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State-of-the-art machine learning (ML) artificial intelligence methods are increasingly leveraged in clinical predictive modeling to provide clinical decision support systems to physicians. Modern ML approaches such as artificial neural networks (ANNs) and tree boosting often perform better than more traditional methods like logistic regression. On the other hand, these modern methods yield a limited understanding of the resulting predictions. However, in the medical domain, understanding of applied models is essential, in particular, when informing clinical decision support. Thus, in recent years, interpretability methods for modern ML methods have emerged to potentially allow explainable predictions paired with high performance. To our knowledge, we present in this work the first explainability comparison of two modern ML methods, tree boosting and multilayer perceptrons (MLPs), to traditional logistic regression methods using a stroke outcome prediction paradigm. Here, we used clinical features to predict a dichotomized 90 days post-stroke modified Rankin Scale (mRS) score. For interpretability, we evaluated clinical features' importance with regard to predictions using deep Taylor decomposition for MLP, Shapley values for tree boosting and model coefficients for logistic regression. With regard to performance as measured by Area under the Curve (AUC) values on the test dataset, all models performed comparably: Logistic regression AUCs were 0.83, 0.83, 0.81 for three different regularization schemes; tree boosting AUC was 0.81; MLP AUC was 0.83. Importantly, the interpretability analysis demonstrated consistent results across models by rating age and stroke severity consecutively amongst the most important predictive features. For less important features, some differences were observed between the methods. Our analysis suggests that modern machine learning methods can provide explainability which is compatible with domain knowledge interpretation and traditional method rankings. Future work should focus on replication of these findings in other datasets and further testing of different explainability methods.

Average Hausdorff distance is a widely used performance measure to calculate the distance between two point sets. In medical image segmentation, it is used to compare ground truth images with segmentations allowing their ranking. We identified, however, ranking errors of average Hausdorff distance making it less suitable for applications in segmentation performance assessment. To mitigate this error, we present a modified calculation of this performance measure that we have coined “balanced average Hausdorff distance”. To simulate segmentations for ranking, we manually created non-overlapping segmentation errors common in magnetic resonance angiography cerebral vessel segmentation as our use-case. Adding the created errors consecutively and randomly to the ground truth, we created sets of simulated segmentations with increasing number of errors. Each set of simulated segmentations was ranked using both performance measures. We calculated the Kendall rank correlation coefficient between the segmentation ranking and the number of errors in each simulated segmentation. The rankings produced by balanced average Hausdorff distance had a significantly higher median correlation (1.00) than those by average Hausdorff distance (0.89). In 200 total rankings, the former misranked 52 whilst the latter misranked 179 segmentations. Balanced average Hausdorff distance is more suitable for rankings and quality assessment of segmentations than average Hausdorff distance.

Excessive fertilizer and chemical usage have led to soil contamination by toxic heavy metals near the Abu-Zaabal industrial complex in Egypt. We introduce a groundbreaking calibration-free methodology using ultrafast Picosecond Laser-Induced Plasma Spectroscopy (CF-Ps-LIPS) for quantifying contaminant elements (Cd, Zn, Fe, Ni) in soils near Egypt’s Abu-Zaabal industrial complex. This study pioneers applying 170 ps laser pulses (Nd: YAG, 1064 nm) to achieve calibration-free analysis, eliminating matrix-matched standards and offering ± 1% agreement with ICP-OES. By integrating plasma diagnostics (electron density N e = 1.2–1.5 × 10 17 cm − 3 and temperature T e = 8508–10,275 K), we establish CF-Ps-LIPS as a rapid, minimally invasive tool for on-site environmental monitoring, validated through spatial contamination gradients linked to wind patterns. Concentrations of Cd (25.1–136.5 mg/kg), Zn (19.8–146.9 mg/kg), Fe (59.7–62 mg/kg), and Ni (119.4–157.8 mg/kg) were analyzed across seven sampling sites. The seventh site was used as a test sample of unknown concentration to validate CF-Ps-LIPS. Utilizing the Boltzmann distribution with plotting techniques enables precise plasma electron density and temperature determination under local thermodynamic equilibrium (LTE) conditions. The CF-Ps-LIPS study revealed significant concentration variations dependent on trace metal type, sampling location, and facility orientation. The CF-Ps-LIPS method provides calibration-free, rapid, and accurate detection of metal contaminants in Egyptian soils for the first time. This methodology significantly advances environmental monitoring and soil contamination analysis, allowing on-site assessments with higher efficiency and reliability.

