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Fault detection and isolation in unmanned aerial vehicle (UAV) propellers are critical for operational safety and efficiency. Most existing fault diagnosis techniques rely basically on traditional statistical-based methods that necessitate better approaches. This study explores the application of untraditional feature extraction methodologies, namely Permutation Entropy (PE), Lempel–Ziv Complexity (LZC), and Teager–Kaiser Energy Operator (TKEO), on the PADRE dataset, which encapsulates various rotor fault configurations. The extracted features were subjected to a Chi-Square (χ2) feature selection process to identify the most significant features for input into a Deep Neural Network. The Taguchi method was utilized to test the performance of the recorded features, correspondingly. Performance metrics, including Accuracy, F1-Score, Precision, and Recall, were employed to evaluate the model’s effectiveness before and after the feature selection. The achieved accuracy has increased by 0.9% when compared with results utilizing traditional statistical methods. Comparative analysis with prior research reveals that the proposed untraditional features surpass traditional methods in diagnosing UAV propeller faults. It resulted in improved performance metrics with Accuracy, F1-Score, Precision, and Recall reaching 99.6%, 99.5%, 99.5%, and 99.5%, respectively. The results suggest promising directions for future research in UAV maintenance and safety protocols. [ABSTRACT FROM AUTHOR]

Due to the extensive use of Unmanned Aerial Vehicles (UAVs) and the co-evolution of current technology, a key introduction to fault detection has arisen in recent studies in order to prevent unfortunate consequences. In this study, vibration-based signals from a commercially available innovative quadcopter flying in hover mode are collected using a vibration accelerometer, a data acquisition device, and a laptop. An ADXL335 accelerometer is fixed on the center of the drone where the centerlines of the four blades intersect. The superposition of numerous vibration arrangements over identical spectra hinders the ability to analyze the spectral data in the manner required to locate any framework's discrete vibration. This work presents a technique for separating a synthesized vibration signal towards discrete vibrations and other extraneous vibrations of a structure utilizing the Discrete Wavelet Transform (DWT) integrated with the Fast Fourier Transform (FFT). The research article findings in this study demonstrate the reliability and applicability of specific categories of discrete vibrations that are sorted out during the structural change evaluation to develop the best feasible strategy for removing the undesired and unanticipated vibration components and noise. The methodology demonstrated in this paper has the potential for practical application to multirotor UAVs in general. [ABSTRACT FROM AUTHOR]

Based on decades of single-spacecraft measurements near 1 au as well as data from heliospheric and planetary missions, multi-spacecraft simultaneous measurements in the inner heliosphere on separations of 0.05–0.2 au are required to close existing gaps in our knowledge of solar wind structures, transients, and energetic particles, especially coronal mass ejections (CMEs), stream interaction regions (SIRs), high speed solar wind streams (HSS), and energetic storm particle (ESP) events. The Mission to Investigate Interplanetary Structures and Transients (MIIST) is a concept for a small multi-spacecraft mission to explore the near-Earth heliosphere on these critical scales. It is designed to advance two goals: (a) to determine the spatiotemporal variations and the variability of solar wind structures, transients, and energetic particle fluxes in near-Earth interplanetary (IP) space, and (b) to advance our fundamental knowledge necessary to improve space weather forecasting from in situ data. We present the scientific rationale for this proposed mission, the science requirements, payload, implementation, and concept of mission operation that address a key gap in our knowledge of IP structures and transients within the cost, launch, and schedule limitations of the NASA Heliophysics Small Explorers program. [ABSTRACT FROM AUTHOR]

The photoelectric effect is not truly instantaneous but exhibits attosecond delays that can reveal complex molecular dynamics1–7. Sub-femtosecond-duration light pulses provide the requisite tools to resolve the dynamics of photoionization8–12. Accordingly, the past decade has produced a large volume of work on photoionization delays following single-photon absorption of an extreme ultraviolet photon. However, the measurement of time-resolved core-level photoionization remained out of reach. The required X-ray photon energies needed for core-level photoionization were not available with attosecond tabletop sources. Here we report measurements of the X-ray photoemission delay of core-level electrons, with unexpectedly large delays, ranging up to 700 as in NO near the oxygen K-shell threshold. These measurements exploit attosecond soft X-ray pulses from a free-electron laser to scan across the entire region near the K-shell threshold. Furthermore, we find that the delay spectrum is richly modulated, suggesting several contributions, including transient trapping of the photoelectron owing to shape resonances, collisions with the Auger–Meitner electron that is emitted in the rapid non-radiative relaxation of the molecule and multi-electron scattering effects. The results demonstrate how X-ray attosecond experiments, supported by comprehensive theoretical modelling, can unravel the complex correlated dynamics of core-level photoionization.Time-resolved measurements of the X-ray photoemission delay of core-level electrons using attosecond soft X-ray pulses from a free-electron laser can be used to determine the complex correlated dynamics of photoionization. [ABSTRACT FROM AUTHOR]

Permanent magnet synchronous motors (PMSMs) are of wide utilization in various industrial applications for their precise control capabilities. Hereby, these PMSMs are consistently subjected to operational faults that might lead to heavy consequences effecting overall safety. Responsively, health state monitoring techniques for early failure detection are of paramount necessity to ensure optimum performance and longevity of such applications. A qualification-based methodology is presented in the current study in response to fault diagnosis of three-phased PMSMs using vibration–current fusion of data analytics. Stator faults were induced as inter-turn short circuits by the use of bypassing resistances where experimental datasets from a manufactured test rig were acquired which are current and vibration time-domain signals then progressed into statistical features. Different operating cases were diagnosed and classified based on AdaBoost, a currently-growing machine learning model. Utilizing vibration statistical features alone has improved fault detection to 83.0%, while the vibration–current data fusion has achieved an accuracy of 90.7% which was the highest of them all. The precision, F1 score, and recall values were all of 0.907 that sill validated the accuracy results of the data fusion methodology. This study highlights the potential of the data fusion analysis in early fault diagnosis of which enables proactive maintenance strategies, and enhances reliability of PMSMs in various applications of industrial machinery in addition to renewable energy systems.. [ABSTRACT FROM AUTHOR]

The i-DREAMS project focuses on establishing a framework known as the 'Safety Tolerance Zone (STZ)' to ensure drivers operate within safe boundaries. This study compares Long-Short-Term-Memory Networks and shallow Neural Networks to assess participants' safety levels during i-DREAMS on-road trials. Thirty German drivers' trips and Forty-Three Belgian drivers were analyzed using these methods, revealing factors contributing to risky behavior. Results indicate i-DREAMS interventions significantly enhance driving behavior, with Neural Networks displaying superior performance among the algorithms considered. [ABSTRACT FROM AUTHOR]

Permanent magnet synchronous motors (PMSMs) are widely recognized for their precise control capabilities, making them indispensable in numerous industrial applications. Yet, their susceptibility to faults, particularly stator faults, can lead to severe operational challenges. Effective health monitoring and prompt fault detection are, therefore, pivotal for preserving the performance and lifespan of PMSMs. In this research, we delve into an innovative approach to fault diagnosis in PMSMs by fusing vibration and current data. For the experimental setup, stator faults were simulated as inter-turn short circuits. Comprehensive datasets encompassing three-phase current signals and vibration signals were acquired from the PMSM test rig. These datasets were subsequently processed into statistical features. Leveraging the information gain for feature selection, we discerned crucial attributes for the fault assessment. A gradient boosting-based machine learning model was then employed to distinguish between various fault states, utilizing the selected features. Our findings unveiled that the combined vibration-current data fusion approach stands out, achieving an impressive diagnostic accuracy of 90.7% and an area under the curve of 95.1%. This underscores the efficacy of data fusion in conjunction with gradient boosting for fault diagnosis. The methodology presented herein promises to pave the way for timely fault detection, enabling proactive maintenance regimes, and bolstering the reliability of PMSMs in critical industrial settings. [ABSTRACT FROM AUTHOR]

