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BackgroundThe introduction of direct-acting antiviral drugs (DAAs) could safely eliminate the hepatitis C virus (HCV). Steatosis and fibrosis regression after HCV treatment could occur with subsequent improvement in the portal pressure. However, a subgroup of patients is still at risk of variceal bleeding from persistent clinically significant portal hypertension (CSPHT). Recognition of these patients, hence continuous screening, is clinically relevant. In resource-limited areas, the availability of noninvasive, simple markers to identify at-risk patients will help avoid gastroscopy. We aimed to investigate the utility of liver stiffness measurement (LSM) and the portal vein congestion index (PVCI) as noninvasive markers to identify subgroups of patients who need follow-up after HCV elimination.Patients and methodsRetrospectively, we included 181 patients who received DAAs for HCV and achieved sustained virologic response. After 5 years of follow-up, we evaluated baseline parameters that could predict variceal bleeding. Baseline clinical and laboratory data, including baseline LSM and PVCI, were included. Patients were followed for 5 years for the occurrence of variceal bleeding.ResultsThe ROC analysis revealed that at a cutoff level ≥ 0.563, PVCI could identify patients who experienced variceal bleeding with a 91.8% sensitivity, 90.9% specificity, and 79% PPV. Patients with PVCI ≥ 0.563 and LSM ≥ 21.2 kPa had a shorter interval before variceal bleeding. Cox regression analysis identified baseline CTP, PVCI, and LSM as the only significant independent predictors of variceal bleeding in the study population.ConclusionsAlthough HCV treatment ameliorates liver pathology and may regress PHT, it may give “false assurance” to a subset of patients who are still at risk of variceal bleeding and require close follow-up to avoid devastating variceal rupture. Noninvasive identification and stratification of these patients can be achieved by integrating PVCI and LSM into the management strategy.

Intravenously administered cyclic dinucleotides and other STING agonists are hampered by low cellular uptake and poor circulatory half-life. Here we report the covalent conjugation of cyclic dinucleotides to poly(β-amino ester) nanoparticles through a cathepsin-sensitive linker. This is shown to increase stability and loading, thereby expanding the therapeutic window in multiple syngeneic tumour models, enabling the study of how the long-term fate of the nanoparticles affects the immune response. In a melanoma mouse model, primary tumour clearance depends on the STING signalling by host cells—rather than cancer cells—and immune memory depends on the spleen. The cancer cells act as a depot for the nanoparticles, releasing them over time to activate nearby immune cells to control tumour growth. Collectively, this work highlights the importance of nanoparticle structure and nano-biointeractions in controlling immunotherapy efficacy. STING agonists are often limited by low circulation time and cellular uptake. The conjugation of STING agonists with polymer nanoparticles is shown to enhance stability, circulation time and cellular uptake, increasing the immunotherapeutic activity.

The Internet of Drone Things (IoDT) is a trending research area where drones are used to gather information from ground networks. In order to overcome the drawbacks of the Internet of Vehicles (IoV), such as congestion issues, security issues, and energy consumption, drones were introduced into the IoV, which is termed drone-assisted IoV. Due to the unique characteristics of the IoV, such as dynamic mobility and unsystematic traffic patterns, the performance of the network is reduced in terms of delay, energy consumption, and overhead. Additionally, there is the possibility of the existence of various attackers that disturb the traffic pattern. In order to overcome this drawback, the drone-assisted IoV was developed. In this paper, the bio-inspired dynamic trust and congestion-aware zone-based secured Internet of Drone Things (BDTC-SIoDT) is developed, and it is mainly divided into three sections. These sections are dynamic trust estimation, congestion-aware community construction, and hybrid optimization. Initially, through the dynamic trust estimation process, triple-layer trust establishment is performed, which helps to protect the network from all kinds of threats. Secondly, a congestion-aware community is created to predict congestion and to avoid it. Finally, hybrid optimization is performed with the combination of ant colony optimization (ACO) and gray wolf optimization (GWO). Through this hybrid optimization technique, overhead occurs during the initial stage of transmission, and the time taken by vehicles to leave and join the cluster is reduced. The experimentation is performed using various threats, such as flooding attack, insider attack, wormhole attack, and position falsification attack. To analyze the performance, the parameters that are considered are energy efficiency, packet delivery ratio, routing overhead, end-to-end delay, packet loss, and throughput. The outcome of the proposed BDTC-SIoDT is compared with earlier research works, such as LAKA-IOD, NCAS-IOD, and TPDA-IOV. The proposed BDTC-SIoDT achieves high performance when compared with earlier research works.

