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Ventilator-induced lung injury (VILI) is a significant risk for patients with acute respiratory distress syndrome (ARDS). Management of the patient with ARDS is currently dominated by the use of low tidal volume mechanical ventilation, the presumption being that this mitigates overdistension (OD) injury to the remaining normal lung tissue. Evidence exists, however, that it may be more important to avoid cyclic recruitment and derecruitment (RD) of lung units, although the relative roles of OD and RD in VILI remain unclear. Forty pigs had a heterogeneous lung injury induced by Tween instillation and were randomized into four groups (in/i= 10 each) with higher (↑) or lower (↓) levels of OD and/or RD imposed using airway pressure release ventilation (APRV). OD was increased by setting inspiratory airway pressure to 40 cmHsub2/subO and lessened with 28 cmHsub2/subO. RD was attenuated using a short duration of expiration (∼0.45 s) and increased with a longer duration (∼1.0 s). All groups developed mild ARDS following injury. RD ↑ OD↑ caused the greatest degree of lung injury as determined by [Formula: see text]/[Formula: see text] ratio (226.1 ± 41.4 mmHg). RD ↑ OD↓ ([Formula: see text]/[Formula: see text]= 333.9 ± 33.1 mmHg) and RD ↓ OD↑ ([Formula: see text]/[Formula: see text] = 377.4 ± 43.2 mmHg) were both moderately injurious, whereas RD ↓ OD↓ ([Formula: see text]/[Formula: see text] = 472.3 ± 22.2 mmHg;iP/ilt; 0.05) was least injurious. Both tidal volume and driving pressure were essentially identical in the RD ↑ OD↓ and RD ↓ OD↑ groups. We, therefore, conclude that considerations of expiratory time may be at least as important as pressure for safely ventilating the injured lung.bNEWamp; NOTEWORTHY/bIn a large animal model of ARDS, recruitment/derecruitment caused greater VILI than overdistension, whereas both mechanisms together caused severe lung damage. These findings suggest that eliminating cyclic recruitment and derecruitment during mechanical ventilation should be a preeminent management goal for the patient with ARDS. The airway pressure release ventilation (APRV) mode of mechanical ventilation can achieve this if delivered with an expiratory duration (TsubLow/sub) that is brief enough to prevent derecruitment at end expiration.

The effects of a functional additive (Sanacore® GM; SAN) on immune and antioxidant indices, and the resistance of gilthead seabream (Sparus aurata) against Vibrio alginolyticus infection were investigated. For this, four diets containing 0% (the control), 0.1%, 0.2%, and 0.4% SAN were offered to triplicated groups of fish (20–23 g) for ten weeks. Subsequently, fish were injected intraperitoneally with V. alginolyticus and monitored for further ten days. Feeding the fish on SAN-supplemented diets showed positive effects on leukocyte counts and its differential percentages. Serum lysozyme activity and total immunoglobulin values, as well as blood phagocytic activity and indices, were linearly and quadratically higher in SAN-fed fish, especially at the 0.4% SAN diet. Similarly, linear and quadratic increases in catalase, superoxide dismutase, and total antioxidant capacity were observed in SAN-fed fish, particularly at the 0.4% SAN diet. Conversely, malondialdehyde values decreased in SAN-fed fish compared with the control group, which showed its highest value. The highest expression of the IL-1β gene coupled with the lowest TNF-α and HSP70 genes expressions was found in the fish fed with the 0.4% SAN. On the other hand, fish fed on the control diet showed the lowest IL-1β gene coupled with the highest TNF-α and HSP70 genes expressions. After bacterial infection, most of the control fish died with a relative percent of survival of 5.0%; meanwhile feeding gilthead seabream on SAN-enriched diets significantly enhanced their protection against V. alginolyticus infection fed on the 0.4% SAN diet showed 100% survival. The SAN administration to gilthead seabream especially at the 0.4% level led to significant promotions in antioxidative and immune responses and augmented the fish resistance to V. alginolyticus infection.

Fish transportation is a regular farming and experimental practice that mainly results in stress conditions that may extend to induce a high mortality rate. In the present experimental simulation, Oreochromis niloticus were transported for 2 h and maintained for another 6 h in transportation containers to assess the effect of tranquilization with tricaine methanesulfonate (MS-222) and/or the addition of iodine on mortality rate and restoring the normal physiological functions. Experimental fish were divided into four groups: group 1 (control) was transported in farm water without MS-222 or iodine, group (2) was transported in farm water supplemented with 40 mg/L of MS-222, fish in group (3) were transported in farm water supplemented with 40 mg/L of MS-222 + 10 ppm iodine, and fish in group (4) were transported in farm water containing 10 ppm iodine. Blood samples were collected for the determination of serum cortisol and glucose, while skin mucus was collected for assaying lysozyme, peroxidase and antibacterial activity; cumulative mortality rate; and food reflexes which were assessed at 0 h, 1 h, 6 h, 48 h, 7 days and 14 days post 2 h transportation. The results indicated that fish tranquilization with MS-222 and/or treatment with iodine mitigated the stress condition associated with transportation and accelerate restoration of the normal physiological and immunological status. So, it was recommended to use the MS-222 as a tranquillizer together with iodine as an antiseptic during transportation of O. niloticus.

