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Aims The effect of elevated heart rate (HR) on morbidity and mortality is evident in chronic stable heart failure; data in this regard in acute decompensated heart failure (ADHF) setting are scarce. In this single‐centre study, we sought to address the prognostic value of HR and beta‐blocker dosage at discharge on all‐cause mortality among patients with heart failure and reduced ejection fraction and ADHF. Methods and results In this retrospective observational study, 2945 patients were admitted for the first time with the primary diagnosis of ADHF between January 2008 and February 2018. Patients were divided by resting HR at discharge into three groups (HR 90 b.p.m.). Evidence‐based beta‐blockers were defined as metoprolol, bisoprolol, and carvedilol. The doses of prescribed beta‐blockers were calculated into a percentage target dose of each beta‐blocker and divided to four quartiles: 0 75% of the target dose. Cox regression was used to calculate the hazard ratio for various HR categories and adjusting for clinical and laboratory variables. At discharge, 1226 patients had an HR 90 b.p.m. The 30 day mortality rate was 2.2%, 3.7%, and 12.1% (P 90 b.p.m., respectively. The adjusted hazard ratio was significantly increased only in HR above 90 b.p.m. category (hazard ratio, 2.318; 95% confidence interval, 1.794–2.996). Conclusions Patients with ADHF and an HR of

The gigantic growth of platforms that give individuals the ability to write a review that is visible to everyone and the huge number of documents shared on the internet have triggered the researchers to try to detect if these platforms are trying to mislead and deceive people. There is a crucial need to find ways to automatically identify fake reviews and detect deceptive people or groups. The main aim of this research is to detect deception in open domain text by using a machine learning technique. Several sets of features are used to analyse the text including unigram, part of speech, and production rules. The experimental results showed that combined feature sets of (part of speech and production rules) using the support vector machine classifier achieve the best accuracy, and it clearly improves on the accuracy of the results reported in a previous study.

Objective: To document prevalence and clinical presentation of skin diseases in donkeys as well as to investigate predilections for the most common conditions. Design: Epidemiological study Animals: A total of 1134 donkeys at northern Egypt were investigated. Procedures: A questionnaire was constructed to verify the number of infected contact animals as well as the associated factors. Physical examination was carried out and the distribution of skin lesions was recorded. Skin scraping and biopsy were obtained to perform bacteriological, mycological and histopathological examinations. Results: Thirty-five (3.09%) Out of 1134 noticed donkeys had skin affections including mange (18/35; 51.42%), dermatophytosis (6/35; 17.14%), bacterial dermatitis (6/35; 17.14%) urticaria (2/35; 0.57%) and allergic dermatitis (3/35; 0.86%). Conclusion and clinical relevance: The mange and dermatophytosis are the prevalent skin diseases in donkeys. Contact with other animal species of contaminated environment may contribute to the occurrence of the diseases.

The goal of this work is to demonstrate the optimal strategy of an inventory system for perishable goods with hybrid demand dependent on selling price and stock under the partial backlogging with a certain fixed ratio. In this system, the concept of pre-payment policy with a discount facility and fixed preservation investment are also introduced. Then, this inventory system is modelled mathematically by governing differential equations, and solving these equations, the corresponding average profit of the proposed model is obtained as a non-linear maximization problem. To check the optimality of the solution of the obtained non-linear maximization problem, some results are derived with the help of pseudo concavity and optimality conditions of the objective function of the non-linear maximization problem. Then to justify the model, three examples are taken and solved by Lingo software. Also, the concavity of the average profit is examined graphically. Finally, a post optimality analysis is performed to show the effects of known inventory parameters on the optimal policy.

Congestive heart failure (CHF) is often associated with kidney and pulmonary dysfunction. Activation of the renin‐angiotensin‐aldosterone system (RAAS) contributes to avid sodium retention, cardiac hypertrophy and oedema formation, including lung congestion. While the status of the classic components of RAAS such as renin, angiotensin converting enzyme (ACE), angiotensin II (Ang II) and angiotensin II receptor AT‐1 is well studied in CHF, the expression of angiotensin converting enzyme‐2 (ACE2), a key enzyme of angiotensin 1‐7 (Ang 1‐7) generation in the pulmonary, cardiac and renal systems has not been studied thoroughly in this clinical setting. This issue is of a special interest as Ang 1‐7 counterbalance the vasoconstrictory, pro‐inflammatory and pro‐proliferative actions of Ang II. Furthermore, CHF predisposes to COVID‐19 disease severity, while ACE2 also serves as the binding domain of SARS‐CoV‐2 in human host‐cells, and acts in concert with furin, an important enzyme in the synthesis of BNP in CHF, in permeating viral functionality along TMPRSST2. ADAM17 governs ACE2 shedding from cell membranes. Therefore, the present study was designed to investigate the expression of ACE2, furin, TMPRSS2 and ADAM17 in the lung, heart and kidneys of rats with CHF to understand the exaggerated susceptibility of clinical CHF to COVID‐19 disease. Heart failure was induced in male Sprague Dawley rats by the creation of a surgical aorto‐caval fistula. Sham‐operated rats served as controls. One week after surgery, the animals were subdivided into compensated and decompensated CHF according to urinary sodium excretion. Both groups and their controls were sacrificed, and their hearts, lungs and kidneys were harvested for assessment of tissue remodelling and ACE2, furin, TMPRSS2 and ADAM17 immunoreactivity, expression and immunohistochemical staining. ACE2 immunoreactivity and mRNA levels increased in pulmonary, cardiac and renal tissues of compensated, but not in decompensated CHF. Furin immunoreactivity was increased in both compensated and decompensated CHF in the pulmonary, cardiac tissues and renal cortex but not in the medulla. Interestingly, both the expression and abundance of pulmonary, cardiac and renal TMPRSS2 decreased in CHF in correlation with the severity of the disease. Pulmonary, cardiac and renal ADAM17 mRNA levels were also downregulated in decompensated CHF. Circulating furin levels increased in proportion to CHF severity, whereas plasma ACE2 remained unchanged. In summary, ACE2 and furin are overexpressed in the pulmonary, cardiac and renal tissues of compensated and to a lesser extent of decompensated CHF as compared with their sham controls. The increased expression of the ACE2 in heart failure may serve as a compensatory mechanism, counterbalancing the over‐activity of the deleterious isoform, ACE. Downregulated ADAM17 might enhance membranal ACE2 in COVID‐19 disease, whereas the suppression of TMPRSS2 in CHF argues against its involvement in the exaggerated susceptibility of CHF patients to SARS‐CoV2.

