Ultrastructure Microscopic Characterization of Apoptosis in Myelomoncytic Leukemia Cell Line Treated with Velogenic Viscerotropic Newcastle Disease Virus Strain AF 2240.

OBJECTIVE: Leukemia is a group of hematologic malignancies in the bonemarrow that arise from the dysfunctional proliferation of developing leukocytes. It is classified as either acute or chronic based on the rapidity of proliferation and as myelocytic or lymphocytic based on the cell of origin. Newcastle Disease Virus (NDV) is an avian paramyxovirus, which has been demonstrated to possess significant oncolytic activity against mammalian cancers because its ability to kill tumor cells with limited toxicity to normal cells. METHODS:  In this study, the morphophical changes and apoptosis induction of WEHI 3B leukemia cell line treated with NDV strain AF2240 were studied by scanning electron microscopes and  transmission electron microscopes techniques. RESULT: Electron microscopy indicated that NDV strain AF 2240 significantly altered cell morphology and reduced cell viability. Furthermore,  early apoptosis was observed 6 h post-inoculation by fluorescence microscope. CONCLUSION: Our results suggest that NDV has ability to induce significant apoptoic structural changes in WEHI 3B leukemia cell line. These findings provide new insights into the mechanism of action of NDV virotherapy and could lead to the development of more effective treatments for leukemia.

Synthesis and analysis of a novel thermal interface material for DC-DC boost converter.

The rapid evolution of power electronics has triggered an intensified focus on thermal management within electronics circuits, stemming from the critical necessity to mitigate thermal-related failure rates. Thermal management in power electronics circuits relies heavily on efficient heat transfer to prevent overheating of components and ensure their reliable operation, optimal performance, and safety. To facilitate the effective heat transfer, a thermal interface material (TIM) is utilized between switching components such as MOSFETs and heat sinks to improve surface contact, which increases heat transfer. In this research work, a novel thermal interface material (TIM) based on Tungsten-Gallium is introduced and evaluated to enhance thermal properties such as thermal conductivity and viscosity of Gallium-based TIM material with the addition of Tungsten microparticles. The study involves the examination of three distinct TIM samples with varying Tungsten content. Their surface morphology, composition, and topography were analyzed through techniques such as Scanning Electron Microscopy (SEM) and Atomic Force Microscopy (AFM) within the context of a DC-DC boost converter. The results indicate that the addition of Tungsten significantly enhances TIM's viscosity and fluidity, even at high temperatures reaching up to 308 °C, which is crucial for power electronics circuits. In addition, thermal constant analyzer, and DC-DC converter circuit such as boost converter circuit were utilized for thermal and electrical characterization, respectively. These characterization results demonstrate that 10%/wt. addition of Tungsten can increase the thermal conductivity of Gallium from 13.1 to 22.82 W/m.K at room temperature, which represents an overall 74.2% increase in thermal conductivity. Furthermore, when the proposed TIM sample 2 was used in a boost converter circuit, the switching frequency of MOSFET IRF3808 was increased up to 20 kHz while the conduction losses were also lowest compared to other TIM samples.

Variance in multi-blade induced lightning overvoltages among different wind farm topologies.

The impact of the topological formation of wind farms upon the lightning induced overvoltages injected into the grid was not covered earlier in literature. However, this topic is highly important to be investigated to allow the usage of the most reliable topology against lightning strikes. For such reason, the paper investigates this point with consideration of most damaging cases as lightning strikes to multi-blades. The testing used ATP software for four main topologies, radial, single-sided ring SSR, double sided ring and star topology. The features defining the similarities in response and the variance range between these topologies were recorded and analyzed. The multi-blade strikes gave an expected increase of 15% to 100% in the injected overvoltage to the grid for all topologies. The star topology showed the most reliable performance by allowing the least injected overvoltage to the grid. The percentage of reduction in the magnitude of the injected overvoltages reached 50.78%, 66.07% and 89.04% for SSR, DSR and star topology respectively with respect to radial topology. Recommendation was provided for design engineers to consider star topology during design phase in terms of more reliable lightning protection.

