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Many medical schools have implemented near-peer tutoring (NPT) programs based on the substantial benefits of these programs to both tutors and tutees. This study correlated the frequency of attending weekly NPT sessions to students' academic performance, and also compared performance of high and low attending students.Twenty-one weekly NPT sessions were delivered by fourth-year (M4) students to first-year (M1) students. Attendance was recorded, and accordingly students were divided into three groups, high (15-21 sessions), moderate (7-14 sessions), and low (0-6 sessions) attendance groups. Pearson product-moment correlation coefficient was computed to assess the relationship between students' frequency of attendance and their overall performance on overall basic medical sciences at the end of M1 year and M2 mid-year NBME® CBSE. Students' performance was also analyzed using ANCOVA and Bonferroni post hoc test to compare differences between the three attendance groups.An increase in number of attended NPT weekly sessions corresponds with an increase in students' performance on overall M1 basic sciences weighted average (Attending NPT weekly sessions is a valuable experience that is associated with an improvement in M1 medical students' academic performance. However, low performing students tend to miss attending NPT weekly sessions.

Cutting parameters are often chosen for machining by machine operators in the industry. The experience and efficiency of the machine operator in producing a quality product are frequently used to decide parameter selection—low productivity results from improper parameter selection, inefficient machining, and technological issues. Today's key issues in the machining industry are focusing on increasing machining performance on surface roughness while minimising coolant usage. The study's objective is to enhance the performance of the nozzle lubrication system during the turning operation of an aluminium alloy 319 workpieces (Al319) to generate good surface roughness by applying turning parameters such as cutting speed, feed rate, and the depth of cut. Response Surface Method (RSM) was used to create the experimental method for this investigation, carried out using a CNC lathe machine with two axial movements and a wet cooling nozzle with a size of 1.0 mm. Synthetic soluble lubricants, Al2O3-coated cemented carbide inserts, and Aluminium alloy 319 were utilised as cutting tools and workpiece materials. To study the influence of cutting parameters on surface roughness, the Analysis of Variance (ANOVA) approach was utilised while the response surface method was performed to achieve an optimum machining performance (RSM). When comparing dry and wet cooling systems, the size of 1.0 mm nozzle shows appropriate surface roughness. According to the ANOVA analysis, the key factor impacting the surface roughness as machining performance in lubrication technique experiments was the utilisation of 1.0 mm nozzle size. The findings of combination machining parameters at a cutting speed of 270 m/min and a cutting depth of 0.60 mm at a feed rate of 0.08 mm/min offered the best results, achieving a surface roughness, Ra of 0.94 µm. The use of coolant size nozzle 1.0 mm technology combined with the use of correct machining parameters can improve machining cuts. The novel size of 1.0 mm nozzle in this current research is also valuable for reducing and increasing productivity in the machining business, as well as reducing dependency on machining operators' experience and abilities.

The purpose of this study was to investigate bacterial contamination and heavy metal concentrations in 80 samples of raw milk (cow:40 and buffalo:40) gathered from local markets in Baghdad, Iraq. The culture results were classified into ten categories: E. coli was 100% in each cows and buffaloes, Enterobacter Spp 23.75% (25% cow, 22.5% buffalo), Pseudomonas Spp 13.75% (15% cow,12.5% buffalo), Klebsiella Spp 15% (17.5% cow, 12.5% buffalo), Staphylococcus aureus 12.5% (15% cow, 10% buffalo), Staph. epidermidis 5% (for each cow and buffalo), Proteus spp. 10% (12.5% cows, 7.5% buffaloes), E. coli O157 15% (25% cow, 5% buffalo), Yersinia enterocolitica 3.75% (5% cow, 2.5% buffalo) and Salmonella 13.75% (25% cow 2.5% buffalo). The averages of heavy metals concentrations in cow milk samples were (0.62±0.25), (0.25±0.22), (0.31±0.20) and (21±2) mg/kg and in buffalo milk samples were (0.60±0.3), (0.33±0.15), (0.27±0.11) and (18±2.5) mg/kg for Lead (Pb), Cadmium (Cd), Copper (Cu) and Nickel (Ni) respectively. The high concentrations of pathogenic bacteria and metals found in the milk products is a sign of inadequate hygiene and sanitation during milking and post-milking operations, as well as excessive levels of heavy metal pollution in the environment which will affect meat and milk produced by these animals.

