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Schubert-Bornschein (SB) is the most common type of people with congenital stationary night blindness (CSNB). The aim of the study is to describe the optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) findings in patients with SB CSNB.Prospective, observational case series including three patients with genetically confirmed CSNB along with matched controls, who underwent complete ophthalmic examination and multimodal imaging.On SD-OCT, a significant focal outer plexiform layer (OPL) thickening and a corresponding focal outer nuclear layer (ONL) thinning were identified in the macular area (p 0.001). OCTA analysis overall showed decreased density of macular deep capillary plexus (mDCP) and macular choriocapillaris (mCC) (p = 0.008 and p = 0.033, respectively). DCP vessel density in the area corresponding to OPL thickening was significantly increased compared to the remaining retina (p 0.001).SB CSNB is characterized by retinal vascular impairment, as detected on OCTA.

Numerical study has been conducted to investigate shock waves generated by flashing water jet. This study presents results of a numerical simulation of flash evaporation phenomena occurring when a jet of superheated water is injected through a nozzle into low-pressure water vapor. Due to the sudden pressure drop, flashing takes place, and the sensible heat of the water converts into latent heat of evaporation. The multiphase flow field in the evaporation zone and induced shock waves are explored via a 2D transient investigation in Ansys Fluent. The Mixture model is applied with slip velocities to model the non-homogeneous multiphase flows. Resulting distributions of the fluid properties velocity, Mach number, pressure, liquid volume fraction, density, and in addition to speed of sound inside the flashing chamber at different time steps are presented and discussed. The results show that once the superheated water is injected, it flashes immediately and generates a shock wave. The primary and reflected shock waves are characterized by discontinuous fluid properties in a narrow region across the shock. The generated shock waves are moving shock waves and can be useful to transfer energy directly between fluids without using mechanical components such as pistons or vaned impellers, which can be exploited in industrial and technological applications such as utilizing resulting shock waves in creating useful compression.

Background: T. gondii is an intracellular protozoan parasite that can establish a latent infection in thecentral nervous system that may develop into chronic inflammation resulting in neurobehavioral problemsin the host. The processes behind these alterations are still largely mysterious.Objective: Detection of behavioral, histopathological and immunohistochemical changes in mice infectedby T. gondii Me49 strain.Material and Methods: A total of 105 adult male Swiss albino mice were divided into 60 used forexperimental infection, and 45 as control. Assessment of physical appearance was monitored foracute toxoplasmosis daily for three weeks post infection (PI). Correlation between behavior changesand the degree of infection was conducted by measuring histopathological (H&E and silver stain) andimmunohistochemical (presence or absence of CD3, CD138 and caspase-3 immunoreactive cells)parameters weekly starting from 7th week to the 12th week PI.Results: Infected mice had neurobehavioral problems. Variable degrees of perivascular and interstitialinflammatory infiltrates, astrocytosis, deteriorated neurons, and meningitis were demonstrated byhistopathology when compared to uninfected controls. Inflammatory cells (mainly lymphocytes) enteredthe parenchyma at mild, moderate, and severe levels in the brains of infected mice. Immunohistochemicalassessment of CD3, CD138 and caspase-3 revealed a substantial increase in CD3 expression by clusters ofactivated astrocytes in the cerebral parenchyma, suggesting an increase in astrocyte numbers and functionthat was progressive over time. CD138 and caspase-3 immunoreactivity showed decreased expression bythe activated astrocytes.Conclusion: Chronic toxoplasmosis causes deterioration in cognitive and emotional behavior of theinfected host, resulting in neuropsychiatric and behavioral disturbances.

Background: p16 is a tumor suppressor protein important in regulating cell cycle. In bladder cancer, p16 mutations are widespread and tend to be more prevalent in low-grade superficial tumors than in higher-grade invasive tumors. Objective: To evaluate expression of p16 in 25 cases of cervical squamous cell carcinoma and 25 cases of urinary bladder squamous cell carcinoma. Patients and methods: This study was carried out in the Histopathology Department of Al-Azhar University Hospitals and from some private laboratories during the period from August 2019 up to January 2020. H & E stained sections were prepared from paraffin blocks for revision of diagnosis. Immunohistochemical analysis was done on 4 micron sections of formalin-fixed paraffin-embedded tissue using the labeled streptavidin-biotin method after antigen retrieval. Antibodies against P16 were utilized on sections from paraffin blocks. CINtec Histology kit includes a two-step antibody method for detection of human p16 antibody. Results: Expression of P16 was positive in 92% of cases of squamous cell carcinoma of the uterine cervix and 60% of cases squamous cell carcinoma of the urinary bladder. In patients with cervical squamous cell carcinoma, there was statistically significant relation between intensity of P16 staining and tumor grading. In patients with squamous cell carcinoma of the urinary bladder, there was a statistically significant relation between intensity of P16 staining and tumor grading and staging. Moderate/strong staining intensity can predict staging 2B among patients with squamous cell carcinoma of the uterine cervix, and negative/weak staining intensity can predict staging 1A, 1B, 2A with sensitivity 52.9% and specificity 37.5% among patients with squamous cell carcinoma of the urinary bladder. Conclusion: p16 immunohistochemical expression alone should not be used as a marker for differentiation between cervical and urinary squamous cell carcinoma.

Background Papillomas of the breast pose challenges for treatment decisions as their risk for transformation to breast cancer is low but not negligible. To spare low-risk patients the burden of substantial treatment side effects, prognostic indicators are needed for cancerous progression. The secreted metastasis mediator Osteopontin (OPN) is a marker for breast cancer aggressiveness, and its variants are prognosticators for transformation in diverse premalignant breast lesions. Here, we test whether the presence of OPN-c or OPN-exon-4 in papillomatous lesions may reflect progression risk. Methods By immunohistochemistry, we analyze OPN-c and OPN-exon-4 in papillomas from 114 women as well as correlations between staining and progression. In departure from prior spliced OPN biomarker publications, we utilize novel monoclonal antibodies. Results Fewer than 5% of OPN-c pathology score 0–1 (intensity) versus almost 18% of score 2–3 experienced cancer in follow-up. Nine of 12 women, who progressed, had pathology scores of 2–3 for OPN-c intensity at the time of initial diagnosis, and none had a score of 0. When developing a combined risk score from intensity plus percent positivity for OPN-c, the progression risk for patients with low score was 3.2%, for intermediate score was 5.7%, and for high score was 18.8%. Papillomas in patients, who were later diagnosed with cancer in the contralateral breast, displayed stronger staining positivity than non-progressors. Conclusion OPN splice variant immunohistochemistry on biopsies of breast papillomas will allow counseling of the patients on their risk to develop breast cancer at a later time.