Efficacy of Cerebellar Transcranial Magnetic Stimulation in Treating Essential Tremor: A Randomized, Sham-Controlled Trial.

BACKGROUND AND PURPOSE: Repetitive transcranial magnetic stimulation (rTMS) of the cerebellar hemisphere represents a new option in treating essential tremor (ET) patients. We aimed to determine the efficacy of cerebellar rTMS in treating ET using different protocols regarding the number of sessions, exposure duration, and follow-up duration. METHODS: A randomized sham-controlled trial was conducted, in which 45 recruit patients were randomly allocated to 2 groups. The first (active group) comprised 23 patients who were exposed to 12 sessions of active rTMS with 900 pulses of 1-Hz rTMS at 90% of the resting motor threshold daily on each side of the cerebellar hemispheres over 4 weeks. The second group (sham group) comprised 22 patients who were exposed to 12 sessions of sham rTMS. Both groups were reassessed at baseline and after 1 day, 1 month, 2 months, and 3 months using the Fahn-Tolosa-Marin tremor-rating scale (FTM). RESULTS: Demographic characteristics did no differ between the two groups. There were significant reductions both in FTM subscores A and B and in the FTM total score in the active-rTMS group during the period of assessment and after 3 months (p=0.031 and 0.011, respectively). However, subscore C did not change significantly from baseline when assessed at 2 and 3 months (p=0.073 and 0.236, respectively). Furthermore, the global assessment score was significantly higher in the active-rTMS group (p>0.001). CONCLUSIONS: Low-frequency rTMS over the cerebellar cortex for 1 month showed relative safety and long-lasting efficacy in patients with ET. Further large-sample clinical trials are needed that include different sites of stimulation and longer follow-ups.

Outcomes of Upper Gastrointestinal Bleeding at United States Teaching and Non-teaching Hospitals: A National Inpatient Sample Analysis.

BACKGROUND/AIMS: Studies have varied results regarding the impact of the teaching and non-teaching status of hospitals on the outcomes for hospitalized patients with upper gastrointestinal bleeding (UGIB). To evaluate these outcomes, we conducted a retrospective cohort study using the 2014 National Inpatient Sample (NIS) database. METHODS: We included all adult patients who were admitted with the principal diagnosis of UGIB. Patients admitted to rural and urban non-teaching hospitals were classified as non-teaching, whereas those admitted to urban teaching hospitals were classified as teaching. The main outcomes of interest were in-hospital mortality, percentage of patients requiring inpatient endoscopy, and endoscopic therapy, packed red blood cell (PRBC) transfusion, length of stay (LOS), and total hospitalization charges. RESULTS: The study included 132,085 (97%) with nonvariceal UGIB (NVUGIB) and 4,200 (3%) with variceal UGIB (VUGIB). Of them, 62% were managed at teaching hospitals. Compared with admitted patients at non-teaching hospitals, patients with nonvariceal UGIB admitted at teaching hospitals had similar adjusted in-hospital mortality rates (adjusted odds ratio (OR): 0.97, 95% confidence interval (CI): 0.79-1.19), inpatient endoscopy rates (OR: 0.98, 95% CI: 0.91-1.1), and early endoscopy rates (within 24 hours) (OR: 0.98, 95% CI: 0.91-1.1) and lower PRBC transfusion rates (OR: 0.87, 95% CI: 0.79-0.97) but higher endoscopic therapy rates (OR: 1.3, 95% CI: 1.2-1.4), length of stay (mean increase of 0.43 days) (P<0.01), and total hospital charges (mean increase of $4,369) (P<0.01). Patients with variceal UGIB had similar adjusted in-hospital mortality rates (OR: 1.2, 95% CI: 0.61-2.3), inpatient endoscopy rates (OR: 0.97, 95% CI: 0.67-1.4), early endoscopy rates (within 24 hours) (OR: 0.97, 95% CI: 0.67-1.4), endoscopic therapy rates (OR: 2.5, 95% CI: 0.54- 11.2), and total hospital charges (P=0.45), and lower PRBC transfusion rates (OR: 0.63, 95% CI: 0.45-0.88) but higher length of stay (mean increase of 0.69 days) (P=0.02). CONCLUSIONS: Patients with nonvariceal UGIB treated at US teaching hospitals and non-teaching hospitals have similar mortality, rates of in-hospital endoscopy, and early endoscopy, but teaching hospitals have higher rates of in-hospital therapeutic endoscopy, length of stay, and total hospital charges. There was no difference in any of the outcomes for variceal gastrointestinal (GI) bleeding treated at teaching hospitals compared with those treated at non-teaching hospitals, except for length of stay, which was higher among patients admitted to teaching hospitals compared to those admitted to non-teaching hospitals.

