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In the present paper, regular spacelike spatial Minkowski Pythagorean hodograph (MPH) curves are characterized with rational rotation-minimizing frames (RRMFs). We define an Euler–Rodrigues frame (ERF) for MPH curves and by means of this concept, we reach the definition of MPH curves of type (n,m). Expressing the conditions provided by these curves in the form of a Minkowski–Hopf map that we define; it is aimed to establish a connection with the Lorentz force that occurs during the process of computer numerical control (CNC)-type sinker electronic discharge machines (EDMs). This approach is reinforced by split quaternion polynomials. We give conditions satisfied by MPH curves of low degree to be type (n,m) and construct illustrative examples. In five-axis CNC machines, rotation-minimizing frames are used for tool path planning, and in this way, unnecessary rotations in the tool frame are prevented and tool orientation is provided. Since we obtain MPH curves with RRMF using the ERF, finally we define the Fermi–Walker derivative and parallelism along MPH curves with respect to the ERF and give applications.

General anaesthesia has a priority in surgical interventions of clavicle; however, regional techniques may come to the fore in the presence of increased risk factors. The innervation of the clavicle region is very complex and has not been fully described; therefore, only a limited number of different regional anaesthesia approaches should be considered. Here, we present the management of a clavicle fracture with a combination of an interscalene block (ISB) and deep cervical plexus block (dCPB) in a patient with severe maxillo-facial trauma (MFT) and diaphragmatic hernia due to combat injury. A 35-year-old male admitted to the emergency room as a war-wounded patient had suffered MFT and an unstable clavicle defect during the Syrian War. A diaphragmatic hernia was also detected during examination. The patient underwent operation with regional anaesthesia of the clavicle under spontaneous respiration. With standard monitoring and sedation, ISB and dCPB were performed under ultrasound guidance with a mixture of 0.25% bupivacaine (20 mL) and 0.5% lidocaine (10 mL). In the perioperative period, the patient's vital signs remained stable. The patient had no pain during the surgery. We suggest that the combination of ISB and dCPB is an efficient option for management of clavicle fracture in patients with multiple comorbidities.

Introduction: The ongoing pandemic of the coronavirus disease 2019 (COVID-19) is a global health concern. It has affected more than 5 million patients worldwide and resulted in an alarming number of deaths globally. While clinical characteristics have been reported elsewhere, data from our region is scarce. We investigated the clinical characteristics of mild to moderate cases of COVID-19 in Saudi Arabia. Methods: This is a descriptive, cross-sectional study. Data of 401 confirmed COVID-19 patients were collected from 22 April 2020 to 21 May 2020 at five tertiary care hospitals in Riyadh, Saudi Arabia. The patients were divided into four groups according to age, Group 1: 0–60 years; and their clinical symptoms were compared. Results: The median (IQR) age in years was 10.5 (1.5−16) in group I, 34 (29−41) in group II, 53 (51−56) in group III, and 66 (61−76) in group IV. Most patients were male (80%, n = 322) and of Arabian or Asian descent. The median length of stay in the hospital was 10 (8–17) days (range 3–42 days). The most common symptoms were cough (53.6%), fever (36.2%), fatigue (26.4%), dyspnea (21.9%), and sore throat (21.9%). Hypertension was the most common underlying comorbidity (14.7%), followed by obesity (11.5%), and diabetes (10%). Hypertensive patients were less likely to present with shortness of breath, cough, sputum, diarrhea, and fever. Conclusion: There was no significant difference in the symptoms among different age groups and comorbidities were mostly seen in the older age group. Interestingly, hypertensive patients were found to have milder symptoms and a shorter length of stay. Further larger collaborative national studies are required to effectively understand clinical characteristics in our part of the world to efficiently manage and control the spread of SARS-CoV-2.

