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In this paper, we provide a sparse image restoration algorithm with a SSIM-based objective function. The proposed technique is a modification to the SSIM-inspired OMP (iOMP) and, and it has two parallel sparse restoration paths. One of them is L 2 -sense OMP and the other is SSIM -sense OMP (iOMP). Both paths intersects only at the starting point and gives different quality levels after each iteration. This distinction enables us to select the coefficients of the best quality and to avoid the uncertainty issue of iOMP. From the point of view of the SSIM levels, the conducted experiments proved that, the proposed methodology works better than iOMP and OMP. Also, the performance of this method is checked for significance by the t-test, and the obtained results proved that the method works well especially for large images and the data-independent based dictionary.

The world has been concerned and worried about the depletion of the liquid oil fuel, besides new environmental rules are to be followed to reduce pollution hazards and global warming. The utilization of natural gas (as a near term fuel) and hydrogen (as long-term fuel) are receiving great attention, because they have less pollution effects. Since the aviation has a great deal in environmental pollution effects due to the cruise flight in the upper troposphere (supersonic aircraft) or in the lower stratosphere (subsonic aircraft) where most of the ozone concentrate, which helps in protecting the earth form ultra violet radiation. Therefore, the use of alternate fuel has a great attention in aviation. In the present study, the thrust specific fuel consumption and specific thrust for the aircraft during aircraft flight profile are predicted, when using aviation fuel and natural gas. The P&W JT9D –7R-turbofan jet engine is taken as a base line engine propelling the Boeing 747-200 aircraft as a base line aircraft with four engine nacelles mounted on wings. The model engine fuel-air cycle representation is carried out for design point calculations based on sea level static conditions and variable specific heats along engine components. The predicted engine performance results compared very well with the reported values by the manufacture. Predictions carried out using aviation fuel and natural gas show an increase in the specific thrust by 3% and decrease in the thrust specific fuel consumption by 14% and fuel to air ratio by 11%, when using natural gas.

Objective: This clinical trial evaluates the effect of erbium, chromium:yttrium–scandium–gallium–garnet (Er,Cr:YSGG) root surface biomodification and laser harvesting of de-epithelialized gingival ...

Background Therapeutic interventions for hepatocellular carcinoma (HCC) particularly in patients with advanced liver disease may lead to more aggravation of clinical and biochemical parameters of liver functions. We aimed to assess the utilization of easily applied variables which evaluate residual hepatic reserve to predict liability for complications and hepatic decompensation in cirrhotic patients with ablated HCC particularly when these patients were exposed to specific medical treatment such as DAAs and systemic therapy for HCC such as sorafenib. This study included 3 groups with HCC. Group 1: patients with ablated HCC and Child-Turcotte-Pugh (CTP) class A, who received Sofosbuvir (SOF)-based treatment (n = 250), group 2: HCC patients CTP (A), managed with sorafenib after transarterial chemoembolization (TACE) (n = 250) and group 3 as a control group of non-cirrhotic patients (n = 176). Evaluation for all patients was done by routine laboratory investigations including liver and kidney functions, complete blood count, platelet indices and plasma ammonia, upper gastrointestinal (GI) endoscopy and estimation of liver volume by ultrasound and liver stiffness (LS) by Fibroscan. Results Unfavorable outcome and increased incidence of complications during DAAs were independently associated with severity of thrombocytopenia (p = 0.001) at a cut-off 78,000/μl, LS > 20 kPa (p = 0.001), liver volume < 500 ml (p = 0.002), and gamma globulin levels > 4 gm/dl (p = 0.004). In the sorafenib group, unfavorable outcome and complications were independently associated with PDW/MPV ratio > 2.74 (p = 0.001), level of ammonia > 87 μg/dl (p = 0.001), LS > 25 kPa (p = 0.001), and liver volume < 490 ml (p = 0.001). Conclusion Non-invasive parameters of residual hepatic reserve are promising tools to guide therapy and avoid further complications in patients with liver cirrhosis and ablated HCC.

Background: Direct-acting antiviral agents therapy is considered a breakthrough in hepatology due to high rates of sustained virologic response in all patients including those with decompensated cirrhosis. However, impact of Direct-acting antiviral agents-induced sustained virologic response on hepatocellular carcinoma development remains conflicting. Aims: This study aimed at evaluating the change in circulating levels of vascular endothelial growth factor and transforming growth factor-β1, the main angiogenic factors involved in hepatocarcinogenesis process, in cirrhotic patients achieved sustained virologic response after Direct-acting antiviral agents therapy. Study Design: This was a prospective, single-center, cohort study. Place and Duration of Study: Patients were recruited from the outpatient clinic of National Liver Institute, which considered a tertiary referral center in Menoufia University, Egypt (September 2018 to February 2019). Methodology: Forty-five decompensated cirrhotic hepatitis C virus infected patients with no history of hepatocellular carcinoma participated in the study. All patients received 60mg oral daclatasvir and 400mg oral sofosbuvir once daily for 12 or 24 weeks with or without ribavirin. Serum levels of vascular endothelial growth factor and transforming growth factor-β1 were measured at baseline and 12 weeks after the end of therapy. Results: The median serum levels of vascular endothelial growth factor showed a non-statistically significant increase (from 1123 ng/L to 1269 ng/L, P = 0.126). But, transforming growth factor-β1 median serum levels exhibited a non-statistically significant reduction (from 13.22 ng/ml to 12.44 ng/ml, P = 0.163) 12 weeks after treatment. Conclusion: Our findings show direct-acting antiviral agents therapy do not affect vascular endothelial growth factor and transforming growth factor-β1 serum levels. But, a larger scale prospective cohort study on an extended follow-up period is recommended.

Kidney fibrosis constitutes the shared final pathway of nearly all chronic nephropathies, but biomarkers for the non-invasive assessment of kidney fibrosis are currently not available. To address this, we characterize five candidate biomarkers of kidney fibrosis: Cadherin-11 (CDH11), Sparc-related modular calcium binding protein-2 (SMOC2), Pigment epithelium-derived factor (PEDF), Matrix-Gla protein, and Thrombospondin-2. Gene expression profiles in single-cell and single-nucleus RNA-sequencing (sc/snRNA-seq) datasets from rodent models of fibrosis and human chronic kidney disease (CKD) were explored, and Luminex-based assays for each biomarker were developed. Plasma and urine biomarker levels were measured using independent prospective cohorts of CKD: the Boston Kidney Biopsy Cohort, a cohort of individuals with biopsy-confirmed semiquantitative assessment of kidney fibrosis, and the Seattle Kidney Study, a cohort of patients with common forms of CKD. Ordinal logistic regression and Cox proportional hazards regression models were used to test associations of biomarkers with interstitial fibrosis and tubular atrophy and progression to end-stage kidney disease and death, respectively. Sc/snRNA-seq data confirmed cell-specific expression of biomarker genes in fibroblasts. After multivariable adjustment, higher levels of plasma CDH11, SMOC2, and PEDF and urinary CDH11 and PEDF were significantly associated with increasing severity of interstitial fibrosis and tubular atrophy in the Boston Kidney Biopsy Cohort. In both cohorts, higher levels of plasma and urinary SMOC2 and urinary CDH11 were independently associated with progression to end-stage kidney disease. Higher levels of urinary PEDF associated with end-stage kidney disease in the Seattle Kidney Study, with a similar signal in the Boston Kidney Biopsy Cohort, although the latter narrowly missed statistical significance. Thus, we identified CDH11, SMOC2, and PEDF as promising non-invasive biomarkers of kidney fibrosis.

