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Abstract Background and Aims Bowel preparation is considered as major obstacle before colonoscopy, and it is often reported as the most feared part of the procedure. The aim of this study is to determine the difference in efficacy between a split dose of PEG and the previous day regimen in cleaning the colon, using Boston bowel preparation scale. In addition, also to evaluate patient satisfaction regarding the modality of preparation. Methods The study included 200 hospitalized patients undergoing colonoscopy at Beirut hospitals between 2021 and 2023. One of the two regimens will be prescribed randomly to the patients before colonoscopy: 98 (49%) in Group A (patients treated with PEG preparation as a split dose for 2 days), and 102 (51%) in Group B (patients taking PEG preparation as a whole dose). Data was analyzed using SPSS version 25. Results Patients were distributed between 105 (52.5%) males and 95 (47.5%) females. The top two indications for colonoscopy were bleeding (34%), change in bowel habits (constipation/diarrhea) (32%). Patients experienced adverse events noting cramps (48.5%), stomach ache (32%), headache (31%), vomiting (53%), nausea (53%), sleep disturbance (27%), bloating (26.5%), and malaise (26%). A statistically significant difference (p = 0.040) was detected in sleep disturbance: 20.4% of patients in group A and 33.3% of patients in group B. The average satisfaction score was 3.02 ± 1.03 over 4 (Group A) and 3.04 ± 0.99 over 4 (Group B) (p = 0.896). The average BBPS was 8.07 ± 1.14 (Group A) and 8.28 ± 1.0 (Group B) (p = 0.162). Conclusion The two administrations were almost similar in term of satisfaction and BBPS. As multiple factors like age, sexe, comorbidities may contribute in altering how much a given drug is safe and efficace, more research is needed to choose the best 3regimen for each patient.

Abstract The use of inexpensive, lightweight, and portable particulate matter (PM) sensors is increasingly becoming popular in air quality monitoring applications. As an example, these low‐cost sensors can be used in surface or underground coal mines for monitoring of inhalable dust, and monitoring of inhalable particles in real‐time can be beneficial as it can possibly assist in preventing coal mine related respiratory diseases such as black lung disease. However, commercially available PM sensors are not inherently calibrated, and as a result, they have vague and unclear measurement accuracy. Therefore, they must initially be evaluated and compared with standardised instruments to be ready to be deployed in the fields. In this study, three different types of inexpensive, light‐scattering‐based widely available PM sensors (Shinyei PPD42NS, Sharp GP2Y1010AU0F, and Laser SEN0177) are evaluated and calibrated with reference instruments. PM sensors are compared with reference instruments in a controlled environment. The calibration is done by means of different machine learning techniques. The results demonstrate that the calibrated response obtained by fusion of sensors has a higher accuracy in comparison to the calibrated response of each individual sensor.

Abstract Schwannoma are tumors of Schwann cells of the peripheral nerve sheath. Sacral location is rarely reported especially in spondyloarthritis patients. Herein, we report a case of uncommon pygalgia in a 25‐year‐old man with history of a non‐radiographic axial spondyloarthritis and in whom the diagnosis of sacral Schwannoma was established.

Abstract Hyper‐inflammation, cytokine storm, and recruitment of immune cells lead to uncontrollable endothelial cell damage in patients with coronavirus disease 2019 (COVID‐19). Sphingosine 1‐phosphate (S1P) signaling is needed for endothelial integrity and its decreased serum level is a predictor of clinical severity in COVID‐19. In this clinical trial, the effect of Fingolimod, an agonist of S1P, was evaluated on patients with COVID‐19. Forty patients with moderate to severe COVID‐19 were enrolled and divided into two groups including (1) the control group (n = 21) receiving the national standard regimen for COVID‐19 patients and (2) the intervention group (n = 19) that prescribed daily Fingolimod (0.5 mg) for 3 days besides receiving the standard national regimen for COVID‐19. The hospitalization period, re‐admission rate, intensive care unit (ICU) administration, need for mechanical ventilation, and mortality rate were assessed as primary outcomes in both groups. The results showed that re‐admission was significantly decreased in COVID‐19 patients who received Fingolimod compared to the controls (p = .04). In addition, the hemoglobin levels of the COVID‐19 patients in the intervention group were increased compared to the controls (p = .018). However, no significant differences were found regarding the intubation or mortality rate between the groups (p > .05). Fingolimod could significantly reduce the re‐admission rate after hospitalization with COVID‐19. Fingolimod may not enhance patients' outcomes with moderate COVID‐19. It is necessary to examine these findings in a larger cohort of patients with severe to critical COVID‐19.