The experiences a person is going through plays a significant role in forming his mental image. In fact, a person retrieves these experiments and all that perceived by his senses. So, the mental image is affected by a person's perception and experiences either they are positive or negative. The study 's objective is crystallized in identifying the mental image exchanged between police members and community members and its impact on societal stability. The study sample is selected randomly, divided into two groups, the police sample that consists of (50) items and the other society's divergent categories and consists of (200) items. The study belongs to the descriptive (qualitative) type of studies using the social survey approach. The study tools are embodied in the scale, observation and some other statistical approaches as for instance, T. Test, Frequencies, Percentages, and Coefficient Correlations. The study comes to the following results: Results indicate that the nature of the mental image overwhelmed by citizens towards the police members is positive, as they consider the police as a national institution with positive situations towards the Egyptian people despite the existence of some shortness. Results also indicate the image that the research population carry about the police authority is positive, particularly, after the 30 June revolution. This image is built by media and personal experiments. The most important study recommendations: Cooperation between media and police members in diffusing security awareness in all mass communications for all different classes' citizens. Simplify procedures in police administrations in which the audience are dealing with such as Traffic, Passports and Civil Status. Intensify training and use up-to-date weapons and equipments in police authority administration to ensure keep in line with present era, the organized crime, and including the computer in all works. Concerning more with raising morals of police officers and workers, secure their present and future for achieving optimal performance. Improve services presented to citizens using modern techniques.

The paper introduces a novel 3-D chaotic fractional system. A thorough analytical study of the new system is done using Lyapunov spectrum, bifurcation analysis, equilibrium point analysis, existence & uniqueness of solution, etc. The system is synchronized using a novel technique ’Quad-compound combination anti-synchronization’ with its parallel systems using non linear and adaptive sliding mode control method. A comparative study of the obtained results has been done and illustration of achieved synchronization in secure communication is also provided.

The objective of the present study is to use discriminant analysis to distinguish three types of floral honey from each other and from sugar-feeding honey by parameters that can be determined easil...

The massive use of the social media and the huge number of messages that are shared on the internet, create a countless need to automatically detect the age and gender of the people who write these messages. Several sites and platforms attempt to mislead and cheat the people who are visiting them by providing deceptive information about the age and the gender of their customer. The traditional way to detect deceivers was by human judgment, but this way is no longer suitable since lots of interviews are not conducted face to face. This paper presents an automate tool with a unique set of features that used to analyze a given text. The features include the unigram, part of speech, and production rules. The accuracy results of the proposed method outperform the existing techniques. The best results achieved by using the production rules features.

Background Infertility is the third most serious disease worldwide estimated by the WHO. Despite the worldwide use of ICSI, it still has a low birth rate (30%). Patients and Methods The current study was a prospective study that included 180 women undergoing Intra-cytoplasmic sperm injection (ICSI) procedure. Using Flexible Antagonist protocol; during oocyte retrieval, follicular fluids of mature follicles (>17 mm) aspirated. Results The number of retrieved oocytes ranged from (1 to 33 oocytes) mean number 10±7. Follicular fluid E2 concentration ranged from 246±199 (0 to 700) (ng/ml). Oocyte maturation about 116 were MII (64.4%) of oocytes. And 64 (35.6%) were MI and GV. 107 cases (59.4) had normal fertilization lamos_zzzz@hotmail.com and 73(40%) had abnormal fertilization of MII injected oocytes. Embryo quality 63.9% (115) of fertilized MII oocytes were blastocysts and 65 (blastomere and others) and 60.6% of cases had embryo transfer on day 5 and 39.4 had transfer on day 3. Chemical pregnancy was positive in 85 cases (47.2%) and the clinical pregnancy positive in 66 cases (%). Conclusion Follicular fluid E2 concentration had fair predictive value in oocyte maturation, fertilization, embryo quality, chemical and clinical pregnancy. But it was an independent predictor of MII-grade oocytes production.

Background Endosonography (EUS) evolved from purely diagnostic imaging modality to be a method that allows tissue acquisition and therapeutic intervention. EUS-guided fine needle aspiration (EUS-FNA) permits cytological confirmation of imaging findings and is performed with high sensitivity and specificity in addition to low incidence of adverse events. Standard EUS-FNA involve use of either no-suction or suction techniques. New sampling technique; capillary (stylet slow-pull) technique, involves slow withdrawal of the stylet creating a small negative pressure. Aim of the work The aim of this study is to compare the quality of samples acquired by capillary technique versus suction technique using 22-gauge needles. Patients and methods Patients referred for EUS-FNA for upper gastrointestinal lesions (pancreatic or luminal) were included in the study. Each lesion was sampled twice, the first was taken using suction technique (applying negative pressure suction using standard 10 ml syringe) while the second one by capillary (stylet slow-pull) technique. After sample processing and staining, cytopathologist reviewed the material blinded to the technique used. The quality of samples was assessed regarding 3 aspects; cellularity, sample contamination by blood or mucosal cells. Results A total of 51 patients (37/14 males/females, mean age 55.4) referred for EUSFNA were included. Cytological diagnosis was: pancreatic adenocarcinoma in 38/51 (74.51%), Gastrointestinal stromal tumor in 4/51 (7.84%), inconclusive result in 3/51 (5.88%), the rest were solid pseudopapillary neoplasm, Serous cystic neoplasm, Mucinous cystic neoplasm, inflammatory lesions (papillitis, pancreatitis) and metastatic lesion 1 patient for each (1.96%). The sample cellularity score showed no statistically significant difference between both sampling techniques (P = 0.18). Blood contamination score was significantly lower in the capillary technique (P Conclusion Both techniques provided comparable diagnostic performance. However, capillary technique showed less sample contamination by blood cells resulting in a slightly better-quality sample.

