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Abstract Background Metabolic dysfunction-associated steatotic liver (MASLD) disease is the commonest hepatic cause of liver fibrosis and cirrhosis after the introduction of the direct acting antivirals and eradication of hepatitis C. MASLD is usually associated with metabolic syndrome and elevated inflammatory markers. Magnetic resonance spectroscopy (MRS) offers a non-invasive diagnostic, alternative to liver biopsy. This is a case–control diagnostic-accuracy study conducted on 40 patients in the Hepato-gastroenterology Unit in the Internal Medicine Department, Ain Shams University Hospitals, to study the role of MRI spectroscopy as a new diagnostic model for assessment of liver steatosis in non-diabetic MASLD patients compared to the standard ultrasound and clinical criteria. MASLD was diagnosed by a combination of a validated ultrasound hepatic steatosis score grading system and hepatic steatosis index using clinical and laboratory parameters. MRS was performed in all patients and fat peak, water peak, and fat fraction % were measured, and diagnostic accuracy of different MRS is compared to the US scoring and different laboratory and clinical parameters. To our knowledge this is the first study conducted on MRS in our region and Egypt. Results This study revealed no statistically significant difference between the two groups regarding HbA1C, creatinine, while there was highly statistically significant difference regarding fasting blood sugar, 2 h post-prandial glucose level, urine albumin, and low-density lipoprotein levels. Hepatic steatosis score grading by abdominal ultrasound on the 20 controls showed no fatty changes with grade 0 (50%), and on the 20 MASLD patients showed that 2 cases were grade 1 steatosis (5%), 9 cases were grade 2 steatosis (22.5%), and 9 cases were grade 3 steatosis (22.5%). The diagnostic accuracy of predicting hepatic steatosis using different MRS parameters: fat peak, water peak, and fat fraction had area under the curve of 99.9%, 88.6%, and 100%, respectively. The sensitivity and specificity of fat fraction in detecting hepatic steatosis were 100%. The sensitivity and specificity of the fat peak in detecting hepatic steatosis were 100% and 95%, respectively. Moreover, the sensitivity and specificity of the water peak in detecting the hepatic steatosis were 88.6% and 85%, respectively. There is a statistically significant correlation between the three MRS parameters and the abdominal ultrasound hepatic steatosis score grades. Conclusion MRS parameters: fat fraction, fat peak, and water peak, have high diagnostic accuracy for predicting the liver steatosis. Moreover, MRS has the added advantage of being a non-invasive and a tool with low radiation risk. MRS also shows the metabolic changes in the liver and could be an eligible outcome in therapeutic clinical trials.

Abstract Background In cervical cancer, accurate diagnosis of parametrial invasion (PMI) helps in determining the next step in management, either surgical resection or neoadjuvant therapy. Cervical cancer staging is still determined according to the clinical findings. But it is widely recognized that there are differences between clinical evaluation and the actual disease extent, particularly for PMI. In this prospective study, we investigate the relationship between clinical staging and magnetic resonance imaging (MRI) staging with post-management findings among patients with cervical cancer who underwent pre-treatment MRI, using fused T2-weighted image/diffusion-weighted imaging (T2/DWI). Results Based on examination under anesthesia (EUA), 80% of patients showed PMI, while fused T2/DWI was positive for PMI in 77.5% of patients. In all analyzed cases (40 females), MRI had sensitivity, specificity, and accuracy of 91%, 75%, and 87.5% compared to EUA. In the operated patients (24 females), MRI likewise had sensitivity, specificity, and accuracy of 81.3%, 87.5%, and 83%, respectively. In comparison with the postoperative results, the EUA showed higher sensitivity and accuracy than MRI (92.9% vs. 81.3%) and (83.3% vs. 79.2%), respectively, in the detection of PMI in operated cases. However, MRI was more specific in the PMI detection in cases with cervical cancer than EUA (75% vs. 70%). Conclusion MRI (with the aid of fused T2/DWI) improves the diagnostic performance for the PMI assessment in cases with cervical carcinoma. Therefore, MRI is helpful in choosing surgical candidates.

Smart contracts offer automation for various decentralized applications but suffer from vulnerabilities that cause financial losses. Detecting vulnerabilities is critical to safeguarding decentralized applications before deployment. Automatic detection is more efficient than manual auditing of large codebases. Machine learning (ML) has emerged as a suitable technique for vulnerability detection. However, a systematic literature review (SLR) of ML models is lacking, making it difficult to identify research gaps. No published systematic review exists for ML approaches to smart contract vulnerability detection. This research focuses on ML-driven detection mechanisms from various databases. 46 studies were selected and reviewed based on keywords. The contributions address three research questions: vulnerability identification, machine learning model approaches, and data sources. In addition to highlighting gaps that require further investigation, the drawbacks of machine learning are discussed. This study lays the groundwork for improving ML solutions by mapping technical challenges and future directions.

