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Background Blastocystis spp. (BC) often passes as a harmless resident of the gut. However, it may be associated with gastrointestinal disturbances, such as abdominal pain and diarrhea. The variation in the clinical spectrum of BC infection is, in part, due to its diverse genotypic profile, where ongoing research continues to discover new BC subtypes. This study aimed at investigating the association between different BC subtypes and intestinal inflammation as assessed by fecal calprotectin (FCP) and tumor necrosis factor alpha (TNF-α) levels. Methods Patients complaining of gastrointestinal tract (GIT) symptoms were investigated for the presence of BC infection by microscopy and stool culture on Jones’ medium. Out of 163 patients, 88 were confirmed to be infected with BC. They were further divided according to the dominant BC subtype by RFLP genotyping. Patients were treated with metronidazole at a dose of 250 mg 3 times daily for ten days and were evaluated for symptom improvement after the treatment course. Moreover, FCP and TNF-α levels were measured in stool samples by ELISA before and after therapy. Results BC subtype 3 was found to be the dominant subtype in 62 samples (70.5%), while subtype 4 was dominant in 26 samples (29.5%). A higher number of patients infected with BC subtype 3 reported the presence of GIT manifestations. After treatment, 17 subtype 3-infected patients (27.4%) witnessed improvement of their GIT symptoms, as compared to 9 patients infected with BC subtype 4 (34.6%). In subtype 3 infected patients, 71% were free of BC stages by both microscopic examination and stool culture, while 92.3% of patients infected with subtype 4 showed fecal parasite clearance. FCP and TNF-α levels were higher in patients infected with BC subtype 3 as compared to BC subtype 4, both before and after treatment with metronidazole. In the BC subtype 3-infected groups, fecal TNF-α and FCP levels decreased significantly after treatment. Conclusion In our cohort study, BC subtype 3 was the most prevalent subtype among patients reporting gastrointestinal symptoms. The ST3 group exhibited numerically higher inflammatory markers compared to ST4. These trends shed light on the potential link between Blastocystis genetic diversity and intestinal inflammation. Although the observational nature of this study and the unequal group sizes limit the ability to establish a definitive causal relationship, these findings provide a BC subtype-oriented diagnostic and therapeutic design within a hospital-based setting that could facilitate the design of more tailored management strategies for patients with BC-associated symptoms. Graphical Abstract

Schistosoma mansoni is a major cause of schistosomiasis, a neglected tropical disease that induces granulomatous inflammation, fibrosis, and liver damage. Fucoidan (FUC), a sulfated polysaccharide from brown seaweed, was evaluated for its anti-helminthic, anti-inflammatory, and antifibrotic effects against immature stages of  S. mansoni  in mice. Forty-eight CD-1 Swiss male albino mice were infected and allocated into six groups: infected untreated control, praziquantel-treated, and FUC-treated groups at 7, 21, 35, and 42 days post-infection. Treatment with FUC at 7, 21, and 35 dpi significantly reduced worm burden, granuloma size, fibrosis, and the expression of TNF-α, IL-1β, and iNOS in liver tissue. The strongest antipathological effects were observed with early-to-mid treatment, particularly FUC7, FUC21, and FUC35. In contrast, FUC42 showed weaker benefit, indicating that efficacy is timing-dependent. These findings suggest that FUC may be a promising candidate for early intervention in  S. mansoni  infection.

Background The aim of this study was to evaluate the physicochemical properties of two newly introduced premixed calcium silicate-based root canal sealers (AH Plus Bioceramic Sealer and Bio-C Sealer) compared to a resin-based root canal sealer (ADseal root canal sealer). Methods Solubility, pH analysis, calcium ion release, and film thickness of each sealer were evaluated following ISO guidelines. The data were examined using the two-way ANOVA test. Furthermore, X-ray diffraction (XRD) examination was performed to investigate the crystalline phase of each type of sealer. X-ray fluorescence (XRF) analysis was done for the chemical elemental analysis of each sealer. Results The least film thickness, highest alkalinity, and highest calcium ion release were all displayed by AH Plus Bioceramic Sealer. High solubility, high alkalinity, intermediate calcium ion release, and intermediate film thickness were all displayed by Bio-C Sealer. While ADseal root canal sealer displayed the greatest film thickness, least solubility, alkalinity, and calcium ion release. Conclusions Both AH Plus Bioceramic Sealer and Bio-C Sealer represented adequate properties to be considered a good sealer that could be used as a potential alternative to resin-based root canal sealers.

