This study delves into an in-depth examination of the biomechanical characteristics of various materials commonly utilized in the fabrication of artificial ankle joints. Specifically, this research focuses on the design of an ankle joint resembling the salto-talaris type, aiming to comprehensively understand its performance under different loading conditions. Employing advanced finite element analysis techniques, this investigation rigorously evaluates the stresses and displacements experienced by the designed ankle joint when subjected to varying loads. Furthermore, this study endeavors to identify the vibrating frequencies associated with these displacements, offering valuable insights into the dynamic behavior of the ankle joint. Notably, the analysis extends to studying random frequencies across three axes of motion, enabling a comprehensive assessment of directional deformities that may arise during joint function. To validate the effectiveness of the proposed design, a comparative analysis is conducted against the star ankle design, a widely recognized benchmark in ankle joint prosthetics. This comparative approach serves dual purposes: confirming the accuracy of the findings derived from the salto-talaris design and elucidating the relative efficacy of the proposed design in practical application scenarios.

هشاشة العظام مرض يتميز بانخفاض كتلة العظام مما يزيد من خطر الإصابة بالكسور. يعتبر مقياس كثافة امتصاص الأشعة السينية ثنائي الطاقة (DXA) بمثابة المعيار الذهبي لقياس كثافة المعادن في العظام (BMD). في سورية، يعد DXA مكلفاً وغير متوفر على نطاق واسع ويقترن بتردد قوي بين المرضى فيما يتعلق بالتعرض للإشعاع المؤين. من ناحية أخرى، وجدت العديد من الدراسات الحديثة أن الموجات فوق الصوتية الكمية (QUS) مفيدة في تحديد تشخيص هشاشة العظام وإعطاء معلومات دقيقة حول صفات العظام. كان الهدف من هذه الدراسة هو تصميم وبناء جهاز قياس كثافة العظام بالموجات فوق الصوتية لقياس كثافة المعادن بالعظام. الجهاز محمول (0.4 كيلو غرام) وهو اقل تكلفة بكثير وليس له اي اثر ضار من الاشعاعات المؤينة. تم تصميم الجهاز باستخدام زوج من أجهزة توليد واستشعار بالموجات فوق الصوتية HC-SR04 لإرسال واستقبال الموجات فوق الصوتية عبر العظم ثم تضخيمها وقراءتها رقمياً باستخدام منصة Arduino. تم تنفيذ الجهاز باستخدام نموذج مُصمم مسبقاً باستخدام برنامج CAD، مع رأس قياس متحرك بحيث يمكن أن يكون مناسباً للعديد من المرضى من مختلف الأعمار. تم اختبار الجهاز على العديد من الأفراد الأصحاء والمرضى من مختلف الجنسين، الذين تتراوح أعمارهم بين 18 و 85 عاماً، كما تمت معايرته والتحقق من صحته باستخدام قيمة كثافة المعادن بالعظام التي يوفرها مقياس كثافة العظام DXA. أظهرت النتائج أن أجهزتنا حساسة بدرجة كافية للتمييز بين الأفراد الأصحاء والمرضى باستخدام أدوات منخفضة التكلفة. وفقًا لذلك، قد يكون للجهاز المقترح فرصة جيدة في المستقبل ليتم اعتباره مقياس كثافة عظام محمول فعال ومنخفض التكلفة.

Abstract This study discusses the presence of various food additives in child-oriented snacks in the Syrian market. A total of 65 additives were found in the 603 snacks studied. The most common additives were E500 (Sodium carbonates), which is used as an acidity regulator, anticaking agent, and emulsifying agent, present in 35.7% of the products. Next was E322 (Lecithin), an antioxidant and emulsifier, found in 31.6% of the products. E551 (Silicon dioxide), a carrier and anti-foaming agent, was present in 26.4% of the products. E102 (Tartrazine), a color, was detected in 16.7% of the snacks. Also, the most commonly used colors, preservatives, acidity regulators, antioxidants, sweeteners, thickeners/stabilizers/emulsifiers, and flavor enhancers in Syrian child-oriented foods were determined. Some words like perfumes, enhancers, and natural or synthetic flavors were mentioned without specific additives being identified.