Background: Nowadays, care of a cataractous patient greatly exceeds surgical removal of the opacified lens. In a step foreword to welfare of the elderly, phacoemulsification can perform as a refractive tool, addressing both spherical and astigmatic refractive errors. Aim of Study: The aim of that work was to evaluate safety and effectiveness of OCCIs, as an innovative procedure for correction of corneal astigmatism, during phacoemulsification. Patients and Methods: The study assessed 64 patients, who underwent phacoemulsification. Pre-operative and post-operative corneal topography was done, documented and statistically analyzed for each patient. Results: The study revealed a decrease of pre-operative corneal astigmatism from a pre-operative mean of –1.78D to a post-operative mean of 1.09D in OCCI group and a decrease of pre-operative corneal astigmatism from a pre-operative mean of –1.71D to a postoperative mean of 1.29D in single incision group. Conclusion: The present study revealed that OCCIs with appropriate pre-operative corneal topography represent a real advance in the applications of refractive lenticular surgery. OCCIs provide an innovative technique for managing pre-operative, regular, corneal astigmatism. This is simple, easy to learn technique, with no extra instrumentation. The OCCIs in this study was safe, with no wound related complications. However, OCCIs require careful early post-operative care, due to their penetrating nature. Once the wounds are sealed, risk of further complications approaches zero. Further studies on that technique, employing different incision architecture are required to help development of nomograms correlating the incision length, width, age of the patient, and the amount of pre-operative corneal astigmatism to be corrected.

Energy building simulations are little based on their effect on the microclimate, most of software applications deal with energy consumption for appliances usage electricity for indoor spaces and neglecting the impact of the Solar Reflective Index (SRI) phenomenon for outdoor open spaces. The paper framework introduces a comprehensive simulation workflow of the built environment with the assistance of Ladybug & Honeybee and Butterfly plugins across grasshopper interface to model a shared relationship between urban microclimate, building energy usage, and thermal comfort outdoors. Two districts have been investigated in Egypt, both have different Azimuth and Latitude angle degrees to measure the impact of solar radiation on pedestrians and their outdoor thermal comfort using Mean Radiant Temperature and Universal Thermal Climate Index (UTCI). This workflow provides considerable versatility compared with other current methods and allows parametric study of multiple environment strategies both indoors and outdoors. The result describes the effect of SRI are too noticeable on the outdoor thermal comfort for the pedestrians in existing canyon, especially after defining the material specs and properties for each building. As considerably, the transpiration phenomenon is exempted along the simulation with no effect of vegetation and their humidity affect. “Strong heat stress” is the main output conclusion for both districts as categorized by UTCI stress level and the difference between the condense urban and rural areas from measuring the Mean Radiant Temperature is about 3 °C for Shaykh Zayed district and 1 °C for the Fifth Settlement district and this is due to the materials absorption and emissions for the long and short waves, respectively.

AIM To evaluate the ability of diffusion-weighted magnetic resonance imaging (DW-MRI) to differentiate between benign and malignant bony tumours. MATERIALS AND METHODS This prospective study was conducted from October, 2018 to December, 2019. The study included 62 patients (37 male and 25 female) with clinically suspected bony lesions referred to the Radiology Department. Patients underwent clinical examination, radiography, computed tomography (CT), and ultrasonography examinations. MRI studies were conducted using a 1.5-T MRI machine, and post-processing analysis was done using a Philips Extended MRI workspace workstation. RESULTS The mean apparent diffusion coefficient (ADC) value of benign lesions ranged between 0.85 × 10−3 and 2.44 × 10−3 mm2/s. The lowest ADC values were measured in a giant cell tumour and in an inclusion epidermoid cyst (0.85 × 10−3 and 0.93 × 10−3 mm2/s, respectively). The highest measurement was in bony cysts (2.44 × 10−3 mm2/s) followed by osteoid osteoma (2.2 × 10−3 mm2/s) and osteochondroma (1.85 × 10−3 mm2/s). Amongst malignant lesions, ADC values ranged from 0.42 × 10−3 to 2.4 × 10−3 mm2/s. The lowest value was measured in malignant round cell tumour Ewing's/primitive neuroectodermal tumour (PNET), and the highest was measured in conventional chondrosarcoma. Metastatic lesions were observed in 11 patients with a mean ADC value of 0.71 × 10−3 mm2/s, followed by osteosarcoma in six patients with a mean ADC value of 0.74 × 10−3 mm2/s. CONCLUSION There was a significant difference between the mean, minimum, and maximum ADC values of benign and malignant tumours. The present findings indicate that the best cut-off ADC range to predict malignancy is 0.78–0.86 × 10−3 mm2/s, with a sensitivity of 89.47%, specificity of 97.22%, and accuracy of 94.55%.

Purpose: To compare the outcomes of iStent vs. iStent inject implantation combined with phacoemulsification. Methods: This single center retrospective comparative case series included subjects with open angle glaucoma who underwent iStent or iStent inject implantation combined with phacoemulsification with ≥1 year follow-up. The main outcome measures were in-group and between-group changes in intraocular pressure (IOP) and medication number, proportion of eyes that achieved IOP ≤15 mmHg, and surgical success defined as 20% IOP reduction from baseline at 6/12 months. Univariate/multivariate regression analyses were done to identify predictors of surgical failure. Results: One hundred ninety-seven eyes of 148 patients were included (122 iStent, 75 iStent inject). Both groups achieved significant IOP and medication reduction at months 6/12 (P < 0.05). At month 6, IOP was significantly lower in iStent inject vs. iStent eyes (P = 0.003), but the difference was insignificant by month 12 (P = 0.172). Medication number was comparable in both groups at months 6/12 (P > 0.05). More iStent inject eyes achieved IOP ≤15 mmHg at month 6 (P = 0.003) and 12 (P = 0.047). Surgical success was comparable in both groups at months 6/12 (P > 0.05). Kaplan–Meier survival analysis showed similar cumulative rate of surgical failure at year-1 in both groups (P = 0.644). The multivariate model identified older age (P = 0.017) and lower baseline IOP (P = 0.002) as the strongest predictors of surgical failure. Conclusion: Compared to iStent, iStent inject achieved lower IOP at month 6 and higher proportion of eyes achieved IOP ≤15 mmHg at month 6/12. However, surgical success was similar in both groups. Predictors of surgical failure were older age and lower baseline IOP rather than the stent type.