Vehicular ad hoc networks (VANETs) were initially designed to assist in traffic management and delivery of safety messages. Due to the significant evolution in modern vehicles, the features offered by VANETs have expanded to include comfort and entertainment relevant services. This expansion has further increased the need to secure them. The security of VANETs is mainly dependent on sharing a cryptographic group key confidentially. Due to the frequent change in group membership, there is a need to update the group key repeatedly, which is difficult in highly dynamic networks like VANETs. Therefore, designing a secure, scalable, and efficient group key management protocol is challenging. Existing group key management protocols introduce a variety of limitations, including high computational cost for both group key computation and retrieval, additional computational and communication overhead when the membership in the group changes, and collusion among receiving vehicles. To overcome these limitations, this paper introduces a novel group key management protocol, $ALMS$ . Performance analysis reveals that, compared to existing protocols, $ALMS$ is more scalable since it introduces a low computational overhead for both the Trusted Authority (TA) and the receiving vehicles. Also, it does not suffer from the key distribution limitation as symmetric key management protocols do. Moreover, $ALMS$ introduces only a light overhead on the TA for group membership change. This is achieved by decoupling the initialization from group key computation and performing it offline without affecting the size of the encrypted group key.

Introduction: Chronic inflammation causes articular bone and cartilage degeneration in people with rheumatoid arthritis (RA). Despite recent advancements in the management of RA, adverse side effects and ineffective treatments remain a problem. Access to treatment is hampered by financial restrictions. As a result, medications that reduce inflammation and bone resorption that are both safe and less expensive are required. Mesenchymal stem cells (MSCs) have recently been identified as a potential therapy for RA. Aim of study: The aim of this study was to examine the anti-arthritic effect of rat bone marrow-MSCs, oligosaccharides and human placental extract, individually and combined on RA model, using Complete Freund's adjuvant (CFA) induced arthritis in rats. Materials and methods: In female rats, RA was induced by injecting CFA in the paw of hind limb. Rat bone marrow-MSCs, oligosaccharides, and human placental extract (HPE) were given individually and in combination via intra-peritoneal route. Complete blood picture (CBC), erythrocyte sedimentation rate (ESR), serum cortisol, urea, uric acid and other biochemical parameters were measured to determine the safety and efficacy of the different treatments. Histopathological analysis of bone sections was carried out.Result: Combining oligosaccharides and HPE with rat-bone marrow MSCs had a favorable anti-arthritic and anti-inflammatory effect in CFA-induced arthritis in rats, with no negative effects on CBC, renal functions, serum cortisol, ESR, and liver enzymes. Histopathological analysis showed healing and remodeling of osteoporotic lesions in arthritic rats. Conclusion: Combination of rat MSCs, oligosaccharides and HPE has potential to be an effective treatment for rheumatoid arthritis.

ObjectivesPaediatric cancer is a leading cause of death for children. Children in low-income and middle-income countries (LMICs) were four times more likely to die than children in high-income countries (HICs). This study aimed to test the hypothesis that the COVID-19 pandemic had affected the delivery of healthcare services worldwide, and exacerbated the disparity in paediatric cancer outcomes between LMICs and HICs.DesignA multicentre, international, collaborative cohort study.Setting91 hospitals and cancer centres in 39 countries providing cancer treatment to paediatric patients between March and December 2020.ParticipantsPatients were included if they were under the age of 18 years, and newly diagnosed with or undergoing active cancer treatment for Acute lymphoblastic leukaemia, non-Hodgkin’s lymphoma, Hodgkin lymphoma, Wilms’ tumour, sarcoma, retinoblastoma, gliomas, medulloblastomas or neuroblastomas, in keeping with the WHO Global Initiative for Childhood Cancer.Main outcome measureAll-cause mortality at 30 days and 90 days.Results1660 patients were recruited. 219 children had changes to their treatment due to the pandemic. Patients in LMICs were primarily affected (n=182/219, 83.1%). Relative to patients with paediatric cancer in HICs, patients with paediatric cancer in LMICs had 12.1 (95% CI 2.93 to 50.3) and 7.9 (95% CI 3.2 to 19.7) times the odds of death at 30 days and 90 days, respectively, after presentation during the COVID-19 pandemic (pConclusionsThe COVID-19 pandemic has affected paediatric oncology service provision. It has disproportionately affected patients in LMICs, highlighting and compounding existing disparities in healthcare systems globally that need addressing urgently. However, many patients with paediatric cancer continued to receive their normal standard of care. This speaks to the adaptability and resilience of healthcare systems and healthcare workers globally.