Introduction:Sexuality is an important part of women's physical & psychological health. Female sexual function is affected during pregnancy. Aim: we aimed to assess and compare sexual function & related endocrinological & psychological aspects in pregnant and non-pregnant women. Methods: A total of sexually active 40 women included two groups: 20 pregnant women and 20 non- pregnant women who served as controls. Sexual function (using Female Sexual Function Index), the psychological status (using Depression, Anxiety and Stress Scale) and Serum total testosterone & estradiol levels were assessed. Results: The studied women’s age ranged from 19 to 35years. The mean of desire, arousal, orgasm, and total score domains in pregnant women (2.97±0.98, 3.00±0.82, 3.53±0.93, 21.77±3.89 respectively) were significantly lower when compared to non- pregnant women (p < 0.05).In pregnant women,the depression & stress axis showed significant negative correlations with desire, satisfaction, and total score domains (p < 0.05). Bothaxes showed also significant negative correlations with total testosterone in both pregnant & non-pregnant women(p < 0.05).There were negative correlations between satisfaction in pregnant women and each of female age, husbands’ age, duration of marriage and parity (r=-0.6 p=.00.5, r=-0.59 p=.006, r=-0.72 p=.001, r=-0.59, p=.005 respectively). Conclusions: Sexual function is affected in pregnant women more than non- pregnant women. Hormonal changes, depression and stress are interrelated factors along with other factors such as age, husband’s age and duration of marriage affect the sexual function in pregnant women. So, when evaluating pregnant women, sexual function along with all these factors should be considered and assessed.

Objective: We had previously shown that long-acting cabotegravir (CAB-LA) injections fully protected macaques from vaginal simian HIV (SHIV) infection. Here, we reassessed CAB-LA efficacy in the presence of depot medroxyprogesterone acetate and multiple sexually transmitted infections (STIs) that are known to increase HIV susceptibility in women. Design: Two macaque models of increasing vaginal STI severity were used for efficacy assessment. Methods: The first study (n = 11) used a double STI model that had repeated exposures to two vaginal STI, Chlamydia trachomatis and Trichomonas vaginalis. Six animals were CAB-LA treated and five were controls. The second study (n = 9) included a triple STI model with repeated exposures to C. trachomatis, T. vaginalis and syphilis, and the contraceptive, depot medroxyprogesterone acetate (DMPA). Six animals were CAB-LA treated and three were controls. All animals received up to 14 vaginal SHIV challenges. A survival analysis was performed to compare the number of SHIV challenges to infection in the drug-treated group compared with untreated controls over time. Results: All six CAB-LA treated animals in both models, the double STI or the triple STI-DMPA model, remained protected after 14 SHIV vaginal challenges, while the untreated animals became SHIV-infected after a median of two challenges (log-rank P

In this article, we consider the synchronization problem in a network of nonlinear multiagent systems having the same relative degree $r$ . The agents do not have access to their state or output and only have relative output information from their neighbors. The controller structure is decentralized in nature and, therefore, depends only on the relative information available to it. The agent dynamics are transformed into relative dynamics by a change of coordinates where the agent dynamics are coupled. Extended high-gain observers are used to estimate the nonlinear coupling at each agent and then cancel them using feedback control. Therefore, the problem changes to a stabilization problem of $N$ nonlinear systems in the relative coordinates. It is shown that the agents achieve practical synchronization and the synchronization error can be made arbitrarily small by tuning the high-gain observer parameter. Finally, simulations are done with a network of power systems to show the efficacy of the proposed controller.

Background/Aim: The current study aimed to evaluate the impact of sustained virological response (SVR) after two sofosbuvir (SOF) containing regimens on the clinical outcomes, non invasive markers of hepatic fibrosis and liver stiffness. Patients and Methods: The study included 200 patients with compensated HCV cirrhosis. Group 1: received SOF and Ribavirin (RBV) for 6 months, Group 2: received SOF, Daclatsvir (DAC) and RBV for 3 months. Hepatitis C Virus Ribonucleic Acid (HCV RNA) by Polymerase Chain Reaction (PCR) was done at baseline, end of treatment (EOT), SVR12, SVR48. Model for end stage liver disease (MELD) score was calculated, the aspartate aminotransferase to platelet ratio index (APRI) and Fibrosis-4 (FIB-4) scores were done. FibroScan was done at baseline and SVR48. Results: SVR12 occured in 75% and 96% in group 1 and 2, respectively. There was improvement in both of APRI and FIB-4 scores at EOT in the two groups, and maintained to SVR48. A significant improvement in mean liver stiffness (LS) occurred at SVR48 compared to baseline in the study groups. Improvement in LS was observed more in group 2. There was a significant decrease in the mean value of MELD score in group 2 and non-significant decrease in group 1 at SVR48 in comparison to pre-treatment mean value. Conclusion: SOF/DAC/RBV was effective treatment regimen in compensated liver cirrhosis. This regimen resulted in significant improvement in MELD score, and liver stiffness at SVR48.

