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Childhood asthma represents a worldwide problem, involving genetic, immune defense and environmental components. MicroRNAs (miRs) are non-coding, single-stranded RNAs involved in immune regulation. The aim was to evaluate clinical potential of plasma miR-21 and miR-146a involved in T helper differentiation in childhood asthma and non-asthmatic controls. Group 1 consisted of 27 asthmatic children receiving inhaled corticosteroids (ICSs), which was compared to group 2 with 21 healthy control children. All patients were assessed by pulmonary function tests. miR-21 and miR-146a expression levels were determined by real-time quantitative PCR, and IL-13 was measured using ELISA. Group 1 showed significant up-regulation of plasma miR-21 and miR-146a levels with mean values 42.6-fold and 4.7-fold higher than average expression, respectively, in group 2. miR-21 levels positively correlated with IL-13 levels and eosinophil percentage, while miR-146a only correlated to eosinophil percentage. There was a linear association between each of miR-21 and miR-146a expression and FEV1 (forced expiratory volume in the first second), miR-21 and miR-146a are up-regulated in asthmatic children. miR-21 served as a better asthma biomarker. Association between both markers and FEV1 points to their role in determining asthma outcome following ICS treatment. miR-21 and miR-146a play a role in eosinophilic endotypic classification of asthma.

This study investigates the index properties of artificially prepared mixtures of Bentonite and Kaolinite to simulate different types of fine-grained soils with diverse expansive characteristics, with a particular focus on understanding how various index characteristics influence swelling behavior. A series of controlled laboratory tests were conducted to evaluate the specific unit weight, free swell, consistency limits, and compaction parameters. The results show that altering the Bentonite content significantly affects the index properties of the mixtures, which in turn influences their swelling behavior. As the Bentonite content increases, the specific unit weight also increases due to the dense and compact nature of Bentonite. Additionally, the swelling properties of Bentonite cause substantial increases in the free swell and Atterberg limits, highlighting its critical role in controlling swelling potential and plasticity. Conversely, the maximum dry unit weight decreases with increasing Bentonite content due to its high water absorption capacity, which reduces compaction efficiency. These diverse index characteristics, such as free swell, Atterberg limits, and specific unit weight, are found to have a significant impact on the swelling behavior of the mixtures. By adjusting the Bentonite content, these mixtures effectively simulate a range of fine-grained soils with varying swelling potentials. These findings provide valuable insights into the behavior of soils with expansive properties, offering a foundation for optimizing their use in applications like engineered barriers, liners, and foundations, where controlling swelling and plasticity is essential.

In today’s rapidly evolving digital landscape, the surge in smartphone usage is paralleled by an increasing wave of cyberthreats, highlighting the limitations of existing signature-based malware detection methods. To address this problem, our research introduces a Time-Aware Machine Learning (TAML) framework specifically designed for Android malware detection. Our framework extracts the best time-correlated features and then it builds time-aware and time-agnostic machine learning (ML) models. The ML models are trained on the KronoDroid dataset, which contains more than 41,000 benign Android apps and more than 36,000 malicious apps developed between 2008 to 2020. Our experimental evaluation revealed that the Last Modification Date ‘LastModDate’ feature is a critical variable for time-aware classification. Moreover, our empirical analysis reveals that real-device detection outperforms emulator-based detection. Impressively, the time-correlated features boosts the detection performance and achieving an outstanding 99.98% F1 score in a time-agnostic setting. In addition, on each year, our time-aware experiments outperformed the traditional ML detection models. Our time-aware classifier achieved a 91% F1 score on average and a maximum F1 score of 99% of yearly chunk experiments over 12 years. These experimental results affirm the effectiveness of our proposed method in detecting Android malware.

Due to growing geopolitical tensions and uncertainty, energy supplies have recently become more vulnerable, endangering the safety of energy supply chains. It has therefore become essential to enhance the security and sustainability of energy supplies by establishing energy hubs (EHs) along energy transmission routes. These hubs offer a practical solution that facilitates energy import, conversion, storage, and export, thereby improving energy trade and exchange between producing and consuming countries. Nevertheless, the successful establishment and operation of these EHs is difficult and calls for several requirements. This study aims to develop a practical framework that includes the main requirements for the effective establishment and operation of global energy hubs (GEHs). A mixed-method approach was employed, incorporating in-depth interviews with key stakeholders and survey data from 53 oil and gas companies. The study identified critical success factors for establishing and operating GEHs, including geographical location, infrastructure readiness, environmental stability, geopolitical positioning, and stakeholder collaboration. It combines scientific and practical components into a comprehensive reference that provides policymakers and energy planners with actionable guidance for establishing and operating GEHs. The research findings would support the sustainability and resilience of energy supply chains. The study also offers a strategic roadmap for nations looking to develop GEHs. Future research is encouraged to assess energy hub performance under different geographies and markets to enhance adaptability and efficiency.

