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Rüzgar enerjisinin değerlendirilmesi, herhangi bir yerde bulunan potansiyel rüzgar enerjisi hakkında uzmanları bilgilendiren entegre analizlerin bir biçimidir. Bu tür değerlendirmenin başlangıç noktası, belirli bir yerde yaygın olarak meydana gelen rüzgar modellerini anlamaktır. Bunu, rüzgar verileri toplama ve toplanan verileri analiz etme izler. Bu makale, birinci ve ikinci bölgelerin kapsamlı bir çalışmasıdır. Bu nedenle, ortalama rüzgar hızı, yön verisi, kısa vadeli varyasyonlar (veya rüzgarlar), yıllık, mevsimsel ve hatta günlük değişiklikler / varyasyonlar ve yüksekliğe bağlı varyasyonlar gibi birkaç parametre dikkate alınmalıdır. Bahsedilen tüm parametreler sahaya özgü olduğundan, uzun bir süre boyunca yerinde ölçümlerle doğru bir şekilde belirlenebilir. Bu çalışma, rüzgar değerlendirmesi ve potansiyel rüzgar enerjisi üzerine odaklandığından Gharyan şehri bir konum olarak seçildi ve alt konumları Gharyan 1, 2, 3 ve 4 olarak adlandırıldı. İlk olarak, rüzgar enerjisi kaynağı ile ilgili konumun yakınında bulunan meteoroloji istasyonlarından alınan veriler arka planda toplandı. Genellikle, her bir konum için 3 saatlik uzun vadeli rüzgar verileri kullanılır ve daha sonra, göbek yüksekliğindeki gerçek rüzgar hızını bulmak için rüzgar verilerinin yeniden hesaplanması yapılır. Önemli hesaplama parametreleri arasında, önerilen her bir saha için hesaplanması gereken Weibull dağılımı, ortalama rüzgar hızı, yıllık kapasite faktörü ve yıllık enerji faktörü yer alır. Yıllık kapasite ve enerji faktörlerinin hesaplanması, genellikle Vestas (V60, 850kW) olarak adlandırılan rüzgar türbinini seçmek için gereklidir. Bu makale, Libya'daki bazı tesislerin, özellikle yıllık enerji, kapasite faktörü ve kabul edilebilir enerji üretim kapasitesinin kaydedildiği Gharyan'da bulunan dört bölgede yeterli rüzgar enerjisine sahip olduğunu açıkça göstermektedir., Assessing the potential of wind energy involves an integrated analysis approach, the conclusions of which inform the experts of the field about the possibilities of harnessing wind energy on a certain location. This type of analysis is made of multiple steps, starting from observing and understanding commonly occurring wind patterns at the designated site, followed by collection of data and finally analysis. The current paper is an extended study on the first two steps where several parameters such as wind’s average speed and its direction, as well as various changes such as short-term ones (or gusts), yearly, seasonal, and even daily changes, and height-related variations were collected. Since the above-mentioned parameters are site-specific, they can be accurately determined through on-site measurements during extended time periods. The site for this study is the city of Gharyan in Libya which was divided into four sub-locations. Data were gathered from meteorological stations located in the vicinity of the designated area in three-hours periods, and they were then used to recalculate wind’s real speed and height at a specific hub. Among the important calculation parameters were Weibull's distribution, average wind speed, annual capacity factor, and the annual energy factor, all of them required for each proposed site. The calculations of the annual capacity and energy factors are necessary for choosing the appropriate wind turbine, generally named Vestas (V60, 850kW). The current study clearly shows that some sites, in particular four locations in Ghayran where feasible annual energy, capacity factor, and acceptable power generation capacity were recorded have wind energy for civilian purposes.

OBJECTIVE Resection of meningiomas in direct contact with the anterior optic apparatus carries risk of injury to the visual pathway. Stereotactic radiosurgery (SRS) offers a minimally invasive alternative. However, its use is limited owing to the risk of radiation-induced optic neuropathy. Few SRS studies have specifically assessed the risks and benefits of treating meningiomas in direct contact with the optic nerve, chiasm, or optic tract. The authors hypothesized that SRS is safe for select patients with meningiomas in direct contact with the anterior optic apparatus. METHODS The authors performed an international multicenter retrospective analysis of 328 patients across 11 institutions. All patients had meningiomas in direct contract with the optic apparatus. Patients were followed for a median duration of 56 months after SRS. Neurological examinations, including visual function evaluations, were performed at follow-up visits. Clinical and treatment variables were collected at each site according to protocol. Tumor volumes were assessed with serial MR imaging. Variables predictive of visual deficit were identified using univariable and multivariable logistic regression. RESULTS SRS was the initial treatment modality for 64.6% of patients, and 93% of patients received SRS as a single fraction. Visual information was available for 302 patients. Of these patients, visual decline occurred in 29 patients (9.6%), of whom 12 (41.4%) had evidence of tumor progression. Visual decline in the remaining 17 patients (5.6%) was not associated with tumor progression. Pre-SRS Karnofsky Performance Status predicted visual decline in adjusted analysis (adjusted OR 0.9, 95% CI 0.9–1.0, p < 0.01). Follow-up imaging data were available for 322 patients. Of these patients, 294 patients (91.3%) had radiographic evidence of stability or tumor regression at last follow up. Symptom duration was associated with tumor progression in adjusted analysis (adjusted OR 1.01, adjusted 95% CI 1.0–1.02, adjusted p = 0.02). CONCLUSIONS In this international multicenter study, the vast majority of patients exhibited tumor control and preservation of visual function when SRS was used to treat meningioma in direct contact with the anterior optic pathways. SRS is a relatively safe treatment modality for select patients with perioptic meningiomas in direct contact with the optic apparatus.

AIM To study the incidence, extent and fate of uterine ischaemia as one of the forms of non-target embolisation following uterine artery embolisation (UAE), as detected on immediate post-embolisation and contrast-enhanced magnetic resonance imaging (MRI) examinations at the 3-month follow-up. MATERIALS AND METHODS A retrospective study was undertaken comprising 43 women (mean age: 44.8 ± 3.79 years). MRI was performed before, immediately after (within 6 h), and 3 months after successful UAE. Areas of uterine ischaemia were identified on immediate post-embolisation MRI as regions of newly developed (compared to pre-embolisation MRI) absent enhancement within the uterus not corresponding to the location of the leiomyoma. The volume of the ischaemic region was calculated using the formula (height × length × width × 0.523). RESULTS Uterine ischaemia was encountered in 29 patients (67.44%). The mean volume of the ischaemic region immediately after UAE was 29.29 ± 19.15 ml (range: 7.36–87.71 ml). At 3-month follow-up, it was 0.35 ± 0.95 ml (range: 0–3.5 ml) with 25 (86%) patients showing complete resolution of the ischaemia. The mean reduction in the volume of the ischaemic region at the 3-month follow-up was 98.24 ± 5.72% (range: 72–100%). This volume reduction was statistically significant (p CONCLUSION Uterine ischaemia as a form of non-target embolisation following UAE might be encountered in up to two thirds of patients. These ischaemic areas are significantly reduced at the 3-month follow-up with up to 86% of cases showing complete reversibility of the ischaemia.