Parametric Optimization of FDM Process for PA12-CF Parts Using Integrated Response Surface Methodology, Grey Relational Analysis, and Grey Wolf Optimization.

Efficiently managing multiple process parameters is critical for achieving optimal performance in additive manufacturing. This study investigates the relationship between eight key parameters in fused deposition modeling (FDM) and their impact on responses like average surface roughness (Ra), tensile strength (TS), and flexural strength (FS) of carbon fiber-reinforced polyamide 12 (PA 12-CF) material. The study integrates response surface methodology (RSM), grey relational analysis (GRA), and grey wolf optimization (GWO) to achieve this goal. A total of 51 experiments were planned using a definitive screening design (DSD) based on response RSM. The printing process parameters, including layer thickness, infill density, and build orientation, significantly affect Ra, TS, and FS. GRA combines responses into a single measure, grey relational grade (GRG), and a regression model is developed. GWO is then employed to optimize GRG across parameters. Comparison with GRA-optimized parameters demonstrates GWO's ability to discover refined solutions, reducing average surface roughness to 4.63 µm and increasing tensile strength and flexural strength to 88.5 MPa and 103.12 MPa, respectively. Practical implications highlight the significance of GWO in industrial settings, where optimized parameters lead to reduced costs and improved product quality. This integrated approach offers a systematic methodology for optimizing FDM processes, ensuring robustness and efficiency in additive manufacturing applications.

The Safety of Cold Versus Hot Snare Polypectomy in Polyps 10-20 mm: A Systematic Review and Meta-Analysis.

Colonoscopy remains the primary method for preventing colorectal cancer. Traditionally, hot snare polypectomy (HSP) was the method of choice for removing polyps larger than 5 mm. Yet, for polyps smaller than 10 mm, cold snare polypectomy (CSP) has become the favored approach. Lately, the use of CSP has expanded to include the removal of sessile polyps that are between 10 and 20 mm in size. Our systematic review and meta-analysis aimed to evaluate the safety of cold snare polypectomy (CSP) compared to hot snare polypectomy (HSP) for resecting polyps measuring 10-20 mm. We searched the Medical Literature Analysis and Retrieval System Online (MEDLINE), Embase, and Cochrane databases up to April 2020 to find studies that directly compared CSP to HSP for polyps larger than 10 mm. Our main focus was on assessing the risk of delayed bleeding after polypectomy; a secondary focus was the incidence of any adverse events that required medical intervention post procedure. Our search yielded three comparative studies, two observational studies, and one randomized controlled trial (RCT), together encompassing 1,193 polypectomy procedures. Of these, 485 were performed using CSP and 708 with HSP. The pooled odds ratio (OR) for post-polypectomy bleeding (PPB) was 0.36 (95% confidence interval {CI}: 0.02, 7.13), with a Cochran Q test P-value of 0.11 and an I2 of 53%. For the risk of any adverse events necessitating medical care, the pooled OR was 0.15 (95% CI: 0.01, 2.29), with a Cochran Q test P-value of 0.21 and an I2 of 35%. The quality of the two observational studies was deemed moderate, and the RCT was only available in abstract form, preventing quality assessment. Our analysis suggests that there is no significant difference in the incidence of delayed post-polypectomy bleeding or other adverse events requiring medical attention between CSP and HSP for polyps measuring 10-20 mm.