This study aims to investigate the prevalence of hypothyroidism in T2DM patients and its relationship with lipid profiles and clinical parameters. The results indicate that 82% of the T2DM patients did not have hypothyroidism, whereas 18% had hypothyroidism. People with both conditions had a higher average body mass index (BMI) of 32.1 ± 6.1 kg/m² than those with only T2DM did (mean: 34.4 ± 6.8 kg/m², p  < 0.001). Compared with the control group, the hypothyroid group presented higher glycosylated hemoglobin (HbA1c) levels (mean: 10.1% vs. 5.48%, p  < 0.001). Compared with T2DM patients without hypothyroidism, T2DM patients with hypothyroidism presented significantly poorer lipid profiles, with lower high-density lipoprotein and higher low-density lipoprotein and triglyceride. T2DM patients with hypothyroidism had a greater prevalence of vitamin D deficiency (average: 28.2 ± 20.0 ng/mL) than control patients did (average: 59.5 ± 11.7 ng/mL, p  < 0.001). In conclusion, T2DM with hypothyroidism is associated with poorer metabolic indicators than those of T2DM patients without hypothyroidism. Individuals who have both conditions have an increased BMI, higher FBS levels, poorer lipid profiles, and decreased vitamin D levels. These results highlight the importance of implementing specific management plans for T2DM patients who also have hypothyroidism.

Background: In the Kingdom of Saudi Arabia, various COVID-19 vaccines were administered during the pandemic. However, region-specific real-word comparative data on their immunogenicity remain limited. This study aimed to assess the serological responses to Pfizer-BioNTech (BNT162b2), Moderna (mRNA-1273), and AstraZeneca (ChAdOx1 nCoV-19) vaccines in a diverse population living in KSA. Methods: This observational study included 236 adults recruited from vaccination sites in Riyadh. Participants provided serum samples at predefined intervals: before the first dose, after the first dose, after the second dose, and post-vaccination infection (if applicable). IgG and neutralising antibodies were quantified using ELISA assays. Demographic and vaccination data, and their associations with antibody responses, were evaluated. Results: At baseline, 75.4% of participants were positive for SARS-CoV-2 IgG, suggesting high prior exposure. Marked incremental increases in IgG levels were observed after each vaccine dose. Both Moderna and Pfizer elicited stronger responses, with Pfizer inducing the strongest early response and Moderna achieving the highest overall titres. Among IgG-positive individuals, neutralising antibodies were detected in 98.1%. There were no statistically significant differences by age or gender, although males tended to show higher mean titres. Heterologous vaccine schedules induced comparable or enhanced immunogenicity relative to homologous schedules, supporting their use in flexible immunisation strategies. Conclusions: All COVID-19 vaccines administered in Saudi Arabia elicited robust antibody responses, particularly the mRNA-based vaccines. Our findings support their continued use and justify varied vaccination approaches, including mix-and-match booster strategies, to enhance community immunity.

Background: The optimal timing of cranioplasty (CP) after decompressive craniectomy (DC) remains debated. Early reconstruction may enhance neurological recovery through restoration of cerebral perfusion and cerebrospinal fluid dynamics, yet concerns persist regarding postoperative complications. Objective: To evaluate the impact of early versus delayed cranioplasty on neurological outcomes and postoperative complications in adults following decompressive craniectomy. Methods: A systematic review was conducted in accordance with PRISMA guidelines (PROSPERO ID: CRD420251123808). PubMed, OVID, and Web of Science were searched for studies published between January 2017 and December 2025. Eligible studies compared early and delayed CP in adults and reported neurological outcomes and/or complications. Results: Twenty-one retrospective cohort studies including 8462 patients were analyzed. Neurological improvement was observed in both groups across multiple validated scales (GOSE, GOS, GCS, mRS, BI, FIM, NIHSS, MMSE). Early CP was consistently associated with superior recovery, including higher one-year Barthel Index improvement (74.1% vs. 54.8%), greater FIM gains (7.31% vs. 4.66%), and higher composite recovery rates (95.6% vs. 80.0%). No study demonstrated superior recovery with delayed CP. Infection, hydrocephalus, and seizure rates were comparable between groups. However, hematoma (21% vs. 10.4%) and hygroma (7.49% vs. 4.73%) were more frequent after early CP, although hematoma rates were influenced by a large database study. Bone flap resorption was less frequent with early CP (1.44% vs. 6.26%). Conclusions: Early cranioplasty is associated with improved neurological recovery but carries an increased risk of select complications, particularly hematoma and hygroma, representing a clinically relevant trade-off. Delayed CP does not demonstrate overall superior safety due to higher bone flap resorption. Timing should be individualized, and prospective multicenter studies with standardized definitions are needed.