Congestive heart failure (CHF) often leads to progressive cardiac hypertrophy and salt/water retention. However, its pathogenesis remains largely unclarified. Corin, a cardiac serine protease, is responsible for converting proANP and proBNP to biologically active peptides. Although the involvement of corin in cardiac hypertrophy and heart failure was extensively studied, the alterations in corin and proprotein convertase subtilisin/kexin-6 (PCSK6), a key enzyme in the conversion of procorin to corin, has not been studied simultaneously in the cardiac and renal tissues in cardiorenal syndrome. Thus, this study aims to examine the status of PCSK6/corin in the cardiac and renal tissues of rats with CHF induced by the creation of aorto-caval fistula (ACF). We divided rats with ACF into two subgroups based on the pattern of their urinary sodium excretion, namely, compensated and decompensated. Placement of ACF led to cardiac hypertrophy, pulmonary congestion, and renal dysfunction, which were more profound in the decompensated subgroup. Corin immunoreactive peptides were detected in all heart chambers at the myocyte membranal and cytosolic localization and in the renal tissue, especially in the apical membrane of the proximal tubule, mTAL, and the collecting duct. Interestingly, the expression and abundance of corin in both the cardiac ventricles and renal tissues were significantly increased in compensated animals as compared with the decompensated state. Noteworthy, the abundance of PCSK6 in these tissues followed a similar pattern as corin. In contrast, furin expression was upregulated in the cardiac and renal tissues in correlation with CHF severity. We hypothesize that the obtained upregulation of cardiac and renal PCSK6/corin in rats with compensated CHF may represent a compensatory response aiming at maintaining normal Na+ balance, whereas the decline in these two enzymes may contribute to the pathogenesis of avid sodium retention, cardiac hypertrophy, and blunted atrial natriuretic peptide/brain natriuretic peptide actions in decompensated CHF.

Objective The recent coronavirus pandemic (SARS-CoV-2) has severely increased the burden on the field of oncology, leading to the implementation of new rules to overcome its negative impact. An important issue is the psychological impact of the pandemic on already vulnerable populations, such as oncology staff, as reported by oncology associations. This study assessed the anxiety level among oncology staff during the coronavirus disease 2019 pandemic and related it to its risk factors and the effectiveness of departmental interventions that seek to provide coping methods. Methods A cross-sectional survey was administered to the oncology staff at our oncology center. Generalized anxiety disorder scale "yes-or-no" questions were used to determine secondary objectives regarding the concern of infection and the impact of a departmental intervention on overcoming distress. Results Overall, 199 participants were included in the analysis; more than 60% were women, with a median age of 34 years. More than 50% had anxiety and the most significant risk factors were parenthood and contraction of infection (P-value 0.03 and 0.02, respectively). Most responders reported an increase in the workload during the pandemic, but coping methods applied by the administration had improved anxiety levels as reported by a majority of the responders. Conclusion Oncology staff members have been negatively affected by the pandemic, although coping methods helped to improve anxiety. In the future, attention must be focused on the most vulnerable groups.

We present an 85-year-old male patient with persistent irritative symptoms and recurrent bladder stones after being treated twice with cystolitholapaxy. The patient had a history of left inguinal hernia, repaired 24 years ago. The provisional diagnosis was recurrent stones due to a bladder outlet obstruction, and imaging revealed possible stones inside a bladder diverticulum. We did not expect the stones to be a complication of synthetic mesh, and eventually the stones failed to be crushed by mechanical lithotriptor. The patient was explored, the stones were removed, and we found the mesh penetrating the left wall of urinary bladder (UB) with dense adhesion to the left pelvic wall. For a radical cure, the mesh with part of the UB wall had to be removed and repaired, but in view of this unexpected event, the patient required general after spinal anesthesia. The postoperative procedure passed uneventfully.

Introduction Nephrotic syndrome (NS) usually responds to steroid therapy; however, the majority of children relapse, resulting in prolonged and repeated courses of steroid therapy. Vitamin D is a vital component of bone metabolism and calcium homeostasis. Maintenance of adequate levels of vitamin D is recommended to maintain good bone health and other organ systems of NS patients. The study aimed to assess serum 25 (OH) D levels in children with NS, compare its level with healthy age and sex-matched controls and compare its level in different types of NS. Patients and Methods It was a cross-sectional study for measuring 25(OH) D levels in 60 patients with NS and 60 apparently healthy children, to be compared as controls. Nephrotic patients were classified as steroid sensitive (20 cases) steroid dependent (20cases), and steroid resistant (20 cases). Serum 25-hydroxyvitamin [25(OH) D] was measured using Enzyme Linked Immune Sorbent Assay (ELISA) technique. Results Serum 25(OH) D was significantly lower in NS patients than control group (p

Introduction Urinary tract infection (UTI) is the second most common bacterial infection in children. Aim of the study To estimate the value of urinary Interleukin-6 (IL-6) in diagnosis of UTI in children and also if it can differentiate between upper and lower UTI. Patients and Methods This study included 80 children, divided into 40 patients suffering from UTI and 40 healthy children served as a control group. Patients were classified into acute pyelonephritis (n=22) and lower UTI (n=18). Urine IL-6 was measured by enzyme-linked immune- sorbent assay (ELISA) technique. Results Urinary IL-6 was significantly higher in patients with UTI than control group (p value

Self-inserted urethral foreign bodies (FBs) are rare. Neither reported case was the self-inflicted FB due to a lack of financial resources nor was either case complicated by Fournier's gangrene. We present a 54-year-old male who inserted a household pipe to relieve his urine retention. Unfortunately, the FB became stuck inside, perforated the urethra, and required perineal exploration. After it was removed, the urethra was closed over a 16F urethral catheter. The wound was complicated by severe infection and resulting Fournier's gangrene. This required an additional surgery for debridement and urine diversion. Retrospectively, it would have been better if the urethra had been left open with SP tube only. We are sharing a clinical lesson learned by the practicing urologist and surgeons. Conclusively, self-inserted FBs in the urethra may lead to a series of complications. Patients with limited financial resources need more attention and care because they may hurt themselves unintentionally.

