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Leishmaniasis is a group of contagious diseases having high surveillance among dogs. According to World Health Organization (WHO), ninety-two territories were infected around the world in 2018. One billion dogs live in areas endemic for Leishmaniasis and are at risk of infection. Almost one million cases are reported annually. The dog's population is categorized into five classes like susceptible (S), latent (L), infectious (I), uninfected (R), and infected (Q). The Leishmaniasis delayed model is developed to analyze and control its spread. Equilibria, positivity, boundedness, reproduction number, and parameter sensitivity are the model's essential features. The stability of the model is investigated in a local and global sense with the help of the Routh Hurwitz criterion and Lyapunov theory. In the end, simulations are presented to verify the theoretical analysis of the delayed model.

Background: Diabetic foot ulcers (DFUs) are a life-threatening ailment caused by diabetes. Several growth factors, as well as their various combinations, have shown promising effect in aiding diabetic foot ulcer. However, contradictory or paradoxical results are often available, and debates about this issue are ongoing. Therefore, a comprehensive meta-analysis was performed to compare the efficacy and safety of epidermal growth factor (EGF) and placebo in healing diabetic foot ulcers. Methods: The database search included relevant English literature from Cochrane Library, PubMed, Google Scholar, Elsevier, and EMBASE that was published between 2009 and 2021. Inclusion criteria included type 1 and 2 diabetic patients with foot wounds focusing on complete healing rate. Exclusion criteria included combined therapy, non-human studies, reviews, and protocols. To assess the quality of each study, biases regarding random sequence generation, allocation concealment, participant and personnel blinding, outcome assessment blinding and incomplete outcome data were thoroughly identified. Results: Eight randomized control trials comprising 620 patients (337 in EGF group, 283 in placebo group), were included in this meta-analysis. EGF achieved a significantly higher complete healing rate than placebo after four weeks of treatment, with relative risk (RR): 3.04 (0.50, 18.44) and heterogeneity (Chi2 = 6.46, df = 2 (P = 0.04) I2 = 69 %). Notably, the healing frequency in the placebo group was 17%, whereas the healing frequency in the epidermal growth factor group was 34%. Likewise, after eight weeks of treatment, the relative risk and heterogeneity were RR: 2.59 (1.42, 4.72) and (Chi2 =7.92, df= 4 (p= 0.09): I2= 49%), respectively. Moreover, the risk ratio at 12 weeks was RR: 1.01 (0.42, 2.46), and heterogeneity was (Chi2 =8.55, df= 2 (p= 0.01): I2= 77%). Conclusions: Our findings indicate that EGF significantly promotes wound healing, and could be recommended as an effective and safe treatment for DFUs.

AimThe primary mission of cardiopulmonary resuscitation (CPR) is to provide adequate blood flow and oxygen delivery for restoring spontaneous circulation from cardiac arrest (CA) events. Previously, studies demonstrated that chest compression synchronized ventilation (CCSV) improved systemic oxygen supply during CPR, and aortic balloon occlusion (ABO) augments the efficacy of external CPR by increasing blood perfusion to vital organs. However, both them failed to make a significant improvement in return of spontaneous circulation (ROSC). In this study, we investigated the effects of combined CCSV and ABO on the outcomes of CPR in swine.MethodsThirty-one male domestic swine were subjected to 8 min of electrically induced and untreated CA followed by 8 min of CPR. CPR was performed by continuous chest compressions and mechanical ventilation. At the beginning of CPR, the animals were randomized to receive intermittent positive pressure ventilation (IPPV, n = 10), CCSV (n = 7), IPPV + ABO (n = 7), or CCSV + ABO (n = 7). During CPR, gas exchange and systemic hemodynamics were measured, and ROSC was recorded. After resuscitation, the function and injury biomarkers of vital organs including heart, brain, kidney, and intestine were evaluated.ResultsDuring CPR, PaO2 was significantly higher accompanied by significantly greater regional cerebral oxygen saturation in the CCSV and CCSV + ABO groups than the IPPV group. Coronary perfusion pressure, end-tidal carbon dioxide, and carotid blood flow were significantly increased in the IPPV + ABO and CCSV + ABO groups compared with the IPPV group. ROSC was achieved in five of ten (IPPV), five of seven (CCSV), six of seven (IPPV + ABO), and seven of seven (CCSV + ABO) swine, with the rate of resuscitation success being significantly higher in the CCSV + ABO group than the IPPV group (P = 0.044). After resuscitation, significantly improved myocardial and neurological function, and markedly less cardiac, cerebral, renal, and intestinal injuries were observed in the CCSV + ABO group compared with the IPPV group.ConclusionThe combination of CCSV and ABO improved both ventilatory and hemodynamic efficacy during CPR, promoted ROSC, and alleviated post-resuscitation multiple organ injury in swine.