Unmanned aerial vehicles (UAVs) have gained significant importance due to their wide applicability in modern life. Fault diagnosis plays a crucial role in ensuring their safe and reliable operation. This study evaluated a smart drone's performance under different actuator damage modes. Flight experiments included healthy, minor, moderate, and severe damage with motor base shifting scenarios. Each flight lasted 10 min with a consistent hovering height of 1.2 m. The study underscored the importance of leveraging embedded recorded data to enhance fault diagnosis techniques and improve the reliability and safety of UAV operations. The effectiveness of utilizing the embedded recorded data for fault diagnosis is demonstrated, eliminating the need for conventional test-rigs and reducing associated costs and analysis time. The drone's embedded system recorded flight data, specifically pitching and rolling angles in degrees, which were soft-labeled for analysis. Classification analysis was performed using the ORANGE data-mining program, leveraging the Stacking technique that combined three models: Stochastic Gradient Descent (SGD), K-nearest Neighbor (KNN), and Support Vector Machine (SVM). The individual accuracies of the SGD, KNN, and SVM models were 72.2%, 74.5%, and 71.2%, respectively. However, the stacking technique improved overall accuracy significantly to 96%. The findings highlighted the potential of machine learning techniques and the stacking method in accurately assessing drone performance offering a reliable and cost-effective approach for evaluating UAV performance under varying levels of actuator damage. [ABSTRACT FROM AUTHOR]

Recently, Norvidas has introduced the general multidimensional Hermite sampling series, which involves samples from a function and its mixed and non-mixed partial derivatives. The convergence of this sampling series is slow unless the sample values |f(x)| rapidly decay as | x j | → ∞ for all 1 ≤ j ≤ n . In this paper, we investigate a modified version of this sampling series that utilizes a multivariate Gaussian multiplier to approximate functions from two classes of multivariate analytic functions using a complex approach. The first class comprises entire functions of exponential type in n variables that fulfill a decay condition, while the second class includes analytic functions in n variables defined on a multidimensional horizontal strip. It has a significantly higher convergence rate compared to the general multidimensional Hermite sampling series. [ABSTRACT FROM AUTHOR]

Background and Aims: Endoscopic retrograde cholangiopancreatography (ERCP) is the standard of care for the management of choledocholithiasis but carries risk of complications which may result in significant morbidity and mortality. While currently available guidelines endorse the use of ERCP for the management of symptomatic common bile duct stones, the need for ERCP in incidentally found asymptomatic choledocholithiasis is more controversial, and practice varies on a geographic and institutional level. This systematic review and meta-analysis is conducted to compare post-ERCP adverse events between asymptomatic and symptomatic choledocholithiasis patients. Methods: We searched PubMed/Embase/Web of Science databases to include all studies comparing post-ERCP outcomes between asymptomatic and symptomatic choledocholithiasis patients. The primary outcome was post-ERCP pancreatitis (PEP), while secondary outcomes included post-ERCP cholangitis, bleeding, and perforation. We calculated pooled risk ratios (RR) and 95% confidence intervals (CIs) using the Mantel–Haenszel method within a random-effect model. Results: Our analysis included six observational studies, totaling 2,178 choledocholithiasis patients (392 asymptomatic and 1786 symptomatic); 53% were female. Asymptomatic patients exhibited a higher risk of PEP compared with symptomatic patients (11.7% versus 4.8%; RR 2.59, 95% CI 1.56–4.31, p ≤ 0.001). No significant difference was observed in post-ERCP cholangitis, bleeding, or perforation rates between the two groups. Conclusions: Asymptomatic patients with choledocholithiasis appear to have a higher risk of PEP than symptomatic patients, while the risk of other post-ERCP adverse events is similar between the two groups. Interventional endoscopists should thoroughly discuss potential adverse events (particularly PEP) with asymptomatic patients before performing ERCP and utilize PEP-prevention measures more liberally in this subgroup of patients. [ABSTRACT FROM AUTHOR]

Purpose: Sickle cell patients presented with progressive hip pain and limitation of daily activities, as evidenced by low preoperative hip scores and failed conservative therapy. Management of femoral head avascular necrosis (AVN) using total hip replacement (THR) in sickle cell disease (SCD) is widespread in developed countries, but it is still in its initiation stage in developing countries. The outcome of using cementless THR among SCD patients is still unknown with lack of published studies from regional countries. This study aimed to evaluate the outcome of using cementless primary THR among patients with sickle cell disease with end-stage hip avascular necrosis in Yemen. Methods: Thirty cementless primary total hip arthroplasty (THA) were performed for AVN of the femoral head in 27 sickle cell patients, at Al.-Thawra Modern General Hospital-Sana'a, Yemen, from January 2018 to December 2022. Results: The mean age of the patients was 27 ± five years (ranged 18–37 years) with a male to female ratio was 3:1. Steinberg staging for hip AVN was stage IV, one patient (3%); stage VI, thirteen patients (45%); and stage V, sixteen patients (51%). THR was on right side 14 (52%), left side 10 (37%), and bilateral 3 (11%). The implant used was ceramic on polyethylene acetabular liner. All patients showed improvement in Harris hip score from preoperative mean hip score was 25 ± 8 points to postoperative mean hip score was 88 ± 6 points at the last follow-up. Mean of the length of stay in hospital was 12.7 ± eight days (ranged from 4 to 32 days); the mean operating time was 107 ± 23 min. Three cases had superficial wound infection; four patients had five intraoperative fractures; two cases had pulmonary complications; one case had abdominal crisis. All patients had postoperative leg length discrepancy less than 2 cm. None had deep infection, nerve injury, wound hematoma, aseptic loosing, dislocation, DVT, heterotopic ossification, or death. Conclusion: THR in SCD has a good outcome using cementless THA with a low rate of complication in Yemen, a developing country. [ABSTRACT FROM AUTHOR]

Background: Helicobacter pylori is a fastidious pathogen that is required a complicated medium for growth. Invading epithelial cells of the stomach. H. pylori virulence factors are classified by function, acidic resistivity, adhesion, chemotaxis and motility, molecular mimicry, immunological invasion and modulation, and toxins formation such as cytotoxin-associated genes A (cagA) and vacuolating cytotoxin A (vacA). This study aims to determine a simple and innovative technique to isolate H. pylori from gastric biopsies and assess pathogenicity by virulence factor gene detection. Methods: A total of 200 patients who were suspected of having H. pylori infection had two antral gastric biopsies undertaken. A rapid urease test (RUT) was used for one, and Brain Heart Infusion broth (BHI) was used to cultivate the other. The molecular study included diagnostics utilizing the 16sRNA housekeeping gene along with the identification of the virulence factors genes (cagA, cagT, and vacA) and sequencing, Result: Of the 200 antral gastric biopsies collected, 135 were positive rapid urease tests, and 17 H. pylori isolates were successfully obtained from 135 biopsies. The 16SrRNA as a housekeeping gene is confirmed, and about 53%, 70.5%, and 82.3% of the 17 isolates show carrying cagA, cagT, and vacA genes, respectively. All peptic ulcer isolates have the cagA gene, while Gastroesophageal Reflux Disease (GERD) and non-peptic ulcer disease (NPUD) isolates show the lack of the cagA gene. All bacteria, which were isolated from peptic ulcer, nodular gastritis, and gastritis patients, have a vacA gene. Conclusion: The effective method for isolating H. pylori is centrifuging the transport broth after 24 h of incubation. The cagA toxin causes peptic ulcer while vacA toxin induces several histopathological changes in the stomach. Three virulence genes were present in all peptic ulcer-causing bacteria, while only one or none were present in the GERD and NPUD biopsy isolates. [ABSTRACT FROM AUTHOR]

