Ahmed Mohamed

This study investigates the influence of sodium hydroxide (NaOH) concentration (0 M, 0.2 M, 0.5 M, and 1.0 M) on the hydration kinetics, mechanical properties, and microstructural evolution of Limestone Calcined Clay Cement (LC3). Experimental analyses, including isothermal calorimetry, compressive strength testing, X-ray diffraction (XRD), thermogravimetric analysis (TG/DTG), scanning electron microscopy coupled with energy-dispersive X-ray spectroscopy (SEM-EDS), and Fourier-transform infrared spectroscopy (FT-IR), were conducted on LC3-35 paste samples. Results indicate that elevated NaOH concentrations accelerate early hydration, with the 1.0 M sample exhibiting a C3S reaction peak at 1.5 h, compared to 2 h for the control (0 M). However, compressive strength at 28 days peaked in the control (~ 50 MPa) and 0.5 M samples (~ 47 MPa), while the 1.0 M formulation showed reduced performance (~ 36 MPa), suggesting an optimal NaOH range of 0.2 M–0.5 M. Microstructural analysis revealed enhanced formation of calcium (alumino) silicate hydrate (C-A-S-H) gels at moderate NaOH levels, transitioning to sodium-incorporated C-(N)-A-S-H phases at higher concentrations, accompanied by interactions with ferrite phases (C4AF). Notably, density variations showed no direct correlation with strength, underscoring the dominance of chemical and microstructural factors. These findings demonstrate that controlled alkali activation (≤ 0.5 M NaOH) enhances early pozzolanic reactivity and strength development in LC3 without compromising long-term performance, supporting its viability as a sustainable, low-clinker cement alternative. Future research should prioritize quantitative analysis of C-A-S-H gel and calcium sulfate (CaSO4) content to refine LC3 formulations for industrial applications.

Abstract Objective To investigate the role of posterior colpotomy first technique in preserving vaginal length and support with total abdominal hysterectomy (TAH).

The live-attenuated oral vaccine intrOv is an IFNγ-susceptible mutant of C. muridarum that is rapidly cleared from the large intestine by IFNγ-producing group 3 innate lymphoid cells (IFNγ+ILC3s), while the wild-type C. muridarum maintains long-lasting colonization. Although we have previously shown that IL-23 receptor signaling is essential for IFNγ+ILC3s to clear intrOv, the cellular source of IL-23 remains unknown. In the current study, we found that intrOv induces IL-23 in the large intestine, which correlates with intrOv inhibition. Mice deficient in IL-23p19 fail to inhibit intrOv, demonstrating the necessity for IL-23 to promote the inhibition of intrOv. To identify the responsible IL-23 producers, transgenic mice expressing CD11c promoter-driven diphtherial toxin receptor are used to deplete dendritic cells. We found that depletion of CD11c-expressing cells significantly reduces IL-23 and IFNγ, allowing intrOv to grow, while wild-type CD11c-expressing cells are sufficient to rescue IL-23p19-deficient mice to inhibit intrOv in the large intestine. Thus, we have demonstrated that CD11c-expressing cells inhibit the live-attenuated chlamydia oral vaccine intrOv via an IL-23-dependent mechanism, providing novel information to improve the safety and efficacy of intrOv and to reveal the intricate interactions of an obligate intracellular bacterium with host mucosal tissues.

This study examines the role of digital talent in driving marketing innovation within tourism and hospitality organizations in the context of ongoing tourism digitalization. Specifically, it investigates how digital culture and digital strategy mediate the relationship between digital talent and marketing innovation. Data were collected from employees working in Class A travel agencies and five-star hotels in Greater Cairo, Egypt. Using a purposive sampling approach, a bilingual e-survey was distributed, yielding 432 valid responses for analysis. The findings indicate that digital talent plays a crucial role in enabling marketing innovation in tourism and hospitality organizations. Its influence occurs both directly and indirectly through digital culture and digital strategy, highlighting the importance of aligning digital competencies with an organization-wide digital mindset and a clearly defined digital strategy. The results demonstrate how digital capabilities support the transformation of tourism and hospitality marketing practices in the era of digital transformation. This study contributes to the literature by providing empirical evidence on the mechanisms through which digital talent enhances marketing innovation in tourism organizations. The findings offer important theoretical and practical implications for researchers, managers, and tourism and hospitality practitioners seeking to strengthen innovation-driven marketing strategies in an increasingly digital tourism environment.