In this work we conceive a method of how the Lagrange multiplier of modified Variational Iteration Method can be defined from Laplace transform, And we use this technique to solve both differential equations and FDEs with initial value conditions, With Illustrative examples by applying the modified VIM to both Ordinary differential equations and fractional Differential Equations.

A robust, optimized power system stabilizer (PSS) is crucial for oscillation damping, and thus improving electrical network stability. Additionally, real-time testing methods are required to significantly reduce the likelihood of software failure in a real-world setting at the user location. This paper presents an Antlion-based proportional integral derivative (PID) PSS to improve power system stability during real-time constraints. The Antlion optimization (ALO) is developed with real-time testing methodology, using hardware-in-the-loop (HIL) that can communicate multiple digital control schemes with real-time signals. The dynamic power system model runs on the dSPACE DS1104, and the proposed PSS runs on the field programmable gate arrays (FPGA) (NI SbRIO-9636 board). The optimized PSS performance was compared with a modified particle swarm optimization (MPSO)-based PID-PSS, through different performance indices. The test cases include other step load perturbations and several short circuit faults at various locations. Twelve different test cases have been applied, through real-time constraints, to prove the robustness of the proposed PSS. These include 5 and 10% step changes through 3 different operating conditions and single, double, and triple lines to ground short circuits through 3 different operating conditions, and at various locations of the system transmission lines. The analysis demonstrates the effectiveness of ALO and MPSO in regaining the system’s stability under the three loading conditions. The integral square of the error (ISE), integral absolute of the error (IAE), integral time square of the error (ITSE), and integral time absolute of the error (ITAE) are used as performance indices in the analysis stage. The simulation results demonstrate the effectiveness of the proposed PSS, based on the ALO algorithm. It provides a robust performance, compared to the traditional PSS. Regarding the applied indices, the proposed PSS, based on the ALO algorithm, obtains significant improvement percentages in ISE, IAE, ITSE, and ITAE with 30.919%, 23.295%, 51.073%, and 53.624%, respectively.

Astaxanthin (AX) is one of the commonly used feed supplements to enhance the growth performance and provide antioxidant and immune functions of several aquatic animals. In the current study, juveniles of white-leg shrimp (Litopenaeus vannamei) with mean initial weight of 0.340 ± 0.041 g were fed with diets supplemented with 0 (control), 25, 50, 100, and 200 mg/kg feed for 8 weeks. At the end of the feeding trial, shrimps were exposed to Vibrio harveyi, and their mortality rates were observed for additional 10 days. The growth indices in the AX-fed groups were significantly (P P P cMn-SOD, CAT, and GPx genes were significantly upregulated in the hepatopancreas of L. vannamei fed with AX-enriched diets (especially in the 200-mg/kg feed treatment) as compared with the control diet. The immunity indices of the AX treatments (hematocyte count, total protein, lysozyme, phagocytic activity, and phenoloxidase) of L. vannamei were linearly (P P V. harveyi abundance. After the bacterial challenge, feeding L. vannamei with dietary AX significantly increased (P L. vannamei against V. harveyi infection.

The TCAV method reduces lung damage in ARDS. However, so far, no study has evaluated the impact of the TCAV method on ventilator-induced lung injury and cardiac function in experimental emphysema. The TCAV method at EFT/EPF ratio of 25%, compared with EFT/EPF of 75% (frequently used in ARDS), reduced lung inflammation, alveolar heterogeneity and hyperinflation, and pulmonary arterial hypertension in elastase-induced emphysema. TCAV may be a promising and personalized ventilation strategy for patients with emphysema.

Obesity is an independent risk factor for cardiovascular diseases. Coronary artery calcium (CAC) is a direct measure of coronary atherosclerosis. The study investigated the effect of bariatric surgery on CAC scores in people with severe obesity subjected to laparoscopic sleeve gastrectomy (LSG). This prospective study included 129 people with severe obesity in two groups; the LSG group (n=74) subjected to surgery and the diet group (n=55), managed by a diet regimen and lifestyle modification. Cardiovascular risk was assessed by Framingham risk score (FRS) and coronary calcium score (CCS) measured by computed tomography initially and after 3 years. The two groups had a comparable CAD risk before treatment according to FRS or CCS. After treatment, CCS improved significantly in the LSG group (p=0.008) but not in the diet group (p=0.149). There was no correlation between FRS and CCS (r=0.005, p=0.952). Treatment resulted in significant weight reduction and improved fasting blood glucose and lipid profile in the two groups. The change of weight, blood glucose, and HDL, and remission of diabetes mellitus (DM) were significantly higher in the LSG group compared to the diet group. LSG may reduce the risk of developing future cardiovascular comorbidities evidenced by reducing CAC scores. Significant weight reduction and improvement of cardiovascular risk factors may recommend LSG as a cardioprotective procedure in people with severe obesity.

