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Background: Family-centred critical care recognises the impact of a loved one's critical illness on his relatives. Open visiting is a strategy to improve family satisfaction and psychological outcomes by permitting unrestricted or less restricted access to visit their family member in the intensive care unit (ICU). However, increased family presence may result in increased workload and a risk of burnout for ICU staff. Objectives: The objective of this study was to evaluate ICU staff perceptions regarding visiting hours and family access in Australian and New Zealand ICUs. Secondary outcomes included an evaluation of current visiting policies, witnessed events in ICUs, and barriers to implementing open visiting policies. Design: A web-based survey open to all healthcare workers in Australia and New Zealand ICUs was distributed through local, state-based, and national critical care networks. Open visiting was defined as ICUs open for visiting >14 h per day. Main results: We received 1255 valid responses. Most respondents were nurses (n = 930, 74.1%) with a median critical care experience of 10 y. Most worked in open visiting ICUs (n = 749, 59.7%). Reported visiting hours varied greatly with a median of 20 h per day (interquartile range: 10–24 h). Open visiting was perceived as beneficial for the relatives, but less so for patients and staff (relatives: n = 845, 67.3%, patients: n = 561, 44.7%, staff: n = 257, 20.5%, p < 0.0001). Respondents from closed visiting units and nurses identified more risks from open visiting than other professional groups. Generally, staff preferred not to change from their current practice. Conclusion: We report that staff perceived open visiting as beneficial for relatives, but also identified risks to themselves, including increased workload, a risk of burnout, and a risk of occupational violence. Reluctance to change highlights the importance of addressing staff perceptions when implementing an open visiting policy.

The computation of the solid angle and the detector efficiency is considering to be one of the most important factors during the measuring process for the radioactivity, especially the cylindrical γ-ray NaI(Tl) detectors nowadays have applications in several fields such as industry, hazardous for health, the gamma-ray radiation detectors grow to be the main essential instruments in radiation protection sector. In the present work, a generic numerical simulation method (NSM) for calculating the efficiency of the γ-ray spectrometry setup is established. The formulas are suitable for any type of source-to-detector shape and can be valuable to determine the full-energy peak and the total efficiencies and P/T ratio of cylindrical γ-ray NaI(Tl) detector setup concerning the truncated conical radioactive source. This methodology is based on estimate the path length of γ-ray radiation inside the detector active medium, inside the source itself, and the self-attenuation correction factors, which typically use to correct the sample attenuation of the original geometry source. The calculations can be completed in general by using extra reasonable and complicate analytical and numerical techniques than the standard models; especially the effective solid angle, and the detector efficiency have to be calculated in case of the truncated conical radioactive source studied condition. Moreover, the (NSM) can be used for the straight calculations of the γ-ray detector efficiency after the computation of improvement that need in the case of γ-γ coincidence summing (CS). The (NSM) confirmation of the development created by the efficiency transfer method has been achieved by comparing the results of the measuring truncated conical radioactive source with certified nuclide activities with the γ-ray NaI(Tl) detector, and a good agreement was obtained after corrections of (CS). The methodology can be unlimited to find the theoretical efficiencies and modifications equivalent to any geometry by essential sufficiently the physical selective considered situation.

Objectives The detection of SARS-CoV-2 RNA in blood and platelet concentrates from asymptomatic donors, and the detection of viral particles on the surface and inside platelets during in vitro experiments, raised concerns over the potential risk for transfusion-transmitted-infection (TTI). The objective of this study was to assess the efficacy of the amotosalen/UVA pathogen reduction technology for SARS-CoV-2 in human platelet concentrates to mitigate such potential risk. Material and methods Five apheresis platelet units in 100% plasma were spiked with a clinical SARS-CoV-2 isolate followed by treatment with amotosalen/UVA (INTERCEPT Blood System), pre- and posttreatment samples were collected as well as untreated positive and negative controls. The infectious viral titer was assessed by plaque assay and the genomic titer by quantitative RT-PCR. To exclude the presence of infectious particles post-pathogen reduction treatment below the limit of detection, three consecutive rounds of passaging on permissive cell lines were conducted. Results SARS-CoV-2 in platelet concentrates was inactivated with amotosalen/UVA below the limit of detection with a mean log reduction of > 3.31 ± 0.23. During three consecutive rounds of passaging, no viral replication was detected. Pathogen reduction treatment also inhibited nucleic acid detection with a log reduction of > 4.46 ± 0.51 PFU equivalents. Conclusion SARS-CoV-2 was efficiently inactivated in platelet concentrates by amotosalen/UVA treatment. These results are in line with previous inactivation data for SARS-CoV-2 in plasma as well as MERS-CoV and SARS-CoV-1 in platelets and plasma, demonstrating efficient inactivation of human coronaviruses.

Introduction: Pterygium is a common ophthalmic problem in the Middle East where exposures to dust and sun rays are risk factors. The condition is more prevalent in middle-aged males and can be considered as an aging process. The aim of this study is to test both the degenerative and the proliferative components of Pterygium by both reduced glutathione and topoisomerase one activity. Methods: The study applied immunohistochemistry staining for both reduced glutathione and topoisomerase 1. Results: The samples expressed positive glutathione staining in most primary Pterygium conditions and all secondary Pterygium. On the other hand, the topoisomerase 1 immunohistochemistry expressed focal activity in secondary conditions suggesting a progenitor cell role in the pathogenesis of Pterygium in conjunction with oxidative stress. Conclusion: Pterygium represents dual pathology with a proliferative component and a degenerative one that needs further studies. It is possible to use combination immunohistochemistry markers to predict the prognosis of Pterygium behavior.

Background Liver cirrhosis is a diffuse process in which the anatomical structure and function of the liver are disturbed. Lipid metabolism occurs mainly in the hepatocytes. In liver cirrhosis, it is expected to detect abnormal lipid profile and abnormal neutrophil to lymphocyte ratio due to necro-inflammation and hepatocyte dysfunction. This study aimed to estimate the lipid profile in patients with liver cirrhosis and to assess its relation to the severity of the liver disease based on Child-Pugh Turcotte score and Neutrophil to Lymphocyte Ratio (NLR). Methods: This study included 500 cirrhotic patients. All patients are subjected to history taking, clinical examination, liver and renal function tests, lipid profile, and also abdomino-pelvic ultrasound. Child -Pugh score, fibrosis-4 score (FIB4), and neutrophil and platelet lymphocyte ratio were calculated. Results: A total of 500 patients were enrolled in this study; 12 patients were excluded (two patients were on the immunosuppressive drug, three patients had body mass index (BMI) >30, and seven patients took lipid-lowering drugs). Cholesterol level was significantly higher in patients with Child- Score A than B and C. Cholesterol, Low-Density Lipoprotein (LDL), and very-low-density lipoprotein (VLDL) cholesterol were significantly higher in Child B than C. A significant negative correlation was found between cholesterol level and each of FIB4 and NLR ratios. Conclusion: There was a significant negative correlation between the severity of liver cirrhosis and lipid profiles (except triglyceride), FIB4 and NLR ratio.