Investigating the efficacy and safety of rupatadine (RUP) versus montelukast (MON) as adjuvant therapy for patients with rheumatoid arthritis (RA). From December 2018 to December 2019, 75 patients with active RA were enrolled in this randomized double-blind placebo-controlled study. The patients were randomized into three groups (n = 25 in each group); methotrexate (MTX) group which received MTX 15–25 mg/week plus placebo tablet once daily; MTX/RUP group which received MTX plus RUP 10 mg once daily; and MTX/MON group which received MTX plus MON 10 mg once daily. The treatment duration was 3 months. At baseline and 3 months after treatment, blood samples were collected for the biochemical analysis of high-sensitivity C-reactive protein (hs-CRP), interleukins 8 and 17 (IL-8, IL-17), E-selectin, and clusterin (CLU) levels. Clinical and functional assessments using Disease Activity Score-CRP (DAS28-CRP) and Multidimensional Health Assessment Questionnaire (MDHAQ) were performed. Both RUP and MON produced clinical and functional improvements which were translated by significant improvements in DAS28-CRP score and MDHAQ. Rupatadine significantly reduced all measured parameters (P

Purpose: The main objective of this study is to measure the effect of managerial ability on financial reporting timeliness in Egypt., Methodology: We analyzed a sample of Egyptian firms listed on the EGX100 index, the final sample was 62 firms during the period 2014 - 2018, we measured managerial ability depending on data envelope analysis (DEA) presented by Demerjian et al. (2012). The data was analyzed through the OLS method., Findings: Under the resource-based theory, we expect that higher ability managers own the utmost human capital, they are more able to maintain good internal control systems and provide higher earnings quality. Consequently, we predict that higher ability managers provide financial statements in a timely manner. The results confirm a negative relationship between managerial ability and financial reporting lag., Originality/Value: Our results provide insights to researchers, investors, regulators, auditors, and other stakeholders in emerging economies to understand and perceive the implications of managerial ability on financial reporting timeliness., peer-reviewed

Higher education and research and innovation in Europe continue to suffer from an indefensible waste of female talent and gender inequality. The European Commission recommends that these organizations adopt gender equality plans (GEPs) and other initiatives for institutional change. However, the levels of readiness, expertise, and experience with such interventions are wide-ranging across institutions and member states, thus collaborative approaches might be particularly valuable. Drawing on the experiences of transnational and multi-institutional communities of practice (CoPs) for gender equality (GE), we illuminate how the CoP approach supported change agents, who leveraged CoP membership to respond to challenges in promoting GE initiatives. Being part of collaborative, co-designed CoPs for learning, knowledge sharing, and institutional change provided external support to the change agents' activism and allowed them to build legitimacy around GE work. CoP members leveraged this support through learning opportunities, knowledge transfer, sharing practice, political support, and solidarity from the CoP stakeholders. Findings also show that when CoPs were transnational, multi-institutional, and interdisciplinary, their heterogeneity did raise some challenges in relation to the divergence of members' contexts and geopolitical idiosyncrasies and that this should be considered when designing CoPs which transcend national and institutional boundaries.

Emergency medical technicians (EMTs) and paramedics take immediate care of patients who are injured or unhealthy and ensure their transportation to or from the hospital. Almost 10% of all European Union employees work in health and social care systems, and a considerable number of them work in hospitals. The same is the case in Saudi Arabia, where the health care system is well developed and vibrant. With such a large workforce working in an environment where they can face accidents and injuries, accidents do happen. According to the International Labor Organization, there are 270 million occupational accidents causing 2 million deaths annually. The study was conducted at King Fahd Military Complex, Dhahran and Red Crescent. The study was aimed to identify the nature, frequency and causes of work-related injuries among paramedical staff. The present is among the largest studies of WRIs in EMTs in Saudi Arabia. In this study, we found a very high rate of verbal and physical violence against healthcare personnel. Physical violence negatively affects levels of satisfaction in workers. Studies indicate that exposure to both chronic and critical incident stressors increases the risk of EMS personnel developing post-traumatic stress reactions. The risk of WRIs to paramedics and EMTs is obviously high. The most common injuries were verbal/ physical violence, needle stick injuries and motor vehicle accidents. The most common cause for these WRIs was carelessness on part of EMTs.

Background: Lipid abnormalities increase Coronary Heart Disease (CHD) risk. Our developed indexes 1,2 were reported in scientific Journals. Here, we verified and evaluated the cardiac enzymes-lipid profile ratio's diagnostic value for diagnosing CHD patients. Methods: Lipid profiles and cardiac enzymes were estimated in all chest pain patients. The area under the receiver-operating characteristic curve (AUC) was used to evaluate the markers' diagnostic accuracy. Results: There were varieties of significant differences (P < 0.01- P < 0.0001) of Creatine Kinase MB (CK-MB) - lipid profile ratio and Troponin I-lipid profile ratio within the groups of chest pain patients. For discriminating between Non-Coronary Chest Pain (NCCP) and Stable Angina (SA) groups, the AUCs were the greatest for CK-MB- High-density Lipoprotein (HDL) ratio (0.62) and for Troponin I-HDL (0.62). Moreover, for discriminating between NCCP and Unstable Angina (UA) groups, the AUC was the greatest for CK-MB-HDL ratio (0.97). Also, for discriminating between NCCP and Acute Myocardial Infarction (AMI) groups, the AUC was the greatest for index 2 (0.99). Similarly, for discriminating between SA and UA groups, the AUC was the greatest for CK-MB-HDL ratio (0.90). For discriminating between SA and AMI groups, the AUC was the greatest for index 2 (0.97). Finally, for discriminating between UA and AMI groups, the AUC was the greatest for index 2 (0.78). Conclusion: Independent CK-MB-HDL ratio can be used as a good and simple index for diagnosing CHD in chest pain patients and discriminating between the different groups of these patients

Renewable energy has become an auspicious alternative to fossil fuel resources due to its sustainability and renewability. In this respect, Photovoltaics (PV) technology is one of the essential technologies. Today, more than 90 % of the global PV market relies on crystalline silicon (c-Si)-based solar cells. This article reviews the dynamic field of Si-based solar cells from high-cost crystalline to low-cost cells and investigates how to preserve high possible efficiencies while decreasing the cost. First, we discuss the various types of c-Si solar cells with different device architectures and report recent developments. Next, thin-film solar cells with their recent advancements are given. Then, Si nanowires solar cells and their recent results are discussed. Finally, we present the most encouraging tendencies in achieving low-cost solar cells utilizing cheap materials like heavily doped silicon wafers.

Background: The non-contact optical methods are preferable in Intra-ocular Lens (IOL) power calculation as they have higher resolution, better patient tolerance and greater acceptability. Aim: to compare between LENSTAR LS900 and IOL Master V4 in IOL power calculation. Material and Methods: This prospective comparative study included 60 eyes of 40 cataract patients. Patients with immature cataract of any age and both genders were included while those with dense cataract, media opacities, previous ocular diseases or surgeries or intraoperative complications were excluded. Patients were assessed by a complete comprehensive ophthalmic evaluation. Each patient was evaluated twice, one by the IOL Master and the other by the LENSTAR LS900. Outcome measures were axial length (AL), vertical keratometric dioptric power (K1), horizontal keratometric dioptric power (K2), and IOL power measurements. Results: The mean age of the patients was 67.08 ± 5.34 years. Thirty-five patients were males and 25 were females. The IOL master and LENSTAR were similar (p>0.05) in terms of the AL (24.82 ± 2.21and 24.80 ± 2.20), K1 (43.13 ± 1.66 and 43.14 ± 1.68), K2 (44.14 ± 1.56 and 44.27 ± 1.52) and IOL power (16.86 ± 5.24 and 16.84 ± 5.26). The target refraction on IOL master was -0.01 ± 0.06 compared with 0.04 ± 0.10 on LenStar. The actual refraction was 0.00 ± 0.33. There were non-significant differences between target and actual refractions on both devices (p>0.05). Conclusion: Both the optical biometers, IOL Master and LENSTAR provide similarly precise biometry and IOL power calculation in cataract patients.