Aims/Introduction To study the epidemiology, genetic landscape and causes of childhood diabetes mellitus in the State of Qatar. Materials and methods All patients (aged 0–18 years) with diabetes mellitus underwent biochemical, immunological and genetic testing. American Diabetes Association guidelines were used to classify types of diabetes mellitus. The incidence and prevalence of all the different types of diabetes mellitus were calculated. Results Total number of children with diabetes mellitus was 1,325 (type 1 n = 1,096, ≥1 antibody; type 2 n = 104, type 1B n = 53; maturity onset diabetes of the young n = 20; monogenic autoimmune n = 4; neonatal diabetes mellitus n = 10;, syndromic diabetes mellitus n = 23; and double diabetes mellitus n = 15). The incidence and prevalence of type 1 diabetes were 38.05 and 249.73 per 100,000, respectively, and for type 2 were 2.51 and 23.7 per 100,000, respectively. The incidence of neonatal diabetes mellitus was 34.4 per 1,000,000 live births, and in indigenous Qataris the incidence was 43.6 per 1,000,000 live births. The prevalence of type 1 diabetes and type 2 diabetes in Qatari children was double compared with other nationalities. The prevalence of maturity onset diabetes of the young in Qatar was 4.56 per 100,000. Conclusions This is the first prospective and comprehensive study to document the epidemiology and genetic landscape of childhood diabetes mellitus in this region. Qatar has the fourth highest incidence of type 1 diabetes mellitus, with the incidence and prevalence being higher in Qatari compared with non‐Qatari. The prevalence of type 2 diabetes mellitus is also higher in Qatar than in Western countries. The incidence of neonatal diabetes mellitus is the second highest in the world. GCK is the most common form of maturity onset diabetes of the young, and a large number of patients have type 1B diabetes mellitus., This is the first comprehensive, prospective study from the Middle East North Africa region to systematically study the causes of diabetes in every child in the State of Qatar. The State of Qatar has the fourth highest incidence of type 1 diabetes in the world. The incidence of type 2 diabetes is much higher in Qatar than in Western countries. Both type 1 and type 2 diabetes are more common in the Qatari population than the non‐Qatari population. Mutations in GCK were the most common cause of maturity onset diabetes of the young, and mutations in the PTF1A and INS genes were the most common cause of neonatal diabetes in this population.

Background Glioblastoma is the most aggressive primary malignant brain tumor in adults and is characterized by poor prognosis. Immune evasion occurs via programmed death-ligand 1 (PD-L1)/programmed death receptor 1 (PD-1) interaction. Some malignant tumors have responded to PD-L1/PD-1 blockade treatment strategies, and PD-L1 has been described as a potential predictive biomarker. This study discussed the expression of PD-L1 and CD8 in glioblastomas. Materials and methods Thirty cases of glioblastoma were stained immunohistochemically for PD-L1 and CD8, where PD-L1 expression in glioblastoma tumor tissue above 1% is considered positive and CD-8 is expressed in tumor infiltrating lymphocytes. The expression of each marker was correlated with clinicopathologic parameters. Survival analysis was conducted to correlate progression-free survival (PFS) and overall survival (OS) with PD-L1 and CD8 expression. Results Diffuse/fibrillary PD-L1 was expressed in all cases (mean expression, 57.6%), whereas membranous PD-L1 was expressed in six of 30 cases. CD8-positive tumor-infiltrating lymphocytes (CD8+ TILs) had a median expression of 10%. PD-L1 and CD8 were positively correlated (p = .001). High PD-L1 expression was associated with worse PFS and OS (p = .026 and p = .001, respectively). Correlation of CD8+ TILs percentage with age, sex, tumor site, laterality, and outcomes were statistically insignificant. Multivariate analysis revealed that PD-L1 was the only independent factor that affected prognosis. Conclusion PD-L1 expression in patients with glioblastoma is robust; higher PD-L1 expression is associated with lower CD8+ TIL expression and worse prognosis.

Objectives Children with antibody positive type 1 diabetes mellitus (type 1 diabetes) are at an increased risk of developing celiac disease (CD) which suggests a common autoimmune basis with both high-risk human lymphocyte antigen (HLA) and non-HLA factors playing a role in the pathophysiology. We aim to describe the prevalence, immune profile, and clinical characteristics of children with CD who have type 1 diabetes mellitus in Qatar. Methods All children (aged 0–18 years) attending a regional diabetes clinic with antibody positive type 1 diabetes were screened for CD. Measurement of tissue transglutaminase IgA and IgG as well as anti-endomysial antibody, was done, clinical details about the birth history, family history of diabetes and CD, age of onset, and ethnicity were collected. Results Out of the 1,325 children with antibody positive type 1 diabetes, 54 were identified to have CD on screening and then confirmed on small bowel biopsy. The prevalence of CD in the type 1 diabetes childhood population in Qatar is 4.07%. CD and type 1 diabetes were more prevalent in the Qatari children (n=32) as compared to non-Qatari (n=22) and occurred mostly in the age group 6–10 years. The most common type 1 diabetes antibodies in children with CD were glutamic acid decarboxylase and insulin autoantibody. Twelve subjects were asymptomatic for CD symptoms and picked up only on screening. Conclusions The prevalence of CD in children with type 1 diabetes in Qatar is comparable to reports from around the world. Many children were asymptomatic and thus routine screening is recommended.

Aim of the work: To investigate the potential association of protein programmed death 1 (PD-1) serum level and its gene expression inrecent onset systemic lupus erythematosus (SLE) patients and study its association with the disease activity. Patients and methods: The study included 80 recently diagnosed SLE patients and 80 healthy controls. SLE disease activity index (SLEDAI) was assessed. The serum level of soluble (sPD-1) was assessed by enzyme linked immunosorbent assay (ELISA) and its gene expression level was evaluated by real time-polymerase chain reaction (RT-PCR). Results: They were 68 females and 12 males (F: M 5.7:1) with age 30.8 ± 8.7 years and disease duration of 3.2 ± 1.7 months. The sPD-1 and PD-1 gene expression level (folds) were significantly elevated in patients (1280.6 ± 1448.1 pg/ml and 0.3 ± 0.06 folds) than controls (109.1 ± 11.9 pg/ml and 0.03 ± 0.008 folds) (p

Recently, Bayesian Optimization (BO) provides an efficient technique for selecting the hyperparameters of machine learning models. The BO strategy maintains a surrogate model and an acquisition function to efficiently optimize the computation-intensive functions with a few iterations. In this paper, we demonstrate the utility of the BO to fine-tune the hyperparameters of a Random Forest (RF) model for a problem related to the recognition of splice-junction genetic sequences. Locating these splice-junctions prompts further understanding of the DNA splicing process. Specifically, the BO algorithm optimizes four RF hyperparameters: number of trees, number of splitting features, splitting criterion, and leaf size. The optimized RF model automatically selects the most predictive features of the training data. The dataset is obtained from the UCI machine learning repository where half of the records represent two different types of splice-junctions and the other half does not represent any splice-junction. Experimental results proved the advantage of the BO-RF with 99.96% and 97.34% training and test classification accuracies respectively. The results also demonstrated the ability of the RF model to select the most important features, ensuring the best possible results using Support Vector Machine (SVM), K-Nearest Neighbor (KNN), and decision tree (DT) models. Some practical procedures in model development and evaluation such as out-of-bag error and cross-validation approaches are also referred to.

