Search

Chest radiography (CXR) is the most frequently performed radiological test worldwide because of its wide availability, non-invasive nature, and low cost. The ability of CXR to diagnose cardiovascular diseases, give insight into cardiac function, and predict cardiovascular events is often underutilized, not clearly understood, and affected by inter- and intra-observer variability. Therefore, more sophisticated tests are generally needed to assess cardiovascular diseases. Considering the sustained increase in the incidence of cardiovascular diseases, it is critical to find accessible, fast, and reproducible tests to help diagnose these frequent conditions. The expanded focus on the application of artificial intelligence (AI) with respect to diagnostic cardiovascular imaging has also been applied to CXR, with several publications suggesting that AI models can be trained to detect cardiovascular conditions by identifying features in the CXR. Multiple models have been developed to predict mortality, cardiovascular morphology and function, coronary artery disease, valvular heart diseases, aortic diseases, arrhythmias, pulmonary hypertension, and heart failure. The available evidence demonstrates that the use of AI-based tools applied to CXR for the diagnosis of cardiovascular conditions and prognostication has the potential to transform clinical care. AI-analyzed CXRs could be utilized in the future as a complimentary, easy-to-apply technology to improve diagnosis and risk stratification for cardiovascular diseases. Such advances will likely help better target more advanced investigations, which may reduce the burden of testing in some cases, as well as better identify higher-risk patients who would benefit from earlier, dedicated, and comprehensive cardiovascular evaluation.

Background: Hypericum species are widely acknowledged for their biological attributes, with notable attention being paid to Hypericum perforatum, commonly known as St. John’s wort (SJW) within the Hypericum section of the Hypericaceae family. This species is among the most thoroughly investigated herbal medicines, particularly in terms of its application in the management of mild to moderate depression. SJW is used to treat depression, menopausal symptoms, attention-deficit hyperactivity disorder (ADHD), somatic symptom disorder, obsessive–compulsive disorder, and skin conditions, such as wounds and muscle pain. However, the usefulness and effectiveness of SJW for male sexual and reproductive health (SRH) are not well known. Objective: To assess the current evidence in the literature on the effect of SJW on male SRH. Methods: This narrative review followed a predetermined protocol and used MEDLINE and PubMed to identify articles published in English on the effects of SJW on male SRH. The search used various keywords, such as “Hypericum Perforatum”, “St. John’s Wort”, and terms related to sexual and reproductive health issues. Articles published between the inception of the database and August 2023 were included. Results: We identified 12 articles published from 1999 to 2019, the majority of which were experimental and conducted on animals. These studies demonstrate variability in terms of design, sample size, type of SJW extract used, the dosage administered, and duration of treatment. Studies have indicated potential sexual dysfunction (SD) due to SJW, which includes reduced libido, delayed ejaculation, delayed orgasm, and erectile dysfunction. Additionally, reproductive toxicity has been suggested, as evidenced by spermicidal effects through the inhibition of sperm motility, abnormal spermatozoa, chromosomal aberrations, and DNA denaturation. Furthermore, some studies have reported potential adverse events during maternal exposure, inhibition of fertilization, and disruption of reproductive parameters. Conclusions: Our review suggests that the safety and efficacy of SJW in the treatment of human SRH remain unclear. Further comprehensive, well-designed studies with larger samples, longer exposure periods, and specific dosages are needed to clarify SJW's effects of SJW. Therefore, consultation with healthcare professionals before using herbal remedies or supplements is crucial.

Abstract Background Alagille syndrome (ALGS) is a rare autosomal dominant multisystem disorder that affects the liver, heart, eyes, vertebrae, and kidneys and is associated with characteristic facies. This work aimed to study the spectrum of the clinical features of ALGS in an Egyptian cohort of patients in conjunction with partial sequencing of the JAG1 gene. Methods This study included 17 pediatric ALGS patients diagnosed on clinical grounds: facial features, cholestatic liver disease, and cardiac, vertebral, and ocular findings. Molecular analysis was conducted in 10 selected exons of the JAG1 gene. Results The clinical features of ALGS included cholestatic liver disease (100%), facial dysmorphism (100%), cardiac abnormalities (88.2%), butterfly vertebrae (64.7%), posterior embryotoxon (35.2%), poor growth (41%), xanthomata (11.8%), and hiatus hernia (11.8%). Five novel pathogenic JAG1 mutations were identified in this study, including two nonsense mutations, one splicing mutation, one frameshift insertion, and one frameshift deletion. In two patients, the mutations were confirmed to be de novo, as the mutations could not be detected in both parents. Conclusion Five novel JAG1 pathogenic variants were identified in this study. This is the first molecular study to report pathogenic mutations in the JAG1 gene within an Egyptian cohort of children with ALGS.