Paramedics were only given the essentials to deal with influenza vaccination. On the other hand, 67.6 percent of them were actually vaccinated. To reduce the spread of the virus, healthcare providers should work hard to immunize the population around us at any given time. There has been a lot of study into flu, and the general consensus is that it is a type of acute respiratory illness. Influenza is a very contagious and transmissible viral disease that can cause very severe symptoms. This was designed to determine those parents who smoke, how aware they are about the flu symptoms, and how they deal with them. This survey is a part of a study that was conducted by us of healthy male paramedics. When they were given an online questionnaire that included eight questions, all the participants found the questions to be very straightforward. As a result of this survey, we will know exactly what the Saudi parents really know about disease prevention and treatments. The purpose of the study is to find out if the paramedics of Saudi Hospitals would like to be vaccinated against seasonal influenza. The paper uses the word "seriously" to talk about the importance of vaccination (which is an interesting word choice). This research was conducted on a sample of 222 healthy male paramedics assessed by the use of an online questionnaire, along with a personal rating of beliefs regarding influenza vaccination and the status of self-reported vaccination. The paper also identifies the reasons why the people in question are not being vaccinated and the outcomes. By conducting a percentage analysis by reviewing the questionnaire results, it was found that the paramedics were very unaware of the importance of and effectiveness of the Hepatitis B Vaccination. According to what the paramedics found, the vaccine wasn't available in the hospitals, so they couldn't administer it, either.

The role of the androgen receptor (AR) in estrogen receptor (ER)-α-positive breast cancer is controversial, constraining implementation of AR-directed therapies. Using a diverse, clinically relevant panel of cell-line and patient-derived models, we demonstrate that AR activation, not suppression, exerts potent antitumor activity in multiple disease contexts, including resistance to standard-of-care ER and CDK4/6 inhibitors. Notably, AR agonists combined with standard-of-care agents enhanced therapeutic responses. Mechanistically, agonist activation of AR altered the genomic distribution of ER and essential co-activators (p300, SRC-3), resulting in repression of ER-regulated cell cycle genes and upregulation of AR target genes, including known tumor suppressors. A gene signature of AR activity positively predicted disease survival in multiple clinical ER-positive breast cancer cohorts. These findings provide unambiguous evidence that AR has a tumor suppressor role in ER-positive breast cancer and support AR agonism as the optimal AR-directed treatment strategy, revealing a rational therapeutic opportunity. Functional interplay of sex hormones in estrogen receptor–positive breast cancer unveils the therapeutic potential of androgen receptor agonists.

Introduction Obesity is associated with erectile dysfunction in many studies. This study aims to inspect the impact of weight-loss surgery on the erectile function in the Saudi male population. Patients and methods Forty-two consecutive male patients who underwent weight-loss surgery during a period from February 2013 to July 2016 were included in the study. Unmarried patients were excluded from the study. A designed questionnaire includes the short version of the International Index of Erectile Function (IIEF), usage of phosphodiesterase inhibitors, overall satisfaction before and after the intervention, marriage duration, and fertility postsurgery. All the participants were contacted through phone in July 2018, and then the questionnaire was mailed to them. All the data were analyzed and compared to a control group of married obese patients, who were waiting for the bariatric surgeries, using specific statistical tests. Results Thirty patients responded and completed the survey. Their mean age was 41.9 years (range 26-62), and the mean preoperative body mass index (BMI) was 46.3 ± 7.5, with a significant reduction in the BMI postoperatively to a mean of 30 ± 5.5. The IIEF score improved, and the overall satisfaction and feelings were better (76.7%). Only 16.7% of cases needed PDEI before and after the operation. Thirteen (43.3%) patients got children after the surgery. Univariate and multivariate analysis showed that age was a significant factor in association with both erectile function and fertility after bariatric surgeries (P = 0.02). Fertility was better in patients who underwent laparoscopic sleeve gastrectomy than gastric bypass surgery (P = 0.01). Conclusion The weight-loss surgeries have a significant effect on erectile function, and they improve patient sexual satisfaction. Most of these patients feel better sexual function after bariatric surgeries. Fertility outcome seems to have a positive correlation with this type of surgery. However, a larger sample size and more elaborate studies are warranted to substantiate this claim.

Background: Color Doppler ultrasonography enables the non-invasive study of physiologic and pathophysiologic changes in the uterine and ovarian circulation in pregnant and non-pregnant women. Aim of the work: To evaluate the potential value of color Doppler of the uterine artery, corpus luteum blood flow, and subchorionic blood vessels in abnormal first-trimester pregnancy. Patients and methods: The study included 200 pregnant women in the first trimester in the antenatal care clinic of the Department of Obstetrics and Gynecology AL Azhar University [Assiut], divided into two groups; control group [100 cases] with normal pregnancy and study group [100 cases] which was further subdivided into threatened abortion [60 cases], blighted ovum [20 cases] and vesicular mole [20 cases]. Results:The uterine artery resistance index [RI] of the study groups was lower than the control group. The decrease was highly significant in the uterine artery RI of both threatened abortion and blighted ovum groups and significant in the vesicular mole group. Uterine artery pulsatility index [PI] showed a significant decrease in the study group compared with the control cases. There was a highly significant negative correlation between gestational age and both RI and PI of the study group's uterine artery. There was a higher prevalence of abortion in a group of threatened abortion compared to the control group. Conclusion: The prevalence of pregnancy complications is increased in association with abnormal blood flow patterns of the early uteroplacental circulation. Doppler indices of the early gestation uteroplacental circulation have an important value in the threatened abortion follow up.

In the twenty years since Dr. Leo Breiman’s incendiary paper Statistical Modeling: The Two Cultures was first published, algorithmic modeling techniques have gone from controversial to commonplace in the statistical community. While the widespread adoption of these methods as part of the contemporary statistician’s toolkit is a testament to Dr. Breiman’s vision, the number of high-profile failures of algorithmic models suggests that Dr. Breiman’s final remark that “the emphasis needs to be on the problem and the data” has been less widely heeded. In the spirit of Dr. Breiman, we detail an emerging research community in statistics — data-driven decision support. We assert that to realize the full potential of decision support, broadly and in the context of precision health, will require a culture of social awareness and accountability, in addition to ongoing attention towards complex technical challenges.