Background/Objectives: COVID-19 impacts technical success of endoscopic retrograde cholangiopancreatography (ERCP). In this study, we aimed to assess the influence of COVID-19 on hospitalizations that underwent ERCP. Methods: We identified all adult COVID-19 and non-COVID-19 hospitalizations that underwent ERCP in the United States using the National Inpatient Sample for 2020. Hospitalization characteristics, clinical outcomes, and complications were compared between the two groups. Results: In 2020, 2015 COVID-19 and 203,094 non-COVID-19 hospitalizations underwent ERCP. The COVID-19 cohort had a higher mean age (60.3 vs 55.6 years, p < 0.001) and a higher proportion of Blacks and Hispanics compared to the non-COVID-19 cohort. After adjusting for confounders, the COVID-19 cohort had higher all-cause inpatient mortality (4.77 vs 1.45%, aOR 4.09, 95% CI 2.50–6.69, p < 0.001), mean length of stay (LOS) [10.19 vs 5.94 days, mean difference: 3.88, 95% CI 2.68–5.07, p < 0.001] and mean total hospital charges (THC) [$152,933 vs $96,398, mean difference: 46,367, 95% CI 21,776–70,957, p < 0.001] compared to the non-COVID-19 cohort. Increasing age, higher Charlson Comorbidity Index, and post-ERCP pancreatitis were identified to be independent predictors of inpatient mortality for COVID-19 hospitalizations that underwent ERCP. Furthermore, the COVID-19 cohort had higher odds of developing post-ERCP pancreatitis (PEP) (11.55 vs 7.05%, aOR 1.64, 95% CI 1.19–2.25, p = 0.002) compared to the non-COVID-19 cohort, after adjusting for confounders. However, there was no statistical difference in the rates of bowel perforations and post-ERCP hemorrhage between the two groups. Conclusion: COVID-19 hospitalizations that underwent ERCP had higher inpatient mortality, mean LOS, mean THC, and odds of developing PEP compared to the non-COVID-19 cohort. Clinical Trial Registration: This study is not a part of a clinical trial. [ABSTRACT FROM AUTHOR]

The rising prevalence of severe obesity has led to a parallel increase in bariatric surgeries, raising a complex array of medicolegal issues. This review aims to analyze and synthesize literature on bariatric surgery malpractice, focusing on patient demographics, surgical complications, litigation costs, and the nature of malpractice cases. A systematic search was conducted across multiple databases for relevant studies published up to May 2023. Our review endeavors to provide insights into these medicolegal challenges and their implications and foster an informed dialogue on strategies for their effective management. By doing so, we hope to enhance ethical and legally sound bariatric practices, safeguarding both patient welfare and surgical practitioners from legal repercussions. [ABSTRACT FROM AUTHOR]

Introduction: Peptic ulcers with adherent clots are associated with a high-risk of rebleeding and mortality. However, the optimal management of bleeding ulcers with adherent clots remains unclear. We conducted this systematic review and meta-analysis to compare endoscopic therapy and conservative therapy to manage bleeding ulcers with adherent clots. Methods: We systematically searched PubMed, Embase, and Web of Science databases through October 2022 to include all studies comparing the endoscopic and conservative therapeutic approaches for bleeding ulcers with adherent clots. Our primary outcome was rebleeding (overall and 30-day). The secondary outcomes were mortality (overall and 30-day), need for surgery, and length of hospital stay (LOS). The random-effects model was used to calculate the pooled odds ratios (OR) and mean differences (MD) with the corresponding confidence intervals (CI) for proportional and continuous variables, respectively. Results: Eleven studies (9 RCTs) with 833 patients (431 received endoscopic therapy vs. 402 received conservative therapy) were included. Overall, endoscopic therapy was associated with lower overall rebleeding (OR 0.41, 95% CI 0.22–0.79, P = 0.007), 30-day rebleeding (OR 0.43, 95% CI 0.21–0.89, P = 0.002), overall mortality (OR 0.47, 95% CI 0.23–0.95, P = 0.04), 30-day mortality (OR 0.43, 95% CI 0.21–0.89, P = 0.002), need for surgery (OR 0.44, 95% CI 0.21–0.95, P = 0.04), and LOS (MD − 3.17 days, 95% CI − 4.14, − 2.19, P < 0.00001). However, subgroup analysis of randomized controlled trials (RCTs) showed no significant difference in overall mortality (OR 0.78, 95% CI 0.24–2.52, P = 0.68) between the two strategies, with numerically lower but statistically non-significant rates of overall rebleeding (7.2% vs. 18.5%, respectively; OR 0.42, 95% CI 0.17–1.05, P = 0.06), statistically lower rate of need for surgery (OR 0.28, 95% CI 0.08–0.96, P = 0.04) with endoscopic therapy compared to conservative therapy. Conclusions: Our meta-analysis demonstrates that endoscopic therapy was overall associated with lower rates of rebleeding (overall and 30-day), mortality (overall and 30-day), need for surgery, and LOS, compared to conservative therapy for the management of bleeding ulcers with adherent clots. However, subgroup analysis of RCTs showed that endoscopic therapy was associated with numerically lower but statistically non-significant rates of overall rebleeding and a statistically lower rate of need for surgery compared to conservative therapy with similar overall mortality rates. Combined treatment with thermal therapy and injection therapy was the most effective treatment modality in reducing rebleeding risk. Further large-scale RCTs are needed to validate our findings. [ABSTRACT FROM AUTHOR]

The topology of grid-connected seven-switch boost-type current source inverter (CSI7) is a promising alternative to the conventional six-switch current source inverter (CSI) due its superiority in terms of reliability and energy efficiency. It is a simple single-stage boost-type converter that allows the injection of high quality sinusoidal AC-currents with controllable power factor into the grid with a DC-link voltage lower than the grid voltage amplitude. This paper evaluates the performance of grid-connected photovoltaic (PV) CSI7 in terms of power losses and efficiency considering distinct configurations of the voltage reverse blocking power switches, i.e., silicon IGBTs (Si-IGBTs) in series with hyper-fast recovery silicon diodes (Si-HFRDs) and Si-IGBTs in series with wide band-gap silicon-carbide Schottky-barrier diodes (SiC-SBDs). The proposed investigation is based on experimental tests and combined electrical-thermal computer co-simulations using PLECS and simulink. The obtained results empathize the features of SiC-SBDs based power switches in terms of reducing the inverter's power losses and improving the overall system efficiency. They also demonstrate the high performance of the CSI7 topology in terms of power quality in grid-connected PV applications. [ABSTRACT FROM AUTHOR]

Purpose of Review: Despite the available pneumococcal conjugate vaccination (PCV), children in developing countries suffer significant morbidity and mortality from pneumococcal illness. This review outlines the pneumococcal carriage rate, common serotypes, antibiotic resistance, and PCV coverage among western Asian children. Recent Findings: The carriage rate and prevalence of PCV serotypes remain high among children in Western Asia. In recent times, the national immunization rates have increased, but there was a considerable rate of invasive pneumococcal diseases (IPD) strains and non-invasive pneumococcal diseases (NIPD) serotypes with high antimicrobial resistance rates and many communities in western Asian countries are experiencing the phenomenon of pneumococcal vaccine serotype replacement (PVSR). Summary: An accurate and updated disease surveillance in Western Asia is urgently needed to guide immunization efforts and protect children effectively. Increasing the PCV covering rate and antimicrobial stewardship is crucial for countries to implement strict systems and effectively minimize the high rate of resistance. [ABSTRACT FROM AUTHOR]

The article discusses the digital revolution in healthcare education, specifically focusing on the European Society of Intensive Care Medicine's (ESICM) Academy Critical Care Education (ACE) courses. These courses provide easily accessible and low carbon footprint education for healthcare professionals worldwide. The ACE courses were developed to modernize the ESICM's eLearning provision and cover the knowledge domain of the Competency-Based Training in Intensive Care Medicine curriculum. The article highlights the growth and success of the ACE courses, as well as future plans for advancements in technology and collaborative learning. [Extracted from the article]

