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The United Arab Emirates (UAE) Government's Policy is to institute a safe and permanent geological disposal facility (GDF) for the final disposal of higher activity radioactive wastes (HAW). The UAE has yet to identify or decide on a disposal site, and geological data specific to the characterisation of a GDF host rock either lacks sufficient details or is not available in the public domain. However, initial screenings of geological environments in the UAE give an indication of potential suitable host rock formations. This paper presents the results of a study into the factors that influence the risk to future generations from the disposal of Spent Nuclear Fuel (SNF) in a deep underground geological disposal facility. For the purpose of this study the GDF was assumed to be in a High Strength Rock (HSR) geological environment in the Khor Fakkan (KF) Block. GoldSim's Contaminant Transport code was used to model the potential dispersion of radioactivity from a GDF. which enabled the calculation of risk to future generations. The GDF radiological source term was based on the UAE's forecasted SNF inventory. The model created from GoldSim emphasizes the transport of radionuclides through the GDF's engineered barrier systems (EBS), through the surrounding geosphere and into the biosphere. Once in the biosphere the radiation dose to the reference receptor is determined via ingestion from well drinking water, or inhalation through atmospheric dispersion. The paper explores the factors that influence the assessment of risk to people both now and in the future. The analyses presented in this paper are not meant to be used in site selection decision making or in the assessment of the suitability of the location to host a GDF for nuclear waste. The selection of a disposal site in the UAE would depend on a more detailed analysis of site-specific conditions.

Arwa Al Nuairi,1 Hala Bermamet,1 Hind Abdulla,1 Mecit Can Emre Simsekler,1 Siddiq Anwar,2 Krista L Lentine3 1Department of Industrial and Systems Engineering, Khalifa University of Science and Technology, Abu Dhabi, 127788, United Arab Emirates; 2Sheikh Shakhbout Medical City, Abu Dhabi, 10001, United Arab Emirates; 3Saint Louis University Center for Abdominal Transplantation, St. Louis, MO, USACorrespondence: Mecit Can Emre Simsekler, Khalifa University of Science and Technology, Department of Industrial and Systems Engineering, P.O. Box 127788, Abu Dhabi, United Arab Emirates, Tel +9712 312 4058, Fax +971 2 447 2442, Email emre.simsekler@ku.ac.aePurpose: Patient satisfaction is a measure of care quality that assists providers in determining the effectiveness of their services while meeting patients’ expectations. This study aimed to review existing studies that have focused on patients’ satisfaction determinants in Hemodialysis (HD) settings.Methods: Electronic databases (PubMed, ScienceDirect, Scopus, and Google Scholar) were searched from 2000 onwards to identify studies using search terms related to patient satisfaction and hemodialysis centers. Article review was limited to studies written in English. A total of 19 articles were included by following the PRISMA statement. Data were extracted using a structured form and summarized in a tabular format to identify different determinants that showed a relationship with patient satisfaction. Determinants were classified into provider-related determinants and patient-related characteristics.Results: Provider-related determinants of patient satisfaction in HD centers include staff, facility, service, and treatment. Patient-related characteristics associated with satisfaction include demographics and health status history. Based on this systematic review, key correlates of patient satisfaction in hemodialysis centers include: staff, facility, service, treatment, patient’s demographics, and health status.Conclusion: The findings of this study can help healthcare facilities in taking measures in line with the specified determinants to enhance patient satisfaction and improve the organizational performance of the healthcare centers. It is important to constantly study and improve these determinants based on patient feedback to improve patient satisfaction and quality of care.Keywords: hemodialysis patients, patient satisfaction, patient experience, healthcare quality

The disposal of Higher Activity Wastes, particularly long lived Heat Generating High Level Waste (HG-HLW) such as Spent Nuclear Fuel (SNF) is one of the biggest challenges encountered by the peaceful civil nuclear energy industry. The United Arab Emirates (UAE) has emplaced laws and instituted a policy in which geological disposal is a potential choice for SNF disposal. Available geological data in the public domain provide initial indications of geological environments that might be suitable to host a Geological Disposal Facility (GDF) in the UAE. This paper aims to present an indicative preliminary Performance Assessment (PA) demonstrating radiological dose and risk estimations from hosting a GDF in the Jebel al Dhanna (JAD) location consisting of an Evaporite geological environment in the form of a Salt Dome (Diapir) that protrude above the surface. Modelling the dispersion of harmful radionuclides from the GDF hosted at the JAD location is achieved by utilising GoldSim's Contaminant Transport code, which has successfully provided an evaluation of radiological risks to current and future generations from the disposal of the UAE's forecasted SNF inventory. The developed GoldSim model highlights the migration of radionuclides from within disposed waste packages, past the engineered barrier system (EBS), through the surrounding geosphere or the Natural Barrier System (NBS), reaching a reference receptor. Due to the lack of detailed and site specific data, analyses presented in this paper are to be viewed as generic and are not to be utilised directly as a site selection tool. The analyses presented are expected to go through several revisions and development stages once sufficient site specific data is made available and will then be presented in, and be a part of a UAE site specific safety case report. The analyses presented in this paper are not meant to be used in site selection decision making or in the assessment of the suitability of the location to host a GDF for nuclear waste. The selection of a site for a GDF in the UAE is a matter for the UAE Government and depend upon a more detailed analysis of site-specific conditions.