Abstract Due to its several advantages (especially low volume and weight), power electronic transformer has gained notable attraction in railway applications. The main focus of this work is devoted to development a fully filed programmable gate array (FPGA)‐based control platform for power electronic transformer in the aforementioned application. Due to the parallel processing of FPGAs that results in a faster control algorithm execution, reliable operation (which is of major importance in traction applications) is guaranteed. For this purpose, an input series output parallel power electronic transformer structure is built, and various considerations for reliable and stable operation of the power electronic transformer in traction applications, such as safe start‐up and bidirectional power flow, along with the required control and pulse generation schemes, have been designed and implemented in a Xilinx FPGA control platform. Moreover, a modified control algorithm is proposed for controlling the power electronic transformer in a simple and more reliable manner. This control scheme is developed based on the output voltage of the DC–DC–LLC resonant converter, and can effectively control the sum of rectifier DC‐link voltages and track the input sine reference current, with a lower number of required sensors. Finally, the effectiveness of the proposal has been tested from various aspects by experimental tests.

Abstract High‐dose corticosteroids have been associated with increased risk of serious infection in patients with metastatic melanoma treated with immune checkpoint inhibitors targeting cytotoxic T‐lymphocyte antigen 4. This potential association needs to be examined further among patients with other cancer types and for other immune checkpoint inhibitors. We examined whether receipt of high‐dose corticosteroids was associated with increased rates of hospitalization for infection among 981 Danish renal, urothelial, and lung cancer patients followed from first administration of programmed death receptor 1 (PD‐1)/programmed death ligand 1 (PD‐L1) immune checkpoint inhibitors. Our cohort analysis was based on the information from national medical registries. During follow‐up, 522 patients (53.2%) initiated treatment with high‐dose corticosteroids and 317 patients (32.3%) experienced at least one hospitalization for infection. In analyses adjusted for age, sex, and previous use of chemotherapy/targeted therapy, initiation of high‐dose systemic corticosteroids was associated with increased rate of hospitalization for infections (hazard ratio (HR) = 2.96, 95% confidence interval (CI) = 2.41–3.65) even in patients not receiving any chemotherapy/targeted therapy (HR = 3.66, 95% CI = 2.25–5.96). Our findings showed that high‐dose corticosteroid initiation is associated with hospitalization for infection in patients treated with PD‐1/PD‐L1 immune checkpoint inhibitors. Clinicians and patients should be aware of this risk of infection when initiating treatment with high‐dose corticosteroids.

Abstract Aims Somatic mutations in haematopoietic stem cells can lead to the clonal expansion of mutated blood cells, known as clonal haematopoiesis (CH). Mutations in the most prevalent driver genes DNMT3A and TET2 with a variant allele frequency (VAF) ≥ 2% have been associated with atherosclerosis and chronic heart failure of ischemic origin (CHF). However, the effects of mutations in other driver genes for CH with low VAF (

In this article, the applications of the Power Index Method (PIM) are presented to ascertain function solutions of the AKNS equation. We find out adequate explicit general solutions for the AKNS in the form of exponential, trigonometric, and logarithmic functions which have their importance in the physical sciences. We have used function transformations in which indexes of independent variables are nonrestricted parameters. During our investigation, we have seen that the nonlinear AKNS can be reduced to linear ODE by using PIM. All the solutions contain independent variables with parameters, and they are graphically represented by choosing suitable values of parameters.

