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Diabetic osteoporosis (DO) is a metabolic bone disorder associated with diabetes mellitus. It is characterized by reduced bone mass, alterations in bone tissue structure as observed under microscopy, increased susceptibility to fractures, and represents one of the complex manifestations of diabetes mellitus in the skeletal system. Hence, it is necessary to prevent and treat DO by enhancing research on its pathogenesis and thereby improving the existing treatment approaches. To explore the mechanism by which curcumin regulates mitochondrial oxidative stress in osteoblasts for treatment of DO via Sirt3/FoxO3a pathway. Firstly, a high-glucose culture model of mouse osteoblast (MC3T3-E1) was established. On this basis, Western Blot and SiRNA techniques were employed to explore the effects of curcumin on the related proteins of SIRT3/FoxO3a, antioxidant enzymes, and mitochondrial function within cells, as well as the osteogenic differentiation of osteoblasts. Eventually, a rat model of diabetic osteoporosis was constructed, and the role of curcumin in regulating the SIRT3/FoxO3a signal to scavenge oxidative stress and restore bone structural integrity in vivo was investigated. The high glucose microenvironment significantly inhibited the cell viability of MC3T3-E1 cells, decreased the level of intracellular antioxidant enzymes, and altered the mitochondrial membrane potential and structure. Curcumin can reverse the mitochondrial oxidative stress damage of MC3T3-E1 and enhance the osteogenic differentiation capacity of cells by activating the SIRT3/FoxO3a pathway. The beneficial effects of curcumin were abolished upon SIRT3 silencing, suggesting that SIRT3/FoxO3a is the principal pathway through which curcumin modulates cellular functions. Based on a rat model of DO, curcumin increased the level of SIRT3 and enhanced bone mineral density and trabecular number in a dose-dependent manner. Curcumin reduces mitochondrial oxidative stress damage through activation of the SIRT3/FoxO3a signaling pathway to improve diabetic osteoporosis.

Physical adjunctive interventions (PAIs), including vibration devices and low-level laser therapy, are promoted to accelerate tooth movement, improve aligner tracking, and reduce discomfort in clear aligner treatment (CAT), but randomized evidence remains inconsistent. This systematic review aimed to assess whether PAIs improve CAT outcomes in terms of objective tooth-movement metrics, aligner tracking, overall treatment efficiency, and patient-centered outcomes, and to appraise the risk of bias and the certainty of the evidence at the outcome level. Comprehensive electronic searches of PubMed, Embase, Scopus, Web of Science, and CENTRAL were conducted from database inception (earliest available indexing date in each database) to 30 June 2025 (coverage cut-off). Grey literature searching and hand-searching were also performed, with no restrictions on language or publication status. Eligible studies were human randomized controlled trials (RCTs) comparing CAT combined with PAIs versus CAT alone or sham interventions. Two independent reviewers performed study selection and data extraction, with risk of bias assessed using the Cochrane RoB 2 tool and certainty of evidence appraised with GRADE. Random-effects meta-analyses were conducted when feasible; otherwise, results were narratively summarized. The protocol was prospectively registered (PROSPERO CRD420251132229). Seven RCTs involving 266 participants were included. No significant improvement in Little's Irregularity Index (maxilla MD = 0.08, p = 0.869; mandible MD = 0.44, p = 0.487). Vibration improved aligner tracking under a 7-day change schedule (p = 0.003) but not case completion (p = 0.999). Overall compliance was approximately 77%, and no between-group difference was observed (p = 0.390). Pain was slightly lower on days 1-3 only (p < 0.05); no quality-of-life benefits were observed; periodontal indices remained unchanged; biomarkers showed inconsistent results. The certainty of evidence was low to very low, suggesting that further well-designed RCTs are likely to change the effect estimates and may alter the conclusions. Across objective tooth-movement metrics, aligner tracking, treatment efficiency, and patient-centered outcomes, current randomized evidence does not demonstrate a consistent benefit of physical adjunctive interventions in clear aligner treatment. Interpretation is limited by outcome-level risk of bias concerns and low to very low certainty of evidence.

