Prostate cancer across four countries in the Middle East: a multi-centre, observational, retrospective and prognostic study.

Prostate cancer (PC) is the second most prevalent cancer in males, with a steadily increasing incidence in the Middle East (ME). The aim of this study was to capture real-world data on the characteristics, disease progression, and treatment patterns among PC patients in the ME. This was a retrospective, observational, multi-centre study conducted across ten hospitals/research centers in Lebanon, Kingdom of Saudi Arabia, Iraq and Kuwait. Data were abstracted from medical records of 615 male patients who were diagnosed with PC between January 2012 and the site initiation date (December 2018-May 2019) and received at least one PC treatment/intervention. The observation period ranged between 84 and 88 months. Data were collected on demographics, clinical characteristics, time to progression to the subsequent clinical state or therapy (progression from localised/locally advanced PC to castration and to metastatic PC (metastatic castration-sensitive PC (mCSPC) or metastatic castration-resistant PC (mCRPC)), progression from mCSPC to mCRPC, and mCRPC patients' progression to first subsequent line of therapy), treatment patterns, and mortality. Most patients had localised/locally advanced PC (57.7%), followed by mCSPC (37.4%), and mCRPC (4.1%) at the time of inclusion in the study. Most patients were at tumours, nodes and metastases (TNM) stage IIIa (40.1%) or TNM stage IVb (27.8%) at study entry. Median time to metastatic disease, castration-resistance and next line therapy was 84 months (95% CI: 68-84), 41 months (95% CI: 30-56) and 7 months (95% CI: 0-41), respectively. The mortality rate was 3.6%. Disease progression was most common among patients with mCSPC (35.1%) or mCRPC (14.8%), and treatment discontinuation was most common among patients with mCRPC (36.6% treatments discontinued). The results show that most patients were at an advanced TNM stage at study entry, suggestive of a lack of awareness regarding PC. Disease progression was most common among patients with metastatic disease, reflecting the challenge of treating metastatic disease and highlighting the need for novel treatments.

Targeted potent antimicrobial and antitumor oxygen-heterocyclic-based pyran analogues: synthesis and computational studies.

The process of creating a series of 3-amino-1-aryl-8-methoxy-1H-benzo[f]chromene-2-carbonitriles (4a-q) involved reacting 6-methoxynaphthalen-2-ol (1), the appropriate aromatic aldehydes (2a-q), and malononitrile (3) in an absolute ethanol/piperidine solution under Ultrasonic irradiation. However, the attempt to create 3-amino-1-aryl-1H-benzo[f]chromene-2,8-dicarbonitrile (6a, d, e) was unsuccessful when 6-cyanonaphthalen-2-ol (5) was stirred at room temperature, reflux, Microwave irradiation, or Ultrasonic irradiation. In addition, the target molecules were screened against Staphylococcus aureus (MRSA), Staphylococcus aureus, Bacillus subtilis, Bacillus cereus, Escherichia coli and Klebsiella pneumonia, as well as a panel of three human cancer cells lines such as MCF-7, HCT-116, HepG-2 and two normal cell lines HFL-1 and WI-38. The obtained results confirmed that the pyran derivatives (4 m, i, k) which have a double chlorine at 3,4/2,3/2,5-positions, a single halogen atom 3-Cl/4-Br (4c, e) and a double bromine at 3,5-positions with a single methoxy group at 2-position (4n), of phenyl ring, and, to a lesser extent, other pyran derivatives with monoihalogenated (4a, b, d, f), dihalogenated (4 g, h, j, l) or trisubstituent phenyl ring (4o, p, q). Furthermore, compounds 4b-e, g, i, j, m, and n showed negligible activity against the two normal cell lines, HFL-1 and WI-38. Moreover, compound 4 g exhibited the strongest antimicrobial activity among the other pyran derivatives (4a-f, g-q) when compared to Ciprofloxacin. The MIC was assessed and screened for compound 4 g, revealing bactericidal effects. Lastly, SAR and molecular docking were studied.

Bee chitosan nanoparticles loaded with apitoxin as a novel approach to eradication of common human bacterial, fungal pathogens and treating cancer.