AIM As more infants survive surgery in the newborn period for major congenital anomalies, the focus has shifted to the quality of care for parents as well as infants. In contemporary neonatal intensive care units (NICUs), doctors are encouraged to practice family-centred care and partner with parents in their infant's care. This study explored doctors' perceptions and parents' self-reported needs and stressors in a surgical NICU. METHODS From January 2014 to September 2015, parents of infants admitted for general surgery for a major congenital anomaly who were present in the NICU between 48 and 72 h of admission and doctors caring for their infant at the time of data collection were invited to participate. Matched data were provided using the Neonatal Family Needs Inventory and the Parental Stressor Scale:NICU. RESULTS Matched data for 12 doctor-parent dyads showed that doctors (neonatal medical trainees) consistently under-rated the importance of parents' needs and identified fewer of mothers' than fathers' most important needs. Doctors also consistently under-rated parents' stressors. They perceived few of fathers', but all of mothers', greatest stressors. Thematic analysis revealed four themes: infant pain management; parental autonomy; empathy; and communicating reassurance and education to parents. CONCLUSION The findings suggest incongruences between doctors' perceptions and parents' self-reported needs and stressors. While there is hesitation in making recommendations with this sample size, the findings highlight issues that may inform further research and contribute to a dialogue regarding the role of doctors in family-centred relationship-based models of care in the NICU.

The aim of this research was to determine the conditions of the application of risk management for commercial banks in Indonesia and to determine the effect of the application of risk management on banking stock price returns based on model 1, model 2, model 3 and determine the best model for stock price return estimation. In measuring the level of risk management implementation in banking, two approaches are used, namely trend analysis and empirical analysis. The following conclusions can be drawn: (1) In model 1, trends The movement of the NETIM variable in one year from period one (March) to period four (December) always goes up and down at the beginning of the year. next. The NONIM variable, the movement in the quarterly period at the beginning tends to be flat, starting to rise in the December 2016 period, while the movement from year to year is not very volatile. (2) In model 2, the trend of the movement of the AVERAGE variable during the 2016-2019 period tends to increase as indicated by the trend line . (3) In model 3, trends The movement of the PRIN1 and PRIN2 variables from year to year during the study period seems to fluctuate (4) Based on the results of the comparison of the four regression estimation models, it can be concluded that the first model is the best model in explain the variation of the movement of the return variable.

BACKGROUND HIV-positive individuals who maintain an undetectable viral load cannot transmit the virus to others. In 2012, an HIV population-based survey was conducted in Ndhiwa sub-county (Kenya) to provide information on the HIV local epidemic. We carried out a second survey 6 years after the first one, to assess progress in HIV diagnosis and care and differences in the HIV prevalence and incidence between the two surveys. METHODS A cross-sectional, population-based survey using cluster sampling and geospatial random selection was implemented in 2018, using the same design as 2012. Consenting participants aged 15-59 years were interviewed and tested for HIV at home. HIV-positive individuals received viral load testing (viral suppression defined as

The present study investigated whether rTMS treatment for depression reduced stress and whether early responsiveness of rTMS predicted outcomes for depression, anxiety, and stress at the conclusion of treatment. Participants (n = 109) were inpatients at a psychiatric hospital referred for rTMS for depression. Linear mixed models were used to analyse data across time and regression analyses were used to assess early responsiveness. Effect sizes, and clinically significant and reliable change were also analysed. Decreases in scores for depression, anxiety, and stress were evident from pre- to mid-treatment, and from mid- to post-treatment. Large effect sizes were reported from pre- to post-treatment for depression and stress. Changes in depression from pre- to mid-treatment predicted post-treatment depression and stress scores. Clinically significant change was most common for stress and reliable change was most common for depression. Standard rTMS treatment for depression appears to have non-specific benefits in that participant anxiety and stress ratings also improve significantly. Early improvements in depressive symptoms may be indicative of later depression and stress outcomes, suggesting clinical benefit in assessing outcomes during rTMS treatment.

In the current work, the optical properties of tin oxide thin films have been tailored via gamma irradiation for energy applications. The effect of Gamma radiation (50, 100, 150, 200 and 250 kGy) on the microstructural, absorption and oscillator parameters of SnO2 thin films has been investigated. XRD results reveal that the SnO2 films have the symmetry of the space group P42/mnm belonging to the tetragonal system. The crystallite size of γ-irradiated SnO2 thin film slightly increases as the irradiation dose increases. The allowed optical band gaps are estimated by applying various methods such as Tauc’s method, derivation of absorption spectrum fitting and absorption spectrum fitting approaches. The dispersion parameters are extracted from the dispersion curve of the real part of the refractive index. The single-effective-oscillator and Drude models for free charge carrier absorption are applied to obtain the dispersion parameters before and after γ-irradiation.

Introduction: The goal of this study was to understand individuals with cerebral palsy (CP) and their family’s attitudes and preferences to genomic research, including international data sharing and biobanking. Methods: Individuals with CP and their family members were invited to participate in the web-based survey via email (NSW/ACT CP Register) or via posts on social media by Cerebral Palsy Alliance, CP Research Network, and CP Now. Survey responses included yes/no/unsure, multiple choices, and Likert scales. Fisher’s exact and χ2 tests were used to assess if there were significant differences between subgroups. Results: Individuals with CP and their families (n = 145) were willing to participate in genomics research (68%), data sharing (82%), and biobanking efforts (75%). This willingness to participate was associated with completion of tertiary education, previous genetic testing experience, overall higher genomic awareness, and trust in international researchers. The survey respondents also expressed ongoing communication and diverse information needs regarding the use of their samples and data. Major concerns were associated with privacy and data security. Discussion: The success of genomic research and international data sharing efforts in CP are contingent upon broad support and recruitment. Ongoing consultation and engagement of individuals with CP and their families will facilitate trust and promote increased awareness of genomics in CP that may in turn maximize participant uptake and recruitment.

A one-day antismoking programme was conducted for 289 students in a male secondary school in Abha, Saudi Arabia. The one-group pretest/post-test design to evaluate the programme was based on an Arabic version of the WHO standard questionnaire for young people. The results showed that the prevalence rate of regular smoking was 14.5%. The students showed marked variability in correct responses to various factual items. The programme had a significant impact on nonsmokers [P < 0.01] and prespecialty students [P < 0.01]. With the exception of smokers, the students showed an overall positive attitude towards public action, but the impact of the one-day programme was less than satisfactory

The optical properties of Gafchromic EBT films are investigated under various solar power intensities. The films are exposed to solar radiation with different powers (0, 0.3, 0.5, 0.8, 1 SUN) for 30 min in each case. The absorbance, transmittance and reflectance of the films are thoroughly investigated. Other important parameters such as: absorption coefficient, extinction coefficient, energy bandgaps and refractive index are determined. These parameters show strong dependence on the solar power intensity, suggesting that EBT films can be considered as suitable candidates for many sensing and dosimetry applications.