Objective The use of social media applications to disseminate information has substantially risen in recent decades. Spine and back pain-related hashtags have garnered several billion views on TikTok. As such, these videos, which share experiences, offer entertainment, and educate users about spinal surgery, have become increasingly influential. Herein, we assess the quality of spine surgery content TikTok from providers and patients. Methods Fifty hashtags encompassing spine surgery (“#spinalfusion,” “#scoliosissurgery,” and “#spinaldecompression”) were searched using TikTok’s algorithm and included. Two independent reviewers rated the quality of each video via the DISCERN questionnaire. Video metadata (likes, shares, comments, views, length) were all collected; type of content creator (musculoskeletal, layperson) and content category (educational, patient experience, entertainment) were determined. Results The overall DISCERN score was, on average, 24.4. #Spinalfusion videos demonstrated greater engagement, higher average likes (p = 0.02), and more comments (p < 0.001) compared to #spinaldecompression and #scoliosissurgery. #Spinaldecompression had the highest DISCERN score (p < 0.001), likely explained by the higher percentage of videos that were educational (p < 0.001) and created by musculoskeletal (MSK) professionals (p < 0.001). Compared to laypersons, MSK professionals had significantly higher quality videos (p < 0.001). Similarly, the educational category demonstrated higher quality videos (p < 0.001). Video interaction trended lower with MSK videos and educational videos had the lowest interaction of the content categories (likes: p = 0.023, comments: p = 0.005). Conclusion The quality of spine surgery videos on TikTok is low. As the influence of the new social media landscape governs how the average person consumes information, MSK providers should participate in disseminating high-quality content.

The jet pump is an artificial lift employed when the reservoir pressure declines and the well deviation increases. The use of computer well models for optimizing the oil well output has proven to be a successful strategy, and has helped increasing the efficiency and production of numerous wells. The objective of this study was to use a production optimization technique that achieves some improvements, and recommend approaches toward increasing the oil well production. The effects of the motive fluid flow rate and pressure on the oil production rate were investigated to determine the optimal injection rate and pressure on the performance of the deep well water-oil axial jet-pump. Additionally, the effects of the well-head pressure, water cut, and roughness of tubing on oil production of this jet pump type were investigated. The results revealed that the impact on the oil lift performance is significant. The oil production increased by 19.43%, and the optimal economic value for the injection rate and pressure for the GA-1A well are 744.44 BFPD and 2722.22 psig, respectively. In summary, increasing the tubing roughness decreased the well's total liquid production. Thus, maintaining the well integrity is a very important factor because not doing so can lower the productivity by up to 20%–25%.

Objective To analyze the usage of floor-mounted robot in minimally invasive lumbar fusion. Methods Patients who underwent minimally invasive lumbar fusion for degenerative pathology using floor-mounted robot (ExcelsiusGPS) were included. Pedicle screw accuracy, proximal level violation rate, pedicle screw size, screw-related complications, and robot abandonment rate were analyzed. Results Two hundred twenty-nine patients were included. Most surgeries were primary single-level fusion. Sixty-five percent of surgeries had intraoperative computed tomography (CT) workflow, 35% had preoperative CT workflow. Sixty-six percent were transforaminal lumbar interbody fusion, 16% were lateral, 8% were anterior, and 10% were a combined approach. A total of 1,050 screws were placed with robotic assistance (85% in prone position, 15% in lateral position). Postoperative CT scan was available for 80 patients (419 screws). Overall pedicle screw accuracy rate was 96.4% (prone, 96.7%; lateral, 94.2%; primary, 96.7%; revision, 95.3%). Overall poor screw placement rate was 2.8% (prone, 2.7%; lateral, 3.8%; primary, 2.7%; revision, 3.5%). Overall proximal facet and endplate violation rates were 0.4% and 0.9%. Average diameter and length of pedicle screws were 7.1 mm and 47.7 mm. Screw revision had to be done for 1 screw (0.1%). Use of the robot had to be aborted in 2 cases (0.8%). Conclusion Usage of floor-mounted robotics for the placement of lumbar pedicle screws leads to excellent accuracy, large screw size, and negligible screw-related complications. It does so for screw placement in prone/lateral position and primary/revision surgery alike with negligible robot abandonment rates.

