Extraintestinal pathogenic E. coli (ExPEC) strains are associated with causing a wide range of infections such as urinary tract infections and bacteraemia. Over the past two decades, the levels of antimicrobial resistance of ExPEC strains have increasingly been reported worldwide, and this is attributed to the global emergence and dissemination of a single ExPEC lineage, known as E. coli ST131. This review explored the current knowledge of E. coli ST131 in Saudi Arabia, focusing on its antimicrobial resistance, virulence capacity and metabolic potential. Many local reports have shown that the antimicrobial resistance levels of E. coli ST131 were higher than non-ST131, particularly to front-line agents used for the empirical treatment of infections caused by ExPEC. Furthermore, E. coli ST131 strains have been associated with high virulence capacity, which could drive the current success of this clone locally. The metabolic activity of ST131 was also found to be slightly higher than non-ST131 strains that obtained from blood population. Taken together, the future studies should focus on elucidating the factors that drive the success of ST131.

The development of multifunctional photocatalysts that efficiently operate under visible light remains a fundamental challenge for sustainable wastewater treatment and oxygen evolution. In this work, we report a novel reticular and high-entropy TiO₂-based nanotubular hybrid system integrated with Cu:ZnO nanoparticles and carbon quantum dots (C-dots), designed to achieve synergistic enhancement in charge dynamics and surface reactivity. The high-entropy configuration introduces lattice distortion and defect sites that extend the optical absorption edge and promote rapid charge separation, while the Cu:ZnO interface accelerates electron transport and facilitates multi-pathway redox reactions. Simultaneously, the C-dots serve as photonic antennas, enabling visible-light sensitization through π–π conjugation and energy up-conversion. Structural and optical analyses confirm the formation of a reticular nanotubular network providing hierarchical porosity and large interfacial area for catalytic interactions. Under simulated solar irradiation, the hybrid demonstrates remarkable photocatalytic efficiency, achieving over 95% degradation of organic contaminants and enhanced oxygen evolution activity compared to pristine TiO₂. The introduced design concept coupling reticular high-entropy stabilization with optoelectronic co-catalyst modulation presents a new paradigm for next-generation photocatalysts capable of simultaneous environmental remediation and clean energy generation.

Background: Accurate segmentation and characterization of brain tumors from magnetic resonance imaging (MRI) are paramount for diagnosis, treatment planning, and monitoring. While deep learning models like U-Net have set a high standard for segmentation, they can fail to detect complex, multifocal disease and often lack the tools for in-depth clinical characterization beyond basic volume. Methods: A comprehensive, web-based platform built upon a hybrid Convolutional Neural Network (CNN) and Transformer architecture is presented. An end-to-end workflow is provided by the system from medical image upload (DICOM/NIfTI) to final analysis. It features a dedicated, interactive 3D reconstruction environment with real-time controls for mesh manipulation, lighting, and data export (STL for 3D printing, JSON for reports). All measurements are performed in native medical imaging units (millimeters) to ensure clinical accuracy. The platform also includes a detailed analysis tool for calculating a full suite of morphological and clinical metrics, including an estimated WHO grade. Results: Quantitatively, the Hybrid model achieved a mean Dice coefficient of 0.91 and a mean sensitivity of 0.94 across the test set, outperforming the U-Net (0.86 Dice, 0.88 sensitivity) and a traditional algorithm (0.72 Dice, 0.75 sensitivity). In a representative case of multifocal glioma, the hybrid model identified three distinct tumor foci with a total volume of 67,480 mm³, whereas the U-Net identified only a single mass of 15,140 mm³, representing a 4.4-fold increase in detected tumor burden. These results were visualized and explored in the platform's interactive 3D viewer, which provided real-time statistics and allowed for immediate export of the 3D model. Conclusion: Our work demonstrates a complete platform that not only leverages a state-of-the-art segmentation model but also provides the necessary tools for interactive visualization, analysis, and data dissemination. By seamlessly integrating a high-performance algorithm with a user-centric interface, the system serves as a powerful tool for medical education, clinical training, and reproducible research.

