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The frequency–magnitude statistics of 6527 earthquakes with 1.0 ≤ ml ≤ 5.7 and focal depths between 0 and 49 km in the Red Sea region between 1980 and 2021 show that the threshold magnitude, above which most of the Red Sea earthquakes are precisely located, is 1.5. The b-value, which identifies regional stress situations and associated energy release modalities, has a value of 0.75, less than in historical data, and averages between 0.4 and 0.85 as it varies over time, indicating modest stress accumulation. We utilised these instrumental data to examine dynamic stress patterns in the Red Sea region, shedding light on the region’s geodynamics and providing a foundation for estimating the region’s seismic hazard. The computed fractal dimension (Dc) has a relatively high value of 2.3, which is significant for the Red Sea’s geological complexity and structural diversity. This result indicates the regular distribution of Red Sea earthquakes, which occur in clusters or along fault lines. The low b-value and comparatively high Dc were most likely due to major earthquakes in the past and the greater stress they caused. The focal mechanisms of the big earthquakes, predominantly normal solutions, are consistent with the movement and extensional regime. The pressure and tension (P-T) axes show a compression axis trending NW-SE and a tension axis trending NE-SW. According to the stress inversion results, the maximum principal stress (σ1) is oriented vertically, the minimum stress axis (σ3) is subhorizontal and strikes in the NE-SW direction, and the intermediate principal stress (σ2) is trending in the NE-SW direction. The variance in the region that characterises the homogeneity of stress directions within the range is 0.19. The stress ratio (R), which identifies the faulting type, is 0.76, suggesting a normal faulting pattern for the region. The hazard parameters are expressed by the probability of exceedance for 1-, 10-, 50-, and 100-year return periods. The highest probability that an earthquake will occur within a 50-year period is thought to be around 6.0. The largest observed catalogue and instrumental magnitudes in the area, 5.7 and 6.7, respectively, show average recurrence intervals of 36 and 142 years.

On 6 February 2023, Türkiye experienced a pair of consecutive earthquakes with magnitudes of Mw 7.8 and 7.5, and accompanied by an intense aftershock sequence. These seismic events were particularly impactful on the segments of the East Anatolian Fault Zone (EAFZ), causing extensive damage to both human life and urban centers in Türkiye and Syria. This study explores the analysis of a dataset spanning almost one year following the Turkiye mainshocks, including 471 events with a magnitude of completeness (Mc) ≥ 4.4. We employed the maximum likelihood approach to estimate the b-value and Omori-Utsu parameters (K, c, and p-values). The estimated b-value is 1.21 ± 0.1, indicating that the mainshocks occurred in a region characterized by elevated stress levels, leading to a sequence of aftershocks of larger magnitudes due to notable irregularities in the rupture zone. The aftershock decay rate (p-value = 1.1 ± 0.04) indicates a rapid decrease in stress levels following the main shocks. However, the c-value of 0.204 ± 0.058 would indicate a relatively moderate or low initial productivity of aftershocks. Furthermore, the k-value of 76.75 ± 8.84 suggests that the decay of aftershock activity commenced within a range of approximately 68 to 86 days following the mainshocks. The fractal dimension (Dc) was assessed using the correlation integral method, yielding a value of 0.99 ± 0.03. This implies a tendency toward clustering in the aftershock seismicity and a linear configuration of the epicenters. The slip ratio during the aftershock activity was determined to be 0.75, signifying that 75% of the total slip occurred in the primary rupture, with the remaining fraction distributed among secondary faults. The methodologies and insights acquired in this research can be extended to assist in forecasting aftershock occurrences for future earthquakes, thus offering crucial data for future risk assessment.

