Sarah Khalil

Plain English
This case report describes a 27-year-old man with an aggressive rectal cancer who developed a rare metastasis in the soft tissue behind his knee (the popliteal fossa) within one year, despite ongoing chemoradiotherapy. MRI, PET/CT, and ultrasound-guided biopsy confirmed the metastasis, which arose from a signet-ring cell subtype of rectal cancer known for unusual spread patterns. The case highlights the value of multimodality imaging for evaluating unexpected soft tissue masses in cancer patients and the need to consider atypical metastatic sites in this tumor type.

Plain English
This observational study examined factors that predict postictal delirium — a confused state following seizures — in 69 patients with schizophrenia receiving electroconvulsive therapy. Use of clozapine, anticholinergic medications, the presence of catatonia, tobacco smoking, longer seizure duration, and scheduling ECT sessions one day apart were all associated with developing postictal delirium. Identifying these predictors enables clinicians to modify treatment protocols to reduce this distressing side effect.

Plain English
This randomized controlled trial tested whether dalfampridine — a drug that improves nerve signal conduction — could improve walking, cognition, and fatigue in 89 patients with relapsing-remitting multiple sclerosis who had mild-to-moderate symptoms and reported both fatigue and cognitive difficulties. At three months, the dalfampridine group showed significantly lower disability and better cognitive performance than placebo, with meaningful reductions in fatigue. The results support a broader beneficial effect of dalfampridine beyond walking speed alone in MS patients with residual symptoms.

Plain English
This case report describes a 7-year-old boy who developed palatal myoclonus — involuntary rhythmic movements of the palate — two years after a motor vehicle accident, along with characteristic MRI changes consistent with hypertrophic olivary degeneration, a rare brain injury pattern. Carbamazepine provided marked improvement. Post-traumatic hypertrophic olivary degeneration has been reported only once before in an adult, making this the first known pediatric case resulting from trauma.

Plain English
This study compared blood sugar trajectories in the first month after simultaneous pancreas-kidney transplantation in 80 patients with type 1 versus type 2 diabetes, tracking glucose at six standardized time points. Glycemic control, insulin requirements, complications, and one-month insulin independence were statistically equivalent between the two groups. The results support applying uniform perioperative glucose management protocols to both types of diabetes recipients after this transplant operation.

Plain English
This one-health study from Egypt's Fayoum region tracked antibiotic-resistant bacteria (ESBL-producing E. coli and Klebsiella) across poultry, dairy cows, farm workers, hospitalized patients, and environmental samples in three seasons. Prevalence and specific resistance gene patterns varied significantly by season and source, with the farm environment appearing to play a role in sustaining and spreading resistance. The findings underscore the importance of coordinated surveillance across human, animal, and environmental sectors to address antibiotic resistance.

Plain English
An international survey of 39 cochlear implant specialists from 16 countries examined how imaging is used before cochlear implant surgery across the world. All respondents used both CT and MRI, with MRI favored for diagnosis and surgical candidacy assessment while CT was preferred for surgical planning; 80% also used image-based surgical planning software. The survey establishes a global consensus picture and identifies opportunities for protocol standardization to improve patient safety and outcomes.

Plain English
This laboratory study in Staphylococcus aureus found that truncating mutations in a key regulatory protein (Rel) confer broad tolerance to antimicrobial fatty acids produced by human skin, through a pathway distinct from the bacteria's normal stress response. The tolerance worked through the alternative sigma factor SigB and a transcriptional regulator called SarA, which together remodel the bacterial cell wall to resist lipid-based killing. These findings identify a previously unknown mechanism that may help S. aureus colonize and infect skin, representing a potential new treatment target.

Plain English
This case report describes a 51-year-old woman with flea-borne typhus who deteriorated rapidly to severe acute respiratory distress syndrome requiring intubation, and whose lung lavage revealed pulmonary alveolar proteinosis — an accumulation of surfactant-like material — not previously described in rickettsial infections. The case illustrates how this relatively uncommon infection can cause life-threatening organ failure and documents a novel pulmonary complication. Early recognition and treatment of flea-borne typhus are essential given its capacity for rapid progression.