Abstract Background Induction of lysosomal function and autophagy is regarded as an adaptive mechanism in response to cellular stress. The transcription factor EB (TFEB) has been identified as a master regulator of lysosomal function and autophagy. TFEB is a member of the microphthalmia family of bHLH-LZ transcription factors that includes other members such as micropthalmia-associated transcription factor (MITF), TFE3, and TFEC. TFEB controls lysosome biogenesis and autophagy by upregulation of a family of genes belonging to the Coordinated Lysosomal Expression and Regulation (CLEAR) network. Here, we investigated the expression of TFEB in cells subjected to nutrient deprivation and lysosomal stress. We studied transcriptional induction of TFEB-regulated genes in response to nutrient deprivation and lysosomal stress in retinal pigment epithelial (RPE) cells. Furthermore, we also investigated the induction of autophagy and lysosomal genes upon overexpression of constitutively active form of TFEB. Methods Expression of TFEB and MITF protein levels were evaluated in cells subjected to prolonged periods of nutrient deprivation. mRNA levels of the CLEAR network genes was measured by quantitative real time PCR (qRT-PCR) analysis in cells deprived of nutrients, treated with ammonium chloride and upon overexpression of constitutively active TFEB. Immunostaining with LC3 antibody was used to measure autophagy flux. Labeling with lysoTracker dye was used to assess lysosomes. Results Our results show that nutrient deprivation increases protein levels of TFEB and MITF in ARPE-19 cells. Nutrient stress induces the expression of lysosomal (LAMP1, CTSD MCOLN1, SGSH) and autophagy (BECN1) genes. Lysosomal stress also increases the expression of lysosomal (ATP6V0A1 and LAMP1) and autophagy (p62 and BECN1) genes. Our results show that overexpression of constitutively active TFEB also induces the expression of CLEAR network genes. Conclusions Collectively, these observations suggest that nutrient stress induces the protein expression of both MITF and TFEB in ARPE-19 cells. TFEB-regulated transcriptional program plays an important role in adaptive response of cells during both nutrient and lysosomal stress.

ObjectivesStudies have shown that acute kidney injury (AKI) occurrence post SARS-CoV-2 infection is complex and has a poor prognosis. Therefore, more studies are needed to understand the rate and the predications of AKI involvement among hospitalized COVID-19 patients and AKI's impact on prognosis while under different types of medications.Patients and methodsThis study is a retrospective observational cohort study conducted at Bahrain Defence Force (BDF) Royal Medical Services. Medical records of COVID-19 patients admitted to BDF hospital, treated, and followed up from April 2020 to October 2020 were retrieved. Data were analyzed using univariate and multivariate logistic regression with covariate adjustment, and the odds ratio (OR) and 95% confidence (95% CI) interval were reported.ResultsAmong 353 patients admitted with COVID-19, 47.6% developed AKI. Overall, 51.8% of patients with AKI died compared to 2.2% of patients who did not develop AKI (p< 0.001 with OR 48.6 and 95% CI 17.2-136.9). Besides, deaths in patients classified with AKI staging were positively correlated and multivariate regression analysis revealed that moderate to severe hypoalbuminemia (ConclusionsThe incidence of AKI in hospitalized COVID-19 patients and the mortality rate among AKI patients were high and correlated with AKI staging. Furthermore, laboratory testing for serum albumin, hypercoagulability and cardiac injury markers maybe indicative for AKI development. Therefore, clinicians should be mandated to perform such tests on admission and follow-up in hospitalized patients.

