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Energy drinks are rapidly gaining prominence in the global beverage industry, with projected sales reaching $60 billion within the next five years. These beverages often contain high levels of caffeine and the amino acid taurine, among other ingredients. The increasing consumption of energy drinks by children has sparked concerns regarding potential caffeine toxicity. In the present study, an energy drink was administrated at doses of 5 ml/Kg or 10 ml/Kg body weight. The comet assay demonstrated a significant elevation in DNA damage, evidenced by increased % DNA in tail and olive tail moment in the energy drink groups. Additionally, there were notable elevation in malondialdehyde levels as an oxidative stress marker, while reduction in superoxide dismutase activity and glutathione levels as antioxidant markers in energy drink groups. Furthermore, acetylcholinesterase activity and dopamine levels were significantly decrease in the energy drink groups compared to the control group. The high-dose groups exhibited a more pronounced effect than the low-dose groups, indicating a dose-dependent adverse effect.

Various applications in remote sensing rely on object detection approaches, such as urban detection, precision farming, and disaster prediction. Faster RCNN has gained popularity for its performance but comes with significant computational and storage demands. Model compression techniques like pruning and quantization are frequently employed to mitigate these challenges. This paper introduces a novel bi-stage compression approach to create a lightweight Faster R-CNN for satellite images with minimal performance degradation. The proposed approach employs two distinct phases: aware training and post-training compression. First, aware training employs mixed-precision FP16 computation, which enhances training speed by a factor of 1.5 to 5.5 while preserving model accuracy and optimizing memory efficiency. Second, post-training compression applies unstructured weight pruning to eliminate redundant parameters, followed by dynamic quantization to reduce precision, thereby minimizing the model size at runtime and computational load. The proposed approach was assessed on the NWPU VHR-10 and Ship datasets. The results demonstrate an average 25.6% reduction in model size and a 56.6% reduction in parameters while maintaining the mean Average Precision (mAP).

COVID-19 is a pandemic disease caused by SARS-CoV-2, which is an RNA virus similar to the hepatitis C virus (HCV) in the replication process. Sofosbuvir/ledipasvir is an approved drug to treat HCV infection. This study investigates the efficacy of Sofosbuvir/ledipasvir as a treatment for patients with moderate COVID-19 infection. This is a single-blinded parallel-randomized controlled trial. The participants were randomized equally into the intervention group that received Sofosbuvir/ledipasvir (S.L. group), and the control group received Oseltamivir, Hydroxychloroquine, and Azithromycin (OCH group). The primary outcomes were the cure rate over time and the incidence of serious adverse events. The secondary outcomes included the laboratory findings. 250 patients were divided equally into each group. Both groups were similar regarding gender, but age was higher in the S.L. group (p=0.001). In the S.L. group, 89 (71.2%) patients were cured, while only 51 (40.8%) patients were cured in the OCH group. The cure rate was significantly higher in the S.L. group (RR=1.75, p<0.001). Kaplan-Meir plot showed a considerably higher cure over time in the S.L. group (Log-rank test, p=0.032). There were no deaths in the S.L. group, but there were six deaths (4.8%) in the OCH group (RR=0.08, p=0.013). Seven patients (5.6%) in the S.L. group and six patients (4.8%) in the OCH group were admitted to the intensive care unit (ICU) (RR=1.17, P=0.776). There were no significant differences between treatment groups regarding total leukocyte and neutrophils count, lymph, and urea. Sofosbuvir/ledipasvir is suggestive of being effective in treating patients with moderate COVID-19 infection. Further studies are needed to compare Sofosbuvir/ledipasvir with new treatment protocols.