Charcoal stoves constitute an essential energy provision for millions residing in sub-Saharan Africa; however, conventional designs exhibit inefficiency and pose health risks, contributing to approximately 3.2 million premature fatalities each year due to household air pollution. This systematic review consolidates advancements in charcoal stove technology, with an emphasis on enhancing thermal efficiency, minimizing emissions, and ensuring user safety. Utilizing a methodologically rigorous approach, a total of 52 peer-reviewed studies (1994–2025) were meticulously examined from databases such as Scopus and ScienceDirect, employing standardized testing protocols (e.g., Water Boiling Test). The findings indicate that innovative designs, including rocket and gasifier stoves, attain thermal efficiencies ranging from 17% to 87%, in contrast to the 11% to 16% efficiencies observed in traditional models, alongside reductions in carbon monoxide emissions by as much as 75% and a decrease in fuel consumption by 70%. Nonetheless, performance outcomes exhibit variability in practical applications, influenced by user behavior and the durability of materials employed. The review emphasizes the imperative for validation through field-based studies and the development of economically accessible designs to promote widespread adoption. These technological innovations hold the potential to provide sustainable cooking solutions, thereby contributing to public health and the achievement of environmental objectives such as Sustainable Development Goal 7.

The primary concern in healthcare services within hospitals is patient safety. Quality management and patient safety are not only related to medical factors; several non-medical factors also influence them. These factors are personal, organizational culture, motivation, and patient safety culture. There has been no research at Koja Regional Hospital to date regarding patient safety culture related to personal factors, organizational culture, and motivation, which are crucial for implementing a patient safety culture as a primary step in improving service quality. This study aimed to identify and explain the factors that influence patient safety culture, including personal factors, organizational culture, and motivation. It used a cross-sectional design. Primary data were collected through questionnaires with 116 respondents. This study involved a dependent variable, Patient Safety Culture, two independent variables, Personal Factors and Organizational Culture, and one mediating variable, Motivation. It was analyzed using path analysis via Structural Equation Modeling (SEM). The results showed that personal factors have a significant positive effect on patient safety culture, indicated by a path coefficient of 0.311, a T-statistic of 3.603 (p = 0.000). Correspondingly, organizational culture plays a positive and significant role, with a path coefficient of 0.396 and a T-statistic of 2.957 (p = 0.003). The influence of organizational culture on motivation shows a path coefficient of 0.778 and a T-statistic of 11.996 (p < 0.000). To improve patient safety culture, Koja Regional Hospital requires simultaneous, complementary, and continuous interventions. The success of a patient safety program depends not only on individual abilities but also on innovation within a supportive organizational culture, good motivation, and a work environment that fosters patient safety.

The aim of this study was to assess the available literature on the efficacy of vitamin D supplementation on the osseointegration of dental implants in humans. The present literature review explores the question: “Does vitamin D supplementation have an impact on dental implant osseointegration?” Relevant publications were identified through electronic searches in PubMed and Google Scholar, covering the period from January 2018 to April 2025, using the MeSH terms: Vitamin D, Dental Implants, and Osseointegration. Only human studies published in English or French were considered. The reviewed literature includes articles such as narrative and systematic reviews, clinical trials, randomized clinical trials, case series, and case reports the electronic search yielded a total of 1,542 articles. Eight articles met the inclusion criteria [2 randomized clinical trials, 2 prospective studies, 1 retrospective study, 1 case report, and 2 literature reviews], comprising clinical data from 316 patients. Vitamin D supplementation may enhance osseointegration, notably in patients with deficiency. More research is needed to standardize supplementation protocols.

Blood exposure accidents [BEAs] are major occupational hazards in dental practice, since they carry the risk of transmission of potentially fatal pathogens like Human Immunodeficiency Virus [HIV], Hepatitis B and C [HBV and HCV]. Although protocols for prevention and management of BEAs are well established, knowledge gaps and underreporting are prevalent especially in North African countries like Tunisia. This study aims to evaluate the level of awareness, frequency of exposure and reporting practices of BEAs among Tunisian dentists. A cross-sectional and single-center study was conducted among dentists from June 28 to November 18 2022 that included professors, residents, interns, private practice dentists and public sector dentists. A 16-item survey was created using “Google Form” and distributed via email and in Tunisian dentists Facebook groups. 50 printed copies were distributed in the academic dental clinic of Monastir. An excel sheet and the “IBM SPSS” software were used for data analysis of the respondents, 50.6% demonstrated sufficient knowledge regarding general aspects of BEAs; however, 63% reported feeling inadequately informed about their management. A total of 168 BEAs were recorded, of which only 29.8% were officially reported to occupational health authorities’ Tunisian dentists possess sufficient knowledge regarding BEAs and their management, Nevertheless, many still feel ill-informed about the subject. Providing additional information could strengthen their knowledge, encourage reporting and enhance prevention efforts in Tunisia.