Abstract Background Waldenstrom macroglobulinemia (WM) is a rare lymphoma with an incidence rate of 3 per million people per year, with approximately 1000 to 1500 new cases diagnosed each year in the USA. It is primarily seen in Caucasian males with a median age of 70 years old. Patients are most often asymptomatic, but WM can manifest itself with constitutional symptoms such as lethargy, bleeding, organomegaly, and neurological or fundoscopic abnormalities. WM is characterized by immunoglobulin M (IgM) monoclonal gammopathy, lymphocytic infiltration of bone marrow, and normocytic anemia due to bone marrow replacement. Case presentation Our patient is a Hispanic 67-year-old female that presents with one month of intermittent band-like bilateral headache accompanied by dizziness, light-headedness, nausea, and blurred vision. A thorough diagnostic workup was performed, including serum protein electrophoresis (SPEP) with serum immunofixation (SIFE) showing an M spike and IgM kappa. Bone marrow biopsy was significant for lymphoplasmacytic infiltration with nodular B cells (CD19+, CD20+, CD22+). Computerized Tomography (CT) imaging showed splenomegaly in the patient. Treatment was provided for hyperviscosity syndrome with plasmapheresis twice. The patient reported improvement of her symptoms and was then scheduled for chemotherapy. Throughout 7 months, our patient received multiple cycles of bortezomib, dexamethasone, and rituximab. While her symptoms improved her psychiatric status got progressively worse. Conclusion It is important not to neglect symptoms such as a headache, which may seem small, but could serve as a clue in the diagnosis of Waldenstrom's macroglobulinemia.

Orthogonal Frequency Division Multiplexing (OFDM) is the best choice for wireless and wired high data rate communications. The OFDM system has many advantages such as high spectral efficiency, robustness to channel fading, and immunity to impulse interference. However, it has a main drawback, which is the Peak to Average Power Ratio (PAPR). Selecting Mapping (SLM) and Partial Transmit Sequences (PTS) are the two essential techniques for reducing the PAPR; however, they need to send side information to indicate how the transmitter generates signals. In this paper, Particle Swarm Optimization (PSO)-based dummy sub-carriers are inserted with the data to reduce PAPR without transmitting side information. The incorporation of PSO-based Dummy Sub-carriers Insertion (DSI) method on this system is performed by measuring the PAPR at the IFFT output (Inverse Fast Fourier Transform) after adding 6 adaptive sub-carrier sequences to the input data of IFFT. The PSO-based dummy algorithm decides to send the data once the PAPR of this data sequence and dummy sub-carrier is under a specific threshold. Using MATLAB as a mathematical simulation tool, simulation results are presented for a standard OFDM network model. The network model has been simulated in an Additive White Gaussian Noise (AWGN) channel environment to investigate PAPR and Bit-Error Rate (BER) performance. The simulation results show that the dummy sequence based on PSO reduces PAPR down to 4 dB compared to a conventional OFDM system and down to 3 dB compared with the clipping technique for the same BER performance.

Dent defects can decrease the life span of oil and gas pipelines. Therefore, they need constant monitoring and maintenance to ensure the pipeline’s safety and integrity. Subsequently, this paper performs a strain-based reliability analysis on pipe dent defects using a response surface method (RSM) with a quadratic response surface (RS), including the interaction terms between the RS variables. The analyses are performed to determine the factors controlling the dent defects’ probability of failure (POF). Different pipe configurations, pipe lengths, indenter sizes, and dent depths are considered in this study. A suitable finite element (FE) model for the reliability analysis was developed for this study using the FE analysis software ABAQUS. The uncertainties in the pipe wall thickness, the dent depth, the yield strength of the pipe material, and the strain capacity are considered for the reliability analysis. The first-order reliability method (FORM) is used in the RSM as the reliability method to calculate the POF and the most probable point (MPP). The POFs of several dent defects were calculated. It has been found that the POF, which is highly related to the nominal value of the maximum equivalent plastic strains generated in the dent defect, is not only related to the indentation depth or the size of the indenter. Thus, the dent depth criterion used in the engineering practice can lead to inconsistent reliability levels in dented pipes.