Modulation of antioxidant defense and PSII components by exogenously applied acetate mitigates salinity stress in Avena sativa.

Salinity stress has detrimental effects on various aspects of plant development. However, our understanding of strategies to mitigate these effects in crop plants remains limited. Recent research has shed light on the potential of sodium acetate as a mitigating component against salinity stress in several plant species. Here, we show the role of acetate sodium in counteracting the adverse effects on oat (Avena sativa) plants subjected to NaCl-induced salinity stress, including its impact on plant morphology, photosynthetic parameters, and gene expression related to photosynthesis and antioxidant capacity, ultimately leading to osmoprotection. The five-week experiment involved subjecting oat plants to four different conditions: water, salt (NaCl), sodium acetate, and a combination of salt and sodium acetate. The presence of NaCl significantly inhibited plant growth and root elongation, disrupted chlorophylls and carotenoids content, impaired chlorophyll fluorescence, and down-regulated genes associated with the plant antioxidant defense system. Furthermore, our findings reveal that when stressed plants were treated with sodium acetate, it partially reversed these adverse effects across all analyzed parameters. This reversal was particularly evident in the increased content of proline, thereby ensuring osmoprotection for oat plants, even under stressful conditions. These results provide compelling evidence regarding the positive impact of sodium acetate on various plant development parameters, with a particular focus on the enhancement of photosynthetic activity.

Analysis of thermal decomposition kinetics of chicken feather fiber reinforced Poly-lactic acid composites filament.

Derivative Thermogravimetric analysis under air was used to observe the thermal decomposition process of Chicken feather fiber (CFF) reinforced Poly-lactic acid (PLA) composite filament of 2.2 mm diameter. The thermal degradation of the sample was initiated at 140 Ö¯C. Approximately 75 % of the thermal degradation occurred between the temperature of 357 Ö¯C and 399 Ö¯C. The composite's activation energy was established using the Coats-Redfern method. The results showed that the activation energy of 112.06 kJ/mol is utilized for the sample throughout the temperature range of 23 Ö¯C to 398 Ö¯C. A low activation energy is indicative of rapid chemical reactions between the CFF and PLA molecules. The results from TGA and DTGA indicate that the addition of CFF in the PLA matrix enhanced the thermal stability.

Optimization of a pre-concentration method for the analysis of mercury isotopes in low-concentration foliar samples.

Hg isotope analysis in samples from background regions is constrained by the presence of low Hg concentration and therefore requires a pre-concentration method. Existing Hg pre-concentration methods are constrained by long sample processing time and limited sample loading capacity. Using foliar samples as a test case, an optimized Hg pre-concentration method is presented that involves the microwave-assisted digestion of samples for Hg isotope analysis with the addition of a pre-digestion step. Microwave-digested foliar samples and CRMs were transferred to an impinger, reduced with SnCl2, and collected in a 2.25 mL concentrated inverse aqua regia (3:1 HNO3:HCl, v/v). This resulted in an optimal acid concentration in the solution ideal for analysis on MC-ICP-MS. The time for purging with Hg-free N2 was optimized to 30 min and the efficiency of the pre-concentration method was tested using a combination of approaches. Tests performed on pure reagents and matrix of foliar samples spiked with 197Hg radiotracer showed recoveries averaging 99 ± 1.7% and 100 ± 3.0%, respectively. Mercury at concentrations as low as 1.83 ng g-1 was pre-concentrated by digesting aliquots of foliage samples in individual digestion vessels. Recoveries following their pre-concentration averaged 99 ± 6.0%, whereas recoveries of 95 ± 4.7% and 95 ± 2.5% were achieved for NIST SRM 1575a (pine needle) and reagents spiked with NIST SRM 3133, respectively. Analysis using multicollector-ICP-MS showed low fractionation of δ202Hg during sample pre-concentration with no significant mass-independent fractionation. The proposed method is a relatively simple and robust way to prepare Hg samples for Hg isotopic analysis and is suitable even for complex biological matrices.

Application of traceable calibration for gaseous oxidized mercury in air.

