Magnetic susceptibility in the assessment of toxic heavy metal elements in the surface sediments of Inner Ambon Bay, Maluku province, Indonesia.

The Inner Ambon Bay (IAB) is an important area for the economic development of the city of Ambon, one of only a few urban areas in eastern Indonesia. This study is intended to monitor the anthropogenic impact on IAB by employing combined rock magnetic and geochemical analyses on 20 samples collected from IAB and the surrounding rivers. Magnetic susceptibility values of samples in the IAB averaged 26.37× 10-8 m3/kg, which is relatively high and comparable to that of contaminated coastal environments. Magnetic susceptibility correlated positively with certain metals such as Cr, Co, Ni, and Mn but negatively with Hg. Geochemical analyses showed that Hg and Ag contents were relatively high but pose only moderate risk to the environment based on the geo-accumulation index. Furthermore, the potential ecological risk index (PERI) showed that there were two points that showed moderate ecological risk. Multivariate statistical analysis (principal component analysis (PCA), Pearson's correlation coefficient (PCC), and hierarchical cluster analysis (HCA)) outlined that the metallic accumulation in the sediments of IAB was related to lithological, geological, and anthropogenic impacts. Therefore, oil spills and household waste are likely major reasons for anthropogenic pollution in the sediments of the IAB.

Assessment of the in-vitro probiotic efficacy and safety of Pediococcus pentosaceus L1 and Streptococcus thermophilus L3 isolated from Laban, a popular fermented milk product.

Probiotics are beneficial microorganisms, mostly lactic acid bacteria (LAB), that offer health benefits to the host when consumed in adequate amounts. This study assessed the probiotic efficacy and safety of LAB strains isolated from Laban, a traditional fermented milk product. Seven primarily selected Gram-positive, catalase-negative, non-spore-forming isolates were examined for their antimicrobial activity against the bacterial pathogens Bacillus cereus, Salmonella typhi, Staphylococcus aureus, and Vibrio cholera, and the fungal pathogen Candida albicans. Two isolates, identified as Pediococcus pentosaceus L1 and Streptococcus thermophilus L3, which showed antimicrobial activity against all pathogens, were further evaluated for their probiotic competence. The selected isolates demonstrated strong resistance to low pH, bile salts, and phenol, indicating their potential for gastric endurance. They also exhibited high cell surface hydrophobicity to various hydrocarbons, autoaggregation, and coaggregation properties, demonstrating strong adhesion abilities. In addition, both isolates showed strong antioxidant activity and were non-hemolytic. Although the isolates had some resistance to certain antibiotics, they were generally susceptible to commonly used antibiotics. The two LAB strains also exhibited promising technological properties, such as milk coagulation and exopolysaccharide production, indicating their potential to enhance the quality of dairy products. The results suggest that the LAB strains isolated from Laban have strong potential as probiotics, and due to their food origin, they are highly likely to exhibit maximal efficacy in food and pharmaceutical products for human consumption.

A rare case of type 2 Kounis syndrome secondary to iodinated contrast.

Immune-mediated acute coronary syndrome, also known as Kounis syndrome (KS), is an underrecognized and challenging diagnosis. In this case report, we present a case of cardiac arrest secondary to iodinated contrast allergy requiring emergent cardiac catheterization and hemodynamic support secondary to type 2 KS. KS necessitates a high index of clinical suspicion by the treating physician in order to address both the hypersensitivity reaction and its cardiac implications. Learning objectives: Kounis syndrome (KS) is a clinically distinct entity from anaphylaxis; managing KS in the same way as anaphylaxis can worsen cardiac demand and ischemia. In addition, KS may present as coronary vasospasm or plaque rupture; regardless, percutaneous coronary intervention (PCI) should be performed as worse outcomes have been described in cases where PCI is not performed or delayed.

Efficacy and safety of therapeutic HPV vaccines to treat CIN 2/CIN 3 lesions: a systematic review and meta-analysis of phase II/III clinical trials.

