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In this work, we introduce a new definition for the fractional differential operator that generalizes several well-known fractional differential operators. In fact, we introduce the notion of the p -proportional ω -weighted κ -Hilfer derivative includes an exponential function, D a , λ σ , ρ , p , κ , ω , and then we consider a non-instantaneous impulse differential inclusion containing D a , λ σ , ρ , p , κ , ω with order σ ∈ (1 , 2) and of kind ρ ∈ [ 0 , 1 ] in Banach spaces. We deduce the relevant relationship between any solution to the studied problem and the integral equation that corresponds to it, and then, by using an appropriate fixed-point theorem for multi-valued functions, we give two results for the existence of these solutions. In the first result, we show the compactness of the solution set. Next, we introduce the concept of the (p , ω , κ) -generalized Ulam-Hyeres stability of solutions, and, using the properties of the multi-valued weakly Picard operator, we present a result regarding the (p , ω , κ) -generalized Ulam-Rassias stability of the objective problem. Since many fractional differential operators are particular cases of the operator D a , λ σ , ρ , p , κ , ω , our work generalizes a number of recent findings. In addition, there are no past works on this kind of fractional differential inclusion, so this work is original and enjoyable. In the last section, we present examples to support our findings. [ABSTRACT FROM AUTHOR]

We report a 12-month-old female infant who had a history of neonatal sepsis with liver micro-abscesses that resolved with intravenous antibiotics during neonatal period. During her neonatal admission period, no umbilical vein catheter was inserted. Also, she did not undergo any abdominal surgeries or had a postnatal history of necrotizing enterocolitis. However, the child developed upper gastrointestinal bleeding in form of hematemesis and melena secondary to esophageal varices at the age of 12 months with an extra-hepatic portal vein obstruction with cavernous transformation and portal hypertension subsequently. The child underwent a successful endoscopic injection sclerotherapy. She is now 20-month-old and has portal hypertension but otherwise asymptomatic. We are proposing the possibility of a delayed-onset portal hypertension as a complication of liver abscess and neonatal sepsis. [ABSTRACT FROM AUTHOR]

We prove two results concerning the existence of solutions for functional differential inclusions that are governed by sweeping processes, with noncompact valued perturbations in Banach spaces. Indeed, we have two goals. The first is to give a technique that allows considering sweeping processes with noncompact valued perturbations and associated with a multivalued function depending on time. The second is to give a technique to overcome the arising problem from the nonlinearity of the normalized mappings, when we deal with sweeping processes with noncompact valued perturbations and associated with a multivalued function depending on time and state. [ABSTRACT FROM AUTHOR]

We have proven an existence theorem concerning the existence of solutions for a functional evolution inclusion governed by sweeping process with closed convex sets depending on time and state and with a noncompact nonconvex perturbation in Banach spaces. This work extends some recent existence theorems concerning sweeping processes from Hilbert spaces setting to Banach spaces setting. Moreover, it improves some recent existence results for sweeping processes in Banach spaces. [ABSTRACT FROM AUTHOR]

Objective: The majority of adolescents with type 1 diabetes have poor glycemic control, calling for an action to be taken. The aim of this study was to identify the determinants of poor glycemic control among adolescents with type 1 diabetes. Methods: Data were collected for all adolescents with type 1 diabetes (age < 20 years), who attended diabetes clinics at one hospital, and had at least one result of HbA1c performed during the study year. The average level of HbA1c was calculated from all the HbA1c results collected over one year. Glycemic control was defined as poor if the HbA1c was >8%. Variables studied were gender, age, age at diagnosis, diabetes duration, annual clinic attendance, frequency of blood glucose monitoring, healthy eating, medication adherence, and frequency of HbA1c performance over one year. Results: The study included 78 adolescents with type 1 diabetes (47.4% males). Mean age was 15.4+2.0 years, mean age at diagnosis was 9.0+3.6 years, and mean duration of diabetes was 6.6+3.8 years. The mean of the average level of HbA1c was 10.2+1.9%, and 84.6% had HbA1c >8%. Mean frequency of HbA1c performance was twice per year, and mean annual clinic attendance was three visits. Poor glycemic control was significantly associated with female gender (p<0.05). Healthy eating, medication adherence, and frequent HbA1c performance (> 3 per year) were significantly associated (p<0.001) with better glycemic control (HbA1c<8%). With regression analysis, healthy eating, medication adherence and HbA1c performance remained as the major determinants of the glycemic control. Conclusions: The overall glycemic control in adolescents with type 1 diabetes was poor, putting them at high risk of developing diabetes complications at an early stage of life. Healthy behavior was a major determinant of glycemic control. Behavioral healthy intervention strategies should be integrated in the management plan of diabetes care to improve glycemic control and reduce diabetes complications in this vulnerable group. Disclosure: A.M.A. Aladsani: None. [ABSTRACT FROM AUTHOR]