This study was aimed to determine the anthropogenic and natural factors affecting hydrological regime of rivers, reliability and safety of hydroelectric facilities. The work of the Uchkurgan hydroelectric complex before and after the commissioning of the Toktogul reservoir with a hydroelectric power station is considered. The observations were conducted over a period of 92 years. A significant decrease in the unevenness of the average long-term water flow has been established for various periods. A homogeneity graph was built, which showed the periods of influence of anthropogenic factors in 1975 and 1990. The following scenarios for determining the maximum water discharges were considered: local water consumption regime, commissioning of the Toktogul reservoir, and energy mode. The estimated verification flow of 0.01% security satisfies the design capacity of the hydroelectric complex of 2720 m3/s..

In this study, the phytochemical composition and the possible prophylactic effects of an aqueous ethanol extract of Haematoxylon campechianum flowers (HCF) on peripheral neuropathic pain in a chronic constriction injury (CCI) rat model are investigated. Rats with induced CCI were subjected to neuropathic pain behaviour tests and evaluated by chemical, thermal, and mechanical sensation tests and functional recovery of the brain stem and sciatic nerve at 7- and 14-day intervals. The effect of the extract on acute pain and inflammation is also investigated. The extract exerted both peripheral and central analgesic and anti-inflammatory properties in addition to antipyretic effects that are clear from targeting COX, LOX and PGE. It was found that CCI produced significant thermal and mechanical hyperalgesia, cold allodynia and deleterious structural changes in both sciatic nerve and brain stem. Treatments with HCF extract significantly improved cold and thermal withdrawal latency, mechanical sensibility and ameliorated deleterious changes of sciatic nerve and brain stem at different dose levels. The extract also ameliorated oxidative stress and inflammatory markers in brain stem and sciatic nerve. It suppressed the apoptotic marker, p53, and restored myelin sheath integrity. The effects of HCF extract were more potent than pregabalin. Fifteen secondary metabolites, mainly gallotannins and flavonoids, were characterized in the extract based on their retention times and MS/MS data. The identified phenolic constituents from the extract could be promising candidates to treat neuropathic pain due to their diverse biological activities, including antioxidant, anti-inflammatory and neuroprotective properties.

Structural elucidation of the active (DFG-Asp in) and inactive (DFG-Asp out) states of the TAM family of receptor tyrosine kinases is required for future development of TAM inhibitors as drugs. Herein we report a computational study on each of the three TAM members Tyro-3, Axl and Mer. DFG-Asp in and DFG-Asp out homology models of each one were built based on the X-ray structure of c-Met kinase, an enzyme with a closely related sequence. Structural validation and in silico screening enabled identification of critical amino acids for ligand binding within the active site of each DFG-Asp in and DFG-Asp out model. The position and nature of amino acids that differ among Tyro-3, Axl and Mer, and the potential role of these residues in the design of selective TAM ligands, are discussed.

Patients with neuropathic pain experience chronic painful tingling, burning, and prickling sensations accompanied with hyperalgesia and/or allodynia. In this study, 38 secondary metabolites of a methanol extract from Salix tetrasperma flowers were identified by liquid chromatography-mass spectrometry (HPLC-MS/MS). The extract showed substantial anti-inflammatory, central and peripheral anti-nociceptive, antipyretic, and antioxidant activities in vitro and in different animal models. In the chronic constriction injury (CCI) rat model, the extract was able to attenuate and significantly relieve hyperalgesia and allodynia responses in a dose dependent manner and restore the myelin sheath integrity and Schwann cells average number in the sciatic nerve. The enzyme-linked immunosorbent assay (ELISA) showed that the extract significantly reduced the expression of various pro-inflammatory biomarkers including nuclear factor kabba B (NF-κB), tumor necrosis factor alpha (TNF-α), prostaglandin E2 (PGE2), 5-lipoxygenase (5-LOX), cyclooxygenase-2 (COX-2), inducible nitric oxide synthase (iNOS), and the oxidative stress biomarker NADPH oxidase 1 (NOX1), in brain stem and sciatic nerve tissues. These findings were supported by in vitro enzyme inhibition assays (COX-1, COX-2 and 5-LOX). Moreover, the extract significantly reduced p53 expression in the brain stem tissue. These findings support the use of S. tetrasperma in folk medicine to alleviate pain. It could be a promising natural product for further clinical investigations to treat inflammation, nociceptive pain and chronic neuropathic pain.