OBJECTIVES: We aim to assess the efficacy and safety of therapeutic human papillomavirus (HPV) vaccines to treat cervical intraepithelial neoplasia of grade 2 or 3 (CIN 2/3). DESIGN: Systematic review and meta-analysis, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses recommendations. DATA SOURCES: PubMed, Embase, Web of Science, Global Index Medicus and CENTRAL Cochrane were searched up to 31 January 2022. ELIGIBILITY CRITERIA: Phase II/III randomised controlled trials (RCTs) and single-arm studies reporting the efficacy of therapeutic vaccines to achieve regression of CIN 2/3 lesions were included. Studies evaluating only safety and side effects of the vaccine were excluded. DATA EXTRACTION AND SYNTHESIS: Two independent reviewers extracted data and evaluated study quality. A random-effect model was used to pool the proportions of regression and/or HPV clearance. RESULTS: 12 trials met the inclusion criteria. Out of 734 women (all studies considered) receiving therapeutic HPV vaccine for CIN 2/3, 414 regressed to normal/CIN 1 with an overall proportion of regression of 0.54 (95% CI 0.39 to 0.69) for vaccinated group; 166 women (from five RCTs) receiving placebo only achieving a pooled normal/CIN 1 regression of 0.27 (95% CI 0.20 to 0.34). When including only the five two-arm studies, the regression proportion for the 410 vaccine group participants was higher than that of the 166 control group participants (relative risk (RR) 1.52; 95% CI 1.14 to 2.04). The pooled proportion of high-risk human papillomavirus (hrHPV) clearance was 0.42 (95% CI 0.32 to 0.52) in the vaccine group (six studies with a total of 357 participants) and 0.17 (95% CI 0.11 to 0.26) in the control group (three RCTs with a total of 104 participants). Based on these three RCTs, the hrHPV clearance was significantly higher in the vaccinated group (250 participants) compared with the control group (RR 2.03; 95% CI 1.30 to 3.16). Similar results were found regarding HPV 16/18 clearance. No significant unsolicited adverse events have been consistently reported. CONCLUSIONS: The efficacy of the therapeutic vaccines in the treatment of CIN 2/3 was modest. Implementation issues such as feasibility, acceptability, adoption and cost-effectiveness need to be further studied. PROSPERO REGISTRATION NUMBER: CRD42022307418.

The journey of cancer patients and the quest to equity: findings from Morocco.

OBJECTIVES: Rapid diagnostic and assessment pathways for cancer patients provide timely and effective care. This study took place in Morocco, where the majority of patients treated in the public sector are diagnosed at an advanced stage. The aim of this study was to determine the duration of different time intervals along the cancer patient pathway and to highlight problem areas so that strategies can be implemented to make the process more equitable and effective. STUDY DESIGN: Cross-sectional study. METHODS: Recently diagnosed cancer patients were recruited from four major oncology centres in Morocco; namely, Marrakech, Casablanca, Rabat, and Fez. A questionnaire survey was administered, including sociodemographic and medical information and questions on access to the oncology centre, beliefs, and opinions on the medical staff. The dates of symptom recognition, assessment, diagnosis referral, biopsy, and treatment initiation were collected. Different time intervals (patient, diagnosis, biopsy, and treatment) were estimated and their determinants were investigated. RESULTS: A total of 812 patients were interviewed. The majority of participants were breast cancer patients. In total, 60% of participants were at stage III-IV. The main facilitators of cancer diagnosis confirmation and treatment initiation were easy access to diagnosis and treatment facilities, financial resources, personal history of cancer, time availability, late stage at diagnosis, advanced age, and private health insurance. The patient interval (i.e., time from symptom recognition to initial healthcare assessment) had a median duration of 30 days. The biopsy and treatment intervals were within the current international recommendations (7 and 28 days, respectively). However, the diagnosis interval (52 days) was twice as long as the recommended timeframes from the UK, Australia, and the World Health Organization (<28 days). CONCLUSIONS: Interval targets should be defined to encourage health systems to be more equitable and effective and to ensure that cancer patients are treated within a defined timeframe.

Therapeutic efficacy of albendazole and berberine loaded on bovine serum albumin nanoparticles on intestinal and muscular phases of experimental trichinellosis.