Minatallah A Elshafie, Magdy K Khalil, Maha L ElSheikh, Nagwa I Mowafy Department of Anesthesia and Intensive Care, National Liver Institute, Menoufia University, Sheeben Elkom City, EgyptCorrespondence: Minatallah A Elshafie,Department of Anesthesia and Intensive Care, National Liver Institute, Menoufia University, Sheeben Elkom City, Egypt, Tel +20 111 224 8935, Email menna80mas@gmail.comBackground: Hepatic resection is a major abdominal surgery with challenging pain management. We aimed to investigate the effect of erector spinae plane block (ESPB) with opioid free anesthesia (OFA) in cirrhotic patients scheduled for liver resection on perioperative pain management in terms of hemodynamic stability. Secondarily, we assessed time to first request for analgesia and perioperative fentanyl consumption, nausea and vomiting within 24 hours after surgery.Methods: Forty patients were randomized to block group (n = 20): OFA with ESPB and conventional group (n = 20): conventional balanced anesthesia with opioids (OFA associated non-opioid drugs [dexmedetomidine, magnesium sulfate, xylocaine, and acetaminophen] and ESPB). Bilateral ESP block was done with ultrasound guidance at the level of thoracic vertebrae T 6– 7, the local anesthetic dose was 20 mL Bupivacaine 0.25% with adjuvant dexmedetomidine (0.5 μg/kg) on each side. We monitored hemodynamic stability as the primary endpoint (heart rate, mean arterial blood pressure, and cardiac output).Results: Bilateral ESPB offered somatic and visceral analgesia for hepatic resection patients with no intraoperative fentanyl required. Postoperatively, the block group with dexmedetomidine adjuvant to the local anesthesia drugs showed delay in the first request for analgesia (p = 0.092) and decreased fentanyl requirement (p < 0.001), so no patient in the ESP group suffered from postoperative nausea and vomiting compared to 50% in the conventional group (p < 0.001).Conclusion: Bilateral ESP block with OFA is an effective approach for intra- and postoperative analgesia in cirrhotic patients undergoing liver resection.Keywords: hepatic surgery, cirrhosis, coagulopathy, pain management

Background:Dengue fever is a vector-borne infectious tropical disease caused by the dengue virus, the most common arthropod-borne infection in humans. According to WHO, the best strategy to avoid dengue endemic is to educate people about the disease and preventative measures? Despite the efforts to avoid the dengue virus, the newest national survey statistics show that dengue fever is still on the increase among the population. The major goal of this study was to examine university students' knowledge of dengue and preventative measures, as well as to determine the relationship between awareness of dengue and drivers of knowledge of dengue infection in Government College University Faisalabad students. Aim:The aim of this review is to highlight Dengue fever (break-borne fever). Materials and methods:This was a survey review article. This research work was conducted at Government College University, Faisalabad. And this research work was conducted in three months (Between February 2020 and April 2020). A cross-sectional study investigation was carried out. A total of 500 students were interviewed, with pre-tested questioners being used. Results:A cross-sectional investigation was carried out. A total of 500 students were interviewed, with pre-tested questioners being used. The sampling was done in a convenient manner. In Government College University Faisalabad, several medical terminologies were put in plain English, and interviewers were trained for data collecting. The research was carried out at Government College University in Faisalabad. The course of study was also thought to have an influence on Dengue fever knowledge. SPSS was used to examine the findings of this investigation. The total score range was 25. The participants (26.4%) showed scores from a range of 10 or below 10 which means they had poor knowledge about dengue awareness. While the participants (45.4%) showed scores from a range of 11 to 18 which means they had fair knowledge about dengue awareness. The participants (28.2%) s showed scores ranging from 19 to 25 which means they had good knowledge about dengue fever awareness. Conclusion:Of this study is that knowledge is poor between the study respondents while the majority of persons had clear understanding of fever, headache, joint pain as general signs and symptoms of dengue viral fever. However, a huge proportion exhibited vague opinions of other different signs and symptoms involving muscular pain and skin rashes. Only rare of them knew that dengue viral fever is caused by mosquito bites, and was conscious that the mosquito causing dengue breeds in artificially collected water.

International audience; In this paper it is proposed to extend the result described in Khalil and Praly (2014) and the references therein, regarding the high-gain observer-based nonlinear control to the case of systems with diffusion sensor dynamic. Based on some usual hypotheses, we provide sufficient conditions involving the high-gain parameter and the length on the PDE sensor. In fact it is brought into light an explicit trade off between them: the larger the observer gain, the smaller the length of the PDE sensor needs to be. The stability analysis of the closed loop is based on a Lyapunov functional.

The world has changed rapidly since the emergence of the COVID-19 pandemic, and the education community has not been immune to these changes. With abrupt school closings and a rapid transition to online teaching and learning, the educational technologies have been stretched to their limits and pedagogic approaches blossomed. As the world strives to reestablish normalcy, it will be under the influence of the long-lasting impact of the pandemic. This manuscript provides recommendations for the online conversion of anatomical sciences curricula in health sciences programs. Strategic guidelines are emerging for building on these changes to enhance teaching and learning in the current pandemic era.