This paper divided into two items; the first is to assess the technical state of pump stations on the two branches of the Nile Delta for irrigation by solar energy to compensate the shortage of Nile water especially in such intensively cultivated region such as Delta. The second is studying the economics of these pumps when use the solar energy instead of Diesel. Reduction in Nile water resources in Egypt is inevitable due to the Grand Ethiopian Renaissance dam (GERD). Where the major of the expected impact is a reduction in irrigation canals levels, the surface water could be pumped to irrigate these agriculture lands. HEC-RAS model is used to estimate the decline in the Nile level (in the two branches; Damietta and Rosetta). Two cases are of proposed of power system sources for the operation of pump station on Damietta and Rosetta Branches. The time period of the tested system was 25 years. The results showed that; around 28 pump stations will be hurt in the new conditions of the Nile level decline while 6 only can be operate in safe. the capital cost of the solar system was high when compared with the diesel cost, but the net present cost was highly economic in the solar system. The net present cost of the solar system to irrigates 23100 km2 (5.5 Million feddan) which are the cultivated areas in delta, in first and second cases as; about 33.1 (million LE during 25 years), and about 6.76 (milliard LE during 25 years) respectively. The total greenhouse gas emission by diesel system was about 32,469 (kg/year/4200 m2) with considering the daily working hours of pumps is 8 hours. Finally, either solar energy or diesel usages will increase the economic burden of Egypt but using the solar pump is less impact.

Powder samples of infant’s milk formula from thirty four different brands commonly consumed in Egypt were collected from drug stores and local markets. The concentrations of seventeen elements (Al, Br, Ca, Cl, Co, Cu, Fe, I, K, Mg, Mn, Na, Rb, Sb, Sc, Se, and Zn) were determined by instrumental neutron activation analysis. The results reveal that the infants’ milk provides adequate amounts of most essential elements; and considered as a suitable source of nutrient for infants during their early life stages. The activity concentrations of 226Ra, 232Th and 40K were measured and used to estimate the radiation hazard indices.

Study Design: Prospective case series, therapeutic Level IV. Objectives: Functional and radiographic outcome evaluation of patients with spondylolysis treated with pars interarticularis defect repair with iliac bone grafting and application of a construct consisting of a pair of polyaxial pedicle screws connected by a U-shaped rod passing beneath the spinous process. Methods: Twenty-five patients (27 operated lumbar levels) with an average of 20 months of follow-up (range 12–24 m) with spondylolysis who met our inclusion criteria were treated with the above-mentioned technique. Functional assessment was by the Visual Analog Score (VAS) for low back pain (LBP) and Oswestry Disability Index (ODI). Fusion was confirmed with plain x-rays and when indicated with computed tomography scan. Return to activities of daily living (ADL) was also assessed. Results: There were 16 males (64%) and 9 females (36%), with a mean age of 18 ± 3 years at surgery, with a mean operating time of 79 ± 13 min and a mean blood loss of 186 ± 57 ml. ODI significantly improved from a mean of 63 ± 7 preoperatively to 10 ± 4 at 12 months postoperatively (P < 0.001). The mean preoperative LBP VAS score 8 ± 1 showed also a statistically significant decrease of values to 1 ± 1 at 12 months, (P < 0.001). At 12 m, all patients returned to unrestricted ADL. Pars healing was present in 19 patients (76%) at 6 months and in all patients at 12 months. Conclusions: Polyaxial pedicular screws with a U-shaped rod offer an effective and reproducible treatment for spondylolysis with an appropriate fusion rate, predictable return to daily activities, and good pain relief in young adults.

Patients with resectable esophageal cancer are recommended to undergo chemoradiotherapy before esophagectomy. A longer time to surgery (TTS) and/or time to consultation (TTC) may be associated with inferior cancer-related outcomes and heightened anxiety. Thoracic cancer surgery centers (TCSCs) oversee esophageal cancer management, but differences in TTC/TTS between centers have not yet been examined. This Ontario population-level study used linked administrative healthcare databases to investigate patients with esophageal cancer between 2013–2018, who underwent neoadjuvant chemoradiotherapy and then surgery. TTC and TTS were time from diagnosis to the first surgical consultation and then to surgery, respectively. Patients were assigned a TCSC based on the location of the surgery. Patient, disease, and diagnosing physician characteristics were investigated. Quantile regression was used to model TTS/TTC at the 50th and 90th percentiles and identify associated factors. The median TTS and TTC were 130 and 29 days, respectively. The adjusted differences between the TCSCs with the longest and shortest median TTS and TTC were 32 and 18 days, respectively. Increasing age was associated with a 16-day longer median TTS. Increasing material deprivation was associated with a 6-day longer median TTC. Significant geographic variability exists in TTS and TTC. Therefore, the investigation of TCSC characteristics is warranted. Shortening wait times may reduce patient anxiety and improve the control of esophageal cancer.

A hallmark of ARDS is progressive shrinking of the ‘baby lung,’ now referred to as the ventilator-induced lung injury (VILI) ‘vortex.’ Reducing the risk of the VILI vortex is the goal of current ventilation strategies; unfortunately, this goal has not been achieved nor has mortality been reduced. However, the temporal aspects of a mechanical breath have not been considered. A brief expiration prevents alveolar collapse, and an extended inspiration can recruit the atelectatic lung over hours. Time-controlled adaptive ventilation (TCAV) is a novel ventilator approach to achieve these goals, since it considers many of the temporal aspects of dynamic lung mechanics.