Abstract Background Children with cerebral palsy (CP) have motor deficits caused by spasticity, weakness, contractures, diminished selective motor control (SMC), and poor balance. The purpose of the current study was to evaluate the influence of mirror feedback on lower extremity selective motor control and balance in children with hemiplegic cerebral palsy. Understanding the relationship between SMC and balance will help children with hemiplegic CP receive more appropriate therapies. Methods Forty-seven children of both sexes diagnosed with hemiplegic CP participated in the study. Group1 (Gr1 - control group) received conventional physical therapy training while group 2 (Gr2 - intervention group) received conventional physical therapy training in addition to bilateral lower extremity mirror therapy (MT). The primary outcome measure used was Selective Control Assessment of Lower Extremity scale (SCALE), while the secondary outcome measure was the Pediatric Balance Scale (PBS). Results There were significant differences in Selective Control Assessment of Lower Extremity Scale (SCALE) and Pediatric Balance Scale (PBS) between both groups in favor of Gr2. After treatment, both groups improved significantly, yet Gr2 outperformed Gr1 by a large margin. Conclusion Mirror therapy may be a useful addition to home-based motor interventions for children with hemiplegic CP due to its relative simplicity, low cost, and high patient adherence. Additionally, it may help children improve their selective motor skills and balance. Trial registration Current Controlled Trials using African Clinical Trials Registry website with ID number PACTR202105604636415 retrospectively registered on 21/01/202.

Cyclin-dependent kinases (CDK2, CDK4, CDK6), cyclin D1, cyclin E1 and phosphorylated retinoblastoma (pRB1) are key regulators of the G1/S cell cycle checkpoint and may influence platinum response in ovarian cancers. CDK2/4/6 inhibitors are emerging targets in ovarian cancer therapeutics. In the current study, we evaluated the prognostic and predictive significance of the CDK2/4/6–cyclin D1/E1–pRB1 axis in clinical ovarian cancers (OC). The CDK2/4/6, cyclin D1/E1 and RB1/pRB1 protein expression were investigated in 300 ovarian cancers and correlated with clinicopathological parameters and patient outcomes. CDK2/4/6, cyclin D1/E1 and RB1 mRNA expression were evaluated in the publicly available ovarian TCGA dataset. We observed nuclear and cytoplasmic staining for CDK2/4/6, cyclins D1/E1 and RB1/pRB1 in OCs with varying percentages. Increased nuclear CDK2 and nuclear cyclin E1 expression was linked with poor progression-free survival (PFS) and a shorter overall survival (OS). Nuclear CDK6 was associated with poor OS. The cytoplasmic expression of CDK4, cyclin D1 and cyclin E1 also has predictive and/or prognostic significance in OCs. In the multivariate analysis, nuclear cyclin E1 was an independent predictor of poor PFS. Tumours with high nuclear cyclin E1/high nuclear CDK2 have a worse PFS and OS. Detailed bioinformatics in the TCGA cohort showed a positive correlation between cyclin E1 and CDK2. We also showed that cyclin-E1-overexpressing tumours are enriched for genes involved in insulin signalling and release. Our data not only identified the prognostic/predictive significance of these key cell cycle regulators but also demonstrate the importance of sub-cellular localisation. CDK2 targeting in cyclin-E1-amplified OCs could be a rational approach.

Omar Hashem,1 Hosam Sheha2,3 1Cornea and Refractive Department, Research Institute of Ophthalmology, Giza, Cairo, Egypt; 2Department of Ophthalmology, Florida International University, Herbert Wertheim College of Medicine & Glaucoma Research Organization, Miami, FL, USA; 3Department of Ophthalmology, Manhattan Eye, Ear and Throat Hospital, Hofstra Northwell School of Medicine, New York, NY, USACorrespondence: Omar Hashem, Research Institute of Ophthalmology, 2 Al Ahram Street, Giza, Cairo, Egypt, Tel +201222422032, Email Hashemomar@yahoo.comPurpose: To evaluate long-term safety, effectiveness, and stability of unilateral LASIK in pediatric myopic anisometropic amblyopia.Methods: This retrospective study included children who received unilateral LASIK for myopic anisometropia of > 6 D, after mandatory 6-month occlusion/penalization therapy. They were evaluated at 6 months, 1 year, 2 years and biannually until 10 years. Outcome measures included visual acuity, refraction, ocular alignment, stereopsis, corneal clarity, and corneal topography.Results: 32 patients (16 girls) with mean age of 8.6 ± 2.3 years completed 10 years of follow up after unilateral LASIK. Mean preoperative spherical equivalent refraction (SER) was − 10.3D ± 2.0D in the affected eye, with anisometropic difference of − 9.5D ± 1.7D. Mean post-LASIK SER was − 1.3D± 0.8D (p< 0.001). Anisometropia significantly decreased to 0.3D± 0.8D, 0.4D± 1.0D, and 1.0± 2.5D at 6 months, 1 year and 10 years respectively (p< 0.001). 11 patients (34%) who had preoperative intermittent exotropia (< 15°) regained orthophoria in all gazes, while 5 of 10 who had constant exotropia with large angle (> 30°) required strabismus surgery for ocular alignment. BCVA improved from 0.04± 0.6 Decimal at baseline to 0.6 ± 0.2 after LASIK and occlusion therapy (p< 0.001). Despite insignificant refractive regression in both eyes, patients have maintained orthophoria, improved stereopsis, clear cornea, and the topography showed no evidence of post-LASIK ectasia.Conclusion: LASIK appears safe, effective, and stable for correcting refractory pediatric myopic anisometropia, in which conventional measures fail or endanger normal visual development. Eliminating anisometropic aniseikonia consequently restores binocular vision and stereopsis which, along with amblyopia therapy, would reverse amblyopia and prevent recurrence.Keywords: amblyopia, aniseikonia, LASIK, pediatric myopic anisometropia