Residential projects are described as complex, dynamic systems that are subject to uncertainty. Cost performance is a fundamental challenge. As a result, project managers must adequately identify risks that might lead to cost overruns in residential construction projects. Simulation is noticed to be a useful technique for dealing with these complications. Therefore, this study developed a hybrid dynamic approach to study the effect of different risks on the cost performance of construction projects. The proposed approach combines system dynamics (SD) and discrete event simulation (DES), which can take into consideration the dynamics of the project environment, which contains various continuous influencing factors as well as the construction operations. The developed hybrid model is validated through serial model structure tests and model behavior tests, with the aid of data collected from a real construction project used in the simulation process. Based on the simulation results, it is concluded that the proposed hybrid dynamic approach is helpful to enhance the process performance by permitting construction managers to identify possible process improvement areas that traditional methods may miss.

NOABSTRACTThe study aimed to investigate the implementation of Competency-Based Language Teaching assessment and proficiency in English speaking skills.The study adopted a mixed methods approach and descriptive survey design. A random sample of 97 grade four English teachers and 56 grade four students were selected. The study utilized various methods to collect data, including a questionnaire, observation, interview, and oral test. The study employed both quantitative and qualitative data analysis methods.The result showed that there was limited implementation of Competency-Based Language Teaching assessment in speaking skills. The findings also showed that the teachers’ awareness of the purpose of the speaking skills assessment in Competency-Based Language Teaching was below average. The study also found that students scored below satisfactory in speaking skills competencies, indicating that they did not achieve the intended level of mastery.Teachers' awareness of the assessment's aim must be ensured to guarantee the implementation of the Competency-Based Language Teaching assessment. Competency-Based Language Teaching assessment also should ensure the achievement of learners’ speaking competency.The number of schools selected as the sample was only four for the questionnaire and achievement test.The study recommends that teachers implement Competency-Based Language Teaching assessments practically in spoken language instruction, be aware of the purpose of Competency-Based Language Teaching assessments in speaking skills, and promote learners based on the mastery of competency at each level.

Study Design: Retrospective cohort study.Purpose: To evaluate the safety and efficacy of the far-lateral approach in the resection of ventral and ventrolateral upper cervical meningiomas.Overview of Literature: Upper cervical meningiomas are a common disease entity. These lesions can be surgically treated via many accesses. The far-lateral approach is a very appealing technique for these lesions.Methods: We assessed 23 patients with a mean age of 57.3±15 years. According to the Japanese Orthopedic Association (JOA) scale; eight patients had grade 0, nine had grade I, and six had grade II. All patients underwent plain radiography and magnetic resonance imaging of the cervical spine. The foramen magnum was involved in 10 patients, C1–2 in seven, C2–3 in four, and C3–4 in two. All patients were operated via the far-lateral approach.Results: Gross total resection was achieved in 21 patients. Sixteen lesions were psammomatous, five were fibroblastic, and two were meningothelial meningiomas. The mean operative duration was 135±40 minutes, while the mean operative blood loss was 450±210 mL, and the mean hospital stay was 4.3±2.2 days. At the final follow-up that was conducted at 27.6±21 months and as per the JOA score; 16 patients were classified into grade 0 and 7 into grade II. The condition of none of our patients deteriorated postoperatively. There was no significant correlation of the clinical outcome with tumor level, pathological subtype of the tumor, symptom duration, age, and sex. There was no significant correlation of tumor resection completeness with tumor level, tumor pathological subtype, or tumor topography (ventral or ventrolateral).Conclusions: The far-lateral approach is a safe and effective access for ventral and ventrolateral cervical meningiomas. It allows direct access to tumor with no spinal cord or nerve roots traction, and thus may yield a fairly better outcome than the standard posterior approach.