Plain English
This umbrella review synthesized evidence from 17 systematic reviews covering 76 randomized trials on physical devices and energy-based therapies designed to speed up orthodontic tooth movement. Low-level laser therapy showed the most clinically meaningful acceleration of tooth alignment, while vibration devices showed minimal or no benefit, and most evidence was rated as low to very low certainty due to methodological limitations. Photobiomodulation (laser and LED therapy) is the most promising physical adjunct for accelerating orthodontic treatment, but standardized protocols are needed before routine adoption.

Plain English
This systematic review and meta-analysis pooled data from 18 studies involving nearly 4,000 children and adolescents with type 2 diabetes to estimate how common fatty liver disease (MASLD) is in this group. The pooled prevalence was 37%, rising to 55% in studies using MRI-based measurement, with substantial variation depending on the diagnostic method used. The high prevalence highlights the need for routine liver health screening in young people with type 2 diabetes.

Plain English
Researchers synthesized a copolymer (P(AAm/CS)) using gamma irradiation of acrylamide and carbon disulfide and tested it against human pancreatic cancer cells in the laboratory. The copolymer showed strong cancer cell-killing activity with an IC50 of about 99 μg/mL, inducing apoptosis in about 68% of treated cells and upregulating key pro-apoptotic genes while suppressing a survival gene. These laboratory results position the copolymer as a candidate for further development as a polymer-based pancreatic cancer therapy.

Plain English
Researchers developed a nasal spray formulation of carvedilol — a heart and blood pressure medication — loaded into tiny fat-based particles called transbilosomes to improve the drug's bioavailability, which is normally poor due to a short half-life. In a rat model of diabetic atherosclerosis, the optimized nasal spray improved carvedilol bioavailability 7.4-fold and reduced blood glucose, cholesterol, and triglycerides significantly more than the oral drug form. The formulation shows promise as an improved delivery system for managing cardiovascular and metabolic complications of diabetes.

Plain English
This particle physics study reports the first observation of coherent phi(1020) meson photoproduction from heavy nuclei, using data from ultraperipheral lead-lead collisions at the Large Hadron Collider's CMS detector. The measured production cross section was about five times lower than a model treating the nucleus as a collection of free nucleons, consistent with nuclear shadowing effects that suppress gluon density in nuclei at low momentum fractions. The result provides a new tool for probing the internal gluonic structure of heavy nuclei at an energy scale bridging two regimes of quantum chromodynamics.

Plain English
This case report describes an 80-year-old woman with complex cerebrovascular anatomy who presented unconscious after rupture of an anterior communicating artery aneurysm, with catastrophic hemorrhage involving multiple brain regions and a second aneurysm, leaving her with a Glasgow Coma Scale score of 3. Given the severity of hemorrhage, pre-existing vascular anomalies, and near-zero prognosis for meaningful recovery, the clinical team transitioned to palliative care rather than pursuing surgical or endovascular intervention. The case illustrates how imaging findings can guide rapid decisions about the appropriateness of comfort-focused care in catastrophic intracranial hemorrhage.

Plain English
This review synthesizes how environmental exposures — UV radiation, pollution, smoking, diet, and stress — accelerate skin aging through epigenetic changes in DNA methylation and histone modification, and how epigenetic clocks can now quantify biological age in skin. It also covers an expanding toolkit of topical agents, energy-based therapies, and systemic treatments targeting these epigenetic mechanisms to reverse or slow visible aging. The review frames skin aging as a biologically modifiable process, opening pathways for personalized prevention and treatment strategies.

Plain English
This study investigated MECP2 Duplication Syndrome — a severe neurodevelopmental disorder — using human cells, brain organoids, and mouse models, and found that doubling the MECP2 gene dose disrupts a previously unrecognized link between mitochondrial function and purine biosynthesis. Mitochondrial Complex III failure triggers a cascade of redox stress, DNA damage, and abnormal purinosome activity that impairs brain cell development and maturation. Targeting the mitochondria-purinosome axis could represent a new treatment approach for this and related metabolic neurodevelopmental disorders.

