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Quality-Of-Life Outcomes Of Tympanoplasty/Mastoidectomy Operations, Peter Shokr Meglaa, Ahmed Hemdan Eldeeb, Hisham Atef Abada, Yousef Kamel Shabana

Mansoura Medical Journal

Background: Chronic suppurative otitis media (CSOM) impairs quality of life (QoL) via otorrhea, hearing loss, and psychosocial effects, with surgery (tympanoplasty/mastoidectomy) as mainstay treatment despite limited patient-centered outcome data. This study aimed to evaluate QoL changes post-tympanoplasty/mastoidectomy in CSOM using validated tools.

Methods: This prospective study included 50 adults with CSOM at Mansoura University Hospitals. Pre/postoperative assessments included Chronic Otitis Media Outcome Test-15 (COMOT-15), Short Form-36 Health Survey (SF-36), Hearing Handicap Inventory for the Elderly-Screening (HHIE-S), Tinnitus Evaluation Questionnaire (TEQ), Situational Vertigo Questionnaire (SVQ), pure tone audiometry (PTA), and air-bone gap (ABG).

Results: PTA improved from 48.5±10.2 to 28.3±8.4 dB …

Fascia Transversalis Block With Different Volumes Of Local Anesthetic And Its Impact On Postoperative Pain In Major Abdominal Surgery: Prospective Randomized Study, Eman Eltabey Lotfi Taman, Mostafa Mohamed Ali Saied, Khaled Mohy Eldeen El Bahrawy, Abdelrahman Mamdouh El Naggar

Mansoura Medical Journal

Background Effective postoperative analgesia remains crucial in abdominal surgery to reduce physiological stress, improve respiratory function, and enhance recovery. The transversalis fascia plane block (TFPB) has recently emerged as an advantageous technique targeting the T12–L1 nerves responsible for somatic and visceral abdominal innervation. Objective To investigate the analgesic efficacy of different volumes of local anesthetic administered in TFPB and compare their effect on postoperative pain, visceral discomfort, and opioid requirements. Methods Eighty-one adult patients undergoing major abdominal surgery under general anesthesia were randomized into 3 groups: control (systemic analgesia only), lowvolume TFPB (20 mL total), and high-volume TFPB (25 mL …

Diagnostic Performance Of Digital Breast Tomosynthesis In The Characterisation Of Breast Lesions: Correlation With Sono-Mammography And Histopathology., Amira Hamed Megahed, Mona Mahmoud Zaky, Maha Mohamed Bilal

Mansoura Medical Journal

Background: Breast lesions range from benign to malignant, with early detection critical for management. Digital mammography is the standard screening tool but may be limited in dense breasts. Ultrasound (US) aids lesion characterisation, while digital breast tomosynthesis (DBT) reduces tissue overlap, enhancing lesion detection.

Objective: To evaluate the diagnostic performance of digital breast tomosynthesis in the characterisation of breast lesions compared with sono-mammography, using histopathology as the reference standard.

Methods: This prospective study included 33 symptomatic female patients with a mean age (45.4 ± 8.2 years) who presented with symptoms such as palpable breast lumps, Mastalgia and nipple discharge between …

Comparative Study Between Serum Levels Of Interleukin-19 And Interleukin-38 In The Egyptian Patients With Non-Segmental Vitiligo, Reem Ahmed Al Maaddawy, Mohamed Kh. Selim, Ahmed Fawzi Ismail, Ahmad S. Hasan, Manar Ali Hassan

Mansoura Medical Journal

Background: The precise etiology of vitiligo remains unclear; nonetheless, it is predominantly regarded as an autoimmune disorder. This work aimed to compare serum levels of IL-19 and IL-38 between patients with non-segmental vitiligo (NSV) and healthy controls (HC). Patients and Methods: This study included 88 participants, evenly split into two groups: 44 individuals with non-segmental vitiligo and 44 healthy controls. Both groups underwent full history taking. The Vitiligo Area Severity Index (VASI) score and Vitiligo Disease Activity (VIDA) score were used to assess disease severity and activity. The levels of human IL-19 and IL-38 were also measured.