This study aimed to evaluate the thermal, chemical, and physical properties of VDW.1Seal, Fill Root ST, and ADseal sealers. Thermal properties were analyzed using Thermogravimetric analysis (TGA) and Differential thermal analysis (DTA). Attenuated total reflection Fourier Transform Infrared Spectroscopy (ATR-FTIR) analysis was performed as a complementary test to confirm TGA/DTA analysis. The chemical composition of the set sealer material was identified using an X-ray powder diffraction (XRD) system. Other physical properties of each sealer were investigated; ten specimens were used to measure the solubility (at 24 h and 28 days), and another ten specimens were used to assess pH changes and calcium ion release (after 7 and 14 days). Film thickness was done according to ISO 6876 specs. The data were analyzed using the two-way ANOVA test. Results showed that for all sealers, TGA analysis revealed a direct relationship between sealer mass loss and temperature rise. In addition, the decomposition of the tested sealers started at 145 °C, 135 °C and 91 °C for VDW.1Seal, ADseal sealer, and Fill Root ST, respectively. XRD analysis revealed a higher degree of crystallinity for VDW.1Seal and ADseal. ADseal showed the least solubility; VDW.1Seal exhibited the highest alkalinity, calcium ion release, and the lowest film thickness.

Background Pulmonary embolism (PE) is a sudden obstruction of pulmonary arteries usually associated with a high rate of mortality due to acute right ventricular failure. Early diagnosis is of much importance because most patients die within the first hours of presentation. Emergency management is usually highly valuable and right heart failure is potentially reversible. Multidetector computed tomography pulmonary angiography (CTPA) is the best diagnostic imaging modality to document acute pulmonary embolism. Overuse of CTPA increases the unrequired risk of radiation exposure, increasing the risk of malignancy, contrast-related anaphylaxis, and acute kidney injury. To abolish these issues, the simplified score for suspected acute pulmonary embolism using variable D dimer cut-off value in combination with clinical signs can exclude pulmonary embolism safely. Aim of the study To evaluate the predictive accuracy of YEARS score in the diagnosis of pulmonary embolism compared to CTPA that might lead to a decrease in the overuse of CTPA. Methods The study was held at the chest unit in Kasr ElAini hospitals. It included 50 patients, for which full history, examination, calculation of wells score, D-dimer, YEARS score, and CTPA were done. Results The results showed that the YEARS score succeeded in predicting the presence or the absence of PE in 80% of the 50 enrolled patients in our study. YEARS score has a sensitivity of 90% and specificity of 65%. Conclusion Patients with zero YEARS score and D-dimer ≥ 1000 ng/ml as well as those with ≥ 1 YEARS score and D-dimer ≥ 500 ng/ml are rendered PE likely by the YEARS algorithm with a sensitivity of 90%. Using years score, we can exclude pulmonary embolism in patients with zero YEARS score and a D-dimer ˂ 1000 ng/ml as well as in patients with ≥ 1 YEARS score and D-dimer ˂ 500 ng/ml with 65% specificity, thus decreasing overuse of CTPA in the diagnosis of PE.

PurposeThe present work applies the standard-setting in the multidisciplinary Objective Structured Practical Examination (OSPE) of the MusculoSkeletal and Integument systems (MSK) module using Modified Ebel’s method to differentiate the competent students from the non-competent ones.Materials and methodsOne hundred fifty-six students participated in the multidisciplinary OSPE. The MSK-OSPE consists of mid-module and final. According to the blueprint of the OSPE, the mid-module OSPE tested the knowledge and skills of the upper limb, and the final OSPE verified the knowledge and skills of the lower limb. Modified Ebel’s method was used to identify the Minimum Pass Level (MPL) in each station and the whole exam accordingly.ResultsFifty-seven percent (57%) of the students passed both exams, while 25.6% did not pass the mid-module exam and 31.4% did not pass the final exam, 17.9% did not pass both exams and 25% did not pass one exam. The MPL for most of the stations in both exams using modified Ebel’s method of the standard-setting was more than 50% which is the conventional pass mark. However, the MPL for stations 4, and 6 in the mid-module exam (ulna and arteries of the upper limb) and stations 7, 9, and 14 (muscles of the lower limb, anatomy of ankle joint, physiology of nerve) was < 50%. While the total pass mark of the mid-module OSPE was 66% and the pass mark for the final OSPE was 60%ConclusionThe minimal pass level (MPL) in mid module and final OSPE were 66% and 60% respectively which are more than the conventional cut off point (50%) that indicating that the standard-setting was effective in identifying poor performers who cannot be identified by the conventional method that led to enhance the quality of OSPE as an assessment tool. Moreover, students developed the skills to deal with standardized patients in clinical stations. However, some defects and areas of improvement were identified in some physiological and anatomical stations. The organizing committee recommended identifying the poor performers and conducting extra-tutorial sessions on the defective topics.