Plain English
This narrative review summarizes how arteriovenous fistulas and grafts used for dialysis access alter the heart and lungs by increasing blood flow returning to the heart, which is initially tolerable but can lead to heart muscle thickening, high-output heart failure, and pulmonary hypertension when access blood flow exceeds about 1.5-2.0 liters per minute. Diagnosis involves ultrasound, echocardiography, and right-heart catheterization, while management includes volume control, drugs, and surgical flow reduction when necessary. Routine flow surveillance and echocardiographic monitoring are essential to prevent irreversible cardiovascular damage in dialysis patients.

Plain English
This systematic review and meta-analysis of 22 randomized trials evaluated whether physical therapies — vibration, laser, LED light, ultrasound, and electrical stimulation — used to speed orthodontic treatment also affect tooth root resorption, a known side effect of braces. Low-intensity pulsed ultrasound and LED therapy showed the most evidence of reducing root length and volume loss; vibration and electrical stimulation showed no significant effect; and none of the interventions increased root resorption compared to controls. Evidence certainty was low to very low, making widespread adoption premature.

Plain English
This case-control study measured serum levels of two immune molecules — IL-17 and TNF-alpha — in Sudanese patients with leprosy compared to healthy controls. Leprosy patients had significantly lower IL-17 and much higher TNF-alpha than controls, with IL-17 declining and TNF-alpha rising as disease duration increased. These opposing cytokine patterns reflect distinct immune pathways active in leprosy and may help assess disease activity and treatment response.

Plain English
This scoping review examined the literature on staged prehysterectomy uterine artery embolization — performing UAE before a planned hysterectomy for very large fibroids to reduce surgical blood loss — and found only 9 published articles covering 34 patients in total, mostly case reports. The available data showed large variability in outcomes and insufficient evidence to recommend this as standard practice. The review identifies an urgent need for rigorous prospective research before staged embolization-hysterectomy is widely adopted.

Plain English
This systematic review and meta-analysis quantified how much liver fat and stiffness improve in placebo-treated patients in clinical trials for a severe liver disease (MASH), finding that nearly 1 in 5 placebo recipients showed a clinically meaningful fat reduction on MRI. The placebo response rates were consistent across trials and diagnostic thresholds, suggesting MRI-based measurements are reproducible enough to serve as reliable trial endpoints. These baseline placebo response data are essential for correctly interpreting drug efficacy in future MASH trials.

Plain English
This study tested pyrolysis coupled with gas chromatography-mass spectrometry as a method for detecting THC in cannabis edible products, comparing it to standard GC/MS using seven confiscated edible samples. Py-GC/MS achieved excellent linearity (R=0.99), reduced matrix interference, shortened sample preparation time, and required fewer chemical reagents. The technique offers a faster and more reliable analytical option for forensic analysis of cannabis edibles.

Plain English
This narrative review examined the current evidence on how e-cigarette use affects gum disease and periodontal health, finding mixed results — some studies show worse periodontal health in e-cigarette users compared to non-smokers, while others find minimal effects. The evidence base is limited by small study sizes and short follow-up periods, and the question of whether vaping is safer than smoking for the gums remains unresolved. Dental professionals should discourage e-cigarette use while acknowledging it may be less harmful than conventional smoking for those trying to quit tobacco.

Plain English
This case report describes a 37-year-old woman who presented with peritonitis caused by a spontaneously perforated Meckel's diverticulum — an uncommon congenital intestinal remnant — mimicking appendicitis. Surgery revealed a perforated diverticulum containing hard tissue, and resection with anastomosis cured the condition. The case reinforces that Meckel's diverticulum should remain in the differential diagnosis for acute abdominal pain and peritonitis in adults, even though it is rare, because preoperative diagnosis is nearly impossible.

Plain English
This mouse study compared anti-IL-2/IL-2 complex therapy — a treatment that expands regulatory T cells — to low-dose free IL-2 and topical steroids in an imiquimod-induced psoriasis model. Mice treated with the anti-IL-2/IL-2 complex showed greater expansion of regulatory T cells, reduced skin thickness, and improved histological findings compared to the other groups. The results suggest that boosting regulatory T cells through IL-2 complexes may offer an effective and relatively side-effect-free approach to treating psoriasis.