Background The majority of lung cancer (LC) cases are diagnosed at an advanced stage. Poor awareness of LC symptoms is a contributor to late diagnosis. This study aimed to assess the awareness of LC symptoms among Palestinians, and to examine the factors associated with displaying good awareness. Methods Participants were recruited from hospitals, primary healthcare centers and public spaces using convenience sampling. A translated-into-Arabic version of the validated LC awareness measure was used to assess recognition of 14 LC symptoms. One point was given for each recognized symptom. The total score was calculated and categorized based on the number of symptoms recognized: poor (0–4), fair (5–9), and good (10–14). Multivariable logistic regression was used to examine the association between participant characteristics and having good awareness. The multivariable analysis adjusted for age-group, gender, education, monthly income, occupation, residence, marital status, any chronic disease, knowing someone with cancer, smoking history, and site of data collection. Results Of 5174 potential participants approached, 4817 completed the questionnaire (response rate = 93.1%) and 4762 were included in the final analysis. Of these, 2742 (56.9%) were from the West Bank and Jerusalem (WBJ) and 2020 (43.1%) were from the Gaza Strip. Participants from the WBJ were older, had higher monthly income but lower education, and suffered from more chronic diseases. The most recognized respiratory LC symptom was ‘worsening in an existing cough’(n = 3884, 81.6%) while the least recognized was ‘a cough that does not go away for two or three weeks’(n = 2951, 62.0%). The most recognized non-respiratory LC symptom was ‘persistent tiredness or lack of energy’(n = 3205, 67.3%) while the least recognized was ‘persistent shoulder pain’(n = 1170, 24.6%). A total of 2466 participants (51.8%) displayed good awareness of LC symptoms. Participants from both the Gaza Strip and the WBJ had similar likelihoods to have good awareness levels. Factors associated with a higher likelihood to display good awareness included female gender, having post-secondary education, being employed, knowing someone with cancer, and visiting hospitals and primary healthcare centers. Conclusion About half of the study participants displayed a good level of awareness of LC symptoms. Further improvement in public awareness of LC symptoms by educational interventions might reduce LC mortality by promoting early diagnosis.

To analyze the recovery course of foveal microstructures in eyes with nonsurgical healing of full-thickness macular hole (FTMH).By serial OCT scans, the temporal healing sequences were analyzed in ocular trauma, vitreomacular traction (VMT), cystoid macular edema (CME), and the remaining group. We evaluated correlations between the final best-corrected spectacle visual acuity and reconstruction time of external limiting membrane (ELM), and inner segment/outer segment (IS/OS).The healing (mean±standard deviation in months) most involved fusion at the level of the outer nuclear layer (ONL) (6.3±10.5) followed by restoration of ELM (9.1±13.8), and lastly, by IS/OS regeneration (13.1±19.5). In severe blunt ocular trauma, healing was fast and involved subretinal zipper glue-like reapposition with resulting outer retinal atrophy. Best spectacle-corrected visual acuity correlated with normalization of the clivus (p=0.012), faster ELM (p=0.006), and IS/OS reconstitution (p=0.024). Recurrence of FTMH occurred when the healing was halted (3 eyes) or was aberrant by lamellar hole epiretinal proliferation (LHEP) (3 eyes) or by the persistence of VMT (1 eye).Recovery sequences proceeded from the ONL to the deeper layers with BCVA correlating absolutely and temporally with the restoration of outer retinal layer integrity.

Measurable residual disease (MRD) in plasma cell myeloma is one of the most important determinants for patients' outcome. Several laboratory tests exist to assess for the presence of MRD with variable accuracy. The aim of this study is to examine the sensitivity of immunofixation electrophoresis (IFE), serum free light chain (FLC), bone marrow immunohistochemistry (IHC), and multicolor flow cytometry (FC) and to address potential caveats of each test.Forty patients of plasma cell myeloma who were diagnosed with a positive MRD were retrospectively included in this study. The results of IFE and serum FLC at the time of bone marrow biopsy were collected.In all cases, malignant plasma cells constituted less than 5% of bone marrow cells. MRD was detected by FC in 38 cases (95%) and by IHC in 28 cases (70%). In 2 cases, residual malignant plasma cells appeared in the subcortical area which is difficult to aspirate, and thus they were detected by IHC but not by FC. Among the entire cohort, 38 patients (95%) had positive IFE at the time of bone marrow biopsy, while serum FLC abnormality was detected in 19 patients (48%) only.Both FC and IFE exhibited high sensitivity in detecting MRD in plasma cell myeloma with comparable results. IFE remains less invasive and less expensive than FC. Despite the lower sensitivity of bone marrow IHC staining, its diagnostic role is essential and can be superior to FC in a subset of cases, for which its routine examination is recommended. Serum FLC test provided the least sensitivity among all tests.

ObjectivesTo evaluate lung cancer (LC) risk factor awareness among Palestinians and identify factors associated with good awareness.DesignCross-sectional study.SettingsParticipants were recruited using convenience sampling from hospitals, primary healthcare centres (PHCs) and public spaces located at 11 governorates in Palestine.ParticipantsOf 5174 approached, 4817 participants completed the questionnaire (response rate=93.1%). A total of 4762 questionnaires were included: 2742 from the West Bank and Jerusalem (WBJ) and 2020 from the Gaza Strip. Exclusion criteria were working or studying in a health-related field, having a nationality other than Palestinian and visiting oncology departments or clinics at the time of data collection.ToolA modified version of the validated LC Awareness Measure was used for data collection.Primary and secondary outcomesThe primary outcome was LC risk factor awareness level as determined by the number of factors recognised: poor (0–3), fair (4–7) and good (8–10). Secondary outcomes include the recognition of each LC risk factor.ResultsSmoking-related risk factors were more often recognised than other LC risk factors. The most recognised risk factors were ‘smoking cigarettes’ (n=4466, 93.8%) and ‘smoking shisha (waterpipes)’ (n=4337, 91.1%). The least recognised risk factors were ‘having a close relative with LC’ (n=2084, 43.8%) and ‘having had treatment for any cancer in the past’ (n=2368, 49.7%).A total of 2381 participants (50.0%) displayed good awareness of LC risk factors. Participants from the WBJ and the Gaza Strip had similar likelihood to display good awareness (50.6% vs 49.1%). Being≥45 years, having higher education and monthly income, knowing someone with cancer and visiting hospitals and PHCs seemed to have a positive impact on displaying good awareness.ConclusionHalf of study participants displayed good awareness of LC risk factors. Educational interventions are warranted to further improve public awareness of LC risk factors, especially those unrelated to smoking.