AIM: To study the effect of topical dorzolamide 2% on macular thickness reduction in diabetic cystoid macular edema (CME). METHODS: This was a prospective, non-randomized, open study including eyes with diabetic macular edema (DME). All eyes received topical dorzolamide 2% three times daily for one month. Changes in best-corrected visual acuity (BCVA), and central macular thickness (CMT) by optical coherence tomography) were evaluated at 1wk, 1, and 3mo post-treatment. RESULTS: Ninety-three eyes (84 patients) were included. Mean±SD (logMAR) BCVA improved significantly from 1.08±0.26 pretreatment to 0.66±0.24 at 1mo and 0.87±0.26 at 3mo post-treatment (P

Background: The aim of this study was to characterize the morphological differences of the corpus callosum (CC) concerning gender- and age-related variations, and establish reference values of the CC measurements for Sudanese participants using magnetic resonance imaging (MRI). Methods and Results: MRI scans from 196 males and 189 females, ranging in age from 18 to 84, were reviewed. Only MRI studies without pathological findings were included in the analysis. The following measurements were done: the longitudinal dimensions of the brain, CC, the genu of CC, the splenium of CC, as well as craniocaudal height of the body of CC. Callosal longitudinal dimensions were measured using the Witelson division method. The longitudinal dimension of the genu was found to be larger in females (11.12 +/- 1.54 mm) than in males (10.73 +/- 1.75 mm) (P=0.021). The longitudinal dimension of the brain was greater in males (161.6 +/- 7.2 mm) than in females (159.3 +/- 7.6 mm) (P=0.002). There was a weak statistically significant direct correlation between age and CC ratio (r=0.271, P

In this paper, we propose a computationally efficient deep learning framework to address the issue of sensitivity drift compensation for chemical sensors. The framework estimates the underlying drift signal from sensor measurements by means of a deep neural network with a multiplication-free Hadamard transform based layer. In addition, we propose an additive neural network which can be efficiently implemented in real-time on low-cost processors. The temporal additive neural network structure performs only one multiplication per “convolution” operation. Both the regular network and the additive network can have Hadamard transform based layers that implement orthogonal transforms over feature maps and perform soft-thresholding operations in the transform domain to eliminate noise. We also investigate the use of the Discrete Cosine Transform (DCT) and compare it with the Hadamard transform. We present experimental results demonstrating that the Hadamard transform outperforms the DCT.

Introduction: The final adult height (FAH) of patients with congenital adrenal hyperplasia (CAH) is often lower than the predicted adult height (PAH) using the Bayley-Pinneau (B&P) method. The aim of the current work was to test the validity of B&P in predicting FAH from a bone age (BA) measurement performed at onset of puberty. Material and ethods: This was a retrospective longitudinal observational convenience single-centre study. The study included 54 patients (male and female) with classic CAH, whether salt-wasting (SW) or simple virilising (SV), who had reached FAH. The results of auxological measurements and hormonal data around the time of puberty were retrieved from files. Predicted adult height (PAH) was calculated from a BA taken at onset of puberty and compared with FAH. Results: The median PAH SDS at the onset of puberty (–1.5) was significantly greater than the median FAH SDS (–2.2) (p < 0.001). The median target height SDS (–0.8) was significantly higher than the median FAH SDS (–2.2) (p < 0.001). FAH and FAH SDS were significantly worse in females (150.36 ± 7.23; –2.05 ± 1.13) than in their male counterparts (162.86 ± 3.30; –1.53 ± 0.51) (p value < 0.001; 0.048). In patients with good control, there was no difference between PAH SDS (–1.7) and FAH SDS (–1.5) (p value = 0.37). In patients with poor control (over- or under-treated) FAH SDS (–2.1) was significantly lower than PAH SDS (–1.4) (p value < 0.001). Conclusion: The B&P method was able to accurately predict FAH in children with classic CAH, who were medically well controlled (based on 17-hydroxyprogesterone levels), but overestimated it by a significant 0.7 SD in poorly-controlled patients.

Hydatid cyst disease is a parasitic infection caused by larval stage of Echinococcus granulosusaffecting mainly the liver. Diagnosis of hepatic hydatidosis depends on clinical presentations, serologicalassays and radiological findings. The present study included 40 patients suffered fromhepatic hydatid cysts. They were classified into 4 groups according to therapeutic protocols theyreceived. All cases were subjected to serological assay, radiological examination to categorizecysts and open surgical intervention for treatment. Samples of hydatid fluid and cysts were examinedregarding parasitological, morphometric and histopathological aspects. Viability of cystcontents was assessed using eosin stain. All samples were cultivated for microbiological assessment.Viability was 95-100% in GI (no previous treatment), 50-85% in GII, 25-45% in GIII(single PAIR technique and single Albendazole course) and 0-10% in GIV (repeated PAIR andmedical treatment). Enterococci and Staphylococcus aureus were detected in one samplein GI and 8 samples in GIV respectively.

This study aims to determine the effect of work motivation and work discipline on employee performance mediated by the work environment. The number of respondents involved in this study were 55 respondents, all respondents were employees of the Bureau of Human Resources Polda Metro Jaya. This study uses a quantitative approach. The data in this study are primary data obtained from the results of distributing questionnaires. The collected research data were then analyzed using the Partial Least Square (PLS) analysis technique with the help of the Smartpls program. Based on the results of the analysis in this study, it was found that Work Motivation, Work Discipline and Work Environment have a positive effect on performance, Work Motivation and Work Discipline have a positive effect on the Work Environment, Work environment can mediate the indirect effect of Work Motivation and Work Discipline on performance.

This study aims to determine the most valid forecasting method based on the time series method. This research uses a quantitative descriptive method, the research variable is sales data of MT products belonging to PT. RSM period August 2018 to January 2021. Data processing using Microsoft excel and Minitab 19 software. ABC analysis results show product codes RSM020, RSM021, and RSM017 occupy the three highest ranks in class A by contributing 26.16% sales figures. Based on the forecasting results using various time series methods (linear trend, decomposition, moving average, single exponential smoothing, Holt Method, and Winter Method) it is found that the Winter Method produces the lowest MAPE value, which is below 20%. Product code RSM020 with an alpha value of 0.06; beta 0.09; and 0.07 gamma produces 17.2% MAPE. Product code RSM021 with an alpha value of 0.01; beta 0.01; and 0.01 gamma produces a 15.3% MAPE. Product code RSM017 with an alpha value of 0.01; beta 0.02; and 0.02 gamma produces 18.1% MAPE.