X-ray free-electron lasers (FELs) are state-of-the-art scientific tools capable to study matter on the scale of atomic processes. Since the initial operation of X-ray FELs more than a decade ago, several facilities with upgraded performance have been put in operation. Here we present the first lasing results of Athos, the soft X-ray FEL beamline of SwissFEL at the Paul Scherrer Institute in Switzerland. Athos features an undulator layout based on short APPLE-X modules providing full polarisation control, interleaved with small magnetic chicanes. This versatile configuration allows for many operational modes, giving control over many FEL properties. We show, for example, a 35% reduction of the required undulator length to achieve FEL saturation with respect to standard undulator configurations. We also demonstrate the generation of more powerful pulses than the ones obtained in typical undulators. Athos represents a fundamental step forward in the design of FEL facilities, creating opportunities in FEL-based sciences. Since their initial operation, free-electron lasers are regularly upgraded in their performance and parameter control. Here the authors present the first lasing results of the soft X-ray free-electron laser beamline of the Paul Scherrer Institute, demonstrating different modes of operation and polarisation control of the tailored soft X-ray pulses. [ABSTRACT FROM AUTHOR]

Vitis vinifera L., commonly known as grape is a major fruit crop in the world. Grapes seem to confer health benefits due to their chemical components, biological and antioxidant activities. The present study is conducted to evaluate the biochemical constituents, antioxidant, and antimicrobial potential of ethanolic grape peduncles (EGP) extract. The result of phytochemical analysis revealed the presence of various phytochemicals such as flavonoid, tannin, carbohydrates, alkaloids, cardiac glycoside, phenol, steroid, terpenoids, quinones and anthraquinones. Furthermore, total phenolic content (TPC) and total flavonoid contents (TFC) were 7.35 ± 0.25 mg GAE/g (Gallic Acid Equivalent per gram) and 29.67 ± 0.13 mg QE/g (Quercetin Equivalent per gram) respectively. DPPH (2, 2-diphenyl-1-picrylhydrazyl) free radical scavenging assay revealed IC50 = 159.3 μg/mL. The antibacterial and antifungal study disclosed that the extract was highly potent against Salmonella typhi with maximum zone of inhibition of 27.2 ± 1.60 mm and Epidermophyton floccosum with 74 ± 1.81% inhibition. The extract was analyzed for its cytotoxicity and antileishmanial activity and showed no activity against HeLa cell line and promastigotes of Leishmania major. Elements Fe, Mn, Ni, Pb and Cd were determined by atomic absorption spectroscopy and approximately 50 compounds were identified by Gas Chromatography-Mass Spectrometry (GC–MS). Current work suggest that grape peduncles can be a promising source of bioactive medicinal component. [ABSTRACT FROM AUTHOR]

The packed U-cell inverter is a new and promising multilevel topology that uses a reduced number of power semi-conductors as compared to similar multilevel topologies. Even though many control and modulation algorithms were developed in the research literature, the fault detection and isolation of this converter have not yet been addressed. This paper proposes a new open-circuit fault diagnosis method for a single-phase five-level Packed U-cell inverter (PUC) that makes use of two signatures. The first one is the modulated output voltage that enables the fault detection by verifying the existence of few particular voltage levels. Though this signature does not need a high processing effort to detect the fault, however, only two faulty active power devices can be isolated. Thereafter, a conducted EMI signature, along with the Maximal Overlap Discrete Wavelet Transform (MODWT), is used to isolate the faulty active power device among the remaining power semiconductors. Experimental results are given and discussed to prove that the proposed hybridization of the two signatures is useful for open-circuit fault detection and isolation in PUC inverter. [ABSTRACT FROM AUTHOR]

To formulate a dental bleaching agent with strawberry extract that has potent bleaching properties and antimicrobial efficacy. Enamel specimens (3 × 3 × 2 mm3) were prepared. Quaternary Ammonium Silane (CaC2 enriched) was homogenized with fresh strawberries: Group 1: supernatant strawberry (10 g) extract < Group 2: supernatant strawberry (10 g) extract + 15%HA (Hydroxyapatite) < Group 3: supernatant strawberry (10 g) extract + 15% (HA-2%k21) < Group 4: supernatant strawberry (20 g) extract only (20 g strawberries) < Group 5: supernatant strawberry (20 g) extract + 15% HA < Group 6: supernatant strawberry (20 g) extract + 15% (HA-2%K21) < Group 7: In-office Opalescence Boost 35%. Single-colony lactobacillus was examined using confocal microscopy identifying bacterial growth and inhibition in presence of bleaching agents using 300 µL aliquot of each bacterial culture. Images were analysed by illuminating with a 488 nm argon/helium laser beam. Colour difference (∆E00) was calculated using an Excel spreadsheet implementation of the CIEDE2000 colour difference formula and colour change measured between after staining and after bleaching. Scanning electron microscope was used to image specimens. Raman spectra were collected, and enamel slices were used for STEM/TEM analysis. HPLC was used for strawberry extract analysis. Nano-indentation was performed and X-ray photoelectron spectroscopy. Antioxidant activity was determined along with molecular simulation. hDPSCs were expanded for Alamar Blue Analysis and SEM. Mean colour change was significantly reduced in group 1 compared to other groups (p < 0.05). CLSM showed detrimental effects of different strawberry extracts on bioflms, especially with antimicrobial (p < 0.05). Groups 1, 2 and 3 showed flatter/irregular surfaces with condensation of anti-microbial in group 3. In strawberry specimens, bands predominate at 960 cm−1. HPLC determined the strawberry extracts content. Molecular simulation verified interaction between calcium and polyphenol components. XPS peak-fitted high-resolution corresponding results of Ca2p3/2 and Ca2p1/2 for all k21 groups. Combination of 10 g strawberry extract supernatant and 15% (hydroxyapatite 2%k21) improved the whiteness and provided additional antimicrobial potential. The novel strawberry extract and antimicrobial based dental formulation had immediate bleaching effect without promoting significant changes in enamel morphology. [ABSTRACT FROM AUTHOR]

Purpose: Revisional bariatric surgeries following laparoscopic sleeve gastrectomy (LSG) have demonstrated a dramatic increase worldwide. Recently, one-anastomosis gastric bypass (OAGB) has become a contender as an appropriate revisional procedure; however, no long-term data currently exist on the effectiveness of it as a revisional surgery post-LSG. Methods: A retrospective analysis was performed on all patients who underwent LSG at a public hospital in Kuwait from 2008 to 2017. A list was obtained of those who underwent revisional OAGB surgery after initial LSG, after which a phone survey was performed and demographics were analyzed. Results: A total of 29 patients underwent revisional OAGB post-initial LSG, of which 89.7% were female. Prior to LSG, the mean weight of the patients was 127.5 kg, and the mean BMI was 49.0 kg/m2. The mean weight loss after initial LSG was 43.8 kg, while the average duration until patients underwent revisional OAGB was 5.3 years. The cause for revision was weight regain (86.2%) or inadequate weight loss (13.8%). Prior to undergoing revisional OAGB, the weight and BMI of the patients was 110.9 kg and 42.4 kg/m2, respectively. Revisional OAGB demonstrated a %excess weight loss of 14.5%, 31.9%, 48.0%, 56.3%, 57.2%, and 54.7% at 2 weeks, 3 months, 6 months, 1 year, 4 years, and 5 years, respectively. Twelve morbidities were reported during the follow-up period. Conclusion: Revisional bariatric surgery is technically demanding and may be associated with a high complication rate. However, OAGB as a revisional procedure has proven to be safe and effective in the long-term outcomes of revisional OAGB patients post-LSG. [ABSTRACT FROM AUTHOR]