Hepatitis is an inflammatory condition that can develop hepatocellular carcinoma. Traditional medicine has always been the pillar of medical practice. However, it became less compatible with the current understanding of the diseases and the possible treatment. Therefore, in silico tools could be utilized for building the bridge between the legacy of the past and the current medical approaches allowing access to new therapeutic discoveries. In this work, a Chinese traditional medicine database was screened using structure-based virtual screening to identify molecules that could inhibit p38 alpha mitogen-activated protein kinase (MAPK). Out of the identified compounds, four selected compounds: chrysophanol, physcion, curcumin and hesperidin were isolated from their respective sources and their structures were confirmed by spectroscopic methods. These compounds decreased the gene expression of tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6) and interleukin-1beta (IL-1β) in lipopolysaccharide (LPS) induced inflammation in a hepatocellular carcinoma cell line (HepG2) in a dose-dependent manner. The molecular docking study revealed the specificity of these compounds towards p38 MAPK rather than other MAPKs. In conclusion, the molecular and in silico studies suggest that the isolated compounds could be a potential treatment for hepatitis by resolving inflammation controlled by MAPKs, thus limiting the development of further complications and lower side effects.

Background: Health intervention implementation in Aotearoa New Zealand (NZ), as in many countries globally, usually varies by ethnicity. Māori (the Indigenous peoples of Aotearoa) and Pacific peoples are less likely to receive interventions than other ethnic groups, despite experiencing persistent health inequities. This study aimed to develop an equity-focused implementation framework, appropriate for the Aotearoa NZ context, to support the planning and delivery of equitable implementation pathways for health interventions, with the intention of achieving equitable outcomes for Māori, as well as people originating from the Pacific Islands., Methods: A scoping review of the literature to identify existing equity-focused implementation theories, models and frameworks was undertaken. One of these, the Equity-based framework for Implementation Research (EquIR), was selected for adaptation. The adaptation process was undertaken in collaboration with the project's Māori and consumer advisory groups and informed by the expertise of local health equity researchers and stakeholders, as well as the international implementation science literature., Results: The adapted framework's foundation is the principles of Te Tiriti o Waitangi (the written agreement between Māori rangatira (chiefs) and the British Crown), and its focus is whānau (extended family)-centred implementation that meets the health and wellbeing aspirations, priorities and needs of whānau. The implementation pathway comprises four main steps: implementation planning, pathway design, monitoring, and outcomes and evaluation, all with an equity focus. The pathway is underpinned by the core constructs of equitable implementation in Aotearoa NZ: collaborative design, anti-racism, Māori and priority population expertise, cultural safety and values-based. Additionally, the contextual factors impacting implementation, i.e. the social, economic, commercial and political determinants of health, are included., Conclusions: The framework presented in this study is the first equity-focused process-type implementation framework to be adapted for the Aotearoa NZ context. This framework is intended to support and facilitate equity-focused implementation research and health intervention implementation by mainstream health services., (© 2024. The Author(s).)

With the rapid development of e-commerce and the impact of COVID-19, online takeout has become the first choice of more and more consumers. Previous research has indicated that food packaging is of great significance to marketing performance, yet very little is known about the mechanisms through which food packaging pollution risk affects online takeout consumption. This study proposes an expanded model of the Theory of Planned Behavior (TPB) by incorporating the Concept of Perceived Risk (CPR) to analyze the mechanism of consumers' packaging pollution risk perception (PPRP) on their purchasing intention toward online takeout. Online survey was performed to collect data from 336 valid respondents in China, which was analyzed using structural equation modeling. The research findings verify the effectiveness of the TPB in the context of Chinese online takeout. Notably, the PPRP of online takeout was found to have a significant negative impact on consumers' attitudes, subjective norms, and perceived behavioral control (PBC). It was also confirmed that consumers' attitudes, subjective norms, and PBC regarding online takeout partially mediate the negative relationship between PPRP and purchase intention. In addition, the findings corroborate the granular nuances among three groups concerning consumers' education level. The results do not only provide suggestions to the online takeout industry but also contribute theoretical value and practical significance for the improvement of sustainable food consumption., Competing Interests: Competing interestsThe authors declare no competing interests., (© The Author(s) 2023.)