Abstract Background Coronavirus disease (COVID-19) is a new infection with three pandemic waves up till now. CT plays an important role in diagnosis with multiple reporting systems that can be used during CT analysis. We aimed to compare reporting using the recommendations of the radiological society of North America (RSNA) versus the coronavirus disease reporting and data system (CO-RADS) and to assess the performance of CT if used in asymptomatic patients as a screening. Two hundred and fifty-one patients who underwent chest CT scanning either due to clinical suspicion or as screening before hospital admission were included in this retrospective observational cross-sectional study. This was followed by RT-PCR for confirmation. Three radiologists with different years of experience interpreted the CT findings using the RSNA recommendations and the CO-RADS reporting. The data were collected and compared. Results There was no statistically significant difference noted in the diagnostic accuracy obtained while using the RSNA recommendations and the CO-RADS reporting system. Also, a good inter-rater agreement was noticed while using the two reporting systems. The CT showed a highly significant value while used in the assessment of symptomatic patients in controversy to the screening of asymptomatic patients. Conclusion Both reporting systems show similar diagnostic accuracy with a good almost similar inter-rater agreement. Both can be used while interpreting the CT images of cases with suspected COVID-19 infection. CT can be used effectively in the detection of COVID-19 infection between symptomatic patients while it is of a lower value in the screening of asymptomatic patients.

Abstract Introduction Asthma is a heterogenous disease with various phenotypes that is characterized by airway limitation due to bronchospasm and airway inflammation associated with excessive mucus secretion. Eosinophilic asthma subtype is described as a late onset asthma that presents with more severe respiratory symptoms, and with sputum eosinophilia ≥ 3%. In the current study, we aimed to identify the difference in the clinical and demographic characteristics between eosinophilic and non-eosinophilic asthma subtypes and to determine predictors of eosinophilic asthma. Materials and methods One hundred bronchial asthma patients with age ≥ 18 years were divided into two groups according to sputum eosinophilia. All patients were subjected to medical history, Asthma Control Test (ACT), spirometry, serum IgE level, skin prick testing (SPT), and nasal endoscopy to detect nasal polyposis and allergic signs. Results No statistical difference was found between eosinophilic and non-eosinophilic asthma patients regarding age, gender, and body mass index. Patients with sputum eosinophilia had more severe obstruction by spirometry, and positive SPT to food allergens, pollens, and latex with statistical significance (p values 0.001, 0.016, and 0.017 respectively). Additionally, patients with sputum eosinophilia had lower ACT score, higher serum IgE level and higher serum eosinophil count. Total IgE had the highest diagnostic accuracy for discrimination of sputum eosinophilia among asthma patients. Pollen allergy and the severity of airway obstruction by spirometry were independent predictors of eosinophilic asthma. Conclusion Patients with eosinophilic asthma had more severe airway obstruction, lower ACT scores, higher serum IgE level, and serum eosinophil count. Pollen allergy and obstructive pattern by spirometry were independent predictors of eosinophilic asthma.

Chilling temperature stress is the largest factor affecting tomato performance. Under these conditions, tomato cultivations require protection from cold and frost waves. A field study was conducted to investigate the effect of three wheat sowing dates (November 1st; November 15th and December 1st), and three wheat seeding rates of 25, 37.5, and 50 % of the normal seeding rate (142.8 kg seeds/ha) on the following aspects: yield and yield components of both crops, land equivalent ratio (LER), area time equivalent ratio (ATER), and economic return. The results revealed that intercropping wheat with tomato in mid-November, coupled with a 50 % seeding rate, produced the highest values of fruit setting (%), yield components, and total fruit yield/ha of tomato during both seasons. The climatic conditions prevailing on November 15th favored the increase of grain, straw yield/ha, and yield components compared to the other sowing dates. The density of the wheat seeding rate at 50 % produced the highest grain and straw yield/ha. In addition, intercropping wheat with tomato at a 50 % seeding rate on November 15th led to the highest values of LER (1.77 and 1.80) and ATER (1.35 and 1.36) and increased the net return by 106.6 and 112.0 % compared to the sole tomato cultivation in 1st and 2nd seasons, respectively. These results indicate that intercropping wheat with tomato on November 15th at a 50 % seeding rate can better protect tomato plants from chilling and frost waves.

Article accepted. The article will be published here soon. Pending final quality checks.