Mündigkeit ist für eine aufgeklärte, plurale Lebensweise und demokratische Gesellschaftsordnung eine sine qua non, also eine unerlässliche Notwendigkeit. Bildung, Erziehung, Familienstrukturen uvm sind darauf ausgerichtet, dass junge Menschen befähigt werden eigenverantwortlich zu handeln und kritisch zu denken. Kollektivistische Gesellschaften, die häufig patriarchale und religiöse Strukturen aufweisen, beruhen auf dem Gehorsam gegenüber Älteren und/oder männlichen Familienmitgliedern, wodurch der Fortbestand des Kollektivs gesichert wird. Kommen Faktoren wie Lebenskrisen, biographische Brüche, Mobbing, das Gefühl der Entfremdung und abgehängt worden zu sein, eine fehlende oder eine gar repressive Vaterfigur hinzu, sind günstige Bedingungen für die Empfänglichkeit radikaler Missionierungsversuche geschaffen. Wie können Jugendliche und junge Menschen vor Radikalisierungsbestrebungen geschützt werden? Welche Instrumentarien der aktuellen Präventionsarbeit stehen hierfür zur Verfügung? Diese Fragen werden in diesem Artikel anhand der Workshop-Projekte „ReStart“, „Reflect“ und „ReThink“ der Mansour-Initiative für Demokratieförderung und Extremismusprävention erörtert.

Flash evaporation or flashing is an evaporation phenomenon caused by a sudden pressure drop sufficiently below the saturation pressure. Due to this sudden drop in pressure, the liquid undergoes a quick phase transition and the sensible heat of the liquid converts into latent heat of evaporation. An accidental release of pressurized liquid from supply pipelines or liquid storage tanks can generate a flashing jet with violent phase change. This fast phase change can cause rapid mixture with an oxidant like air and if the liquid is flammable, disastrous effects such as explosions, fires, and damage to industrial equipment can occur. On the other side, flash evaporation can be beneficially employed in industrial applications. It can have a significant effect on the performance of many devices (i.e. injectors and reactors). This work reviews studies devoted to understanding flashing processes. The review includes experimental, theoretical, and numerical studies related to flashing phenomena, their applications and consequences. Furthermore, the review presents shock waves as one of significant consequences that can be produced by flashing evaporation. The understanding of the fluid behavior of the flash evaporation and the resultant shock waves can help to prevent disastrous consequences that may occur due to accidental fluid release as well as can be useful to further develop the phenomena’s industrial and technological applications such as utilize resulting shock waves in creating useful compression.

Staphylococcus pettenkoferi is a recently described coagulase-negative Staphylococcus identified in human diseases, especially in infections of foot ulcers in patients living with diabetes mellitus. To date, its pathogenicity remains underexplored. In this study, whole-genome analysis was performed on a collection of 29 S. pettenkoferi clinical strains isolated from bloodstream and diabetic foot infections with regard to their phylogenetic relationships and comprehensive analysis of their resistome and virulome. Their virulence was explored by their ability to form biofilm, their growth kinetics and in an in vivo zebrafish embryo infection model. Our results identified two distinct clades (I and II) and two subclades (I-a and I-b) with notable genomic differences. All strains had a slow bacterial growth. Three profiles of biofilm formation were noted, with 89.7% of isolates able to produce biofilm and harbouring a high content of biofilm-encoding genes. Two virulence profiles were also observed in the zebrafish model irrespective of the strains’ origin or biofilm profile. Therefore, this study brings new insights in S. pettenkoferi pathogenicity.

Today’s maintenance and renewal planning in transformer stations of energy distribution networks is mainly based on expert knowledge, experience gained from historical data as well as the knowledge gathered from regular on-site inspections. This approach is already reaching its limits due to insufficient databases and almost no information about the stations’ condition being gathered between inspection intervals. A condition-based strategy that requires more maintenance for equipment with a high probability of failure is needed. Great potential is promised by intelligent sensor-based diagnostics, where objective comparability can be achieved by condition monitoring of the station fleet. Cost-effective micro-electromechanical (MEMS)-bases sensor systems promise to provide a suitable solution for network operators and enable a widespread use. In our paper, we present a MEMS-based sensor system, that can be used to gain information about network transparency, station safety as well as maintenance and renewal planning. Moreover, we propose an intelligent measurement scheme which adaptively selects relevant data and avoids unneeded redundancy (Smart Data instead of Big Data).

Background: Adolescents and youth (young people) are central to the success of the 2030 agenda. Sexual and reproductive health (SRH) knowledge among young people is critical for their well-being. The objective study was to assess and analyze publications on SHR knowledge among young people. Method: This study was a bibliometric descriptive one for publications retrieved from Scopus on SHR knowledge among young people. All relevant terms on young people, SHR, and knowledge were implemented to retrieve relevant publications for the study period from 1900 to 2019. Results: The search found 2544 publications. Publication started on 1951. The number of publications showed two steep phases: one in mid-1980s and one after 2005. Four research themes were identified: human immunodeficiency virus (HIV); human papillomavirus (HPV), condom, and contraception with documents on HPV vaccinations being the most recent. The retrieved publications received an average of 10.9 citations per document and an h -index of 61. The top cited documents published before 2010 focused mainly on HIV, HPV, and condom use while those after 2010 focused on HIV testing technology, HIV prophylaxis and HPV vaccination. The retrieved documents originated mainly from the region of the Americas (n=944). When data were normalized, the South-Eastern Asian region had the highest research activity. At the country level, the USA ranked first (n=701; 27.6%) but when data was normalized, India (91.5 publication per GDP per capita) ranked first followed by Nigeria (53.0) and South Africa (17.9). Journal of Adolescent Health (n=39; 1.5%) ranked first but documents published in AIDS Education and Prevention journal received the highest number of citations per document (34.1). The University of California, San Francisco ranked first (n=33; 1.3%) in this field. The average number of authors per publication was 3.8. Research networking in this field was poor. Conclusion: This was the first analysis of publications on SRH knowledge among a category of people who are most often neglected in their SRH needs. Research on knowledge and awareness on this subject need to be carried out in all world regions to tailor sex education and health policies to the sociocultural and religious situation in each country.