Results:Serum IL-38 …

A Comparative Study Of Topical 5% 5-Fluorouracil With Needling Versus 100% Trichloroacetic Acid With Needling Versus Needling Alone In Treatment Of Multiple Warts, Nesma Abd-Elmonem Saad, Hassan A. Fayed, Manar Ali

Mansoura Medical Journal

Aim: This study aimed to compare the efficacy and safety of topical 5% 5-Fluorouracil (5-FU) with Needling versus 100% Trichloroacetic acid (TCA) with Needling versus Needling Alone in treatment of multiple warts.

Methods: This study included a total of 60 patients clinically diagnosed with multiple warts, who were randomly allocated (computer-generated simple randomisation, 1:1:1, concealed in sequentially numbered opaque sealed envelopes) into three equal groups (n=20 per group). The first group received 100% TCA with Needling; the second group received topical 5% 5-FU combined with Needling; the third group underwent Needling alone. The study was single-blinded at the level …

Active Deresuscitation Strategies After Septic Shock: A Scoping Review, Alrefaey K. Alrefaey, Rania E Elbadrawy, Mohamed Aboelela, Mohammed Mamoun

Mansoura Medical Journal

Background: Fluid overload in septic shock patients is linked to higher morbidity and mortality. After the stabilization phase, fluid restriction may not result in the resolution of tissue edema. Active deresuscitation refers to the use of diuretics or ultrafiltration for the removal of excess fluids. Objectives: This review explores the current practices applied for the active deresuscitation strategies after stabilization of septic shock patients.  Search strategy: A literature search was performed through the following databases: Medline, PubMed, Google Scholar, Web of Science, and Scopus for relevant studies from 2015 to January 2026. Selection criteria:  The selected articles included …

Laparoscopic Versus Open Redo Anti-Reflux Surgery, Mohamed Barkok, Mohammed Said, Ahmed Shehta, Abdel-Raouf El-Geidie

Mansoura Medical Journal

Background

Gastroesophageal reflux disease (GERD) is common. Laparoscopic fundoplication became the gold standard for GERD surgery after medical treatment failed. If a previous anti-reflux surgery fails, redo surgery requires a thorough review to determine the cause and a skilled surgical team. Choosing the optimal approach during the redo surgeries, whether open or laparoscopic hasn’t been previously illustrated.

Aim

To compare the outcomes of laparoscopic versus open redo anti-reflux surgeries.

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Patients and methods

This study included 28 patients who underwent redo anti-reflux surgery. The patients were divided according to the approach into laparoscopic (n = 11) and open (n = …

Short Term Echocardiographic And Clinical Assessment Of Aortic Valve Neo-Cuspidization (Ozaki Procedure) In Comparison With Mechanical Aortic Valve Replacement, Amr Mohamed Ahmed Elshabrawy, Mohamed A. Gabr, Eid M Daoud, Mohammed Sanad, Sherif Arafa

Mansoura Medical Journal

Background: Aortic valve neo-cuspidization (AVNeo, Ozaki procedure) has emerged as an alternative to conventional aortic valve replacement, aiming to preserve native aortic root dynamics and improve postoperative hemodynamics. The replacement of the aortic valve presents challenges because both biological and mechanical prostheses have notable limitations.

Aim: To evaluate the short-term clinical and echocardiographic outcomes of aortic valve neocuspidization (Ozaki procedure) compared with mechanical aortic valve replacement (AVR) in patients with isolated aortic valve disease.

Patients and methods: This prospective comparative observational study included 42 adult patients with isolated aortic valve disease. 20 patients underwent AVNeo (Ozaki procedure) and 22 …

Diffusion Mri Characterization Of Paranasal Sinus Masses, Fatma Elsayed Ali, Doaa Khedr Mohamed, Mohamed Magdy El-Rakhawy

Mansoura Medical Journal

Background: In ordinary clinical practice, a number of nasal cavity lesions, both neoplastic and non-neoplastic, are often seen. Because diffusion-weighted MRI imaging (DWI) captures the random migration of water protons, it provides superior characterization of tissues and their physiological processes. Therefore, the current study's goal was to use echoplanar DWI to classify malignant and non-malignant sinonasal lesions.

