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Chest X-ray (CXR) is a common tool used in medical practice. Medical students and interns should acquire knowledge of CXR interpretation, as it is an essential diagnostic tool for a large spectrum of diseases. This systematic review aimed to compare the effect of different intervention techniques on the competency of medical students and interns to demonstrate the level of confidence and competence in interpreting common presentations of CXRs. The population, intervention, comparison, and outcomes (PICO) framework was used to formulate the review question. All related articles in five databases (PubMed, Web of Science, Scopus, Medline, and Embase) were retrieved and the search was completed in March 2023 with no limiters on date and time. The number of relevant studies was 469. A multi-level approach through the Rayyan platform was used for the screening and exclusion processes. Eleven articles were included in the systematic review consisting of eight randomized controlled trials, one quasi-experimental study, one cross-sectional study, and one interventional cohort. Results showed significant effects of teaching methods utilizing deductive or inductive approach, clinical history, patient care comfort survey, and SAFMEDS (Say-All-Fast-Minute-Every-Day-Shuffled). Contrarily, no significant effect was shown by flipped classroom models and mixed and blocked practice, peer-assisted learning vs. expert-assisted learning, and Chester, an artificial intelligence tool. This review identified beneficial approaches that may enhance the learning outcomes of interpreting CXRs for medical students and interns, highlighting the remarkable impact of SAFMEDS on medical students' ability to identify CXR findings as well as the availability and practicality of online and e-learning resources for students.

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Molecular hydrogen is renowned as an odorless and colorless gas. The recommendations developed by China suggest that the inhalation of hydrogen molecules is currently advised in COVID-19 pneumonia treatment. The therapeutic effects of molecular hydrogens have been confirmed after numerous clinical trials and animal-model-based experiments, which have expounded that the low molecular weight of hydrogen enables it to easily diffuse and permeate through the cell membranes to produce a variety of biological impacts. A wide range of both chronic and acute inflammatory diseases, which may include sepsis, pancreatitis, respiratory disorders, autoimmune diseases, ischemia-reperfusion damages, etc. may be treated and prevented by using it. H2 can primarily be inoculated through inhalation, by drinking water (which already contains H2), or by administrating the injection of saline H2 in the body. It may play a pivotal role as an antioxidant, in regulating the immune system, in anti-inflammatory activities (mitochondrial energy metabolism), and cell death (apoptosis, pyroptosis, and autophagy) by reducing the formation of excessive reactive O2 species and modifying the transcription factors in the nuclei of the cells. However, the fundamental process of molecular hydrogen is still not entirely understood. Molecular hydrogen H2 has a promising future in therapeutics based on its safety and possible usefulness. The current review emphasizes the antioxidative, anti-apoptotic, and anti-inflammatory effects of hydrogen molecules along with the underlying principle and fundamental mechanism involved, with a prime focus on the coronavirus disease of 2019 (COVID-19). This review will also provide strategies and recommendations for the therapeutic and medicinal applications of the hydrogen molecule.

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Improper use of antimicrobials has resulted in the emergence of antimicrobial resistance (AMR), including multi-drug resistance (MDR) among bacteria. Recently, a sudden increase in Carbapenem-resistant Enterobacterales (CRE) has been observed. This presents a substantial challenge in the treatment of CRE-infected individuals. Bacterial plasmids include the genes for carbapenem resistance, which can also spread to other bacteria to make them resistant. The incidence of CRE is rising significantly despite the efforts of health authorities, clinicians, and scientists. Many genotypic and phenotypic techniques are available to identify CRE. However, effective identification requires the integration of two or more methods. Whole genome sequencing (WGS), an advanced molecular approach, helps identify new strains of CRE and screening of the patient population; however, WGS is challenging to apply in clinical settings due to the complexity and high expense involved with this technique. The current review highlights the molecular mechanism of development of Carbapenem resistance, the epidemiology of CRE infections, spread of CRE, treatment options, and the phenotypic/genotypic characterisation of CRE. The potential of microorganisms to acquire resistance against Carbapenems remains high, which can lead to even more susceptible drugs such as colistin and polymyxins. Hence, the current study recommends running the antibiotic stewardship programs at an institutional level to control the use of antibiotics and to reduce the spread of CRE worldwide.