This paper is dedicated to studying the stages that Telafer University has gone through at using E-learning. The challenges of converting traditional learning (i.e. classical learning with realistic student attendance in their teaching programs) to E-learning over google classrooms. The efforts to maintain the quality teaching and their outcomes were a very ambiguous experiment that led the authors after more than two years for spreading the Covid-19 Pandemic to evaluate the University's performance using the most modern mathematical tools in uncertainty systems that called the Neutrosophic theory and logic. Finally, the flexibility of the neutrosophic mathematical methods has been applied to analyze the recorded issued data of E-learning in the University.

Abstract Bacterial cellulose (BC) is an ecofriendly biopolymer with diverse commercial applications. Its use is limited by the capacity of bacterial production strains and cost of the medium. Mining for novel organisms with well-optimized growth conditions will be important for the adoption of BC. In this study, a novel BC-producing strain was isolated from rotten fruit samples and identified as Lactiplantibacillus plantarum from 16S rRNA sequencing. Culture conditions were optimized for supporting maximal BC production using one variable at a time, Plackett–Burman design, and Box Behnken design approaches. Results indicated that a modified Yamanaka medium supported the highest BC yield (2.7 g/l), and that yeast extract, MgSO4, and pH were the most significant variables influencing BC production. After optimizing the levels of these variables through Box Behnken design, BC yield was increased to 4.51 g/l. The drug delivery capacity of the produced BC membrane was evaluated through fabrication with sodium alginate and gentamycin antibiotic at four different concentrations. All membranes (normal and fabricated) were characterized by scanning electron microscope, Fourier transform-infrared spectroscopy, X-ray diffraction, and mechanical properties. The antimicrobial activity of prepared composites was evaluated by using six human pathogens and revealed potent antibacterial activity against Escherichia coli, Klebsiella pneumoniae, Staphylococcus aureus, and Streptococcus mutans, with no detected activity against Pseudomonas aeruginosa and Candida albicans.

Introduction Pulmonary arterial hypertension (PH) is commonly found in patients with mitral valve diseases. Most of the drugs used for PH treatment are nonselective pulmonary vasodilators that may cause a modest decrease in pulmonary arterial pressure, but they may cause a marked decrease in systemic vascular resistance as well, which leads to hypotension and a decrease in perfusion of vital organs. Inhaled drugs such as milrinone and nitroglycerine may be safer as a large dose of the drug can selectively target the pulmonary circulation, which leads to a reduction of their systemic adverse effects. Aim This double-blind, randomized study compared milrinone inhalation versus nitroglycerin inhalation on pulmonary artery pressure and other hemodynamics in postoperative patients immediately after mitral valve replacement surgery. Patients and methods A total of 40 participants with isolated mitral stenosis or isolated mitral incompetence or their combination plus PH [mean pulmonary artery pressure (mPAP) >40 mmHg] scheduled for mitral valve replacement were interviewed. Immediately postoperatively in the ICU, we randomized the patients into two groups, with 20 patients each. Group A consisted of 20 patients who received milrinone inhalation, whereas group B consisted of 20 patients who received nitroglycerine inhalation. Hemodynamic parameters (heart rate, systolic blood pressure, diastolic blood pressure, mean blood pressure, central venous pressure, pulmonary artery systolic pressure, pulmonary diastolic pressure, mPAP, fractional shortening, ejection fraction, and pressure of oxygen/fraction of inspired oxygen ratio) were recorded in both groups at three time points: T1, before drug delivery; T2, just after drug delivery; and T3, just before extubation. Results The study showed that both milrinone and nitroglycerin inhalation caused a marked reduction in systolic, diastolic, and mPAPs without causing any hemodynamic deterioration effects on systolic, diastolic, or mean arterial pressures. Conclusion Although both milrinone and nitroglycerin inhalation proved to be effective pulmonary artery vasodilators that avoided systemic adverse effects, nitroglycerin inhalation is a less expensive, easily obtained drug that can serve as an inhaled pulmonary vasodilator in patients with mitral valve diseases and PH following mitral valve replacement surgeries.

Objectives: The present study explores how young urologists in Saudi Arabia are adopting social media as a learning tool and how this new development is shaping as far as learning is concerned. Methods: A 18-item online survey via survemonkey.com was conducted. The survey was distributed through email in Saudi Arabia. The survey targeted young urologists and urology residents. The survey design and distribution was performed according to CHERRIES guidelines. Due to the quantitative nature of study data, SPSS software was used to analyze collected data. Results: A total of 104 young Saudi urologists responded to our survey. Participants were mostly familiar with the use of Twitter (86%), followed closely by YouTube (82%) and then Snapchat and Instagram (73% and 63%, respectively), a large portion (72%) of participants believe that social media has a moderate-to-high influence on their urology knowledge, YouTube was by far the most used source to watch and understand surgical skills, followed by reference books and websites, respectively. Conclusion: Social media has contributed to the spread of medical information among urology community and outside the urology community as well, with easier spread of medical knowledge to all involved by using social media, an extensive impact is achieved to both physicians and patients as well. For future work, this study should be conducted again, to monitor and compare the progression of usage among urologists.