We perform collective spin measurements to study the buildup of two-body correlations between ≈10^{4} spin s=3 chromium atoms pinned in a 3D optical lattice. The spins interact via long range and anisotropic dipolar interactions. From the fluctuations of total magnetization, measured at the standard quantum limit, we estimate the dynamical growth of the connected pairwise correlations associated with magnetization. The quantum nature of the correlations is assessed by comparisons with analytical short- and long-time expansions and numerical simulations. Our Letter shows that measuring fluctuations of spin populations for s>1/2 spins provides new ways to characterize correlations in quantum many-body systems.

Background: Abdominal surgeries are the most common surgeries performed around the world. Closure of abdominal wound is important and a number wound closing techniques are in practice. This study was conducted to determine the outcome of the choice of wound closure technique in emergency laparotomy., Methods: It was a retrospective study from March-September 2019, conducted at the Surgical A unit, Ayub Teaching Hospital, Abbottabad. Ninety-five patients aged 22-60 years, who underwent emergency laparotomies via midline and para-median incisions were included in the study., Results: There were 74 (77.89%) males and 21 (22.11%) females. Anatomical closure technique was used in 67 (70.53%) of study participants while mass closure technique was used in 28 (29.47%) of study participants. 50 (52.63%) patients had anaemia, 27 (28.42%) had hypo-proteinemia, and 14 (14.74%) developed peritonitis. Post-operative wound infection was noticed in 15 (15.79%) patients. Out of 95 patients, 19 (20%) developed burst abdomen. Overall, 5 (5.26%) patients died in the hospital. All cases of burst abdomen occurred within first two weeks of hospital stay (p= 0.004), had an association with peritonitis (p=0.0001) and post-operative wound infection (p= 0.005). Wound closure technique was not associated with development of post-operative complications including burst abdomen (p >0.05)., Conclusions: Postoperative complications occur independently of wound-closure technique and surgeons should have a low threshold for prevention of post-operative complications where possible.

International Scientific Optical Network (ISON) is an open international voluntary project specializing in observations of the near-Earth space objects. Observatories collaborating with ISON provide the global coverage and successfully combine the observations of the space debris and asteroids. The network includes more than 50 telescopes of 27 observatories in 15 countries and has been working since 2005. ISON monitors the whole GEO region and tracks the objects at GEO, GTO, HEO and LEO. ISON data allowing maintenance of the database of the space objects orbits, validating space debris population model and providing conjunction assessment analysis for satellites at high orbits. ISON develops the technology of asteroid survey with small telescopes and arranges regular photometry observations of near-Earth asteroids (NEA) to investigate the YORP effect, search new binary NEAs, and support radar experiments.

In cases of death due to burn injury, it may be of great medico-legal importance to determine if the death is caused by fatal burn injury or due to other factors related to treatment. Therefore, this study aimed to investigate early predictors of mortality in patients with thermal burns admitted to Burn Unit, Ain Shams University Hospitals during a period of one year (2011). The study included 152 cases, mortalities represented 20.4% of the included cases (31 cases). Binary logistic regression analysis showed that, total body surface area (TBSA) of the burns and APACHE III score were significant predictors of mortality. This model resulted in accurate classification of 95.9% of the cases. Further multi-centric studies on larger sample sizes are recommended to validate the results of this study. Also, it is important to study the effect of co-morbidities as confounding factors on the prediction of mortality in patients with thermal burns., (Copyright © 2019 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.)