Background Peritoneal dialysis (PD) is used as renal replacement therapy in patients with end-stage kidney disease. However, peritoneal membrane failure remains problematic and constitutes a critical cause of PD discontinuation. Recent studies have revealed the unique biological action of molecular hydrogen (H 2 ) as an anti-oxidant, which ameliorates tissue injury. In the present study, we aimed to examine the effects of H 2 on the peritoneal membrane of experimental PD rats. Method Eight-week-old male Sprague-Dawley rats were divided into the following groups ( n  = 8–11 each) receiving different test solutions: control group (no treatment), PD group (commercially available lactate-based neutral 2.5% glucose PD solution), and H 2 PD group (PD solution with dissolved H 2 at 400 ppb). Furthermore, the influence of iron (FeCl 3 : 5 μM: inducer of oxidative cellular injury) in the respective PD solutions was also examined (Fe-PD and Fe-H 2 PD groups). The H 2 PD solution was manufactured by bathing a PD bag in H 2 -oversaturated water created by electrolysis of the water. Twenty mL of the test solutions were intraperitoneally injected once a day for 10 days. Parietal peritoneum samples and cells collected from the peritoneal surface following treatment with trypsin were subjected to analysis. Results In the PD group as compared to controls, a mild but significant sub-mesothelial thickening was observed, with increase in the number of cells in the peritoneal surface tissue that were positive for apoptosis, proliferation and vimentin, as seen by immunostaining. There were significantly fewer of such changes in the H 2 PD group, in which there was a dominant presence of M2 (CD163+) macrophages in the peritoneum. The Fe-PD group showed a significant loss of mesothelial cells with sub-mesothelial thickening, these changes being ameliorated in the Fe-H 2 PD group. Conclusion H 2 -dissolved PD solutions could preserve mesothelial cells and peritoneal membrane integrity in PD rats. Clinical application of H 2 in PD could be a novel strategy for protection of peritoneal tissue during PD treatment.

The present-day stress field in Egypt has been investigated on the basis of updated earthquake focal mechanism catalog covering the period from 1951 to 2017. Our catalog contains 234 focal mechanisms compiled from previous studies in addition to 22 new source mechanism solutions achieved in this study. According to the distribution of the recent earthquake epicentres, Egypt is divided into nine seismotectonic regions. The available fault plane solutions in Egypt demonstrate a spatial variability of source mechanisms, which categorize the study area into three groups. The first group includes Dahshour, Beni Suef, Cairo-Suez district, Northern-Central Gulf of Suez and Southern Gulf of Suez, which characterized by pure normal faulting mechanism to normal faulting with strike-slip component. Pure strike-slip faulting has clearly characterised Aswan and Gulf of Aqaba regions in the second group. However, the third group, which contains Abu Dabbab and the northern Egyptian continental margin, is characterized by thrust and strike-slip faulting. To calculate the orientation of the principle stress axes and the shape ratio we have applied the stress inversion technique. The present-day stress regime shows a variability of the tectonic stresses including extensional tectonic, transtensional and strike-slip. The transtensional stress regime with a maximum horizontal extensional NNE stress axis represents the dominant stress field pattern in Egypt. The results exhibit a good agreement with the tectonic settings and recent deformations in Egypt.

Anaplastic thyroid cancer (ATC) is a rare, aggressive malignancy with poor prognosis. Adherence to guidelines from the National Comprehensive Cancer Network (NCCN), American Thyroid Association (ATA), and European Society for Medical Oncology (ESMO) is critical for optimal patient outcomes. As large language models (LLMs) increasingly enter clinical workflows, rigorous evaluation of their alignment with established guidelines is essential. We evaluated five leading LLMs for their ability to generate guideline-concordant responses to clinical questions about ATC. We conducted a comparative study in 2025 following TRIPOD-LLM (Transparent Reporting of a Multivariable Model for Individual Prognosis or Diagnosis, Large Language Models) guidelines. Seventy clinical questions of varying complexity were developed from ATA, NCCN, and ESMO guidelines. Three surgical oncology experts validated each question and subsequently evaluated responses from five LLMs: ChatGPT 4.1, ChatGPT 5, Gemini 2.5 Pro, Claude Sonnet 4, and DeepSeek R1. Each response was scored for relevancy, clarity, accuracy, and adequacy on a 5-point Likert scale. Inter-rater reliability was assessed using both intraclass correlation coefficients (ICC) and Gwet’s AC2 with ordinal weights. Model comparisons used the Kruskal-Wallis test with Dunn’s post-hoc analysis and Bonferroni correction. A pre-specified sensitivity analysis excluding the unblinded model (ChatGPT 5) was performed to confirm robustness. Significant performance differences emerged across all four metrics: accuracy ( p  = 0.007), adequacy ( p  = 0.003), clarity ( p  = 0.014), and relevance ( p  < 0.001). Gemini 2.5 Pro achieved the highest median accuracy (4.5), followed by DeepSeek R1 (4.4), while ChatGPT 4.1 scored lowest (4.0). ICC values ranged from 0.34 to 0.44 (poor to moderate), but Gwet’s AC2 yielded substantially higher estimates of 0.61 to 0.73 (moderate to substantial agreement), reflecting the impact of restricted score range on conventional reliability metrics. The sensitivity analysis excluding ChatGPT 5 confirmed the performance hierarchy among blinded models, with significance preserved or strengthened across all four metrics. Leading LLMs show variable capacity to align with ATC clinical guidelines. While top-performing models hold promise as supportive tools, their inconsistencies across domains and complexity levels preclude autonomous clinical use. These models should serve strictly as decision aids under expert supervision.