OBJECTIVES: This study examines differences in the Learning and Study Strategies Inventory (LASSI) 10-subscale scores between low and high academically performing medical students relative to internal and external examinations. METHODS: The LASSI instrument was administered to 180 medical students from three classes (2016, 2017, and 2018). To measure the strength of association between LASSI 10-subscale scores and performance on overall biomedical sciences and the United States Medical Licensing Examination (USMLE) Step 1, Pearson product-moment correlation analyses were performed. One-way ANOVA and Bonferroni post-hoc analyses were performed to identify statistically significant differences on LASSI scores between students grouped by quartiles according to their performance on USMLE Step 1 examination (external performance measure) and by their average letter grade in the overall biomedical sciences (internal performance measure). RESULTS: Significant associations were observed between Anxiety, Motivation, and Test Strategies and students’ performance on both overall biomedical sciences and USMLE Step 1 examinations. Anxiety, Motivation, and Test Strategies were different between “A” and “C” students in the overall biomedical sciences. Anxiety, Information Processing, Motivation, Selecting Main Idea, and Test Strategies were significantly different between the upper and lower quartiles in USMLE Step 1 student performance. CONCLUSIONS: Anxiety, Motivation and Test Strategies are the main LASSI subscales that were significantly different between high-performing and low-performing students for internal and external examinations. Interestingly, the same LASSI subscales Anxiety, Motivation, and Test Strategies were correlated with students’ performance in internal and external examinations.

The study was aimed to evaluate the therapeutic effects of Zizyphus oxyphyla leaves methanolic (ZOX-LME), on serum liver, kidney and hematology along with other serum parameters in Carbon tetrachloride (CCl4) intoxicated rabbits. Experimental animals were divided into five groups, six rabbits in each. These were: group NC (normal control), group, TC (toxic control) and group ST i.e. silymarine administered group at dose rate (50) mg/kg body weight (BW). Group ET1 and group ET2 treated with (ZOX-LME) at dose 200 mg/kg BW and 400 mg/kg BW. CCl4 administration caused significant (P> 0.05) impairment in serum liver enzymes, blood factors and other serum indices. Treatment with (ZOX-LME) significantly (P 0,05) nas enzimas hepáticas séricas, fatores sanguíneos e outros índices séricos. O tratamento com (ZOX-LME) reduziu significativamente (P < 0,05) e normalizou os níveis de alanina transaminase (ALT), aspartato transaminase (AST) e fosfatase alcalina (ALP) e os índices hematológicos. Também foi observada redução significativa (P < 0,05) nas concentrações de creatinina, ureia, ácido úrico, nitrogênio ureico no sangue (BUN), albumina e glicose. Os níveis alterados de perfil lipídico e eletrólitos séricos (Ca, Mg, Cl, Na, K e P) foram significativamente (P < 0,05) mudando em direção aos níveis normais com a alimentação (ZOX-LME). Além disso, a ingestão de (ZOX-LME) causou melhora significativa nos níveis de GSH, GST e CAT, enquanto reduzia os níveis de TBARS, exibindo capacidade antioxidante. Também (ZOX-LME) mostrou inibição aumentada contra a eliminação percentual do radical livre 2, 2-difenila-1-picrilehidrazila (DPPH). Efeitos de normalização significativos (P < 0,05) foram observados com altas doses de 400 mg / kg de peso corporal de (ZOX-LME) e foram equivalentes aos grupos administrados com silimarina. O estudo histológico do fígado confirmou a atividade hepatoprotetora e curativa renal de (ZOX-LME).

We propose a new algorithm for controlling the transient behavior of the tracking error for nonlinear systems with arbitrary relative degree. In tracking problems, the transient behavior of the error is more important than the behavior of its derivatives. We introduce a concept of virtual output, which converts an arbitrary relative degree system into a relative degree one system. The virtual output is chosen in such a way that the difference between the virtual output and the tracking error can be made arbitrarily small all the time. Assuming that the state derivatives are not available for feedback we use a high-gain observer to estimate the derivatives and construct the virtual output.

Stabilization of an equilibrium point is an important control problem for underactuated systems. For a given control design, the ability of the system to remain stable in the presence of disturbances depends on the size of the region of attraction of the stabilized equilibrium. The sum of squares and trajectory reversing methods are combined together to generate a large estimate of the region of attraction. Then, this estimate is effectively enlarged by applying the impulse manifold method, which can stabilize equilibria from points lying outside the estimated region of attraction. In this paper, the generality of the approach is demonstrated using simulations of a three-link underactuated system. Experimental validation using the pendubot is provided to demonstrate the feasibility of practical implementation.

The emissions pledges of the US and China as outlined in their November 2014 agreement and in the Paris Climate Accord are key aspects of global efforts to reduce greenhouse gas emissions. A number of major US states are still pursuing emissions goals aligned with these targets even though the Trump Administration has withdrawn the US from the Paris Accord. China has also reaffirmed its commitment to its targets. This raises the question of what would be the optimal mix of energy resources each nation should deploy in order to meet its respective target. We examine this question using the Combined Energy and Geoengineering Optimization Model (CEAGOM). Our analysis shows that both nations would need to make significant but achievable adjustments to their respective energy mixes in order to meet their targets.