OBJECTIVES Virtual reality (VR) therapy is growing in use and popularity during pediatric medical procedures. Currently, data that describe the hospital resources used during pediatric procedures with off-the-shelf VR games that are not tailored to medical procedures are lacking. In this study, we aimed to characterize procedural resources associated with VR use during venipuncture in a pediatric emergency department. METHODS This was a secondary analysis of a 2-arm randomized, controlled pilot trial with an external group. Resource use was evaluated in 3 groups: child life (CL)-supported VR engagement, CL support without VR, and a reference group that received no intervention (ie, no CL and no VR). RESULTS The study sample (N = 55) included the following: 15 patients randomly assigned to VR, 20 patients randomly assigned to CL, and 20 patients in the reference group. There was a significant difference in procedure duration, with the VR group exhibiting the longest duration compared with the CL and reference groups (P = .01). CONCLUSIONS Longer procedure times associated with VR use during venipunctures (4–6 minutes on average) may be attributed to pauses to troubleshoot VR games not tailored for medical procedures. Although they are inexpensive and accessible, nontailored VR games may warrant the need for dedicated staff to provide restraint and/or assistance to navigate the VR application. In this study, we offer a protocol on the application of nontailored VR games for pediatric procedures. For those considering a VR program in an inpatient setting, the benefits of pain/anxiety reduction must be weighed against the resources needed, including device costs, staff availability, and increased procedure duration.

Aim: Emerging evidence highlights the impact of stressful conditions on eating behaviours, particularly the consumption of foods high in salt, sugar and fat. The impact of the Coronavirus disease-19 (COVID-19) pandemic on food addiction is still un-estimated. This study aimed to examine the prevalence of food addiction among the Jordanian population during the quarantine. Materials and methods: A Cross-sectional study has been conducted between the 27th of April and the 4th of June of 2020. An online survey of Yale food addiction scale v.2.0 (YFAS 2.0) was distributed. A convenience sample was collected through social media sites. Differences in socio-demographic characteristics were analysed using t-test and chi-square tests. Food addiction was classified based on the scoring scale. Determinants of food addition were predicted by using multivariate logistic regression. Results: The results revealed that the prevalence of food addiction was 21.5% among adults. Among food addiction participants, 76.4% were diagnosed as severely food addicted. More than 50% of the participants reported high consumption of foods rich in sugar, salt, and fat (48.2%, 51.8%, and 52.5%, respectively). Overweight and obese young adults were more likely to have food addiction compared to normal weight. The multinominal logistic regression model revealed that there was no determinants of food addiction among adults. Conclusion: During the first months of the quarantine, the prevalence of food addiction was higher among obese and overweight adults compared to normal-weight adults.

The periocular region is challenging for cosmetic laser surgeons. Surgery and laser resurfacing have traditionally been used to correct periorbital lines and wrinkles. Although effective, the associated downtime with these methods has made many people reluctant to decide for such treatments. More recently, the non-ablative long-pulse 2940 nm Er:YAG laser is being used to improve the structure and function and hence the appearance of skin in the periorbital region. The objective of this study is to evaluate the safety and efficacy of long-pulse 2940 nm Er:YAG laser for non-ablative treatment of periorbital static wrinkles and skin laxity. This is a prospective analysis of 30 patients treated for periorbital rejuvenation using three sessions of non-ablative long-pulse Er:YAG laser over a 3-month period. All patients were assessed according to Fitzpatrick’s classification of periorbital wrinkles to class I, II, or III and were treated with 2940 nm Er:YAG laser using a fluence of 3.75 J/cm2, a repetition rate of 1.7–2 Hz, and with the SMOOTH™ pulse mode (250 ms). The treatment sessions were performed on each patient, 4 weeks apart. Patient improvement was assessed before each laser session as well as at 12 months after the final treatment. Blind photographic evaluations were performed by three independent physicians using unlabeled before and after photos arranged in non-chronological order. Reviewers were asked to determine the before and after photos. Patients were asked to answer a questionnaire measuring satisfaction 4 weeks after each session, and to report any adverse reactions. There was statistically and clinically significant improvement in the Fitzpatrick classification of the periorbital wrinkles. Blinded evaluators correctly identified the before and after photos in all cases. All patients reported mild edema and erythema, which persisted for 1 to 2 days, and superficial peeling of the skin for 4 to 6 days after each laser treatment. No long-term adverse effects were reported. The non-ablative long-pulse 2940 nm Er:YAG laser seems to be a safe and effective treatment for periocular rejuvenation with minimal and tolerable adverse reaction. The improvement attained from the laser sessions was persisting after 1 year denoting the long-term efficacy of the procedure.

Background and study aim: Liver biopsy is the gold standard method to assess hepatic ‎inflammation and fibrosis in chronic hepatitis C infection (HCV). The ‎non-invasive assessment of liver fibrosis is the key target that has ‎inspired many new methods because of the limitations of liver biopsy. ‎The aim of the work was to improve the efficiency of non-invasive liver ‎fibrosis assessment in Egyptian patients with chronic hepatitis C by ‎comparing Doppler ultrasound (US) of hepatic blood flow and ‎fibroscan with liver biopsy‎. Patients and Method: ‎ In this retrospective analysis, 78 patients with HCV had already ‎undergone liver biopsies as part of work panel prior to HCV treatment. ‎Fibroscan examination, abdominal ultrasonography and Doppler ‎ultrasound were done to the patients by experienced operators‎‎.‎ Results: There was a strong positive‏ ‏correlation between the degree of liver ‎fibrosis by fibroscan and the degree of inflammation in the ‎histopathological analysis. Receiver Operator Characteristic (ROC) ‎curve analysis revealed that fibroscan failed to detect FII fibrosis. ‎However, fibroscan was more accurate in detecting FIII ‎fibrosis.The Doppler ultrasound parameter ROC curve analysis, ‎the portal vein blood flow volume (PVBFV) was shown to be ‎more accurate in detecting lower grades of fibrosis than ‎higher‎. Conclusion: For detection higher degrees of fibrosis, Fibroscan has a strong match ‎with liver biopsy; however, Doppler US is more sensitive in detecting ‎lower grades of fibrosis in patients infected with HCV‎ ‎‎‎.

Background To prospectively demonstrate the feasibility of performing dual-phase SPECT/CT for the assessment of the small joints of the hands of rheumatoid arthritis (RA) patients, and to evaluate the reliability of the quantitative and qualitative measures derived from the resulting images. Methods A SPECT/CT imaging protocol was developed in this pilot study to scan both hands simultaneously in participants with RA, in two phases of 99mTc-MDP radiotracer uptake, namely the soft-tissue blood pool phase (within 15 minutes after radiotracer injection) and osseous phase (after 3 hours). Joints were evaluated qualitatively (normal vs. abnormal uptake) and quantitatively [by measuring a newly developed metric, maximum corrected count ratio (MCCR)]. Qualitative and quantitative evaluations were repeated to assess reliability. Results Four participants completed seven studies (all four were imaged at baseline, and three of them at follow-up after 1-month of arthritis therapy). A total of 280 joints (20 per hand) were evaluated. The MCCR from soft-tissue phase scans was significantly higher for clinically abnormal joints compared to clinically normal ones; P