Introduction: Obesity is a chronic relapsing disease of which, globally, the prevalence has reached epidemic proportions. The ACTION-IO study (NCT03584191) investigated the perceptions, attitudes, and behaviors of people with obesity (PwO) and healthcare professionals (HCPs), which can help in devising strategies for its optimal management. Here, we present the results from the United Arab Emirates (UAE). Methods: The ACTION-IO study was a cross-sectional study conducted in 11 countries, including the UAE, that collected data via a survey. Eligible UAE PwO were ≥18 years with a BMI of ≥30 kg/m2 (self-reported height and weight). Eligible HCPs were in direct patient care. Data were collected in the UAE between July 11, 2018, and September 5, 2018. Results: A total of 750 PwO and 200 HCPs completed the survey in the UAE. Both PwO (82%) and HCPs (78%) acknowledged obesity as a chronic disease and agreed that it has a large impact on overall health (PwO 88% and HCPs 80%). More HCPs felt that diabetes and stroke (both 91%) had a larger impact on overall health than did obesity. Many PwO (76%) assumed full responsibility for their weight loss; 84% of HCPs acknowledged responsibility for actively contributing to patient weight loss efforts. The top motivator for weight loss among PwO was wanting to be more fit/in better shape (45%), while HCPs believed the main motivator was general health concerns (83%). The top barrier against initiating weight management discussions provided by HCPs was that they felt PwO were not interested in losing weight (69%), whereas only 10% of PwO selected this response. The mean delay between struggling with excess weight and having a weight management discussion with an HCP was 4 years. Discussion/Conclusion: These UAE results highlight differences in the perceptions and attitudes toward obesity from PwO and HCPs and reflect a need to understand weight management concerns to initiate earlier and more effective PwO–HCP conversations. The findings will inform educational needs on the biological basis of obesity and its clinical management and will help to address regional barriers for effective obesity care.

Purpose: Evaluation of oral health status in children undergoing hemodialysis sessions and kidney transplantation and compared them with healthy children. Materials and Methods: This descriptive study was conducted on 250 children aged 6-18 years old (100 children undergoing hemodialysis, 50 children undergoing kidney transplantation and 100 healthy children as a control group). The oral health status was evaluated regarding to caries experience, gingivitis using PMA index, developmental defects using modified DDE index. Un-stimulated salivary flow rate and pH were also measured. Results: caries experience was significantly lower in both chronic kidney disease (CKD) groups compared to control group. Median PMA was significantly higher in hemodialysis and in transplantation groups compared to control group. The prevalence of developmental enamel defects was 41% in hemodialysis group and 58% in transplantation group compared to 11% in control group (P-value < 0.001). Regarding to saliva analysis, the flow rate was higher among healthy children while the salivary PH was higher among children with CKD. Conclusions: chronic kidney disease may decrease caries experience, increase gingival inflammation, in addition to increase prevalence of developmental defects. Furthermore, children with chronickidney disease have lower salivary flow rate and higher buffering capacity than healthy children.

As a key player in today’s world, online social networks are emerging, providing a platform for expression and content distribution. This technology enables users to communicate easily with each other and share their data instantly. However, the internet isn’t generally protected; it can be a source for abusive and harmful content and causing harm to others. There is a great need for approaches and strategies to solve these issues due to the negative effect of abusive language and cyberbullying. Arabic text is known for its challenges, complexity, and scarcity of its resources. Many languages have made many efforts to find automated solutions for detecting abusive language and cyberbullying, but not much for the Arabic language. This work analyzes 27 studies on automatic Arabic abusive language and cyberbullying and its related detection approaches. The goal of this paper is to review the findings of the previous studies about cyberbullying and abusive detection in Arabic content on online social networks and help researcher in the future to develop automatic detection systems that are effective and realistic.

Clustering has emerged as an effective tool for the processing and assessment of the vast data generated by modern applications; its primary aim is to classify data into clusters in which the items are grouped into a given category. However, various challenges, such as volume, velocity, and variety, occur during the clustering of big data. Different algorithms have been proposed to enhance the performance of clustering. The landmark-based spectral clustering (LSC) technique has been proven to be efficient in clustering big datasets. In this study, an algorithm called adaptive landmark-based spectral clustering (ALSC) is proposed for clustering big datasets. The proposed algorithm comprises the adaptive competitive learning neural network (ACLNN) algorithm, which can be efficiently used to determine the number of clusters and the LSC technique. The ACLNN algorithm can also be used with small datasets. Thus, in our implementation, the original big dataset is split into N small sub datasets, which run in parallel by N copies of the ACLNN algorithm. To evaluate the performance of the proposed algorithm, two distinctive datasets, namely, Fashion-MNIST and United States Postal Service are used. The experiments show that the proposed ALSC algorithm produces high clustering accuracy with the identification of the number of clusters. Results reveal that the normalized mutual information and adjusted Rand index of the proposed algorithm outperform state-of-the-art models.

Abstract. Background: Elevated homocysteine levels and malnutrition are frequently detected in hemodialysis patients and are believed to exacerbate cardiovascular comorbidities. Omega-3 fatty acids have been postulated to lower homocysteine levels by up-regulating metabolic enzymes and improving substrate availability for homocysteine degradation. Additionally, it has been suggested that prevention of folate depletion by vitamin E consumption decreases homocysteine levels. However, data on the effect of omega-3 fatty acids and/or vitamin E on homocysteine levels and nutritional status have been inconclusive. Therefore, this study was planned to examine the effect of combined supplementation of fish oil, as a source of omega-3 fatty acids, with wheat germ oil, as a source of vitamin E, on homocysteine and nutritional indices in hemodialysis patients. Methods: This study was a randomized, double-blind, placebo-controlled trial. Forty-six hemodialysis patients were randomly assigned to two equally-sized groups; a supplemented group who received 3000 mg/day of fish oil [1053 mg omega-3 fatty acids] plus 300 mg/day of wheat germ oil [0.765 mg vitamin E], and a matched placebo group who received placebo capsules for 4 months. Serum homocysteine and different nutritional indices were measured before and after the intervention. Results: Twenty patients in each group completed the study. At the end of the study, there were no significant changes in homocysteine levels and in the nutritional indices neither in the supplemented nor in the placebo-control groups (p > 0.05). Conclusions: Fish oil and wheat germ oil combination did not produce significant effects on serum homocysteine levels and nutritional indices of hemodialysis patients.

Background: The most prominent source of anovulatory infertility in the world is polycystic ovary syndrome. Getting pregnant these days has a larger risk of early maternal death than in the general population. It induces symptoms in about five and ten percent of women of reproductive age (12-45 years old). Women that are insulin tolerant are more prone to have Elevated Insulin levels, Polycystic OVARIES and Hyperandrogens. They are at risk for suboptimal reproductive activity attributable to compromising ovarian function and hormonal equilibrium. The aim of this research was to determine the prevalence of late pregnancy failure in women with Polycystic Ovary Syndrome (PCOS) taking metformin as compared to women who don't take it. Materials and Methods: This case control-controlled study included 100 females and divided in to two groups. Each group composed of 50 patients and the patients were distributed in each group by simple Randomization method. Results: There was no significant difference between control and study group regarding todescriptive data. Association between rate of pregnancy loss and metformin treatment early pregnancy loss was significantly frequent in control group than in study group with metformin treatment. Gestational age (weeks)at which pregnancy loss occurred is significantly higher in study group than in control group. The rate of early pregnancy loss among studied groups is significantly lower than in control group. Conclusion: Metformin therapy in pregnant women with polycystic ovary syndrome was associated with a significant reduction in the rate of early pregnancy loss. It was well tolerated by patients with a minimum of side effects. However, extended studies are required to evaluate its effect on further pregnancy complications and fetal outcomes.