Methods: Fifty patients with paranasal sinus masses who were sent to Mansoura University Hospitals' Diagnostic Radiology Department for radiological examination, including a traditional MRI procedure, were included in this prospective research, Diffusion Weighted Images (DWI) and apparent diffusion coefficient (ADC). The final diagnosis …

Clinical Outcomes Of Anticoagulant Therapy In Cirrhotic Patients With Benign Portal Vein Thrombosis, Dalia Elsayed Tawfik, Muhammad Abdulaty Diasty, Aya Ahmed Elboghdady, Hatem Abdel Wahab Elalfy

Mansoura Medical Journal

Background

Portal vein thrombosis (PVT) is among the recognized vascular complications encountered in cirrhotic patients and may significantly influence disease progression and survival. The clinical course of PVT differs according to its etiology, particularly when hepatocellular carcinoma (HCC) is absent. This study was designed to assess the outcomes of benign portal vein thrombosis in cirrhotic patients.

Methods

This prospective observational study enrolled 18 cirrhotic patients diagnosed with non-malignant portal vein thrombosis. All participants underwent comprehensive clinical evaluation, laboratory investigations, and radiological assessment. Severity of liver disease was determined using the Child–Pugh classification and MELD score. Radiological imaging was utilized to …

Serum Zinc Levels In Children With Complicated Community Acquired Pneumonia: A Case-Control Study, Eslam Elhendawy, Angi Alwakeel, Shimaa R. Hendawy, Amal Osman

Mansoura Medical Journal

Background Zinc performs an important part in maintaining proper immune function, and its deficiency has been connected to an increased risk of severe respiratory infections. However, there is limited data on serum zinc concentrations in children suffering from complicated community-acquired pneumonia (cCAP), particularly within the Egyptian pediatric population. Objectives This study aimed to evaluate serum zinc levels in children diagnosed with severe cCAP in comparison to healthy controls and to assess the diagnostic effectiveness of serum zinc levels in distinguishing children with cCAP. Methods This study included 100 children with severe cCAP and 100 age- and sex-matched healthy controls enrolled …

Evaluation Of Sodium Butyrate As An Anti-Fibrotic Agent In Experimental Schistosomiasis Mansoni Infection, Rania Eladl Hassan, Manar Ezzelarab Ramadan, Nora Ibrahim Aboulfotouh, Ramy Ahmed Abdelsalam Sallam, Basma Hamed Othman, Soha Ibrahim Awad

Mansoura Medical Journal

Background: Schistosomiasis is a prominent neglected tropical disease that is caused by Schistosoma mansoni, and it is characterized by granuloma formation, which advances to hepatic fibrosis and serious liver damage. The standard medication is praziquantel (PZQ), but it has minimal effect on larvae and no effect on fibrosis which is a main pathological feature in schistosomiaiss. So, new alternatives were suggested, such as sodium butyrate (SB), which is a fatty acid salt with medicinal qualities.

Objective: This study investigated the anti-fibrotic effect of sodium butyrate (SB) in a mouse model of S. mansoni-induced liver immunopathology using …

Intelligence Quotient In Egyptian Children With Attention-Deficit/Hyperactivity Disorder, Yomna Sh. Abdrabouh, Zeinab A. Gomaa, Mohammed A. Elwasify, Ibrahem H. Elkalla

Mansoura Medical Journal

Background: Attention-Deficit/Hyperactivity Disorder (ADHD) affects cognitive functioning in children, yet evidence remains limited in Middle Eastern populations regarding comprehensive IQ evaluation and associated clinical characteristics. This study aimed to assess verbal, non-verbal, and total IQ in Egyptian children with ADHD and examine their associations with sociodemographic, developmental, educational, and clinical factors while identifying factors associated with IQ classification.

Methods: A cross-sectional observational study enrolled 150 Egyptian children aged 6-12 years diagnosed with ADHD according to DSM-5 criteria with IQ above 80 at Mansoura University Hospital from February 2022 to October 2023. Intellectual functioning was evaluated using the Stanford-Binet Intelligence Scale, …

Validation Of Anorectal Manometry Based On The Continence Clinical Scoring Systems For Evaluation Of Fecal Continence In Patients With Anorectal Malformations, Momen Abdelglil, Mohamed El-Sherbiny, Mahmoud Abdelwahab, Adham Elsaeid

Mansoura Medical Journal

Background/purpose: Anorectal malformations (ARM) are complex anomalies associated with long-term problems such as fecal incontinence. Clinical scoring systems are commonly used to assess bowel function but lack proper validation. Anorectal manometry is an objective tool for evaluating anorectal function. This study aimed to correlate anorectal manometric parameters and clinical continence scoring systems to enhance the postoperative evaluation of children with ARMs.