Purpose>This paper aims to enlighten the importance of the risk management process which is considered as a major procedure to effectively handle the potential inherent risks in the construction industry. However, most traditional risk analysis techniques are based on theories that deal with each risk factor as an independent, which does not take into consideration the causal relationships between risk factors.Design/methodology/approach>This study aspires to identify the overall risk of the administrative construction projects in Egypt and to recognize the most influencing risk factors through the project life cycle by using Bayesian belief networks (BBN). Through a review of the literature, 27 risk factors were identified and categorized as the most common risk factors in the construction industry. A structured questionnaire was performed to estimate the probability and severity of these risks. Through site visits and interviews with experts in the construction field, 200 valid questionnaires were collected. A risk analysis model was developed using BBNs, then the applicability of this model was verified using a case study in Egypt.Findings>However, the outcome showed that critical risks that manipulate administrative construction projects in Egypt were corruption and bribery, contractor financial difficulties, force majeure, damage to the structure and defective material installation.Practical implications>The proposed study presents the possibilities available to the project parties to obtain a better forecast of the project objectives, including the project duration, total project cost and the target quality by examining the causal relationships between project risks and project objectives.Originality/value>This study aspires to identify the overall risk of the administrative construction projects in Egypt and to recognize the most influencing risk factors through the project life cycle by using BBNs.

Inflammatory processes are increasingly attributed to macrophage polarization. Proinflammatory macrophages promote T helper (Th) 1 response, tissue repair, and Th2 responses. Detection of macrophages in tissue sections is facilitated by CD68. Our study is focused on the expression of CD68 and the estimation of proinflammatory cytokines in children’s patients with chronic tonsillitis secondary to vitamin D supplementation. This hospital-based Randomized prospective case–control study was conducted on 80 children with chronic tonsillitis associated with vitamin D deficiency where (40 received vitamin D 50,000 IU weekly for 3–6 months and 40 received 5 ml distilled water as placebo). The serum 25-hydroxyvitamin D [25(OH)D] was measured using an Enzyme-linked immunosorbent assay on all included children. Different histological and immunohistochemical studies for the detection of CD68 were done. There was a significantly lower serum level of 25(OH)D in the placebo group versus the vitamin D group ( P  < 0.001). The levels of pro-inflammatory cytokines, TNFα, and IL-2 significantly increased in the placebo group as compared to the vitamin D group ( P  < 0.001). The increased level of IL-4 and IL-10 in the placebo group as compared to the vitamin D group was insignificant ( P  = 0.32, 0.82) respectively. Vitamin D supplementation alleviated the deleterious effect of chronic tonsillitis on the histological structure of the tonsil. Tonsillar tissues of the children in the control and vitamin D groups demonstrated a highly statistically significantly lower number of CD68 immunoexpressing cells compared with those in the placebo group ( P  < 0.001). Low vitamin D may play a role in chronic tonsillitis. Vitamin D supplementation could help reduce the occurrence of chronic tonsillitis in susceptible children.

Ethics statements are an essential aspect of research reporting. They aim to ensure the integrity and credibility of scientific research by maintaining high standards of professionalism and placing a strong emphasis on human well-being. Adhering to ethical norms is crucial for promoting data sharing, reproducibility, and overall research integrity. Ethics statements generally include adherence to legislation, disclosure of conflicts of interest, transparency in funding, standards of authorship, ethical treatment of research participants, and the management of sensitive data. The ICMJE, WAME, and COPE organizations offer recommendations to ensure the maintenance of these standards. The significant increase in publication volume in rheumatology research, along with the rise of social media and artificial intelligence, presents new and complex difficulties that require establishing clearer and universally accepted ethical guidelines. Rheumatology journals should prioritize the development of cohesive ethical principles as well as the encouragement of uniform ethics training for researchers, editors, and publishers.

Carnivorans are a diverse group of mammals that includes carnivorous, omnivorous and herbivorous, domesticated and wild species, with a large range of brain sizes. Carnivory is one of several factors expected to be cognitively demanding for carnivorans due to a requirement to outsmart larger prey. On the other hand, large carnivoran species have high hunting costs and unreliable feeding patterns, which, given the high metabolic cost of brain neurons, might put them at risk of metabolic constraints regarding how many brain neurons they can afford, especially in the cerebral cortex. For a given cortical size, do carnivoran species have more cortical neurons than the herbivorous species they prey upon? We find they do not; carnivorans (cat, mongoose, dog, hyena, lion) share with non-primates, including artiodactyls (the typical prey of large carnivorans), roughly the same relationship between cortical mass and number of neurons, which suggests that carnivorans are subject to the same evolutionary scaling rules as other non-primate clades. However, there are a few important exceptions. Carnivorans stand out in that the usual relationship between larger body, larger cortical mass and larger number of cortical neurons only applies to small and medium-sized species, and not beyond dogs: we find that the golden retriever dog has more cortical neurons than the striped hyena, African lion and even brown bear, even though the latter species have up to three times larger cortices than dogs. Remarkably, the brown bear cerebral cortex, the largest examined, only has as many neurons as the ten times smaller cat cerebral cortex, although it does have the expected ten times as many non-neuronal cells in the cerebral cortex compared to the cat. We also find that raccoons have dog-like numbers of neurons in their cat-sized brain, which makes them comparable to primates in neuronal density. Comparison of domestic and wild species suggests that the neuronal composition of carnivoran brains is not affected by domestication. Instead, large carnivorans appear to be particularly vulnerable to metabolic constraints that impose a trade-off between body size and number of cortical neurons.