Plain English
This study used real-time PCR to detect and genotype Giardia parasites in 332 stool samples from patients with diarrhea, finding an overall prevalence of 15% with mixed assemblage A and B infections being most common (46%). Assemblage distribution was significantly associated with patient age, place of residence, and contact with animals, but not with gender, water source, or clinical symptoms. The high prevalence of mixed assemblages and observed genetic variability highlight the importance of molecular tools for understanding Giardia transmission patterns.

Plain English
This retrospective study from Egypt's Children's Cancer Hospital analyzed outcomes for 115 children with simultaneous bilateral Wilms' tumor — the largest single-center series reported — treated from 2007 to 2020. Five-year event-free and overall survival were 69% and 77% respectively, with high-risk tumor pathology being the strongest predictor of worse outcomes. Nearly 7% of survivors developed end-stage renal disease, and the study emphasizes the need for kidney-sparing surgery and tailored treatment approaches in this challenging patient group.

Plain English
Researchers synthesized a ternary nanocomposite material (ReMIL-CN) and demonstrated it could simultaneously serve as an energy storage electrode and a hydrogen peroxide sensor. The material stored energy with high efficiency and stability over 10,000 cycles, and detected hydrogen peroxide down to 0.1 micromolar concentrations with rapid response. These dual-function properties make it a candidate for integration into self-powered wearable biosensors and portable bioelectrochemical monitoring devices.

Plain English
This systematic review and meta-analysis of five randomized trials covering 2,208 patients evaluated the efficacy and safety of upadacitinib — a targeted JAK1 inhibitor — for moderate-to-severe atopic dermatitis. Upadacitinib significantly outperformed placebo and dupilumab across multiple measures of skin clearance and itch reduction, with the 30 mg dose showing stronger effects than 15 mg. The drug is an effective treatment option with an acceptable safety profile, though longer-term safety data and head-to-head comparisons with other biologics are still needed.

Plain English
This particle physics search for the rare decay of a D0 meson into two muons used 64.5 inverse femtobarns of proton-proton collision data from the CMS detector at the Large Hadron Collider. No significant signal was found, and the upper limit on the decay rate was set at 2.4 × 10^-9 — the tightest constraint ever placed on any flavor-changing neutral current decay in the charm quark sector. This result sets an important benchmark for testing extensions to the Standard Model of particle physics.

Plain English
This cross-sectional study surveyed 229 asthma patients in Sudan during the ongoing war that began in April 2023, finding that 60% had poorly controlled asthma, nearly half had not attended any follow-up visits, and many were self-adjusting medications or using whatever was available. Dose reduction and disrupted care access were linked to worse asthma control, while refugee status paradoxically predicted slightly better control, possibly due to access to aid-provided medications. The study documents significant asthma management gaps during armed conflict and highlights the need for telemedicine and improved patient education in crisis settings.

Plain English
This case report describes a 39-year-old woman with recurrent anaphylaxis initially labeled idiopathic who was eventually diagnosed with allergy to carmine — a natural red food colorant derived from cochineal insects — through careful dietary history review and custom skin prick testing. The patient became symptom-free after eliminating carmine from her diet, cosmetics, and medications. The case illustrates that food additives are an underappreciated cause of recurrent anaphylaxis that requires targeted, patient-guided investigation to identify.

Plain English
This small case-control study measured serum levels of microRNA-30e-5p in 25 Egyptian type 2 diabetes patients with kidney disease versus 25 without, finding significantly reduced levels in those with kidney disease. The reduction in this microRNA correlated with the presence of diabetic kidney disease, suggesting it may serve as an early blood-based biomarker for this complication. Validation in larger and more diverse populations is needed before clinical application.

Plain English
This study developed and validated a new computer-based assessment tool for critical thinking in middle school students, based on the PACIER framework that measures six facets: problem solving, analysis, creative thinking, interpretation, evaluation, and reasoning. Testing 700 eleven-year-old students in the UAE five times over one school year, the assessment demonstrated acceptable reliability and validity. The tool offers a practical instrument for measuring progress in educational programs designed to develop critical thinking skills.

Plain English
This quasi-experimental study implemented an antibiotic stewardship program in a neonatal intensive care unit in Egypt, modifying the sepsis treatment protocol based on local antibiotic resistance data and tracking outcomes across two phases covering 1,200 patients. The intervention phase increased microbiological cultures and definitive therapy use while reducing empirical treatment, and most importantly reduced 14-day and 28-day mortality in late-onset sepsis by about 18-21 percentage points. Tailoring empirical antibiotic choices to local resistance patterns can substantially reduce neonatal sepsis mortality.