Background: We identified trends of inpatient therapeutic endoscopic retrograde cholangiopancreatography (ERCP) in the United States (US), focusing on outcomes related to specific patient demographics. Methods: The National Inpatient Sample was utilized to identify all adult inpatient ERCP in the US between 2007–2018. Trends of utilization and adverse outcomes were highlighted. P-values ≤ 0.05 were considered statistically significant. Results: We noted a rising trend for total inpatient ERCP in the US from 126,921 in 2007 to 165,555 in 2018 (p = 0.0004), with a significant increase in utilization for Blacks, Hispanics, and Asians. Despite an increasing comorbidity burden [Charlson Comorbidity Index (CCI) score ≥ 2], the overall inpatient mortality declined from 1.56% [2007] to 1.46% [2018] without a statistically significant trend (p = 0.14). Moreover, there was a rising trend of inpatient mortality for Black and Hispanic populations, while a decline was noted for Asians. After a comparative analysis, we noted higher rates of inpatient mortality for Blacks (2.4% vs 1.82%, p = 0.0112) and Hispanics (1.17% vs 0.83%, p = 0.0052) at urban teaching hospitals between July toand September compared to the October to June study period; however, we did not find a statistically significant difference for the Asian cohort (1.9% vs 2.10%, p = 0.56). The mean length of stay (LOS) decreased from 7 days in 2007 to 6 days in 2018 (p < 0.0001), while the mean total hospital charge (THC) increased from $48,883 in 2007 to $85,909 in 2018 (p < 0.0001) for inpatient ERCPs. Compared to the 2015–2018 study period, we noted higher rates of post-ERCP pancreatitis (27.76% vs 17.25%, p < 0.0001) from 2007–2014. Conclusion: Therapeutic ERCP utilization and inpatient mortality were on the rise for a subset of the American minority population, including Black and Hispanics. [ABSTRACT FROM AUTHOR]

Background and Aim: The natural history of KRAS mutations in mucinous pancreatic cysts (MPCs) over time remains to be fully understood. The aim of this study was to examine the performance of DNA markers and assess changes of KRAS mutations over time. Methods: Patients who underwent EUS-FNA of pancreatic cysts with at least two separate molecular analysis results were included in the study. We assessed the baseline patient and cyst characteristics, and DNA fluid analysis. The presence of either a KRAS mutation, or a CEA > 192 ng/ml was used as the diagnostic standard for mucinous cysts when surgical pathology was not available. Results: A total of 933 pancreatic cyst fluid samples were collected, including 117 with ≥ 2 FNAs. Examinations were performed over a median of 30 months (range 1–115 months). Forty-three (36%) had a mutant KRAS on the index analysis out of which 26 had a change in their KRAS status to the wild-type. Eighty-one (64%) had a wild-type KRAS on the index analysis out of which 18 had change in their KRAS status to mutant type. There was no significant difference in the index cyst characteristics, presence of symptoms, or main duct involvement based on KRAS status change. Increasing age was associated with a changing KRAS mutation status (p = 0.023). Conclusion: KRAS mutations gain and loss in pancreatic cyst fluid appears to occur frequently during long-term surveillance of MPCs. Age appears to be the only predictor for KRAS change over time. [ABSTRACT FROM AUTHOR]

Petrochemical industrial wastewater presents a challenge when treated, employing the conventional activated sludge process, such as in the activated sludge process, the loss of biomass due to the harsh wastewater conditions and the inhibition caused by the elevated levels of industrial compounds. Hybrid biological reactors may present a resource to be tapped in the operation of an industrial wastewater treatment facility if integrated optimally in the treatment sequence. This paper examines possible integration scenarios of hybrid reactors in a petrochemical wastewater treatment plant in order to improve its organic removal efficiency. A pilot hybrid biological reactor was constructed using high surface area biological carrier and was operated using real wastewater streams from a wastewater treatment plant at two flow rates (400 ml/min and 240 ml/min), two dissolved oxygen levels (2.0 mg/l and 4.0 mg/l), and anaerobic conditions. The reactor was tested using raw, primary, secondary, and effluent streams from the wastewater treatment plant. The reactors were primed with wastewater from the aeration tank of the wastewater treatment plant and was operated for 10 d afterward (total 24 runs). The chemical oxygen demand cumulative removal was used to identify best integration scenario and to benchmark its performance against domestic wastewater. The best performing scenarios were identified as anaerobic (400 ml/min) for raw wastewater treatment and [(400 ml/min and dissolved oxygen (DO) 2.0 mg/l)] for secondary wastewater polishing. The results reflected the unfavorable conditions for biodegradation after the primary chemical treatment. This conclusion was confirmed upon benchmarking the hybrid reactor performance using domestic wastewater. [ABSTRACT FROM AUTHOR]

Background: Endoscopic sleeve gastroplasty (ESG) is a minimally invasive endoscopic weight loss procedure used to treat obesity. The long-term goal of this project is to develop a Virtual Bariatric Endoscopy (ViBE) simulator for training and assessment of the ESG procedure. The objectives of this current work are to: (a) perform a task analysis of ESG and (b) create metrics to be validated in the created simulator.Methods: We performed a hierarchical task analysis (HTA) by identifying the significant tasks of the ESG procedure. We created the HTA to show the breakdown and connection of the tasks of the procedure. Utilizing the HTA and input from ESG experts, performance metrics were derived for objective measurement of the ESG procedure. Three blinded video raters analyzed seven recorded ESG procedures according to the proposed performance metrics.Results: Based on the seven videos, there was a positive correlation between total task times and total performance scores (R = 0.886, P = 0.008). Endoscopists expert were found to be more skilled in reducing the area of the stomach compared to endoscopists novice (34.6% reduction versus 9.4% reduction, P = 0.01). The mean novice performance score was significantly lower than the mean expert performance score (34.7 vs. 23.8, P = 0.047). The inter-rater reliability test showed a perfect agreement among three raters for all tasks except for the suturing task. The suturing task had a significant agreement (Inter-rater Correlation = 0.84, Cronbach's alpha = 0.88). Suturing was determined to be a critical task that is positively correlated with the total score (R = 0.962, P = 0.0005).Conclusion: The task analysis and metrics development are critical for the development of the ViBE simulator. This preliminary assessment demonstrates that the performance metrics provide an accurate assessment of the endoscopist's performance. Further validation testing and refinement of the performance metrics are anticipated. [ABSTRACT FROM AUTHOR]

Purpose: Our aim was to report the characteristics and long-term surgical outcomes of three subgroups of horizontal strabismus in a single institution (divided by strabismus subtype) in a developing country and look into pre-operative factors predictive of surgical success. Methods: Two hundred and forty-four complete charts of patients, divided into 152 esotropes (ET) and 92 exotropes (XT) who had undergone horizontal strabismus surgeries, were retrospectively reviewed. Charts of patients with muscle palsy, Duane syndrome and consecutive strabismus were excluded; 172 patients were included divided into partially accommodative ET, congenital ET and intermittent XT. Surgical success was defined as a post-operative angle deviation of 12 prism diopters or less. Results: The mean follow-up period of all patients was 31.64 ± 23.12 months. The subgroups were divided into partially accommodative ET (60 patients), congenital ET (60 patients), and intermittent XT (52 patients). Esotropes (both partially accommodative and congenital) presented earlier (p < 0.001). Also, partially accommodative ET had a significantly higher spherical equivalent (SE) compared to congenital ET patients, who had a higher SE than intermittent XT (p < 0.001). Congenital ET patients had a significantly larger angle of deviation (for both far and near) than both partially accommodative ET and intermittent XT patients (p < 0.001). The overall success rate was 72.67% for the whole group with no significant differences among subgroups. Success rate of partially accommodative ET surgery was 78.33% compared to that of congenital ET at 66.67% and intermittent XT at 73.07%. Significant post-operative improvement in sensory fusion was observed mainly for patients with partially accommodative esotropia and intermittent exotropia. Conclusion: Our results showed that esotropes (both partially accommodative and congenital) presented earlier, with a higher spherical equivalent in the partially accommodative ET subgroup, while the congenital ET subgroup had the largest angle of deviation for both distance and near. The overall surgical success rate for horizontal strabismus surgery was 72.67% with the 3 subgroups having similar success rates. A younger age at presentation and absence of amblyopia were positively correlated with surgical success in the partially accommodative esotropia group. [ABSTRACT FROM AUTHOR]

Before the exit exam, shall it be a national exam or an European Diploma in Intensive Care (EDIC), ESICM offers exam-focused preparatory courses. To fill this gap, the European Society of Intensive Care Medicine (ESICM) is now launching a new educational initiative called Intensive Care Fundamentals (ICF). Launching "Intensive Care Fundamentals": an ESICM educational initiative for newcomers to intensive care unit. [Extracted from the article]