An investigation was conducted to examine the photothermal and thermomechanical effects of short-pulse laser irradiation on normal tissues. This study analyzed the impact of short-pulse laser radiation on the heat-affected region within tissues, taking into consideration a set of laser variables, namely wavelength, intensity, beam size, and exposure time. The beam size ranged between 0.5 and 3 mm, and the intensity of the laser radiation ranged from 1 to 5 W/mm2 at wavelengths of 532 and 800 nm. A three-layered, three-dimensional model was implemented and studied in a polar coordinate system (r = 10 mm, z = 12 mm) in COMSOL Multiphysics (version 5.4, COMSOL Inc., Stockholm, Sweden) to perform numerical simulations. The Pennes bioheat transfer model, Beer-Lambert, and Hooke’s law are integrated to simulate the coupled biophysics problem. Temperature and stress distributions resulting from laser radiation were produced and analyzed. The accuracy of the developed model was qualitatively verified by comparing temperature and mechanical variations following the variations of laser parameters with relevant studies. The results of Box-Behnken analysis showed that beam size (S) had no significant impact on the response variables, with p-values exceeding 0.05. Temperature (Tmax) demonstrates sensitivity to both beam intensity (I) and exposure time (T), jointly contributing to 89.6% of the observed variation. Conversely, while beam size (S) has no significant effect on stress value (Smax), wavelength (W), beam intensity (I), and exposure time (T) collectively account for 71.6% of the observed variation in Smax. It is recommended to use this model to obtain the optimal values of the laser treatment corresponding to tissue with specified dimensions and properties.

Problem: Syrian medical research synthesis lags behind that of neighboring countries. The Syrian war has exacerbated the situation, creating obstacles such as destroyed infrastructure, inflated clinical workload, and deteriorated medical training. Poor scientific writing skills have ranked first among perceived obstacles that could be modified to improve Syrian research conduct at every academic level. However, limited access to personal and physical resources in conflict areas consistently hampers the implementation of standard professional-led interventions. Intervention: We designed a peer-run online academic writing and publishing workshop as a feasible, affordable, and sustainable training method to use in low-resource settings. This workshop covered the structure of scientific articles, academic writing basics, plagiarism, and the publication process. It was also supplemented by six practical assignments to exercise the learned skills. Context: The workshop targeted healthcare professionals and medicine, dentistry, and pharmacy trainees (undergraduate and postgraduate) at all Syrian universities. We employed a systematic design to evaluate the workshop’s short- and long-term impact when using different instructional delivery methods and assignment formats. Participants were assigned in a stratified manner to four groups; two groups attended the workshop synchronously, and the other two groups attended asynchronously. One arm in each group underwent a supervised peer-review evaluation for the practical writing exercises (active), while the other arm in each group self-reviewed their work on the same exercises using exemplary solutions (passive). We assessed knowledge (30 questions), confidence in the learned skills (11 questions), and the need for further guidance in academic writing (1 question) before the workshop and one month and one year after it. Impact: One-hundred-twenty-one participants completed the workshop, showing improved knowledge, confidence, and need for guidance. At one-year follow-up, participants showed stability in these gains. Outcomes for the synchronous and asynchronous groups were similar. Completing practical assignments was associated with greater knowledge and confidence only in the active arms. Participants in the active arms engaging in the peer-review process showed greater knowledge increase and reported less need for guidance compared to those who did not engage in the peer-review. Lessons learned: Peer-run interventions can provide an effective, affordable alternative to improving scientific writing skills in settings with limited resources and expertise. Online academic writing training can show improvements regardless of method of attendance (i.e., synchronous versus asynchronous). Participation in supplementary practical exercises, especially when associated with peer-review, may improve knowledge and confidence.

Abstract Background: While medical research productivity is rapidly accelerating in the world generally, it remains poor in many third-world countries due to many factors including the lack of training and the brain drain of healthcare professionals. Syria had been showing a slow upward trend until the war broke out and severely hindered academic growth and productivity. A continued lack of data on the scale of, and factors behind, this phenomenon needs to be addressed to better understand the current academic productivity and inform educational policies and resource allocation. Additionally, one of the challenges is the small sample sizes of previous cross-sectional studies that evaluated the perspectives of Syrian academics to disentangle the factors that paved the way for these published healthcare workers to pursue research. Therefore, we present a case-control study that targeted this specific population and compared its characteristics and self-reported perceptions to matching controls without previous research involvement. Methods: We first identified Syrian early-career published authors in the healthcare field through an extensive search of PubMed and Google scholar. The questionnaire was subsequently publicly published to recruit matching controls: unpublished researchers and participants with no prior research contributions. The questionnaire covered participants’ research contributions, alongside their self-assessed knowledge, attitudes, and barriers towards research. Results: Six-hundred-sixteen participants were recruited. Their knowledge, attitudes, and perceived barriers explained 46% and 34% of the variability in research involvement and publication, respectively (P < 0.001). Getting involved in and publishing research studies associated with higher research-related knowledge and attitudes (P < 0.001). Respondents’ assessment of research-related barriers and their academic scores did not differ between cases and controls. Superior research-related knowledge and attitudes were associated with male gender, higher English competency, and better internet connectivity. Meanwhile, extracurricular training and mentors’ support were associated with more positive research-related attitudes and less perceived barriers. Conclusions: Research productivity of early-career medical professionals in Syria exhibits a positive correlation with their knowledge and favorable attitudes towards medical research. Noteworthy, demographic variations are linked to disparities in research-related knowledge and motivation. In conclusion, these results suggest a potential avenue for enhancement through concentrated efforts on improving extracurricular training interventions and mentors’ support.