Abstract Background Noninvasive preoperative evaluation of axillary lymph nodes proved to have a significant role not only on the protocol of treatment of breast cancer but also impact the whole life of the patient. Complications of lymph node biopsy or axillary clearance increase the need for noninvasive reliable diagnostic tool. We aimed in the current study to evaluate the role of diffusion-weighted magnetic resonance imaging (DW-MRI) and apparent diffusion coefficient (ADC) in discrimination between benign and malignant axillary lymph nodes. We included 44 suspicious lymph nodes from 29 patients. Qualitative DW-MRI was analyzed into restricted or not; ADC maps and cut-off value were calculated, and they were correlated with histopathological results, which were the gold standard tool of the current study. Results The cut-off value of ADC-differentiated between malignant and benign lymph nodes was 0.89 × 10−3 mm2/s. The statistical indices including the sensitivity, specificity, PPV, NPV and accuracy were 89.66%, 86.67%, 93.9, 81.2% and 87.8%, respectively, with P value

Clothing plays an important role in our social life as it has become a means of acquaintance and interaction, as it sheds light on the social character and position of the wearer and is considered an integral part of the individual's personality and social focus. The elderly is one of the advanced age groups, and it is a category that needs care and attention like any of the special groups, as it needs a full understanding of some of the physical and psychological changes that it goes through during its life.One of the important needs of elderly women in that age period is to look good, and due to the increase in the number of elderly women in the recent period, the fashion sector and clothing makers must adopt their own needs and requirements and take into account that the clothes are practical, comfortable, large-sized and compatible with the physical changes that have occurred on them.It is important to pay attention to research on elderly women's clothing, as it represents a segment of not less than 20% of any society to study a pattern of clothing and printed design that is in harmony with the psychological, health and social activities practiced by the elderly. It is the one that gives beauty and comfort to the wearer. Each individual can realize the distinctive characteristics of his personality and link these characteristics with the appropriate lines, colors, material and design. It is necessary for the elderly to maintain a beautiful appearance through appropriate clothes for them, and this helps them satisfy their psychological, health and physical desires.There are some countries that are interested in this age group and its requirements, and fashion designers work to create designs that are compatible with international fashion trends and meet the needs of older women, such as Germany and America. If fashion is a game of young models that capture the eye with their gracefulness, freshness and beauty, it is time to change this viewpoint.Key words: Innovation, Graphic designs, Woman Clothes, Fashion, Elderly ladies

Elizabeth Yeu,1,2 Omar Hashem,3 Hosam Sheha3– 5 1Virginia Eye Consultants, Norfolk, VA, USA; 2Eastern Virginia Medical School, Norfolk, VA, USA; 3Research Institute of Ophthalmology, Cairo, Egypt; 4Florida International University Herbert Wertheim College of Medicine, & Glaucoma Research Organization, Miami, FL, USA; 5Manhattan Eye, Ear and Throat Hospital, Hofstra Northwell School of Medicine, New York, NY, USACorrespondence: Hosam Sheha, Department of Ophthalmology, Manhattan Eye, Ear and Throat Hospital, 210 E 64 Street, New York, NY, 10065, USA, Tel +1 917-810-9555, Email hoss88@gmail.comPurpose: To assess the effectiveness of cryopreserved amniotic membrane (CAM) after debridement in treating epithelial basement membrane dystrophy (EBMD) prior to cataract surgery.Methods: This pilot study included 2 treatment groups: a prospective study group of 9 subjects with significant EBMD who received debridement followed by self-retained CAM, and a retrospective, control group of 10 consecutive subjects who received debridement followed by a bandage contact lens (BCL). Slit-lamp photography after fluorescein staining were used to monitor healing. Corneal topography and IOL calculation were compared at baseline and 1 month after the procedure. Refraction and ocular surface stability were also compared after cataract surgery.Results: Corneal reepithelialization after debridement occurred in 4.6 ± 0.8 days in the study group and 6.8 ± 0.6 days in the control (p < 0.05). Corneal topography showed changes in curvature from 43.5 ± 1.2D at baseline to 44.6 ± 1.2D at 1 month in the study group and from 45.0 ± 0.6D to 45.7 ± 0.8D in the control (p = 0.38). Average change in IOL calculation was 1.56 D in the study group, compared to 0.95 D in control (p = 0.29). Post-cataract refraction in both groups was within ± 0.5 Diopter of the anticipated, and corneal surface remained stable without EBMD recurrence.Conclusion: Management of ocular surface disorders prior to cataract surgery stabilizes IOL calculation and reduces postoperative refractive surprises. CAM relatively accelerated healing after debridement; however, it was not better than BCL in stabilizing the ocular surface and improving visual outcome. The use of CAM in cases of EBMD remains speculative.Keywords: amniotic membrane, cataract, EBMD, ocular surface