Peritoneal encapsulation (PE) is a rare congenital malformation in which the small intestine is partially or totally encased in a supplementary peritoneal sac. PE is usually asymptomatic; therefore, it is one of the rarest etiologies of bowel obstruction. Our patient presented at the age of 55 with no prior surgical history and a 3-day history of abdominal pain associated with nausea, vomiting, belching, and constipation. An obstruction secondary to an internal hernia—visualized on a CT scan—was suspected as the initial etiology. On exploratory laparotomy, the small bowel was covered by a thick adherent sac. These findings are consistent with PE, a condition that deserves recognition among clinicians worldwide. Intraoperatively, the sac was excised, and the small bowel was pulled up to the peritoneal cavity starting from the ileocecal valve to the duodenojejunal junction. In the postoperative period, the patient was managed with intravenous fluids, analgesics, and antibiotics. Wound infection was the only postoperative complication. Otherwise, all symptoms subsided, and the patient improved and was discharged home on the 8th postoperative day.

In this article, we focus on the new exact solutions of Burger’s equation by using a new technique which is known as the power index method (PIM). In this method, we choose suitable indexes of independent variables and similarity transformation so that the partial differential equation may be converted into ODE. We have obtained analytic solution of the ODE by using symbolic package Maple. We have got exact solution of Burgers’ equation by using analytic solution of ODE and similarity transformation. The proposed method has been effectively employed to find new exact solutions for the nonlinear Burgers’ equation. Finally, the proposed resulting answers are compared with the homotopy perturbation, decomposition, and variational iteration solutions.

Neutrosophy deals with neutrosophic logic, probability, and sets. Actually, the neutrosophic set is a generalization of the classical set, fuzzy set, and intuitionistic fuzzy set. A neutrosophic set is a mathematical notion serving issues containing inconsistent, indeterminate, and imprecise data. The notion of intuitionistic fuzzy metric space is useful in modelling some phenomena, where it is necessary to study the relationship between two probability functions. In this study, the concept of an orthogonal neutrosophic metric space is initiated. It is a generalization of the neutrosophic metric space. Some fixed point results are investigated in this setting. For the validity of the obtained results, some nontrivial examples are given.

In this article, Lie and discrete symmetry transformation groups of linear and nonlinear Newell-Whitehead-Segel (NWS) equations are obtained. By using these symmetry transformation groups, several group invariant solutions of considered NWS equations have been constructed. Furthermore, some more group invariant solutions are generated by using discrete symmetry transformation group. Graphical representations of some obtained solutions are also presented.

Background. Neuropathic pain is a common chronic pain, which is related to hypersensitivity to stimulus and greatly affects the quality of life of patients. Maladaptive gene changes and molecular signaling underlie the sensitization of nociceptive pathways. We previously found that the activation of microglial glucagon-like peptide 1 receptor (GLP-1R) could potently relieve formalin-, bone cancer-, peripheral nerve injury-, and diabetes-induced pain hypersensitivity. So far, little is known about how the gene profile changes upon the activation of GLP-1R signaling in the pathophysiology of neuropathic pain. Methods. Spinal nerve ligation (SNL) was performed to induce neuropathic pain in rats. Mechanical allodynia was assessed using von Frey filaments. The expression of IL-10, β-endorphin, and μ-opioid receptor (MOR) was examined by real-time quantitative polymerase chain reaction (qPCR) and whole-cell recording. Measurements of cellular excitability of the substantia gelatinosa (SG) neurons by whole-cell recording were carried out. R packages of differential gene expression analysis based on the negative binomial distribution (DESeq2) and weighted correlation network analysis (WGCNA) were used to analyze differential gene expression and the correlated modules among GLP-1R clusters in neuropathic pain. Results. The GLP-1R agonist, exenatide, has an antiallodynic effect on neuropathic pain, which could be reversed by intrathecal injections of the microglial inhibitor minocycline. Furthermore, differential gene expression analysis (WGCNA) indicated that intrathecal injections of exenatide could reverse the abnormal expression of 591 genes in the spinal dorsal horn induced by nerve injury. WGCNA revealed 58 modules with a close relationship between the microglial GLP-1R pathway and features of nerve injuries, including pain, ligation, paw withdrawal latency (PWL), and anxiety. The brown module was identified as the highest correlated module, and the Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis indicated that inflammatory responses were most correlated with PWL. To further unravel the changes of hyperalgesia-related neuronal electrophysiological activity mediated by microglia GLP-1 receptors, whole-cell recording identified that MOR agonism stimulated a robust outward current in the sham groups compared with the spinal nerve ligation (SNL) groups. This inhibitory effect on the SNL group was more sensitive than that of the sham group after bath application of β-endorphin. Conclusions. Our results further confirmed that the GLP-1R pathway is involved in alleviating pain hypersensitivity mediated by spinal microglia activation, and inflammatory responses were the most correlated pathway associated with PWL changes in response to exenatide treatment. We found that the identification of gene regulation in response to GLP-1R activation is an effective strategy for identifying new therapeutic targets for neuropathic pain. Investigation for the activation of spinal microglial GLP-1R which might ameliorate inflammatory responses through gene expression and structural changes is providing a potential biomarker in pain management.