Core–shell nanoparticles (CSNPs) have attracted attention in biomedical applications as they have highly useful materials with modified characteristics, such as high stability, dispersibility, higher permeability to certain target cells and reduction in consumption of precious materials. Synthesis of core–multishell nanoparticles with suitable sizes, structural characteristics and absorption using simple methods continues to be a challenge. In this study, Fe 3 O 4 @ Au @ SiO 2 CSNPs were synthesized in three stages to control their size and the potential for tuning their properties. Field emission scanning electron microscope images confirmed that Fe 3 O 4 @ Au @ SiO 2 CSNPs have a small particle size of about 22.5 nm, average crystalline size in X-ray diffractometer analysis was 22.8 nm, stability was about − 49.1 mV, and synthesis with magnetic and optical properties improved their biocompatibility. Treatment of CAL-51 and HBL-100 cell lines by Fe 3 O 4 @ Au @ SiO 2 CSNPs under NIR laser and alternating magnetic field generated enough heat to increase cell death. [ABSTRACT FROM AUTHOR]

Purpose: Overexpression and activation of matrix metalloproteinase-13 (MMP-13) within atheroma increases susceptibility to plaque rupture, a major cause of severe cardiovascular complications. In comparison to pan-MMP targeting [18F]BR-351, we evaluated the potential for [18F]FMBP, a selective PET radiotracer for MMP-13, to detect extracellular matrix (ECM) remodeling in vascular plaques possessing markers of inflammation. Procedures: [18F]FMBP and [18F]BR-351 were initially assessed in vitro by incubation with en face aortae from 8 month-old atherogenic ApoE−/− mice. Ex vivo biodistributions, plasma metabolite analyses, and ex vivo autoradiography were analogously performed 30 min after intravenous radiotracer administration in age-matched C57Bl/6 and ApoE−/− mice under baseline or homologous blocking conditions. En face aortae were subsequently stained with Oil Red O (ORO), sectioned, and subject to immunofluorescence staining for Mac-2 and MMP-13. Results: High-resolution autoradiographic image analysis demonstrated target specificity and regional concordance to lipid-rich lesions. Biodistribution studies revealed hepatobiliary excretion, low accumulation of radioactivity in non-excretory organs, and few differences between strains and conditions in non-target organs. Plasma metabolite analyses uncovered that [18F]FMBP exhibited excellent in vivo stability (≥74% intact) while [18F]BR-351 was extensively metabolized (≤37% intact). Ex vivo autoradiography and histology of en face aortae revealed that [18F]FMBP, relative to [18F]BR-351, exhibited 2.9-fold greater lesion uptake, substantial specific binding (68%), and improved sensitivity to atherosclerotic tissue (2.9-fold vs 2.1-fold). Immunofluorescent staining of aortic en face cross sections demonstrated elevated Mac-2 and MMP-13-positive areas within atherosclerotic lesions identified by [18F]FMBP ex vivo autoradiography. Conclusions: While both radiotracers successfully identified atherosclerotic plaques, [18F]FMBP showed superior specificity and sensitivity for lesions possessing features of destructive plaque remodeling. The detection of ECM remodeling by selective targeting of MMP-13 may enable characterization of high-risk atherosclerosis featuring elevated collagenase activity. [ABSTRACT FROM AUTHOR]

Introduction The Orbera365 is a new balloon that can stay in the stomach for up to 12 months. The aim of this study is to investigate the safety and effect of Orbera365. Method Prospective study on our initial experience with a consecutive group of patients who underwent the insertion of Orbera365 in the period between September 2019 and August 2020. The patients were followed up to assess, pain, nausea, and vomiting after procedure, weight loss, and the complication rate. Results A total of 97 patients underwent Orbera365 placement. Mean weight and BMI before the procedure were 93.8±15.2 kg and 35.2±4.4 kg/m2, respectively, which dropped to 80.6±13.1 kg and 29.8±4.0 kg/m2 by 8.2 months and were 82.4±16.1 and 30.4±4.6 at the last day of follow-up of 12.9 months. Fourteen patients did not tolerate the balloon, and had to have it removed, six of them in the frst week, and eight within the first 8 months of insertion. Other than intolerance, two patients had balloon rupture, three patients had leakage at time of insertion requiring balloon replacement, two patient had pancreatitis, one patient had spontaneous balloon hyperinflation, and one patient had balloon deflation and vomited the balloon. At day of last follow-up, total body weight loss % (TBWL%) was 16.2±10.1 and %EWL was 54.6±38.3. Conclusion Orbera365 is safe and effective for weight loss. [ABSTRACT FROM AUTHOR]

FBMC is one of the new emerging multicarrier techniques that are proposed to replace the CP-OFDM in future communications mainly because the FBMC does not need cyclic prefix to combat multipath channels and has better spectral containment that reduces the adjacent channel interference. Both of these properties enhance the overall spectral efficiency of the communication system adopting the FBMC. These desired merits of the FBMC come on the expense of higher implementation complexity. This paper aims to present a unified treatment of the theory of the FBMC alongside with the complexity considerations associated with the implementation of the FBMC system. A comparison between FBMC and CP-OFDM in terms of computational requirement is presented, and a comparison of performance based on LTE parameters is also presented and showed the FBMC capability to perform better without the need for CP using simple pilot based one-tap frequency domain channel estimation and equalization. It is also shown that for backward compatibility, a communication system can operate based on either CP-OFDM or FBMC by sharing the same IFFT/FFT and equalizer blocks. [ABSTRACT FROM AUTHOR]

Objectives: Chest CT has been widely used to screen and to evaluate the severity of COVID-19 disease in the early stages of infection without severe acute respiratory syndrome, but no prospective data are available to study the relationship between extent of lung damage and short-term mortality. The objective was to evaluate association between standardized simple visual lung damage CT score (vldCTs) at admission, which does not require any software, and 30-day mortality. Methods: In a single-center prospective cohort of COVID-19 patients included during 4 weeks, the presence and extent of ground glass opacities(GGO), consolidation opacities, or both of them were visually assessed in each of the 5 lung lobes (score from 0 to 4 per lobe depending on the percentage and out of 20 per patient = vldCTs) after the first chest CT performed to detect COVID-19 pneumonia. Results: Among 210 confirmed COVID-19 patients, the number of survivors and non-survivors was 162 (77%) and 48 (23%), respectively at 30 days. vldCTs was significantly higher in non-survivors, and the AUC of vldCTs to distinguish survivors and non-survivors was 0.72 (95%CI 0.628–0.807, p < 0.001); the best cut-off vldCTs value was 7. During follow-up, significant differences in discharges and 30-day mortality were observed between patients with vldCTs ≥ 7 versus vldCTs < 7: (98 [85.2%] vs 49 [51.6%]; p < 0.001 and 36 [37.9%] vs 12 [12.4%]; p < 0.001, respectively. The 30-day mortality increased if vldCTs ≥ 7 (HR, 3.16 (1.50–6.43); p = 0.001), independent of age, respiratory rate and oxygen saturation levels, and comorbidities at admission. Conclusions: By using chest CT in COVID-19 patients, extensive lung damage can be visually assessed with a score related to 30-day mortality independent of conventional risk factors of the disease. Key Points: • In non-selected COVID-19 patients included prospectively during 4 weeks, the extent of ground glass opacities(GGO) and consolidation opacities evaluated by a simple visual score was related to 30-day mortality independent of age, respiratory rate, oxygen saturation levels, comorbidities, and hs-troponin I level at admission. • This severity score should be incorporated into risk stratification algorithms and in structured chest CT reports requiring a standardized reading by radiologists in case of COVID-19. [ABSTRACT FROM AUTHOR]