Aims: To find cytology changes among women attending obstetrics and gynaecology clinic with complaints of vaginal discharges. Settings and Design: This descriptive hospital-based cytological study was conducted at the outpatient clinic of the obstetrics and gynaecology department. Materials and Methods: Two hundred women with complaints of vaginal discharge were selected. Their detailed histories were documented on a special request form. Pap smears were then obtained and sent for cytological examination to the cytopathology department. All low-grade squamous intraepithelial lesion (LSIL) cases were advised to follow-up with Pap smears in the next 6–12 months. Those with high-grade squamous intraepithelial lesion (HSIL) were further investigated by a cervical biopsy and managed accordingly. Statistical analysis used: The statistical analysis was performed using, the Statistical Package for Social Science (SPSS). Chi-square and cross-tabulation were used in this study. Results: The cytological examination of Pap smears showed no changes (i.e. negative findings) in 88 (44%) cases, while Candida species infection was the most prevalent, which was found in 67 (33.5%) of the cases. Bacterial vaginosis was found in 39 women (19.5%); 6 women (3%) were reported with dyskaryotic changes. Two cases were found to have LSIL and 4 women had HSIL. Conclusion: Infection is common among the illiterate group of women. Women with vaginal discharges should undergo screening tests for evaluation by cervical smear for the early detection of cervical precancer conditions. There is an urgent need to establish a screening program for cervical cancer in Sudan.

Objectives: To compare the cytological findings of preoperative buccal smears with their histopathological types in oral cavity tumors. Materials and Methods: This study investigated 45 patients with oral tumors who had undergone preoperative buccal smears of oral lesions and were diagnosed by postoperative histopathological examination. Two samples were taken from patients that were clinically diagnosed with oral squamous cell carcinoma (OSCC): smears for cytological examination and biopsies for histopathological diagnosis. Results: Of the 45 cases studied, histopathology showed the presence of OSCC (n = 39 [86.7%]), verrucous carcinoma (n = 2 [4.4%]), and hyperkeratosis (n = 4 [8.9%]). OSCC cases predominantly occurred in males, with a ratio of 3.8:1 (P = 0.000); the majority of OSCC cases, in both males (27; 87%) and females (6; 75%), were older than 50 years. Most OSCC cases, 32 (82.1%), were toombak dippers, and 28 out of the 32 were males (87.5%). In addition, the labiogingival, a common site of toombak dipping, was a prevalent lesion site of OSCC (13 patients, 33.3%) (P = 0.004). The cytological findings showed good diagnostic concordance with the histopathological findings; in 39 cases of OSCC, 31 patients had positive smears and biopsies and eight patients had negative smears but positive biopsies, for an overall sensitivity of 79.5% and specificity of 100%. Conclusion: Despite the small number of cases in this study, we realized that the diagnostic accuracy of preoperative buccal smear cytology for oral lesions was high and that it is a safe, easy-to-perform, and clinically useful diagnostic procedure.

Cryptosporidium is known as a parasite of humans especially children of both those who are immunodeficient and immunocompetent. The effect of prolonged diarrhea and dehydration can be dangerous, especially for young and immunodeficient persons. This study was designed to find out the watery and alcoholic effect of some medicinal plant extracts against the parasite. No significant differences between the watery and alcoholic extracts of the three medicinal plant used (Corindrum sativum, Curcuma longa, Viscum album) were noted. All the plants were dose related, Curcuma longa had the highest effect on Cryptosporidium oocysts shedding in laboratory infected Balb/c mice. With rate of 100% on the 7th day of treatment at 750 mg/kg and on the 5th day at 1000mg/kg in the watery extracts. And a rate of 100% on the 4th day at 1000mg/kg in alcoholic extracts, followed by Viscum album with rate of 48, 54% on the 7th day at 750, 1000mg/kg respectively for watery extract and 73, 76% on the 7th day at 750, 1000mg/kg respectively for alcoholic extract. The Coriondrum sativum had the lowest effect at all concentrations used in both watery and alcoholic extracts. No significant differences were seen with folic acid and potassium chloride adding to the watery and alcoholic plant extracts. Except with the antibiotic (azithromycin) in which its activity was increased to 100% on the 4th day of treatment whereas its effect was only 68% without them

This prospective study was designed to compare the three surgical procedures used in the treatment of pilonidal sinus. 103 patients divided in to three groups by simple random sampling, Group I, 45 patients treated by Excision alone, Group II, 45 patients treated by Excision and simple primary closure while group III, 13 patients treated by Excision and w plasty. Comparison between these procedures with regard to Gender, Sex, Obesity, operating time, hospital stay and complication include recurrence by using ANOVA test and other statistical tests. In conclusion, there is relation between obesity and PND and its Recurrence, also excision alone is satisfactory procedure, because it take less operative time with short hospital stay and associated with fewer complication including recurrence, also meticulous hygiene and shaving of present healing area as well as daily regime to obese patient should be taken in consideration to avoid recurrence.