Internet-based tools and social media are greatly developed in the tech world. Today, technology is widely accepted and used by all generations. These tools are great and very useful for students in terms of learning, collaboration and information sharing. We aim to present a model for learning programming in social learning environments with the context of the Affinity Research Group (ARG) model. The proposed model is called “Learning Programming in Social Environments within Affinity Group (LPSEAG)”. We test the proposed model for two academic years. A comparative approach was used. In the experiment, we divide the students into two categories: (1) Learn programming in the context of using the LPSEAG model, (2) Learn programming in the context of social media groups. Qualitative and quantitative results are compared for the two categories. From the results obtained it was clearly found that the students’ satisfaction was high on working within a group using the LPSEAG model compared to the responses of students that use social media groups only. Moreover, the quantitative results supports the assumptions that the use of LPSEAG model in learning programming in the introductory programming courses enhances the learning outcomes. Learning programming in groups enhances the learning outcomes for students whatever the student’s programming level. Teachers are encouraged to create students’ programming groups and implement LPSEAG model to increase learning outcomes and facilitate learning environments for students over-distance. More researches are needed to develop CVLEs which encourage students to learn programming with teams over distance.

This paper was prepared to introduce the importance of knowledge and awareness by adhering to international standards when establishing large economic projects (> 1.0 m $) through preparing a detailed feasibility study. This includes all stages of the project (from idea to operation) and identifies project outputs and indicators of success, in order to establish best projects and for the optimal use of public money, based on a comparison and clarification with some successful projects to benefit from their experience. In fact, most projects in the Sudan are not studied and implemented according to a disciplined professional hierarchy and international standards, which often leads to their failure. Therefore, defining this problem and describing the solution should be a professional duty, the greater of which is located in the economic, engineering, the administrative, and the executive sectors, but the opinion of the civil engineer still remains as a key factor from the idea to the operational (Rule of Thumb). To solve this problem, we proposed simple guidelines for establishing projects from the idea to the operating, benefiting from our experience with the Ministry of Finance and Economic Planning and the Islamic Development Bank, and guidelines from consultant homes and financing institutions in this regard. Finally, we think that our suggested guidelines can be used as basic platform for all those involved and those in charge of these projects, so that the Ministry of Finance and Economic Planning (the largest financier) can end up as binding directors (along the lines of purchase and contracting laws and regulations) to obtain the funding required to implement projects public financed with loans or grants by global or local funding agencies.

Purpose This paper aims to describe how the COVID-19 pivot to online teaching enabled a student-produced podcast assessment to be created and substituted for the final examination in an MBA accounting course. Design/methodology/approach This paper provides instructors’ reflections and feedback from students on the usefulness of podcasts as an assessment tool in accounting education. Also included are the assignment instructions and a marking rubric which can be adapted as a sharing network. Findings The pivot to the authentic podcast assessment proved to be a very positive outcome during COVID-19 for instructors and students. The students embraced and enjoyed the task, and importantly it was an efficient learning experience that connected theory to practice, while preserving authenticity. Originality/value Podcasts have grown in popularity and have been widely used with students as receivers. The accounting education literature is however devoid of instances where podcasts have been used as an assessment tool. Although the assessment was changed because of the COVID-19 pandemic, it has ongoing applicability as a useful assignment in future semesters.

Background A growing body of evidence suggested that uric acid (UA) may contribute in the pathways underlying osteoarthritis (OA) pathogenesis; however, studies that investigated the relationship between UA and OA emerged inconclusive results. The purpose of the study was to explore the association of serum uric acid (sUA) levels with clinical severity, radiological severity of knee osteoarthritis (KOA) based on Kellgren-Lawrence (KL) grading system, and MRI changes in non-gouty patients. Results WOMAC scores: pain, stiffness, function, and total score are significantly higher in H-sUA group than L-sUA group (p = 0.004, p = 0.019, p = 0.018, p = 0.008 respectively). Joint space width (JSW) is significantly narrower in H-sUA group than L-sUA group (p = 0.013). H-sUA group had more frequent KL grade 4 (p < 0.001), osteophytes grade 4 (p < 0.001), focal bone erosion (p < 0.001), bone marrow lesions (p = 0.023), and synovitis (p = 0.011) than L-sUA group. Female KOA patients in H-sUA group had significantly higher pain, stiffness, and function and total WOMAC scores than L-sUA group (p = 0.003, p = 0.015, p = 0.008, p = 0.004), more frequently had KL grade 4 and osteophytes grade 4 (p = 0.003, p < 0.001), significantly narrower JSW (p = 0.016), more frequently show focal bone erosion (p = 0.002), bone marrow lesions (p = 0.019), and synovitis (p = 0.004) than L-sUA group. In regression analysis, female sex (p = 0.035), duration of KOA (p = 0.031), and sUA level (p = 0.025) were associated with KL severity. For female patients with KOA, KL severity is associated with duration of KOA (p = 0.045) and sUA (p = 0.009). Conclusion Higher sUA level is associated with higher clinical severity, higher radiographic KL grades, and more frequent MRI findings in patients with primary KOA patients. Our results also indicated that sUA level was significantly associated with KOA severity in female patients, but not in male patients. More studies are warranted to explore whether the two conditions exist simultaneously or there is a direct causal relationship between the two conditions.

Reaching a postmortem diagnosis of hypothermia is challenging in forensic practice. Therefore, this study was conducted to detect the histopathological, histochemical and biochemical changes that occur in adult albino rats following exposure to induced fatal hypothermia. Twenty-four adult albino rats were divided into the negative control, moderate hypothermia, severe hypothermia and hypoxia groups. Rats in the control group were euthanized when those in the moderate hypothermic group died. Blood samples were collected via heart puncture, and the cerebrum, heart, suprarenal gland, kidney, liver and skeletal muscle were removed to investigate the biochemical, histochemical and histopathological changes. Postmortem assessment depicted significant changes in lipid peroxidation, represented by increased malondialdehyde levels in the studied organs of the rats in hypothermic and hypoxia groups. Histopathological examination of the rats’ organs revealed degeneration and necrosis in the hypothermia and hypoxia groups. Sections taken from the severe hypothermic rats revealed a loss of normal cardiac tissue architecture, necrotic changes in the pyramidal cells in the cerebral cortex, and massive necrosis, mainly in the tubules of the renal cortex and medulla. These findings suggest that histological changes might be used as biochemical markers for postmortem diagnosing of fatal hypothermia, particularly in severe hypothermic conditions. Key points Death by hypothermia is a serious public health problem worldwide. Confirming a diagnosis and determining the cause of death in cases of hypothermia are among the most difficult practices in forensic medicine. Death by hypothermia might be associated with structural abnormalities in various organs. Studies using different tissue staining techniques will enable an overall illustration of the role of histopathological changes in body organs as indicators of hypothermia.