Epilepsy is a chronic widely prevalent neurologic disorder, affecting brain functions with a broad spectrum of deleterious consequences. High mobility group box1 (HMGB1) is a nuclear non-histone protein that targets vital cell receptor of toll-like receptor 4 (TLR4) and advanced glycation end products (RAGE). HMGB1 mediated TLR4/RAGE cascade has been scored as a key culprit in neuroinflammatory signalling that critically evokes development of impaired cognition and epilepsy. The current study aimed to investigate the neuroprotective effect of pentoxifylline (PTX) on pentylenetetrazol (PTZ)-kindling rats by its anti-inflammatory/antioxidant capacity and its impact on memory and cognition were investigated, too. PTZ was intraperitoneally injected 35 mg/kg, every 48 h, for 14 doses, to evoke kindling model. Phenytoin (30 mg/kg, i.p.) and PTX (60 mg/kg, i.p.) or their combination were given once daily for 27 days. PTX treatment showed a statistically significant effect on behavioural, histopathological and neurochemical analysis. PTX protected the PTZ kindling rats from epileptic seizures and improved memory and cognitive impairment through the Morris water maze (MWM) test. Furthermore, PTX reversed PTZ hippocampal neuronal loss by decreasing protein expression of amyloid-β peptide (Aβ), Tau and β site-amyloid precursor protein cleavage enzyme 1 (BACE1), associated with a marked reduction in expression of inflammatory mediators such as HMGB1, TL4, and RAGE proteins. Furthermore, PTX inhibited hippocampal apoptotic caspase 1 protein, total reactive oxygen species (TROS) along with upregulated erythroid 2-related factor 2 (Nrf2) content. In conclusion, PTX or its combination with phenytoin represent a promising drug to inhibit the epilepsy progression via targeting the HMGB1/TLR4/RAGE signalling pathway.

We use a regular and modular eight-variable Karnaugh map to reveal some technical details of Boolean minimization usually employed in solving problems of Qualitative Comparative Analysis (QCA). We utilize as a large running example a prominent eight-variable political-science problem of sparse diversity (involving a partially-defined Boolean function (PDBF), that is dominantly unspecified). We recover the published solution of this problem, showing that it is merely one candidate solution among a set of many equally-likely competitive solutions. We immediately obtain one of these rival solutions, that looks better than the published solution in two aspects, namely: (a) it is based on a smaller minimal set of supporting variables, and (b) it provides a more compact Boolean formula. However, we refrain from labelling our solution as a better one, but instead we stress that it is simply un-comparable with the published solution. The comparison between any two rival solutions should be context-specific and not tool-specific. In fact, the Boolean minimization technique, borrowed from the area of digital design, cannot be used as is in QCA context. A more suitable paradigm for QCA problems is to identify all minimal sets of supporting variables (possibly via integer programming), and then obtain all irredundant disjunctive forms (IDFs) for each of these sets. Such a paradigm stresses inherent ambiguity, and does not seem appealing as the QCA one, which usually provides a decisive answer (irrespective of whether it is justified or not).The problem studied herein is shown to have at least four distinct minimal sets of supporting variables with various cardinalities. Each of the corresponding functions does not have any non-essential prime implicants, and hence each enjoys the desirable feature of having a single IDF that is both a unique minimal sum and the complete sum. Moreover, each of them is unate as it is expressible in terms of un-complemented literals only. Political scientists are invited to investigate the meanings of the (so far) abstract formulas we obtained, and to devise some context-specific tool to assess and compare them.

Background Cyclin-dependent kinase 9 (CDK9) has been shown to play an important role in tumorigenesis of several malignancies. However, the expression of CDK9 in ovarian cancer from Middle Eastern ethnicity remains unknown. Methods A tissue microarray of 441 epithelial ovarian cancer (EOC) samples was used to study the expression of CDK9 immunohistochemically and their clinico-pathological associations were determined. Cox proportional hazards regression model was used for univariate and multivariate analysis of recurrence-free survival. Results CDK9 over-expression was noted in 56.2 % (248/441) of EOCs and was associated with adverse clinico-pathological parameters such as distant metastasis (p p p = 0.0105) and high Ki-67 index (p p = 0.0030). We also found that CDK9 outperforms Ki-67 as a predictor of tumor recurrence in EOC. Conclusions Our results show that CDK9 expression correlates with markers of advanced disease in Middle Eastern EOC and is also a prognostic marker. CDK9 overexpression also identifies a subset of patients with highest likelihood of recurrence across the patient cohort. These patients may benefit from additional alternative therapies targeting CKD9.

We present non-linear optical properties of graphene oxide (GO) doped with low chirality metallic single walled carbon nanotubes (m-SWCNTs) thin films. The weight percentage of the m-SWCNTs was 5, 10, and 20 wt%. High-resolution transmission electron microscope (HRTEM), high resolution scanning electron microscope (HRSEM), Raman, and UV–vis spectroscopy were used to characterize the prepared samples. We have investigated their nonlinear optical properties using open and closed Z-scan technique at Nd:YAG laser at 1064 nm laser pulses (7 ns, 10 Hz). The nonlinear absorption coefficient β, nonlinear refractive index n2, and third order nonlinear susceptibility χ3 were calculated. The results show that all samples exhibit reverse saturable absorption (RSA) because of increasing metallicity and/or partial reduction of GO during laser illumination. The nonlinearity response of the GO/m-SWCNT films increase as the m-SWCNTs percentage increases. The high non-linear optical parameters of the GO/m-SWCNTs films make them as superior candidates for near-infrared (NIR) laser protection applications.

The propagation of household recycling is undeniable and thorough. Recycling behaviour among households in urban areas and Malaysia has, however, received less attention. Therefore, the purpose of this preliminary study is to outline the influence that household behaviour is motivated through waste recycling. The survey carried out in six (6) suburbs of Shah Alam using a convenient sampling method to perform a site inventory and questionnaire survey. The findings are affected by the influences of recycling and individual activities representing their contribution to recycling domestic waste. Keywords: Human Behaviour; Domestic Waste Recycling; Waste Generation; Urban Households. eISSN 2514-751X © 2020 The Authors. Published for AMER ABRA cE-Bs by e-International Publishing House, Ltd., UK. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer–review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians / Africans / Arabians) and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning & Surveying, Universiti Teknologi MARA, Malaysia. DOI: https://doi.org/10.21834/ajebs.v5i17.373

Homomorphic encryption is an emerging form of encryption that provides the ability to compute on encrypted data without ever decrypting them. Potential applications include aggregating sensitive encrypted data on a cloud environment and computing on the data in the cloud without compromising data privacy. There have been several recent advances resulting in new homomorphic encryption schemes and optimized variants. We implement and evaluate the performance of two optimized variants, namely Bajard-Eynard-Hasan-Zucca (BEHZ) and Halevi-Polyakov-Shoup (HPS), of the most promising homomorphic encryption scheme in CPU and GPU. The most interesting (and also unexpected) result of our performance evaluation is that the HPS variant in practice scales significantly better (typically by 15-30 percent) with increase in multiplicative depth of the computation circuit than BEHZ, implying that the HPS variant will always outperform BEHZ for most practical applications. For the multiplicative depth of 98, our fastest GPU implementation performs homomorphic multiplication in 51 ms for 128-bit security settings, which is faster by two orders of magnitude than prior results and already practical for cloud environments supporting GPU computations. Large multiplicative depths supported by our implementations are required for applications involving deep neural networks, logistic regression learning, and other important machine learning problems.