This study aims to study the efficiency of the Waist-to-Height Ratio (WHtR) for determining coronary artery disease. It compares the frequency of abnormal WHtR, as a proxy for abdominal obesity, to that of body mass index (BMI) and waist circumference (WC). It also relates the findings to other cardiometabolic risk factors in University Hospital patients. A cross-sectional study design was used, where a sample of 200 patients (142 males and 58 females) who attended the adult cardiac clinic were purposively included. BMI, WC, and WHtR were measured, where frequencies of WHtR were compared to those of BMI and WC. The findings were related to the history of coronary artery disease (CAD) and history of cardiometabolic risk factors, including diabetes mellitus (DM), hypertension (HTN), and hyperlipidemia. Majority of the male patients were older, taller, and had a lower BMI value. It also showed that the prevalence of dyslipidemia and CAD was higher in male patients. No significant difference between both genders was noticed for weight, WC, WHtR, hypertension, or DM. BMI was least associated with high-risk cardiac population in both males and females (39.4% and 60.3%), followed by WC (84.5% and 96.6%, respectively). WHtR showed the highest association with gender (male 98.6% and females 98.3%). These findings were noticed in patients with all risk factors. WHtR is superior to BMI and WC for determining the elevated risk of diabetes, hypertension, dyslipidemia, and CAD in a single university institute. The role of WHtR in both normal and diseased Saudi population should be delineated.

Strengthening with externally bonded CFRP reinforcement is widely used in structural reinforcement and attractive to stakeholders and engineers because of ease and speed of construction, corrosion resistance, lightweight, high strength, and versatility stiffness which can be oriented according to the need. Numerous research studies were carried out to explore RC beams’ flexural and shear performance when subjected to dynamic impact loading. The results were auspicious in using such a technique of strengthening. Regular square section reinforced concrete frame members strengthened by CFRP material is taken as the research object. However, little attention to the impact behavior of CFRP-shear-strengthened square reinforced concrete (RC) specimens has been paid. The dynamic response of CFRP to reinforced concrete members under unequal cross-impact is discussed. This paper investigates the effectiveness of CFRP strengthening on the square RC specimen in preventing shear failure and evaluation of the flexural performance of the strengthened specimen under the impact load. The drop hammer impact test is firstly conducted on RC specimens with and without CFRP strengthening. The results show that using CFRP to strengthen the RC specimen in shear is very effective at preventing shear failure and leading the specimen’s response to flexural domination. This result is also the motivation for developing a numerical model supported by experimental tests to study the flexural performance of strengthened RC specimens. It is found that the strengthened specimen is prone to exhibit pure bending deformation under the impact load in terms of dynamic amplification factor (DAF) for section moment. Then, an extensive parameter study is carried out to evaluate further the influence of impact velocity, reinforcement ratio, and concrete strength on the flexural performance of the strengthened specimen and CFRP layers. Such a holistic study may provide preliminary research regarding the use of CFRP to strengthen RC specimens in shear under impact loads and will enhance the current state of knowledge in this area; also, the optimal value of the CFRP reinforcement layer was proposed.