A novel series of 1,2,3-triazole/1,2,4-triazole hybrids 5a, 5b, and 6a–i was designed and synthesized as antiproliferative agents targeting aromatase enzymes. The antiproliferative activity of the new hybrids against four cancer cells was studied using Erlotinib as a control. Compounds 6a and 6b demonstrated the highest antiproliferative activity among these hybrids, with GI50 values of 40 nM and 35 nM, respectively. Compound 6b was the most potent derivative, with a GI50 of 35 nM, comparable to Erlotinib’s GI50 of 33 nM. Compound 6b inhibited all cancer cell lines with comparable efficacy to Erlotinib. Compounds 5a, 5b, and 6a–i were tested for inhibitory action against aromatase as a potential target for their antiproliferative activity. Results revealed that compounds 6a and 6b were the most potent aromatase inhibitors, with IC50 values of 0.12 ± 0.01 µM and 0.09 ± 0.01 µM, respectively, being more potent than the reference Ketoconazole (IC50 = 2.6 ± 0.20 µM) but less potent than Letrozole (IC50 = 0.002 ± 0.0002). These findings indicated that compounds 6a and 6b had significant aromatase inhibitory action and are potential antiproliferative candidates. The findings were further linked to molecular docking investigations, which gave models of strong interactions with the aromatase domain for inhibitors with high binding scores.

Mental and behavioral problems primarily affect the mind and brain, altering emotions and cognition. Society is heavily burdened by mental disorders, particularly if they are not identified or treated early. Despite the significant influence of mental health on people’s ability to function in many areas of life, biomedical engineering research remains remote. This study engages feature engineering and machine learning to find the significant characteristics that margin between (healthy controls and depression), and (healthy controls and schizophrenia) performing computer-aided diagnosis systems for mental health diagnosis. This research extracted twenty-seven features based on several well-known scientific functions, such as entropy, correlation, and energy, to identify two of the five main mental symptom clusters (psychomotor and disorganization). The most expressive features were selected according to four techniques based on the wrapper and filter methods, then examined using five classification techniques. Sixty different experimental models were executed for each dataset separately, based on various forms of data representation, feature selection techniques, and classification methods. In addition, fifteen multi-label experiments were performed to challenge the system’s proficiency in studying each group versus the other two groups (one versus the rest). The results indicate that the features used are auspicious in determining participants’ mental states and can effectively employ actigraphy data to distinguish between different mental conditions. Experimental models based on daily time series segmentation are the best to apply, considering the number of observations and the classification performance.

Purpose:Previous studies have suggested an association between increased thoracic kyphosis and neural axis abnormalities in patients with adolescent idiopathic scoliosis (AIS). However, the basis for this finding is unclear, and this association has been mainly noted in retrospective studies on a non-consecutive series of patients. The purpose of this study was to assess the relationship between thoracic kyphosis and neural axis abnormalities in patients with AIS. Methods:We studied a consecutive series of AIS patients treated with spinal fusion. Thoracic kyphosis (T2 to T12) was measured from preoperative lateral radiographs. All patients underwent a spine magnetic resonance imaging (MRI) prior to surgery, and MRI reports were reviewed to determine the presence of neural axis abnormalities. Statistical analyses included descriptive statistics and chi-squared analysis. Results:This study included 210 patients with AIS. There were no significant differences in age or gender between patients with thoracic hypokyphosis (kyphosis < 20°), normal thoracic kyphosis (kyphosis 20° to 40°) and thoracic hyperkyphosis (kyphosis > 40°) (p > 0.05). Neural axis abnormalities were present in 17.9% of patients with thoracic hypokyphosis, 9.8% of patients with normal thoracic kyphosis and 13.6% of patients with thoracic hyperkyphosis (p = 0.60). There were no significant differences in rates of Chiari malformation, syrinx, intra-spinal masses and other central nervous system abnormalities between groups (p > 0.05). Conclusions:Thoracic kyphosis was not associated with neural axis abnormalities in our consecutive series of patients with AIS. Increased thoracic kyphosis may not be a reliable indicator for the presence of neural axis abnormalities in patients with AIS. Level of Evidence:IV.