Waugh's syndrome (WS) is the rare association of intussusception and intestinal malrotation. We present two such cases in a 5-month-old infant and a 9-year-old girl. Both patients presented with intussusception and were diagnosed with malrotation during workup and surgical exploration. We conclude that the possibility of intestinal malrotation must be taken into consideration while managing children with intussusception.

Disc battery ingestion and esophageal injury is well-known in children. Insertion of a disc/lithium battery into body's natural orifices is rarely reported. We present a case of self-insertion of a lithium battery into the vagina by a 2 ½ year old female. Vaginoscopy was performed and the battery was retrieved which had corroded and caused vaginal ulceration. Post-operative outcome was favorable. Treating physicians must be aware of the hazardous effects of insertion of lithium batteries as it may cause significant damage in a short period.

A neonate with patent urachus (PU) who later developed hypertrophic pyloric stenosis (HPS) is being reported. The newborn was first operated for PU; post-operatively he developed persistent vomiting and radiological workup confirmed HPS. Pyloromyotomy was performed with an uneventful recovery.

Gossypiboma (GP) or retained surgical sponge is one of the rare surgical complications which can happen despite precautions. Because of the medico-legal issues, it is under-reported. An 8-year-old thalassemic girl, with a history of splenectomy and cholecystectomy, presented to us with acute intestinal obstruction and required surgical exploration. Intraluminal gossypiboma obstructing the ileum was found. Though a rare cause, gossypiboma should also be included in the differential diagnoses of postoperative intestinal obstruction.

SLE is a heterogeneous disease, characterized by variation in clinical and serological manifestations. This study intended to verify the role of anti-nucleosome (anti-NCS) antibodies in diagnosis of SLE and lupus nephritis and to establish the correlation between antibody reactivity and disease activity. Study subjects included 35 patients diagnosed as SLE and two control groups. While the first is a group with other collagen diseases (n = 80), the second included 50 matched apparently healthy subjects. Serum IgG anti-NCS antibodies in all subjects were detected by ELISA. Serum anti-NCS were higher in SLE than in the two control groups (P < 0.001). Serum anti-NCS antibody levels were higher in SLE patients with renal affection (P < 0.001), malar rash and with hematological disorders (P < 0.05). Anti-NCS antibodies showed a higher diagnostic sensitivity (74.7%) and specificity (96%) than anti-dsDNA. Combining data of anti-NCS and anti-dsDNA antibodies increased the diagnostic specificity to 97.3%. In conclusion, serum anti-NCS antibodies have diagnostic value and play role in the assessment of disease activity especially active renal disease and may predict disease outcome.

Amyand's hernia is a rare clinical condition in which a normal or an inflamed appendix lies in the inguinal hernial sac. Perforated appendicitis in an Amyand's hernia is even more uncommon. Herein we report such a rare case in a 4 month old baby who presented with an irreducible right inguino-scrotal swelling. Exploration revealed perforated appendix in the hernial sac with local abscess. A transherniotomy appendectomy was done. Postoperatively, the patient developed wound infection, which resolved with wound care. Pediatric / hernia surgeons must remember this rare clinical situation while managing children with acute right inguino-scrotal swellings.

Background: Different laser systems are reported to be effective in treatment of telangiectasia and erythema, but comparative studies on 1064-nm neodymium-yttrium aluminum garnet (Nd-YAG) laser and pulsed dye laser (PDL) in treatment of erythemato-telangiectatic rosacea are lacking. Substance (P) is implicated in rosacea pathogenesis., Objectives: To compare the effect of Nd-YAG laser and PDL on erythemato-telangiectatic rosacea, both clinically and immunohistochemically on cutaneous substance (P) expression., Methods: This split-face comparative study included 15 patients with erythemato-telangiectatic rosacea treated on the right side with Nd-YAG laser and on the left side with PDL: three sessions, 4 weeks apart. Evaluation of the patients was done using erythema and telangiectasia grading scores, patient's self-assessment, physicians' clinical assessment of the patient, and immunohistochemical assessment of substance (P)., Results: One month after the three laser sessions, excellent response was achieved in 73.3% of patients after Nd-YAG and in 53.3% of patients after PDL with significantly lower substance (P) concentration after Nd-YAG laser than after PDL. Positive correlations were found between the decrease in erythema and telangiectasia grading scores and the decrease in substance (P) concentration., Conclusions: The use of Nd-YAG laser and PDL appears to be safe and effective measures in treatment of erythemato-telangiectatic rosacea. Both types of laser decrease the concentration of substance (P) in the skin. This effect is more pronounced with Nd-YAG laser., (© 2013 Wiley Periodicals, Inc.)