Energy-consuming countries are affected by obstructions in supplies or conflicts that may occur along the energy transit path. Hence, the presence of a global logistics hub for energy acting as a connecting bridge between energy-supplying and energy-consuming countries can overcome such troubles, support the sustainable flow of energy, and achieve the overall operational efficiency of the energy supply chain. However, establishing a global energy hub is a complicated issue, especially in the absence of a clear approach for this. Through conducting a systematic literature review on 36 papers over the past two decades, we identified the key determinants for each player in the energy supply chain and proposed a leading and integrated conceptual framework for establishing and operating a global logistics energy hub, with a particular focus on oil and gas. This article contributes to knowledge by providing a comprehensive review targeting energy hubs from a logistics perspective, as previous studies have addressed energy hubs from other perspectives such as political, legal, and security perspectives, while the logistics perspective has not been tackled comprehensively. Moreover, the suggested framework can be then used by further researchers to develop the performance of energy hubs. Practically, this framework can be employed to identify the requirements for a country to become a global energy hub.

Despite the availability and benefits of the Human papillomavirus (HPV) vaccine, parental acceptance remains low in the eastern mediterranean region (EMR). Therefore, this meta-analysis aimed to estimate the pooled proportion of parental uptake and willingness to vaccinate their children with the HPV vaccine and their determinants in the EMR. We searched PubMed Central, PubMed Medline, Scopus, Web of Science, ProQuest, Google Scholar, and medRxiv according to PRISMA guidelines until the 5th of April 2024. We included all papers discussing parental uptake and willingness to vaccinate their children with the HPV vaccine in EMR without time or language limitations. The study risk of bias was assessed using the Newcastle–Ottawa Scale quality assessment tool. We pooled data using the random effect model. Leave one sensitivity analysis, subgroup analysis, and meta-regression were used to address heterogeneity. Out of 1551 screened studies, thirty-three studies of 18,455 parents from 12 countries fully met the inclusion criteria and were eligible for meta-analysis. The pooled proportion of parental willingness for future HPV vaccination, based on 32 studies involving 17,815 parents was 61 % (95 % CI: 54–68 %, I2 = 99 %). Using meta-regression, the proportion of working parents, study quality, and geographical region explained approximately 52.46% of the observed heterogeneity. In contrast, based on 9 studies involving 5029 parents, the pooled proportion of parental uptake was 7 % (95 % CI: 5–10 %, I2 = 91 %). Using meta-regression, study quality and geographical region explained 71.42% of the observed heterogeneity. Despite the high parental willingness for HPV vaccination, the uptake of the vaccine in EMR remains critically suboptimal and far behind the goal of the World Health Organization's cervical cancer elimination strategy. Urgent interventions are needed, including adding the vaccine to the national vaccination programs (NVPs) and tailoring parents–targeted awareness campaigns to improve knowledge and address barriers to vaccine uptake.

Human serum albumin (HSA) is the frontline antioxidant protein in blood with established anti-inflammatory and anticoagulation functions. Here, we report that COVID-19-induced oxidative stress inflicts structural damages to HSA and is linked with mortality outcome in critically ill patients. We recruited 39 patients who were followed up for a median of 12.5 days (1–35 days), among them 23 had died. Analyzing blood samples from patients and healthy individuals (n=11), we provide evidence that neutrophils are major sources of oxidative stress in blood and that hydrogen peroxide is highly accumulated in plasmas of non-survivors. We then analyzed electron paramagnetic resonance spectra of spin-labeled fatty acids (SLFAs) bound with HSA in whole blood of control, survivor, and non-survivor subjects (n=10–11). Non-survivors’ HSA showed dramatically reduced protein packing order parameter, faster SLFA correlational rotational time, and smaller S/W ratio (strong-binding/weak-binding sites within HSA), all reflecting remarkably fluid protein microenvironments. Following loading/unloading of 16-DSA, we show that the transport function of HSA may be impaired in severe patients. Stratified at the means, Kaplan–Meier survival analysis indicated that lower values of S/W ratio and accumulated H 2 O 2 in plasma significantly predicted in-hospital mortality (S/W≤0.15, 81.8% (18/22) vs. S/W>0.15, 18.2% (4/22), p=0.023; plasma [H 2 O 2 ]>8.6 μM, 65.2% (15/23) vs. 34.8% (8/23), p=0.043). When we combined these two parameters as the ratio ((S/W)/[H 2 O 2 ]) to derive a risk score, the resultant risk score lower than the mean (<0.019) predicted mortality with high fidelity (95.5% (21/22) vs. 4.5% (1/22), log-rank χ 2 =12.1, p=4.9×10 −4 ). The derived parameters may provide a surrogate marker to assess new candidates for COVID-19 treatments targeting HSA replacements and/or oxidative stress.