Simulated annealing is a stochastic local search method, initially introduced for global combinatorial mono-objective optimisation problems, allowing gradual convergence to a near-optimal solution. An extended version for multiobjective optimisation has been introduced to allow a construction of near-Pareto optimal solutions by means of an archive that catches nondominated solutions while exploring the feasible domain. Although simulated annealing provides a balance between the exploration and the exploitation, multiobjective optimisation problems require a special design to achieve this balance due to many factors including the number of objective functions. Accordingly, many variants of multiobjective simulated annealing have been introduced in the literature. This paper reviews the state of the art of simulated annealing algorithm with a focus upon multiobjective optimisation field.

Oriental cholangiohepatitis (OCH) is a disease characterized by intrabiliary pigment stone formation, resulting in recurrent bouts of cholangitis. OCH is found mostly in Southeast Asia but it is occasionally recognized in Western societies. OCH etiology is largely unknown. We report our experience with a patient who presented with acute cholecystitis. Following laparoscopic cholecystectomy, she developed acute cholangitis due to multiple biliary tree stones. She underwent ERCP to clear the stones from common bile duct. For the intrahepatic stones, she underwent novel hybrid percutaneous endoscopic technique. The procedure resulted in complete clearance of biliary tree stones and resolution of her symptoms. The aim of this case is to increase awareness of this disease when patients from endemic areas present with biliary stones.

TiO2/polypyrrole composites with high dielectric constant have been synthesized by in situ polymerization of pyrrole in an aqueous dispersion of low concentration of TiO2, in the presence of small amount of HCl. Structural, optical, surface morphological, and thermal properties of the composites were investigated by X-ray diffractometer, Fourier transform infrared spectroscopy, field-emission scanning electron microscopy, and thermogravimetric analysis, respectively. The data obtained from diffractometer and thermal gravimetric analysis confirmed the crystalline nature and thermal stability of the prepared composites. The dielectric constant of 5 wt% TiO2 increased with filler content up to 4.3 × 103 at 1 kHz and then decreased to 1.25 × 103 at 10 kHz.

Introduction Although most studies report high frequencies of consent to HIV tests, critics argue that clients are subject to pressure, that acceptors later indicate they could not have refused, and that provider‐initiated HIV testing raises serious ethical issues. We examine the meaning of consent and why clients think they could not have refused. Methods Clients in Burkina Faso, Kenya, Malawi and Uganda were asked about consenting to HIV tests, whether they thought they could have refused and why. Textual responses were analyzed using qualitative and statistical methods. Results Among 926 respondents, 77% reported they could not have said no, but in fact, 60% actively consented to test, 24% had no objection and only 7% tested without consent. There were few significant associations between categories of consent and their covariates. Conclusions Retrospectively asking clients if they could have refused to test for HIV overestimates coercion. Triangulating qualitative and quantitative data suggests a considerable degree of agency.

Background. Several characteristics appear to be important for estimating the likelihood of reentering the workforce after surgery. The aim of the present study was to describe work status in a two-year time period around the time of cardiac surgery and estimate the probability of returning to the workforce. Methods. We included 681 patients undergoing coronary artery bypass grafting and/or heart valve procedures from 2003 to 2007 in the North Denmark Region. We linked hospital data to data in the DREAM database which holds information of everyone receiving social benefits. Results. At the time of surgery 17.3% were allocated disability pension and 2.3% were allocated a permanent part-time benefit. Being unemployed one year before surgery reduced the likelihood of return to the workforce (RR=0.74 (0.60–0.92)) whereas unemployment at the time of surgery had no impact on return to the workforce (RR=0.96 (0.78–1.18)). Sickness absence before surgery reduced the likelihood of return to the workforce. Conclusion. This study found the work status before surgery to be associated with the likelihood of return to the workforce within one year after surgery. Before surgery one-fifth of the population either was allocated disability pension or received a permanent part-time benefit.

Meconium peritonitis pseudo-cyst is very rare. Its perinatal management is controversial and can be associated with increased fetomaternal morbidity and mortality. A 34-week gestation infant with large meconium peritonitis pseudo-cyst, detected by intrapartum fetal ultrasound study, had abnormally increased ratio of fetal abdominal circumference to head circumference. Intrapartum aspiration of the pseudo-cyst was performed and was followed by a smooth vaginal delivery. The postnatal course of the baby showed that early laparotomy was essential for stabilisation of the infant's general condition.