In the pursuit of science, competitive ideas and debate are necessary means to attain knowledge and expose our ignorance. To quote Murray Gell-Mann (1969 Nobel Prize laureate in Physics): “Scientific orthodoxy kills truth”. In mechanical ventilation, the goal is to provide the best approach to support patients with respiratory failure until the underlying disease resolves, while minimizing iatrogenic damage. This compromise characterizes the philosophy behind the concept of “lung protective” ventilation. Unfortunately, inadequacies of the current conceptual model–that focuses exclusively on a nominal value of low tidal volume and promotes shrinking of the “baby lung” - is reflected in the high mortality rate of patients with moderate and severe acute respiratory distress syndrome. These data call for exploration and investigation of competitive models evaluated thoroughly through a scientific process. Airway Pressure Release Ventilation (APRV) is one of the most studied yet controversial modes of mechanical ventilation that shows promise in experimental and clinical data. Over the last 3 decades APRV has evolved from a rescue strategy to a preemptive lung injury prevention approach with potential to stabilize the lung and restore alveolar homogeneity. However, several obstacles have so far impeded the evaluation of APRV’s clinical efficacy in large, randomized trials. For instance, there is no universally accepted standardized method of setting APRV and thus, it is not established whether its effects on clinical outcomes are due to the ventilator mode per se or the method applied. In addition, one distinctive issue that hinders proper scientific evaluation of APRV is the ubiquitous presence of myths and misconceptions repeatedly presented in the literature. In this review we discuss some of these misleading notions and present data to advance scientific discourse around the uses and misuses of APRV in the current literature.

CaiB is a DR cluster actinobacteriophage that was isolated from soil in Florida using Gordonia rubripertincta NRRL B-16540 as the host. The genome is 61,620 bp, has a GC content of 68.6%, and contains 85 predicted protein coding genes. CaiB has several putative operons and has repeated intergenic regions that may be involved in gene regulation.

The aim of this study is to investigate the protective effects of Quercetin (QCT) on Hydroxychloquine (HCQ)-induced myocardial affection in rats. HCQ has been found to produce toxic effects including cardiac manifestation. Adding QCT to HCQ ameliorates its effects and prevents cardiac manifestations. For this purpose, eighty adult male rats were divided into four groups (n = 20). Group 1 (control) and group 2 (QCT-treated). Group 3 (HCQ treated) received 20 mg/kg of HCQ and group 4 (QCT + HCQ treated) received quercetin (50 mg/kg; orally) combined with HCQ for 4 weeks. Cardiac troponin-I and oxidative markers (Malondialdehyde (MDA), and total serum antioxidant) were estimated in serum. In addition, histopathological and morphometric changes of the rat heart were assessed. The HCQ treated group showed increased serum levels of cardiac troponin-I, MDA and decreased serum levels of total antioxidant. Pathological picture of myocardial hypertrophy and degeneration together with depleted cardiac tissue expression of troponin T were also observed. The characteristic features were presence of whorled myelin bodies and curvilinear bodies by EM examination. These parameters improved better in the group receiving combination of QCT together with HCQ. So, Adding QCT to HCQ could be prophylactic measure against its cardiotoxic effect compared with HCQ treatment alone.

The worldwide pandemic caused by the SARS-CoV-2 virus has resulted in over 84,407,000 cases, with over 1,800,000 deaths when this paper was submitted, with comorbidities such as gender, race, age, body mass, diabetes, and hypertension greatly exacerbating mortality. This review will analyze the rapidly increasing knowledge of COVID-19-induced lung pathophysiology. Although controversial, the acute respiratory distress syndrome (ARDS) associated with COVID-19 (CARDS) seems to present as two distinct phenotypes: type L and type H. The “L” refers to low elastance, ventilation/perfusion ratio, lung weight, and recruitability, and the “H” refers to high pulmonary elastance, shunt, edema, and recruitability. However, the LUNG-SAFE (Large Observational Study to Understand the Global Impact of Severe Acute Respiratory Failure) and ESICM (European Society of Intensive Care Medicine) Trials Groups have shown that ∼13% of the mechanically ventilated non-COVID-19 ARDS patients have the type-L phenotype. Other studies have shown that CARDS and ARDS respiratory mechanics overlap and that standard ventilation strategies apply to these patients. The mechanisms causing alterations in pulmonary perfusion could be caused by some combination of 1) renin-angiotensin system dysregulation, 2) thrombosis caused by loss of endothelial barrier, 3) endothelial dysfunction causing loss of hypoxic pulmonary vasoconstriction perfusion control, and 4) hyperperfusion of collapsed lung tissue that has been directly measured and supported by a computational model. A flowchart has been constructed highlighting the need for personalized and adaptive ventilation strategies, such as the time-controlled adaptive ventilation method, to set and adjust the airway pressure release ventilation mode, which recently was shown to be effective at improving oxygenation and reducing inspiratory fraction of oxygen, vasopressors, and sedation in patients with COVID-19.