Background: We utilized the data from the Saudi national biliary atresia (BA) study (2000–2018) to describe the clinical, biochemical, imaging, and histopathological features of BA and the perioperative clinical practices among local pediatric gastroenterologists. Methods: This is a retrospective, multicenter, nationwide study that included 10 tertiary care governmental hospitals including the four liver transplant (LT) centers in different regions across Saudi Arabia. Results: BA was diagnosed in 204 infants (106 females; 10% preterm). The median age at referral was 65 days. Congenital anomalies were present in 68 patients (33%); 22 were splenic malformation (10.8%). The medians of laboratory investigations were total bilirubin (189 μmol/l), direct bilirubin (139 μmol/l), ALT (164 u/l), and GGT (472 u/l). The level of serum GGT was normal in 26 cases (12.7%). The ultrasound findings included hypoplastic or atrophic gall bladder (GB) (65%), normal GB (30%), and cord sign (5%). A HIDA scan was performed in 99 cases (48.52%). Magnetic resonance cholangiopancreatography (MRCP) was performed in 27 cases (13%). A total of 179 liver biopsies (88%) were obtained. The most common histopathologic findings were bile duct proliferation (92%), canalicular cholestasis (96%), bile plugs (84%), and portal fibrosis (95%). Cholangiography was performed in 139 cases (68%): operative in 122 (60%) and percutaneous in 17 (8%). A total of 143 children (70%) underwent Kasai portoenterostomy (KPE) at a median age of 70 days. After KPE, steroid was used in 37% of the cases and 100 cases (70%) were prescribed prophylactic antibiotics for variable duration (ranging between 3 and 12 months). Conclusion: Our data show marked variation in the diagnostic evaluation and perioperative management of BA cases among the different tertiary centers. There is a need to establish a national BA registry in Saudi Arabia aiming to standardize pre- and postoperative clinical practices. Additionally, normal serum GGT level, normal GB size on ultrasound, and being a premature baby should not preclude the diagnostic workup for BA. [ABSTRACT FROM AUTHOR]

Background: Outcomes in biliary atresia (BA) have been well-documented in large national cohorts from Europe, North America, and East Asia. Understanding the challenges that preclude success of the Kasai portoenterostomy (KPE) is the key to improve the overall outcomes of BA and implementing intervention strategies. Here, we analyzed the data from the Saudi national BA study (204 BA cases diagnosed between 2000 and 2018) to identify the prognostic factors of BA outcomes. Methods: One hundred and forty-three cases underwent KPE. Several prognostic factors (center case load, congenital anomalies, serum gamma-glutamyl transferase, use of steroids, ascending cholangitis post-operatively, and degree of portal fibrosis at time of KPE) were investigated and correlated with the primary outcomes of interest: 1) success of KPE (clearance of jaundice and total serum bilirubin <20 mmol/l after KPE), 2) survival with native liver (SNL), and 3) overall survival. Results: Use of steroids after KPE was associated with clearance of jaundice, 68% vs. 36.8% in the BA cases that did not receive steroids (P = 0.013; odds ratio 2.5) and a significantly better SNL rate at 2 - and 10-year of 62.22% and 57.77% vs. 39.47% and 31.57%, respectively (P = 0.01). A better 10-year SNL was observed in centers with caseload <1/year (group 1) as compared to centers that performed ≥1/year (group 2) [45.34% vs. 26.66%, respectively; P = 0.047]. On comparison of the 2 groups, cases in group 1 had KPE at significantly earlier age (median 59.5 vs. 75 days, P = 0.006) and received steroids after KPE more frequently than group 2 (69% vs. 31%, P < 0.001). None of the remaining prognostic variables were identified as being significantly related to BA outcome. Conclusion: Steroids use post-KPE predicted clearance of jaundice and better short- and long-term SNL. There is a need to establish a national BA registry in Saudi Arabia aiming to standardize the pre- and post-operative clinical practices and facilitate clinical and basic research to evaluate factors that influence BA outcome. [ABSTRACT FROM AUTHOR]

Owing to the anticipated energy crisis, the demand for photocatalytic H 2 evolution is also growing. Herein, a hydrothermal process is used to prepare an S-scheme CdS/N-rGO heterojunction system. Different characterizations reveal that robust interfacial contact and integration of CdS and N-rGO effectively promote the surface area, photoresponse, and separation and migration of photoinduced electron-hole pairs, endowing CdS/N-rGO composite an excellent photocatalytic activity. Under visible light illumination, the CdS/N-rGO obtains a promising H 2 evolution efficiency of 58.8 mmolh−1g−1, which is nearly 21-times more than that of bare CdS. The prepared composite also exhibits excellent stability in recycling experiments. This work might open up novel ways to design excellent N-rGO-based S-scheme photocatalysts for solar fuel generation. [ABSTRACT FROM AUTHOR]