Antimicrobial resistance is one of the largest medical challenges because of the rising frequency of opportunistic human microbial infections across the globe. This study aimed to extract chitosan from the exoskeletons of dead bees and load it with bee venom (commercially available as Apitoxin [Api]). Then, the ionotropic gelation method would be used to form nanoparticles that could be a novel drug-delivery system that might eradicate eight common human pathogens (i.e., two fungal and six bacteria strains). It might also be used to treat the human colon cancer cell line (Caco2 ATCC ATP-37) and human liver cancer cell line (HepG2ATCC HB-8065) cancer cell lines. The x-ray diffraction (XRD), Fourier transform infrared (FTIR), and dynamic light scattering (DLS) properties, ζ-potentials, and surface appearances of the nanoparticles were evaluated by transmission electron microscopy (TEM). FTIR and XRD validated that the Api was successfully encapsulated in the chitosan nanoparticles (ChB NPs). According to the TEM, the ChB NPs and the ChB NPs loaded with Apitoxin (Api@ChB NPs) had a spherical shape and uniform size distribution, with non-aggregation, for an average size of approximately 182 and 274 ± 3.8 nm, respectively, and their Zeta potential values were 37.8 ± 1.2 mV and - 10.9 mV, respectively. The Api@ChB NPs had the greatest inhibitory effect against all tested strains compared with the ChB NPs and Api alone. The minimum inhibitory concentrations (MICs) of the Api, ChB NPs, and Api@ChB NPs were evaluated against the offer mentioned colony forming units (CFU/mL), and their lowest MIC values were 30, 25, and 12.5 µg mL-1, respectively, against Enterococcus faecalis. Identifiable morphological features of apoptosis were observed by 3 T3 Phototox software after Api@ChB NPs had been used to treat the normal Vero ATCC CCL-81, Caco2 ATCC ATP-37, and HepG2 ATCC HB-8065 cancer cell lines for 24 h. The morphological changes were clear in a concentration-dependent manner, and the ability of the cells was 250 to 500 µg mL-1. These results revealed that Api@ChB NPs may be a promising natural nanotreatment for common human pathogens.

Iron/Copper/Phosphate nanocomposite as antimicrobial, antisnail, and wheat growth-promoting agent.

BACKGROUND: One of the current challenges is to secure wheat crop production to meet the increasing global food demand and to face the increase in its purchasing power. Therefore, the current study aimed to exploit a new synthesized nanocomposite to enhance wheat growth under both normal and drought regime. The effectiveness of this nanocomposite in improving the microbiological quality of irrigation water and inhibiting the snail's growth was also assessed. RESULTS: Upon the employed one-step synthesis process, a spherical Fe/Cu/P nanocomposite was obtained with a mean particle size of 4.35 ± 1.524 nm. Cu2+, Fe2+, and P4+ were detected in the dried nanocomposite at 14.533 ± 0.176, 5.200 ± 0.208, and 34.167 ± 0.203 mg/ml concentration, respectively. This nanocomposite was found to exert antibacterial activity against Escherichia coli and Salmonella typhi. It caused good inhibition percent against Fusarium oxysporum (43.5 ± 1.47%) and reduced both its germination rate and germination efficiency. The lethal concentration 50 (LC50) of this nanocomposite against Lanistes carinatus snails was 76 ppm. The treated snails showed disturbance in their feeding habit and reached the prevention state. Significant histological changes were observed in snail digestive tract and male and female gonads. Drought stress on wheat's growth was mitigated in response to 100 and 300 ppm treatments. An increase in all assessed growth parameters was reported, mainly in the case of 100 ppm treatment under both standard and drought regimes. Compared to control plants, this stimulative effect was accompanied by a 2.12-fold rise in mitotic index and a 3.2-fold increase in total chromosomal abnormalities. CONCLUSION: The finding of the current study could be employed to mitigate the effect of drought stress on wheat growth and to enhance the microbiological quality of irrigation water. This is due to the increased efficacy of the newly synthesized Fe/Cu/P nanocomposite against bacteria, fungi, and snails. This methodology exhibits potential for promoting sustainable wheat growth and water resource conservation.