Recent investigations of underactuated systems have demonstrated the benefits of control inputs that are impulsive in nature. Here we consider the problem of stabilization of energy level sets of underactuated systems exploiting impulsive braking. We consider systems with one passive degree-of-freedom (DOF) and the energy level set is a manifold where the active coordinates are fixed and the mechanical energy equals some desired value. A control strategy comprised of continuous inputs and intermittent impulsive braking inputs is presented. The generality of the approach is shown through simulation of a three-DOF Tiptoebot; the feasibility of implementation of impulsive control using standard hardware is demonstrated using a rotary pendulum.

Objectives This retrospective cohort study examines incidence, risk factors, and clinical outcomes of acute myocardial infarction (AMI) and acute ischemic stroke (AIS) within one year of gram-negative bloodstream infection (GN-BSI) based on predefined clinical criteria. Methods Hospitalized adults with GN-BSI at Prisma Health-Midlands hospitals in South Carolina, USA from 2010 through 2015 were identified. Kaplan-Meier analysis was used to determine incidence of AMI and AIS within one year after GN-BSI. Multivariate Cox proportional hazards regression models were used to examine risk factors for AMI or AIS and impact on 1-year mortality. Results Among 1292 patients with GN-BSI, 263 and 17 developed AMI and AIS within 1-year with incidences of 23.4% and 1.9%, respectively. Majority of AMI were type 2 (164; 62%); 99 patients had type 1 AMI with incidence of 8.9%. Age >65 years (hazard ratio [HR] 1.52, 95% CI: 1.17–1.99), prior coronary artery disease or stroke (HR 1.74, 95% CI: 1.34–2.25), hypertension (HR 1.55, 95% CI: 1.13–2.15), end-stage renal disease (HR 1.52, 95% CI: 1.09–2.08), and quick Pitt bacteremia score (HR 1.55 per point, 95% CI: 1.40–1.72) were predictors of AMI/AIS. Development of type 1 AMI or AIS after GN-BSI was independently associated with increased 1-year mortality (HR 1.47, 95% CI: 1.03–2.07). Conclusions AMI and AIS occur frequently within one year of GN-BSI and have negative impact on 1-year survival. Future randomized clinical trials are needed to determine the most effective clinical interventions for prevention of AMI/AIS following BSI in high risk patients and improve survival after these events.

The study was conducted from May -November 2019 among 114 dacryocystitis patients attending toophthalmology department of Al-Yarmuk central hospital in Baghdad city. From of 114 patients withdacryocystitis, 90 (79%) patients had bacterial dacryocystitis, 24 (21%) with fungal dacryocystitis. Accordingto the results 83(73%) recorded with chronic dacryocystitis and 31(27%) with acute dacryocystitis. The highpercentage was bacterial dacryocystitis (32%), fungal dacryocystitis (38%) were at age of 74±0.3 y and thelow percentage of bacterial was (11%) at 63±0.5 y and with fungal dacryocystitis (8%) at age of 42±0.3y.Patients with bacterial dacryocystitis had diabetes mellitus (56 %),arthritis and hypertension (28%,16 %)while the DM with fungal dacryocystitis (46%), arthritis, hypertension (38 %,16 %), S.aureus 23(26%),S.epidermidis 18 (20%),Streptococcus spp. 14 (16%), Pseudomonas spp. 11 (12%), E. coli 10 (11%),Enterobacter spp 9 (10%) finally Proteus spp. 5 (6%), while Aspergillus flavus represented 9 (37%) ascausing fungal dacryocystitis, Aspergillus fumigates 7 (29%), Aspergillus niger 4 (17%)and Candida spp 4(17%) . The antibiotic susceptibility tests revealed that S. aureus isolates were sensitive to Chloramphenicol(83%),. S.epidermidis isolates showed sensitivity to Gentamycin and Tetracycline (88%), Streptococcusspp showed the susceptibility to Erythromycin (93%), Ciprofloxacin (86%) respectively,Pseudomonas sppisolates considered highly sensitive to Tetracycline and Chloramphenicol (91%), E.coli isolates were alsosusceptible to Chloramphenicol (90%), Enterobacter spp were sensetive to Tetracycline and Gentamicin(78%),Proteus spp isolates seems sensitive to Chloramphenicol and Tetracycline (100%), Aspergillus spp.and Candida spp. isolates remain sensitive to Itraconazole, Voriconazole .