الملخص: أهداف البحث: تعتبر اللياقه البدنية ركيزة أساسية لطلاب العلاج الطبيعي في تعزيز صحتهم الجسدية. الطلاب المصابين بالسمنة وزيادة الوزن قد يكون لهم قدرات بدنية محدودة. لذلك، قمنا بالتحقيق في تأثير زيادة الوزن والسمنة على الحركة، والقوة وخفة الحركة لطلاب العلاج الطبيعي. طرق البحث: في هذه الدراسة المقطعية المستعرضة، جمعنا البيانات لعينة من ١٣ مشاركا زائد الوزن و٩ مشاركا مصابا بالسمنة من طلاب العلاج الطبيعي، تتراوح أعمارهم من ١٩ إلى ٢٤ عاما. قمنا بقياس مرونة العمود الفقري، والطرف العلوي والسفلي تليها قوة الطرف العلوي باستخدام اختبار تعليق ثني الذراع والخفة الحركية باستخدام اختبار سباق العدو ١١×١٠. النتائج: لم يظهر اختبار ''ت'' للعينة المستقلة بمقارنة القيم المتوسطة بين المشاركين المصابين بزيادة الوزن والمصابين بالسمنة اختلافا جذريا لاختبار سباق العدو ١١×١٠. ولكن، كان هناك نتائج ذات دلالة إحصائية لاختبار تعليق ثني الذراع. أظهر اختبار ارتباط بيرسون ارتباطا سلبيا معتدلا بين مؤشر كتلة الجسم وتعليق ثني الذراع، يشير ذلك إلى أن المشاركين مع مؤشر كتلة الجسم الأعلى يميلوا إلى التمسك لوقت أقل أثناء اختبار تعليق ثني الذراع. أظهر تقييم الارتباط ارتباطا إيجابيا ضعيفا بين مؤشر كتلة الجسم واختبار سباق العدو ١١×١٠. الاستنتاجات: في هذه الدراسة، أظهر طلاب الجامعة المصابون بالسمنة ضعفا في العوامل البدنية خصوصا قوة الطرف العلوي من الجسم وحركة الأطراف السفلية مقارنة مع المشاركين الذين يعانون من زيادة الوزن. كما أظهر طلاب الجامعة المصابين بالسمنة وزيادة الوزن انخفاضا في القدرات البدنية والوظيفية. Abstract: Objective: Physical fitness is a fundamental pillar for physical therapy students in promoting their physical health. Obese and overweight students might have limited physical capabilities. Therefore, we investigated the effect of overweight and obesity on the mobility, strength, and agility of physical therapy students. Methods: In this cross-sectional study, we collected data from a sample of 13 overweight and 9 obese physical therapy students, aged between 19 and 24 years. We measured spinal, upper, and lower limb mobility; upper body strength (using the flexed-arm hang test), and agility (using the 11 × 10 shuttle sprint test). Results: The independent sample t test comparing the mean values of overweight and obese participants showed no significant difference [t(20) = -0.16, p > 0.05] for the 11 × 10 shuttle sprint test. However, there was significant difference [t (15.2) = 3.79, p

Background Nuclei classification, segmentation, and detection from pathological images are challenging tasks due to cellular heterogeneity in the Whole Slide Images (WSI). Methods In this work, we propose advanced DCNN models for nuclei classification, segmentation, and detection tasks. The Densely Connected Neural Network (DCNN) and Densely Connected Recurrent Convolutional Network (DCRN) models are applied for the nuclei classification tasks. The Recurrent Residual U-Net (R2U-Net) and the R2UNet-based regression model named the University of Dayton Net (UD-Net) are applied for nuclei segmentation and detection tasks respectively. The experiments are conducted on publicly available datasets, including Routine Colon Cancer (RCC) classification and detection and the Nuclei Segmentation Challenge 2018 datasets for segmentation tasks. The experimental results were evaluated with a five-fold cross-validation method, and the average testing results are compared against the existing approaches in terms of precision, recall, Dice Coefficient (DC), Mean Squared Error (MSE), F1-score, and overall testing accuracy by calculating pixels and cell-level analysis. Results The results demonstrate around 2.6% and 1.7% higher performance in terms of F1-score for nuclei classification and detection tasks when compared to the recently published DCNN based method. Also, for nuclei segmentation, the R2U-Net shows around 91.90% average testing accuracy in terms of DC, which is around 1.54% higher than the U-Net model. Conclusion The proposed methods demonstrate robustness with better quantitative and qualitative results in three different tasks for analyzing the WSI.

The immune system governs key functions that maintain renal homeostasis through various effector cells that reside in or infiltrate the kidney. These immune cells play an important role in shaping adaptive or maladaptive responses to local or systemic stress and injury. We increasingly recognize that microenvironments within the kidney are characterized by unique distribution of immune cells, the function of which depends on this unique spatial localization. Therefore, quantitative profiling of immune cells in intact kidney tissue becomes essential, particularly at a scale and resolution that allow the detection of differences between the various "nephro-ecosystems" in health and disease. In this review, we discuss advancements in tissue cytometry of the kidney, performed through multiplexed confocal imaging and analysis using the Volumetric tissue exploration and analysis (VTEA) software. We highlight how this tool has improved our understanding of the role of the immune system in the kidney and its relevance in pathobiology of renal disease. We also discuss how the field is increasingly incorporating machine learning to enhance the analytical potential of the imaging data and provide unbiased methods to explore and visualize multidimensional data. Such novel analytical methods could be particularly relevant when applied to profiling immune cells. Furthermore, machine learning approaches applied to cytometry could present venues for non-exhaustive exploration and classifications of cells from existing data and improving tissue economy. Therefore, tissue cytometry is transforming what used to be a qualitative assessment of the kidney into a highly quantitative imaging-based "omics" assessment that compliments other advanced molecular interrogation technologies.

We report a 68-year-old end-stage renal disease female patient on dialysis for 15 years. She sustained consecutive fractures starting with left-sided femoral neck fracture, followed 16 months later by a right-sided one. On her recovery from her right hip injury she sustained a stress type subtrochanteric fracture at the entry site of the fixation implants and an ipsilateral humeral shaft fracture. Cementless total hip replacement was done for the left femoral neck, and osteosynthesis was done for her undisplaced right femoral neck fracture. Revision fixation was done for her right subtrochanteric fracture with a long Gamma nail that was statically locked. The humeral fracture was fixed with an interlocking nail in a closed manner. This case highlights the fact that sequential hip fractures is an ominous event which is likely to be followed by a quick cascade of bone injuries with trivial trauma and a high rate of unexpected complications. Our treatment approach is explained here, stressing the unexpected complications and challenges met.

Breast cancer is the most common malignancy among women worldwide. The current COVID-19 pandemic represents an unprecedented challenge leading to care disruption, which is more severe in low- and middle-income countries (LMIC) due to existing economic obstacles. This review presents the global perspective and preparedness plans for breast cancer continuum of care amid the COVID-19 outbreak and discusses challenges faced by LMIC in implementing these strategies. Prioritization and triage of breast cancer patients in a multidisciplinary team setting are of paramount importance. Deescalation of systemic and radiation therapy can be utilized safely in selected clinical scenarios. The presence of a framework and resource-adapted recommendations exploiting available evidence-based data with judicious personalized use of current resources is essential for breast cancer care in LMIC during the COVID-19 pandemic.

