A new approach for enhancing LSB steganography using bidirectional coding scheme

This paper proposes a new algorithm for embedding private information within a cover image. Unlike all other already existing algorithms, this one tends to employ the data of the carrier image more efficiently such that the image looks less distorted. As a consequence, the private data is maintained unperceived and the sent information stays unsuspicious.  This task is achieved by dividing the least significant bit plane of the cover image into fixed size blocks, and then embedding the required top-secret message within each block using one of two opposite ways depending on the extent of similarity of each block with the private information needed to be hidden. This technique will contribute to lessen the number of bits needed to be changed in the cover image to accommodate the private data, and hence will substantially reduce the   amount of distortion in the stego-image when compared to the classic LSB image steganography algorithms

Antifungal Activity of Shirazi Thyme (Zataria multiflora Boiss.) Essential Oil against Hypomyces perniciosus, a causal agent of wet bubble disease of Agaricus bisporus

Wet bubble disease (WBD) caused by Hypomyces perniciosus is a major constraint of button mushroom (Agaricus bisporus) cultivated worldwide. A few synthetic chemical fungicides are used to control WBD. In our study, the potential of essential oil (EO) from Zataria multiflora in inhibition of H. perniciosus was evaluated as an alternative to chemical fungicides. An isolate of H. perniciosus was isolated from wet bubble diseased A. bisporus and pathogenicity of the mycoparasite was determined under artificially inoculated conditions. The mycoparasitic fungus was identified using sequences of the internal transcribed spacer (ITS) region of ribosomal DNA. The EO was extracted from the aerial parts of Z. multiflora by microwave extraction method and evaluated in vitro for its antifungal activity against H. perniciosus. The EO of Z. multiflora (ZEO) at the tested concentrations (50% and 100%) inhibited the growth of H. perniciosus in the agar diffusion test. The minimum inhibitory concentration (MIC) of ZEO was 0.04% as assessed by the poisoned food technique. The chemical composition of ZEO was determined by gas chromatography-mass spectrometry analysis. A total of 23 compounds were identified. Among them, the most abundant compounds were Linalool (20.3%) and Bornyl acetate (15.5%). Linalool at the tested concentrations of 0.25% and 0.125% completely inhibited the mycelial growth of H. perniciosus in an in vitro assay. These results suggest that ZEO can be exploited for control of WBD

Assessment of aflatoxin B1 content and aflatoxigenic molds in imported food commodities in Muscat, Oman

Aflatoxins, mainly produced by Aspergillus flavus and A. parasiticus are considered as serious food safety and human health issues due to their hepatotoxic effects. In the present study, the occurrence of aflatoxin B1 (AFB1), the most potent human liver carcinogen, and prevalence of toxigenic isolates of Aspergillus spp. were assessed in 140 food commodities in Muscat markets, Oman, and the 95 quarantined imported food commodities. These samples consisted of rice, corn, peanut, red chilli powder, soybean, dried dates and tree nuts. AFB1 was analyzed using competitive ELISA/LC-MS and the aflatoxigenic fungi were detected using plating technique followed by molecular identification. No AFB1 was detected in 89 (63.6%) samples collected from local markets, while 44 (31.4%) samples contained 1-5 ppb and the remaining 7 (5%) samples (red chili powder) contained 6-10 ppb. None of the samples exceeded the maximum permissible limit of 10 ppb set for foods by Oman legislation. Of the 95 quarantined samples, only 17 (17.9%) samples were positive and contained AFB1 at concentrations ranging from 1-3.4 ppb. Four isolates of Aspergillus pp. were isolated from the collected samples and were identified as Aspergillus flavus (A14, A16 and A23) and A. chevalieri (A46) on the basis of internal transcribed spacer (ITS) sequences of ribosomal DNA. Among them, A. flavus strain A14 alone produced AFB1 (7.6 ppb), while A16, A23, and A46 were non-toxigenic. This is the first detailed report on the occurrence of AFB1 in food commodities imported into Oman

Medication errors occurrence and reporting: A qualitative study of the Jordanian nurses' experiences