Introduction: Aluminium (Al) is accumulated in the brain causing neurotoxicity and neurodegenerative disease like Alzheimer's disease (AD), multiple sclerosis, autism and epilepsy. Hence, attenuation of Al-induced neurotoxicity has become a “hot topic“ in looking for an intervention that slow down the progression of neurodegenerative diseases. Objective: Our study aims to introduce a new strategy for hampering aluminum chloride (AlCl3)-induced neurotoxicity using a combination of sesamol with the probiotic bacteria; Lactobacillus rhamnosus (L. rhamnosus) and also to test their possible ameliorative effects on AlCl 3 -induced hepatotoxicity. Methods: Sprague-Dawley male rats were randomly divided into five groups (n = 10/group) which are control, AlCl 3 , AlCl 3 + Sesamol, AlCl 3 + L. rhamnosus and AlCl 3 + Sesamol + L. rhamnosus . We surveilled the behavioral, biochemical, and histopathological alterations centrally in the brain and peripherally in liver. Results: This work revealed that the combined therapy of sesamol and L. rhamnosus produced marked reduction in brain amyloid-β, p-tau, GSK-3β, inflammatory and apoptotic biomarkers, along with marked elevation in brain free β-catenin and Wnt3a, compared to AlCl 3 -intoxicated rats. Also, the combined therapy exerted pronounced reduction in hepatic expressions of JAK-2/STAT-3, inflammatory (TNF-α, IL-6, NF-κB), fibrotic (MMP-2, TIMP-1, α-SMA) and apoptotic markers, (caspase-3), together with marked elevation in hepatic PPAR-γ expression, compared to AlCl 3 -intoxicated rats. Behavioral and histopathological assessments substantiated the efficiency of this combined regimen in halting the effect of neurotoxicity. Discussion: Probiotics can be used as an add-on therapy with sesamol ameliorate AlCl 3 -mediated neurotoxicity and hepatotoxicity.

Abstract BACKGROUND: Children with cerebral palsy (CP) can present with severe secondary dystonia with or without associated spasticity of their extremities. OBJECTIVE: To assess the outcomes of combined anterior and posterior lumbar rhizotomy for the treatment of mixed hypertonia in the lower extremities of children with CP. METHODS: Fifty children with CP were subjected to combined anterior and posterior lumbar rhizotomies in a prospective study. Clinical outcome measurements were recorded preoperatively and were evaluated at 2, 6, and 12 months postoperatively. The operative techniques were performed by laminotomy from L1-S1, and intraoperative monitoring was used in all cases. All patients underwent intensive postoperative physiotherapy programs. RESULTS: Changes in muscle tone, joint range of motion, and dystonia were significant (P =.000) at postoperative assessment visits. CONCLUSION: This study demonstrated the potential of combined anterior and posterior lumbar rhizotomies to improve activities of daily living in children with CP and with mixed spasticity and dystonia.

The rapid development of industries discharges huge amounts of wastewater that contain surface water. For this reason, we used NiO/polydopamine (NiO/PDA) nanocomposite as an efficient material for the removal of Methyl violet 2B from water. It was synthesized and then characterized by Fourier Transform Infrared (FT-IR) spectroscopy, X-ray Diffraction (XRD), Scanning Electron Microscopy (SEM), Energy Dispersive X-ray (EDX) analysis, Transmission Electron Microscopy (TEM), and Brunauer–Emmett–Teller (BET). The EDX analysis confirmed the presence of O, Ni, N, and C. The composite has an average particle size of 18 nm. Its surface area is 110.591 m2/g. It was found that the efficiency of dye removal by adsorption on NiO/PDA exceeded that of bare NiO. The adsorption capacity of NiO and NiO/PDA are 126 and 284 mg/g, respectively. The effects of adsorbent dose, dye concentration, and pH on the removal efficiency were examined. The efficiency increased with increasing the adsorbent dose and pH, but dropped from 85 to 73% within 30 min as the initial dye concentration was increased from 0.984 to 4.92 mg/L. Such a drop in the removal efficiency is due to the blocking of the surface-active sites of NiO/PDA, with the high population of dye molecules derived from the continuous increase in dye concentration. The adsorption results of the dye fitted well with the pseudo-second-order kinetics and Langmuir isotherm. The reusability data showed that NiO/PDA was stable across three adsorption–regeneration cycles, thus it can be considered a good recyclable and efficient adsorbent. Because of these results, it can be considered that this method can be applied for the treatment of wastewater.