Patients and methods:

We conducted a descriptive cross-sectional study including 47 children who had undergone definitive surgical repair for ARMs between January 2010 and June 2021. Fecal continence was assessed using the Kelly and Templeton & Ditesheim scoring systems. …

Neonatal Intestinal Obstruction: Etiological Spectrum, Surgical Outcomes, And Predictors Of Mortality In A Tertiary Referral Center In Egypt”, Mohamed M. Abdelghany, Kamal Abd El-Elah Ali, Mohamed Said Elsherbiny, Mohamed Attia Shehata

Mansoura Medical Journal

Background: Neonatal intestinal obstruction (NIO) remains a major surgical emergency associated with substantial morbidity and mortality, particularly in low- and middle-income countries. Early identification of neonates at increased risk of adverse outcomes may improve perioperative management and survival. This study aimed to evaluate the etiological spectrum, surgical management, short-term outcomes, and predictors of mortality among neonates undergoing surgery for intestinal obstruction in a tertiary referral hospital in Egypt, with particular emphasis on the prognostic value of perioperative inflammatory markers. Objective: this study aimed to evaluate the causes and early postoperative outcomes among neonates operated for intestinal obstruction in a tertiary …

Ageing With Hiv: Epidemiological Transition, Biological Mechanisms, And The Impact Of Evolving Antiretroviral Therapy, Jude Eteneneng Enoh, Roland Tiagha Akah

Mansoura Medical Journal

The scale up of antiretroviral therapy (ART) has led to the evolution of HIV infection into a chronic condition, leading to a rapid growth in the number of older adults with HIV. This trend involves several biological, medical, and psychological challenges that go beyond conventional HIV treatment. The current mini-review provides a summary of recent data (2014 – 2026) regarding the changing epidemiology of HIV, biological aspects of ageing, and comorbidities and health systems associated with ageing.

Ageing is driven by persistent immune activation, inflammation, immune senescence, and microbial translocation, all of which accelerate biological ageing. These biological factors lead …

The Relationship Between U.S. Presidents And Governors From Opposing Political Parties: Policy Implementation And Crisis Management, Adam Richey

Honors College Theses

This thesis studies the impact of partisan divisions between U.S. presidents and state governors in regard to policy implementation and crisis management of the American federal system. While previous research has mainly addressed congressional polarization, executive relationships across different levels of government have received comparatively less scholarly focus.  Particularism theory argues that electoral incentives shape executive behavior, and this study finds that political alignment significantly affects cooperation, coordination, and responsiveness during times of crises. Focusing on qualitative comparative case study methods, the analysis examines Hurricane Katrina (2005) and the COVID-19 pandemic (2020–2021). The results show that partisan division most often …

Perinatal Inflammation And Oxidative Stress Alter Adult Rat (Rattus Norvegicus) Motor Behavior, Alexander Young

Honors College Theses

Recent evidence in comparative animal models suggests that early life exposure to elevated inflammation (via LPS exposure) and oxidative stress (via acetaminophen exposure) may synergistically interact to alter typical neurodevelopmental trajectories, resulting in lasting effects on both behavior and gut-brain neurochemistry. The current study observed emotional and motor behaviors and collected fecal-boli to measure Tyrosine (TE) levels in male and female Long-Evans (Rattus norvegicus) rats. Subjects were either treated with [1] saline [2] lipopolysaccharide (LPS) to introduce an inflammatory state, [3] acetaminophen (APAP) to introduce oxidative stress, or [4] a dual-hit of both LPS + APAP on postnatal day (PD) …

Exploring The Effects Of Mindset And Mood On Cognitive Performance, Pamela Kplivi

Honors College Theses

Individual and situational factors such as mindset and mood can shape performance on creative problem solving tasks. This study examined the potential effects of mindset (growth vs. fixed) and mood (positive, neutral, negative) on performance. Performance was measured using a shortened 60-item version of the Compound Remote Associates Task (CRAT; Bowden & Jung- Beeman, 2003). 92 undergraduate students completed self report measures of mindset (ITIS; Dweck, 1999) and self-efficacy (Schwarzer & Jerusalem, 1995). Participants were randomly assigned to a video-based mood induction condition and completed a self-reported mood survey (PANAS; Watson et al., 1988). Manipulation checks confirmed the effectiveness of …