Background Hepatitis C virus (HCV) is a widespread global infection responsible for chronic liver disease, which can progress to fibrosis, cirrhosis, and hepatocellular carcinoma, influenced by viral, immune, and host genetic factors. Heme oxygenase-1 (HO-1) and adenosine deaminase acting on RNA 1 (ADAR1) are key regulators of antiviral immunity. Polymorphic variants in the HO-1 and ADAR1 genes (rs2071746 and rs1127313, respectively) may alter host susceptibility, viral replication, and the severity of hepatic injury, highlighting their potential as molecular markers of HCV pathogenesis in the Egyptian population. Methods Single-nucleotide polymorphisms (SNPs) were genotyped using TaqMan allelic discrimination assays in 100 participants, comprising 50 patients with chronic HCV infection and 50 healthy controls with comparable age and gender distribution. Clinical, biochemical, and virological assessments were conducted to evaluate hepatic status and viral load. Results The T allele of HO-1 demonstrated a significant association with HCV susceptibility (OR = 4.89, p  < 0.001), with predominance of the AT genotype. The frequency of the G allele of ADAR1 was significantly higher among patients (OR = 3.18, p  < 0.001). HO-1 variants correlated with hepatic steatosis, higher FIB-4 scores, and increased liver enzyme levels, while polymorphisms of ADAR1 showed no significant association with liver injury indices. Conclusion Polymorphisms in HO-1 (rs2071746) and ADAR1 (rs1127313) influence host susceptibility and disease progression in HCV infection. The HO-1 T allele and AT genotype were strongly associated with HCV infection, whereas the A allele correlated with greater fibrosis and steatosis severity. Similarly, the ADAR1 G allele and AG genotype were more prevalent in HCV patients and associated with higher viral loads, implicating ADAR1 in viral persistence and immune modulation. Those variants could potentially serve as genetic predictors for disease outcomes in HCV-infected individuals, warranting further large-scale studies.

Another approach for recovering zirconium and rare earth elements has been proposed. This process is based on the separation of Zr-sulfide from the prepared chloride leach liquid of the hydrous oxide cake (obtained following the previous alkaline breakdown of Gabal El-Faliq pegmatite concentrate). At the optimal conditions of pH 3, 10% Na 2 S concentration, precipitation period of 25 min, and precipitation temperature of 80 °C, zirconium sulfide precipitated almost completely. The filter chloride solution, free of Zr ions, was then treated with oxalic acid to separate the REE-oxalate cake. Finally, a flow sheet for preparing pure products from the metals of interest was established. The chloride leaching experimental data were well interpreted using a shrinking core model with diffusion control across a porous product layer. The activation energy was measured to be 2.31 kJ/mol. The low activation energy supported the discovery that the chloride leaching rate is determined by a diffusion-controlled process. The experimental data were graphically and statistically examined, and the aforementioned model proved to suit the results satisfactorily.

As fast as smart technology has been spread all over the world, digital marketing is the aim of the future and all purchasing process are going through that way. Interactive fashion marketing has taken a place in that technology and it success and increase so fast. So, it was observed that women specially the working one are taking too long time and efforts to reach their target in shopping process and some have a problem in dealing with the technology. The aim of the study is to raise the awareness in dealing with the technology and make it easier and to lessen the time spent in shopping and also the efforts too. The paper followed the descriptive and semi experimental method to analyze the impact of interactive marketing on women's and how many women's are using such technology and how can they deal with it. As a result of that technology is the future all over the world for all gender categories and levels.

Background/Objectives: Spinal metastases are a frequent and serious complication in cancer patients, often causing severe pain, instability, and neurological deficits. Thermal ablation techniques such as radiofrequency ablation (RFA), microwave ablation (MWA), and cryoablation (CA) have emerged as minimally invasive treatments. These techniques rely on precise imaging guidance to effectively target lesions while minimizing complications. This systematic review aims to compare the efficacy of different imaging modalities—computed tomography (CT), magnetic resonance imaging (MRI), fluoroscopy, and mixed techniques—in guiding thermal ablation for spinal metastases, focusing on success rates and complications. Methods: A systematic literature search was conducted across PubMed, OVID, Google Scholar, and Web of Science databases, yielding 3733 studies. After screening, 51 studies met the eligibility criteria. Data on success rates, tumor recurrence, complications, and patient outcomes were extracted. Success was defined as no procedure-related mortality, tumor recurrence or expansion, or nerve injury. This systematic review followed PRISMA guidelines and was registered with PROSPERO (ID: CRD42024567174). Results: CT-guided thermal ablation demonstrated high success rates, especially with RFA (75% complete success). Although less frequently employed, MRI guidance showed lower complication rates and improved soft-tissue contrast. Fluoroscopy-guided procedures were effective but had a higher incidence of nerve injury and incomplete tumor control. Mixed imaging techniques, such as CBCT-MRI fusion, showed potential for reducing complications and improving targeting accuracy. Conclusions: CT remains the most reliable imaging modality for guiding thermal ablation in spinal metastases, while MRI provides enhanced safety in complex cases. Fluoroscopy, although effective for real-time guidance, presents limitations in soft-tissue contrast. Mixed imaging techniques like CBCT-MRI fusion offer promising solutions by combining the advantages of both CT and MRI, warranting further exploration in future studies.