To combat the increased emission rate and energy waste, a business case for an online optimizer was established to examine the energy-saving and emission reduction figures. Prior to embarking on this study, there is a need to understand the performance of oil and gas companies in managing the continuous flared gas. From the data gathered, it was quite evident that oil and gas operators do not significantly invest in optimizing gas flaring. The survey has included 706 participants from more than 59 different countries and indicated that there is a lack of awareness where regular monitoring of flared gas is overlooked. The survey shows about 17.6% of the participants never analyzed flared gas compositions, while only 36.6% of participants do this on monthly basis. More importantly, the survey indicated that most participants don’t update their process operating conditions in response to day and night or yearly seasons thermal conditions. The optimization study is primarily focusing on having an online flared gas controller technique to continually monitor and analyze flared gas compositions with an intention to automatically manipulate separator operating conditions to increase the flared gas recovery. This approach was tested using a dynamic model developed for three real offshore and onshore oil and gas fields in Egypt and Saudi Arabia. In the three cases of study, this approach was able to adjust the operating conditions of the separator based on the flared gas analysis and the objective function identified to largely recover heavy hydrocarbons and control flared gas.

Background: Juvenile idiopathic arthritis (JIA) is one of the most common rheumatic diseases in children. In all subtypes of JIA, a low bone mass has been detected in a high percentage of children due to failure to develop adequate bone mineralization. Objective: To determine the extent of osteoporosis among children with JIA. Patients and Methods: A cross sectional study on thirty patients diagnosed with JIA. In addition, age and sex matched thirty healthy children worked as control. Bone mineral density (BMD) and Z score of lumbar spine, neck of the femur and distal radius were analysed and adjusted for age and sex among patients and controls. Lunar DPX-NT 2013 made in USA by General Electric did dual energy X-ray absorptiometry (DEXA) scan. Results: 60% of patients were males with a male to female ratio of 3:2. Our patients' age ranged between 6-15 years. The disease duration ranged between 6 months and 10 years. We found that 24 patients (80%) had osteoporosis (age- matched Z score was below normal), while among the control group only 4 children (13.3%) had osteoporosis. There was a significant difference between patients and controls regarding DEXA scan findings. Patients with longer duration of JIA at diagnosis had more osteopenia and osteoporosis than those with short duration of disease. The mean ± SD of disease duration in patients with JIA who were suffering from osteoporosis was 5.1 ± 2.76 years. In oligoarticular type, majority of the cases had osteoporosis 40% (12 patients). In systemic onset JIA 8 cases (26.7%), six of them were osteoporotic. The psoriatic type was diagnosed in four patients (13.3%), all of them were osteoporotic. The polyarticular RF +ve type was diagnosed in four patients (13.3%), half of them were osteoporotic and the polyarticular RF -ve type was diagnosed only in 2 patients (6.7%), all of them were within normal bone density. Conclusion: Results obtained from this study suggest that osteoporosis was a frequent complication of JIA. JIA patients are likely to have low BMD. Children with JIA who have oligoarticular and systemic onset of JIA patients were more susceptible to low BMD.

Background: Rheumatoid Arthritis (RA) is a chronic systemic autoimmune disorder of unknown etiology characterized by symmetrical joint synovitis and pain. RA has a wide clinical spectrum and may vary from mild nonerosive disease to severe inflammation and joint damage with extra articular manifestations. To detect enthesopathy, the European League Against Rheumatism (EULAR) recommends magnetic resonance imaging (MRI) or ultrasonography (US). Objective: To detect subclinical enthesitis in rheumatoid arthritis patients and its relation to disease parameters and disease activity. Patients and Methods: This prospective observational study included 50 adult patients diagnosed as rheumatoid arthritis according to the 2010 ACR-EULAR classification criteria for rheumatoid arthritis. The study was carried out in the Musculoskeletal Ultrasonography Unit of the Rheumatology, Physical Medicine and Rehabilitation Department, Al-Azhar University Hospitals Assiut. Results: We found that the mean age in case group was 46.3 ± 8.4 years. Females accounted for 62% (31 patients) of all patients. The disease duration ranged from one year to 15 years with a mean of 6.2 ± 1.9 years. The BMI was 19.5 ± 42 kg/m2 . Mean of disease activity evaluated by the disease activity score in 28 joints was 4.7 ± 1.5. Our findings demonstrated that prevalence of subclinical enthesitis in patients with rheumatoid arthritis was 32%. There was a statistically significant relation between 28-joint Disease Activity Score (DAS28) score and ultrasound detected enthesitis (p. value < 0.05). Conclusion: BMI, old age and long disease duration were suggested as the risk factors for subclinical enthesitis.

Background: To evaluate and compare preoperatively multi-detector computed tomography and digital panoramic radiography of jaw bones in patients submitted to dental implant restoration. Patients and methods: We conducted a diagnostic test accuracy study, Al-Azhar University Hospital Assuit. Thirty patients, with partial edentulous areas, were enrolled in the study and they were 11 females and 19 males with mean age of 37 years. Patients were included if they were systemically healthy, at least 18 years old, missing a single or multiple teeth, and their crestal residual ridge width ranging from 3 to 5 mm. Results: A higher Cronbach's alpha for the multi-detector computed tomography (MDCT) modality, as well as a lower reliability of error were found. Moreover, unlike digital panorama radiography, MDCT obtained length and width could predict the implant length and diameter. These results highlight the superiority of MDCT to digital panorama radiography in the preoperative assessment before dental implantation. Conclusion: Superiority of MDCT to digital panorama radiography in determining the implant site parameters before dental implantation. Future studies should consider reducing the cost of MDCT and improving its accessibility in low-resource settings.

RATIONALE AND OBJECTIVE: The use of kidney histopathology for predicting kidney failure is not established. We hypothesized that use of histopathological features of kidney biopsy specimens would improve prediction of clinical outcomes made using demographic and clinical variables alone. STUDY DESIGN: Retrospective cohort study and development of a clinical prediction model. SETTING AND PARTICIPANTS: All 2720 individuals from the Biopsy Biobank Cohort of Indiana who underwent a kidney biopsy between 2002 and 2015 and had at least two years of follow-up. NEW PREDICTORS & ESTABLISHED PREDICTORS: Demographic variables, comorbidities, baseline clinical characteristics, and histopathological features. OUTCOMES: Time to kidney failure, defined as sustained estimated glomerular filtration rate

Autosomal Dominant Tubulointerstitial Disease (ADTKD) is a dominantly inherited progressive non-glomerular disease. Several factors, such as a non-specific clinical presentation and relative rarity, impede the phenotyping of ADTKD into clinically relevant subtypes, and impair the appropriate implementation of genetic testing. The study by Olinger et al describe the largest multicenter ADTKD cohort, which is likely to become a key resource. The authors also provide a new clinical tool that could guide diagnosis and genetic testing.