BACKGROUND: The current speciation methods for mercury (Hg) measurements are fraught with considerable uncertainty, from sample collection to calibration. High reactivity of gaseous oxidized Hg (GOM) species and their ultra-trace level presence makes them difficult to sample and calibrate. Given that improper calibration may lead to measurement biases, reliable and metrologically traceable calibration methods are required for accurately quantifying GOM in air. In the present study, we applied the recently developed calibration method based on non-thermal plasma oxidation of elemental Hg, to a commercially available Hg air speciation system for actual environmental measurements of GOM for the first time. RESULTS: Hg species such as HgO, HgCl2, and HgBr2 were produced with trace amounts of reactant gases (oxygen and electrolytically produced chlorine and bromine) and the production was driven by plasma-assisted oxidation. The plasma oxidation efficiency of elemental Hg with oxygen was 98.5 ± 7.5 % (k = 2), while that for chlorine and bromine was 96.8 ± 6.9 % (k = 2) and 97.4 ± 9.6 % (k = 2), respectively. The calibration method was tested against the internal permeation (Hg0) source of the Tekran 2537B Hg analyzer on-field by loading HgO to different KCl-coated denuders using the plasma. GOM concentrations were measured using the Tekran speciation system. With internal calibration, concentrations were up to 9.1 % lower than those in plasma calibration, thereby emphasizing the importance of the calibration strategy. Measurement uncertainty (k = 2) further emphasizes this distinction. Internal calibration measurement uncertainty was 36.8 %, while plasma calibration boasted lower uncertainty at 13.8 %. SIGNIFICANCE: The non-thermal plasma calibration strategy, as a unique and discrete calibration method traceable to the NIST SRM 3133 for ambient air GOM measurements, provide a higher level of confidence in the accuracy of GOM measurements with several advantages over other methods. Calibrations at extreme low concentrations (<100 pg) are possible with this method relevant to ambient air GOM concentrations.

Efficacy of platelet-rich plasma (PRP) in benign vocal fold lesions: a systematic review and meta-analysis.

OBJECTIVES: To evaluate the efficacy of platelet-rich plasma (PRP) in benign vocal fold lesions. METHODS: MEDLINE, Cochrane Central, Web of Science, and Scopus databases were searched in April 2023 for relevant clinical trials. Inclusion criteria were clinical trials evaluating the efficacy of PRP in benign vocal fold lesions. We conducted a comparative double-arm analysis using the pooled mean difference (MD) and 95% confidence interval (CI). Outcomes of interest included the vocal handicap index (VHI), the Jitter and Shimmer percentages, and the noise-to-harmonic ratio (NHR). RESULTS: Six studies matched the inclusion criteria. The pooled analysis shows that PRP was associated with significantly lower VHI scores compared with the control (MD = - 5.06, p < 0.01). Regarding the Jitter percentage, the PRP group was not superior to the control group at 2 and 4 weeks. However, the results revealed that PRP significantly reduced the Jitter percentage at 3 months (MD = - 0.61, p = 0.0008). The overall analysis favored the PRP arm significantly (p < 0.001). As for the Shimmer percentage, the combined effect estimate favored the PRP group (MD = - 1.22, p = 0.002). Subgroup analysis according to the time did not reveal any significant differences between studies at 2 weeks, 4 weeks, and 3 months. The analysis of the NHR outcome revealed a significant difference between both groups (MD = -1.09, p = 0.01). However, at 4 weeks, the treatment group had a significantly lower NHR % compared to the control group (MD = - 0.61, p = 0.02). There was no significant difference at 3 months (MD = - 2.14, p = 0.14). CONCLUSIONS: Platelet-rich plasma is effective in reducing VHI scores, Jitter and Shimmer percentages, and NHR values. This effect is more evident after follow-up, especially 3 months.