Multiscale tribology analysis of MHD hybrid nanofluid flow over a curved stretching surface.

In this study, we investigate the interactions of a hybrid nanofluid on a curved surface that is being stretched. The magnetic field is perpendicular to the flow and interacts with a mixture of molybdenum disulfide and argentum nanoparticles suspended in pure water, forming a hybrid nanomaterial. Our investigation considers heat transport analysis under different conditions, such as magnetohydrodynamic, Darcy-Forchheimer porous medium flow, Joule heating, and a convective boundary condition. We employ numerical and statistical methods to study the problem's intricacies comprehensively. Our findings indicate that Darcy-Forchheimer flow includes viscous and inertial forces, which results in higher flow rates and reduced skin friction. Additionally, the convective boundary condition leads to uniform temperature distribution within the hybrid material due to rapid internal heat transfer relative to surface resistance, significantly increasing the heat transfer rate.

Comparative analysis of GAN-based fusion deep neural models for fake face detection.

Fake face identity is a serious, potentially fatal issue that affects every industry from the banking and finance industry to the military and mission-critical applications. This is where the proposed system offers artificial intelligence (AI)-based supported fake face detection. The models were trained on an extensive dataset of real and fake face images, incorporating steps like sampling, preprocessing, pooling, normalization, vectorization, batch processing and model training, testing-, and classification via output activation. The proposed work performs the comparative analysis of the three fusion models, which can be integrated with Generative Adversarial Networks (GAN) based on the performance evaluation. The Model-3, which contains the combination of DenseNet-201+ResNet-102+Xception, offers the highest accuracy of 0.9797, and the Model-2 with the combination of DenseNet-201+ResNet-50+Inception V3 offers the lowest loss value of 0.1146; both are suitable for the GAN integration. Additionally, the Model-1 performs admirably, with an accuracy of 0.9542 and a loss value of 0.1416. A second dataset was also tested where the proposed Model-3 provided maximum accuracy of 86.42% with a minimum loss of 0.4054.

Global production patterns: Understanding the relationship between greenhouse gas emissions, agriculture greening and climate variability.

Climate change due to increased greenhouse gas emissions (GHG) in the atmosphere has been consistently observed since the mid-20th century. The profound influence of global climate change on greenhouse gas (GHG) emissions, encompassing carbon dioxide (CO2), methane (CH4), and nitrous oxide (N2O), has established a vital feedback loop that contributes to further climate change. This intricate relationship necessitates a comprehensive understanding of the underlying feedback mechanisms. By examining the interactions between global climate change, soil, and GHG emissions, we can elucidate the complexities of CO2, CH4, and N2O dynamics and their implications. In this study, we evaluate the global climate change relationship with GHG globally in 246 countries. We find a robust positive association between climate and GHG emissions. By 2100, GHG emissions will increase in all G7 countries and China while decreasing in the United Kingdom based on current economic growth policies, resulting in a net global increase, suggesting that climate-driven increase in GHG and climate variations impact crop production loss due to soil impacts and not provide climate adaptation. The study highlights the diverse strategies employed by G7 countries in reducing GHG emissions, with France leveraging nuclear power, Germany focusing on renewables, and Italy targeting its industrial and transportation sectors. The UK and Japan are making significant progress in emission reduction through renewable energy, while the US and Canada face challenges due to their industrial activities and reliance on fossil fuels.

Entropy analysis of MHD hybrid nanoparticles with OHAM considering viscous dissipation and thermal radiation.

This research explores the 3-D flow characteristics, entropy generation and heat transmission behavior of nanofluids consisting of copper and titanium in water as they flow across a bidirectional apparent, while considering the influence of magneto-hydrodynamics. The thermophysical properties of nanofluids are taken advantage of utilizing the Tiwari and Das demonstrate. The concept of the boundary layer has facilitated the comprehension of the physical ideas derived from it. By applying requisite transformations, the connected intricate sets of partial differential equation have been converted into ordinary differential equation. The modified model is calculated employing the widely recognized technique known as OHAM by using Mathematica program BVPh2.0 Software. For different dimensionless parameters computational and graphical investigations have been performed. It is notice that as fluid parameters change, they exhibit distinct responses in comparison to the temperature, velocity profiles and entropy generation. The results show that velocity profile rise with greater estimates of the magnetic parameter and the rate of entropy formation. Furthermore, thermal profiles become less significant as Eckert and Prandtl numbers increase.