In 1991, Stewart launched the theory of economic value added (EVA) as a modern measure of financial performance assuring its ability in analyzing and improving the firm performance. Later on, in 2009, he introduced the economic value added momentum (EVA Momentum) as the single best firm financial performance measurement tool. Therefore, this study has the purpose of investigating the impact of EVA and EVA Momentum on firm financial performance indicators; return on assets (ROA) and return on equity (ROE) using Generalized Least Squares (GLS) regression. This paper is also aiming to contribute into announcing the economic value added measure with the highest explanatory power relevant to firm financial performance via conducting relative information content analysis along with Stepwise regression. Data were collected for companies listed in the Egyptian Stock Exchange over the period 2010-2019 excluding the financial sector. Statistical techniques are conducted using the statistical package of EViews-version 10. The results showed significant impact for both economic values added on firm financial performance, except for EVA with ROE. In addition, it was found that EVA Momentum could be considered as the most effective economic measure in improving and explaining the financial performance.

This paper investigates the behaviors of Boost DC Chopper used in Photovoltaic energy systems where the solar irradiation changes during the day time causing current and voltage changes. Varying the solar irradiation causes output chopper voltage changes in order to keep working at maximum extracted solar power. The chopper voltage changes leading to variable duty cycle operation of chopper switch and causes a significant change in switch losses in terms of the dissipated power. In addition to that the chopper behaviors are studied when the chopper voltage is boosting up to a predetermined reference value leading to a significant change in chopper current, voltage, duty cycle and occurred losses. A mathematical model for chopper performances and switch losses is derived, and a simulation model using Matlab/ Simulink platforms is conducted to follow the chopper behaviors. Simulation results for concreteSUNPOWER panel type SPR-315E-WHT-D with 315 Watts peak indicates that during the daylight time transistors are exposed to complicated changes in their current, voltage and dissipated power. Furthermore changing the output voltage according to load requirements causes heavy stress on the transistor in terms of current, oscillations and losses as well. Simulation results show that there are optimized values of irradiation, chopper voltage and duty cycle where the transistor losses are minimized. In addition to that, projecting the transistor losses over the daylight time at a given irradiation rate shows how these losses vary among the year, and the amount of energy dissipated across the main chopper switch which is around 2970 Whr/yr for the present case. Furthermore, the conducted simulation also shows the occurred in the transistor behaviors when solar irradiation changes, and can be serving for further studies.

Background: Non-alcoholic fatty liver disease (NAFLD) is a chronic liver disease that is considered the most common liver disease all over the world. It causes metabolic and hepatic damage that can progress to cirrhosis and hepatocellular carcinoma. Objective: Our research pointed to study the preventive effects of canagliflozin (CANA) or atorvastatin (ATO) on dexamethasone-induced hepatic steatosis and dyslipidemia. Methods: Animals were grouped as; control group; DEX group; ATO/DEX-treated group; CANA/DE-treated group and ATO+CANA/DEX-treated group. Results: Significant elevations in GSH, SOD and CAT activities, while high significant decreases in serum GOT, GPT, ALP, urea, blood glucose, CK-MB, LDH, T.G, T.C, MDA and P.C levels were demonstrated in treated groups as compared to DEX group in the experimental periods. Also, significant reductions in SGPT, SGPT, ALP, CK-MB, LDH, T.C and T.G levels were detected in CANA/DEX group as compared to ATO/DEX group. All these results were confirmed with histopathological findings where the severe damages and fatty degeneration in both kidney and liver tissues developed by dexamethasone administration resolved by administration of atorvastatin alone or better with Canagliflozin. Conclusion: These results indicate that canagliflozin was as effective as atorvastatin or combination of both in reducing dyslipidemia and hepatic steatosis. The antioxidant and hypolipidemic effects of canagliflozin may be responsible for the beneficial effects.

This paper develops a framework to study multi-hop relaying in a vehicular network consisting of vehicles and Road Side Units (RSUs), and the effect of this relaying on the network coverage and the communication delay. We use a stochastic geometry model that consists of a combination of Poisson Line Process (PLP) and 1D Poisson Point Process (PPP) to reliably characterize the vehicular network layout and the locations of the vehicles and the RSUs. Using this model, we analyze the effect of the different network parameters on the coverage provided by the RSUs to the vehicles. Then, we investigate how the uncovered vehicles can receive their intended packets by relaying them through multiple hops that form connected paths to the RSUs. We also analyze the delay introduced to packet delivery due to multi-hop relaying. Namely, we present results that illustrate the coverage gains achieved through multi-hop relaying and the delays induced. Such results could be used by network planners and operators to decide on the different configurations and operational parameters of the vehicular network to suit particular scenarios and objectives.

Recently, the integration between healthcare services and new technologies has been enhanced to be very necessary and effective inside digital Hospitals. Digital hospitals include a huge number of healthcare advanced technologies that have special digital and architectural requirement; these requirements cannot be provided in traditional hospitals. Many previous studies and guidelines addressed few numbers of digital hospital’s rooms and their architectural requirements. Hence, in this study, healthcare advanced technologies has been determined for outlining the architectural consideration of digital hospital’s rooms. Accordingly, Robotic Surgery Ward (RSW) has been compared with Traditional Surgery Ward (TSW) for: a) demonstrating the effect of an advanced technology (Robotic technology) on a digital hospital ward and b) helping designers to find out the main architectural and economic principles of designing RSWs besides TSWs. The main findings in this study are: a) outlining the main architectural characteristics of digital hospitals in general and digital hospital’s rooms in specific, b) articulating the main architectural and economic aspects for RSW and robotic surgery rooms, which is different from TSW. As an application of the comparative analyses, possible design alternatives of RSW and TSW has been also proposed and compared.

Objective Approximately 30% of lung cancer patients develop central airway obstruction (CAO) that remarkably shortens survival. There is little data about the benefits of stenting within this heterogeneous patient group. Our objective was to review their overall survival (OS) and their risk of hospitalization versus patients who did not have lesions requiring stent placement. Methods We retrospectively reviewed charts of 171 non-small cell lung cancer (NSCLC) patients who underwent bronchoscopy in the University of Cincinnati Cancer Center from the year 2011 to 2013. Twenty-five patients with advanced lung cancer were evaluated by interventional pulmonology service for endobronchial stent placement for CAO. Eight patients did not require placement of a stent and 17 had obstructive lesions that required stenting by interventional pulmonology. Results Demographical parameters such as age and gender did not have a significant impact on the risk of hospitalization or OS of both groups of patients, however, those whose lesions did not mandate stent placement had significantly lower odds of hospitalization compared to patients with CAO requiring a stent (OR: 15.913, 95% CI: 1.211-209.068, P = 0.0352). Patients with advanced NSCLC and CAO that required stent placement had an OS of 13.9 m [3.9-19.9 m] compared to an OS of 23.9 m for patients with CAO not requiring a stent. We found out that patients with less severe CAO have lower odds of hospitalization and better OS compared to patients with CAO mandating stent placement. Conclusion CAO patients with interventional pulmonology (IP) evaluation and management in addition, may have improved OS suggesting that IP consultation might offer both improvement in quality of life and overall survival to patients with advanced NSCLC and CAO. .