As one of the OMICS in systems biology, metabolomics defines the metabolome and simultaneously quantifies numerous metabolites that are final or intermediate products and effectors of upstream biological processes. Metabolomics provides accurate information that helps determine the physiological steady state and biochemical changes during the aging process. To date, reference values of metabolites across the adult lifespan, especially among ethnicity groups, are lacking. The “normal” reference values according to age, sex, and race allow the characterization of whether an individual or a group deviates metabolically from normal aging, encompass a fundamental element in any study aimed at understanding mechanisms at the interface between aging and diseases. In this study, we established a metabolomics reference database from 20–100 years of age from a biracial sample of community-dwelling healthy men and women and examined metabolite associations with age, sex, and race. Reference values from well-selected healthy individuals can contribute to clinical decision-making processes of metabolic or related diseases.

Treatment of dermatophytosis is quite challenging. This work aims to investigate the antidermatophyte action of Azelaic acid (AzA) and evaluate its efficacy upon entrapment into transethosomes (TEs) and incorporation into a gel to enhance its application. Optimization of formulation variables of TEs was carried out after preparation using the thin film hydration technique. The antidermatophyte activity of AzA-TEs was first evaluated in vitro. In addition, two guinea pig infection models with Trichophyton (T.) mentagrophytes and Microsporum (M.) canis were established for the in vivo assessment. The optimized formula showed a mean particle size of 219.8 ± 4.7 nm and a zeta potential of −36.5 ± 0.73 mV, while the entrapment efficiency value was 81.9 ± 1.4%. Moreover, the ex vivo permeation study showed enhanced skin penetration for the AzA-TEs (3056 µg/cm2) compared to the free AzA (590 µg/cm2) after 48 h. AzA-TEs induced a greater inhibition in vitro on the tested dermatophyte species than free AzA (MIC90 was 0.01% vs. 0.32% for T. rubrum and 0.032% for T. mentagrophytes and M. canis vs. 0.56%). The mycological cure rate was improved in all treated groups, specially for our optimized AzA-TEs formula in the T. mentagrophytes model, in which it reached 83% in this treated group, while it was 66.76% in the itraconazole and free AzA treated groups. Significant (p < 0.05) lower scores of erythema, scales, and alopecia were observed in the treated groups in comparison with the untreated control and plain groups. In essence, the TEs could be a promising carrier for AzA delivery into deeper skin layers with enhanced antidermatophyte activity.

The present work was planned to evaluate the reactor production of 47Sc from calcium and titanium targets at Egyptian Second Research Reactor (ETRR-2) based on 46Ca (n, γ) 47Ca $$\mathop{\longrightarrow}\limits^{\beta - }$$ 47Sc and 47Ti (n, p) 47Sc nuclear ractions, respectively. A comparison between the two routs in terms of specific activity of 47Sc and co-produced radioimpurities was carried out. The MCNPX2.7.0 code was used to estimate the levels of all radionuclides produced throughout as well as after the irradiation of 46CaCO3, natTiO2 and 47TiO2 targets. The computational results were verified by experimental measurements, and a good aggrement was found between both. Additionally, our results showed that 47Sc production is greatly preferred from titanium route rather than calcium route.

The neutron spectrum is an essential factor in making possible the increase of 233U isotope breeding from thorium fuel in an accelerator-driven subcritical (ADS) system; therefore, studying the eff...

Neutron transmutation doping (NTD) is one of the several techniques used for n-type doping with good homogeneity. NTD performances were investigated in this work within a project funded by the Academy of Scientific Research and Technology (ASRT), Egypt, for the “production of doped Silicon Wafers for Solar Panels and Basic Electronics,” 2015–2018. The Egypt second research reactor (ETRR-2) has two irradiation positions for silicon doping using NTD. The two positions can accommodate silicon ingots with large diameters up to six inches. One crucial parameter that affects the quality of the product is the distribution of the dopant in the irradiated ingot. The irradiation facility provides the option of rotating the sample during irradiation for flattening the radial distribution of the dopant. Since the neutron flux is not flat along the irradiation position due to leakage and the effect of control rods, the generated dopant will be not flat along the axial direction. To overcome this problem, this paper proposed an irradiation procedure to smooth the dopant distribution along the axial direction. Such procedure can be applied for NTD facilities that has not an acceptable axial neutron flux distribution in silicon doping process. The procedure is based on loading the irradiation position by two ingots staked end to end and, at the middle of the irradiation duration, the two ingots swap their places. This strategy was verified by MCNP5 calculations and experimentally.

Turkey reoviruses have been implicated in multiple disease syndromes resulting in significant economic losses to the turkey industry. It has been known for decades that turkey enteric reovirus (TERV) is involved in poult enteritis complex, but turkey arthritis reovirus (TARV), the causative agent of tenosynovitis in turkeys, emerged in 2011. In 2019, we isolated reovirus from several cases of hepatitis in turkeys and tentatively named it turkey hepatitis reovirus (THRV). The comparative pathogenesis of these viruses, and correlation with their genetic make-up (if any), is not known. In this study, we inoculated nine groups of 1-week-old turkey poults with two THRV, five TARV and two TERV via oral route. A tenth group served as a negative control. A subset of birds from each group was euthanised at 3, 5, 7, 14, 21, and 28 days post-inoculation (dpi). Tissues were collected for histology and real-time RT-PCR. All nine viruses were found to be enterotropic; the virus gene copy number in the intestine reached a peak at 5 dpi followed by a sharp decline at 7 dpi. All viruses caused a significant decline in body weight gain of birds as compared to the negative control group. Both TARV and THRV strains replicated in tendons and produced histologic lesions consistent with tenosynovitis. Hepatic lesions were produced by THRV only and the virus was re-isolated from liver and spleen of inoculated birds fulfilling Koch's postulates. The results of this study should be helpful in facilitating diagnosis and designing future mitigation plans.