Background: Machine learning (ML) is a key component of artificial intelligence (AI). The terms machine learning, artificial intelligence, and deep learning are erroneously used interchangeably as they appear as monolithic nebulous entities. This technology offers immense possibilities and opportunities to advance diagnostics in the field of medicine and dentistry. This necessitates a deep understanding of AI and its essential components, such as machine learning (ML), artificial neural networks (ANN), and deep learning (DP). Aim: This review aims to enlighten clinicians regarding AI and its applications in the diagnosis of oral diseases, along with the prospects and challenges involved. Review results: AI has been used in the diagnosis of various oral diseases, such as dental caries, maxillary sinus diseases, periodontal diseases, salivary gland diseases, TMJ disorders, and oral cancer through clinical data and diagnostic images. Larger data sets would enable AI to predict the occurrence of precancerous conditions. They can aid in population-wide surveillance and decide on referrals to specialists. AI can efficiently detect microfeatures beyond the human eye and augment its predictive power in critical diagnosis. Conclusion: Although studies have recognized the benefit of AI, the use of artificial intelligence and machine learning has not been integrated into routine dentistry. AI is still in the research phase. The coming decade will see immense changes in diagnosis and healthcare built on the back of this research. Clinical significance: This paper reviews the various applications of AI in dentistry and illuminates the shortcomings faced while dealing with AI research and suggests ways to tackle them. Overcoming these pitfalls will aid in integrating AI seamlessly into dentistry.

Vitamin A plays a prominent role for maintaining optimal bone status, but its impact upon the bone in response to vitamin A deficiency is not well defined. The purpose of this study was to evaluate how replenishing vitamin A by either whole food cod liver oil (COD) or the active metabolite of vitamin A, retinoic acid (RA), altered bone thickness of vitamin A-deficient (VAD) rats. Weanling rats were administered a control diet (CTRL) or VAD diet for 9 weeks. This was followed by four weeks of treatment in which the VAD group was divided into the following 4 subgroups: (1) VAD (9 weeks)-VAD (4 weeks); (2) VAD-CTRL; (3) VAD-COD; and (4) VAD-RA. Compared to controls, VAD rats had thicker bones which showed marked dysplasia. VAD-rats treated with COD produced a thinner bone that was not significantly different from that of untreated rats. In contrast, RA did not significantly change the thicker bone, and also had significantly greater periosteal and endosteal osteoblast numbers compared to VAD-COD. Active osteoclasts were not detected in VAD rats, nor during the treatment period. These findings suggest that the abnormal bone thickness in VAD rats appears to be more effectively restored to bone thickness of untreated control rats when treated with COD.

Background: Evans syndrome (ES) is a rare autoimmune disorder of unknown etiology. It is characterized by the occurrence of two or more hematologic immune cytopenias, most often immune thrombocytopenia and autoimmune hemolytic anemia (AIHA). In this study we present a rare case of a 9-year-old girl, who was diagnosed with secondary ES associated with active systemic lupus erythematosus (SLE). Case presentation: On November 16th, 2018, a 9-year old girl, presented for the first time with recent onset of gum bleeding and decreased level of consciousness for two weeks. On examination, she was conscious but not oriented, unable to walk, showed scanty hair with oral and gum bleeding, and had multiple bruises and massive hepatosplenomegaly. No parental consanguinity, and no similar history in the family was noted. She had low platelet count (1×103 /μL), with high mean platelet volume (19 fl), anemia (HB 5.5 g/dL), with normal white blood cell count, positive direct Coombs test, and hemolysis with no malignant cells on a peripheral blood smear. Bone marrow evaluation showed hypercellularity, and increased number of megakaryocytes, with no other significant abnormalities. Her flowcytometry study was normal. Brain computed tomography (CT) revealed left subdural hematoma with elements of old brain atrophy (Photo 1), with significant dilatation of ventricular system. Chest X-ray showed mild right pleural effusion. Abdominal ultrasonography showed hepatosplenomegaly with no focal lesions, and mild-to-moderate ascites. Both antinuclear antibody and anti-phospholipid antibody tests showed positive results and C3 was low. Hepatitis and human immunodeficiency virus (HIV) serology were negative.Autoimmune lymphoproliferative syndrome gene sequence analysis was negative. The patient was diagnosed with SLE, after she fulfilled the American Rheumatology Association criteria, associated with Evans syndrome. Any planned surgery was postponed until thrombocytopenia correction, and their aim was to increase the platelet count to a level of above 100.The patient received packed red blood cells (RBCs) and platelets several times. To control her condition, several medications were tried. These medications included intravenous immunoglobulin (1 gm/kg) for two successive days, prednisolone (2 mg/kg/day); however, no improvement was observed after 10 days. Therefore, all of these medications were replaced with methylprednisolone pulse therapy (30 mg/kg for three days), with one dose of anti-D (75 mcg/kg IV). Our next choice was mycophenolate mofetil, which was stopped after finishing the course of five weeks, but the patient did not show any improvement. Moreover, platelets failed to respond to four doses of Rituximab (370 mg/m2/dose) for four weeks and to two cycles of high dose of dexamethasone 20mg/m2 for 4 days every 4 weeks. On 12/29/2018, chloroquine (4 mg/kg/day) was administered for two weeks in conjunction with cyclosporine (4 mg/kg/day). Splenectomy was an option but was not performed because her platelet levels never recovered. Her anemia started to improve on 1/9/2019 with combination of prednisolone and cyclosporine and Coombs test results were negative. On 1/23/2019, the patient was started on Eltrombopag, in a dose-escalated manner starting with 25 mg/kg/day up to 75 mg/kg/day in addition to corticosteroids. One week later, her platelet counts markedly improved (Photo 2). No major side effects were reported. On 2/12/2019, the patient underwent left side burr-hole evacuation of subdural hematoma, but her consciousness was never regained. She was maintained in intensive care unit and ventilated, but she developed multiple postoperative complication, including sepsis with high inflammatory markers and spiking fever. Her platelet count was continuously high, so the dose of Eltrombopag was decreased to 50 mg/kg/day to just keep the level between 50 and 100. Despite all of therapeutic interventions, she passed away one month later, on 3/13/2019, due to respiratory failure. Conclusion: The incidence of ES is quite rare, especially in children. Eltrombopag is a safe and effective drug for management of refractory thrombocytopenia in cases of ES associated with SLE. Figure Disclosures No relevant conflicts of interest to declare.