Background & Aim: Medication errors are a significant concern in healthcare, with effective management largely dependent on understanding its causes and reporting practices. This study aims to explore the experiences of Jordanian nurses in relation to medication error occurrence and reporting within the Jordanian context and the factors that may influence their decisions to report or not. Methods & Materials: A qualitative descriptive approach was used. 24 nurses from three different hospitals were interviewed. The hospitals included a major governmental institution, a private facility, and a university hospital, ensuring diverse healthcare settings. Data were analyzed using Braun and Clarke’s thematic analysis, and the study was reported guided by the COREQ checklist. Results: Three major themes were identified: Obsolete policies and guidelines, Adapting to an Unhealthy Environment, and Trying to adjust: creating own definition for medication errors. In our study, medication errors emerged as a pervasive issue across Jordanian hospitals, attributed to both systemic failures and individual practices. Despite existing policies, participants reported frequent medication errors due to obsolete guidelines, lack of adherence, and an environment that hinders effective medication administration. Conclusion: The study reveals the critical issues of medication errors in Jordanian hospitals due to outdated policies and challenging environments. It emphasizes the need for updated protocols and a culture supportive of error reporting. Addressing these factors is essential for improving patient safety and healthcare quality

The Holy month of Ramadan: A blessed union (Etihad) of societal collective effervescence, belonging and positive mental health for all [version 1; peer review: 2 approved]

Ramadan is a month-long religious festival and observed globally by Muslims, characterised by intermittent fasting, prayer, reflection and a focus on community. Fasting is one of the five pillars of Islam and has well documented positive impacts on physical health. An article by Bandarian et al., (2021) highlighted the research gaps in Ramadan fasting studies relating to health and disease. The article called for more research studies on different health and disease conditions other than nutrition and metabolic disorders. The authors on this correspondence article continue this call and respectfully articulate the wider societal impact and benefits of Ramadan through its positive impact, through embracing multicultural, multinational and multifaith communities within the United Arab Emirates

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Mapping artificial intelligence adoption in hepatology practice and research: challenges and opportunities in MENA region

BackgroundArtificial intelligence (AI) is increasingly relevant to hepatology, yet real-world adoption in the Middle East and North Africa (MENA) is uncertain. We assessed awareness, use, perceived value, barriers, and policy priorities among hepatology clinicians in the region.MethodsA cross-sectional online survey targeted hepatologists and gastroenterologists across 17 MENA countries. The survey assessed clinical and research applications of AI, perceived benefits, clinical and research use, barriers, ethical considerations, and institutional readiness. Descriptive statistics and thematic analysis were performed.ResultsOf 285 invited professionals, 236 completed the survey (response rate: 82.8%). While 73.2% recognized the transformative potential of AI, only 14.4% used AI tools daily, primarily for imaging analysis and disease prediction. AI tools were used in research by 39.8% of respondents, mainly for data analysis, manuscript writing assistance, and predictive modeling. Major barriers included inadequate training (60.6%), limited AI tool access (53%), and insufficient infrastructure (53%). Ethical concerns focused on data privacy, diagnostic accuracy, and over-reliance on automation. Despite these challenges, 70.3% expressed strong interest in AI training., and 43.6% anticipating routine clinical integration within 1–3 years.ConclusionMENA hepatologists are optimistic about AI but report limited routine use and substantial readiness gaps. Priorities include scalable training, interoperable infrastructure and standards, clear governance with human-in-the-loop safeguards, and region-specific validation to enable safe, equitable implementation

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance.

Investment in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing in Africa over the past year has led to a major increase in the number of sequences that have been generated and used to track the pandemic on the continent, a number that now exceeds 100,000 genomes. Our results show an increase in the number of African countries that are able to sequence domestically and highlight that local sequencing enables faster turnaround times and more-regular routine surveillance. Despite limitations of low testing proportions, findings from this genomic surveillance study underscore the heterogeneous nature of the pandemic and illuminate the distinct dispersal dynamics of variants of concern-particularly Alpha, Beta, Delta, and Omicron-on the continent. Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve while the continent faces many emerging and reemerging infectious disease threats. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century