Purpose: To evaluate the recent intraoperative lagophthalmos formula method for levator resection in determining postoperative lid height in congenital ptosis on Egyptian patients. Methods: This is a prospective case series which included 20 eyelids of 17 Egyptian children with congenital ptosis whose levator function is 4 mm or better. They underwent levator muscle resection guided by the recently presented intraoperative lagophthalmos formula. Preoperative Margin-to-Reflex Distance 1 (MRD1) and levator function were measured then intraoperative palpebral fissure opening was determined from formula: Intraoperative lagophthalmos = 9.08 − (0.48 × Preoperative MRD1) − (0.26 × Levator function). Success was defined as postoperative MRD1 ⩾ 3 mm and difference between both eyelid height ⩽1 mm at 6 months. Results: From 20 eyelids, there were five cases with mild (25%), 11 with moderate (55%), and four with severe (20%) ptosis. They showed success in four cases (80%), eight cases (73%), and three cases (75%) in each degree respectively with an overall success of 15 cases (75%). Conclusion: Proposed intraoperative lagophthalmos formula showed relatively good results in predicting postoperative eyelid level in Egyptian children with simple congenital ptosis with fair to good levator function.

Flexible cystoscopy under local anaesthesia is standard for the surveillance of bladder cancer. Frequently, several reusable cystoscopes fail to reprocess. With the new grasper incorporated single-use cystoscope for retrieval of ureteric stents, we explored the feasibility of using it off-label for diagnosis and the detection of bladder cancer. Consecutive diagnostic flexible cystoscopies between Mar 2016 and Nov 2018 were reviewed comparing the reusable versus the disposable cystoscopes. A total of 390 patients underwent 1211 cystoscopies. Median age was 61.5 years (SD 14.2, 18.8–91.4), males 331 (84.9%) and females 59 (15.1%). Indication for cystoscopy was prior malignancy in 1183 procedures (97.7%), haematuria 19 (1.6%) or bladder mass 7 (0.6%). There were 608 reusable and 603 disposable cystoscopies. There was no significant difference between groups at baseline in age, sex, BMI, smoking status, or prior tumor risk category. There was no significant difference in positive findings (123/608, 20.2% vs 111/603, 18.4%, p = 0.425) or cancer detection rates (95/608, 15.6% vs 88/603, 14.4%, p 0.574) among the two groups, respectively. We conclude that the disposable grasper integrated cystoscope is comparable to reusable cystoscope in the detection of bladder cancer.

A preliminary study of Class-E radio frequency power amplifier for wireless capacitive power transfer (CPT) system is presented in this paper. Due to a limitation in coupling capacitance value, a high frequency operation of switching power inverter is necessary for the CPT system. A GaN MOSFET offers reliability and performance in a high frequency operation with an improved efficiency over a silicon device. Design specification related to the parallel load parameter, LC impedance matching and experimental analysis of the amplifier is explored. An experimental setup for the proposed inverter and its integration with the CPT system is provided, and the power efficiency is investigated. As a result, by utilizing a 6.78 MHz resonant frequency and a 50 Ω resistive load, 50 W of power has been transmitted successfully with an end to end system efficiency over 81 %. Additionally, above 17 W wireless power transfer was demonstrated successfully in the CPT system under 6 pF coupling with the efficiency over 70 %.

The present survey of mite species inhabiting organic manure in different animal-sheds (i.e., buffalo, cow, sheep, goats), in both farms, the experimental farm of the Faculty of Agriculture, Assiut University and the production farm of El-Fateh district, Data showed that there were 28 mite species pertaining to 20 genera of 12 families in three mite orders (Mesostigmata, Astigmata, Trombidiformes). Mesostigmata represented by 19 species (8 families); Astigmata (Acarididia), represented by 8 species (2 families) and Trombidiformes represented by two species belonging to two families. Both mite species of the families Macrochelidae Vithzthum, 1930, and Parasitidae Oudemans, 1901 were recorded in high densities. While scarce numbers of Tarsonemidae Canestrini & Fanzago, 1876 were observed. The annotated checklist reported 150 mite species belonging to 67 genera of 26 families.

AIM: To evaluate the role of medical treatment in the management of inflammatory punctum stenosis guided by spectral domain anterior segment optical coherence tomography (OCT). METHODS: This prospective study included 60 patients complaining of epiphora due to inflammatory punctual stenosis. They were divided into two groups: Group A (30 patients) treated with a combination of preservative free hydrocortisone sodium phosphate 3.35 mg/mL eye drops, and preservative free artificial tears based on sodium hyaluronate, polyethylene and propylene Glycol; Group B (30 patients) treated with the same preservative free artificial tears only. Thirty normal subjects were included for comparison of pre-treatment anatomical parameters. Before starting treatment, all patients underwent anterior segment assessment including slit lamp examination, measurement of intraocular pressure (IOP), fluorescein dye disappearance test, and measurement of the outer punctum diameter (OPD) by Spectral domain anterior segment OCT. All assessments were repeated at each follow up done at 1 and 3mo later, together with subjective evaluation of patient's satisfaction of the treatment outcome by simple rating questionnaire. RESULTS: Punctual diameter increased significantly with treatment in both groups (P

To provide a novel MRI classification system for the symptomatic type II os naviculare by creating a standardized grading of associated bone marrow edema (BME) and correlating with patient symptoms. BME was classified on an ordinal scale: grade 1, faint signal immediately adjacent to the synchondrosis; grade 2, intermediate signal within the os and navicular tuberosity without extending to the navicular body; grade 3, intense signal extending to the navicular body. BME on 59 MRIs was independently graded by three radiologists. Inter- and intra-observer agreement was analyzed using intraclass correlation coefficient. Univariate and multivariate analyses assessed for patient and imaging characteristics predictive of subjective pain score. A cohort of 82 patients without BME represented a control group. Inter-observer agreement of BME grade was 0.95 (CI 0.93–0.97) and intra-observer was 0.92 (CI 0.87–0.96), indicating excellent agreement. In patients with BME, predictors of more severe pain were longer duration of pain (p = 0.02) and presence of soft tissue edema overlying the os naviculare (p

Corticosteroid administration before anticipated preterm birth is a well known antenatal therapy available to improve newborn outcomes. Doppler studies of maternal and foetal vessels provide a way to understand how corticosteroid affects and improves foetal respiratory outcome. This study was registered on 8th of October, 2017 by Menoufia Faculty of Medicine Board with registration number 222-2-10-2017. It included 80 pregnant women divided into two groups. Each group consisted of 40 participants. Group A: participants were between 28 weeks and 34 weeks of gestation and were at risk of preterm labour. Group B: participants were those who had undergone an elective caesarean section (CS) before completing the 39th week of gestation. Each woman had received four doses of Dexamethasone 6 mg intramuscularly, 12 h apart. Doppler studies were performed before the Dexamethasone adminstration and 24 h after the Dexamethasone course. Among both groups, only pregnant women before 34 weeks of gestation showed a significant decrease in middle cerebral artery pulsatility index. However, the other Doppler parameters showed no significant effect. In conclusion, Dexamethasone administration affected only the middle cerebral artery pulsatility index before 34 weeks of gestation.IMPACT STATEMENT