Aeromonas hydrophila infection is one of the major diseases that cause inflammation and immunodepression in aquatic animals. Likewise, waterborne toxins are known for their negative impact on the immunity and antioxidant responses of aquatic organisms. In this study, Lactobacillus plantarum (LP20) was incorporated in Nile tilapia, Oreochromis niloticus , diets (50 mg/kg) to investigate its role in the antioxidant capacity, immunity, and anti-inflammation induced by deltamethrin (DLM) toxicity (96-h LC 50 was 14.9 μg/L) and A. hydrophila (LD 50 , 2 × 10 8 CFU/ml). One hundred and twenty healthy fish with an initial weight of 28.21 ± 1.34 g were allotted in 12 glass aquaria (60 L) and divided randomly into four groups (triplicates, 10 fish per aquarium). The control fish neither received LP20 nor were exposed to DLM. The second group of fish was fed the control diet and subjected to DLM (DLM group). The third group of fish was provided with LP20 without DLM toxicity (LP20 group), and the fourth group of fish was fed LP20 and subjected to DLM (DLM + LP20 group). After 30 days, fish were intraperitoneally injected with A. hydrophila . Ten days post infection, the survival rate was lower in fish exposed to DLM than those exposed to LP20. Further, fish fed on LP20 had elevated serum total protein (sTP), albumin (ALB), globulin (GLB), phagocytic index (PI), phagocytic (PA), and lysozyme activities (LZM), but they had lower urea, uric acid bilirubin, creatinine, glucose, aspartate aminotransferase (AST), alkaline phosphatase (ALP), and alanine aminotransferase (ALT) activities after 24 h, 48 h, and 1 week post A. hydrophila challenge. However, fish exposed to DLM had lower sTP, ALB, GLB and higher urea, uric acid, bilirubin, creatinine, glucose, ALT, AST, and ALP after 24 h, 48 h, and 1 week post A. hydrophila challenge. Markedly, after the A. hydrophila challenge, fish exposed to DLM + LP20 displayed upregulated levels of superoxide dismutase ( SOD ), catalase ( CAT ), and glutathione peroxidase ( GPx ) genes. The transcription of interferon gamma ( IFN- γ), interleukin 12 ( IL-12 ), and tumor necrosis factor alpha ( TNF- α) was upregulated in DLM and DLM + LP20 groups. Fish exposed to DLM downregulated interleukin 8 ( IL-8 ) gene expression after A. hydrophila challenge. Further, fish displayed upregulation of heat shock protein 70 ( HSP70 ) gene expression after DLM toxicity. Besides, fish exposed to DLM toxicity and A. hydrophila infection had severe inflammatory features in the liver, spleen, gills, and intestine, while dietary LP20 relieved the inflammatory features. In summary, dietary LP20 relieves Nile tilapia from oxidative stress, immunosuppression, and inflammation induced by DLM and A. hydrophila infection.

Background Health organizations currently face tremendous challenges in the management of the COVID-19 pandemic. To do this, successful and proven scientific practices and support are needed. Aim This study aimed to explore the challenges, practices, and organizational support dealt with by nursing managers in the management of the COVID-19 pandemic. Method A qualitative content analysis study evaluated 35 nursing managers in five university hospitals through a semi-structured interview. The Consolidated Criteria for Reporting Qualitative Research were used for this qualitative study. Results Three main themes emerged: Challenges include the development of a COVID-19 crisis management plan, a shortage in nursing staff, and psychological problems. Practices include; changes in work schedules for nursing staff, the exchange process, hospital preparation, and training and education. And organizational support includes both support at an organizational level and support at an individual level. Conclusion This study revealed that nursing managers are faced with many challenges in the management of COVID-19, requiring good practices and organizational support. This study offers evidence for nursing managers to expect problems that may arise during the pandemic. Recommendations The COVID-19 pandemic requires the development of an integrated plan, and this plan must be disseminated to the hospital’s nursing and medical teams to better equip them for the current and future crises.