Objective: To share our experience of tracheostomy in COVID-19 positive patients. Study Design: Prospective observational study. Place and Duration of Study: Pak-Emirates Military Hospital, Rawalpindi Pakistan, from Apr to Jul 2020. Methodology: A total of 94 COVID-19 positive cases admitted to the Intensive Care Unit of this hospital, placed on ventilatory support and who ultimately underwent tracheostomy (whether percutaneous or surgical) were included in the study. Patients were included irrespective of any age group or gender. Results: Out of 94 patients placed on ventilator, tracheostomy was performed only in 17 patients. Male predominance was 13 (76%), with mean age of patients as 55.59 ± 12.93 in 12 patients, surgical tracheostomy was performed (70.58%) whereas in 5 (29.4%) cases percutaneous tracheostomy was done. On post-operative follow-up 8 out of 17 (47%) patients recovered and were successfully decannulated whereas 9 (52.9%) patients could not survive. Tracheostomy was successfully performed as early as 8th day of mechanical ventilator support. Health Care Workers (HCWs) involved were subjected to RT-PCR and remained negative for SARS- CoV-2. There was statistically significant association between the type and indication of tracheostomy, p=0.002. Conclusion: Tracheostomy, in COVID-19 positive patients, being aerosol- generating procedure remains a medical hazard for the HCWs. By following strict safety protocols according to the medical resources available and training of the HCWs, it can be performed with complete safety. It can be done as early as 8th day of ventilator support.

Following cardiopulmonary resuscitation (CPR), the ensuing cardiac and cerebral injuries contribute to the poor outcome of cardiac arrest (CA) victims, in which the pathogenetic process is possibly driven by cell pyroptosis and ferroptosis. Mesenchymal stem cells (MSCs) have been shown to be a promising strategy for post-resuscitation cardiac and cerebral protection in rat, but its effectiveness in the clinically relevant swine model and the potential protective mechanism remain unknown. The present study was designed to investigate whether MSCs administration could alleviate post-resuscitation cardiac and cerebral injuries through the inhibition of cell pyroptosis and ferroptosis in swine. Twenty-four male domestic swine were randomly divided into three groups: sham, CPR, and MSC. A dose of 2.5×106/kg of MSCs derived from human embryonic stem cells was intravenously infused at 1.5, and 3 days prior to CA. The animal model was established by 8 min of CA and then 8 min of CPR. After resuscitation, cardiac, cerebral function and injury biomarkers were regularly evaluated for a total of 24 h. At 24 h post-resuscitation, pyroptosis-related proteins (NLRP3, ASC, cleaved caspase-1, GSDMD), proinflammatory cytokines (IL-1β, IL-18), ferroptosis-related proteins (ACSL4, GPX4) and iron deposition in the heart, cortex and hippocampus were measured. Consequently, significantly greater cardiac, cerebral dysfunction and injuries after resuscitation were observed in the CPR and MSC groups compared with the sham group. However, the severity of cardiac and cerebral damage were significantly milder in the MSC group than in the CPR group. In addition, the expression levels of NLRP3, ASC, cleaved caspase-1, GSDMD and ACSL4, the contents of IL-1β and IL-18, and the level of iron deposition were significantly higher while the expression level of GPX4 was significantly lower in the heart, cortex and hippocampus in all resuscitated animals compared with the sham group. Nevertheless, MSCs administration significantly decreased post-resuscitation cardiac, cerebral pyroptosis and ferroptosis compared to the CPR group. Our results showed that the administration of MSCs significantly alleviated post-resuscitation cardiac and cerebral injuries in swine, in which the protective effects were related to the inhibition of cell pyroptosis and ferroptosis.

In orthogonal frequency division multiplexing (OFDM), sidelobes of the modulated subcarriers cause high out-of-band (OOB) radiation, resulting in interference to licensed and un-licensed users in a cognitive radio system environment. In this work, we present a novel technique based on a generalized sidelobe canceller (GSC) for the reduction of sidelobes. The upper branch of the GSC consists of a weight vector designed by multiple constraints to preserve the desired portion of the input signal. The lower branch has a blocking matrix that blocks the desired portion and preserves the undesired portion (the sidelobes) of the input signal, followed by an adaptive weight vector. The adaptive weight vector adjusts the amplitudes of the undesired portion (the sidelobes) so that when the signal from the lower branch is subtracted from the signal from the upper branch, it results in cancellation of the sidelobes of the input signal. The effectiveness and strength of the proposed technique are verified through extensive simulations. The proposed technique produces competitive results in terms of sidelobe reduction as compared to existing techniques.