Hepatocellular carcinoma (HCC) is a common type of liver cancer, with a high mortality rate. Hepatocellular carcinoma is a type of liver cancer that can be effectively managed through early detection and accurate diagnosis, followed by a personalized treatment plan that may include surgical resection, liver transplantation, minimally-invasive techniques, immunotherapy, or targeted therapy depending on the stage and severity of the cancer.

Background Angular knee deformities such as genu varum and genu valgum are common in children and can impact their functional mobility and quality of life. Although surgical interventions like guided growth plates or tension-band plates (TBP) and percutaneous epiphysiodesis transphyseal screws (PETS) are commonly used, comparative analyses of their efficacy and safety are limited. This study aims to evaluate the correction rates and safety profiles of TBP and PETS in treating pediatric coronal angular knee deformities. Methods A comprehensive literature search was conducted in Scopus, Web of Science, and PubMed until November 2024. Only comparative clinical studies comparing PETS and TBP in pediatric patients with coronal knee deformities were included. Results A total of five studies encompassing 473 physes were included. Their methodological quality was assessed using the MINORS criteria, with scores ranging from 18 to 19, indicating a low risk of bias. PETS demonstrated significantly higher correction rates compared to TBP, with an overall pooled mean difference in angular correction of 0.17°/month ( p  < 0.0003). In the femoral subgroup analysis (LDFA), the mean difference correction rate was 0.21°/month in favor of PETS ( p  = 0.01). Additionally, the PETS group achieved a statistically significant mechanical axis deviation mean difference correction rate of 1.02 mm/month ( p  = 0.006). Complication rates were relatively lower with PETS across all included studies. Conclusion PETS achieves faster angular and mechanical axis deviation correction rates compared to TBP, highlighting its efficiency in treating pediatric coronal angular knee deformities. Additionally, PETS demonstrates relatively fewer complications, reinforcing its position as a more effective and cost-efficient option for guided growth in children. Clinical trial number Not applicable. Level of evidence II.

Background Venous congestion significantly contributes to morbidity and mortality in heart failure with reduced ejection fraction (HFrEF). The Venous Excess Ultrasound (VExUS) score, a multi-parameter sonographic assessment of systemic venous congestion, has shown prognostic utility in hospitalized HFrEF. However, its role in risk-stratifying ambulatory HFrEF patients remains unclear. This prospective exploratory study investigated the prognostic value of elevated VExUS scores in ambulatory HFrEF patients. Results Of 109 enrolled patients, 23 (21%) had a high VExUS score (≥ 2). Patients with high VExUS scores had significantly higher rates of the primary composite endpoint of all-cause mortality or HF hospitalization within 90 days (87% vs. 19.8%, p  < 0.001), worsening renal function (47.8% vs. 17.3%, p  < 0.001), and unplanned visits (82.6% vs. 14.8%, p  < 0.001). While dilated IVC had higher sensitivity for the primary outcome, VExUS demonstrated greater specificity, especially in patients with moderate to severe tricuspid regurgitation (TR). Conclusions An elevated VExUS score was associated with adverse short-term outcomes in this exploratory analysis. VExUS score may provide a more specific assessment of congestion than IVC diameter alone, particularly in the presence of significant TR, potentially improving risk stratification in this population.