BackgroundWilms tumor (WT) with an inferior Vena cava (IVC) malignant thrombus comprises 4–10% of all WT cases.MethodsThis retrospective analysis included 51 pediatric patients presenting at Children Cancer Hospital Egypt-57357 from July 2007 to December 2016 with the diagnosis of WT with malignant IVC thrombus.ResultsMedian age at presentation = 4.4 years and 28 cases (55%) were females. Twenty-five patients (49%) were metastatic and 4 patients (7.8%) had bilateral disease. Forty-seven cases (92.2%) had favorable histology with no evidence of anaplasia. Level of thrombus extension at presentation was classified as infra-hepatic, retro-hepatic, supra-hepatic and intra-cardiac in 33, 9, 6 and 3 patients, respectively. Fifty patients started neoadjuvant chemotherapy (CTH) with 16 patients showing complete resolution of thrombus after 6 weeks of CTH. None of the patients developed thrombus progression after neoadjuvant CTH; one patient had stationary intra-cardiac thrombus, while remaining patients showed partial regression of their thrombus and had nephrectomy with en-bloc thrombectomy. The mean cranio-caudal dimension of IVC thrombi at initial presentation was 6.5 cm, and 3.6 cm post 6th week of CTH. The 5-year OS and EFS were 75.9% and 71.1%, respectively. There was no significant correlation of initial levels of thrombus extension with survival.ConclusionNeoadjuvant chemotherapy followed by radical nephrectomy with en-bloc thrombectomy and radiotherapy seems a successful approach for management of patients with WT and IVC tumor thrombus. Measurement of the cranio-caudal dimension of thrombus and its response to treatment should be considered in the surgical planning.

To evaluate the efficacy and safety of prostatic artery embolization (PAE) for benign prostatic hyperplasia (BPH) in patients with chronic liver disease, with subgroup analysis according to Child-Pugh classification. This prospective single-center clinical study enrolled thirty-four male patients (median age, 65 years; IQR 57-71) with symptomatic BPH and chronic liver disease who were refractory to [greater than or equal to]6 months of medical therapy. Baseline clinical, laboratory, and imaging parameters were recorded. Bilateral or unilateral PAE was performed using calibrated microspheres (100-300⯵m and/or 300-500⯵m). Functional outcomes, including International Prostate Symptom Score (IPSS), prostate volume, maximum urinary flow rate (Qmax), post-void residual urine volume (PVR), and quality-of-life (QOL) scores, were assessed at 1 and 6â¯months. Outcomes were analyzed overall and stratified by Child-Pugh classification. Technical success was achieved in all patients, with bilateral embolization in 27 patients (79.4%). Median IPSS decreased from 24.0 at baseline to 18.0 at 1 month (22.2% reduction, p < 0.001) and 12.0 at 6 months (51.7% reduction, p < 0.001), and Qmax increased from 7.4 mL/s to 14.2 mL/s at 6 months (91.9% increase, p < 0.001). PVR and QOL scores also improved significantly (pâ¯<â¯0.001). Both Child-Pugh A (n = 22) and Child-Pugh B (n = 12) improved significantly. Prostate volume decreased more in Child-Pugh B at 1 and 6 months (between-group p < 0.001), while IPSS reduction was greater in Child-Pugh B at 1 month (p = 0.013) and comparable by 6 months (p = 0.435). Minor transient adverse events were observed in most patients, while mild, self-limited procedure-related events occurred in 44% of cases, with no major complications or procedure-related mortality. PAE is a safe and effective minimally invasive option for managing symptomatic BPH in patients with chronic liver disease. Clinically meaningful improvements in symptom scores, urinary flow, and prostate volume were observed across all Child-Pugh classes, supporting the feasibility of PAE in this high-risk population.

The global economy has barely begun to recover from the effects of the COVID-19 pandemic, only to be thrown into a new crisis because of the Russian-Ukrainian war. The war exacerbated the energy problem by causing a shortage of energy supplies for the EU and other countries, affecting quality of life. As a result, establishing energy hubs for collecting, processing, storing, and transiting energy resources between producing and consuming countries has become imperative to manage energy supplies efficiently. However, previous studies have not yet addressed the requirements for setting up energy hubs from a practical point of view. Therefore, this paper investigates the requirements for the establishment of energy hubs, particularly for oil and gas, from a practical perspective. The researchers conducted 13 semi-structured interviews with different energy stakeholders. Using the SWOT analysis matrix tool, the findings assessed the current state of the global oil and gas market, and the main practical requirements for the establishment of energy hubs were identified, along with the elements for implementation. Furthermore, the article highlighted the most pressing practical issues confronting the establishment of energy centres. Finally, the paper laid out a comprehensive practical framework based on the industry practitioners’ views to help establish energy hubs. The framework provides a possible guide for countries to establish energy hubs based on the main requirements outlined in this study. It can also improve the diversity, flexibility, and security of energy supply, especially for countries that rely on sole suppliers, such as the EU.