Study Design: Prospective randomized controlled cohort study. Objective: To compare the outcome of local autograft versus iliac crest bone graft (ICBG) stand-alone transforaminal lumbar interbody fusion (TLIF) in lumbar spondylolisthesis. Methods: One hundred eight patients with low-grade single-level spondylolisthesis underwent operation with pedicular screw fixation (PSF)-augmented stand-alone TLIF. Patients were randomly divided into groups according to bone graft: group I, autograft group; and group II, ICBG group, with 54 patients each. Fifty-nine patients had isthmic spondylolisthesis and 49 had degenerative spondylolisthesis. Clinical outcome parameters included Visual Analogue Scale (VAS), Oswestry Disability Index (ODI), and patient’s satisfaction, while the radiological parameters included fusion rate, slip reduction, segmental angle, and disc height. The mean follow-up period was 38 ± 19 months, with a minimum 24 of months. Results: The preoperative VAS of back pain improved from 8 ± 3.1 to 3.4 ± 2.9 and from 8 ± 3.2 to3.6 ± 2.6 in group I and group II, respectively. The preoperative ODI improved from 41.4 ± 8 to 12.3 ± 7 and from 39 ± 9 to 13 ± 8 in group I and group II, respectively. The fusion rate was 93% in group I and 94.5% in group II. The percentage of slip was reduced from 26.7 ± 7.1% to 16.5 ± 6.1% in group I and from 27.4 ± 8.25 to 15.8 ± 5.2% in group II. Intervertebral disc height increased from 25.27 ± 14.62 to 46.38 ± 15.41 in group I and from 22.29 ± 13.72 to 45.15 ± 16.77 in group II. Segmental angle improved from 10.5 ± 8.1° to 16.7 ± 5.4° in group I and from 11.6 ± 5.3° to 15.9 ± 6.2° in group II. There was no significant difference of the above-mentioned parameters between the 2 groups. Conclusion: Patients with single-level low-grade spondylolisthesis can be effectively treated with PSF-augmented stand-alone TLIF using either local autograft or ICBG with no outcome differences between the 2 groups.

The aim of this study was to systemically assess the efficacy of platelet-rich fibrin (PRF) on maxillary sinus augmentation using the lateral approach. A PubMed search and a hand search of relevant journals and the bibliographies of selected articles were performed. Clinical studies using PRF with open maxillary sinus augmentation were included. The search provided 290 titles; only 8 studies fulfilled the inclusion criteria. Identified studies showed heterogeneity regarding surgical technique, grafting material, implant placement time, protocol, outcome measures, healing time for biopsy, and implant placement, as well as follow-up period. From the 8 identified studies, 3 studies used PRF as a sole filling material, whereas the other 5 studies used PRF with bone substitutes. PRF showed promising results as a sole filling material for sinus lift with simultaneous implant placement, and PRF seemed to accelerate maturation of a demineralized freeze dried bone allograft. Conversely, it had no effect on deproteinized bovine maturation. PRF fibrin membranes represent an easy and successful method to cover the sinus membrane or osteotomy window.