The hybrid nanomaterials represent a revolutionary type of engineered structure that lies on the boundary of the chemistry and materials science and nanotechnology. With a combination of discrete organic-inorganic, metallic-polymeric, or bio-inspired constituents at the nanoscale, the systems are strongly synergistic in terms of physicochemical properties, and by far outperform their individual components. This structural and functional tunability has provided new opportunities in sensor technology, energy conversion and sustainability in catalysis that has never been seen before. Recent progress in interfacial design, atomic-level assembly, as well as nanoscale characterization, have made it possible to highly tune charge dynamics, surface reactivity, and selective molecular recognition. In sensor devices, the hybrid nanomaterials have excellent sensitivity and signal fidelity due to the property of the designs of heterostructures engineering and quantum confinement. Likewise, their hierarchic structures and functional active sites enable efficient energy capture, pollutant reduction as well as green chemical reactions in catalytic systems at ambient conditions. The overlap between artificial intelligence, computational modeling and green synthesis protocols is also rapidly increasing the rational designing of hybrid nanomaterials to be used in sustainable technology applications. It is a review that critically evaluates the new synthesis strategies, structure-property correlations, and multifunctional uses of next-generation hybrid nanomaterials, and shows the progress along with the unfulfilled opportunities of providing scalable, environmentally responsible production. Lastly, the future directions are suggested to a new paradigm of adaptive, circular-economy-oriented design based on integrating efficiency, durability, and ecological compatibility in the state-of-the-art materials engineering.

The FiLaC™ (Fistula Laser Closure) technique has emerged as a valuable sphincter-preserving option for the treatment of cryptogenic anal fistulas, combining efficacy with functional safety. This retrospective study was conducted at the Hepato-Gastroenterology and Proctology Department of Ibn Sina University Hospital, Rabat, between January 2023 and January 2025. Twenty-five patients with cryptogenic anal fistulas underwent treatment using the FiLaC™ procedure, following initial drainage with a seton. Fistulas secondary to Crohn’s disease, tuberculosis, or malignancy were excluded. Cure was defined as complete closure of the fistulous tract and both orifices without recurrence during 24 months of follow-up. The mean age was 45.3 years, with a slight male predominance. Transsphincteric fistulas were the most frequent (44%), and the overall success rate reached 84%, without any case of postoperative incontinence. Univariate analysis showed that a short fistulous tract and a small internal opening were associated with better outcomes (p = 0.036 and p = 0.042, respectively). In multivariate analysis, only the short fistula tract remained a significant independent predictor of success (p = 0.04; OR = 5.12). Recurrent cases were successfully managed with a second FiLaC™ session. The technique was well tolerated and reproducible, with mean energy delivery of 699 Joules and an average fiber withdrawal time of 61.6 seconds. These results confirm that FiLaC™ is a minimally invasive and reliable technique for the management of cryptogenic anal fistulas, offering a high healing rate and optimal preservation of continence. The short length of the fistulous tract appears to be the most decisive predictive factor of long-term success.