Background and Aims: Endoscopic stenting is the standard of care for full thickness esophageal wall defects. The aim of this study is to evaluate outcomes of endoscopic closure of esophageal defects using stenting, with or without endoscopic suturing.Methods: This is a single-center retrospective study of patients with esophageal wall defects who underwent endoscopic interventions. Outcomes of stenting with or without endoscopic suturing of the defect were assessed. Univariate and multivariate logistic regression models were used to examine factors associated with successful defect closure.Results: One hundred and fourteen patients with esophageal wall defects underwent 254 endoscopies with an overall complete closure rate of 75.8%. Twenty-three (20.2%) patients underwent primary closure using endoscopic suturing and subsequent esophageal stenting, while 91 (79.8%) underwent esophageal stenting only. The dual modality group (versus the stent-only group) had similar defect closure rates (84.2 vs. 73.8%, p = 0.55) and time to stent migration (37 vs. 12.5 days, p = 0.07), but was associated with longer procedure times (60 vs. 36 min, p < 0.01) and fewer additional endoscopic procedures (13.6 vs. 43.2%, p = 0.01). Stent suturing significantly decreased migration (35.5 vs. 58.5%, p = 0.04), was associated with fewer additional endoscopies (15.4 vs. 50%, p < 0.01) and reduced need for additional stents (7.7 vs. 34.3%, p < 0.01). On multivariate analysis, chronic defects (> four weeks old) were 81% less likely to close compared to acute (≤ 4 weeks) defects (OR 0.19, CI 0.04-0.77, p = 0.02), and large diameter stents (23 mm) were associated with higher odds of defect closure (OR 3.36, CI 1.02-11.4, p = 0.04).Conclusion: Endoscopic treatment of esophageal wall defects is safe, effective, and more likely to be successful in acute defects using larger caliber stents. Stent suturing reduces migration, need for additional endoscopic procedures, and stent exchanges. Further comparative studies with larger cohorts are needed to validate our results. [ABSTRACT FROM AUTHOR]

Background: A single-procedure session combining EUS and ERCP (EUS/ERCP) for tissue diagnosis and biliary decompression for pancreatic duct adenocarcinoma (PDAC) is technically feasible. While EUS/ERCP may offer expedience and convenience over an approach of separate procedures sessions, the technical success and risk for complications of a combined approach is unclear. Aims: Compare the effectiveness and safety of EUS/ERCP versus separate session approaches for PDAC. Methods: Study patients (2010–2015) were identified within our ERCP database. Patients were analyzed in three groups based on approach: Group A: Single-session EUS-FNA and ERCP (EUS/ERCP), Group B: EUS-FNA followed by separate, subsequent ERCP (EUS then ERCP), and Group C: ERCP with/without separate EUS (ERCP ± EUS). Rates of technical success, number of procedures, complications, and time to initiation of PDAC therapies were compared between groups. Results: Two hundred patients met study criteria. EUS/ERCP approach (Group A) had a longer index procedure duration (median 66 min, p = 0.023). No differences were observed between Group A versus sequential procedure approaches (Groups B and C) for complications (p = 0.109) and success of EUS-FNA (p = 0.711) and ERCP (p = 0.109). Subgroup analysis (> 2 months of follow-up, not referred to hospice, n = 126) was performed. No differences were observed for stent failure (p = 0.307) or need for subsequent procedures (p = 0.220). EUS/ERCP (Group A) was associated with a shorter time to initiation of PDAC therapies (mean, 25.2 vs 42.7 days, p = 0.046). Conclusions: EUS/ERCP approach has comparable rates of success and complications compared to separate, sequential approaches. An EUS/ERCP approach equates to shorter time interval to initiation of PDAC therapies. [ABSTRACT FROM AUTHOR]

Women's contributions to the medical field have increased substantially over the past 4 decades but women remain underrepresented. Since research productivity is an important criterion for promotion, it was essential to assess the gender differences within the faculty of medicine and across departments. We conducted a bibliometric analysis using the Scopus database between 2009 and 2018 at the American University of Beirut (N = 324, 93 women, 231 men). Women comprised 29% of the faculty. The rank of Professor was held by 34% of men and 18% of women (p < 0.0001). Mean number of publications was 30.12 for males compared to 20.77 for females (p = 0.007). Men were more often last authors (p < 0.0001) and corresponding authors (p < 0.01). In the MD subcategory (N = 282), the gender difference in number of publications, H-index, and total citations was not significant. Women MDs were underrepresented as last authors (p < 0.0001). Among PhD faculty (N = 42), males had greater H-Indices (p = 0.02) and were more often last and corresponding authors. After adjusting for the year of appointment: the gender differences in corresponding and last authorship lost statistical significance among MDs but not among PhDs where it became more pronounced. In conclusion, women in the faculty of medicine were underrepresented in most departments, senior ranks and senior research authorships; H-indices generally did not differ, which was partially explained by the later year of appointment among females. In a developing country, greater family responsibilities especially early in their careers, may put women at a disadvantage in research productivity. [ABSTRACT FROM AUTHOR]

Background: Color vision deficiencies are a group of vision disorders, characterized by abnormal color discrimination. They include red-green color blindness, yellow-blue color blindness and achromatopsia, among others. The deficiencies are caused by mutations in the genes coding for various components of retinal cones. Gene therapy is rising as a promising therapeutic modality. The purpose of this review article is to explore the available literature on gene therapy in the different forms of color vision deficiencies. Methods: A thorough literature review was performed on PubMed using the keywords: color vision deficiencies, gene therapy, achromatopsia and the various genes responsible for this condition (OPN1LW, OPN1MW, ATF6, CNGA3, CNGB3, GNAT2, PDE6H, and PDE6C). Results: Various adenovirus vectors have been deployed to test the efficacy of gene therapy for achromatopsia in animals and humans. Gene therapy trials in humans and animals targeting mutations in CNGA3 have been performed, demonstrating an improvement in electroretinogram (ERG)-investigated cone cell functionality. Similar outcomes have been reported for experimental studies on other genes (CNGB3, GNAT2, M- and L-opsin). It has also been reported that delivering the genes via intravitreal rather than subretinal injections could be safer. There are currently 3 ongoing human clinical trials for the treatment of achromatopsia due to mutations in CNGB3 and CNGA3. Conclusion: Experimental studies and clinical trials generally showed improvement in ERG-investigated cone cell functionality and visually elicited behavior. Gene therapy is a promising novel therapeutic modality in color vision deficiencies. [ABSTRACT FROM AUTHOR]

Background: Introduction of the full-thickness resection device (FTRD) has allowed endoscopic resection of difficult lesions such as those with deep wall origin/infiltration or those located in difficult anatomic locations. The aim of this study is to assess the outcomes of the FTRD among its early users in the USA. Methods: Patients who underwent endoscopic full-thickness resection (EFTR) for lower gastrointestinal tract lesions using the FTRD at 26 US tertiary care centers between 10/2017 and 12/2018 were included. Primary outcome was R0 resection rate. Secondary outcomes included rate of technical success (en bloc resection), achievement of histologic full-thickness resection (FTR), and adverse events (AE). Results: A total of 95 patients (mean age 65.5 ± 12.6 year, 38.9% F) were included. The most common indication, for use of FTRD, was resection of difficult adenomas (non-lifting, recurrent, residual, or involving appendiceal orifice/diverticular opening) (66.3%), followed by adenocarcinomas (22.1%), and subepithelial tumors (SET) (11.6%). Lesions were located in the proximal colon (61.1%), distal colon (18.9%), or rectum (20%). Mean lesion diameter was 15.5 ± 6.4 mm and 61.1% had a prior resection attempt. The mean total procedure time was 59.7 ± 31.8 min. R0 resection was achieved in 82.7% while technical success was achieved in 84.2%. Histologically FTR was demonstrated in 88.1% of patients. There were five clinical AE (5.3%) with 2 (2.1%) requiring surgical intervention. Conclusions: Results from this first US multicenter study suggest that EFTR with the FTRD is a technically feasible, safe, and effective technique for resecting difficult colonic lesions. [ABSTRACT FROM AUTHOR]