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Nasopharyngeal carcinoma (NPC) is an uncommon type of malignancy/cancer worldwide. However, NPC is an endemic disease in southeast Asia and southern China and the reasons behind the underlying for such changes are unclear. Even though the Epstein-Barr infection (EBV) has been suggested as an important reason for undistinguishable NPC, the EBV itself is not adequate to source this type of cancer. The risk factors, for example, genetic susceptibility, and environmental factors might be associated with EBV to undertake a part in the NPC carcinogenesis. Normal healthy people have a memory B cell pool where the EBV persists, and any disturbance of this connection leads to virus-associated B cell malignancies. Less is known about the relationship between EBV and epithelial cell tumors, especially the EBV-associated nasopharyngeal carcinoma (EBVaNPC) and EBV-associated gastric carcinoma (EBVaGC). Currently, it is believed that premalignant genetic changes in epithelial cells contribute to the aberrant establishment of viral latency in these tumors. The early and late phases of NPC patients' survival rates vary significantly. The presence of EBV in all tumor cells presents prospects for the development of innovative therapeutic and diagnostic techniques, despite the fact that the virus's exact involvement in the carcinogenic process is presently not very well known. EBV research continues to shed light on the carcinogenic process, which is important for a more comprehensive knowledge of tumor etiology and the development of targeted cancer therapeutics. In order to screen for NPC, EBV-related biomarkers have been widely used in a few high-incidence locations because of their close associations with the risks of NPC. The current review highlights the scientific importance of EBV and its possible association with NPC.

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During the present study, 30 children in Upper Egypt (less than 12 years old) were admitted to Pediatric Intensive Care Unit because of scorpion envenomation. They were compared with 20 apparently normal children of matching age and sex as controls. The victims and controls were subjected to complete clinical examination and full blood picture. The serum levels of interleukin-6 (IL-6), soluble IL-6 receptor (sIL-6R), regulated upon activation normal T cells expressed and secreted (RANTES ) and tumour necrosis factor-alpha (TNF-alpha) were determined once for the controls and twice for the victims, the first sample on admission and the second sample after 24h. All victims showed significantly higher mean values of IL-6, sIL-6R, RANTES, TNF-alpha, and leucocytic count both on admission and on the follow up when compared with controls. According to the clinical manifestations of envenomation, 40% of the victims had a mild envenomation manifestation, while 60% of them had severe manifestations. The severely envenomed children showed significantly higher mean values of IL-6, sIL-6R, TNF-alpha, RANTES and leucocytic count both on admission and on the follow up samples when compared with the mild cases. The non-survival victims (five victims) showed significantly higher mean values of IL-6, sIL-6R, TNF-alpha, RANTES and leucocytic count both on admission and on the follow up samples in comparison to the survivals. Furthermore, those fatal cases showed a non-significant decline in the serum levels of IL-6, sIL-6R, TNF-alpha, RANTES and leucocytic count on the following up samples, while the survivals showed a significant decline in the serum levels of these parameters on the following up samples. In conclusion, these data revealed that IL-6, sIL-6R, TNF-alpha and chemokine, RANTES are involved in the pathogenesis of scorpion envenomation and correlated with its severity.

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The concentrations of 20 trace elements in several ceramics tiles and ceramic composites used in Egypt were elementally analyzed by neutron activation analysis(NAA) technique. The samples and standard were irradiated with reactor for 4 h (in the Second Research Egyptian Reactor(Et-RR-2)) with thermal neutron flux 5.9 x 10(13) n/(cm2 x s). The gamma-ray spectra obtained were measured for several times by means of the hyper pure germanium detection system(HPGe). Also a solid state nuclear track detector(SSNTD) CR-39, was used to measure the emanation rate of radon for these samples. The radium concentrations were found to vary from 0.39-3.59 ppm and the emanation rates were found to vary from (0.728-5.688) x 10(-4) kg/(m2 x s). The elemental analysis of the ceramic tiles and ceramic composites have a great importance in assigning the physical properties and in turn the quality of the material.