There has been no treatment for trichinellosis until now. Therefore, this work targeted to investigating the efficacy of albendazole and berberine alone and loaded on bovine serum albumin (BSA) nanoparticles against intestinal and muscular phases of trichinellosis in mice. Mice were divided into nine different groups: negative control, positive control, blank nanoparticle, albendazole, berberine, a combination of albendazole and berberine, albendazole-loaded nanoparticle, berberine-loaded nanoparticle and combination of albendazole and berberine-loaded nanoparticle. Subsequently, they were sacrificed 6 and 35 days after infection. Treatment efficacies were parasitologically, histopathologically and, immunohistochemically assessed. Parasitological counting for the adult worms and encysted larvae with histopathological assessment using H&E for intestinal and muscular sections and picrosirius red stain for muscular sections were used. Also, immunohistochemical expression of the intestinal nod-like receptor-pyrin domain containing 3 (NLRP3) was investigated. The group treated with nano_combined drugs showed a statistically significant reduction in adult and encysted larval count (p<0.005), a remarkable improvement of intestinal and muscular inflammation, and a reduction in the capsular thickness of the larvae. Also, this group showed the highest reduction of NLRP3 expression. This work revealed that berberine might be a promising anti-trichinellosis drug with a synergistic effect when combined with albendazole through modulation of the immune response, inflammation, and larva capsule formation. Furthermore, delivering both drugs in a nanoparticle form improves their therapeutic response.

Evaluation of the properties of Bungarus caeruleus venom and checking the efficacy of antivenom used in Bangladesh for its bite treatment.

As a disaster-prone country with unique geographical features, snake biting is a major public health concern in Bangladesh. The primary reasons of mortality from snakebite include late presentation to the hospital, low efficacy of antivenom, and a lack of adequate management facilities. Because snake venom characteristics vary depending on geographical location, antivenom should be manufactured from snakes native to the region in which it would be administered. Bungarus caeruleus is a highly venomous snake contributing to the major snakebite issue in Bangladesh. Therefore, the neutralization efficacy of the antivenom against B. caeruleus venom was evaluated in the current study along with the characterization of venom. For biological characterization of venom, RP-HPLC and SDS-PAGE profiling, hemolytic activity, hemorrhagic activity, phospholipases A2 (PLA2) activity, edema inducing activity and histopathological observations were carried out following standard protocol. LD50 of the venom was calculated along with neutralization potency of Incepta antivenom through probit analysis. Results showed that venom possesses phospholipase A2 activity, hemolytic activity and edema inducing activity while hemorrhagic activity was absent in the skin of envenomed mice. Histopathological alterations including necrosis, congestion and infiltrations were observed in envenomed mice organs after hematoxylin and eosin staining. Neutralization study showed that Incepta polyvalent antivenom could neutralize (potency 0.53 mg/ml) the lethal effect in in vitro study on mice. Further investigation on snakebite epidemiology and clinical observations of the envenomed patients will help in combating the snakebite problem more efficiently.

Thermal-Optical Evaluation of an Optimized Trough Solar Concentrator for an Advanced Solar-Tracking Application Using Shape Memory Alloy.

One of the modern methods for enhancing the efficiency of photovoltaic (PV) systems is implementing a solar tracking mechanism in order to redirect PV modules toward the sun throughout the day. However, the use of solar trackers increases the system's electrical consumption, hindering its net generated energy. In this study, a novel self-tracking solar-driven PV system is proposed. The smart solar-driven thermomechanical actuator takes advantage of a solar heat collector (SHC) device, in the form of a parabolic trough solar concentrator (PTC), and smart shape memory alloy (SMA) to produce effective mechanical energy for solar tracking applications from sun rays. Furthermore, a thermal-optical analysis is presented to evaluate the performance of the solar concentrator for the simulated weather condition of Dammam City, Saudi Arabia. The numerical results of the thermal and optical analyses show the promising feasibility of the proposed system in which SMA springs with an activation temperature between 31.09 °C and 45.15 °C can be utilized for the self-tracking operations. The work presented adds to the body of knowledge an advanced SMA-based SHC device for solar-based self-actuation systems, which enables further expansions within modern and advanced solar thermal applications.

A State-of-the-Art Self-Cleaning System Using Thermomechanical Effect in Shape Memory Alloy for Smart Photovoltaic Applications.