Modulation of Interleukin-23 Signaling With Guselkumab in Biologic-Naive Patients Versus Tumor Necrosis Factor Inhibitor-Inadequate Responders With Active Psoriatic Arthritis.

OBJECTIVE: We assessed and compared immunologic differences and associations with clinical response to guselkumab, a fully human interleukin (IL)-23p19 subunit inhibitor, in participants with active psoriatic arthritis (PsA) who were biologic-naive or had inadequate response to tumor necrosis factor inhibitors (TNFi-IR). METHODS: Serum biomarker levels at baseline and after treatment with guselkumab 100 mg every 8 weeks were compared between biologic-naive (n = 251) and TNFi-IR (n = 93) subgroups identified in the pooled DISCOVER-1/DISCOVER-2/COSMOS data set. Baseline biomarker levels determined by achievement of week 24 clinical responses (≥75%/90% improvement in Psoriasis Area and Severity Index [PASI 75/90], Investigator's Global Assessment [IGA] of psoriasis score 0/1 and ≥2-point improvement], ≥20% improvement in American College of Rheumatology criteria [ACR20]) were compared between prior treatment subgroups. RESULTS: Baseline IL-22, TNFα, and beta defensin-2 (BD-2) levels were significantly lower in biologic-naive than in TNFi-IR participants. With guselkumab, week 24 IL-17A, IL-17F, IL-22, serum amyloid A, C-reactive protein, IL-6, and BD-2 levels were significantly reduced from baseline in biologic-naive and TNFi-IR participants (≥1.4-fold difference, nominal P < 0.05). Clinical responders to guselkumab exhibited significantly higher baseline levels of several biomarkers than nonresponders (IL-17A, IL-17F, BD-2 in biologic-naive PASI 90 responders; IL-17A, BD-2 in TNFi-IR IGA 0/1 responders; IL-22, BD-2 in TNFi-IR PASI 90 responders [nominal P < 0.05]) and trended higher in TNFi-IR ACR20 responders. CONCLUSION: Guselkumab modulates IL-23 signaling and provides consistent pharmacodynamic effects in both biologic-naive and TNFi-IR PsA patients. Significantly elevated baseline IL-22, TNFα, and BD-2 levels and associations between baseline IL-22, IL-17A, and BD-2 levels and skin responses to guselkumab suggest greater dysregulation of IL-23/Th17 signaling in patients with TNFi-IR.

Hybrid Control of the DC Microgrid Using Deep Neural Networks and Global Terminal Sliding Mode Control with the Exponential Reaching Law.

The direct current (DC) microgrid is one of the key research areas for our advancement toward carbon-free energy production. In this paper, a two-step controller is designed for the DC microgrid using a combination of the deep neural network (DNN) and exponential reaching law-based global terminal sliding mode control (ERL-GTSMC). The DC microgrid under consideration involves multiple renewable sources (wind, PV) and an energy storage unit (ESU) connected to a 700 V DC bus and a 4-12 kW residential load. The proposed control method eliminates the chattering phenomenon and offers quick reaching time by utilizing the exponential reaching law (ERL). In the two-step control configuration, first, DNNs are used to find maximum power point tracking (MPPT) reference values, and then ERL-based GTSMC is utilized to track the reference values. The real dynamics of energy sources and the DC bus are mathematically modeled, which increases the system's complexity. Through the use of Lyapunov stability criteria, the stability of the control system is examined. The effectiveness of the suggested hybrid control algorithm has been examined using MATLAB simulations. The proposed framework has been compared to traditional sliding mode control and terminal sliding mode control to showcase its superiority and robustness. Experimental tests based on the hardware-in-the-loop (HIL) setup are then conducted using 32-bit TMS320F28379D microcontrollers. Both MATLAB and HIL results show strong performance under a range of environmental circumstances and system uncertainties.