Background The debate for the optimum sodium concentration in the rehydration solution in diabetic ketoacidosis (DKA) persists till the moment. The aim was to compare the outcome of 0.9% saline versus 0.45% saline in children with moderate and severe (DKA) regarding the effect on serum electrolytes, duration of DKA resolution and the incidence of hyperchloremia. Results A retrospective analysis of 121 children with moderate or severe DKA was done. After the initial 4 h in which both groups received normal saline, patients were divided into two groups continuing on 0.9% (N=72) or switched to 0.45% saline (N=49). Serum chloride and Cl/Na ratios were significantly higher in 0.9% saline group at 4 and 8 h. The 0.9% saline group had significantly higher proportion of hyperchloremia at 4 and 8 h (P value: 0.002, 0.02). The median duration of correction of DKA (14 h among 0.9% saline versus 10 h among 0.45% saline) without significant difference (P value= 0.43). The change in plasma glucose, effective osmolarity, corrected Na levels were comparable between groups. Conclusion There is an unavoidable iatrogenically induced rise in serum chloride with higher incidence of hyperchloremia with the use of normal saline in rehydration of children presenting in DKA and shock. The use of 0.45% saline as post-bolus rehydration fluid is not associated with a decline in the corrected serum sodium concentration and does not affect the rate of correction of acidosis or rate of drop in blood glucose or duration of DKA resolution when compared to normal saline.

Missing or erroneous information is a common problem in the analysis of pharmacokinetic (PK) data. This may present as missing or inaccurate dose level or dose time, drug concentrations below the analytical limit of quantification, missing sample times, or missing or incorrect covariate information. Several methods to handle problematic data have been evaluated, although no single, broad set of recommendations for commonly occurring errors has been published. In this tutorial, we review the existing literature and present the results of our simulation studies that evaluated common methods to handle known data errors to bridge the remaining gaps and expand on the existing knowledge. This tutorial is intended for any scientist analyzing a PK data set with missing or apparently erroneous data. The approaches described herein may also be useful for the analysis of nonclinical PK data.

MicroRNAs (miRNAs) are small non-coding RNA molecules that regulate gene expression at the post-transcriptional level through base-pairing predominantly with a 3-untranslated region of target mRNA, followed by mRNA degradation or translational repression. Totally, miRNAs change, through a complex regulatory network, the expression of more than 60% of human genes. MiRNAs are key regulators of the immune response that affect maturation, proliferation, differentiation, and activation of immune cells, as well as antibody secretion and release of inflammatory mediators. In this review, we generally discuss miRNAs, its types and its role in the regulation of the immune system and the autoimmune inflammatory process, focusing on the participation of miRNA-146 in the development of multiple sclerosis (MS), Rhumatoid arthritis and Type-I diabetes mellitus. Disruption of this regulation may lead to the development of various pathological conditions, including autoimmune inflammation. Special attention is given to the role of miRNA-146 in the autoimmune inflammation in multiple sclerosis, Rhumatoid arthritis and Type-I diabetes mellitus. This study concluded that, dysregulation of miR-146 and its target genes was one of the main causes for many autoimmune diseases our findings indicate a significant association of decreased miR-146 expression and the sustained immune imbalance in multiple sclerosis, Rhumatoid arthritis and Type-I diabetes mellitus.

Introduction: Intrahepatic cholestasis of pregnancy (ICP) has been sparsely studied especially in the Middle East. The incidence and outcome of ICP varies worldwide. Its incidence in the Middle East and primary maternal and fetal outcome must be evaluated to ascertain the burden so that appropriate preventive and intervention measures can be formulated and implemented. Objective: To assess the incidence, associations, and maternal-fetal outcomes in ICP. Design: Case-control study. Settings: tertiary care hospital settings affiliated with the academic center in the UAE. Patients and methods: a total of 150 patients were included from October 2016 to September 2018 in the study with 75 cases of ICP and 75 controls matched according to age and date of delivery. The maternal risk factors attributable to ICP were recorded. Biochemical profile of mothers was monitored. Maternal and fetal outcomes were compared in 2 groups. Main outcomes measured: incidence and associations of ICP were evaluated. Maternal and fetal outcomes were compared in cases and controls. Sample size: 150. Result: The incidence of ICP in our study in the UAE was 1.0%. ICP has significant association with past obstetric cholestasis history (p value p value p value p value p value p value p value p value p value p value Conclusion: ICP mothers have low incidence in the UAE and significant association with gestational diabetes and pre-eclampsia. High maternal bile acids above 40 μmol/L have poor fetal outcomes.

The global pandemic of new coronaviruses (COVID-19) has infected many people around the world and became a worldwide concern since this disease caused illness and deaths. The vaccine and drugs are not scientifically established, but patients are recovering with antibiotic drugs, antiviral medicine, chloroquine, and vitamin C. Now it is obvious to the world that a quicker and faster solution is needed for monitoring and combating the further spread of COVID-19 worldwide, using non-clinical techniques, for example, data mining tools, enhanced intelligence, and other artificial intelligence technologies. In this paper, association rule mining is developing for the frequent itemsets discovery in COVID-19 datasets, and the extraction of effective association relations between them. This is done by demonstrates the analysis of the Coronavirus dataset by using the Apriori_Association_Rules algorithm. It involves a scheme for classification and prediction by recognizing the associated rules relating to Coronavirus. The major contribution of this study employment determines the effectiveness of the Apriori_Association_Rules algorithm towards a classification of medical reports. The experimental results provide evidence of the Apriori_Association_Rules algorithm regarding the execution time, memory consumption, and several associated rules that reflect its potential applications to different contexts. Therefore, the Apriori_Association_Rules algorithm will be very useful in healthcare fields to demonstrate the latest developments in medical studies fighting COVID-19.

Introduction Factor VII is an essential blood coagulation factor, yet the minimum level of Factor VII activity (FVII:C) for hemostasis is not well defined. Therefore, patients with seemingly low FVII:C levels diagnosed on presurgical screening are often exposed to potentially unnecessary treatment to mitigate bleeding risk that may not exist. The Pediatric Bleeding Questionnaire (PBQ) a bleeding risk assessment tool has not been validated in patients with low FVII:C. Objective To assess the utility of the PBQ as a bleeding risk predictor in patients with low FVII:C level undergoing surgical procedures. Methods Patients with low FVII:C levels diagnosed in the pre-surgical setting with a completed PBQ were eligible. Patient’s FVII:C, PBQ score, surgery type, perioperative hemostatic measures and bleeding events were recorded. Results Fifty-Two patients (mean age 10.6 years) with mean FVII:C of 39.7% were evaluated. All but 3 patients had a PBQ score ≤2. No perioperative bleeding prophylaxis was administered to 41 (78.8%) patients. None of the patients reported prolonged perioperative bleeding. Conclusion Individuals with low FVII:C detected on presurgical screening are not at high risk for bleeding in the absence of a personal bleeding history and the PBQ did not predict bleeding risk in this setting.