This research aims to present a state-of-the-art cleaning technology solution that effectively overcomes the dust accumulation issue for conventional photovoltaic systems. Although continuous innovations and advanced developments within renewable energy technologies have shown steady improvements over the past years, the dust accumulation issue remains one of the main factors hindering their efficiency and degradation rate. By harvesting abundant solar thermal energy, the presented self-cleaning system uses a unique thermomechanical property of Shape Memory Alloys to operate a solar-based thermomechanical actuator. Therefore, this study carries out different numerical and experimental validation tests to highlight the promising practicability of the developed self-cleaning system from thermal and mechanical perspectives. The results showed that the system has a life expectancy of over 20 years, which is closely equivalent to the life expectancy of conventional photovoltaic modules while operating under actual weather conditions in Dammam city. Additionally, the thermal to mechanical energy conversion efficiency reached 19.15% while providing average cleaning effectiveness of about 95%. The presented outcomes of this study add to the body of knowledge an innovative methodology for a unique solar-based self-cleaning system aimed toward smart and modern photovoltaic applications.

Exploring how reflective practice training affects nurse interns' critical thinking disposition and communication skills.

BACKGROUND: It is useful for nurses to be able to engage in reflective practice. Reflective practice is an essential aspect of experiential learning. AIM: To explore how reflective practice training during an internship programme in Saudi Arabia affected nurse interns' critical thinking disposition and interpersonal communication competency. METHOD: A convenience sample of 93 senior nursing students undertaking the internship programme at a nursing college in a university in Saudi Arabia answered a questionnaire before and after taking part in reflective practice training sessions. The questionnaire used three tools: the Reflective Practice Questionnaire; the Critical Thinking Disposition Scale; and the Interpersonal Communication Competency Scale. RESULTS: After the training, the overall mean scores for reflective practice, critical thinking disposition and interpersonal communication competency were significantly higher than before the training. Reflective practice had a positive correlation with critical thinking disposition and interpersonal communication competency. It also had predictive capability for the variance in critical thinking disposition and interpersonal communication competency (R 2 =0.798 and R 2 =0.553, respectively, P <0.001). CONCLUSION: Reflective practice training provided to nurse interns in Saudi Arabia improved their reflective practice, critical thinking and interpersonal communication. Reflective practice training would be a useful addition to pre-graduate nurse education and to preceptorship or orientation programmes for newly recruited nurses.

Burden of Kaposi sarcoma according to HIV status: A systematic review and global analysis.

In 2020, over 34 000 cases of Kaposi sarcoma (KS) were estimated globally, all attributable to KS herpesvirus (KSHV). Prior to the HIV epidemic, KS already existed in KSHV endemic regions, notably in sub-Saharan Africa (SSA). The HIV epidemic has vastly increased the KS burden. We developed a methodology to provide global estimates of KS burden according to HIV status. A systematic review identified studies reporting HIV prevalence in consecutive KS series. Pooled estimates of HIV prevalence, by country or UN subregion, were used to calculate population-attributable fraction (PAF) and these were applied to IARC's GLOBOCAN 2020 to estimate burden and incidence of HIV-attributable and non-HIV-attributable KS. We identified 55 eligible studies, reporting HIV prevalence ranging from ≤5% to ≥95%. Approximately 80% of KS in SSA was estimated attributable to HIV, vs ~50% in the rest of the world. By applying PAFs to national GLOBOCAN estimates, an estimated 19 560 KS cases attributable to HIV were diagnosed in SSA in 2020 (~80% of the worldwide burden), vs 5064 cases of non-HIV-attributable KS (~60% of the worldwide burden). Incidence of HIV-attributable KS was highest in Southern Africa (6.0 cases per 100 000) and Eastern Africa (3.4), which were also the world regions with highest incidence of non-HIV-attributable KS (0.4 and 1.0 cases per 100 000, respectively). This first systematic effort to produce a global picture of KS burden stratified by HIV status highlights the continuing important burden of HIV-attributable KS in SSA, even in the era of combined antiretroviral therapy.

Age-specific burden of cervical cancer associated with HIV: A global analysis with a focus on sub-Saharan Africa.