Energy transfer through third-grade fluid flow across an inclined stretching sheet subject to thermal radiation and Lorentz force.

The heat and mass transfer through the third grade fluid (TGF) flow over an inclined elongating sheet with the consequences of magnetic field and chemical reaction is reported. The impact of activation energy, heat source/sink, and thermal radiation is considered on the TGF flow. Fluid that demonstrate non-Newtonian (NN) properties such as shear thickening, shear thinning, and normal stresses despite the fact that the boundary is inflexible is known as TGF. It also has viscous elastic fluid properties. In the proposed model, the TGF model is designed in form of nonlinear coupled partial differential equations (PDEs). Before employing the numerical package bvp4c, the system of coupled equations are reduced into non-dimensional form. The finite-difference code bvp4c, in particular, executes the Lobatto three-stage IIIa formula. The impacts of flow constraints on velocity field, energy profile, Nusselt number and skin friction are displayed through Tables and Figures. For validity of the results, the numerical comparison with the published study is performed through Table. From graphical results, it can be perceived that the fluid velocity enriches with the variation of TGF factor and Richardson number. The heat source parameter operational as a heating mediator for the flow system, its influence enhances the fluid temperature.

Effect of guselkumab on serum biomarkers in patients with active psoriatic arthritis and inadequate response to tumor necrosis factor inhibitors: results from the COSMOS phase 3b study.

BACKGROUND: Guselkumab is a selective interleukin (IL)-23 inhibitor targeting the IL-23p19 subunit. In the phase 3b COSMOS trial, guselkumab demonstrated efficacy in treating participants with active psoriatic arthritis (PsA) and inadequate response (IR; lack of efficacy or intolerance) to tumor necrosis factor inhibitors (TNFi). METHODS: Adults with active PsA (≥ 3 swollen joints, ≥ 3 tender joints) and IR to one or two TNFi (TNFi-IR) were randomized 2:1 to guselkumab at Weeks 0, 4, then every 8 weeks (Q8W) or placebo➔guselkumab Q8W at Week 24 with possible early escape at Week 16. Levels of serum cytokines, including interferon É£ (IFNÉ£), IL-10, and tumor necrosis factor α (TNFα); T helper 17 (Th17) effector cytokines IL-17A, IL-17F, and IL-22; and acute phase proteins C-reactive protein (CRP), IL-6, and serum amyloid A (SAA), were assessed and compared with matched healthy controls; guselkumab pharmacodynamics through Week 24 were also assessed. Associations between baseline biomarker levels and 1) baseline disease activity (28-joint disease activity score using CRP [DAS28-CRP], psoriasis area and severity index [PASI], and % body surface area [BSA] affected by psoriasis) and 2) clinical response (including ≥ 20% improvement in American College of Rheumatology criteria [ACR20] response) at Week 24 were assessed. RESULTS: Baseline serum levels of IL-6, IL-10, IL-17A, IL-17F, IL-22, TNFα, and IFNÉ£ were significantly higher in COSMOS TNFi-IR participants than in matched healthy controls. Baseline IL-6, CRP, and SAA levels were associated with baseline DAS28-CRP. IL-17A and IL-17F levels were associated with baseline PASI score and psoriasis BSA. Baseline swollen or tender joint counts did not associate with baseline biomarker levels. At Week 24, significant decreases from baseline in CRP, SAA, IL-17A, IL-17F, and IL-22 levels were seen in guselkumab, but not placebo-, treated participants. IL-17F and IL-22 levels at Week 24 in guselkumab-treated participants did not significantly differ from those of matched healthy controls. Guselkumab-treated participants achieving ACR20 response at Week 24 exhibited higher baseline IL-22 and IFNÉ£ levels versus nonresponders. CONCLUSIONS: Results from COSMOS participants with active, TNFi-IR PsA suggest guselkumab reduces levels of effector cytokines associated with the IL-23/IL-17 pathway, including those associated with baseline arthritis and skin disease activity. TRIAL REGISTRATION: ClinicalTrials.gov: NCT03796858.