What Is The Evolving Role Of Nurses In Telehealth As Future Healthcare Professionals?, Emma G. Lowry

Honors College Theses

Telehealth has evolved into an essential component of healthcare delivery in today's world, something that occurred alongside the COVID-19 pandemic. As healthcare professionals, nurses must be adequately prepared and equipped to use the tools for telehealth. This paper examines the evolving role of nurses in telehealth by assessing undergraduate nursing students’ and practicing nurses’ knowledge, attitudes, and perceived competencies. Data will be collected through a Qualtrics survey utilizing the Awareness, Knowledge, Attitude, and Skills (AKAS) Scale for Telemedicine, supplemented by interviews with telehealth practitioners to provide qualitative context. It is expected that variations in proficiency and attitudes, from previous biased …

Development Of Tunable Rose Bengal Based-Nanogumbos As Potential Selective Chemotherapeutic Agents, William J.A. Russell

Honors College Theses

As cancer remains one of the greatest threats to the global population, the development of chemotherapeutic agents that are selective and tunable is of critical importance. Herein, a series of Rose Bengal (RB)-based GUMBOS, a group of uniform materials based on organic salts, were synthesized via counterion exchange between [Na]₂[RB] and three organic cations: tetrabutylphosphonium bromide [TBP][Br], tetraphenylphosphonium chloride [TPP][Cl], and 1-dodecyl-3-methylimidazolium chloride [C₁₂MIm][Cl]. The resulting GUMBOS were characterized through FT-IR, ESI-MS, NMR, and UV-Vis Spectroscopy. Partition coefficient studies indicated all GUMBOS exhibited hydrophobic physiochemical characteristics. These hydrophobic RB-based GUMBOS …

Effects Of Dietary Perfluorobutane Sulfonate (Pfbs) On Adipose Tissue, Hannah Olofintuyi, Eric Gato

Honors College Theses

Per- and polyfluoroalkyl substances (PFAS) are chemical substances used in a variety of industrial applications and consumer products. Perfluorobutane sulfonate (PFBS) is often used as a replacement for the more harmful (Perfluoroalkyl sulfonate) PFAS chemicals that have been around longer. It is believed that PFBS does not remain in the body as long as other PFAS compounds; however, there is a rising concern that it has the potential to cause damage to human health. This study focused on understanding how dietary PFBS exposure affects metabolism-related processes in adipose tissues in rats. To accomplish study objectives, Sprague Dawley rats were exposed …

From The Classroom To The Workplace: The Role Of Internships In Shaping Student Values, Jasmine Williams

Honors College Theses

A significant degree of research on workplace values has been conducted to better understand how employees are motivated in the hopes of reducing turnover. There also exists a significant body of literature on how internships impact career outcome and can effectively prepare students for the workforce. However, previous studies have not explored the differences between students who have completed internships in comparison to those who have not. The goal of this research is to determine whether internships create a significant impact on students’ workplace values (e.g. intrinsic, extrinsic, altruistic, and social) when compared to students who have not completed an …

Preventing Coccus Longulus Infestation, Nicholas Wellls

Honors College Theses

In the Armstrong greenhouse, the Coccus longulus scale insect is a prevalent problem on a specific species of Begonia known as Begonia ‘Richmondensis’. Inside the greenhouse there are several types of begonias with very similar characteristics to the Richmondensis begonia. However, none of these other begonias are infested by C. longulus, despite similar leaf thickness and environmental conditions such as humidity and light. This project examined whether differences in the chemical composition of the Begonia leaves can explain this pattern. Results were not statistically significant, but they showed that the chemicals had a noticeable impact on the scale, and …

How Is The Use Of Ai Impacting Nursing Students Education?, Lorna H. Strain

Honors College Theses

The use of Artificial Intelligence (AI) in education is rapidly increasing and reshaping how nursing students learn and engage with content. This thesis proposal looks at the impact of AI on the education of nursing students and explores students' perceptions of its use in their learning and education. As AI becomes more prevalent, many students are using it for study aids and content personalization, while schools are using it in simulations and textbook platforms. Many recognize its benefits, such as enhanced critical thinking, improved accessibility of materials, and more immersive learning. Concerns persist around ethical use, academic integrity, and the …

Validity Assessment Of Resting Heart Rate Variability From The Garmin Health Snapshot, Kayla M. Porter, Andrew Flatt

Honors College Theses

Purpose: To assess the agreement between the Garmin Forerunner 265 (a commercially available sports watch) and a single-channel electrocardiographic (ECG) chest strap for determining resting heart rate variability (HRV). Secondary aims were to assess the impact of skin tone and body position on measurement accuracy.