Background While current surgical approaches for obstructed defecation syndrome (ODS) primarily target rectocele and rectal intussusception, excessive perineal descent (PD) may contribute to persistent symptoms and suboptimal surgical outcomes. This study aimed to evaluate early outcomes of transverse perineal support (TPS), a procedure designed to reinforce the perineum, in patients with ODS and pathological PD. Patients and method All consecutive patients with ODS and pathological PD were assessed for eligibility. After at least one year of conservative management (dietary fiber, biofeedback, laxatives) that failed to relieve symptoms, twenty-nine patients were evaluated preoperatively using the Cleveland Clinic Constipation Score (CCCS), Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12), perineometry, anorectal manometry, and MRI defecography. All patients underwent TPS procedure and were followed up for a minimum of 6 months. The primary outcome was the change in CCCS at 6 months. Results Significant postoperative improvements were observed. The CCCS decreased significantly, with a mean difference (Post - Pre) of -5.31 (95% CI: -6.13 to -4.48 ; p < 0.001). Postoperative PISQ-12 scores were significantly higher than preoperative scores, with median (IQR) values of 35 (34–36) and 25 (24–27), respectively (p = 0.003). Intrarectal pressure during push increased from 34.34 ± 6.03 mmHg preoperatively to 41.17 ± 5.85 mmHg postoperatively with a mean difference (Post - Pre) of 6.83 (95% CI: 5.41 to 8.24; p < 0.001). Perineal descent measured by perineometry decreased from 2.29 ± 0.55 cm preoperatively to 1.74 ± 0.51 cm postoperatively with a mean difference of -0.64 cm (95% CI: -0.75 to -0.52; p < 0.001). No mesh-related complications (erosion, chronic pain) were observed. Nine patients (31.03%) reported persistent symptoms. All had rectal intussusception. Compared with patients who improved, these patients were older, had smaller perineal bodies, and greater preoperative perineal descent. Conclusions Transverse perineal support procedure may be an effective option for selected patients with ODS and pathological PD. Outcomes were less favorable in patients with rectal intussusception, older age (observed as an association only, not causation) or smaller perineal body dimensions, underscoring the importance of careful patient selection and individualized surgical planning. Given the small sample size and the absence of a control group, these findings should be interpreted with caution as associational rather than causal.

Angioscopy is an emerging technology in neurointervention.[1–4][1] The Vena MicroAngioscope (MA) is a sterile, single-use, full-color, forward-viewing angioscope delivered through a guiding or distal access catheter, with or without flow arrest, and saline irrigation. The device is 160 cm in length, with a 3 Fr distal radiopaque tip, and connects to the Vena Camera Control Unit for illumination and real-time image capture (see [video 1][2]). We present a video demonstrating the second-generation MA used with the SmartGUIDE deflectable tip guidewire in treating a carotid–cochlear dehiscence causing pulsatile tinnitus.[5][3] A 45-year-old man underwent balloon occlusion testing confirming symptom origin, followed by BeGraft covered stent placement. The MA demonstrated intraluminal vascular indentation consistent with the underlying bony defect. Post-deployment angioscopy confirmed complete defect coverage, optimal wall apposition, and absence of thrombus, while detecting subtle iatrogenic endothelial injury that was undetectable by angiography, underscoring its value for intraprocedural vessel wall assessment.­Video 1  [1]: #ref-1 [2]: #F1 [3]: #ref-5

Purpose This study aimed to synthesise diagnostic evidence comparing a novel myocardial perfusion radiotracer [¹⁸F]flurpiridaz PET with SPECT myocardial perfusion imaging (MPI) in detecting coronary artery disease (CAD). Methods A systematic search to Feb 2026 was conducted in Web of Science, Scopus, PubMed, and the Cochrane Library. Studies comparing [¹⁸F]flurpiridaz PET with SPECT/MPI were screened. Primary outcomes were sensitivity and specificity using invasive coronary angiography as the reference standard. Secondary outcomes included image quality and radiation dose. Results Out of 558 studies, 28 publications were fully screened, and three trials comparing [¹⁸F]flurpiridaz PET with [⁹⁹ᵐTc]Tc-sestamibi/tetrofosmin SPECT were identified (1476 patients). For ≥ 50% stenosis, pooled sensitivity/specificity were 76% (95% CI 71–81%)/71% (63–78%) for flurpiridaz PET and 61% (53–69%)/76% (60–86%) for SPECT; for ≥ 70% stenosis, values were 87% (77–94%)/63% (52–73%) versus 73% (62–81%)/72% (50–87%), respectively. In patients with BMI ≥30kg/m², sensitivity/specificity were 74% (68–78%)/73% (64–80%) for flurpiridaz PET and 61% (49–72%)/75% (56–88%) for SPECT. In women, sensitivity/specificity were 73% (57–84%)/76% (70–81%) for flurpiridaz PET versus 50% (29–70%)/78% (60–90%) for SPECT. Rest and stress image quality favoured flurpiridaz PET (RR1.29[1.19–1.41] and 1.14[1.11–1.17], both p<0.00001) with superior image quality and lower radiation dose. Conclusion This first meta-analysis suggests higher sensitivity of [¹⁸F]flurpiridaz PET vs SPECT MPI with significantly lower radiation dose and improved image quality. [¹⁸F]flurpiridaz is especially useful for assessing women and patients with high BMI, given its superior sensitivity and comparable subgroup specificity. However, findings should be interpreted cautiously due to the limited number of studies. Graphical Abstract

NOUAKCHOTT, Mauritania (AP) — The United Nations refugee agency said Tuesday it is “extremely saddened” after well over 100 people died or went missing from boats off Mauritania last week while trying to make their way to Europe.

The United Nations refugee agency says it is “extremely saddened” after nearly 150 people died or went missing off Mauritania last week. It said 144 people were dead or missing