Objective To evaluate the efficacy of shockwave therapy versus ultrasound-guided steroid injection in the treatment of chronic supraspinatus tendinopathy. Patients and methods This study was carried out on 30 patients with calcific and noncalcific supraspinatus tendinopathy for more than 3 months. A clinical assessment was performed for all patients including pain scoring by the visual analog scale and full shoulder examination at the start of the study and 6 weeks later. Shoulder ultrasound was performed at the start of the study. Fifteen patients received four sessions of radial shockwave therapy (Intelect Radial Shockwave, UK) 3 bar pressure, 2000 pulses, 20 Hz. Fifteen patients received a single ultrasound-guided subacromial steroid injection (1 ml triamcinolone 40 mg and 1 ml lidocaine). Results Both groups showed a statistically significant improvement in pain relief (visual analog scale) and clinical examination: tenderness, shoulder range of motion, and muscle power. There was no statistically significant difference between both groups. Conclusion Radial shockwave therapy has no additional benefit over ultrasound-guided steroid injection in the short term in patients with chronic supraspinatus tendinopathy.

Breast cancer is one of the most prevalent cancer types with a high mortality rate in women worldwide. This devastating cancer still represents a worldwide public health concern in terms of high morbidity and mortality rates. The diagnosis of breast abnormalities is challenging due to different types of tissues and textural variations in intensity. Hence, developing an accurate computer-aided system (CAD) is very important to distinguish normal from abnormal tissues and define the abnormal tissues as benign or malignant. The present study aims to enhance the accuracy of CAD systems and to reduce its computational complexity. This paper proposes a method for extracting a set of statistical features based on curvelet and wavelet sub-bands. Then the binary grey wolf optimizer (BGWO) is used as a feature selection technique aiming to choose the best set of features giving high performance. Using public dataset, Digital Database for Screening Mammography (DDSM), different experiments have been performed with and without using the BGWO algorithm. The random forest classifier with 10-fold cross-validation is used to achieve the classification task to evaluate the selected set of features&rsquo, capability. The obtained results showed that when the BGWO algorithm is used as a feature selection technique, only 30.7% of the total features can be used to detect whether a mammogram image is normal or abnormal with ROC area reaching 1.0 when the fusion of both curvelet and wavelet features were used. In addition, in case of diagnosing the mammogram images as benign or malignant, the results showed that using BGWO algorithm as a feature selection technique, only 38.5% of the total features can be used to do so with high ROC area result at 0.871.

Our work here is to propose a novel technique by which chaos complete and phase synchronizations can be accomplished via a low-cost scheme. We call the proposed technique a &ldquo, single-state feedback track synchronization control algorithm&rdquo, A single-state feedback track synchronization control algorithm is designed so that both complete and phase synchronizations can be accomplished using the same controller. Complete synchronization between two chaotic systems means complete symmetry between them, but phase synchronization means complete symmetry with a phase shift. In addition, the proposed method is applied to the synchronization of two identical chaotic Lorenz models. The effectiveness and robustness of the proposed algorithm is well illustrated via exhaustive numerical simulation experiments based on the Matlab toolbox of the powerful genetic algorithm. The robustness of the proposed algorithm motivated us to apply this method of synchronization in a secure communication application.

Distributed systems provide smart functionality to everyday objects with the help of wireless sensors using the internet. Since the last decade, the industry is struggling to develop efficient and intelligent protocols to integrate a huge number of smart objects in distributed computing environments. However, the main challenge for smart and distributed system designers lies in the integration of a large number of heterogeneous components for faster, cheaper, and more efficient functionalities. To deal with this issue, practitioners are using edge computing along with server and desktop technology for the development of smart applications by using Service-Oriented Architecture (SOA) where every smart object offers its functionality as a service, enabling other objects to interact with them dynamically. In order to make such a system, researchers have considered context-awareness and Quality of Service (QoS) attributes of device services. However, context modeling is a complicated task since it could include everything around the applications. Moreover, it is also important to consider non-functional interactions that may have an impact on the behavior of the complete system. In this regard, various research dimensions are explored. However, rich context-aware modeling, QoS, user priorities, grouping, and value type direction along with uncertainty are not considered properly while modeling of incomplete or partial domain knowledge during ontology engineering, resulting in low accuracy of results. In this paper, we present a semantic and logic-based formal framework (hybrid) to find the best service among many candidate services by considering the limitations of existing frameworks. Experimental results of the proposed framework show the improvement of the discovered results.

Cytolethal distending toxin (CDT) is a heterotrimeric AB-type genotoxin produced by several clinically important bacterial pathogens. To better understand the risk of CDT within the food supply and human gastroenteritis patients in Qatar, we investigated the frequency of the CDT gene (cdtB) among Escherichia coli (E. coli) strains recovered from food products, animal livestock, and human gastroenteritis patients. In this cross-sectional study, E. coli isolates were screened for cdtB using polymerase chain reaction (PCR). cdtB positive strains were further examined for E. coli cdtB gene types (cdt I, cdt II, cdt III, cdt IV and cdtV), serotypes O157: H7, and non-O157 Shiga toxin-producing E. coli O26, O45, O103, O111, O121, and O145. Screening for other virulent factors, stx (Shiga toxin gene) and eae (gene that encodes intimin) genes were also performed. The cdtB gene was detected in E. coli isolates sourced from all three groups; animal livestock (17%), retail foods (8%), and human gastroenteritis patients (3%). Although the incidence of cdtB gene harboring E. coli is relatively low among gastroenteritis patients, there is still a risk of infection from animal reservoirs as well as retail food products. Among the three groups, E. coli isolates from humans had the lowest occurrence of cdtB, stx, eae, and O157: H7. Furthermore, we advise implementing monitoring at the food production and preparation level.

In this paper, a generalized algorithm to develop a class of approximating binary subdivision schemes is presented. The proposed algorithm is based on three-point approximating binary and four-point interpolating binary subdivision schemes. It contains a parameter which classifies members of the new class of subdivision schemes. A set of efficient properties, for instance, polynomial generation and reproduction, support, continuity, and Hölder continuity, is discussed. Moreover, applications of the proposed subdivision schemes are given in order to demonstrate their variety, flexibility, and visual performance.