Plain English
This cross-sectional study of 240 nurses at two Jordanian hospitals found a weak but statistically significant positive relationship between self-efficacy — belief in one's ability to perform tasks — and job performance. Monthly income, education level, age, years of experience, and available support were significant predictors of self-efficacy. The findings suggest that investing in nurse professional development and creating supportive work environments may improve both nurse confidence and patient care quality.

Plain English
This study developed two nasal spray formulations of carvedilol — one using standard transbilosomes and one using pH-sensitive transbilosomes with a gel-forming polymer — and compared their ability to treat diabetes-accelerated atherosclerosis in rats. Both nasal formulations outperformed oral carvedilol in bioavailability, arterial blood flow, and blood lipid and glucose control, with the pH-sensitive formulation offering additional targeting and sustained-release benefits. The nasal delivery approach could substantially improve carvedilol's therapeutic effectiveness in cardiovascular and metabolic disease management.

Plain English
An international expert panel used a modified Delphi consensus process to develop a new classification system for chronic pelvic pain, ultimately producing the "R U MOVVING SOMe" framework covering 12 pain categories: Reproductive, Urinary, Musculoskeletal, Other, Vulvovaginal, Vascular, Idiopathic, Neurologic, Gastrointestinal, Sensitization, Overlapping pain conditions, and Mental health. The system reached high consensus among 65-77 international stakeholders from diverse professional backgrounds. A standardized classification tool for chronic pelvic pain should improve communication, diagnosis, clinical practice, and future research in this complex field.

Plain English
This case series enrolled 90 patients aged 25-60 with partial or full-thickness rotator cuff tears and gave each a single ultrasound-guided platelet-rich plasma (PRP) injection, following them with ultrasound for 12 weeks. Complete tendon healing was documented by imaging in 69% of patients, with no significant association between healing and patient age, sex, or injury characteristics. The high imaging-defined healing rate is promising, but the absence of a control group means the contribution of PRP versus natural healing cannot be determined without a randomized trial.

Plain English
This cross-sectional study assessed the accuracy of combining three physical examination tests — Apley's compression test, McMurray's test, and joint line tenderness — for diagnosing medial meniscal knee injuries, using arthroscopy as the gold standard in 185 patients. The combined clinical examination achieved 91% sensitivity, 88% specificity, and 90% overall diagnostic accuracy. These results support relying on the combined clinical exam to diagnose medial meniscal injuries, reserving arthroscopy primarily for definitive surgical treatment.

Plain English
This study in heat-stressed broiler chickens tested whether dietary supplementation with a blend of three microalgae species at different doses could mitigate heat stress effects on growth, meat quality, and stress-related gene expression. The highest dose (10 g/kg diet) reduced stress hormones and inflammatory markers, improved antioxidant enzyme activity, increased omega-3 fatty acid content in breast muscle, and downregulated heat shock and sirtuin stress response genes. Microalgae blend supplementation at 10 g/kg shows strong potential as a nutritional strategy to improve productivity and meat quality in poultry under heat stress conditions.

Plain English
This study examined the growth process of imine covalent organic framework nanoparticles in solution using real-time dynamic light scattering and liquid cell electron microscopy, a technically challenging observation because these particles normally precipitate before they can be studied. Three distinct growth stages were identified — nucleation, growth, and ripening — along with quantitative measurements of nucleation and growth rates. These mechanistic insights enable more controlled synthesis of these porous materials and their processing into thin films for potential applications in separation, sensing, and energy storage.

Plain English
This cross-sectional study of 981 Jordanian patients with chronic conditions used both traditional regression and machine learning to identify factors that predict medication adherence. Higher health literacy, having diabetes or cardiovascular disease, and fewer prescribed medications were associated with better adherence, while married status and certain insurance types were linked to lower adherence; machine learning identified health literacy as the most influential predictor. The findings highlight health literacy as a priority target for adherence interventions, and the explainable machine learning approach demonstrates value for predicting complex behavioral outcomes in resource-limited settings.