Background: Three-dimensional (3D) visualization systems, also known as heads-up systems, are now available for eye surgery and as with every new device there is need for a specific evaluation. Objectives: The aim of this study was to compare the efficiency, surgical comfort, and safety of a 3D visualization system to a standard binocular microscope (BM) in routine ophthalmologic procedures. Method: After a 4-week training period, a 3D visualization system (Ngenuity, Alcon®) available in one of the Robert Debré Hospital Ophthalmology Departments’ operating rooms was compared to a standard BM (OPMI LUMIRA 700, Zeiss®), in the process of a call for new device evaluation. From December 2017 to March 2018, 5 surgeons and their respective residents were asked to fill in a questionnaire for all procedures. Before the surgery, the surgeon recorded: (i) the type of surgery (cataract [PK], retinal detachment [RD], epiretinal membrane peeling [ERM], macular hole, vitreous haemorrhage [VH]), (ii) the type of visualization system chosen (3D or BM), and (iii) the estimated surgical risk (low, intermediate, or high grade). At the end of the procedure, the primary surgeon recorded the remaining parameters, including: (i) surgery duration, (ii) intraoperative complications, (iii) percentage of endoillumination for posterior segment surgeries, (iv) status of the operator (senior or resident) and operator switch if necessary (senior only, resident only, or resident with help of the senior), and rated: (i) the visual comfort (low, normal, excellent), (ii) the operative fluency (low, normal, excellent), (iii) backaches (none, low, moderate, important), and (iv) headaches (range from 0 to 10). Age and sex were collected retrospectively. The procedures performed with 3D and BM were subsequently compared using univariate (χ2, Fisher, Wilcoxon) and multivariate analysis (generalized linear model), allowing us to identify parameters independently associated with PK surgery duration. Results: A total of 102 valid questionnaires, relative to 73 PK and 29 vitreoretinal procedures, respectively, were analysed. As regards PK (3D, n = 25 vs. BM, n = 48), the mean age, sex ratio, surgical risk, intraoperative complications (1/25 vs. 4/48), visual comfort, backaches, and headaches were similar between the two systems. The use of 3D allowed faster PK surgeries (16.44 ± 4.36 vs. 21.44 ± 7.50 min; p = 0.007) and slightly enhanced the operative fluency. In vitreoretinal surgeries (3D, n = 14 vs. BM, n = 15), no obvious differences between the two visualization systems were observed, although the use of the 3D system was found to slightly decrease the operative fluency. Parameters independently associated with PK surgery duration were 3D visualization (β = –4.4 ± 1.4; p = 0.002), high preoperative surgical risk (β = 6.2 ± 2.4; p = 0.012), intraoperative complications (β = 8.7 ± 2.6; p = 0.001), and surgeon status (β = –4.4 ± 1.3; p = 0.001) in univariate and multivariate analysis. Conclusions: 3D visualization can be safely used in routine practice. It slightly improves the operative fluency, allowing faster PK surgery.

Simple Summary Despite the impressive progress in the treatment of triple-negative breast cancer (TNBC), oncologists still face several provocative clinical scenarios in daily practice where clear evidence-based recommendations are lacking, and expert opinion is of utmost importance. In an attempt to seek guidance for these controversial topics in TNBC management, a consensus recommendations session for TNBC was held during the 12th round of the Breast-Gynaecological & Immuno-oncology International Cancer Conference (BGICC) Egypt, 2020. This special session convened a multidisciplinary committee of 35 panellists who specialize in breast cancer care from 13 countries. The consensus covered all the aspects of TNBC management starting from defining TNBC to the management of metastatic disease and highlighted the rapidly evolving landscape in this field. Consensus was reached in 70% of the statements (35/50). In addition, areas of warranted research were identified to guide future prospective clinical trials. Background: The management of patients with triple-negative breast cancer (TNBC) is challenging with several controversies and unmet needs. During the 12th Breast-Gynaecological & Immuno-oncology International Cancer Conference (BGICC) Egypt, 2020, a panel of 35 breast cancer experts from 13 countries voted on consensus guidelines for the clinical management of TNBC. The consensus was subsequently updated based on the most recent data evolved lately. Methods: A consensus conference approach adapted from the American Society of Clinical Oncology (ASCO) was utilized. The panellists voted anonymously on each question, and a consensus was achieved when >= 75% of voters selected an answer. The final consensus was later circulated to the panellists for critical revision of important intellectual content. Results and conclusion: These recommendations represent the available clinical evidence and expert opinion when evidence is scarce. The percentage of the consensus votes, levels of evidence and grades of recommendation are presented for each statement. The consensus covered all the aspects of TNBC management starting from defining TNBC to the management of metastatic disease and highlighted the rapidly evolving landscape in this field. Consensus was reached in 70% of the statements (35/50). In addition, areas of warranted research were identified to guide future prospective clinical trials.

The present research focuses on the soundscapes of two localities representative of the oasis cities of southeast Algeria, Sidi Okba and El Kantara, in order to define the nature of the soundscapes and the impact that road traffic can have on them. In this paper, the method of sound walks has been used in order to record the sound experience of city dwellers in pre-selected routes. The processing of these sound recordings with the S_TOOLS-STx software shows the diversity and the denaturation of the soundscapes in these two localities. The current nature of sounds and the exposure levels, especially in new urban centers, and the extinction of these oases could have a negative impact on the general comfort and health of the inhabitants and on the sensitive natural biodiversity of these fragile human settlements, increasing the risk of the syndrome of sick cities.

Large brain arteriovenous malformations (AVMs) pose a management dilemma because of the limited success of any single treatment modality by itself. Surgery alone is associated with significant morbidity and mortality. Similarly, embolization alone has limited efficacy. Volume-staged Gamma Knife radiosurgery (VSGR) has been developed for the treatment of large AVMs to increase the efficacy and improve safety of treatment of these lesions. The aim of this study was to assess the efficacy and safety of VSGR technique for the treatment of large brain AVMs.The study included patients treated by VSGR between May 2009 and July 2015. All patients had large AVMs (10 mL). There were 29 patients.Twenty-four patients completed radiographic follow-up, with 15 obliteration cases (62.5%). A total of 56 sessions were performed. The mean AVM volume was 16 mL (range, 10.1-29.3 mL). The mean prescription dose was 18 Gy (range, 14-22 Gy). The mean follow-up duration was 43 months (range, 21-73 months). One patient died during follow-up of an unrelated cause. Two patients had hemorrhage during follow-up. Symptomatic edema developed in 5 patients (17%). The factors affecting obliteration were smaller total volume, higher dose/stage, nondeep location, compact AVM, AVM score3,18 Gy dose, and15 mL total volume. The factors affecting symptomatic edema were smaller total volume and shorter time between first and last sessions (P = 0.012). T2 image changes were affected by Spetzler-Martin grade ≥3 (P = 0.013) and AVM score ≥3 (P = 0.014).VSGR provides an effective and safe treatment option for large brain AVMs. Smaller AVM volume is associated with higher obliteration rate.