Background and Aims: Data on comparative efficacy of various available endoscopic ultrasound-guided liver biopsy (EUS-LB) needles are limited. We sought to compare the performance of a novel Franseen-tip 22G fine-needle biopsy (FNB) device to that of 19G needle platforms for liver parenchyma. Methods: Consecutive patients referred for EUS and suspected to have hepatic parenchymal disease underwent EUS-LB using different EUS needles and were included in this retrospective study. Two blinded expert liver pathologists independently reviewed and reported on: total number of tissue fragments, length of longest fragment, number of complete and incomplete portal tracts (CPT and IPT), and specimen adequacy. Results: A 22G Franseen-tip needle (A) was used in 30 patients; 19G Tru-Cut needle (B) in 50 patients; 19G reverse beveled non-Tru-Cut needle (C) in 27 patients; and a 19G flexible non-Tru-Cut needle (D) in 28 patients. In the order of needles, A, B, C and D, > 10 tissue fragments were obtained in 100%, 6%, 82%, and 96% samples, the mean number of CPTs was 6.9; 3.0; 7.3; and 16.9, length of longest fragment was 3.8, 4. 7, 3.9, and 8.4 mm, and specimen adequacy was 66.7%, 46%, 82.1%, and 81.5%, respectively. A positive correlation was obtained between number of CPTs and length of longest fragment in samples accrued by 19G needles. Conclusion: EUS-LB specimens using 22G Franseen-tip needle appear highly fragmented, leading to inferior specimen adequacy compared to 19G non-Tru-Cut needles. We also report on using length of longest fragment as an additional criterion for specimen adequacy as it positively correlates with number of CPTs standard. [ABSTRACT FROM AUTHOR]

The Kuwait Oil Company currently pumps about 10 Mm3/yr from one of its well fields in central Kuwait (Eocene Aquifer) and plans to increase this rate to 30 Mm3/yr to meet its water demand. The objective of this study is to investigate the sustainability of brackish groundwater resources for oil operations in the mentioned well field in a way to identify the consequences of increasing the pumping rates on groundwater levels and groundwater salinity. A suitable methodology to assess the sustainability of brackish groundwater utilization has been developed based on pumping tests in addition to flow and salinity numerical modeling. Extensive hydrogeological and salinity field investigations were also conducted. The results show that pumping rate should not be increased above 20 Mm3/yr in the aquifer of the study, otherwise a sharp decline in groundwater levels and a significant increase in groundwater salinity will occur. The results of the pumping tests show that the hydraulic properties of the Eocene Aquifer can support regional utilization of the aquifer, but any additional pumping wells should be located within a wider area than the current well field. The salinity variation analysis shows that a mixing process between brackish and saline water is taking place. [ABSTRACT FROM AUTHOR]

Purpose: To identify whether there are functional abnormalities in the retina of amblyopic eyes using multifocal electroretinography (mfERG). Methods: This is a prospective study of patients ≥ 7 years of age identified with unilateral amblyopia (strabismic or anisometropic). Multifocal ERG and flash ERG were performed to compare parameters between the amblyopic and non-amblyopic fellow eyes. A complete analysis of the five ring averages was done including the central ring. Results: Thirty-eight patients were included: mean age was 14.3 ± 7.3 years; 18 patients were strabismic and 20 were anisometropic. Amblyopic eye responses across the rings in multifocal ERG were diminished compared with fellow non-amblyopic eyes with significant differences detected in the central rings (p = 0.001). On the other hand, flash ERG did not show any consistently significant differences. When divided by severity, amplitudes of central rings were significantly lower in severely amblyopic eyes compared with non-amblyopic eyes (p = 0.001), while in mild amblyopia, no significant differences were observed. No significant difference was observed between anisometropic and strabismic amblyopic eyes. Conclusions: Using multifocal ERG, significantly decreased amplitudes were observed in amblyopic eyes compared with normal fellow eyes in the central ring. This correlated with the severity of amblyopia. No difference was observed when comparing the two groups of amblyopia (strabismic and anisometropic). Those findings may help clarify the pathophysiology of amblyopia better and open the door for new objective ways to monitor the response to amblyopia treatment but this needs to be further studied. [ABSTRACT FROM AUTHOR]

Brown algae comprise the largest biomass producers in coastal waters and play important ecological roles. The complex nature of cell wall polysaccharides limits the extraction of bioactive compounds from these seaweeds. The aim of the study was to use enzyme-assisted extraction as a tool to release the bioactive compounds from seven brown seaweeds of Kuwait coast and characterization of the active extracts. The enzymatic extracts obtained by hydrolysing seaweeds with five carbohydrases and three proteases were screened for antioxidant and antimicrobial activity. Yield, total phenolics, and bioactivity were as a function of species difference in cell wall composition and specificity of the enzyme used. Among the six species of brown seaweeds studied, the enzymatic extracts obtained from Sargassum boveanum, Sargassum angustifolium, and Feldmannia irregularis showed high antioxidant activity in different assays. Though antimicrobial activities of the enzymatic extracts were low, Flavourzyme resulted in more number of seaweed extracts with antimicrobial activity against foodborne pathogens. In general, carbohydrases resulted in extracts with high radical scavenging activity whereas proteases resulted in extracts with high iron chelating activity. The extracts with highest antioxidant activity such as S. boveanum-Viscozyme and Alcalase extracts were further fractionated and characterized. The polyphenol and polysaccharide-rich fractions were responsible for the high radical scavenging and reducing power whereas the iron chelating activity and inhibition of lipid oxidation in liposome model system was mainly contributed by polysaccharide and protein-rich fractions. The results of study showed that enzyme-assisted extraction could be useful to make tailor-made seaweed extracts with specific bioactivity. [ABSTRACT FROM AUTHOR]

Intense x-ray free-electron laser (XFEL) pulses hold great promise for imaging function in nanoscale and biological systems with atomic resolution. So far, however, the spatial resolution obtained from single shot experiments lags averaging static experiments. Here we report on a combined computational and experimental study about ultrafast diffractive imaging of sucrose clusters which are benchmark organic samples. Our theoretical model matches the experimental data from the water window to the keV x-ray regime. The large-scale dynamic scattering calculations reveal that transient phenomena driven by non-linear x-ray interaction are decisive for ultrafast imaging applications. Our study illuminates the complex interplay of the imaging process with the rapidly changing transient electronic structures in XFEL experiments and shows how computational models allow optimization of the parameters for ultrafast imaging experiments. X-ray free electron lasers provide high photon flux to explore single particle diffraction imaging of biological samples. Here the authors present dynamic electronic structure calculations and benchmark them to single-particle XFEL diffraction data of sucrose clusters to predict optimal single-shot imaging conditions. [ABSTRACT FROM AUTHOR]

The present research is focused on the synthesis of copper–silver bimetallic nanoparticles using the extracts from the date palm tree (Phoenix dactylifera) leaves. The effect of operational parameters such as type of solvent, pH of the plant extract, salt concentration, and the solution temperature on the particle size and yield of the resultant nanoparticles is reported for the first time. Water–ethanol mixture of 1:1 (v/v) ratio was found to be the best solvent for the extraction of phenolic compounds from the leaves. The novelty of this work lies in the fact that the addition of capping reagent extracted by the green synthesis process from aqueous Sidr leaves reduced the average particle size of the nanoparticles to 26 nm. The characterizations of the copper–silver bimetallic nanoparticles were performed using particle size analyzer, scanning electron microscopy, energy-dispersive X-ray, and X-ray diffraction analysis. Thus, the synthesis of bimetallic copper–silver nanoparticle using palm leaves extract would provide the associated process chemistry. Produced bimetallic nanoparticles were used to establish their catalytic activity to degrade the methylene blue dye from aqueous solution. Well diffusion studies using the as-produced nanoparticles on Bacillus subtilis (Gram-positive) and Escherichia coli (Gram-negative) exhibited the antibacterial ability of the copper–silver bimetallic nanoparticles. The potential catalytic activity for dye degradation and antibacterial assay using nanoparticles highlights the efficacy of the palm leaves and its components. [ABSTRACT FROM AUTHOR]