HIV substantially worsens human papillomavirus (HPV) carcinogenicity and contributes to an important population excess of cervical cancer, particularly in sub-Saharan Africa (SSA). We estimated HIV- and age-stratified cervical cancer burden at a country, regional and global level in 2020. Proportions of cervical cancer (a) diagnosed in women living with HIV (WLHIV), and (b) attributable to HIV, were calculated using age-specific estimates of HIV prevalence (UNAIDS) and relative risk. These proportions were validated against empirical data and applied to age-specific cervical cancer incidence (GLOBOCAN 2020). HIV was most important in SSA, where 24.9% of cervical cancers were diagnosed in WLHIV, and 20.4% were attributable to HIV (vs 1.3% and 1.1%, respectively, in the rest of the world). In all world regions, contribution of HIV to cervical cancer was far higher in younger women (as seen also in empirical series). For example, in Southern Africa, where more than half of cervical cancers were diagnosed in WLHIV, the HIV-attributable fraction decreased from 86% in women ≤34 years to only 12% in women ≥55 years. The absolute burden of HIV-attributable cervical cancer (approximately 28 000 cases globally) also shifted toward younger women: in Southern Africa, 63% of 5341 HIV-attributable cervical cancer occurred in women <45 years old, compared to only 17% of 6901 non-HIV-attributable cervical cancer. Improved quantification of cervical cancer burden by age and HIV status can inform cervical cancer prevention efforts in SSA, including prediction of the impact of WLHIV-targeted vs general population approaches to cervical screening, and impact of HIV prevention.

Removal of Cadmium, Copper, and Lead From Water Using Bio-Sorbent From Treated Olive Mill Solid Residue.

Olive Mill Solid Residue (OMSR) can be utilized as a bio-sorbent in wastewater treatment. Even though several studies on OMSR as a bio-sorbent were carried out, there is still a need to investigate a simple and relatively inexpensive OMSR treatment that increases pollutant removal. In this study; OMSR is used in batch experiments to remove toxic heavy metals from aqueous solutions including Cd2+, Cu2+, and Pb2+ ions. The effect of OMSR treatment (untreated; OMSR-U, treated with n-hexane; OMSR-H, and treated with water; OMSR-W) was investigated by chemical oxygen demand and cation exchange capacity. It was confirmed by both tests that OMSR-W was the best treatment. The same result was re-confirmed by batch uptake experiments of the heavy metal ions. Using OMSR-W as a bio-sorbent; the effect of several parameters such as pH, contact time, bio-sorbent concentration, metal ions concentration, and the presence of other metal species were studied to figure their influence on the metal ions uptake. The optimum conditions for single metal systems were found to occur at pH 5.5, an initial metal concentration of 50 mg/L, a shaking time of 60 minutes, a bio-sorbent concentration of 20 g/L. In binary metal ions solutions; Cd2+ uptake was increased in presence of Cu2+ or Pb2+. However, the uptake of Cu2+ and Pb2+ was decreased in presence of other metals. The equilibrium sorption data for single metal systems were described by the Langmuir isotherm model. The highest value of maximum uptake was found for Pb2+ (4.587 mg/g) followed by Cd2+ (4.525 mg/g) and Cu2+ (4.367 mg/g). These results show that OMSR-W, which has a very low economical value, could be used for the treatment of wastewater contaminated with heavy metals.

Chemical, biological and protein-receptor binding profiling of Bauhinia scandens L. stems provide new insights into the management of pain, inflammation, pyrexia and thrombosis.

Bauhinia scandens L. (Family, Fabaceae) is a medicinal plant used for conventional and societal medication in Ayurveda. The present study has been conducted to screen the chemical, pharmacological and biochemical potentiality of the methanol extracts of B. scandens stems (MEBS) along with its related fractions including carbon tetrachloride (CTBS), di-chloromethane (DMBS) and n-butanol (BTBS). UPLC-QTOF-MS has been implemented to analyze the chemical compounds of the methanol extracts of Bauhinia scandens stems. Additionally, antinociceptive and anti-inflammatory effects were performed by following the acetic acid-induced writhing test and formalin-mediated paw licking test in the mice model. The antipyretic investigation was performed by Brewer Yeast induced pyrexia method. The clot lysis method was implemented to screen the thrombolytic activity in human serum. Besides, the in silico study was performed for the five selected chemical compounds of Bauhinia scandens, found by UPLC-QTOF-MS By using Discover Studio 2020, UCSF Chimera, PyRx autodock vina and online tools. The MEBS and its fractions exhibited remarkable inhibition in dose dependant manner in the antinociceptive and antiinflammatory investigations. The antipyretic results of MEBS and DMBS were close to the standard drug indomethacin. Investigation of the thrombolytic effect of MEBS, CTBS, DMBS, and BTBS revealed notable clot-lytic potentials. Besides, the phenolic compounds of the plant extracts revealed strong binding affinity to the COX-1, COX-2, mPGES-1 and plasminogen activator enzymes. To recapitulate, based on the research work, Bauhinia scandens L. stem and its phytochemicals can be considered as prospective wellsprings for novel drug development and discovery by future researchers.