Dermatophytosis is a contagious fungal disease among animal communities. The major concerns of dermatophytosis are cost of treatment, difficulty of control, and the public health consequences. The objective of the present study was to compare the clinical efficacy of Sumaq and Neem extract cream with that of traditional treatments, eniloconazole and glycerine iodine, on dermatophytosis in Arabian horses. For this purpose, 37 Arabian horses with dermatophytosis had been used. Fungal isolation and identification for each horse were carried out by standard microbiological procedures. Sumaq (Rhus coriaria Linn.) and Neem (Azadirachta indica) seed extracts were selected based on in vitro effectiveness. Horses were randomly allocated into four groups. The first group (n = 8) was treated with glycerine iodine 10% daily for 7 days. The second group (n = 10) was treated using eniloconazole 10% emulsified concentrate four times with 2 days interval. The third group (n = 11) was treated with Neem seeds extract (20% cream) daily for 10 days, and the fourth group (n = 8) was treated with Sumaq extract (5% cream) daily for 10 days. Clinical and mycological evaluations were assessed at 0, 7, 14, 21, and 28 days post-treatment. The Sumaq and eniloconazole were more effective on clinical index score after 7 days of treatment followed by Neem seed 20% cream. At 28 days post-treatment, a complete healing was obtained by Sumaq 5% cream and eniloconazole (median clinical sum score = zero) followed by Neem (median clinical sum score = 1.5). Moreover, Dermatophytes spp. was isolated only from two horses, one from Neem group and the other from glycerin iodine group. The present results indicate that Sumaq 5% and Neem seed extract are effective alternative treatment for dermatophytosis in Arabian horses.

A new public authenticated encryption scheme based on chaotic maps and factoring problems is proposed. The chaos-based cryptosystem offers an encryption scheme with several advantages including sec...

Congestive heart failure (CHF) often leads to progressive cardiac hypertrophy and salt/water retention as evident by peripheral and lung edema. Although the pathogenesis of CHF remains largely unclarified, it is widely accepted that neurohormonal changes and inflammatory processes are profoundly involved in structural and functional deterioration of vital organs including, heart, kidney and lungs. Corin, a cardiac serine protease, is responsible for converting pro-ANP and pro-BNP to biologically active natriuretic peptides (NPs). Although the involvement of corin in cardiac hypertrophy and heart failure was extensively studied, the alterations in corin and PCSK6, a key enzyme in the conversion of procorin to corin, have not been studied in the pulmonary tissue. Thus, this study aims at examining the status of PCSK6/Corin in the lung of rats with CHF induced by the creation of aorto-caval fistula (ACF) between the abdominal aorta and vena cava in SD rats. Rats with ACF were divided into 2 subgroups based on the pattern of their daily sodium excretion, compensated and decompensated CHF. Placement of ACF led to cardiac hypertrophy, pulmonary congestion, and renal dysfunction, which were more severe in the decompensated subgroup, despite remarkable elevation of circulatory ANP and BNP levels. Corin mRNA and immunoreactive peptide were detected in pulmonary tissue of all experimental groups. However, the expression and abundance of pulmonary corin significantly increased in the decompensated animals, but not in the compensated ones. Noteworthy, the expression of PCSK6 and ANP/BNP in the pulmonary tissue followed a similar pattern as corin. The upregulation of pulmonary Corin/PCSK6 and NPs were accompanied by local activation of cathepsin L and certain cytokines including IL-6. In light of the anti-inflammatory role of NPs, we postulate that the obtained upregulation of pulmonary PCSK6/Corin along NPs in rats with decompensated CHF may represent a counterbalance response to the inflammatory milieu characterizing CHF especially in severe cases.

Background/Purpose Nephrotic syndrome is the commonest etiology of proteinuria in children. Steroid-resistant nephrotic syndrome (SRNS) is defined by resistance to standard steroid therapy, and it continues to be one of the most intractable etiologies of renal failure. Molecular studies discovered specialized molecules in podocytes that play a role in proteinuria. Mutations in NPHS2 that encodes for podocin constitute a frequent cause of SRNS worldwide. This study aimed to screen for podocin mutations in SRNS Egyptian children and their parents. Methods Our study included patients from 10 unrelated Egyptian families diagnosed with SRNS. Mutational analysis of the NPHS2 gene was performed by polymerase chain reaction amplification of the whole coding region of the gene and direct sequencing. Results Positive consanguinity was detected in five cases, and four of them had a positive family history of SRNS in a family member. Mutational analysis of NPHS2 revealed pathogenic mutations in four cases (40%) including a novel missense in one patient (c.1A>T; p.M1L). Conclusion Our study concludes that mutations of NPHS2 gene are common among Egyptian children with SRNS. We support a model where ethnicity plays an important role in specific NPHS2 mutations, since a novel mutation was found in one patient in this study. Future study on a large number of Egyptian patients with SRNS is warranted to identify the actual genetic contribution of this gene in the development of SRNS in our population, which might help in patients' prognosis and management.

Acute kidney injury (AKI) in the newborn is a common problem in the neonatal intensive care unit with many underlying factors such as asphyxia, respiratory distress syndrome (RDS), and urogenital anomalies. The aim of this study is to highlight possible risk factors and profile of neonates developing AKI in the Neonatal Intensive Care Unit (NICU) of Cairo University Pediatric Hospital. The study was carried out on 90 neonates (30 patients and 60 controls), among neonates admitted to NICU. The study was done over two months, from January 2015 to March 2015. Our study showed that sepsis was detected in 53.3%, prematurity in 46.67%, RDS in 43.3%, congenital heart disease in 20%, and hypoxic-ischemic encephalopathy in 6.67% of patients. Maternal illness and low body temperature were both significant risk factors of AKI in neonates. History of maternal illness, low body temperature, sepsis, prematurity, and respiratory distress can contribute to the development of AKI in neonates.