Using the deep Convolution Neural Networks (CNNs) for Object detection in satellite images accomplish promising results, especially for large objects. While Small objects detection in the same spatial resolution images does not attain the same results. For instance, vehicle detection in high-resolution satellite images, the targeted object maybe existed in an area that does not exceed 15 square pixels, which will not make a sufficient effect in the deeper layers. In addition; the interfering with the surrounding background, noise effect, the neighboring object's shadows, and various vehicle colors. In the proposed paper, an analysis study is performed to evaluate the effect of changing the object size on the detection results. A separate resampling algorithm is applied to the input test images to change its size - bear in mind the built-in detection model resampling layer-, which results in changing the object size, and accordingly extends the object impact in deep layers. Through Transfer Learning, the Faster R-CNN pre-trained object detection model with Inception-V2is applied to submeter satellite images and passenger vehicles as the target objects. The Experimental results show the change in detection accuracy with the change of the object size.

Signal segmentation is a generic task in many time series applications. We propose approaching it via Bayesian changepoint algorithms, i.e., by assigning segments between changepoints. When successive signals show a recurrent change-point pattern, estimating changepoint recurrence is beneficial for two reasons: While recurrent changepoints yield more robust signal segment estimates, non-recurrent changepoints bear valuable information for unsupervised anomaly detection.This study introduces the changepoint recurrence distribution (CPRD) as an empirical estimate of the recurrent behavior of observed changepoints. Two generic methods for incorporating the estimated CPRD into the process of assessing recurrence of future changepoints are suggested. The knowledge of non-recurrent changepoints arising from one of these methods allows additional unsupervised anomaly detection.The quality both of changepoint recurrence estimation via CPRD and of changepoint-related signal segmentation and un-supervised anomaly detection are verified in a proof-of-concept study for two exemplary machine tool monitoring tasks.

In this study, we consider the problem of detecting process-related anomalies for machine tools. The similar shape of successive sensor signals, which arises due to the same process step sequence applied to each workpiece, suggests extracting shape-related features. In recent years, shapelets dominated the field of shape-related features. Unfortunately, they involve a high computational burden due to hyperparameter optimization.We introduce alternative shape-related features relying on abrupt signal changes (changepoints) reflecting the changes of process steps. During normal operation, changepoints follow a highly recurrent pattern, i.e., appear at similar locations. Thus, being able to distinguish regular, recurrent from abnormal, non-recurrent changepoints allows detecting process anomalies.For changepoint recurrence estimation, we extend the Bayesian Online Changepoint Detection (BOCPD) method. The extension allows distinguishing normal and abnormal changepoints relying on empirical estimates of the changepoint recurrence distribution. Subsequently, changepoint-related features are introduced and compared to shapelets and wavelet-based features in a case study comprising real-world machine tool data.Qualitative results verify changepoint locations being comparable to shapelet locations found by the FLAG shapelet approach. Furthermore, quantitative results suggest superior classification performance both to shapelets and wavelet-based features.

This paper introduces and evaluates the performance of a novel cipher scheme, Ambiguous Multi-Symmetric Cryptography (AMSC), which conceals multiple coherent plain-texts in one cipher-text. The cipher-text can be decrypted by different keys to produce different plain-texts. Security analysis showed that AMSC is secure against cipher-text only and known plain-text attacks. AMSC has the following applications: 1) it can send multiple messages for multiple receivers through one cipher-text; 2) it can send one real message and multiple decoys for camouflage; and 3) it can send one real message to one receiver using parallel processing. Performance comparison with leading symmetric algorithms (DES, AES and RC6) demonstrated AMSC’s efficiency in execution time.

In the above article [1] , on pages 11 and 14, math appears incorrectly in some paragraphs.

Securing multi-party communication is very challenging particularly in dynamic networks. Existing multi-recipient cryptographic schemes pose variety of limitations. These include: requiring trust among all recipients to make an agreement, high computational cost for both encryption and decryption, and additional communication overhead when group membership changes. To overcome these limitations, this paper introduces a novel multi-recipient asymmetric cryptographic scheme, AMOUN. This scheme enables the sender to possibly send different messages in one ciphertext to multiple recipients to better utilize network resources, while ensuring that each recipient only retrieves its own designated message. Security analysis demonstrates that proposed scheme is secure against well-known attacks. Evaluation results demonstrate that lightweight AMOUN outperforms RSA and Multi-RSA in terms of computational cost for both encryption and decryption. For a given prime size, in case of encryption, AMOUN achieves 86% and 98% lower average computational cost than RSA and Multi-RSA, respectively; while for decryption, it shows performance improvement of 98% compared to RSA and Multi-RSA.

Today's demands regarding workpiece quality in cutting machine tool processing require automated monitoring of both machine condition and the cutting process. Currently, best-performing monitoring approaches rely on high-frequency acoustic emission (AE) sensor data and definition of advanced features, which involve complex computations. This approach is challenging for machine monitoring via embedded sensor systems with constrained computational power and energy budget. To cope with constrained energy, we rely on data recording with microelectromechanical system (MEMS) vibration sensors, which rely on lower-frequency sampling. To clarify whether these lower-frequency signals bear information for typical machine monitoring prediction tasks, we evaluate data for the most generic machine monitoring task of tool condition monitoring (TCM). To cope with computational complexity of advanced features, we introduce two intelligent preprocessing algorithms. First, we split non-stationary signals of recurrent structure into similar segments. Then, we identify most discriminative spectral differences in the segmented signals that allow for best separation of classes for the given TCM task. Subsequent feature extraction only in most relevant signal segments and spectral regions enables high expressiveness even for simple features. Extensive evaluation of the outlined approach on multiple data sets of different combinations of cutting machine tools, tool types and workpieces confirms its sensibility. Intelligent preprocessing enables reliable identification of stationary segments and most discriminative frequency bands. With subsequent extraction of simple but tailor-made features in these spectral-temporal regions of interest (Rols), TCM typically framed as multi feature classification problem can be converted to a single feature threshold comparison problem with an average F1 score of 97.89%.