Methods: Young adults (n = 30, 57% women) aged 18–39 years without known cardiovascular conditions and without tattooing or scarring on the dorsal left wrist were recruited. HRV was recorded simultaneously using ECG and the Forerunner 265’s optical sensor during Garmin’s 2-minute “Health Snapshot.” Measurements were obtained in three standardized positions: supine, seated, and standing. …

Elevated Temperature Flexure Behavior Of Continuous Carbon Fiber Reinforced Zrb2–Zrsi2 Ultrahigh Temperature Ceramic Matrix Composites, Jacob Stacy, Aaron Ginsparg, Jason Lonergan, Jeremy Watts, Gregory Hilmas

Materials Science and Engineering Faculty Research & Creative Works

Ultrahigh temperature ceramic matrix composites (UHTCMCs) were fabricated from unidirectional prepreg tapes consisting of a matrix of ZrB₂ with 5, 10, and 15 vol.% ZrSi₂ additions and continuous polyacrylonitrile carbon fibers and were densified at 1600°C in a hot press. The relative matrix densities ranged from 88% to 93% with interlayer spacings of ∼72 µm and fiber volume fractions between 30% and 36%. Phenolic resin additions were utilized to react with ZrSi₂ acting as a transient sintering aid to form ZrC and SiC phases. Elastic moduli of the UHTCMCs decreased with increasing temperature during 4-pt flexure testing. …

On Dark Skinned Jesus Of Nazareth: Why Color Matters, Nicholas Berkel

MA Theses

This thesis examines the historical, religious, and cultural consequences of portraying Jesus as white within Christian art. Although Western art has overwhelmingly depicted Christ with white skin, archaeological, and contextual evidence supports a dark-skinned Jesus rooted in the ethnogeography of first century Palestine. The persistence of a White Jesus has shaped religious imagination and perception for centuries, reinforcing racial hierarchy and legitimizing systems of white supremacy. Through an interdisciplinary analysis combining biblical studies, Christian iconography, ethnography of ancient Semitic, Greco-Roman, and Egyptian peoples, medieval symbolism, modern mass-produced imagery, and Black thought, this study demonstrates how Jesus’ original complexion was gradually …

Kidney Dysfunction, Biochemical Changes, Dna Alteration, And Mapks Regulation Following Chronic Exposure To Regular And Occasional Hookah Smoke In Mice, Naserddine Hamadi, Anas Nemmar, Sumaya Beegam, Nur Elena Zaaba, Ozaz Elzaki, Abderrahim Nemmar

All Works

Regular hookah smoking (Reg-HS) has become a major global public health issue, linked to significant health risks, including kidney damage. A less frequent pattern of use, known as occasional hookah smoking (Occ-HS), is also common; however, there has been little progress in understanding the direct impact of Occ-HS on kidneys. To investigate how varying frequencies of HS inhalation affect the kidney, we exposed mice to nose-only HS under two regimens, occasional (30 min once weekly) and regular (30 min five times per week) for a duration of 6 months. This study explored the impact on renal damage, inflammatory responses, oxidative …

Integrative Machine Learning Of Genetic And Lifestyle Factors For Personalized Skin Health, Yassine Benachour, Lina Maloukh, Barbara Geusens

All Works

Objective: To develop an AI framework that combines genetic, phenotypic, and lifestyle data for profiling skin-health patterns and generating hypothesis-supporting summaries for potential decision support. Methods and procedures: A dataset of 5,254 individuals integrates six genes (FLG, AQP3, MMP-1, MMP-3, SOD2, GPX), six phenotype severities, and 20+ lifestyle factors. Mutation burden and interactions are tested by ANOVA. K-modes clustering identifies four interpretable dermatological profiles within the cohort and is embedded in leakage-free nested cross-validation (train-only selection; test labels from training centroids). Subtypes are predicted from genetics plus lifestyle using an XGBoost (XGB) classifier; explainability uses gain, permutation importance, and SHAP …