Response of Maize Seedlings to Silicon Dioxide Nanoparticles (SiO2NPs) under Drought Stress.

Recently, the use of nanofertilizers has received a great deal of attention in managing plants under biotic and abiotic stresses. However, studies that elucidate the role of silicon dioxide nanoparticles (SiO2NPs) in regulating maize tolerance to drought stress are still at early stages of development. In this study, plants that were treated with SiO2NPs (0.25 g/L as foliar spray) displayed considerable improvement in the growth indices, despite being subjected to drought stress. In addition, the action of SiO2NPs led to a considerable rise in the levels of chlorophylls, proline, cell membrane integrity, leaf water content, and antioxidant enzymes (superoxide dismutase (SOD), catalase (CAT), and guaiacol peroxidase (G-POX)). In contrast, an inverse trend was seen in the oxidative injury, the total amount of soluble sugars, and the activity of ascorbate peroxidase (APX). At the same time, carotenoids were unaffected in SiO2NPs-treated and non-treated plants under drought stress. The results of the molecular investigation that was conducted using qRT-PCR showed that the relative expression of the D2 protein of photosystem II (PsbD) was elevated in SiO2NPs-treated plants in response to drought stress, while the expression of the osmotic-like protein (OSM-34) and aquaporin (AQPs) was downregulated in SiO2NPs-treated plants in response to drought stress. This research could pave the way for further investigations into how SiO2NPs boost plant resistance to drought stress.

Multi-Agent Variational Approach for Robotics: A Bio-Inspired Perspective.

This study proposes an adaptable, bio-inspired optimization algorithm for Multi-Agent Space Exploration. The recommended approach combines a parameterized Aquila Optimizer, a bio-inspired technology, with deterministic Multi-Agent Exploration. Stochastic factors are integrated into the Aquila Optimizer to enhance the algorithm's efficiency. The architecture, called the Multi-Agent Exploration-Parameterized Aquila Optimizer (MAE-PAO), starts by using deterministic MAE to assess the cost and utility values of nearby cells encircling the agents. A parameterized Aquila Optimizer is then used to further increase the exploration pace. The effectiveness of the proposed MAE-PAO methodology is verified through extended simulations in various environmental conditions. The algorithm viability is further evaluated by comparing the results with those of the contemporary CME-Aquila Optimizer (CME-AO) and the Whale Optimizer. The comparison adequately considers various performance parameters, such as the percentage of the map explored, the number of unsuccessful runs, and the time needed to explore the map. The comparisons are performed on numerous maps simulating different scenarios. A detailed statistical analysis is performed to check the efficacy of the algorithm. We conclude that the proposed algorithm's average rate of exploration does not deviate much compared to contemporary algorithms. The same idea is checked for exploration time. Thus, we conclude that the results obtained for the proposed MAE-PAO algorithm provide significant advantages in terms of enhanced map exploration with lower execution times and nearly no failed runs.

Effect of germanium oxide on the structural aspects and bioactivity of bioactive silicate glass.

Ternary silicate glass (69SiO2-27CaO-4P2O5) was synthesized with the sol-gel route, and different percentages of germanium oxide GeO2 (6.25, 12.5, and 25%) and polyacrylic acid (PAA) were added. DFT calculations were performed at the B3LYP/LanL2DZ level of theory for molecular modelling. X-ray powder diffraction (XRPD) was used to study the effect of GeO2/PAA on the structural properties. The samples were further characterized using DSC, ART-FTIR, and mechanical tests. Bioactivity and antibacterial tests were assessed to trace the influence of GeO2 on biocompatibility with biological systems. Modelling results demonstrate that molecular electrostatic potential (MESP) indicated an enhancement of the electronegativity of the studied models. While both the total dipole moment and HOMO/LUMO energy reflect the increased reactivity of the P4O10 molecule. XRPD results confirmed the samples formation and revealed the correlation between the crystallinity and the properties, showing that crystalline hydroxyapatite (HA) is clearly formed in the highest percentages of GeO2, proposing 25% as a strong candidate for medical applications, consistent with the results of mechanical properties and the rest of the characterization results. Simulated body fluid (SBF) in vitro experiments showed promising biocompatibility. The samples showed remarkable antimicrobial and bioactivity, with the strongest effect at 25%. The experimental findings of this study revealed that the incorporation of GeO2 into the glass in terms of structural characteristics, bioactivity, antimicrobial properties, and mechanical properties is advantageous for biomedical fields and especially for dental applications.