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Major and trace element in seven different kinds of milk powder were studied. The concentration of 24 elements were determined by ICP-OES method, from these elements 9 elements determined by INAA. The determination of trace element contents of foodstuffs, especially milk as daily drink for all peoples age which being a complex food has great importance. The elemental analysis of milk is important both as an indicator of environmental contamination and because milk is a significant pathway for toxic metal intake and a source of essential nutrients for humans. The major elements are Ca, K, Mg, Na, P and S. While trace element are B, Ba, Co, Cr, Cu, Fe, Li, Mn, Mo, Ni, Sb, Se, Sn, Sr, V, W and Zn. ICP-OES technique is shown to be a powerful tool for trace determinations in powder samples. This is shown by its use for analysis of a series of the milk powders mentioned and comparative results of other direct technique such as instrumental neutron activation analysis. Analysis of both standard reference material A-11 milk powder and NBS Orchard leaves for quality accurance had been completed, and used for a relative method calculate. The importance of the major and trace elements to human health was discussed.

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A latex agglutination test to detect urinary antigens for visceral leishmaniasis (VL) was studied. In 204 patients with suspected VL, KAtex had a sensitivity of 95.2% with good agreement with microscopy smears but poor agreement with 4 different serology tests. It was also positive in 2 confirmed VL cases co-infected with HIV. In all K4tex-positive confirmed cases actively followed up after treatment, the test became negative 1 month after completion of treatment. While IC4tex had a specificity of 100% in healthy endemic and non-endemic controls, the direct agglutination test (DAT) was positive in 14% of the KAtex-negative healthy endemic controls. KAtex is a simple addition to the diagnostics of VL particularly at field level and as a complementary test for the diagnosis of VL in smear-negative cases with positive DAT results.

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A latex agglutination test to detect urinary antigens for visceral leishmaniasis [VL] was studied. In 204 patients with suspected VL, KAtex had a sensitivity of 95.2% with good agreement with microscopy smears but poor agreement with 4 different serology tests. It was also positive in 2 confirmed VL cases co-infected with HIV. In all KAtex-positive confirmed cases actively followed up after treatment, the test became negative 1 month after completion of treatment. While KAtex had a specificity of 100% in healthy endemic and non-endemic controls, the direct agglutination test [DAT] was positive in 14% of the KAtex-negative healthy endemic controls. KAtex is a simple addition to the diagnostics of VL particularly at field level and as a complementary test for the diagnosis of VL in smear-negative cases with positive DAT results

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Natural radioactive materials under certain conditions can reach hazardous radiological levels. The natural radionuclide (238U, 232Th, 40K) contents of rock samples at various locations in the North Tushki area were investigated using gamma-spectrometric analysis. Estimates of the measured radionuclide content have been made for the absorbed dose rate of gamma radiation. The equivalent radium (Req) and the external hazard index (Hex) which resulted from the natural radionuclides in soil are also calculated and tabulated. The studied samples have been collected from various rock exposures in the North Tushki area. The distribution of major oxides, U and Th were studied. It is found that the enrichment and depletion of the major oxides are mainly due to the effect of hydrothermal alteration, which caused mobility of some major oxides, which increases some elements and decreases others. It is important to mention that the study area is far from the development region of the Tushki project and is only a local hazard. Therefore, additional regional studies of the Tushki Project area should be under taken to explore any unexpected environmental hazard due to the high concentration of the radioactive elements, which have been observed at its north boundary.

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Elemental analysis of iron ore samples and first industrial iron production prepared by the Egyptian Iron and Steel Company of Helwan near Cairo were determined by instrumental neutron activation analysis technique. Five samples from each kind were irradiated for a 48 hours at a thermal neutron flux of 4 x 10(12) n/(cm2.s) in the first Egyptian research reactor ET-RR-1. Also the Pneumatic irradiation Rabbit system (PIRS) attached to the reactor in Inshass, was used to measure the elements of short-life time. The gamma-ray spectra were recorded by means of the hyper pure germanium detection system. The concentration percentage values of major, minor and trace elements are presented. The long and short lived isotopes were considered. A comparative study and a discussion on the elemental concentration values are given.

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The technique of instrumental neutron activation analysis was applied as a sensitive nondestructive analytical tool for the determination of heavy metals and rare earth elements in phosphate fertilizer ingredients. The contents of heavy metals Fe, Zn, Co, Cr and Sc as well as rare earth elements La, Ce, Hf, Eu, Yb and Sm were determined in four samples representing the phosphate fertilizer components (e.g. rock phosphate, limestone and sulfur). These samples were collected from the Abu-Zabal phosphate factory in El-Qalubia governarate, Egypt. The aim of this study was to determine the elemental pattern in phosphate ingredients as well as in the produced phosphate fertilizer. Fair agreement was found between the results obtained for the standard reference material Soil-7 and the certified values reported by the International Atomic Energy Agency. The results for the input raw materials (rock phosphate, limestone and sulfur) and the output product as final fertilizer are presented and discussed.