Thomas John,1,2,&ast; Sean Tighe,3,4,&ast; Hosam Sheha4,5,&ast; 1Thomas John Vision Institute, Tinley Park, IL, USA; 2Department of Ophthalmology, Loyola University at Chicago, Maywood, IL, USA; 3Department of Biochemistry and Molecular Biology, University of Miami, Miami, FL, USA; 4Department of Ophthalmology, Florida International University Herbert Wertheim College of Medicine & Glaucoma Research Organization, Miami, FL, USA; 5Department of Ophthalmology, Manhattan Eye, Ear, and Throat Hospital, Hofstra Northwell School of Medicine, New York, NY, USA&ast;These authors contributed equally to this workCorrespondence: Hosam ShehaManhattan Eye, Ear, and Throat Hospital, 210 East 64th Street, New York, NY, 10065, USATel +1 917-810-9555Email Hoss88@gmail.comSean TigheDepartment of Ophthalmology, Florida International University, 11200 SW 8th Street, Miami, FL, 33199, USATel +1 813-690-0099Email seanthomastighe@gmail.comAbstract: Corneal melt remains a challenging complication of Boston keratoprosthesis (KPro) and may lead to disastrous consequences such as endophthalmitis, KPro extrusion, and permanent loss of vision. Several procedures have been suggested to repair established melts; however, KPro removal or exchange is often required due to high recurrence. We herein describe a novel surgical technique to repair corneal melt: a lamellar corneal graft is centrally trephined, and a radial cut is extended from the central opening to create a keyhole graft. The graft is draped around the KPro and tightly secured around the central stem. The radial cut is closed with sutures, and the graft is secured into the underlying tissue with fibrin glue and sutures. The graft remains stable with the KPro in place, while the patients maintain a 20/200 vision or better at two years. This technique is a useful alternative for securing KPro and preventing corneal melt recurrence.Keywords: corneal melt, keratoprosthesis, lamellar keratoplasty

Background: We aim to investigate whether circulating microparticle (CMPs) subsets were raised amongst people presenting with a new diagnosis of HIV and advanced immune suppression in Malawi, and whether they associated with arterial stiffness. Methods: Microparticle characterisation and carotid femoral Pulse Wave Velocity (cfPWV) were carried out in a cohort of adults with a new HIV diagnosis and CD4

This study aims to understand the effect of different color scheme in perceptions and food product preference, product trial, and purchase intention. Using quantitative approach, the questionnaires data were cross tested by chi square and one-way ANOVA. The study found there were no significant differences between the price perception, the perceived quality, product preferences, product trial and intense to buy in the different color schemes, except white dominant color in perceived quality aspect. Respondents assessed the use of monochrome color schemes tended to have higher price perceptions and higher quality than white, yellow, analog, and complementary color schemes. It is expected to be a reference to provide an understanding of packaging design strategy especially food products by using color scheme.

Dina Sheha,1 Lobna El-Korashi,2 Amany M AbdAllah,3 Marwa M El Begermy,4 Doaa M Elzoghby,5 Amira Elmahdi1 1Department of Internal Medicine, Allergy and Clinical Immunology, Faculty of Medicine, Ain Shams University, Cairo, Egypt; 2Department of Medical Microbiology and Immunology, Faculty of Medicine, Zagazig University, Zagazig, Egypt; 3Department of Family Medicine, Faculty of Medicine, Zagazig University, Zagazig, Egypt; 4Department of Otorhinolaryngology, Faculty of Medicine, Ain Shams University, Cairo, Egypt; 5Department of Clinical Pathology, Faculty of Medicine, Ain Shams University, Cairo, EgyptCorrespondence: Dina ShehaFaculty of Medicine, Ain Shams University, El-Abbassia Street, Cairo, 11566, EgyptTel +20 1001525144Email DinaSheha@med.asu.edu.egBackground: Recent data display the possible role of cytokines such as interleukin-10 (IL-10), IL-17 and IL-23 as a link between dyslipidemia and atopy; however, the relationship between dyslipidemia, allergic rhinitis (AR), and the underlying mechanisms involved is unclear.Purpose: To measure the lipid profile and IL-17A level in AR patients in comparison to healthy controls, and correlate serum lipid level with the severity of symptoms and quality of life (QoL) of AR patients.Patients and Methods: Peripheral blood samples were collected from AR patients (n=70) and a control group (n=80). Samples were analyzed for serum total IgE by ELISA, serum lipid profile, and IL-17A level by ELISA. Severity of AR symptoms was assessed by visual analogue scale (VAS) score and the rhinoconjunctivitis QoL questionnaire.Results: Serum lipid profile and level of IL-17A in AR patients were significantly higher in comparison to controls (P < 0.001). Positive correlations were found between total cholesterol (TC) and the severity of AR and QoL. IL-17A was positively correlated with triglyceride (TG) level and low-density lipoprotein cholesterol (LDL-C) (P=0.011, r=0.303; P=0.043, r=0.242, respectively). Additionally, IL-17A was negatively correlated with high-density lipoprotein cholesterol (HDL-C) level (P=0.036, r=− 0.251). IL-17A was positively correlated with both age and VAS score with statistical significance (P=0.033, r=0.225; P=0.011, r=0.302, respectively).Conclusion: Dyslipidemia might play a potential role in the severity of AR symptoms and impairment of patients’ QoL. Highlighting this association might alert physicians to evaluate the lipid profile in AR patients for timely diagnosis and treatment of dyslipidemia in an attempt to improve disease control and improve QoL.Keywords: allergic rhinitis, cholesterol, dyslipidemia, IgE, interleukin-17, quality of life