Exploring treatment of inflammatory bowel disease with infliximab in the Middle East and Northern Africa: An analysis of the HARIR observational cohort study.

Background: In 2017, inflammatory bowel disease, including Crohn's disease (CD) and ulcerative colitis (UC) affected more than 6.8 million people worldwide, with increased incidence in newly industrialized countries. Although treatment options were previously limited to symptom reduction, current approaches benefit from disease-modifying biologics. In this study, we aimed to explore disease characteristics, treatment, and outcomes of patients with CD or UC treated with infliximab or golimumab in routine clinical practice in the Middle East and Northern Africa. Methods: HARIR was a prospective, observational, multicenter study (NCT03006198), in patients who were treatment naïve or who received two or fewer biologic agents. Observed data from routine clinical practice were presented descriptively. Results: Data from 86 patients enrolled from five countries (Algeria, Egypt, Kuwait, Qatar, and Saudi Arabia) were analyzed, 62 with CD and 24 with UC. All patients received infliximab. Clinically meaningful efficacy data were observed only for the CD group (up to Month 3) due to limited patient numbers. Crohn's Disease Activity Index (CDAI) scores at Month 3 indicated a positive response to treatment (reduced score of ≥70 and ≥25% compared with baseline) for 14/48 (29.2%) patients; notably, 28/52 (53.8%) patients had CDAI score <150 at baseline. Rates of serious and severe adverse events (AEs) were low in both groups. The most common AEs were gastrointestinal disorders. Conclusion: Infliximab treatment was well tolerated in this Middle Eastern and Northern African population, and a clinical response was observed for 29.2% of CD patients. Limited accessibility to biologics and concomitant treatments restricted study conduct.

A Robust Brain Tumor Detector Using BiLSTM and Mayfly Optimization and Multi-Level Thresholding.

A brain tumor refers to an abnormal growth of cells in the brain that can be either benign or malignant. Oncologists typically use various methods such as blood or visual tests to detect brain tumors, but these approaches can be time-consuming, require additional human effort, and may not be effective in detecting small tumors. This work proposes an effective approach to brain tumor detection that combines segmentation and feature fusion. Segmentation is performed using the mayfly optimization algorithm with multilevel Kapur's threshold technique to locate brain tumors in MRI scans. Key features are achieved from tumors employing Histogram of Oriented Gradients (HOG) and ResNet-V2, and a bidirectional long short-term memory (BiLSTM) network is used to classify tumors into three categories: pituitary, glioma, and meningioma. The suggested methodology is trained and tested on two datasets, Figshare and Harvard, achieving high accuracy, precision, recall, F1 score, and area under the curve (AUC). The results of a comparative analysis with existing DL and ML methods demonstrate that the proposed approach offers superior outcomes. This approach has the potential to improve brain tumor detection, particularly for small tumors, but further validation and testing are needed before clinical use.

Effects of Fogging System and Nitric Oxide on Growth and Yield of 'Naomi' Mango Trees Exposed to Frost Stress.