Background Autophagy is a catabolic process, utilized constitutionally by body cells to recycle nutrients and to remove unwanted/damaged intracellular constituents. It is enhanced during periods of stress, such as starvation and hypoxia, aiding in cell survival and it is linked to major cellular processes, such as apoptosis and antigen expression. The process has been extensively studied in vitro models or tumor tissue samples with rare application on human subjects. Methods Plasma samples from 24 advanced solid tumor patients were collected at different time points before and after chemotherapy. Their exosomes were isolate and blotted for microtubule-associated protein-1 light chain-3 (LC-3B) protein as a marker for autophagy. All the subjects received a standard chemotherapy regimen of carboplatin- gemcitabine with chloroquine (CQ)/ hydroxychloroquine (HCQ) in chronic doses throughout their treatment period as an autophagy modulator. CQ/HCQ was given in 50 mg increments as guided by their tolerability to treatment. Results A total of 267 plasma samples were obtained for the 24 patients and processed. Each sample corresponds to a single time point. The first group included 6 patients, all received 50 mg of CQ with chemotherapy. LC-3B I was detected in their isolated exosomes, while LC3-BII was not detected in their samples. The second cohort of patients included 3 subjects who re-ceived 100mg of HCQ. They demonstrated both LC3-BI and II on day 15 after chemotherapy in one patient, and on third cycle after 24 hours in the second patient. The third cohort included 3 subjects who received 150 mg of HCQ. All cases demonstrated LC3-BI and II on first cycle of treatment after less than 24 hours. The last cohort included 8 subjects, who received a fixed dose of 100 mg of HCQ with treatment. In this cohort, we were able to detect both LC3-B isoforms on advanced time points of second and third cycles. Conclusion Detection of autophagy protein LC3-B in exosomes serves as a dynamic method to monitor autophagy. It can be utilized to study the effects of anti-neoplastic agents on autophagy and mechanisms of drug resistance, however, to standardize our results a larger specimen of patients should be included.

Background Atrial fibrillation represents a common complication after coronary artery bypass and valvular surgery, although it is a benign arrhythmia it may contribute to the morbidity, high cost and prolonged ICU stay. Objectives The purpose of this study is to investigate and analyze the incidence and risk factors associated with postoperative atrial fibrillation (POAF) and its impact on intensive care unit (ICU) and postoperative hospital stay in patients undergoing coronary artery bypass graft surgeries (CABG) at Ain Shams University hospitals using the medical records of patients who underwent(CABG) surgeries from July 2018 to July 2019. Patients and Methods Our study was conducted in Ain Shams University hospitals from July 2018 to July 2019. This study was a retrospective non randomized on total 660 patients who undergone isolated Coronary artery bypass graft surgeries (CABG) during this period, of them we targeted 100 cases who developed POAF after surgery. Results Our results show that age, history of hypertension,smoking,history of renal impairment and recent myocardial infarction were all predictors of atrial fibrillation after cardiac surgery. POAF developed more frequent in patients who had larger left atrium diameter and lower ejection fraction. Our present results indicate that there is significant association between longer bypass and cross clamping time and development of POAF. We also found that patients who had postoperative lower serum potassium experienced more frequent POAF than who had normal potassium levels. In our study, we found that use of preoperative beta blocking drugs reduces risk of developing POAF. Early electrocardiographic ischemic postop. changes was also associated with high risk to develop POAF. No significant relation between use of intra-aortic balloon pump and development of POAF. Also, no significant relation between POAF and development of stroke or thromboembolic manifestations as POAF is usually self limiting,transient and resolves spontaneously in most of cases. Conclusion The current study found that low ejection fraction, dilated left atrium, hypertension, smoking, old age, male gender, prolonged bypass time, prolonged cross clamping time, renal impairment, previous myocardial infarction, ungrafted dominant right coronary artery, low temperatures on bypass, early ischemic changes postoperative, hypokalemia, use of adrenaline and nor adrenaline, all of these factors were a significant predictors for development of atrial fibrillation after cardiac surgery.

Despite recent developments in offline signature recognition systems, there is however limited focus on the recognition problem facet of using an inadequate sample size for training that could deliver reliable and easy to use authentication systems. Signature recognition systems are one of the most popular biometric authentication systems. They are regarded as non-invasive, socially accepted, and adequately precise. Research on offline signature recognition systems still has not shown competent results when a limited number of signatures are used. This paper describes our proposed practical offline signature recognition system using the oriented FAST and rotated BRIEF (ORB) feature extraction algorithm. We focus on the practicality of the proposed system, which requires only the minimum number of signatures per user to achieve a high level of fidelity. We manifest the practicality of our approach with a signature database of 300 signatures from 100 different individuals, implying that only two signatures are needed per person to train the proposed system. Our proposed solution achieves a 91% recognition rate with a median matching time of only 7 ms.

To describe the clinical features, epidemiology, autoantibody status, HLA haplotypes and genetic mechanisms of type 1 diabetes mellitus (T1DM). Patients (0–18 years) with diabetes were recruited. Clinical data was collected, autoantibodies and c-peptide were measured. Whole Genome Sequencing was performed. Genomic data analysis was compared with the known genes linked with T1DM and HLA alleles were studied. 1096 patients had one or more antibody positivity. The incidence of T1DM in 2020 was 38.05 per 100,000 children and prevalence was 249.73. GADA was the most common autoantibody followed by IAA. Variants in GSTCD, SKAP2, SLC9B1, BANK1 were most prevalent. An association of HLA haplotypes DQA1*03:01:01G (OR = 2.46, p value = 0.011) and DQB1*03:02:01G (OR = 2.43, p value = 0.022) was identified. The incidence of T1DM in Qatar is the fourth highest in the world, IA2 autoantibody was the most specific with some patients only having ZnT8 or IA2 autoantibodies thus underlining the necessity of profiling all 4 autoantibodies. The genes associated with T1DM in the Arab population were different from those that are common in the Caucasian population. HLA-DQ was enriched in the Qatari patients suggesting that it can be considered a major risk factor at an early age.

Context Idiopathic type 1 diabetes is characterized by the absence of autoantibodies and the underlying mechanisms are not clear. Objective We aimed to study the epidemiology, describe the clinical characteristics, and report results of genetic studies in pediatric patients with idiopathic type 1 diabetes. Methods This was a prospective study of type 1 diabetes patients attending Sidra Medicine from 2018 to 2020. Autoantibodies (GAD65, IAA, IA-2A, and ZnT8) were measured and genetic testing was undertaken in patients negative for autoantibodies to rule out monogenic diabetes. Demographic and clinical data of patients with idiopathic type 1 diabetes were compared with patients with autoimmune type 1 diabetes. Results Of 1157 patients with type 1 diabetes, 63 were antibody-negative. Upon genome sequencing, 4 had maturity onset diabetes of the young (MODY), 2 had Wolfram syndrome, 1 had H syndrome, and 3 had variants of uncertain significance in MODY genes; 53 patients had idiopathic type 1 diabetes. The most common age of diagnosis was 10 to 14 years. C-peptide level was low but detectable in 30 patients (56.6%) and normal in 23 patients (43.4%) The average body mass index was in the normal range and 33% of the patients had a history of diabetic ketoacidosis (DKA). Conclusion Four percent of the children had idiopathic type 1 diabetes. There were statistically significant differences in the C-peptide level and insulin requirement between the 2 groups. DKA was less common in the idiopathic group. Mutations in MODY genes suggest the importance of autoantibody testing and genetic screening for known causes of monogenic diabetes in idiopathic type 1 diabetes. The mechanism of idiopathic type 1 diabetes is unknown but could be due to defects in antibody production or due to autoantibodies that are not yet detectable or discovered.