Amyloodiniosis and vibriosis are serious diseases in European seabass (

In this paper, we report on the design and synthesis of a novel series of quinazoline-2,4(1

Timely cancer treatment improves survival and anxiety for some sites. Patients with esophageal cancer require specific workup before treatment, which can prolong the time from diagnosis to treatment (treatment interval [TI]). The geographical variation of this interval remains uninvestigated in patients with esophageal cancer.This retrospective population-level study conducted in Ontario used linked administrative health care databases. Patients treated for esophageal cancer between 2013 and 2018 were included. The TI was time from diagnosis to treatment. Patients were assigned a geographical Local Health Integration Network on the basis of postal code. Covariates included patient, disease, and diagnosing physician characteristics. Quantile regression modeled TI length at the 50th and 90th percentile and identified associated factors.Of 7509 patients, 78% were male and most were aged between 60 and 69 years. The 50th and 90th percentile TI was 36 (interquartile range, 22-55) and 77 days, respectively. The difference between the Local Health Integration Network with the longest and shortest TI at the 50th and 90th percentile was 18 and 25 days, respectively. Older age (Geographic variability of time to treatment exists across Ontario. Investigation of facility-level differences is warranted. Patient and disease factors are associated with longer wait times. These results might inform future health care policy and resource allocation.

Pediatric acute respiratory distress syndrome (PARDS) remains a significant cause of morbidity and mortality, with mortality rates as high as 50% in children with severe PARDS. Despite this, pediatric lung injury and mechanical ventilation has been poorly studied, with the majority of investigations being observational or retrospective and with only a few randomized controlled trials to guide intensivists. The most recent and universally accepted guidelines for pediatric lung injury are based on consensus opinion rather than objective data. Therefore, most neonatal and pediatric mechanical ventilation practices have been arbitrarily adapted from adult protocols, neglecting the differences in lung pathophysiology, response to injury, and co-morbidities among the three groups. Low tidal volume ventilation has been generally accepted for pediatric patients, even in the absence of supporting evidence. No target tidal volume range has consistently been associated with outcomes, and compliance with delivering specific tidal volume ranges has been poor. Similarly, optimal PEEP has not been well-studied, with a general acceptance of higher levels of FiO2 and less aggressive PEEP titration as compared with adults. Other modes of ventilation including airway pressure release ventilation and high frequency ventilation have not been studied in a systematic fashion and there is too little evidence to recommend supporting or refraining from their use. There have been no consistent outcomes among studies in determining optimal modes or methods of setting them. In this review, the studies performed to date on mechanical ventilation strategies in neonatal and pediatric populations will be analyzed. There may not be a single optimal mechanical ventilation approach, where the best method may simply be one that allows for a personalized approach with settings adapted to the individual patient and disease pathophysiology. The challenges and barriers to conducting well-powered and robust multi-institutional studies will also be addressed, as well as reconsidering outcome measures and study design.

Background:Speculations whether treatment with angiotensin-converting enzyme inhibitors (ACE-I) or angiotensin II receptor blockers (ARB) predisposes to severe coronavirus disease 2019 (COVID-19) or worsens its outcomes. This study assessed the association of ACE-I/ARB therapy with the development of severe COVID-19.Methods:This multi-center, prospective study enrolled patients hospitalized for COVID-19 and receiving one or more antihypertensive agents to manage either hypertension or cardiovascular disease. ACE-I/ARB therapy associations with severe COVID-19 on the day of hospitalization, intensive care unit (ICU) admission, mechanical ventilation and in-hospital death on follow-up were tested using a multivariate logistic regression model adjusted for age, obesity, and chronic illnesses. The composite outcome of mechanical ventilation and death was examined using the adjusted Cox multivariate regression model.Results:Of 338 enrolled patients, 245 (72.4%) were using ACE-I/ARB on the day of hospital admission, and 197 continued ACE-I/ARB therapy during hospitalization. Ninety-eight (29%) patients had a severe COVID-19, which was not significantly associated with the use of ACE-I/ARB (OR 1.17, 95% CI 0.66-2.09; P = .57). Prehospitalization ACE-I/ARB therapy was not associated with ICU admission, mechanical ventilation, or in-hospital death. Continuing ACE-I/ARB therapy during hospitalization was associated with decreased mortality (OR 0.22, 95% CI 0.073-0.67; P = .008). ACE-I/ARB use was not associated with developing the composite outcome of mechanical ventilation and in-hospital death (HR 0.95, 95% CI 0.51-1.78; P = .87) versus not using ACE-I/ARB.Conclusion:Patients with hypertension or cardiovascular diseases receiving ACE-I/ARB therapy are not at increased risk for severe COVID-19 on admission to the hospital. ICU admission, mechanical ventilation, and mortality are not associated with ACE-I/ARB therapy. Maintaining ACE-I/ARB therapy during hospitalization for COVID-19 lowers the likelihood of death.Clinical Trial Registration:ClinicalTrials.gov, NCT4357535.