BACKGROUND/PURPOSE: B-cell-chronic lymphocytic leukemia (B-CLL) is the most common leukemia in the Western world and shows a remarkable heterogeneity in the clinical course. Understanding the genetic basis of B-cell-CLL may help in clarifying the molecular bases of this clinical heterogeneity. Recurrent chromosomal aberrations at 13q14, 12q15, 11q22-q23 and 17p13, and TP53 mutations are the first genetic lesions identified as drivers of the disease. While some of these lesions are associated with poor outcome (17p13 deletion, TP53 mutations and to a lesser extent, 11q22-q23 deletion), others are linked to a favorable course (13q14 deletion as sole aberration). This study evaluates the frequency of each chromosomal abnormality using fluorescence in situ hybridization (FISH) Panel at our institution with comparison to other international studies. MATERIALS AND METHODS: We reviewed 147 peripheral blood and bone marrow samples which represent all B-cell-CLL cases diagnosed at our hospital from 2012 to 2016 by morphology and flow cytometry immunophenotyping followed by specific B-cell-CLL-FISH panel including MDM2/Cen12 for Trisomy 12, 13q14 (D13S319)/13q34 deletion, ATM (11q22.3) deletion, P53(17p13.1) deletion, and CCND1/IGH translocation (11;14). RESULTS: Between 2012 and 2016, a total of 147 B-cell-CLL patients were investigated using B-cell-CLL-FISH panel at our institution King Faisal Specialist Hospital and Research Center-Riyadh, Kingdom of Saudi Arabia, with age ranging between 36 and 89 years and a median age of 62 years. The majority of the patients with the abnormal FISH pattern, 70% (73/105), had a single abnormality with the remaining 30% (32/105) showed more than one genetic abnormality including two cases where all five probes were positive. CONCLUSION: The heterogeneous clinical course of B-CLL is likely explained by underlying molecular prognostic factors including data from FISH probes. Moving forward, analyzing these factors at diagnosis is recommended for better prognostication and outcome of the disease.

In this work, we present another chaotic (or hyperchaotic) complex nonlinear framework. This chaotic (or hyperchaotic) complex framework can be considered as a speculation of ”Guan” framework [1]. The new framework is a 5-dimensional nonstop real independent chaotic (or hyperchaotic) framework. The fundamental properties and elements of our framework are examined. Once with the all parameters are real and the other with one of these parameters is a complex parameter. When we examine the dynamics of the new framework and the parameters in real form, the conduct of the new framework is chaotic. While when one of these parameters is complex, our new framework is hyperchaotic. On the premise of Lyapunov capacity and dynamic control method, a scheme is designed to accomplish the complex anti-synchronization of two identical chaotic (or hyperchaotic) attractors of these frameworks. The effectiveness of the acquired outcomes will be delineated by a simulation case. Numerical outcomes are schemed to indicate state variables and errors of these chaotic attractors after synchronization to show that synchronization is accomplished. The above outcomes will give hypothetical establishment to the secure communication applications in light of the proposed scheme. In this secure communication scheme, synchronization between transmitter and receiver is accomplished and message signals will be recuperated. The encryption and rebuilding of the signals will be simulated numerically.

The manuscript analyzes fractional order chaotic cryptovirology in blockchain using various methods in dynamics such as Lyapunov exponents, stagnation points, symmetry, bifurcation diagrams etc. The internet is the most powerful tool that has changed every aspect of living. But this internet has also become primary medium of cyber-crime. The dynamics of the modeled system for variable fractional order between 0.8 to 1 is also observed. The chaos in the studied dynamical system is controlled about its two stagnation points using SMC controllers assuming uncertainties and disturbances.

In this paper, we will demonstrate the adaptive complex anti-lag synchronization (CALS) of two indistinguishable complex chaotic nonlinear systems with the parameters which are uncertain. The significance of CALS is not advised well in the literature yet. The CALS contains or consolidate two sorts of synchronizations (anti-lag synchronization ALS and lag synchronization LS). The state variable of the master system synchronizes with an alternate state variable of the slave system. Depending on the function of Lyapunov, a plan is orchestrated to achieve CALS of chaotic attractors of complex systems with unverifiable parameters. CALS of two indistinguishable complexes of Lü systems is viewed as, for example, an occasion for affirming the likelihood of the plan exhibited. In physics, we can see complex chaotic systems in numerous different applications, for example, applied sciences or engineering. With a specific end goal to affirm the proposed synchronization plan viability and demonstrate the hypothetical outcomes, we can compute the numerical simulation.The above outcomes will give the hypothetical establishment to the secure communication applications. CALS of complex chaotic systems in which a state variable of the master system synchronizes with an alternate state variable of the slave system is an encouraging sort of synchronization as it contributes excellent security in secure communication. Amid this secure communication, the synchronization between transmitter and collector is shut and message signals are recouped. The encryption and restoration of the signals are simulated numerically. Keywords: Complex anti-lag synchronization, Chaotic system, Synchronization, Uncertain, Error function, Lyapunov function, Complex

In this paper, we review the complicated (or complex) lag (or slack) synchronization (CLS) of coupled complex chaotic nonlinear structures with unknown parameters. In spite of its unusual properties, the significance of CLS is yet to be fully demonstrated in the literature. Using a Lyapunov function, an adaptive (or versatile) controller is developed to synchronize coupled, generally unknown chaotic complex structures. This enables the uncertain parameters of the structures to be evaluated. The CLS of indistinguishable twin complex Lü structures is recognized as a simulation pattern. A number of results demonstrate the state characteristics, modulus errors, and phase errors for these chaotic attractors following the onset of CLS, thus verifying the theoretical derivations. CLS is an encouraging phenomenon, as the synchronization between the state characteristics of the principal structure and those of the slave structure enable excellent communication security. Numerical simulations of secure communications demonstrate the transmission of an encrypted message and an image signal. Keywords: Complex lag synchronization, Chaotic structures, Unknown, Secure communications, Lyapunov function, Complex

Background Familial Mediterranean fever (FMF) is suggested to be associated with increased risk of atherosclerosis. Epicardial adipose tissue (EAT) thickness is used in prediction of atherosclerotic risk. The aim of our study was to evaluate EAT thickness in FMF patients for early detection of risk of atherosclerosis and to be compared with its level in healthy controls. Methods Thirty 6- to 18-year-old children with FMF and 30 age- and sex-matched children (control group) were included in the study. Disease characteristics, disease severity and Mediterranean fever gene mutations were recorded. EAT thicknesses was measured by echocardiography. Results EAT in patients’ group was significantly greater than that of controls (5.21 ± 2.3 vs. 2.81 ± 2.96 mm, p = 0.001) and was correlated with cholesterol level and platelets count (p = 0.047 and 0.018, respectively). Conclusion This study concluded that EAT thickness was statistically increased in FMF patients than controls with a positive correlation with cholesterol level and platelet count. This finding suggests a higher risk for atherosclerosis in these patients. Follow-up study is needed to verify the effect of treatment of FMF on the EAT thickness. Further studies with larger number of patients following-up EAT are needed to verify this finding.