The previous studies about the relationship between managerial entrenchment and firm value are indecisive as these studies implicitly presume that the relationship between managerial entrenchment and firm value is a direct relation. The point that has received less attention in the existing literature is that the relationship between managerial entrenchment and firm value can be mediated by a contextual variable which has a direct relationship with firm value such as firm profitability. The purpose of this paper is to investigate the direct effect of the managerial entrenchment on firm value and identifies the mediation effect of firm profitability on the relationship between managerial entrenchment and firm value. To test the study hypotheses, the researcher relied on a sample of 113 Egyptian listed corporation (678 observations) and belonging to 13 non-financial sectors over the period from 2014 to 2019. Using path analysis model, the results show that there is a negative and significant relationship between managerial entrenchment and firm value. And also reveal that there is a positive and significant relationship between managerial entrenchment and firm profitability and a negative and insignificant relationship between firm profitability and firm value. And these results assure that there is no mediation effect of firm profitability on the relationship between managerial entrenchment and firm value. Here, adopting earnings management by the managers may be the reason for the absence of the indirect relationship between managerial entrenchment and firm value.

Aim The mechanical response was assessed through finite element analysis by comparing the cross-sectional impact of two rotary file mathematical models: CM wire and R-Phase. Methods New rotary file model designs were developed using computer-aided design software, specifically the SolidWorks package, along with finite element models. The files featured a triangular cross section at the tip, transitioning to either a rhomboid or rectangular cross section with eccentricity. Each model was subjected to cantilever bending and torsional stress analysis. Results The analysis revealed that the maximum stress values were highest for the rectangular cross section (R-phase), followed by the rectangular cross section (CM wire), then the rhomboid cross section (R-phase), with the lowest values associated with the rhomboid cross section (CM wire). In terms of maximum torsional stress, the rectangular cross section (R-phase) again exhibited the highest values, followed by the rectangular cross section (CM), rhomboid cross section (R-phase), and lastly, the rhomboid cross section (CM). These results support clinical recommendations to use files with a triangular-shaped tip and eccentric cross sections to minimize the risk of ledging, thereby enhancing clinical performance by reducing screw-in forces. Additionally, the rectangular cross-section file model demonstrated greater displacement compared to the rhomboid cross-section model. Nevertheless, the rhomboid cross section exhibited superior torsional resistance relative to the rectangular model. Conclusion It was highlighted that both bending and torsional resistance are critical factors to consider when designing file models. Detailed reporting and clear illustration of test results under these loading conditions are crucial for guiding future design improvements and ensuring optimal performance in clinical settings. This attention to detail will help in developing file models that enhance mechanical properties while minimizing risks during use.

Background The aim of the current study is to assess the surface roughness of several recent nickel-titanium (Ni-Ti) rotary endodontic instruments, namely: Protaper next (PTN); Hyflex CM (CM); Hyflex EDM (EDM); WaveOne gold (WOG); and trunatomy (TN), before and after application of 5.25% sodium hypochlorite (NaOCl) irrigant solution. Methods In this in vitro study, five recently introduced rotary endodontic instruments of different metallurgical properties and designs were subjected to Atomic Force Microscopy (AFM) analysis, and then each file was rotated in 5.25% NaOCl for 15 min., with speed and torque according to manufacturer’s instructions. The instruments were then subjected to AFM analysis again. The surface roughness average (Sa) parameter was calculated. Data were analyzed by Paired T test, One-way ANOVA and Tukey tests. Results There was a statistically significant decrease in the surface roughness of all rotary endodontic instruments after immersion in irrigants (P ≤ 0.05). Conclusion The new TN and PTN instruments showed the least surface roughness. All tested Ni-Ti rotary endodontic instruments after irrigants exposure showed a varying increase in surface roughness.