Antipyretic activity of Caesalpinia digyna (Rottl.) leaves extract along with phytoconstituent's binding affinity to COX-1, COX-2, and mPGES-1 receptors: In vivo and in silico approaches.

Caesalpinia digyna (Rottl.) (Family: Fabaceae) is well known for its numerous medicinal values against several human disorders including fever, senile pruritis, diarrhea, tuberculosis, tonic disorder, diabetes, etc. The current study is intended to investigate the in vivo antipyretic activity of the methanol extract of C. digyna leaves (MECD) and its carbon-tetrachloride (CTCD) and butanol fraction (BTCD). Besides, in silico molecular docking and ADME/T profiling of the selective identified bioactive compounds of C. digyna has been also studied to validate the experimental outcomes and establish a better insight into the possible receptor-ligand interaction affinity. In vivo antipyretic activity of MECD, CTCD and BTCD were evaluated by employing yeast induced pyrexia technique in mice model and in silico analysis of the identified compounds of C. digyna has been implemented using PyRx autodock vina, Discovery Studio 2020, UCSF Chimera software and ADME/T online tools. MECD and BTCD unveiled significant antipyretic activity in dose dependent manner whereas, CTCD failed to exhibit significant antipyretic activity. Comparing to other test sample, MECD (400 mg/kg; b.w) (p < 0.001) displayed maximum inhibition of pyrexia. In molecular docking approach, docking score between -6.60 to -10.20 kcal/mol have been revealed. Besides, in ADME/T analysis, no compound violated the lipiniski's 5 rules and displayed any toxicity. Biological and computational approaches ascertain the ethno-botanical use of C. digyna as a good agent against pyrexia and the compounds of C. digyna are primarily proved as safe. Hereafter, further analysis is suggested to validate this research.

MicroRNAs expression analysis shows key affirmation of Synaptopodin-2 as a novel prognostic and therapeutic biomarker for colorectal and cervical cancers.

MicroRNAs play a crucial role in tumorigenesis, tumor progression, and metastasis, and thus they contribute in development of different malignancies including cervical cancer (CC) and colorectal cancer (CRC). Through integrated strategies of computational biology, this study aims to identify prognostic biomarkers responsible for CRC and CC prognosis, and potential therapeutic agents to halt the progression of these cancers. Expression analysis of miRNA datasets of CRC and CC identified 17 differentially expressed miRNAs (DEMs). SYNPO2, NEGR1, FGF7, LIFR, RUNX1T1, CFL2, BNC2, EPHB2, PMAIP1, and CDC25A differentially expressed genes (DEGs) regulated by these DEMs were classified as candidate genes responsible for CRC and CC. Down-regulation of Synaptopodin-2 (SYNPO2) is involved in emergence and progression of these cancers by activating ER, PI3K/AKT, and EMT pathways as well as by suppressing DNA damage response, and cell cycle pathways. Higher methylation rate in promoter region of SYNPO2 could be a possible reason for lowering the expression of SYNPO2 in tumor stages. Hence, the lower expression of SYNPO2 is associated with poor prognosis of CRC and CC and could function as prognostic biomarker and therapeutic target. Fourteen transcription factors were recognized which can activate/inhibit the transcription of SYNPO2 and may be a potential target to regulate expression of SYNPO2 in CRC and CC. Retinoic acid and Estradiol were identified as putative therapeutic drugs for CRC and CC patients. This study will thus help in understanding the underlying molecular events in CRC and CC that may improve the detection of malignant lesions in primary screening and will broaden the clinical applications.

A novel multi-model data-driven ensemble approach for the prediction of particulate matter concentration.