Background: Diabetes mellitus (DM) is a major global health concern causing multi-organ complications, with postmenopausal women being particularly vulnerable due to hormonal and metabolic changes. This study aimed to evaluate the association between microalbuminuria and renal function markers in postmenopausal women with type 2 diabetes mellitus. Aim of the study: The aim of the study was to evaluate the association between microalbuminuria and renal function markers in postmenopausal women with type 2 diabetes mellitus. Methods: This cross-sectional study at the Department of Biochemistry, Dhaka Medical College, Dhaka, Bangladesh (July 2014–June 2015) included 100 postmenopausal women with type 2 diabetes to assess the association of microalbuminuria with renal function markers. After ethical approval and consent, fasting blood and morning urine samples were collected to measure glucose, HbA1c, serum albumin, serum creatinine, urinary creatinine, microalbuminuria, and ACR. Data were analyzed using SPSS 21 with t-tests and Pearson’s correlation; p < 0.05 was significant. Results: In 100 postmenopausal women with type 2 diabetes, 78% were microalbuminuria positive. Prevalence was 94.4% with abnormal serum albumin, 100% with raised ACR, and 91.7% with raised serum creatinine. Microalbuminuria correlated strongly with serum albumin (r = –0.750), urinary creatinine (r = –0.762), ACR (r = +0.997), and serum creatinine (r = +0.694), all p = 0.001. Conclusion: Microalbuminuria is strongly associated with renal function markers, highlighting the need for early detection of kidney dysfunction in postmenopausal women with type 2 diabetes in Bangladesh.

Cotton (Gossypium hirsutum L.) is the backbone of Pakistan’s economy and the primary source of natural fiber worldwide. Despite its significance, cotton productivity remains suboptimal due to a narrow genetic base, biotic and abiotic stresses, and declining soil fertility. Breeding programs therefore focus on developing new, high-yielding, and stress-tolerant advance lines that can outperform existing commercial cultivars. In this study, field evaluation and molecular profiling were conducted on a set of advance lines derived from FH-490 and compared with standard commercial checks (e.g., FH-942, SLH-2010, CIM-70). The experiment was laid out in a randomized complete block design with three replications under normal sowing conditions. Agronomic traits including plant height, monopodial and sympodial branches, number of bolls, boll weight, and seed cotton yield were recorded alongside fiber quality and physiological parameters. Significant variation was observed among the genotypes, with L-1 and L-4 recording the highest yields, while FH-942 and SLH-2010 performed poorly. Molecular analysis using SSR markers revealed polymorphism that differentiated the advance lines, with SSR4-170 notably associated with tolerance under limited water conditions. The integration of field performance with DNA fingerprinting allowed a clearer understanding of both genetic diversity and adaptive potential. This study identifies promising lines (L-1, L-2, L-4, L-5) with superior yield and fiber quality, suggesting their suitability for inclusion in breeding pipelines. Findings emphasize the importance of combining morphological evaluation with molecular tools to accelerate the development of resilient cotton varieties capable of sustaining production under evolving climatic and resource constraints.

Introduction: The main objective of our study is to assess the importance, direction, and predictability of dentofacial changes following LeFort I maxillary advancement while focusing on the extent of improvement of the soft and hard tissue profile of the face after surgery. Material and Method: This is a retrospective study carried out on patients treated in the dentofacial orthopedics unit at the Farhat Hached University Hospital of Soussa. The data of the study were obtained from a sample of 20 participants aged at least 18 years. Cephalometric measurements were performed on each patient and the collected data were analyzed with SPSS 22.0. Spearman's correlation test and simple linear regression test were used. The normality of the sample distribution was studied with the Shapiro-Wilk and Kolmogorov-Smirnov tests. The statistical significance level was set at 5%. Results: A negative and statistically insignificant correlation was found between patient age and the amount of maxillary advancement. The SNA and ANB angles were significantly and positively correlated with the amount of maxillary advancement. There was also a positive, statistically significant correlation between the amount of advancement and the thickness of the postoperative upper lip, which was confirmed by simple linear regression analysis, whereas the Z and nasolabial angles were negatively and significantly correlated with the amount of advancement. Also, a positive and statistically significant correlation was found between upper incisor exposure and upper lip thickness and length. Discussion: The results found in the literature have commonalities and differences with those found in our study, these comparisons will be discussed in our article. Conclusion: These variations should be taken into consideration and anticipated in our daily practice.