The high prevalence of multiple comorbidities poses unique medication-related challenges for geriatric patients. Polypharmacy is a particular concern since taking several medications simultaneously increases the likelihood of adverse drug events and the risk of drug interactions while decreasing patient adherence. These factors are associated with suboptimal health outcomes and a heightened burden on the healthcare system (insurance claims) and the patient (out-of-pocket expenses). These challenges can significantly affect the quality of life of geriatric patients. This chapter critically examines the impact of medication use and polypharmacy on the quality of life of older patients. In addition, the authors discuss how artificial intelligence-based digital tools and precision medicine can address these issues by streamlining medical decision-making, improving the patient experience, and allowing remote monitoring. Finally, they interpret the findings from the lens of ethical considerations associated with the adoption and implementation of digital applications and gadgets.

AimThis study aimed to assess the prevalence and patterns of COVID-19 vaccine side effects among Syrian adults, with a focus on the AstraZeneca and Sputnik Light vaccines, in light of the low vaccination rate in Syria (below 18%) attributed to fear of side effects. MethodA cross-sectional study was conducted between January and May 2022, using probability-based and convenient sampling strategies. Data was collected through online, paper, and face-to-face questionnaires that included demographic and vaccine-related questions. ResultOut of 3,766 participants, the majority were female (56.7 %) and aged 18–24 years (53.3 %). Most participants had a university-level qualification (71.2 %) and were related to the medical sector (53.2 %). A significant proportion (47.0 %) received AstraZeneca, Sputnik Light (22.1 %) and Sinopharm (14.7 %). Common side effects included sleepiness and lethargy (50.0 %), fever and chills (45.0 %), and pain/swelling at the injection site (35.9 %). Multivariate logistic regression analysis revealed that male (OR: 0.57, CI: 0.48–0.68) and participants aged 45–65 years (OR: 0.53, CI: 0.40–0.70) were less likely to experience side effects. Participants who believed COVID-19 posed a high threat to their personal life had higher odds of side effects (OR: 1.74, CI: 1.22–2.46). Vaccine type was also associated with side effects, with Sputnik Light (OR: 2.52, CI: 1.85–3.46) and AstraZeneca (OR: 1.61, CI: 1.26–2.05) having increased odds. ConclusionOur study found that COVID-19 vaccines are well tolerated among the Syrian population, with short-term side effects that typically resolve within three days. These findings are expected to bolster vaccination rates through enhanced public confidence and acceptance.

This study aims to develop an integrated approach for 3D lumbar vertebral biomodel design and analysis, specifically targeting unilevel disc degeneration and the replacement of lumbar artificial discs. Key objectives include improving existing design methods through 3D techniques, inverse modeling, and an engineering biomodel preparation protocol. Additionally, the study evaluates mechanical properties in the implantation area and between disc components to gauge the effectiveness of artificial discs in restoring functional movement within the studied biological model. The construction of a biological model representing the L3–L4 functional spinal unit was based on measurements from radiographic images and computed tomography data obtained from the study sample. The 3D finite element method in Ansys software (v. 19.2, ANSYS, Inc., Canonsburg, PA, USA) was used to monitor the distribution of equivalent stress values within the core of the two artificial discs and the behavior of vertebral bone components in the model. This approach enabled the creation of personalized digital models tailored to the specific implantation requirements of each patient. Stress analysis identified critical areas within the disc cores, suggesting potential design modifications to optimize artificial disc performance, such as selectively increasing core thickness in specific regions and considering adjustments during implantation. For example, preserving part of the lateral annulus fibrosus from the degenerative disc and maintaining the anterior and posterior longitudinal ligaments may play a crucial role in balancing the forces and moments experienced by the lumbar section. This study provides valuable insights into the development of patient-specific solutions for lumbar disc degeneration cases, with the potential for enhancing artificial disc design and implantation techniques for improved functional outcomes.