Background Integrating digital health and telemedicine technologies is transforming healthcare delivery. In light of this transition, it is critical to ascertain the efficacy of patient safety protocols and evaluate the awareness of healthcare professionals, particularly nurses, regarding the integration of digital health technologies. Aim This study examines the factors influencing the successful adoption of digital health and telemedicine technologies from the nurses’ perspective, focusing on ensuring patient safety and enhancing organizational readiness for digital health integration. Methods A cross-sectional study included 246 nurses from outpatient healthcare centers in Egypt. The data collected included demographic information and responses to a series of questionnaires, namely the Patient Safety Culture Survey (PSCS), the Telemedicine Risk Assessment and Mitigation Matrix (TRAMM), the Digital Health Adoption Readiness Assessment (DHARA), and the Digital Health Impact Assessment Tool (DHIA). The descriptive statistical analyses were conducted using the IBM SPSS Statistics software, version 26. Results The sample was predominantly composed of nurses aged 18–35 (40.65%) and 36–55 (44.72%), with a near-equal gender distribution (48.78% male, 51.22% female). Most nurses held college degrees (73.17%) and were familiar with telemedicine (73.17%). The PSCS indicated positive scores for Communication Openness (4.5), Leadership Support (4.2), Teamwork (4.3), and Organizational Learning (4.1), with an overall mean score of 4.275. The TRAMM scores were notably high (total mean score 4.9), indicating effective risk management. The DHARA demonstrated considerable preparedness, as evidenced by a Total Mean Score of 7.85. The DHIA further substantiated this readiness, indicating a robust anticipated impact, particularly in Patient Engagement (9.0) and Usability (8.2). Conclusion The favorable assessment scores indicate a strong awareness of integrating digital health and telemedicine, suggesting the potential for enhanced patient care and healthcare delivery. It is recommended that healthcare organizations prioritize providing ongoing training and support for nurses, enabling them to utilize digital health tools and thereby enhance patient safety effectively. Clinical trial number Not applicable.

The optimal water temperature for the normal growth of Nile tilapia is between 26 and 28 °C, and the toxicity of pesticides is strongly related to water temperature. An alternate approach to augmenting the resistance of fish to ambient water toxicity and low water temperature via synbiotic feeding was proposed. In this study, fish were allocated into four groups with 10 fish in each replicate, where they were fed a basal diet or synbiotics (550 mg/kg) and kept at a suboptimal water temperature (21 ± 2 °C). The prepared diets were fed to Nile tilapia for 30 days with or without deltamethrin (DMT) ambient exposure (15 μg/L). The groups were named control (basal diet without DMT toxicity), DMT (basal diet with DMT toxicity), synbiotic (synbiotics without DMT toxicity), and DMT + synbiotic (synbiotics with DMT toxicity). The results displayed upregulated transcription of catalase, glutathione peroxidase, and interferon (IFN-γ) genes caused by DMT exposure and synbiotic feeding when compared with the controls. Moreover, HSP70 and CASP3 genes displayed increased transcription caused by DMT exposure without synbiotic feeding. However, fish fed with synbiotics showed downregulated HSP70 and CASP3 gene expressions. The transcription of IL-1β and IL-8 genes were also decreased by DMT exposure, while fish fed synbiotics showed upregulated levels. DMT exposure resulted in irregular histopathological features in gills, intestine, spleen, and liver tissues, while fish fed synbiotics showed regular, normal, and protected histopathological images. Our results indicated that dietary synbiotics ameliorated histopathological damages in DMT-exposed tilapia through alleviation of oxidative stress and inflammation as well as enhancing the immunity.