Neurodegenerative diseases are among the leading causes of disability and death worldwide. The disease-related socioeconomic burden is expected to increase with the steadily increasing life expectancy. In spite of decades of clinical and basic research, most strategies designed to manage degenerative brain diseases are palliative. This is not surprising as neurodegeneration progresses \"silently\" for decades before symptoms are noticed. Importantly, conceptual models with heuristic value used to study neurodegeneration have been constructed retrospectively, based on signs and symptoms already present in affected patients; a circumstance that may confound causes and consequences. Hence, innovative, paradigm-shifting views of the etiology of these diseases are necessary to enable their timely prevention and treatment. Here, we outline four alternative views, not mutually exclusive, on different etiological paths toward neurodegeneration. First, we propose neurodegeneration as being a secondary outcome of a primary cardiovascular cause with vascular pathology disrupting the vital homeostatic interactions between the vasculature and the brain, resulting in cognitive impairment, dementia, and cerebrovascular events such as stroke. Second, we suggest that the persistence of senescent cells in neuronal circuits may favor, together with systemic metabolic diseases, neurodegeneration to occur. Third, we argue that neurodegeneration may start in response to altered body and brain trophic interactions established via the hardwire that connects peripheral targets with central neuronal structures or by means of extracellular vesicle (EV)-mediated communication. Lastly, we elaborate on how lifespan body dysbiosis may be linked to the origin of neurodegeneration. We highlight the existence of bacterial products that modulate the gut-brain axis causing neuroinflammation and neuronal dysfunction. As a concluding section, we end by recommending research avenues to investigate these etiological paths in the future. We think that this requires an integrated, interdisciplinary conceptual research approach based on the investigation of the multimodal aspects of physiology and pathophysiology. It involves utilizing proper conceptual models, experimental animal units, and identifying currently unused opportunities derived from human data. Overall, the proposed etiological paths and experimental recommendations will be important guidelines for future cross-discipline research to overcome the translational roadblock and to develop causative treatments for neurodegenerative diseases.

The principal aim of this paper is to analyze the impact of rubber pad systems on levels of vibrations and values of stresses and deformations induced in the subway tunnel segments. Thus, the 3D model has been selected to be isotropically simulated in the ANSYS program to conduct a finite element analysis. Therefore, the proposed track system in the tunnel of line 4 of the Greater Cairo Metro has been selected as an analytical and simulation case study. The impact of using eight different values for the stiffness of the rubber pad system in the case of a single tunnel has been analyzed. The results showed that levels of vibrations are significantly affected and are in logarithmic correlation with the stiffness. Also, the impact of the stiffness on the deformations and stresses are determined as well as mathematical models connecting the different parameters have been introduced.

In this study, a novel, non-toxic, eco-friendly zinc oxide nanoparticles (ZnO-NPs) was used instead of the synthetic fungicides widely used to control the destructive phytopathogenic fungus Fusarium oxysporum, the causative agent of wilt disease in Solanum melongena L. Herein, the biosynthesized ZnO-NPs was carried out by Penicillium expansum ATCC 7861. In vitro, mycosynthesized ZnO-NPs exhibited antifungal activity against Fusarium oxysporum. In vivo, ZnO-NPs suppressed Fusarium wilt disease in cultivated Solanum melongena L. by decreasing the disease severity with 75% of plant protection. Moreover, ZnO-NPs stimulated the recovery of eggplant as an indicated by improving of morphological and metabolic indicators including plant height(152.5%), root length(106.6%), plant fresh biomass (146%), chlorophyll a (102.8%), chlorophyll b (67.86%), total soluble carbohydrates (48.5%), total soluble protein (81.8%), phenol (10.5%), antioxidant activity and isozymes compared with infected control. Therefore, this study suggests using mycosynthesized ZnO-NPs as an alternative to synthetic fungicides not only to eradicate the Fusarium wilt disease in cultivated eggplant (Solanum melongena) but also to promote the growth parameters and metabolic aspects.

Despite the panzootic nature of emergent highly pathogenic avian influenza H5Nx viruses in wild migratory birds and domestic poultry, only a limited number of human infections with H5Nx viruses have been identified since its emergence in 1996. Few countries with endemic avian influenza viruses (AIVs) have implemented vaccination as a control strategy, while most of the countries have adopted a culling strategy for the infected flocks. To date, China and Egypt are the two major sites where vaccination has been adopted to control avian influenza H5Nx infections, especially with the widespread circulation of clade 2.3.4.4b H5N1 viruses. This virus is currently circulating among birds and poultry, with occasional spillovers to mammals, including humans. Herein, we will discuss the history of AIVs in Egypt as one of the hotspots for infections and the improper implementation of prophylactic and therapeutic control strategies, leading to continuous flock outbreaks with remarkable virus evolution scenarios. Along with current pre-pandemic preparedness efforts, comprehensive surveillance of H5Nx viruses in wild birds, domestic poultry, and mammals, including humans, in endemic areas is critical to explore the public health risk of the newly emerging immune-evasive or drug-resistant H5Nx variants.