Efficacy of Cerebellar Transcranial Magnetic Stimulation in Treating Essential Tremor: A Randomized, Sham-Controlled Trial

Background@#and Purpose Repetitive transcranial magnetic stimulation (rTMS) of the cerebellar hemisphere represents a new option in treating essential tremor (ET) patients. We aimed to determine the efficacy of cerebellar rTMS in treating ET using different protocols regarding the number of sessions, exposure duration, and follow-up duration. @*Methods@#A randomized sham-controlled trial was conducted, in which 45 recruit patients were randomly allocated to 2 groups. The first (active group) comprised 23 patients who were exposed to 12 sessions of active rTMS with 900 pulses of 1-Hz rTMS at 90% of the resting motor threshold daily on each side of the cerebellar hemispheres over 4 weeks. The second group (sham group) comprised 22 patients who were exposed to 12 sessions of sham rTMS. Both groups were reassessed at baseline and after 1 day, 1 month, 2 months, and 3 months using the Fahn-Tolosa-Marin tremor-rating scale (FTM). @*Results@#Demographic characteristics did no differ between the two groups. There were significant reductions both in FTM subscores A and B and in the FTM total score in the active-rTMS group during the period of assessment and after 3 months (p=0.031 and 0.011, respectively).However, subscore C did not change significantly from baseline when assessed at 2 and 3 months (p=0.073 and 0.236, respectively). Furthermore, the global assessment score was significantly higher in the active-rTMS group (p>0.001). @*Conclusions@#Low-frequency rTMS over the cerebellar cortex for 1 month showed relative safety and long-lasting efficacy in patients with ET. Further large-sample clinical trials are needed that include different sites of stimulation and longer follow-ups.

Recognition of Arabic Air-Written Letters: Machine Learning, Convolutional Neural Networks, and Optical Character Recognition (OCR) Techniques.

Air writing is one of the essential fields that the world is turning to, which can benefit from the world of the metaverse, as well as the ease of communication between humans and machines. The research literature on air writing and its applications shows significant work in English and Chinese, while little research is conducted in other languages, such as Arabic. To fill this gap, we propose a hybrid model that combines feature extraction with deep learning models and then uses machine learning (ML) and optical character recognition (OCR) methods and applies grid and random search optimization algorithms to obtain the best model parameters and outcomes. Several machine learning methods (e.g., neural networks (NNs), random forest (RF), K-nearest neighbours (KNN), and support vector machine (SVM)) are applied to deep features extracted from deep convolutional neural networks (CNNs), such as VGG16, VGG19, and SqueezeNet. Our study uses the AHAWP dataset, which consists of diverse writing styles and hand sign variations, to train and evaluate the models. Prepossessing schemes are applied to improve data quality by reducing bias. Furthermore, OCR character (OCR) methods are integrated into our model to isolate individual letters from continuous air-written gestures and improve recognition results. The results of this study showed that the proposed model achieved the best accuracy of 88.8% using NN with VGG16.

Systematic Review on the Efficacy, Effectiveness, Safety, and Immunogenicity of Monkeypox Vaccine.

BACKGROUND: The variation in the reported vaccine safety and effectiveness could contribute to the high rates of vaccine hesitancy among the general population and healthcare workers in areas where monkeypox (mpox) is circulating. In this review, our objective was to evaluate the safety, immunogenicity, effectiveness, and efficacy of the mpox vaccines. METHODS: An extensive search for articles across multiple databases was performed, including searching six databases (PubMed Central, PubMed Medline, Scopus, Web of Science, Cochrane, ProQuest), two pre-print databases (European PMC Preprint and MedRxiv), and Google Scholar. RESULTS: A total of 4290 citations were retrieved from the included databases. Following the removal of duplicates and the initial screening of records, a total of 36 studies were included into the analysis. Additionally, we identified five more studies through manual searches, resulting in a total of 41 eligible articles for qualitative synthesis. The study findings revealed that mpox vaccines demonstrate the ability to generate adequate antibodies; however, their effectiveness may decrease over time, exhibiting varying safety profiles. Most of the included studies consistently reported substantial levels of effectiveness and efficacy against mpox. Interestingly, the number of vaccine doses administered was found to influence the degree of immunogenicity, subsequently impacting the overall effectiveness and efficacy of the vaccines. Furthermore, we found that smallpox vaccines exhibited a form of cross-protection against mpox. CONCLUSIONS: Vaccines can be used to prevent mpox and effectively control its spread.