In this paper, a network-on-chip four-level pulse amplitude modulation (4-PAM) scheme is proposed to be used for communication within the network itself in MPSoCs. A current-mode based 4-PAM transmitter is used to encode data transactions between neighboring routers. Decoding data streams is done by a flash-ADC based receiver using clocked latched type comparators. Additionally, this scheme is implemented on networks utilizing high-radix routers with a local concentration factor of 2 IPs per node to encode data streams injected into the network at the network interface and decode them at the input port of the router. We also discuss the required modifications to the router architecture in the input port buffers and introduce a two-stage allocation method to resolve conflicts of output port requests which is essential to maintain system stability after saturation by utilizing a fair flow control methodology. This results in a reduction in wiring load for each router which is an added value that facilitates the routing stage. The evaluation is extended to reflect the overall network performance supporting the use of multi-valued logic and estimate the overhead of implementation on area and power budgets.

In this paper, we propose a version of RSA encryption that uses the Chinese Remainder Theorem (CRT) for the purpose of concealing multiple plain-texts in one cipher-text. This scheme allows the sender to possibly send different information to multiple receivers, and each receiver is only able to decrypt the message intended for them. We prove the algorithm mathematically. Furthermore, we prove our algorithm secure against the chosen plain-text (CPA) attack. We also compare textbook RSA against our algorithm and show the security and size advantages. The new algorithm can also take advantage of current methods that speed up the decryption process of RSA. This scheme will become a basis for further one to many public key cryptosystems.

Many systems rely on the expertise from human operators, who have acquired their knowledge through practical experience over the course of many years. For the detection of anomalies in industrial settings, sensor units have been introduced to predict and classify such anomalous events, but these critically rely on annotated data for training. Lengthy data collection campaigns are needed, which tend to be combined with domain expert annotations of the data afterwards, resulting in costly and slow process. This work presents an alternative by studying live annotation of rare anomalous events in sensor streams in a real-world manufacturing setting by experienced human operators that can also observe the machinery itself. A prototype for visualization and in situ annotation of sensor signals is developed with embedded unsupervised anomaly detection algorithms to propose signals for annotation and which allows the operators to give feedback on the detection and classify anomalous events. This prototype allowed assembling a corpus of several weeks of sensor data measured in a real manufacturing surrounding and was annotated by domain experts as an evaluation basis for this study. The evaluation of live annotations reveals high user motivation after getting accustomed to the labeling prototype. After this initial period, clear anomalies with characteristic signal patterns are detected reliably in visualized envelope signals. More subtle signal deviations were less likely to be confirmed an anomaly due to either an insufficient visibility in envelope signals or the absence of characteristic signal patterns.

Automatic detection of small objects such as vehicles in satellite images is a very challenging task, due to the complexity of the background, vehicles colors, the large size of ground sample distance (GSD) for satellite images and jamming caused by buildings and trees. Many methods were proposed for this task by using handcrafted features (such as a Histogram of an Oriented Gradient, Local Binary Pattern, Scale-Invariant Feature Transform, etc.) along with support vector machine classifier, however, Convolutional Neural Networks (CNN) have proved to be potentially more effective. In this paper, we use two advanced deep learning frameworks, Faster Region CNN (Faster R-CNN) and Single Shot Multi-Box (SSD) based on (CNN) with Inception-V2 as a feature map generator instead of VGG-16, to detect vehicles through Transfer Learning, and making an experimental analysis comparison between the two models. Experimental results on the test dataset demonstrate the effectiveness and efficiency of the proposed methods.

This study aimed to shed the light on the role of Social Media usage in the innovative behavior through the recent information technology (IT) in the organizations specialized in the information and communication technology (ICT) field. The study population consisted of the ICT organizations operating in Jordan as affiliated with the Information and Communication Technology Association (INTAJ) amounting to 161 organization. The analysis unit consisted of the managers in the top and middle level. The study relied on the simple random sample; and it reached a number of conclusions the most important of which is that the perceptions by respondents of the independent variable Social Media Usage were medium; and the same applies to all its dimensions. The dependent variable Innovative Behavior was also medium, as well as all its dimensions. As for the mediator variable IT, the respondents' perceptions were high, along with all its dimensions. The study indicated that there is a statistically significant impact for the Social Media usage with its component on the innovative behavior. Also, it was found that a statistically significant impact for the Social Media usage with its component on the innovative behavior through the IT in the organizations operating in the ICT field in Jordan. These conclusions indicated that there is an opportunity for the ICT organizations to promote its innovative behavior through the Social Media usage. Based on the reached conclusions, the study concluded a set of recommendations the most important of which is that the awareness should be increased with respect to the capacities that are available due to the use of the Social Media as well as the advantages that can be utilized by the ICT organizations in Jordan through this use; the organization should well utilize the Social Media usage especially the Groups and Sharing by taking the necessary decision that lead to the activation of the Social Media role in the various phases of the innovative behavior; and the need for the organizations to direct the use of Social Media through the dissemination of a culture of innovation based on the use of Social Media.

This paper examines mobile Internet adoption and diffusion in the transitional economy of Jordan. Jordan has been in a state of technology-enabled transition since the ascension of the new king, H.M. Abdullah II, led to a national dedication to Internet technology for economic development. This paper analyses results from a study of the adoption of mobile Internet in a sample of Jordanian airline customers. Seven factors were found to predict adoption of mobile Internet. Of particular interest was the finding that the variable 'image' had an influence in the opposite direction to other studies, which may point to specific cultural factors unique to Jordan. The results of this study provide a sound basis for strategic planning and information system development in Jordan with regard to consumer needs and emerging technologies in a transitional economy. The findings have important implications for service providers and industry practitioners, and for researchers who wish to use this study as a found...