Abstract Background Lockdown has been enforced globally to curb the spread of SARS-CoV-2. Patients with uncontrolled asthma are at risk of severe illness from COVID-19, highlighting the priority of adequate asthma control during the pandemic. Staying indoors exposes asthmatics to indoor asthma triggers, including disinfectants used for limiting the virus spread, in addition to psychological stresses of the pandemic which represent crucial contributors to loss of asthma control. Elective medical care, curtailed by the lockdown procedures, compromises adequate asthma follow up. The current study evaluated the effect of COVID-19 lockdown on the level of asthma control and mental health of bronchial asthma patients. The study included 264 bronchial asthma patients, aged 12 years and older, who responded to an online questionnaire including the asthma control test to evaluate asthma control in the preceding 4 weeks. Anxiety and depression scores and the impact of event scale were also provided. Results Seventy percent of asthmatics had uncontrolled asthma, and disinfectant use was associated with perceived increase in asthma symptoms in 77.7%. Anxiety and depression were associated with uncontrolled asthma in 50% of participants, suggesting a possible psychological impact on asthma patients. Conclusions During lockdown, asthma patients participating in the study had significantly uncontrolled disease and associated anxiety and depression. Since regular follow-up of asthma patients is cornerstone to adequate asthma control, alternative methods of medical care for asthma patients during lockdown are warranted, and particular need for mental health support ought to be provided as a continuum to adequate asthma control.

Abstract Background The aim of this study was to prospectively evaluate the role of diffusion weight MRI (DWI) in the characterization of hepatic focal lesions by using apparent diffusion coefficient (ADC). Thirty patients (18 women, 12 men; mean age 48.5 years) with hepatic focal lesions were included in this study. Patients underwent DW MR imaging with the SPLICE sequence. ADC of each focal lesion carcinoma was calculated from DW MR Images obtained with low and high b values. ADCs were compared among pathological types of focal lesions. Results Among the 30 patients included in the study, 46 focal lesions were detected. Twenty-four lesions were metastatic lesions from primary cancer, 7 lesions were hepatocellular carcinoma (HCC), 9 lesions were hemangiomas, and 6 lesions were simple cysts. There was highly significant difference between the mean ADC of the malignant lesions (metastasis and HCC) and the mean ADC of benign lesions (hemangiomas and cysts). The ADC of malignant lesion was much less than that of benign lesion. The mean ADC of malignant lesions (n = 31) was 0.73 ± 0.19 × 10−3 mm2/s, and the mean ADC of benign lesions (n = 15) was 1.94 ± 0.68 × 10−3 mm2/s (p value < 0.001). There was no significant difference between the cysts and hemangiomas. There was no statistically significant difference between the metastases and hepatocellular carcinoma. Conclusion ADCs values were able to differentiate benign from malignant lesions. ADC should be considered in the work up of patients with hepatic focal lesions.

Abstract Diffusion lung capacity for carbon monoxide correlates with HRCT findings in patients with diffuse parenchymal lung disease. Background Diffuse parenchymal lung diseases (DPLDs) affect the alveolar epithelium, pulmonary capillary endothelium, basement membrane, and perivascular and perilymphatic tissues. High-resolution computed tomography (HRCT) of the chest is the gold standard modality for diagnosing DPLD. Pulmonary function tests usually show a restrictive defect in spirometry. Single breath diffusion lung capacity for carbon monoxide (DLCO-SB) technique is used to assess the diffuse parenchymal lung diseases, as there is thickening of the alveolar membrane and diminished total lung capacity due to interstitial processes with severe decline in the transfer factor. The aim of this work was to correlate between Warrick’s HRCT fibrosis score and DLCO-SB in DPLD and to assess the possibility of using DLCO as an only tool to follow up DPLD to avoid repeated radiation exposure of the patients in HRCT chest (decrease need for radiological follow-up) or vice versa. Results This work recruited 89 patients over a period of 10 months duration, 74.2% of them were females. The Warrick’s score, ground-glass opacity, irregular pleural margin, subpleural cyst, honeycombing, and septal and subpleural lines were represented as 96.6%, 70.8%, 55.1%, 49.4%, and 48.3% respectively in HRCT of DPLD. Warrick’s score and its subscores (severity score, extent score, alveolitis score, and fibrosis score) were associated with a highly significant decrease in different pulmonary function indices (FVC, FEV1, TLC, and DLCO) with P value 0.001. A highly significant correlation between DLCO grades and total score grades was found with P value 0.001, and 86.8% of the patients with severe DLCO affection showed severe degree of total fibrosis score. Conclusions Both DLCO-SB and HRCT fibrosis scores were significantly correlated. Lifelong follow-up of function and structure of the lung in DPLD is needed by HRCT and DLCO. In an attempt to minimize repeated radiation exposure and reduce cost, we suggest DLCO to be used alone for longer follow-up periods rather than HRCT chest.