Background: Stem cell-based therapy has received attention as a possible alternative to organ transplantation. The aim of this study was to assess the safety and efficacy of autologous transplantation of bone marrow (BM)-derived stromal cells in post-HCV liver cirrhosis patients., Methodology: 10 × 10(6) of isolated human bone marrow (HBM)-stromal cells in 10 mL normal saline were injected in the spleen of 20 patients with end-stage liver cirrhosis guided by the ultrasonography, and then patients were followed up on monthly basis for six months., Results: A statistically significant decrease was detected in the total bilirubin, aspartate transaminase (AST), alanine transaminase (ALT) (p-value<0.01), prothrombin time (PT), and international normalized ratio (INR) levels (p-value<0.05), while a statistically significant increase in the albumin and PC (p-value<0.05) after follow-up., Conclusion: This study suggested the safety, feasibility, and efficacy of the intrasplenic injection of autologous BM stromal cells in improving liver function in Egyptian patients with cirrhosis., (© 2013 John Wiley & Sons A/S.)

Acute appendicitis is a rare condition in neonates, with a high mortality. If perforated, it seldom presents with radiologically significant pneumoperitoneum. An 11-day-old newborn presented with abdominal distension and reluctance to feeds. X-ray abdomen revealed significant pneumoperitoneum. After optimization of his condition, exploratory laparotomy was performed. Perforated appendix was found and appendicectomy done. Post operative course was stormy that lead to demise of the baby.

Maffucci's syndrome is a rare non hereditary disorder characterized by multiple enchondromas and haemangiomas. A 12 year old boy presented with a painful swelling at his right hand and deformed left upper limb. On detailed workup, he was found to have multiple enchondromas involving long bones and a single haemangioma. A diagnosis of Maffucci's syndrome was established. The clinical features and workup of the disease in our patient is reported.

Empyema thoracis is a well known complication following para-pneumonic effusions in paediatric age group. Usually it is unilateral but rarely could be bilateral. Herein we report a case of bilateral tuberculous empyema thoracis in a 12 years old, unvaccinated girl with a positive history of contact with tuberculosis. She was managed conservatively with tube thoracostomies and anti-tuberculous drugs. Emphasis is on the conservative approach and patience in management of patients with bilateral empyema thoracis.

Pneumoperitoneum in neonates is not an uncommon condition. Free air in peritoneum may be secondary to host of pathological lesions. Usually the patient presents with signs of intraperitoneal sepsis, however presence of air in the scrotum as a concomitant sign is a rare event. Herein we report a 4-day-old neonate who presented with 2 days history of fever and scrotal swelling. Abdominal signs were subtle. Scrotum was hugely distended and tense. Workup of the patient revealed free intraperitoneal gas with air in the scrotum. At exploration, two perforations were found near the greater curvature of stomach and repaired. Post-operative course was uneventful.

Anterior sacral meningocele is a rare condition presenting as a lower abdominal mass. One such case was seen in a baby girl aged 2 months, who was admitted with abdominal distension and urinary difficulty for one week. She had a lower abdominal mass which investigated by MRI, turned out to be an anterior sacral meningocele causing her symptoms. The meningocele was excised successfully via an open abdominal approach. Postoperative recovery and follow-ups remained uneventful. Presentation, various diagnostic modalities and treatment options for an anterior sacral meningocele are briefly discussed.