The occurrence of testicular dislocation resulting from blunt trauma to the scrotum or abdominopelvic region is infrequent. Due to the presence of significant associated injuries, the diagnosis of this condition can often be missed. This case study presents a case of an adult male who experienced bilateral testicular dislocation following a motorbike accident. Additionally, a concise review of relevant literature is included.

Abstract Lung images often have the characteristics of strong noise, uneven grayscale distribution, and complex pathological structures, which makes lung image segmentation a challenging task. To solve this problems, this paper proposes an initial lung mask extraction algorithm that combines threshold and gradient. The gradient used in the algorithm is obtained by the time series feature extraction method based on differential memory (TFDM), which is obtained by the grayscale threshold and image grayscale features. At the same time, we also proposed a lung contour repair algorithm based on the improved convex hull method to solve the contour loss caused by solid nodules and other lesions. Experimental results show that on the COVID-19 CT segmentation dataset, the advanced lung segmentation algorithm proposed in this article achieves better segmentation results and greatly improves the consistency and accuracy of lung segmentation. Our method can obtain more lung information, resulting in ideal segmentation effects with improved accuracy and robustness.

Autism spectrum disorders (ASD) are a diverse group of conditions characterized by difficulty with social interaction and communication. ASD is expected to be a high‐risk disease. Recent studies have focused on the diagnosis based on sociodemographic and family characteristics factors. The development of a diagnosis model, which is primarily based on machine learning methods, has been carried out to alleviate the detection of autism. However, they neglected the importance of ASD features in a training dataset, especially because some features have different levels of contributions to the processing data and possess more relevancies to the classification information than others. Such limitations use preprocessing techniques for the construction of the machine learning model, but the role of the physician's experience towards feature contributions remains limited. However, for certain autism datasets, the relevancies of sociodemographic and family characteristic feature concerning the given class labels should be considered. Accordingly, this study developed a new machine learning model for the diagnosis of ASD based on multi‐criteria decision‐making (MCDM). By using three methodology phases, the model combines two representative theories, namely, MCDM and machine learning. The identification phase for imbalance ASD dataset and application of pre‐possessing stages by imputing missing values, feature selection of sociodemographic and family characteristics, and data imbalanced approach resulted in balanced ASD dataset, including 107,573 cases. The development phase for the new model was achieved by the proposed complex T‐spherical fuzzy‐weighted zero‐inconsistency (CT‐SFWZIC) method. CT‐SFWZIC was developed based on a new fuzzy set (i.e., complex T‐spherical fuzzy) for weighting affected features, and then applied for training and testing the machine learning model considering various complex T‐spherical fuzzy membership functions (i.e., T = 1, 2, 3, 5, 7, and 10). The results obtained from a 10‐fold cross‐validation test for all T values by using nine machine learning classifiers were measured under seven evaluation metrics, namely AUC, accuracy, F1, precision, recall, training time (s), and test time (s). Performance evaluation results reveal that AdaBoost can be used to boost the ASD diagnosis as the best machine learning algorithm for all T values based on all metrics to improve the diagnosis based on physician's assessment. Under the most extreme evaluation metric, which is accuracy, the results of the AdaBoost classifiers for T = 1, 2, 3, 5, 7, 10 have obtained 0.99948, 0.99934, 0.99930, 0.99939, 0.99910, and 0.99930, respectively. [ABSTRACT FROM AUTHOR]

Construction sector spending makes a significant contribution to the global economy, with approximately ${\$}$ 10 trillion being spent on building and construction activities annually. However, the construction industry has traditionally been perceived as slow to adapt to new technologies compared to other sectors. Recently, the construction industry has experienced a substantial shift towards Digital Transformation. As new technologies have emerged, the construction industry has begun to realize the importance of Digital Transformation in the pre-construction, construction, and facility management phases. A high degree of Digital Transformation has been seen regarding site monitoring, wearables, sensors, and identifying hazards. This paper intends to sketch a global picture of digital technologies implemented in the construction industry throughout the entire project lifecycle. By fully analyzing more than 200 papers, the paper finds that various aspects of the construction industry, including technologies, policies, regulations, and infrastructures, are still in the early stages of Digital Transformation. The findings from this review will help researchers and practitioners in the construction industry understand the global picture of digital technology implementation and where the construction industry stands in the Digital Transformation process. This paper also serves as a starting point for future work on Digital Transformation in the construction industry. The research paper is limited to vertical aspects in building projects and does not include horizontal integration. Finally, this study will give a guideline with successful examples of which technologies are being used in specific phases, so future researchers can get a holistic view of the use of digital technology in the entire building environment.