Teachers' experiences of remote teaching in the COVID-19 pandemic for students with intellectual disabilities in the kingdom of Saudi Arabia.

The objective of this study is to investigate the experiences of teachers of students with Intellectual Disabilities (ID) with remote teaching during the COVID-19 pandemic, and to suggest solutions to address challenges. The study used an electronic questionnaire to collect field data from 150 teachers of students with IDs located in various cities of the Kingdom of Saudi Arabia (KSA). The study found that the most significant challenge encountered by teachers was that their students with ID found it challenging to complete online assessments in a specified amount of time and also to communicate with their peers and teachers. The findings of this study highlight the need for teachers to receive support from parents and the Ministry of Education of the KSA to improve the effectiveness of remote teaching for students with intellectual disabilities.

Antecedents for online food delivery platform leading to continuance usage intention via e-word-of-mouth review adoption.

The focus of hospitality initially was on ambience and novelty to attract customers. With the rise of the digital revolution, the hospitality industry has also undergone significant change. Long-distance travel at the workplace, odd working hours, and a variety of food options have driven people staying in Indian metropolises towards online food delivery (OFD) services. The popularity of OFD services has risen because of their practicality, simplicity, and a rise in consumer confidence in digital payments. Specifically, for the food industry, digitalization has opened new horizons to capture customers. The competition is not among the big brands, but big brands are competing with homemakers who run tiffin services, and street food hawkers who claim to provide traditional Dhaba-style food and fast food. The customers are loaded with unlimited options to choose the food in terms of price, cuisine, quality, etc. The present research examines the associations between service quality of OFD services, perceived ease of use, and word-of-mouth review adoption, leading to expectation confirmation modeling. The path analysis was carried out using data from 500 Indian respondents residing in Tier-I cities who have been using OFD services regularly. The research outcome shows that servqual has a positive influence on perceived ease of use and confirmation. Additionally, it encourages continued usage intentions because of its favorable impact on the adoption of e-word-of-mouth reviews.

Safety and Efficacy of Endoscopic Submucosal Dissection in the Management of Gastric Tube Cancers After Esophagectomy: A Systematic Review.

Esophagectomy is the proposed standard of care for resectable primary esophageal cancers and recurrent lesions in the reconstructed gastric tube (GT); however, it carries significant morbidity and mortality. Endoscopic submucosal dissection (ESD) has established its role in the management of primary esophageal cancers with growing evidence of its safety in resecting recurrent primary lesions in GT. Our study aims to evaluate the safety and efficacy of ESD in the management of recurrent, localized primary esophageal cancers in GT. We searched PubMed, CENTRAL, EMBASE, Scopus, and clinical trial registries from inception to March 2023 for articles evaluating the safety and efficacy of ESD in the management of recurrent cancerous lesions in GT. Our primary outcome was the en bloc resection rate. Secondary outcomes were curative resection rate, complete resection rate, intra-procedural complication rate, post-procedure complication rate, and five-year survival rate. Seven studies with a total of 165 patients undergoing 192 ESDs were included in the review. The pooled en bloc resection rate was 92.5% (95% CI: 87.7-95.6), which was reported in all seven studies. Pooled complete resection rate was 78.9% (95% CI: 64.5-88.5) per three studies, pooled curative resection rate was 73.9% (95% CI: 63.5-82.2) per four studies, and pooled intra-procedural complication rate was 10.2% (95% CI: 1.5-46.3), which was reported in four studies. Only three studies reported a five-year survival rate that was 65.5% (95% CI: 56.0-73.9). ESD is safe and efficacious in the management of GT cancer after esophagectomy.

Etiology and clinical characteristics of a non-cystic fibrosis bronchiectasis cohort in a middle eastern population.