The ability to integrate our perceptions across sensory modalities and across time, to execute and coordinate movements, and to adapt to a changing environment rests on temporal processing. Timing is essential for basic daily tasks, such as walking, social interaction, speech and language comprehension, and attention. Impaired temporal processing may contribute to various disorders, from attention-deficit hyperactivity disorder and schizophrenia to Parkinson’s disease and dementia. The foundational importance of timing ability has yet to be fully understood; and popular tasks used to investigate behavioral timing ability, such as sensorimotor synchronization (SMS), engage a variety of processes in addition to the neural processing of time. The present study utilizes SMS in conjunction with a separate passive listening task that manipulates temporal expectancy while recording electroencephalographic data. Participants display a larger N1-P2 evoked potential complex to unexpected beats relative to temporally predictable beats, a differential we call the timing response index (TRI). The TRI correlates with performance on the SMS task: better synchronizers show a larger brain response to unexpected beats. The TRI, derived from the perceptually driven N1-P2 complex, disentangles the perceptual and motor components inherent in SMS and thus may serve as a neural marker of a more general temporal processing.

We study a trajectory tracking problem for a multi-rotor in the presence of modeling error and external disturbances. The desired trajectory is unknown and generated from a reference system with unknown or partially known dynamics. We assume that only position and orientation measurements for the multi-rotor and position measurements for the reference system can be accessed. We adopt an extended high-gain observer (EHGO) estimation framework to estimate the feed-forward term required for trajectory tracking, the multi-rotor states, as well as modeling error and external disturbances. We design an output feedback controller for trajectory tracking that comprises a feedback linearizing controller and the EHGO. We rigorously analyze the proposed controller and establish its stability properties. Finally, we numerically illustrate our theoretical results using the example of a multi-rotor landing on a ground vehicle.

Aim : This study aimed to evaluate the efficacy/safety of Sofosbuvir/Ribavirin and Sofosbuvir/Daclatasvir/Ribavirin in Egyptian cirrhotic HCV patients, and to demonstrate the effects on the haematological and biochemical profile. Patients and Methods: A Prospective study was done on 200 HCV cirrhotic patients. They were allocated into two Groups, Group 1: received Sofosbuvir (SOF) and Ribavirin (RBV) for 24 weeks, Group 2: received SOF, Daclatasvir (DAC) and RBV for 12 weeks. Results : Sustained virological response was achieved in 75 (75%) and 96 (96%) patients in Group 1, 2 respectively. The mean value of Hb and Platelet count decreased in a significant manner at treatment end in both Groups, and the percentage of drop was significantly higher in Group 1 in comparision to Group 2. The mean values of albumin, ALT, and AST decreased in a significant manner at treatment end in both Groups. There was a significant increase in total bilirubin mean value in both Groups at treatment end. The percent of the increase in the indirect bilurubin mean value was significantly higher in Group 2. There was improvement in FIB-4 score at treatment end in both Groups. This improvement was maintained to SVR 12 in both Groups. Conclusion: Cirrhotic patients received SOF, DAC and RBV for 12 weeks had a significantly higher SVR12 rate when compared to those received SOF and RBV for 24 weeks. In patients who achieved sustained virological response, there was improvement in liver function parameters, and FIB4 at the time of SVR12 in comparison to baseline values.

Background Lumbar interbody fusion is a recognized surgical technique in treatment of degenerative lumbar instability. Interbody fusion supplemented with pedicle screw fixation has several advantages over posterolateral fusion and has been advocated to improve fusion rates and clinical outcomes. Interbody fusion places the bone graft in the loadbearing position of the anterior and middle spinal columns thereby enhancing the potential for fusion. In addition, the interbody space has more vascularity than the posterolateral space, also increasing the potential for a solid fusion mass to form. Aim of the Work to assess safety and efficacy of unilateral pedicle screw fixation associated with interbody fusion in Lumbar spine degenerative diseases and to evaluate and compare outcomes of unilateral versus bilateral pedicle screw fixation associated with interbody fusion in lumbar spine degenerative diseases, as regard the operation time, bleeding, postoperative stay, cost, and the clinical and biomechanical results. Material & Methods This observational prospective comparative study of the 2 groups who were operated either unilateral (Group A /25 patients) or bilateral (Group B/25 patients) pedicle screw fixation with interbody fusion was done. Patients were followed up for 1, 6, 12 months. This study occurred at Ain Shams University hospitals. Results No differences were observed between the two groups with respect to demographic data. The patients of the two groups had significant improvement in functional outcome compared to preoperatively, except in early postoperative VAS back and ODI in unilateral group which is better than bilateral group. However, no significant difference noticed in the further follow up. There was no significant difference comparing fusion rate, complication rate and duration of hospital stay between the two groups at postoperative follow-up. There was significantly less blood loss, shorter postoperative pain killer use and significantly shorter operation time in the unilateral PS fixation group as compared with the bilateral PS fixation group in our study. Conclusion Our study suggested TLIF with unilateral PS fixation was as safe and effective as that with bilateral PS fixation. Unilateral PS fixation may significantly reduce the intraoperative blood loss and shorten the operation time, somewhat improve the clinical outcome scores of ODI and VAS Back without significant difference comparing fusion rate, complication rate and duration of hospital stay between the two groups at postoperative follow-up. BPSF with TLIF likely causes more degeneration at the cranial adjacent segment compared with UPSF techniques. However, the long-term follow up is required to demonstrate the impact of these findings.