Objective To compare the effect of N-acetyl cysteine and metformin on hormonal profile (insulin and T) and ovulation rate in women with clomiphene citrate–resistant polycystic ovary syndrome. Design Prospective randomized controlled study. Setting Department of obstetrics and gynecology in a university hospital in Egypt. Patient(s) Sixty-one infertile women with clomiphene citrate–resistant polycystic ovary syndrome were assigned randomly to receive either metformin (1,500 mg/d) or N-acetyl cysteine (1.8 g/d) for 6 weeks. Intervention(s) Hormonal profile was determined before and after the course of treatment. Folliculometry was performed to assess ovulation. Main Outcome Measure(s) Ovulation rate and insulin and T changes. Result(s) In the metformin group, there was a significant decrease in the fasting glucose, fasting insulin, and total T. In the N-acetyl cysteine group, there was no significant difference in the fasting glucose or fasting insulin and there was a significant decrease in total T. There was no significant difference in the fasting glucose–fasting insulin ratio in both groups. In the metformin group, the rate of ovulation was 51.6% (16/31), vs. 6.7% (2/30) in the N-acetyl cysteine group, which was statistically significant. Conclusion(s) Metformin alone is an effective drug in inducing ovulation in clomiphene citrate–resistant polycystic ovary syndrome, whereas N-acetyl cysteine alone is not. Further large studies are required to confirm our results.

As Internet adoption is a fundamental antecedent to online commerce, differences in Internet diffusion between nations can be important. The emerging online markets represented by the developing nations of the Middle East are important, but not as well understood as the online markets of the developed nations of the world. This study makes a comparative analysis between Turkey, one of the more mature developing nations of the region, and Jordan, a smaller developing nation that has recently adopted important technology initiatives. This study suggests that the rapid advance of Internet user motivations and online shopping intentions in the Kingdom of Jordan appear to be a direct result of the new King's recent technology initiative.

The performance of the sparse matrix-vector multiplication (SMVM) on a parallel system is strongly affected by the distribution of data among its components. Two costs arise as a result of the used data mapping method: arithmetic and communication. The communication cost often dominates the arithmetic cost, and the gap between these costs tends to increase. Therefore, finding a mapping method that reduces the communication cost is of high importance. On the other hand, the load distribution among the processing units must not be sacrificed. In this paper, a data mapping method is proposed for SMVM on Network-on-Chip which achieves balanced working load and reduces the communication cost. Afterwards, an FPGA-based architecture is introduced which is designed to fit with the proposed data mapping method.

Purpose: To evaluate safety and clinical results of intravitreal antiangiogenic agents for choroidal neovascularization in pediatric patients. Methods: Retrospective, multicenter, interventional case series. A total of 45 eyes of 39 pediatric patients with choroidal neovascularization of various etiologies were treated with intravitreal injection of antiangiogenic agents (1.25 mg per 0.05 mL of bevacizumab or 0.5 mg per 0.05 mL of ranibizumab). Results: There were 24 girls and 15 boys with group median age of 13 years (range, 3–17 years). Mean follow-up period was 12.8 months (range, 3–60 months). Median visual acuity in terms of logarithm of the minimum angle of resolution at presentation and last follow-up was 0.87 and 0.7, respectively (P = 0.0003). Mean and median number of injections received over the follow-up period was 2.2 and 1, respectively. At the last follow-up, 22 eyes (48%) gained more than 3 lines of vision and 27 eyes (60%) had final visual acuity 20/50 or better. Nine eyes (20%) did not improve and had severe vision loss (20/200 or worse). Conclusion: Intravitreal antiangiogenic therapy for choroidal neovascularization in pediatric patients seems temporarily safe and effective in majority of affected eyes. Because of the rarity and character of this condition, it is unlikely that any clinical trials will soon take place to study this or other treatment option.

Nonalcoholic fatty liver disease (NAFLD) origins are unclear but progression involves inflammation and correlation with obesity and insulin resistance. Advanced glycation end products (AGEs) are ox...

Iterative solvers based on Krylov subspace method proved to be robust in the presence of well monitored inexact matrix vector products. In this paper, we show that the iterative solver performs well while gradually reducing the number of nonzero elements of the matrix throughout the iterations. We benefit from this robustness in reducing the computational effort and the communication volume when implementing sparse matrix vector multiplication (SMVM) on a Network-on-Chip (NoC).

„Er hat meine Ehre verletzt.“ Oder „ich muss meine Ehre verteidigen“ – ist auf deutschen Schulhofen beinahe taglich zu horen. Kaum ein Tag vergeht, ohne dass das Wort „Ehre“ verwendet wird. Meist wird Ehre fur Machtspiele zwischen den Jugendlichen benutzt oder im Zusammenhang, dass eben diese verletzt wurde durch Beschimpfungen der Mutter, durch Schwestern, die Liebesbeziehungen fuhren wollen, knappe und nicht den religiosen Normen entsprechenden Bekleidung tragen oder einfach nur durch eine Lehrerin, die schlechte Zensuren verteilt. Viele Madchen durfen nicht an Klassenfahrten mitfahren, anderen wird verboten an Sexualkunde oder Schwimmunterricht teilzunehmen. Alles im Namen der Ehre.

Network-on-Chip (NoC) was presented as a new System-on-Chip (SoC) paradigm to solve the problem associated with shared buses in multi-core systems by replacing the traditional bus based on-chip interconnections with packet-switched network architecture. The performance of NoCs depends on many influencing factors as e.g., network size, network topology, routing scheme, congestion avoidance method. Investigating the effects of different parameters and configurations on a simulation tool is preferred over a real hardware due to time and cost considerations. In this paper, an NoC simulator using OMNeT++ is built for investigating sparse matrix-vector multiplication (SMVM) using an NoC. More precisely, as an example for these investigations, two methods for increasing the NoC throughput are presented which are dynamic and asynchronous routings.