Background: Febrile seizure is the most common convulsive disorder in childhood. The role of iron in the metabolism of neurotransmitters and carrying oxygen to the brain suggests the possibility of a relationship between iron-deficiency anemia and febrile seizures. Objectives: The aim of study is to study the role of iron-deficiency anemia as a risk factor for febrile seizures. Materials and Methods: This is a hospital-based case–control study performed in 30 children with febrile seizures (case) and 80 febrile children without seizures (control) who were aged between 6 and 60 months. The groups were matched in terms of age, gender, and the use of supplemental iron. Laboratory tests consisted of complete blood count, serum iron, plasma ferritin were done for each patient. Results: Thirty-four percent of the cases with febrile seizure had iron-deficiency anemia compared with 20% of children with febrile illness without seizure and 12% of healthy children. The odds ratio for iron-deficiency anemia in the patients with febrile seizure was 3.059 (95% confidence interval (CI) = 0.969–9.657) compared with the febrile children without convulsion and 5.608 (95% CI = 1.834–17.146) compared with the healthy group. Conclusion: Based on the result of this study, iron deficiency could be an important risk factor for the development of febrile convulsion. This encourages the evaluation of iron status in children with febrile seizure.

Internet Protocol version 6 (IPv6) is envisioned as the cornerstone for future internet connectivity and information technology (IT) expansion. Due to its enormous address pool, extendable headers, high level of security, and mobility, IPv6 is positioned as the next-generation Internet Protocol. NDP is an integral component of IPv6 since it resolves addresses, locates routers, and finds duplicated addresses in a local-link network. Because NDP is based on the premise that all nodes in the network are trustworthy, it is subject to a variety of attacks, including Denial of Service (DoS) on Duplicate Address Detection (DAD) attacks (aka. DoS-on-DAD), Address Resolution-based attacks, Router Advertisement (RA) based attacks, and Redirect attacks. This paper proposes an NDP security (NDPsec) mechanism based on the Ed25519 digital signature to authenticate IPv6 hosts to prevent unauthorized devices from joining the network. The proposed NDPsec mechanism is evaluated and compared to Secure NDP (SeND), Match-Prevention, and Trust-ND mechanisms. The performance is measured in terms of processing time, traffic overhead, and resilience against network-based attacks. The results obtained from the experiments showed that NDPsec successfully prevented cyberattacks, with approximately 144% less processing time and over 50% less traffic overhead compared to SeND (the default security mechanism for NDP protocol). The proposed NDPsec mechanism has remarkable superiority in terms of resilience against attacks compared to Match-Prevention and Trust-ND mechanisms.

Modern wearable healthcare devices require new technologies with resource efficiency in terms of high performance, low energy consumption and diagnostic accuracy. In the field of artificial intelligence, the convolutional neural network (CNN) has performed as an effective algorithm. Field-programmable gate arrays (FPGAs) have been extensively utilised to construct hardware accelerators for CNNs. This paper suggests using an accelerator to create a specific 1-D CNN to classify the electrogram (ExG). ExGs used here include electrocardiogram, electroencephalogram and electromyography. The pipelined structure is designed with a register in the middle to facilitate easy data transfer. A 1-D CNN using an accelerator to categorise ExG signals implemented on Xilinx Zynq xc7z045 platform outperforms FPGA peer applications on the same platform by $1.14\times $ in terms of speed. In addition, the 1-D CNN proposed accelerator operates very efficiently due to the use of a tristate buffer in the multiplexer and the substitution of the shift for the multiplier, resulting in a resource-efficient accelerator with 161 GOP/s/W energy efficiency and 28 GOP/s/KLUT, an improvement of 1.67 over the previous model. Finally, the performance of the accelerator applied to a Xilinx Zynq xc7z045 FPGA operating at 442.948MHz was calculated, achieving 1.145 TFLOP/s.