To systematically and meta-analytically pool the existing evidence regarding the prognostic impact of preoperative anemia (hemoglobin level12 mg/dl) in patients with endometrial cancer.Four (PubMed, Embase, Scopus and Web of Science) databases were searched from inception to 20-August-2020. We assessed the risk of bias using the Newcastle-Ottawa Scale. We estimated the pooled prevalence of preoperative anemia in the included studies. We pooled odds ratios (ORs) and hazard ratios (HRs) with their 95 % confidence intervals (95 % CIs) to evaluate the correlation between preoperative anemia and its impact on clinicopathologic parameters and survival outcomes. Analyses were performed under random- or fixed-effects meta-analysis models depending on data heterogeneity.Seven studies met the inclusion criteria comprising 1495 patients with endometrial cancer. Nearly all studies had low risk of bias. The pooled prevalence of preoperative anemia was 26.5 % (95 % CI: 18.6%-36.2%). Preoperative anemia significantly correlated with advanced FIGO stage III-IV (OR = 5.14, 95 % CI [3.36, 7.86], p0.00001), ≥50 % myometrial invasion (OR = 1.95, 95 % CI [1.36, 2.78], p = 0.0003), lymph node metastasis (OR = 4.46, 95 % CI [2.39, 8.30], p0.00001), non-endometrioid histology (OR = 3.25, 95 % CI [1.89, 5.60], p0.0001), adnexal involvement (OR = 5.88, 95 % CI [3.05, 10.23], p0.001), cervical involvement (OR = 2.91, 95 % CI [1.65, 5.11], p = 0.0002), positive peritoneal cytology (OR = 3.24, 95 % CI [1.41, 7.44], p = 0.006), preoperative thrombocytosis (OR = 6.66, 95 % CI [3.05, 14.52], p0.00001) and lymphovascular space invasion (OR = 3.50, 95 % CI [1.82, 6.74], p = 0.0002). High tumor grade II-III was increased in patients with preoperative anemia, yet this effect was not statistically significant (OR = 2.12, 95 % CI [0.97, 4.66], p = 0.06). Consistently, the five-year overall survival (OS) and disease-free survival (DFS) rates were significantly lower in patients with preoperative anemia when compared to those without preoperative anemia. Pooled HR showed that preoperative anemia was significantly associated with reduced DFS at univariate (HR = 3.22, 95 % CI [1.28, 8.11], p = 0.01) and multivariate (HR = 1.02, 95 % CI [1.00, 1.05], p = 0.03) analyses.Preoperative anemia predicts poor clinicopathologic and survival outcomes in patients with endometrial cancer.

High consumption of trans-fatty acids (TFAs) linked with obesity, disorders of lipoproteins, type 2 Diabetes Mellitus (T2DM), risk factors of coronary heart disease, and development of atherosclerosis. The intent of our trials was to assess the possible bad impact of TFAs on the lipid status and focusing on characterizing the physiological alters in an animal model comparing with cis fatty acids. Sixty male albino rats, with nearly similar average weight 170±5wereassignedinto 4 main groups (15 rats per group) and kept on a standard diet set for 12 weeks. All groups received different diet treatment for successive 12 weeks. Group A: control group received a conventional diet, group B received a diet contained 360 gm TFAs inform of partially hydrogenated vegetable oil (PHVO) l kg of diet, group C was fed a High Fat Diet (HFD) contained 360 gm beef tallow l kg of diet for, and group D received a diet containing 360 gm linseed oil l kg of diet. Both feeding of TFAs and HFD resulted in a marked increase in the body weight in reach to the obesity grade with a significant increase (P≤0.05) in leptin and leptin receptor gene expression. Also, a significant increase in Malondialdehyde (MDA) and Lipoprotein-a (Lp-a) and a marked decrease in total antioxidant capacity (TAC). It could be concluded that TFAs induce combined increased body weight, with imbalance in oxidative stress, dyslipidemia, and elevated atherogenic Lipoprotein-a may be leading to development of atherosclerosis and coronary heart disease.

Background & Objectives: Prevalence of hepatitis B virus in patients with rheumatic diseases has been reported differently among studies. The loss of immune control in these patients may result in the reactivation of HBV replication within hepatocytes. Considering the lifelong use of multiple anti-rheumatic drugs, screening for HBV is recommended before starting immunosuppressive or immunomodulatory therapy. The aim of this study was to select the best and simplest test for screening of HBV in rheumatic patients. Methods: This study was carried out in 102 patients with different rheumatic diseases. Screening to all patients for hepatitis B surface antigen (HBsAg), hepatitis C virus (HCV) antibodies and human immune deficiency virus antibodies (HIV) was done. HBV core antibodies and real time PCR to detect HBV DNA were done. Results: The mean age of the patients was 37.18 ± 12.37 years, 3.9% of them were males and 96.1% were females. HBsAg had 100% Sensitivity, 100% Specificity, 100% PPV, 100% NPV and 99.0% accuracy. While, anti-HBc had 100% Sensitivity, 78% Specificity, 8% PPV, 100% NPV and 78% accuracy in the screening of HBV. Conclusions: HBs Ag was found to be superior to antiHBc for screening for HBV infection in rheumatic patients.

Very few studies have investigated the relationship between body mass index (BMI) and risk of urinary tract infection (UTI), and conclusions from these available studies have been inconsistent. To resolve this inconsistency, we performed a systematic review and meta-analysis to precisely examine the association between BMI and UTI. This meta-analysis was performed based on the PRISMA recommendations. PubMed, Web of Science, Scopus, Embase, and Google Scholar databases were searched for all published observational studies that reported the risk of UTI based on BMI categories up to March 2020. Fourteen (n = 14) articles comprising 19 studies in different populations met our inclusion criteria. The overall analysis showed a significant increased risk of UTI in subjects affected by obesity vs. individuals without obesity (RR = 1.45; 95% CI: 1.28 − 1.63; I2 = 94%), and a non-significant increased risk of UTI in subjects who were overweight (RR = 1.03; 95% CI: 0.98 − 1.10; I2 = 49.6%) and underweight (RR = 0.99; 95% CI: 0.81 − 21; I2 = 0.0%) when compared to subjects who had normal weight. In the stratified analysis, we showed that obesity increased the risk of UTI in females (RR = 1.63; 95% CI: 1.38 − 1.93) and in subjects below 60 years old (RR = 1.53; 95% CI: 1.33 − 1.75). This systematic review and meta‐analysis recognized a significant relationship between BMI and incidence of UTI in obese vs. non-obese subjects, as well as in females and in individuals below 60 years old.