Background: In children born with cleft (lip and) palateresonance and articulation disorders are often observed as aresult of structural deviations of the sound production mechanism.Even after palatal closure, compensatory articulationand resonance disturbance may persist, despite advances insurgical treatment of congenital orofacial clefts [1].Material & Methods: This is a cross-sectional study thatwas conducted upon 70 patients with repaired cleft palate ofdifferent grades in Plastic Surgery Department Assiut UniversityHospital. Data was collected from May 2016 to December2018.Results: The study enrolled 70 children with cleft palateand underwent palatoplasty; out of them 18 (25.7%) patientsdeveloped velopharyngeal dysfunction (VPI). 66% of patientwith velopharyngeal insufficiency has below average IQ.

The current published literature regarding the role of hip arthroscopy in the diagnosis and management of post-traumatic hip pain is still limited. Therefore, we conducted the present prospective study to determine the value of hip arthroscopy in the diagnosis and management of various causes of hip pain after traumatic conditions. The present study included a prospective cohort of 17 patients with symptomatic post-traumatic hip pain. It was conducted between July 2013 and May 2018. The mean age was 22 (19–29) years and the mean follow-up was 24 (r: 7–36) months. Prior to surgery, every eligible patient underwent assessment of functional status using the Modified Harris Hip Score, Oxford hip score (OHS) and Western Ontario and McMaster Universities Arthritis Index (WOMAC) score. All patients underwent arthroscopic management for their diagnosed pathologies. The most commonly encountered diagnosis was labral tear (58.8%), followed by ligamentum teres tear (35.3%) and loose intra-articular fragments (29.4%). In addition, 52.9% of the patients had associated CAM lesion and 11.8% had associated Pincer lesion. The mHSS, OHS and WOMAC score showed significant improvement in the post-operative period (P

OBJECTIVERecurrent or residual adenomas are frequently treated with Gamma Knife radiosurgery (GKRS). The most common complication after GKRS for pituitary adenomas is hypopituitarism. In the current study, the authors detail the timing and types of hypopituitarism in a multicenter, international cohort of pituitary adenoma patients treated with GKRS.METHODSSeventeen institutions pooled clinical data obtained from pituitary adenoma patients who were treated with GKRS from 1988 to 2016. Patients who had undergone prior radiotherapy were excluded. A total of 1023 patients met the study inclusion criteria. The treated lesions included 410 nonfunctioning pituitary adenomas (NFPAs), 262 cases of Cushing’s disease (CD), and 251 cases of acromegaly. The median follow-up was 51 months (range 6–246 months). Statistical analysis was performed using a Cox proportional hazards model to evaluate factors associated with the development of new-onset hypopituitarism.RESULTSAt last follow-up, 248 patients had developed new pituitary hormone deficiency (86 with NFPA, 66 with CD, and 96 with acromegaly). Among these patients, 150 (60.5%) had single and 98 (39.5%) had multiple hormone deficiencies. New hormonal changes included 82 cortisol (21.6%), 135 thyrotropin (35.6%), 92 gonadotropin (24.3%), 59 growth hormone (15.6%), and 11 vasopressin (2.9%) deficiencies. The actuarial 1-year, 3-year, 5-year, 7-year, and 10-year rates of hypopituitarism were 7.8%, 16.2%, 22.4%, 27.5%, and 31.3%, respectively. The median time to hypopituitarism onset was 39 months.In univariate analyses, an increased rate of new-onset hypopituitarism was significantly associated with a lower isodose line (p = 0.006, HR = 8.695), whole sellar targeting (p = 0.033, HR = 1.452), and treatment of a functional pituitary adenoma as compared with an NFPA (p = 0.008, HR = 1.510). In multivariate analyses, only a lower isodose line was found to be an independent predictor of new-onset hypopituitarism (p = 0.001, HR = 1.38).CONCLUSIONSHypopituitarism remains the most common unintended effect of GKRS for a pituitary adenoma. Treating the target volume at an isodose line of 50% or greater and avoiding whole-sellar radiosurgery, unless necessary, will likely mitigate the risk of post-GKRS hypopituitarism. Follow-up of these patients is required to detect and treat latent endocrinopathies.

Recently, the automation of architectural design process has been focused specifically in Healthcare buildings (HCB) for easier implementation and faster feedback. Hence, a great evolution of Computational Implementations (CIs) were appeared and studied for early stages of design process of HCB, such as generating design solutions, evaluation of design solutions or others to provide helpful tools for designers. This paper provides comparative analyses of a set of CIs that can be applied on different architectural design stages in HCB, these stages includes: a) architectural programming and topological diagram, b) generating design alternatives and c) evaluation of design solutions. The focused CIs in this study have been classified to computational tools, computational algorithms, computational approaches and hybrid methods; they are compared using a set of criteria with various evaluation methods. This comparative analysis helps designers to determine the appropriate CI or CIs’ combinations for each main early stage of HCB design, and also the possibilities of connecting two of the studied CIs in a framework to get wider outcomes were studied. The main study findings are the capabilities, limitation and features of each CI, in addition to the best selections in each early stage for different HCB design cases. Also, possible connections between different CIs were discussed on simple examples as a fruitful outcome of analyzing CIs’ combinations.

The proliferation of high data-rate applications and services in next-generation WLANs, as well as the significant increase in the number of Wi-Fi devices, is triggering the search for more bandwidth. For this, the Federal Communications Commission (FCC) is considering a proposal to permit devices, such as those that use the IEEE 802.11 (Wi-Fi) protocol, to operate in the 5.9 GHz band allocated to the intelligent transportation system (ITS). However, the nature of these bands poses a challenge since ITS dedicated short range communications (DSRC) networks use them to share safety-critical messages and may be subject to severe interference from other coexisting transmissions. We discuss the impact of coexistence of Wi-Fi networks on the performance of DSRC through an analytical framework based on stochastic geometry. We consider the recent IEEE 802.11ax Wi-Fi standard, and analyze uplink and downlink transmissions, with voice and background traffic being the highest and lowest priority traffic, respectively. We also validate the fixed contention window size of the derived stochastic geometry model using NS-3 simulations. The proposed framework can serve to increase awareness among regulatory bodies of the extent to which coexistence will adversely affect the performance of DSRC.

Objective: To propose a prototype non-invasive test to estimate voiding reserve in normal adult men; identifying its feasibility, limitations, and initial results.Subjects and methods: In all, 30 a...

Background: The identification of sex from human remains is of fundamental importance in forensic medicine and anthropology, especially in criminal investigations as well as in the identification of missing persons and in attempts at reconstructing the lives of ancient populations. Objective: The aim of this study was to assess specific pelvic parameters (Human sacrum and subpubic angle measurements) in Assiut Governorate population by using plain x-ray films. Patients and methods: The study was conducted on 500 plain x-ray films, which were obtained and collected from the Radiology Department- Al-Azhar Faculty of Medicine (Assiut branch), out of which, 250 were males and 250 were females in the age group of 25–70 years belonging to Assiut population to assess the sacral and subpubic angle measurements. Results: Statistically significant increase in the length of sacrum in males compared to females. The sacral length in males varied from 86–120 mm with the mean value of 100.06 ± 9.00 mm, while the sacral length in females varied from 78–120 mm with the mean value of 93.00 ± 9.46 mm. Conclusion: The present study concluded that the subpubic angle is the best criterion for sex determination of pelvis. It was found that 66.4% of males’ bones and 58.4% of females’ bones could be identified by using subpubic angle alone.