In years with unfavorable weather, winter frost during the blossoming season can play a significant role in reducing fruit yield and impacting the profitability of cultivation. The mango Naomi cultivar Mangifera indica L. has a low canopy that is severely affected by the effects of frost stress. As a result of the canopy being exposed to physiological problems, vegetative development is significantly inhibited. The current investigation aimed to study the influence of spraying nitric oxide and fogging spray systems on Naomi mango trees grafted on 'Succary' rootstock under frost stress conditions. The treatments were as follows: nitric oxide (NO) 50 and 100 µM, fogging spray system, and control. In comparison to the control, the use of nitric oxide and a fogging system significantly improved the leaf area, photosynthesis pigments of the leaf, the membrane stability index, yield, and physical and chemical characteristics of the Naomi mango cultivar. For instance, the application of 50 µM NO, 100 µM NO, and the fogging spray system resulted in an increase in yield by 41.32, 106.12, and 121.43% during the 2020 season, and by 39.37, 101.30, and 124.68% during the 2021 season compared to the control, respectively. The fogging spray system and highest level of NO decreased electrolyte leakage, proline content, total phenolic content, catalase (CAT), peroxidases (POX), and polyphenol oxidase (PPO) enzyme activities in leaves. Furthermore, the number of damaged leaves per shoot was significantly reduced after the application of fogging spray systems and nitric oxide in comparison to the control. Regarding vegetative growth, our results indicated that the fogging spray system and spraying nitric oxide at 100 µM enhanced the leaf surface area compared to the control and other treatments. A similar trend was noticed regarding yield and fruit quality, whereas the best values were obtained when the fogging spray system using nitric oxide was sprayed at a concentration of 100 µM. The application of fogging spray systems and nitric oxide can improve the production and fruit quality of Naomi mango trees by reducing the effects of adverse frost stress conditions.

Improvement in patient-reported outcomes and work productivity following 3-year ustekinumab or tumour necrosis factor inhibitor treatment in patients with psoriatic arthritis: results from the PsABio real-world study.

BACKGROUND: To evaluate the real-world effect of the IL-12/23 inhibitor ustekinumab or of a tumour necrosis factor inhibitor (TNFi) on patient-reported outcomes (PRO) and their association with effectiveness endpoints in psoriatic arthritis (PsA) patients over 3 years. METHODS: In PsABio (NCT02627768), a prospective, observational study, patients with PsA that were prescribed first- to third-line ustekinumab or a TNFi, and remained on that drug for 3 years, were analysed for change in baseline in PROs (EuroQol-5 dimensions health state VAS [EQ-5D VAS], 12-item Psoriatic Arthritis Impact of Disease questionnaire [PsAID-12; range 0-10], Work Productivity and Activity Impairment for Psoriatic Arthritis questionnaire [WPAI; results expressed as a percentage for each domain]), and the association between PROs and WPAI with effectiveness endpoints, clinical disease activity index for psoriatic arthritis (cDAPSA), low disease activity (LDA)/remission, minimal disease activity (MDA) and very low disease activity (VLDA). RESULTS: In 437 patients (mean age 49.1 years, 47.8% female), at 3 years, ustekinumab and TNFi treatment led to comparable improvements in EQ-5D VAS; mean change from baseline (95% confidence intervals [CI]) was 11.0 (6.5; 15.4) and 18.9 (14.0; 23.9), respectively. Both groups improved PsAID-12 after 3 years; mean change from baseline (95% CI) was -2.9 (-3.2; -2.5) and -3.5 (-3.9; -3.2), respectively. At baseline, due to their PsA, TNFi-treated patients had lower work productivity compared to ustekinumab-treated patients; mean productivity reduction (95% CI) was 58.8 [52.4; 65.2] and 43.3 [35.6; 51.1]. Over 3 years, TNFi-treated patients had a greater improvement in work productivity compared to ustekinumab-treated patients, ultimately leaving work productivity to be comparable between groups; mean improvement (95% CI) was 44.5% (38.4; 50.6) and 24.9% (15.8; 34.0), respectively. A similar trend was observed in activity impairment. Patients in both treatment groups who achieved effectiveness endpoints, cDAPSA LDA/remission, MDA, and VLDA had greater improvement in PROs and WPAI than patients who did not achieve these endpoints. CONCLUSIONS: At 3 years, improvements in PROs following ustekinumab or TNFi treatment were generally comparable; however, TNFi-treated patients achieved a greater improvement in work productivity, although this group started from a lower baseline. Achievement of effectiveness endpoints, independent of treatment group, also improved PROs. TRIAL REGISTRATION: ClinicalTrials.gov, NCT02627768. Registered on 11 December 2015.