The aim of the study was to compare the effect of viscotrabeculotomy and the effect of trabeculectomy on the intraocular pressure (IOP) in cases of open angle glaucoma (OAG). Prospective comparative study. The study was conducted on 148 eyes of 148 patients (87 men) presenting with and operated upon for OAG at Mansoura Ophthalmic center of Mansoura University in Mansoura, Egypt from 2012 to 2016. Patients were randomized into viscotrabeculotomy and trabeculectomy groups. Postoperative follow up visits were scheduled at weeks 1 and 2 then months 1, 2, 3, 6, 9, 12, 15, 18, 21 and 24. Complications were noted and managed according to needs. The primary outcome measure was IOP. The study was conducted on 148 eyes (74 right) of 148 patients (87 men). The mean ± SD (range, median) age of the study patients was 50.1 ± 11.5 (20–67, 53) and 51.1 ± 10.0 (27–65, 54.5) years respectively. The mean ± SD (range, median) IOP of the study eyes on maximal tolerated IOP lowering therapy was 23.15 ± 2.31 (19–30, 23.0) and 23.64 ± 1.87 (20–28, 23.0) mmHg respectively and at the end of the 24 months of follow up was 14.91 ± 2.4 (12–23, 14) and 16.64 ± 2.8 (14–25, 16) mmHg respectively (p =

Background Preterm infants routinely require enteral feeding via nasogastric or orogastric tubes as an alternative to oral feeding to meet their nutritional needs. Anecdotal evidence suggests variations in practice related to correct tube placement and assessment of feed intolerance. Purpose To determine the current practices of enteral feeding tube placement confirmation and gastric residual (GR) aspiration of neonatal clinicians in Australia. Methods A cross-sectional online survey comprising 24 questions was distributed to nursing and medical health professionals working in Australian neonatal care units through 2 e-mail listservs made available by professional organizations. Findings The survey was completed by 129 clinicians. A single method was practiced by 50% of the clinicians in confirming tube placement, and most common practice was assessing the pH of GR aspirate. The majority of respondents (96%) reported that they relied on GR aspiration and clinical signs to determine feeding tolerance and subsequent decisions such as ceasing or decreasing feeds. However, the frequency of aspiration, the amount and color of aspirate considered to be normal/abnormal, and decisions on whether to replace gastric aspirate or whether aspiration should be performed during continuous tube feeding varied. Implication for practice This study demonstrated considerable variability in clinical practice for enteral feeding tube placement confirmation and GR aspiration despite most respondents reporting using a unit-based clinical practice guideline. Our study findings highlight the need for not only developing evidence-based practice guidelines for safe and consistent clinical practice but also ensuring that these guidelines are followed by all clinicians. Implication for research Further research is needed to establish evidence-based methods both for enteral feeding tube placement confirmation and for the assessment of feeding intolerance during tube feeding. In addition, the reasons why evidence-based methods are not followed must be investigated.

Introduction There are currently no approved targeted therapies for lung squamous-cell carcinoma (LSCC) and KRAS-mutant lung adenocarcinoma (LUAD). About 30% of LSCC and 25% of KRAS-mutant LUAD exhibit hyperactive NRF2 pathway activation through mutations in NFE2L2 (the gene encoding NRF2) or its negative regulator, KEAP1. Preclinical data demonstrate that these tumors are uniquely sensitive to dual inhibition of glycolysis and glutaminolysis via mammalian target of rapamycin (mTOR) and glutaminase inhibitors. This phase 1 study was designed to assess safety and preliminary activity of the mTOR inhibitor MLN0128 (sapanisertib) in combination with the glutaminase inhibitor CB-839 HCl. Methods Phase 1 dose finding will use the queue-based variation of the 3 + 3 dose escalation scheme with the primary endpoint of identifying the recommended expansion dose. To confirm the acceptable tolerability of the recommended expansion dose, patients will subsequently enroll onto 1 of 4 expansion cohorts (n = 14 per cohort): (1) LSCC harboring NFE2L2 or (2) KEAP1 mutations, or (3) LUAD harboring KRAS/(KEAP1 or NFE2L2) coalterations, or (4) LSCC wild type for NFE2L2 and KEAP1. The primary endpoint of the dose expansion is to determine the preliminary efficacy of MLN0128/CB-839 combination therapy. Conclusion This phase 1 study will determine the recommended expansion dose and preliminary efficacy of MLN0128 and CB-839 in advanced non–small-cell lung cancer with a focus on subsets of LSCC and KRAS-mutant LUAD harboring NFE2L2 or KEAP1 mutations.

This work outlines the clinical implementation of total-body PET/CT from the time of installation at UC Davis EXPLORER Molecular Imaging Center in May 2019 to date (September 2020). This process has not been without challenges: logistical, technical, and medical problems were all encountered and are discussed. The mutual learning/teaching engagement among nuclear medicine technologists, research staff, radiologists, and referring physicians has been the key to the past year's achievements; these include development of ground-breaking clinical protocols for a range of Food and Drug Administration-approved radiotracers, and the attainment of a measure of expertise in clinical total-body PET/CT.

Deep learning models such as long short-term memory (LSTM) are valuable classifiers for time series data like hourly clinical statistics. However, access to health data is challenging due to privacy and legal issues. Homomorphic encryption (HE) offers a potential solution by encrypting confidential data. However, the computational complexity of encrypted operations makes it infeasible for training with gradient descent. Prior works only deal with encrypted procedures during the inference phase of the network. To this end, we design Collective Learning protocol, a secure protocol for sharing classified time-series data within entities to train parameters of the binary classifier model partially. The protocol encrypts each data’s feature activations using HE and trains the last layers using encrypted logistic regression. We evaluate our protocol on a benchmark LSTM network trained on the Medical Information Mart for Intensive Care (MIMIC-III) dataset. We selected the Cheon-Kim-Kim-Song (CKKS) encryption scheme because of its ability to work with real numbers using approximate arithmetic. Our protocol improved the area under the precision-recall curve (AUPRC) score of the in-hospital mortality prediction model. The same protocol was reimplemented using secure multi-party computation (MPC) and compared.

Background: Road traffic accidents are considered to be a leading cause of morbidity and mortality in many countries. Therefore, this cross-sectional study aimed to measure the awareness of the Saudi population in Jeddah about the alarming signs of post-traumatic intracranial hemorrhage and the importance of early presentation. Methodology: A cross-sectional study using an electronic survey questionnaire consisting of 41 questions was conducted in Jeddah for a period of 6 months. The general attitude and awareness of the public toward head injuries were assessed. Results: Data were collected from 310 participants, in which 156 (50.3 %) were male and 154 (49.7%) were female. Findings showed that 56.1% of the people were aware of head injuries. Almost 30% (as a family relative not including the mother) suggested that more education was required about head injuries. Around 208 participants did not know that they should not to drink water after a head injury. Conclusion: There is a need to raise the level of public awareness about head injuries. Many educational awareness campaigns, programs, and seminars are required to build a background of proper actions after head injuries.