BACKGROUND: Bronchiectasis is a widely prevalent airway disease characterized by airway dilatation and recurrent infections, that can lead to respiratory failure in severe cases. The etiology of bronchiectasis varies geographically, but there is a lack of published data examining its etiology specifically within the Middle Eastern population. METHODS: We conducted a retrospective analysis of our bronchiectasis patient registry, extracting clinical and demographic characteristics from electronic medical records. Quantitative variables were presented as the median and interquartile range (IQR), while categorical variables were expressed as numbers and percentages. Statistical comparisons for continuous characteristics were performed using the t-test, and significance was determined by a p-value less than 0.05. RESULTS: In total we analysed 260 records (63% female, 37% male), with median age of 58 years (interquartile range (IQR) 38-71), Body Mass Index (BMI) 25.8(IQR 22-30), forced expiratory volume in the first second (FEV1) %predicted 65 (IQR 43-79) and FEV1/forced vital capacity (FVC) 0.76 (0.67-0.86). Sixty-five cases (25%) were post-infectious in aetiology (excluding post-TB - n:27 10.4%). Forty-eight (18.5%) patients were labelled idiopathic, while Primary Ciliary Dyskinesia (PCD) accounted for 23 (8.8%) cases. Pseudomonas aeruginosa was the most common colonizing organism (32.7%), followed by Haemophilus influenzae (9.2%) and Methicillin-Sensitive Staphylococcus aureus(6.9%). At the time of review, 11 patients had died (median age, FEV %predicted, and bronchiectasis severity index (BSI) 59 years, 38% and 15.5 respectively), all due to respiratory failure, and as expected, all were classed severe on BSI. The BSI score was available for 109 patients, of which 31(28%) were classed mild, 29(27%) were moderate, and 49 (45%) were classed severe. The median BSI score was 8 (IQR 4-11). On dividing the patients according to obstructive vs. restrictive spirometry, we found that patients with FEV1/FVC < 0.70 had significantly higher BSI (10.1 vs. 6.9, p-value < 0.001) and that 8 out of the 11 deceased patients had FEV1/FVC < 70%. CONCLUSIONS: In our study, post-infectious, idiopathic, and PCD were identified as the most common etiologies of bronchiectasis. Additionally, patients with obstructive spirometry appeared to have a worse prognosis compared to those with restrictive spirometry.

Translation and Validation of the Arabic Version of the Reflux Symptom Score, Short Version 12 (RSS-12).

BACKGROUND: The Reflux Symptom Score (RSS) is a patient-related outcomes measure (PROM) that was developed to diagnose Laryngopharyngeal reflux (LPR), by assessing the severity and frequency of specific symptoms and their respective impact on quality of life (QoL). OBJECTIVE: To develop the Arabic version of RSS-12 (Ar-RSS-12), and to assess its validity and reliability. METHOD: The RSS-12 was translated from French into Arabic using the forward-backward translation method, and the translated version underwent transcultural validation. A case-control study was conducted at the otolaryngology clinics of a referral hospital, during the period November to December 2022. It included 61 patients with LPR-related symptoms and a Reflux Symptom Index (RSI) score >13, and 61 control without LPR-related symptoms and negative RSI scores ≤13. The internal consistency, internal and external validity, and Test-Retest reliability of Ar-RSS-12 were analyzed. RESULT: Patients had significantly higher scores than controls in all 12 items and total Ar-RSS and QoL impact scores, with high Z score values. Item scores showed variable correlation levels with total Ar-RSS score, with ear-nose-throat items showing the strongest correlation (Spearman's rho 0.592-0.866). The QoL scores were more strongly correlated to the symptoms' severity than frequency. The internal consistency was high, with Cronbach's alpha = 0.878. Regarding external validity, correlations with RSI score showed high Spearman's rho values for total Ar-RSS (0.905) and QoL total score (0.903). No statistically significant difference was observed between Test and Retest results in any of the 12 items' score or the total score and QoL, indicating the reproducibility of the test. CONCLUSION: The Ar-RSS is a valid and reproducible tool for the screening, assessment, and monitoring of LPR in Arabic speaking patients. The inclusion of symptoms severity and frequency, as well as their individual effects on patient's QoL, support the superior clinical applications of RSS compared to other existing PROMs.