Significant tricuspid regurgitation (TR) is associated with higher risk for adverse cardiovascular outcomes. Left-sided heart disease (LHD) is a potentially important confounder of this association because it is strongly linked to both TR and clinical outcome.We studied 5,886 patients who were followed for a period of 10 years after the index echocardiographic examination. The relationship between TR severity and the end point of admission for heart failure or cardiovascular mortality was analyzed using competing risk analysis, Cox model, and propensity score matching.Higher TR grade was associated with markers of LHD including left ventricular systolic dysfunction, valvular heart disease ≥ moderate, left atrial enlargement, and pulmonary hypertension (all P .001). There was a significant interaction between TR and the presence of LHD with regard to the end point of heart failure in the competing risks model (P = .01) and the combined end point of heart failure and cardiovascular mortality (P = .02). In both models, moderate/severe TR was associated with higher risk for heart failure (hazard ratio [HR] = 3.10; 95% CI, 1.41-6.84; P = .005) and the combined end point of heart failure or cardiovascular mortality (HR = 2.75; 95% CI, 1.33-5.63, P = .006) only in patients without LHD. Propensity score matching yielded 350 patient pairs, of which 88% had LHD. The HR for heart failure or cardiovascular mortality at 10 years was 0.78 (95% CI, 0.56-1.08; P = .14) in the moderate/severe TR group as compared with the trivial/mild TR.Moderate or severe functional TR portends an increased risk for heart failure and cardiovascular mortality only when isolated, without concomitant LHD.

The increased number of Arab users on microblogging services who use Arabic language to write and read has triggered several researchers to study the posted data and discover the user’s opinion and feelings to support decision making. In this paper, a sentiment analysis framework is presented for slang Arabic text. A new dataset with Jordanian dialect is presented. Numerous specific Arabic features are shown with their impact on slang Arabic Tweets. The new set of features consists of lexicon, writing style, grammatical and emotional features. Several experiments are conducted to test the performance of the proposed scheme. The new proposed scheme produces better results in comparison with others. The experiments show that the system performs well without translating the tweets to English or standard Arabic.

The article introduces the fractional modified Sprott A chaotic system with its thorough dynamical analysis such as solution of system, Lyapunov dynamics, route to chaos etc. Penta-compound combination anti-synchronization is introduced and applied on twelve chaotic systems of fractional order using adaptive SMC. The system is also controlled about a randomly chosen point and The synchronization technique is illustrated as application to secure communication. The simulations are performed using MATLAB software.

Even though many security schemes proposed for wireless sensor networks protect transmitted data content from being revealed to different types of attacks and fulfill most of the desired security requirements, they are not addressing concealing the privacy of the contextual information. Contextual information such as event occurrence, event time, and event location can be exposed to an adversary by just monitoring network packet transmission. This kind of information is very important because it can leak location information of key nodes or even detected events themselves. Therefore, proposing a contextual unobservability scheme is a challenging task in sensor networks considering many issues: the broadcast nature of the wireless channel, the different attacker models, the network resource constraints, and the overhead on system performance. Most of the existing location privacy schemes are not addressing all these issues and are either not efficient against global adversaries or degrade significantly network performance. Thus in this paper, we propose an efficient location contextual anonymity scheme for Wireless Multimedia Sensor Network (WMSN) that exploits the cross-layer joint design among the application, routing, and MAC layers. Our proposed location unobservability scheme combines the source coding technique, probabilistic packet transmission, multipath routing, and priority-based dropping policy to enhance the efficiency level of the provided privacy service without noticeably affecting the Quality of Service (QoS) requirement for delivering multimedia content in WMSN. Performance evaluation results show that our proposed privacy mechanism outperforms other proposed location privacy techniques in terms of privacy efficiency (safety period) and network performance (end-to-end delay and energy consumption).

BackgroundSickle cell disease (SCD) is a genetic disorder that results in deformity of red blood cells. Renal dysfunction affects 5–18% of patients with SCD. To date, few studies have described urinary levels of transforming growth factor β-1 (TGF-β1), which is a marker of fibrosis, as a biomarker in identifying patients at risk of developing renal disease in SCD. The aim of this study is to determine prevalence of sickle cell nephropathy in Egyptian SCD patients. We aimed also to evaluate the association of urinary TGF-β1 with other conventional biomarkers of renal damage in SCD patients to identify a novel renal biomarker for early diagnosis of sickle nephropathy.MethodsWe examined 40 SCD patients, 21 with sickle cell anemia, 16 sickle thalassemia, and three with sickle trait. We compared them to 20 control children with matched age and sex. The study was held in the time period between May 2013 and December 2013 in the Hematology Clinic, New Cairo University Children Hospital, Cairo, Egypt.ResultsUrinary excretion of TGF-β1 was 7.07 ± 1.91 ng/mL in SCD patients versus 2.23 ± 0.76 ng/mL in control children (p < 0.001). SCD patients had elevated estimated glomerular filtration rate (177.44 ± 35.6 mL/min/1.73 m2), denoting a state of glomerular hyperfiltration. 47.5% of SCD patients had microalbuminuria. Urinary TGF-β1 correlated positively with microalbuminuria and estimated glomerular filtration rate (p = 0.001 and p = 0.018, respectively).ConclusionWe concluded that urinary TGF-β1 may serve as a marker of early renal injury in SCD.

Patient: Female, 19 Final Diagnosis: Erdheim-Chester disease Symptoms: Exophthalmos, orthopnea Medication: Prednisolone • azathioprine Clinical Procedure: — Specialty: Internal Medicine Objective: Unknown ethiology Background: Erdheim-Chester disease is a rare non-Langerhans-cell histiocytosis of unknown etiology with multi-organ involvement. Case Report: A 19-year-old woman presented with orthopnea, severe fatigue, bilateral exophthalmos, and gradual loss of vision. She had anemia and mild leucocytosis related to chronic illness. Marked left side pleural effusion and massive pericardial effusion with bilateral hydronephrosis were detected by plain X-ray, echocardiography, and computed tomography, respectively. Retro-orbital tissue and bone marrow biopsy revealed histiocytic infiltration, which was CD68-positive and CD1a-negative. Conclusions: This report describes the first case presentation of Erdheim-Chester disease in our country. This case report may advance our understanding of an orphan disease. Our patient’s young age and stable clinical status may allow long-term follow-up of treatment results.