Post-cardiac arrest care represents a critical link in the chain of survival, yet outcomes for patients who achieve return of spontaneous circulation (ROSC) remain suboptimal. The period following ROSC is characterized by the complex, multisystem pathophysiology of post-cardiac arrest syndrome (PCAS), which includes profound brain injury, myocardial dysfunction, and a systemic ischemia-reperfusion response. Improving survival and neurological function requires a shift from a series of isolated interventions to a comprehensive, structured, and multidisciplinary system of care that spans the entire patient journey from the pre-hospital environment to the intensive care unit (ICU) and beyond. This review examines the integrated protocols that define modern post-cardiac arrest management. It details the continuum of care, beginning with pre-hospital stabilization and transitioning to in-hospital therapeutic strategies, including targeted temperature management (TTM), hemodynamic optimization, and neurological protection. A central focus is placed on elucidating the distinct and interdependent roles of a broad multidisciplinary team, encompassing not only direct clinical providers such as Paramedics, Nursing Specialists, and Respiratory Therapists, but also the essential technical and administrative personnel who form the operational backbone of this system. The specific contributions of Radiologic Technologists, Biomedical Technicians and Specialists, Nursing Technicians, Unit Coordinators, and Medical Secretaries are analyzed to demonstrate how their functions are integral to the consistent and reliable implementation of evidence-based guidelines. The review further explores the communication strategies and systemic protocols that orchestrate this complex collaboration, addresses common implementation challenges, and surveys the future landscape of post-cardiac arrest care, including emerging technologies and evolving therapeutic paradigms. The central thesis is that optimal patient outcomes are not merely a function of clinical expertise but are fundamentally dependent on the seamless integration of this entire multidisciplinary ensemble.

Background: Class II malocclusion is one of the most common orthodontic problems and often requires comprehensive treatment strategies. Conventional correction methods typically depend on high levels of patient compliance and may involve complex mechanics or extractions. The introduction of skeletal anchorage systems, particularly infrazygomatic crest (IZC) miniscrews, has provided an effective alternative for non-compliant and non-extraction cases. Objective: This case report aims to demonstrate the effectiveness of IZC-assisted en-masse distalization in correcting a Class II malocclusion Case Presentation: A 20-year-old female presented with a skeletal Class I malocclusion, Angle Class II relationship on the right side, right posterior crossbite, maxillary midline deviation, and proclined anterior teeth. Treatment objectives included correcting the midline, establishing Class I molar and canine relationships, resolving the crossbite, and improving facial esthetics. A passive self-ligating appliance system (Genius system) was used alongside skeletal anchorage via an IZC miniscrew to achieve en-masse distalization. A sequence of NiTi and stainless-steel archwires was used for alignment and torque control. Crossbite correction was achieved using flipped brackets, bite blocks, and criss-cross elastics. En-masse distalization was carried out using an IZC miniscrew and power arms to generate controlled force vectors. Final results showed successful correction of the Class II relationship, midline alignment, ideal overjet and overbite, and improved smile esthetics. Functional occlusion with proper guidance was also achieved. Conclusion: IZC miniscrew-supported distalization provides a reliable, compliance-independent solution for Class II correction. This approach offers excellent control of tooth movement, eliminates the need for extractions in many cases, and enhances both esthetic and functional outcomes with minimal patient cooperation.

The accurate determination of fluoride concentration in environmental and drinking water is critical for protecting public health and ensuring compliance with international water quality standards. In this study, a validated and efficient photometric method for fluoride quantification was developed using the Spectroquant Fluoride Test (Merck). The method is based on the reaction of fluoride ions with alizarin complex one and lanthanum (III) in a weakly acidic buffered medium to form a stable violet-colored complex, the absorbance of which is measured photometrically. The analytical procedure exhibits excellent sensitivity, selectivity, and precision across two quantifiable ranges: 0.10–2.00 mg/L and 1.0–20.0 mg/L F⁻, in accordance with EPA Method 340.3 and APHA Standard Method 4500-F E. Comprehensive validation was conducted to assess linearity, accuracy, and reproducibility, along with extensive interference studies covering common ions and organic substances. The findings confirmed negligible interferences under the optimized conditions, demonstrating the robustness of the method for diverse aqueous matrices. The reagents showed high chemical stability within the recommended storage conditions, maintaining consistent analytical performance over time. Owing to its simplicity, rapid execution, and low operational cost, this photometric approach represents a practical alternative to more complex techniques such as ion-selective electrodes and ion chromatography. The method’s applicability to groundwater, surface water, seawater, wastewater, and drinking water highlights its reliability as a universal tool for routine monitoring and regulatory compliance in fluoride analysis.