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Elemental analysis of two iron ores and initial industrial iron production prepared by the Egyptian Iron and Steel Company of Helwan near Cairo were performed by the instrumental neutron activation analysis technique. Five samples of each type were irradiated for 48 h in a thermal neutron flux of 4 x 10(12) n/cm2 s in the first Egyptian research reactor ET-RR-1. Also, the Pneumatic Irradiation Rabbit System (PIRS), attached to the reactor ET-RR-1 in Inshass, was used to measure short-life elements. The gamma-ray spectra were obtained with a hyper pure germanium detection system. The concentration percentage values of major, minor and trace elements are presented. Implications of the elemental concentration values obtained are presented.

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Geological materials usually contaminated with naturally occurring radioactive materials (NORM) have become a focus of great attention. These NORM under certain conditions can reach hazardous contamination levels. Some contamination levels may be sufficiently severe that precautions must be taken. The present study deals with 60 geological samples (marble and granite) from both Egyptian and foreign locations. The studied samples were analyzed and the concentrations in Bq/kg dry weight of radioisotopes were determined by gamma-ray spectrometry using hyper-pure germanium (HPGe) detector in Bq/kg dry weight. The absorbed dose rate due to the natural radioactivity in the samples under investigation ranged from 2.45 +/- 0.07 to 64.44 +/- 1.93 nGy/h for marble and from 41.55 +/- 1.25 to 111.94 +/- 3.36 nGy/h for granite. The radium equivalent activity varied from 5.46 +/- 0.16 to 150.52 +/- 4.52 Bq/kg for marble samples and from 229.52 +/- 6.89 to 92.16 +/- 2.76 Bq/kg for granite. The representative external hazard index values for the corresponding samples are also estimated and given. The radon exhalation rates for marble and granite samples were also calculated by using solid state nuclear track detector (CR-39). The value of radium exhalation rate varied from 8.0 +/- 2.39 to 30.20 +/- 5.06 Bq/m2/d for marble and 6.89 +/- 1.72 to 25.79 +/- 4.38 Bq/m2/d for granite and the effective radium content was found to vary from 1.700 +/- 0.51 to 6.42 +/- 1.08 Bq/kg for marble and 1.29 +/- 0.32 to 5.63 +/- 0.96 Bq/kg for granite. The values of the radon exhalation rate and effective radium content are found to correspond with the values of uranium concentration measured by the HPGe detector in the corresponding sample.

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The level of natural radioactivity in soil of 30 mining samples collected from six locations in southern Egypt was measured. Concentrations of radionuclides in samples were determined by gamma-ray spectrometer using HPGe detector with a specially designed shield. The obtained results of uranium and thorium series as well as potassium (K-40) are discussed. The present data were compared with data obtained from different areas in Egypt. Also, a solid state nuclear track detector SSNTD (Cr-39) was used to measure the radon concentration as well as exhalation rate for these samples. The radon concentrations were found to vary from 1.54 to 5.37 Bq/kg. The exhalation rates were found to vary from 338.81 to 1426.47 Bq/m2d. The values of the radon exhalation rate are found to correspond with the uranium concentration values measured by the germanium detector in the corresponding soil samples.

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Three different types of glass and four different kinds of aluminum sheet have been analyzed using neutron activation analysis. The irradiation facilities of the first Egyptian research reactor (ET-RR-1) and a hyper-pure germanium (HPGe) detection system were used for the analysis. Among the 34 identified elements, the isotopes 60Co, 65Zn, 110mAg, 123mTe, 134Cs, 152Eu and 182Ta are of special significance because of their long half-lives, providing a background interference for analyzed samples. A comparison between the different types of containers was made to select the preferred one for sample irradiation.

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Heavy metals and rare earth elements in two types of cigarettes were studied. The contents of trace elements were determined by using delayed neutron activation analysis. In the present study 11 elements have been detected in popular and fine brand cigarettes marketed in Egypt. Evaluation of these elements with their potential hazards for smokers is briefly discussed. The material balance (source and sink) for each element was determined. Also the ratio of element recovery to the total amount was assessed.

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