Cognitive radio system is an innovative technology in the wireless communication that has the capability to smartly communicate with each other by opportunistically exploiting the vacant spectrum of primary users. In this work we present a new idea of sidelobe suppression applicable for cognitive users on transmitter and receiver sides. In case of spectrum sharing with the primary users by suppressing the side-lobes at the transmitter and receiver side, the cognitive users will be able to increase the throughput without cooperating the permissible interference temperature limit of the license spectrum. We suggest two generalized sidelobe cancellers (GSCs) that operate in parallel. The first GSC planned to attain the two conflicting objective at the same moment: firstly maximize the cognitive users self throughput; secondly minimize the interference generated by cognitive users at each primary receiver. The second GSC generates two main beams at the positions of the highest amplitude sidelobes of the first one. The values of main beams are equal to the two sidelobe peaks. The subtraction of the outputs of the two GSCs, results in the suppression of the highest pair of sidelobes. This process is repeated iteratively to result in an adaptive algorithm. Simulation results are there to provide the effectiveness of the proposed algorithm.

An easy and efficient approach, based on artificial intelligence technique, is proposed to jointly estimate the amplitude, elevation, and azimuth angles of far field sources impinging on 2-L-shape array. In these proposed artificial intelligence techniques, the metaheuristics based on genetic algorithm and simulated annealing are used as global optimizers assisted with rapid local version of pattern search for optimization of the adaptive parameters. The performance metric is employed on a fitness evaluation function depending on mean square error which is optimum and requires single snapshot to converge. The proposed approaches are easy to understand, and simple to implement; the genetic algorithm specifically hybridized with pattern search generates fairly good results. The comparison of the given schemes is carried out with 1-L-shape array, as well as, with parallel-shape array and is found to be in good agreement in terms of accuracy, convergence rate, computational complexity, and mean square error. The effectiveness and efficiency of the given schemes are examined through Monte Carlo simulations and their inclusive statistical analysis.

Background: Diabetic foot ulcers (DFUs) are a life-threatening ailment caused by diabetes. Several growth factors, as well as their various combinations, have shown promising effect in aiding diabetic foot ulcer healing. However, contradictory or paradoxical results are often available, and debates about this issue are ongoing. Therefore, a comprehensive meta-analysis was performed to compare the efficacy and safety of epidermal growth factor (EGF) and placebo in healing diabetic foot ulcers. Methods: The database search included relevant English literature from Cochrane Library, PubMed, Google Scholar, Elsevier, and EMBASE that was published between 2009 and 2021. Inclusion criteria included type 1 and 2 diabetic patients with foot wounds focusing on complete healing rate. Exclusion criteria included combined therapy, non-human studies, reviews, and protocols. To assess the quality of each study, biases regarding random sequence generation, allocation concealment, participant and personnel blinding, outcome assessment blinding and incomplete outcome data were thoroughly identified. Results: Eight randomized control trials comprising 620 patients (337 in EGF group, 283 in placebo group), were included in this meta-analysis. EGF achieved a significantly higher complete healing rate than placebo after four weeks of treatment, with relative risk (RR): 3.04 (0.50, 18.44) and heterogeneity (Chi 2 = 6.46, df = 2 (P = 0.04) I 2 = 69 %). Notably, the healing frequency in the placebo group was 17%, whereas the healing frequency in the epidermal growth factor group was 34%. Likewise, after eight weeks of treatment, the relative risk and heterogeneity were RR: 2.59 (1.42, 4.72) and (Chi 2 =7.92, df= 4 (p= 0.09): I 2= 49%), respectively. Moreover, the risk ratio at 12 weeks was RR: 1.01 (0.42, 2.46), and heterogeneity was (Chi 2 =8.55, df= 2 (p= 0.01): I 2= 77%). Conclusions: Our findings indicate that EGF significantly promotes wound healing, and could be recommended as an effective and safe treatment for DFUs.

An algorithm is proposed for the detection and joint estimation of target parameters for a radar with a two-element rotating antenna. Rotation of the antenna introduces unwanted effects, which may cause inaccuracy in the parameter estimation. Target detection is performed by adding the processed data from two sensors. Joint estimation of range, Doppler, and direction of arrival (DOA) is carried while compensating the effects of antenna rotation. The detection performance is analyzed in terms of the receiver operating characteristics. Analytical expressions of Cramer-Rao Bound for Doppler, the range and DOA are derived. Computational complexity is also discussed. A simulation demonstrates and verifies the proposed algorithm and its analyses.

A uniform linear array of n antenna elements can steer up to n-1 nulls. In situations where less than n-1 nulls are required to be steered, the existing algorithms have no criterion to utilize the remaining weights for sidelobe suppression. This work combines sidelobe suppression capability with null steering by independent weight control. For this purpose, the array factor is transformed as the product of two polynomials. One of the polynomials is used for null steering by independent weight control, while the second one is for sidelobe suppression whose coefficients or weights are determined by using convex optimization. Finally, a new structure is proposed to incorporate the product of two polynomials such that sidelobe suppression weights are decoupled from those of null steering weights. Simulation results validate the effectiveness of the proposed scheme.