Although titanium (Ti) alloys possess unique properties that allow them to compete with many other materials in advanced industries such as aerospace, marine and biomedical, they have poor machining performances. The primary objective of this study is to investigate the distribution of magnetic field intensity at the cutting environment in single-point diamond turning (SPDT) of Ti–6Al–4 V alloy and its influence on the machining performances, with the goal of achieving the desired machining conditions of magnetic field assisted ultra-precision machining, especially magnetic field intensity and the corresponding machining parameters, and to enhance the machinability of Ti–6Al–4 V alloy. In this study, magnetic field-assisted machining (MFAM) system was designed and coupled with ultra-precision machining (UPM) using single-point diamond turning for increasing the machinability and improving the surface quality of Ti6Al4V alloy machined parts. The finite element method (FEM) was developed to demonstrate the influences of the generated magnetic field on the machining processes. The Experimental results showed the capability of magnetic field assistance to enhance the machining performance of Ti–6Al–4 V alloy. These findings provided strong evidence that a magnetic field has the ability to extend cutting tool life, additionally, MFAM achieved the lowest value of surface roughness, representing a 33 percent improvement in surface roughness. This research contributes to the support of the optimum MFAM by FEM and the achievement of high-quality machined Ti alloys in UPM for similar research works, as demonstrated by the experimental results.

In this paper, the performance of a small centrifugal compressor of an UAV at design and off-design operational conditions is estimated by way of advanced commercial CFD code, ANSYS-CFX-16. Then, the gained performance is compared with published predicted performance using approximate method[1, 2]. The engine used is JetCat P200-sx, which is a single spool turbojet. Considered off-design regimes include centrifugal compressor operations at 73%, 80%, 85%, 90%, 100% and 103% of the design point rotational speed. Commercial CFD code CFX-16, is used for compressor performance prediction at design and off- design operating conditions. The computational grid is created using Turbo-Grid for compressor parts impeller and vanned diffuser. While for both intake device and vaneless diffuser an unstructured tetrahedral mesh with prism layers along the wall surfaces using ANSYS-ICEM CFD mesh is used to resolve the near-wall boundary layer. To gain a reduction in the computational analysis cost, only one passage is considered as a portion of the computational domain and the model is simulated as a steady state problem. Finally, to detect the surge point at each rotational speed the unsteady simulation on performance predictions of centrifugal compressor is investigated. It is a common practice to use compressor characteristics available in graphical form. These plots can be transformed into empirical equations that can be used in automatic calculation. Such approach was done to predict the same compressor performance[13]. The CFD detailed compressor performance is compared with the mentioned published one. The numerical CFD results illustrate good agreement with the analytical model.

The study included 234 patients attended to Iben AL-Haithem hospital of ophthalmology in Baghdad city having microbial keratitis , at age of (18-81) years for the period from September 2017- April 2018 . there were 147 ( 63% ) patients with bacterial keratitis and 87 (37%) with fungal keratitis . Men with bacterial keratitis represented 60% (88) and women 40% (59) ,while men with fungal keratitis were 61% (53) and women 39% (34), the number of the patients with bacterial keratitis were 82(56%) and 51(59%) with fungal keratitis from Baghdad while the internally displaced were 62(44%) with bacterial and 36(41%) with fungal keratitis , the percentage of patients with bacterial keratitis and fungal keratitis were both (34%) at mean age of 73 ± 2.3 y . Most patients with bacterial keratitis recorded having diabetes mellitus(39%) while the diabetic with fungal keratitis represented (41%) , The results revealed that gram positive bacteria was 102 (69%) and gram negative 45 ( 31%) , S.aureus was the most common cause of bacterial keratitis42(29%), followed by S.epidermidis 36(24%) then Streptococcus spp. 24(16%) , Pseudomonas spp. 17 (12%) , Proteus, spp. 13 (9%) , Escherichia coli 9(6%) and Enterobacter spp 6(4%) while Aspergillus fumigates represented 26(30%) as the most common cause of fungal keratitis , Aspergillus flavus 19(22%) , Aspergillus niger 16(18%) , Pencillium spp 11(13%) , Fusarium oxysporium. 8(9%) , Fusarium solani 5(6%) and Candida spp 2(2%) . S. aureus isolates were susceptible to Cloramphenicol and Ciprofloxacin (83%) while they were resistant to Clindamycin (57%) . S.epidermidis isolates were susceptible to Cloramphenicol and Amikacin (86%) ,Streptococcus spp were susceptible to Tetracycline and Clindamycin (88% ,83%) , Pseudomonas spp showed their high susceptibility to Tetracycline(96%) followed by Cloramphenicol and Ciprofloxacin (88%) both each, Enterobacter spp were susceptible to Tetracycline and Gentamicin (100%) while E.coli were susceptible to Cloramphenicol (100%) followed by Ciprofloxacin and Gentamicin (89%) both, fungal isolates were susceptible to all types of antibiotics used in the study as (98%) of Aspergillus spp isolates were sensitive to Itraconazole (98%) Voriconazole, Amphotericin B and Natamycin (95%,93% ,92%) respectively, Pencillium spp. were sensitive to Amphotericin B (100%) then Natamycin and Itraconazole (91%) both, Fusarium spp were sensitive to Natamycin and Itraconazole (100%) , Candida isolates were sensitive (100%) to Amphotericin B, Natamycin and Voriconazole.