Objectives We hypothesized that a time-controlled adaptive ventilation strategy would open and stabilize alveoli by controlling inspiratory and expiratory duration. Time-controlled adaptive ventilation was compared with volume-controlled ventilation at the same levels of mean airway pressure and positive end-release pressure (time-controlled adaptive ventilation)/positive end-expiratory pressure (volume-controlled ventilation) in a Pseudomonas aeruginosa-induced pneumonia model. Design Animal study. Setting Laboratory investigation. Subjects Twenty-one Wistar rats. Interventions Twenty-four hours after pneumonia induction, Wistar rats (n = 7) were ventilated with time-controlled adaptive ventilation (tidal volume = 8 mL/kg, airway pressure release ventilation for a Thigh = 0.75-0.85 s, release pressure (Plow) set at 0 cm H2O, and generating a positive end-release pressure = 1.6 cm H2O applied for Tlow = 0.11-0.14 s). The expiratory flow was terminated at 75% of the expiratory flow peak. An additional 14 animals were ventilated using volume-controlled ventilation, maintaining similar time-controlled adaptive ventilation levels of positive end-release pressure (positive end-expiratory pressure=1.6 cm H2O) and mean airway pressure = 10 cm H2O. Additional nonventilated animals (n = 7) were used for analysis of molecular biology markers. Measurements and main results After 1 hour of mechanical ventilation, the heterogeneity score, the expression of pro-inflammatory biomarkers interleukin-6 and cytokine-induced neutrophil chemoattractant-1 in lung tissue were significantly lower in the time-controlled adaptive ventilation than volume-controlled ventilation with similar mean airway pressure groups (p = 0.008, p = 0.011, and p = 0.011, respectively). Epithelial cell integrity, measured by E-cadherin tissue expression, was higher in time-controlled adaptive ventilation than volume-controlled ventilation with similar mean airway pressure (p = 0.004). Time-controlled adaptive ventilation animals had bacteremia counts lower than volume-controlled ventilation with similar mean airway pressure animals, while time-controlled adaptive ventilation and volume-controlled ventilation with similar positive end-release pressure animals had similar colony-forming unit counts. In addition, lung edema and cytokine-induced neutrophil chemoattractant-1 gene expression were more reduced in time-controlled adaptive ventilation than volume-controlled ventilation with similar positive end-release pressure groups. Conclusions In the model of pneumonia used herein, at the same tidal volume and mean airway pressure, time-controlled adaptive ventilation, compared with volume-controlled ventilation, was associated with less lung damage and bacteremia and reduced gene expression of mediators associated with inflammation.

Protective ventilation strategies for the injured lung currently revolve around the use of low Vt, ostensibly to avoid volutrauma, together with positive end-expiratory pressure to increase the fraction of open lung and reduce atelectrauma. Protective ventilation is currently applied in a one-size-fits-all manner, and although this practical approach has reduced acute respiratory distress syndrome deaths, mortality is still high and improvements are at a standstill. Furthermore, how to minimize ventilator-induced lung injury (VILI) for any given lung remains controversial and poorly understood. Here we present a hypothesis of VILI pathogenesis that potentially serves as a basis upon which minimally injurious ventilation strategies might be developed. This hypothesis is based on evidence demonstrating that VILI begins in isolated lung regions manifesting a Permeability-Originated Obstruction Response (POOR) in which alveolar leak leads to surfactant dysfunction and increases local tissue stresses. VILI progresses topographically outward from these regions in a POOR-get-POORer fashion unless steps are taken to interrupt it. We propose that interrupting the POOR-get-POORer progression of lung injury relies on two principles: 1) open the lung to minimize the presence of heterogeneity-induced stress concentrators that are focused around the regions of atelectasis, and 2) ventilate in a patient-dependent manner that minimizes the number of lung units that close during each expiration so that they are not forced to rerecruit during the subsequent inspiration. These principles appear to be borne out in both patient and animal studies in which expiration is terminated before derecruitment of lung units has enough time to occur.

This work aimed to develop accelerator-driven systems (ADSs) with a subcritical thorium assembly for fuel breeding and clean energy utilization by using several seed fuels. The ADS reactor core was...

Feasibility of 199Au production from neutron activated platinum and gold targets at the Egyptian Second Research Reactor was studied. A comparison between theoretical calculations and experimental measurements for the two targets was carried out. A radiochemical separation of 199Au from irradiated Pt target was achieved using chromatographic column packed with modified chabazite material with elution efficiency of 90 ± 0.54% based on the high separation factor between Au and other produced undesired radionuclides. Three quality control tests; radionuclidic, radiochemical and chemical purities were carried out on the eluted 199Au to ensure its safe application in nuclear medicine.