Abstract Background: To determine KRAS gene in circulating tumor DNA in comparison with histological grading through liquid biopsy in colorectal cancer patients. Methods: This dual-centered cross-sectional study included 73 diagnosed patients of colorectal cancer at different grading levels [Grade I, well differentiated (n = 7, 9.5%); Grade II, moderately differentiated (n = 14,18.9%); and Grade III, poorly differentiated (n = 52, 70%)]. Blood was collected, and plasma was separated. ctDNA was extracted, using magnetic bead-based technique (MagMAX Cell-Free DNA kit). KRAS gene was quantified through qPCR. STRING database was used to find KRAS interactomes. Results: Mean threshold cycle (CT value) of KRAS gene in Grade III samples showed significantly higher (P = 0.001) levels of ctDNA (2.7 ± 1.14) compared with Grade II and Grade I (3.1 ± 0.68, 2.3 ± 0.60), respectively. Grading characterization showed that rectal cancer (n = 22, 42.3%) with Grade III (68.8%) was more prevalent than colon and sigmoid cancer (n = 19, 36.5%, n = 11, 21%, respectively). STRING database showed 10 functional genes interacting with KRAS expressed as gene/proteins. Conclusion: Liquid biopsy can be used to detect ctDNA in plasma of CRC patients and enabled to detect the KRAS gene by qPCR. The technique being less invasive and cost-effective is convenient for multiple biopsies in different cancers.

Medical responders are at-risk of experiencing a wide range of negative psychological health conditions following a disaster. Published literature was reviewed on the adverse psychological health outcomes in medical responders to various disasters and mass casualties in order to: (1) assess the psychological impact of disasters on medical responders; and (2) identify the possible risk factors associated with psychological impacts on medical responders. A literature search of PubMed, Discovery Service, Science Direct, Google Scholar, and Cochrane databases for studies on the prevalence/risk factors of posttraumatic stress disorder (PTSD) and other mental disorders in medical responders of disasters and mass casualties was carried out using pre-determined keywords. Two reviewers screened the 3,545 abstracts and 28 full-length articles which were included for final review. Depression and PTSD were the most studied outcomes in medical responders. Nurses reported higher levels of adverse outcomes than physicians. Lack of social support and communication, maladaptive coping, and lack of training were important risk factors for developing negative psychological outcomes across all types of disasters. Disasters have significant adverse effects on the mental well-being of medical responders. The prevalence rates and presumptive risk factors varied among three different types of disasters. There are certain high-risk, vulnerable groups among medical responders, as well as certain risk factors for adverse psychological outcomes. Adapting preventive measures and mitigation strategies aimed at high-risk groups would be beneficial in decreasing negative outcomes.

Purpose This paper aims to investigate the relationship between entrepreneurial motivation and pharmapreneurial intention among pharmacists in Jordan.The authors also assessed the moderating effect of gender and the COVID-19 pandemic on the relationship between these two variables. Design/methodology/approach This study is a quantitative study targeting pharmacists and using a nonprobability sample. A structured questionnaire was distributed through official channels to the entire population of registered pharmacists in Jordan. SmartPLS 3 was used for carrying an advanced structural equation model analysis, and SPSS 26 for the descriptive statistics. Findings The three entrepreneurial motivation variables (behavioral control [BC], risk tolerance and desirability of self-employment) affected pharmapreneurial intention, with BC contributing more to pharmapreneurial intention among pharmacists in Jordan than the other variables examined. On the other hand, gender and COVID-19 did not moderate this relationship. Research limitations/implications The authors find that entrepreneurial motivation affects pharmapreneurial intention. Consequently, the authors provide insights to policymakers and educators regarding dovetailing the recent financial literacy programs implemented in Jordanian schools with medical education in Jordan to better motivate the formation of pharmapreneurial intention. Practical implications Policymakers and educators should be dovetailing the recent financial literacy programs implemented in Jordanian schools with medical education in Jordan to better motivate the formation of pharmapreneurial intention. Originality/value To the best of the authors’ knowledge, this is the first study to examine pharmapreneurship in Jordan.