Background: With antiprogrammed death receptor-1 (anti-PD-L1) therapy, a recent meta-analysis reported higher incidence of cutaneous, endocrine and gastrointestinal complications especially with dual anti-PD-L1 immunotherapy (IMM). Methods: Our primary outcome was assessment of all cardiotoxicity grades in IMM compared with different treatments, thus a systemic review and a meta-analysis on randomized clinical trials (RCTs) were done. Results: We included 11 RCTs with 6574 patients (3234 patients in IMM arm vs 3340 patients in the other arm). Three non-small-cell lung cancer RCTs, seven melanoma RCTs and only one prostatic cancer RCT met the inclusion criteria. There were five RCTs that compared monoimmunotherapy to chemotherapy “(n = 2631 patients)”. No difference exists in all cardiotoxicity grades or high-grade cardiotoxicity (p > 0.05). Lung cancer exhibited a higher response rate and lower mortality in IMM. Conclusion: There was no reported statistically significant cardiotoxicity associated with anti-PD/PD-L1 use. Lung cancer subgroups showed better response and survival rates.

Purpose This paper aims to examine the issue that arises in the context of benchmark rate (or interest rate) changes made for reasons of monetary policy in a jurisdiction with a significant presence of Islamic banks. Changes, especially increases, in the prevailing interest rate made by central banks raise issues of asset-liability management for banks, which typically have longer maturities on the asset side than on the liabilities side, resulting in exposure to interest rate risk for conventional banks, and what is known as rate of return (RoR) risk for Islamic banks, which for reasons of compliance with Islamic religious law (Shari’ah) do not use interest in their operations. Islamic banks use various financial instruments which reflect the cost of funds by means of contracts of sale on credit or of leasing or forms of partnership, which allow them to earn returns on their funds and to pay returns to customers who deposit funds with them. Design/methodology/approach The methodology of this study consisted of a descriptive analysis of the relevant characteristics of Islamic banks and their economic and regulatory environments, illustrated by a case study approach applied to two jurisdictions, namely, Sudan and Malaysia. Findings In jurisdictions where Islamic banks represent a significant share of the market for financial services, if the contracts used in Islamic financing allow for periodic adjustments of the profit rate or lease rental, this could result in a significant impediment to the full implementation of monetary policy and hence to the maintenance of financial stability. Originality/value This study is (to the best of authors’ knowledge) the first thorough analysis in the literature of the issues arising from the exposure of Islamic banks to RoR risk and has clear implications for regulatory and central bank policy.

Introduction The difference in the amount of orthodontic-induced external root resorption (OIERR) of endodontically treated teeth (ETT) compared with vital pulp teeth (VPT) treatment is controversial. This systematic review and meta-analysis assessed the available evidence regarding OIERR of ETT compared with VPT. Methods PubMed, Scopus, MEDLINE, Web of Science, and Cochrane databases were searched up to May 2018 to retrieve relevant studies. The studies were evaluated for eligibility criteria, and the risk of bias was assessed using the Risk of Bias In Non-randomised Studies of Interventions tool (Cochrane Bias Methods Group, Odense, Denmark). Weighted means of OIERR in ETT and VPT were calculated using a fixed effects model, and a random effects model was used to assess the significance of treatment effects. Results Eight studies were identified, from which 7 were included in the meta-analyses. The funnel plot of the random effects model exhibited a symmetrical distribution, which indicates no publication bias of the included studies. Because of the significant heterogeneity between studies, a random effects model was used. Significantly less OIERR for ETT was identified compared with their contralateral VPT. Conclusions Endodontic treatment does not seem to increase OIERR.

Objectives: Numerous studies addressed the effect of statin on cancer patients. The aim of this study is to define the effect of statin administration with chemotherapy on the patients’ outcomes. Methods: We retrospectively researched the database of the University of Cincinnati cancer to identify lung cancer patients who received statins (S+, n=41) during their treatment in our institute. We also, retrieved data for contemporaneously treated patients who did not receive statins (S-, n=159) as a control arm. Clinico-demographical data and overall survival (OS) were analyzed using Pearson’s Chi-square (χ2) test and Kaplan-Meier survival curves with Log-rank test. Adjustment using Cox proportional hazard ratios (HR) were done based on (age, gender, race and stage) to identify effect of statins on their outcomes. Results: The median age for S+ was 64y (IQR; 55-69) and 71.2% of the patients were white. Histopathology was 55.4% and 31.7% for adenocarcinoma and squamous cell carcinoma, respectively. Fifty-six percent were stage IV in each study arm and the median OS was14.9 m. Median OS was insignificantly lower in S–ve arm (13.7 vs 15.6 months; P=0.652, HR=0.91, 95%CI 0.52-1.57). Our results show that after different types of adjustments, S+ did not show survival advantage (P>0.05) compared to the control arm. Conclusion: While showing an increase in overall survival in patients with advanced lung cancer, the results of this study did not reach statistical significance. This could be due for the small sample size of this retrospective study.

Objectives: The purpose of this work was to determine the dimensions of CFA before the birth of the deep thigh artery, describe the mode of termination of the CFA, search for CFA collaterals, and describe the anatomical variations of the CFA. Methodology: This was a prospective study conducted at the Anatomy Laboratory of the Faculty of Medicine and Odonto-Stomatology of Bamako. CFA arteries of 12 fresh corpses of adults include 9 men and 3 women. A total of 24 CFA arteries were dissected and photographed. Results: The mean length of CFA was 50.9 ± 12.55 mm (range: 31 and 93 mm). Its average diameter was 9.12 ± 1.17 mm (range: 7 and 12 mm). In 70.83%, the CFA artery ended without any particularity. There was 29.17% anatomic variation in the CFA termination mode. The CFA divided into 3 branches (trifurcation) in 25%. The 3 branches were in 20.83%, the FS and a common core to LFCA and AQ; in 4.17%, they were the SFA, the DFA and the MFCA. In 4.17%, it divided into 4 branches which are: the SFA, the DFA, the MFCA and a common core to QA and LFCA. The CFA gave as collateral: circumflex superficial iliac artery in 22 cases (91.67%), superficial epigastric artery in 19 cases (79.17%), upper external pudendal artery in 20 cases (83.33%), and lower external pudendal artery in 14 cases (58.33%). We noted in our series 9 anatomical variations at the collateral level of the CFA or 37.5%. The CFA gave birth to the following branches: the MFCA in 4 cases or 16.67%, the LFCA in 1 case or 4.17%, the QA in 1 case or 4.17%, and a common core to the QA and LFCA in 3 cases or 12.5%. Conclusion: The length of CFA is important. The variations of CFA are frequent and important to know in clinical and surgical practice.