Background: Exosomes are microvesicles that are recently discovered in intercellular communication especially between tumor cells as lung cancer that are important for tumor development and progression. Objectives: Examine the diagnostic role of serum exosomal LncRNA in lung cancer among Egyptian population. Methods: Lung cancer characteristic exosomal RNA-based biomarker Lnc-RNA-RP11-510M2.10 was selected based on bioinformatic methods, followed by RT-qPCR validation of their expression in serum of 20 patients with lung cancer and 10 healthy volunteers. Results: serum exosomal Lnc-RNA-RP11-510M2.10 showed a significant negative association with lung cancer patients in comparison to patients with healthy persons (p

Net ozone production rates averaging 130 ppb/h lasting 3–5 h are calculated for five cities of urban Saudi Arabia where hourly ozone and NO2 measurements were taken for a whole year. Concentrations of ozone in the cities are not unusually high at ~40 ppb during the peak 4 h, but are 50–60 ppb at altitude throughout the day. A mass balance of ozone reveals that the locations represented by the sites export ozone during the peak production periods before mid-day at average rates comparable to the net production, but later a substantial import of ozone is required to balance the budget. Concentrations of NO are high throughout the day (~14 ppb) and night (~11 ppb) and yet significant ozone concentrations remain during the night (~18 ppb). An explanation is that large amounts of ozone are generated in the surrounding areas and aloft by ozone precursors from the cities. It is brought back during the night by transport processes and reacts with fresh emissions of NO driven by nightlife resulting in an outflow of NO2 to create the observed balances. Over the whole day, the regions represented by the sites are net sinks of ozone. We describe and support this picture of ozone balances in urban Saudi Arabia. Around midnight in urban Saudi Arabia nitrogen oxides reach their second peaks of the day. Under these conditions, ozone left over from the day would be destroyed within an hour after sunset, yet it is measured to be about 40% of the daytime maximum levels that persist throughout the night. No process has been found to produce ozone at night, leaving net transport as the only explanation. A mass balance of ozone is carried out at the sites quantifying its net chemical production, transport away from the sites during a few hours each day and import into the sites the rest of the time. The air around the observation sites is found to destroy more ozone every day than is produced there. This, however, may be normal for city centers everywhere with high NO emissions.

Addressing greenhouse gas emissions and the associated global temperature rise will be one of the key issues of the 21st century. The supply and use of energy is the single largest contributor to anthropogenic greenhouse gas emissions through the burning of fossil fuels. Given the role fossil fuel use plays in the global economy, curtailing their use in order to mitigate climate change will be very difficult. This has led to proposals to deploy various types of geoengineering as a means of mitigating the global temperature increase. Current integrated assessment models (IAMs) do not readily incorporate geoengineering options. They are also complex to set up and run. This has led the authors to develop the Combined Energy and Geoengineering Optimization Model (CEAGOM)©. CEAGOM provides an easy to use software platform that explicitly includes geoengineering as potential options as part of the optimization of the energy resource mix for meeting a specified energy demand while still meeting specified climate targets. This paper describes the CEAGOM model and shows that its results compare quite favorably with those from a more complex IAM.

Thirty New Zealand rabbits of vari- ous ages were used for this investi- gation. DMRT1 and STRA8 genes expression was recorded by RT PCR, completed by histological sec- tions of testes in studied ages. DMRT1 and STRA8 genes have dis- tinct roles during spermatogenesis in mammals. The present study hy- pothesized that the change in the level of specific genes expression during spermatogenesis could be re- lated to the change in the comple- ment of germ cell types. Distinct ex- pression patterns were observed for DMRT1 reached the maximum level (peak or plateau) just before sper- matogenesis process at age of 6.5thweek and testicular STRA8 reachedthe maximum level at 6 months. The two genes expression patterns are consistent with their specific roles during spermatogenesis. The pur- pose of the present study was to de- termine the expression of DMRT1 and STRA8 genes throughout post- natal New Zealand rabbit testis thatwould serve as a reference for ex- pression pattern of the studied genes.