media (AOM) episodes, cumulative number of AOM episodes, siblings with Otitis media (OM), hearing level hearing loss scale of the left, and right ears. The pooled effect estimates showed significant difference between tympanostomy with adenoidectomy versus tympanostomy alone in hearing level hearing loss scale of both ears (SMD -0.17, 95% CI [-0.29, -0.05], P -value=0.005). However, the pooled results were not heterogeneous ( P < 0.25, I2 = 24%). CONCLUSIONS: Tympanostomy with adenoidectomy improves hearing compared to tympanostomy alone, but both treatments have similar effects on ear infection rates. Further research with larger samples is needed to confirm these findings and assess long-term benefits.

Factors Influencing Medical Students' Choice of Anesthesiology as a Future Specialty in Saudi Arabia.

Background According to the American Society of Anesthesiologists (ASA), anesthesiologists are experts in administering anesthesia, pain management, and critical care medicine. In addition, they provide general perioperative care. Personal interests, career stability, reputation, income, and clinical rotation experience influence medical students' career choices. Studies show that anesthesiology remains one of the least popular specialties among Saudi medical students. Our study aims to determine the preference for anesthesiology among Saudi medical students and the factors influencing their career choice options. Methodology This cross-sectional study was implemented by distributing a self-administered verified survey. Results Our study included 532 medical students, predominantly female (n=344, 64.7%), aged 18-24 years (n=424, 79.7%), and Saudi nationals (n=508, 95.5%). Most were single (n=500, 94%) without children (n=522, 98.1%). A majority were not interested in anesthesiology as a future specialty (n=297, 55.8%), with some uncertainty (n=148, 27.8%) and a smaller interested group (n=87, 16.4%). Controllable lifestyle (n=294, 55.3%) and financial income (n=213, 40%) were critical factors for choosing anesthesiology as a specialty. Interest in another specialty (n=342, 64.3%) and stress (n=286, 53.8%) were significant opposing factors. Academic year significantly affected consideration (p<0.001), with second-year students showing the highest interest (61.8%) and sixth-year the lowest (24.8%). Other factors showed no significant association. Conclusion Our study reveals low interest in anesthesiology among Saudi medical students. A controllable lifestyle and financial income are key attractions. Interest declines significantly by the sixth year due to their interest in other specialties, lifestyle concerns, and stress.

Integrated solar dryer and distillation system with PCM and injection, powered by PVT panels and solar concentrator.

This research introduces a novel hybrid system integrating solar drying, solar distillation, and photovoltaic thermal panels, aimed at drying agricultural products, producing clean drinking water, and conserving energy. The system enhances the drying air temperature using thermal energy storage materials and a solar dish concentrator connected to a hot water storage tank, ensuring continuous operation even after sunset. The solar distiller, equipped with energy storage materials and an air injection system, is integrated with an external condenser to condense water vapor before expulsion, thereby increasing freshwater productivity. The results revealed that the developed system achieved an accumulative freshwater productivity of 87.1 L per day. The rates of water removal from dried potato slices ranged from 0.18 to 0.91 kg/h between 8:00 am and 10:00 pm. Additionally, the system achieved a gain output ratio of 1.38, indicating a significant improvement in energy efficiency. This innovative system offers practical solutions to address energy and freshwater scarcity, especially in remote regions of the Middle East and North Africa (MENA) region, which are characterized by high solar irradiance. The implementation of such hybrid systems could contribute to sustainable development by reducing reliance on conventional energy sources and mitigating environmental pollution.

Awareness and Underlying Factors for Total Knee Arthroplasty Reluctance in Saudi Arabia.

Background Total knee arthroplasty (TKA) is a successful surgical intervention for advanced knee arthritis. The efficacy of TKA in reducing pain and restoring joint function has been well documented. Despite the rewarding outcomes of TKA for knee osteoarthritis patients, their willingness to consider the procedure is limited. Aim This study aimed to assess patients' awareness and knowledge of total knee arthroplasty benefits and complications. Further, the reasons and factors contributing to reluctance among orthopedic patients in Saudi Arabia should be determined. Methods An online, structured, and self-administered questionnaire was used to collect data from adult orthopedic patients of both genders who were reluctant to undergo total knee arthroplasty despite surgeons' recommendations. The online questionnaire link was shared across multiple platforms, orthopedic forums, and healthcare social media channels. Qualitative data were presented as frequencies and percentages, while continuous data were reported as the mean (standard deviation [SD]). The statistical package for the social sciences software program was used for statistical analysis. Results A total of 629 participants were involved. The awareness of the expected benefits score, on a scale from 7 to 35, showed a mean (SD) of 20.9 (5.6). The score of the attitude towards expected complications, on a scale from 5 to 25, had a mean (SD) of 15.2 (3.6). The attitude towards the expected complications showed a significantly higher mean (SD) score in the older group aged >60 years than the younger one aged <40 years (15.7 (4.1) vs. 14.9 (3.5), respectively). Likewise, overweight and obese participants showed a significantly higher mean (SD) expected complications score compared to the healthy and underweight ones (15.4 (3.7) vs. 14.8 (3.5), respectively). The recorded reasons for refusal to undergo TKA were fear of anesthesia complications (317, 50.4%), followed by financial limitations (245, 39.0%), the unavailability of experienced surgeons (232, 36.9%), and fear of unfavorable outcomes (189, 30.0%). Conclusion There was a gap in knowledge and awareness of total knee arthroplasty among orthopedic patients in Saudi Arabia. Perceptions of benefits were inadequate, and there were misconceptions about the expected complications. The level of expected complications was higher among elderly and obese patients. Furthermore, fear of anesthesia complications and unfavorable outcomes, in addition to economic and financial problems, constituted major barriers to undergoing the procedure.

Exploring Patient Preferences for Information About CT Radiation Exposure: Bridging the Gap Between Patient Preference and Physician Practice.

Background: CT scan utilizes ionizing radiation poses a danger to the patient's health. Thus, telling the patient about ionizing radiation would be critical in promoting shared decision-making and improving patient-doctor communication. However, few studies have examined this topic broadly. Objective: The study was conducted to identify the frequency of physicians informing patients about the radiation risk before ordering a CT scan, as well as to examine the association between patients' demographic characteristics and their awareness of the radiation risks associated with CT scans. Methods: A cross-sectional study was conducted among 387 patients who had undergone CT scans at a tertiary hospital in Riyadh, Saudi Arabia. Data were collected via phone interviews using a structured questionnaire. Chi-squared tests were employed to assess associations between patients' demographic characteristics and their awareness of CT scan radiation risks. Results: When examining knowledge, 58% of patients knew that CT involves harmful radiation. This knowledge was significantly associated with higher education level and previous experience with CT scans. Regarding doctors' practice of providing information to patients about the scan, 344 (88.9%) patients indicated that their doctor had explained to them why they needed the scan. Only 28 (7.2%) patients stated that their doctor had mentioned the amount of radiation, and 74 (19.1%) patients indicated that doctors mentioned the risks associated with the radiation of the scan. Almost all patients (96.9%) preferred to be told about why they needed a CT scan. Conclusion: The vast majority of patients who underwent CT scans did not receive enough information about the harm of the scans. However, most of them preferred to know about this harm.