Accuracy in the prediction of the particulate matter (PM2.5 and PM10) concentration in the atmosphere is essential for both its monitoring and control. In this study, a novel neuro fuzzy ensemble (NF-E) model was proposed for prediction of hourly PM2.5 and PM10 concentration. The NF-E involves careful selection of relevant input parameters for base modelling and using an adaptive neuro fuzzy inference system (ANFIS) model as a nonlinear kernel for obtaining ensemble output. The four base models used include ANFIS, artificial neural network (ANN), support vector regression (SVR) and multilinear regression (MLR). The dominant input parameters for developing the base models were selected using two nonlinear approaches (mutual information and single-input single-output ANN-based sensitivity analysis) and a conventional Pearson correlation coefficient. The NF-E model was found to predict both PM2.5 and PM10 with higher generalization ability and least error. The NF-E model outperformed all the single base models and other linear ensemble techniques with a Nash-Sutcliffe efficiency (NSE) of 0.9594 and 0.9865, mean absolute error (MAE) of 1.63 µg/m3 and 1.66 µg/m3 and BIAS of 0.0760 and 0.0340 in the testing stage for PM2.5 and PM10, respectively. The NF-E could improve the efficiency of other models by 4-22% for PM2.5 and 3-20% for PM10 depending on the model.

Public Knowledge, Attitudes, and Practice towards COVID-19 Pandemic in Saudi Arabia: A Web-Based Cross-Sectional Survey.

(1) Background: COVID-19 has become a worldwide public health problem. No previous study has investigated factors associated with COVID-19 knowledge, attitude, and practice (KAP) after completely lifting the curfew in all Saudi Arabia regions and cities. Therefore, adequate knowledge, a positive attitude, and correct control of COVID-19 are essential to eradicate the disease. Hence, this study aims to assess factors associated with KAP of COVID-19; (2) Methods: This cross-sectional web-based survey was performed with the participation of 4305 individuals aged over 15 years living in Saudi Arabia from 11 to 19 August 2020. They were included using the snowball sampling method; (3) Results: Of the 4305 participants, 94.9% were Saudis, 60% females, and 45.4% were in the age group of 20-34 years, 61.7% married, and 49.3% from the Eastern Province of Saudi Arabia. Most of the participants demonstrated good KAP levels (89.6%, 87.2%, and 87.2%) towards the COVID-19 pandemic, respectively. In addition, most of the participants (85.8%) used the internet and social media as a source for COVID-19 information (4) Conclusions: The finding showed that most of the participants demonstrated good knowledge of COVID-19, positive attitudes, and demonstrated good practices for preventing the spread of disease infection.

Heterotopic Pancreas in the Gallbladder: Case Report and Literature Review.

INTRODUCTION: Heterotopic pancreas (HP) is the congenital presence of pancreatic tissue outside its normal location in the absence of vascular and anatomical connection with the main pancreas. HP can affect any part of the gastrointestinal tract, and it is mostly encountered in the stomach. The gallbladder is a rare site of HP, and our literature review revealed that only 38 cases were reported. We present a case of HP in the gallbladder that was presented with a picture of acute cholecystitis. After the case presentation, we will discuss HP in the gallbladder by reviewing the literature. Case Presentation. A 49-year-old male presented to the emergency department complaining of progressively worsening right upper abdominal pain for the last 24 hours. After thorough history and physical examination, a provisional diagnosis of acute cholecystitis was made. Abdominal ultrasonography revealed a rim of edema surrounding the gallbladder wall with two stones impacted at the gallbladder neck. Laparoscopic cholecystectomy was performed with an uneventful postoperative course, and the patient was discharged the next day. Microscopic examination of the gallbladder showed that a heterotopic pancreatic tissue, composed of a large number of pancreatic acini and few ducts with the absence of islets of Langerhans, was found around the cystic duct. The patient was asymptomatic at the regular follow-up six months postoperatively. CONCLUSION: HP in the gallbladder is an extremely rare finding. Its clinical presentation is not different from other cholecystopathic diseases. Most cases were accompanied by cholelithiasis. Preoperative laboratory and imaging modalities are usually not helpful in the diagnosis of HP in the gallbladder. The definitive diagnosis is made by histological examination of the gallbladder specimen. Laparoscopic cholecystectomy is sufficing treatment.