The objective of the present study was to verify the prevalence and the risk factors associated with dermatophytosis in Arabian horses. For this purpose, a total of 457 Arabian horses in 15 farms were examined. A questionnaire was constructed to include the hypothesized risk factors. Fungal isolation and identification for each horse were carried out by standard microbiological procedures. Logistic regression analysis was used to evaluate the risk factors on both animal and farm levels. Trichophyton spp. was recovered from 50 horses and Microsporum spp. from 27 cases. Trichophyton equinum was more prevalent than Trichophyton mentagrophytes (45 vs. 4) and Trichophyton tonsurans (45 vs. 1). However, Microsporum canis was more prevalent than Microsporum gypseum (21 vs. 5) and Microsporum audouinii (21 vs. 1). On horse level, final multivariate logistic regression analysis showed that there was a significant association between dermatophytosis and horse' age (P 30 horses was the risk factor (P < .05; OR: 1.0; 95% CI: 1–3.03). In conclusion, the present results indicate existance of dermatophytosis in Arabian horses. Identification of the potential risk factors associated with the disease may be helpful to construct the ideal preventive measures.

This paper discusses the sequential estimation of the scale parameter of the Rayleigh distribution using the three-stage sequential sampling procedure proposed by Hall (Ann. Stat.1981, 9, 1229&ndash, 1238). Both point and confidence interval estimation are considered via a unified optimal decision framework, which enables one to make the maximum use of the available data and, at the same time, reduces the number of sampling operations by using bulk samples. The asymptotic characteristics of the proposed sampling procedure are fully discussed for both point and confidence interval estimation. Since the results are asymptotic, Monte Carlo simulation studies are conducted to provide the feel of small, moderate, and large sample size performance in typical situations using the Microsoft Developer Studio software. The procedure enjoys several interesting asymptotic characteristics illustrated by the asymptotic results and supported by simulation.

The thiazolidinedione (TZD) class of Peroxisome proliferator‐activated receptor gamma agonists has restricted clinical use for diabetes mellitus due to fluid retention and potential cardiovascular risks. These side effects are attributed in part to direct salt‐retaining effect of TZDs at the renal collecting duct. A recent study from our group revealed that prolonged rosiglitazone (RGZ) treatment caused no Na+/H2O retention or up‐regulation of Na+ transport‐linked channels/transporters in experimental congestive heart failure (CHF) induced by surgical aorto‐caval fistula (ACF). The present study examines the effects of RGZ on renal and cardiac responses to atrial natriuretic peptide (ANP), Acetylcholine (Ach) and S‐Nitroso‐N‐acetylpenicillamine (SNAP‐NO donor). Furthermore, we assessed the impact of RGZ on gene expression related to the ANP signalling pathway in animals with ACF. Rats subjected to ACF (or sham) were treated with either RGZ (30 mg/kg/day) or vehicle for 4 weeks. Cardiac chambers pressures and volumes were assessed invasively via Miller catheter. Kidney excretory and renal hemodynamic in response to ANP, Ach and SNAP were examined. Renal clearance along with cyclic guanosine monophosphate (cGMP), gene expression of renal CHF‐related genes and ANP signalling in the kidney were determined. RGZ‐treated CHF rats exhibited significant improvement in the natriuretic responses to ANP infusion. This ‘sensitization’ to ANP was not associated with increases in neither urinary cGMP nor in vitro cGMP production. However, RGZ caused down‐regulation of several genes in the renal cortex (Ace, Nos3 and Npr1) and up‐regulation of ACE2, Agtrla, Mme and Cftr along down‐regulation of Avpr2, Npr1,2, Nos3 and Pde3 in the medulla. In conclusion, CHF+RGZ rats exhibited significant enhancement in the natriuretic responses to ANP infusion, which are known to be blunted in CHF. This ‘sensitization’ to ANP is independent of cGMP signalling, yet may involve post‐cGMP signalling target genes such as ACE2, CFTR and V2 receptor. The possibility that TZD treatment in uncomplicated CHF may be less detrimental than thought before deserves additional investigations.

Background Congestive heart failure (CHF) entails a complex interaction between the heart and the kidney that represents a clinical entity called cardiorenal syndrome (CRS). One of the mechanisms underlying CRS includes increased intra-abdominal pressure (IAP). We examined the effect of elevated IAP on kidney function in rats with low- and high-output CHF. Methods and Results Rats with compensated and decompensated CHF induced by means of aortocaval fistula, rats with myocardial infraction (MI) induced by means of left anterior descending artery ligation, and sham control rats were subjected to either 10 or 14 mm Hg IAP. Urine flow (V), Na+ excretion (UNaV), glomerular filtration rate (GFR), and renal plasma flow (RPF) were determined. The effects of pretreatment with tadalafil (10 mg/kg orally for 4 days) on the adverse renal effects of IAP were examined in decompensated CHF and MI. Basal V and GFR were significantly lower in rats with decompensated CHF compared with sham control rats. Decompensated CHF rats and MI rats subjected to 10 and 14 mm Hg IAP exhibited more significant declines in V, UNaV, GFR and RPF than compensated and sham controls. Elevated IAP also induced tubular injury, as evidenced by significantly increased absolute urinary excretion of neutrophil gelatinase–associated lipocalin. In addition, in a nonquantitative histologic analysis, elevated IAP was associated with increase in necrosis and cell shedding to the tubule lumens, especially in the decompensated CHF subgroup. Pretreatment of decompensated CHF rats and MI rats with tadalafil ameliorated the adverse renal effects of high IAP. Conclusions Elevated IAP contributes to kidney dysfunction in high– and low–cardiac output CHF. IAP induces both hemodynamic alterations and renal tubular dysfunction. These deleterious effects are potentially reversible and can be ameliorated with the use of phosphodiesterase-5 inhibition.