The ideal treatment of non-united and neglected fracture neck femur in the young adult still remains unclear and is characterized by many biological and biomechanical challenges. Twenty-one patients with non-united or neglected fracture neck femur aged between 19 and 50 years were treated by a novel subtrochanteric valgus osteotomy and were followed up for a mean of 26.7 months. Patients were assessed by radiological parameters, the Harris Hip Score, Oxford Knee Score, and Askin Bryan Criteria to categorize the overall outcome of the patients at 24 months. Other outcome measures included the occurrence of AVN, adductor lever arm, leg length discrepancy, and mechanical implant failure. All patients treated with the SALVA osteotomy consolidated and displayed a marked improvement of functional and radiological outcome measures. Nevertheless, there were 2 mechanical failures in patients with marked osteopenia and three developed AVN. In patients with un-united/neglected fracture neck femur, SALVA osteotomy appears to be reliable and reproducible. It also restores the abductor lever arm and improves the leg length discrepancy. Technically less demanding conversion to arthroplasty remains still possible prospectively.

Seasonal influenza viruses constitute a major global concern. Currently, H3N2 and H1N1pdm09 are the commonly circulating influenza A viruses. The haemagglutin and neuraminidase genes of influenza A(H3N2) and A(H1N1)pdm09 viruses from Egyptian paediatric patients with respiratory distress were sequenced. Mutational analysis of all published sequences from Egypt was evolutionary tracked for both HA and NA genes. Phylogenetic analysis of H3N2 HA showed that the Egyptian strains belong to 3C2 subclade while Egyptian A(H1N1)pdm09 strains belong to 6B1 subclade. Some Egyptian A(H1N1)pdm09, 2013-2014, strains form a new subclade; 6B3. High score of mutations were recorded in HA of H1N1pdm09 but higher was recorded in H3N2 strains. These findings confirmed a high mutation rate of influenza A subtypes specially H3N2 strains.

Orthostatic intolerance (OI) is a group of disorders characterized by symptoms that occur upon standing and resolve with recumbence. Although well established but not widely recognized, these diagnoses may create uncertainty for clinicians dealing with a patient affected by OI and requiring a surgical procedure. To determine the rate of intra- and postoperative major adverse events in patients with OI undergoing surgery with general anesthesia. The study was a retrospective study of patients with orthostatic intolerance who underwent surgery requiring general anesthesia from 1 January 2000 to 31 December 2018. A total 171 patients with OI underwent 190 surgeries. In patients with POTS and orthostatic-induced VVS, there were no major significant adverse events. There was one episode of AVNRT in a patient with POTS and one episode of bradycardia secondary to vasovagal reflex in a patient with orthostatic-induced VVS. Moreover, there were 13 (6.8%) episodes of postoperative hypotension. However, the majority of these episodes were related to bleeding, volume depletion or sepsis. All cases of hypotension responded well to appropriate therapy. In patients with OH, the rate of postoperative major adverse cardiac events was 4.7%, and the 30-day mortality rate was 6.1%. This is not significantly different from the calculated risk for patients without OH. There were no myocardial infarctions or deaths at 30 days in patients with POTS or orthostatic-induced VVS. Patients with OI may not experience higher rates of perioperative complications compared with patients without OI syndromes.

This work is concerned with the development of a simple and accurate procedure for trace elements determination in infusion of medicinal plants using neutron activation analysis. The developed scheme involves irradiation of herb (tea in the present work) before immersion into boiled water and then analyzing the induced radioactivity in the infusion using HPGe detector to determine the concentration levels of the extracted elements. Results were corrected for geometry and γ-ray attenuation effects using Monte Carlo simulation. The effects of irradiation dose and infusion period on the extraction process were also evaluated. The developed method proved its efficiency and capability for evaluation of the daily intake of elements reach our body through consumption of medicinal plants.

To assess the capability of Kyoto University Research Reactor to supply the domestic needs of medical isotopes, its neutron flux has been fully characterized. The production rates of theranostics radionuclides 177Lu (from 176Lu (n, γ) 177Lu), 176Lu (n, γ) 177mLu/177Lu and 176Yb (n, γ) $$^{177} {\text{Yb}}\mathop{\longrightarrow}\limits{{\beta^{ - } (1.88\;{\text{hr}})}}^{177} {\text{Lu}}$$ reactions), and 47Sc (from 46Ca (n, γ) $${^{47} {\text{Ca}}} \mathop{\longrightarrow}\limits^{{\beta^{ - } (4.54\;{\text{d}})}} {^{47} {\text{Sc}}}$$ and Ti (n, p) 47Sc) were evaluated. The activity (per gram of target) of 47Sc produced from Ti was found to be 10 times higher than that produced from Ca. Production of 177Lu from the decay of its isomer 177mLu was found to be produce less radioactive wastes than Yb route and can be used as a generator for long-time use.

A novel series of 3-, 4-substituted, and 3,4-di substituted quinazoline derivatives were prepared via various cyclized regents and most of the newly prepared compounds evaluated for their antimicrobial activities in vitro against Gram-positive, Gram-negative bacterial strains and fungi strains. The structures of the quinazoline derivatives have been confirmed using spectroscopic analyses (IR, NMR, and EI-MS). Some of the synthesized derivatives displayed a moderate antimicrobial activity in comparison with reference drugs, for example compounds 13d, 15a, 17b, 18b, 18d, 25, and 29a-c. Among the synthesized compounds, the pyrimidoqunazoline derivative 6c elicited the highest activity.