Background and aim Previous studies reported that iron-deficiency could be a risk factor for febrile seizure (FS), as the latter is more common in children younger than 2 years, and iron-deficiency anemia is also common in children of the same age. Yet, the relationship between iron deficiency and FS is not yet determined, and that is why this study was suggested. The aim of this study was to assess the association between iron-deficiency anemia and febrile convulsion (FC). Patients and methods This study included 60 children aged 6 months to 5 years. These children were divided into three groups: a group of 20 patients with FC, a group of 20 patients with fever but without FC, and a group of 20 healthy children. Results The main findings of this study were that there was a higher incidence of FSs found among children who received formula feeding. Furthermore, children with FSs had the lowest level of hematocrit, mean corpuscular volume, mean corpuscular hemoglobin concentration, and transferrin saturation values. However, iron-deficiency anemia was not associated with increased incidence of FCs. Conclusion It can be concluded that formula feeding, low hematocrit, mean corpuscular volume, mean corpuscular hemoglobin concentration, and transferrin saturation are reinforcing factors for FSs.

Introduction For so many years, femoral access has been the standard access for all interventional cardiologists performing coronary angiography and percutaneous coronary interventions. In the past 15 years, radial access gained more fame over femoral access as it has a lower risk of bleeding and it is more convenient to patients due to early mobilization and less hospital stay. Recently, the distal transradial access in the anatomical snuffbox has emerged as a new access for coronary procedures that carries some advantages over the standard proximal transradial access. These advantages include radial artery preservation in patients who may use radial artery graft for coronary bypass surgeries and those with end-stage renal disease who may use the radial artery for arterio-venous fistula. Aim The aim of this study is to compare the feasibility, safety, and complications of coronary angiography and intervention between distal transradial and conventional transradial access. Patients and methods This study was conducted between January 2019 and June 2020 on 100 patients who presented with chronic coronary syndrome previously known as stable angina to the outpatient clinic of our center who were scheduled for coronary angiography with possible coronary angioplasty if indicated. These patients were categorized into two groups, group A that consisted of 50 in which coronary angiography was done by conventional transradial route and group B that consisted of 50 in which coronary angiography was done by distal transradial route. Their demographic features and complications were recorded. Results Our results showed that patients who had their procedures through conventional radial access had more hematoma, bleeding, hand ischemia, and loss of radial artery than those who had their procedures done through distal transradial access. Conclusion From our results, we can conclude that distal transradial access in the anatomical snuffbox for coronary angiography and intervention is a better alternative, safe, and feasible option in comparison to conventional transradial access for both patients and operators.

For many reasons, Ethereum attracts more investors, researchers, and even scammers; this is the first platform that enables the new Decentralized Applications (DApps) to run on top of the blockchain network. However, the rich semantics and applications of DApps inevitably introduce many security issues that have grabbed significant attention from industry and academics due to their destructive impact on DApps in recent years. Therefore, there is a vital need to study the applicability of Intrusion Detection System in detecting Ethereum-based attacks. Hence, this paper is among the first comprehensive review that studies the applicability of IDS in detecting Ethereum-based attacks. In addition, this paper lists all the potential attacks on Ethereum passing through the vulnerabilities that cause those attacks and ending with the consequences of each attack. Furthermore, this paper analyses all the IDS-based related works of Ethereum attacks detection since the Ethereum platform was launched in 2015. Finally, this paper discusses the open issues regarding vulnerabilities and attacks, challenges, and future directions.

Prediction of the formation of pore and fracture pressure before constructing a drilling wells program are a crucial since it helps to prevent several drilling operations issues including lost circulation, kick, pipe sticking, blowout, and other issues. IP (Interactive Petrophysics) software is used to calculate and measure pore and fracture pressure. Eaton method, Matthews and Kelly, Modified Eaton, and Barker and Wood equations are used to calculate fracture pressure, whereas only Eaton method is used to measure pore pressure. These approaches are based on log data obtained from six wells, three from the north dome; BUCN-52, BUCN-51, BUCN-43 and the other from the south dome; BUCS-49, BUCS-48, BUCS-47. Along with the overburden pressure gradient and clay volume, which were also established first, data such as gamma ray, density, resistivity, and sonic log data are also required. A key consideration in the design of certain wells is the forecasting of fracture pressure for wells drilled in the southern Iraqi oilfield of Buzurgan. The pressure abnormality is found in MA, MB21, MC1 and MC2 units by depending on pore pressures calculated from resistivity log. In these units, depths and its equivalent normal and abnormal pressure are detected for all sex selected wells; BUCS-47, BUCS-48, BUCS-49, BUCN-43, BUCN-51 and BBCN-52. For MA, MB21, MC1, and MC2 units, the highest difference in pore pressure values are 1698 psi @ 3750 m (BUCN-51), 3420 psi @ 3900 m (BUCN-51), 788 psi @ 3980 m (BUCS-49), and 5705 psi @ 4020 m (BUCN-52). On other hands, MB11 and MB12 units have normal pressure trend in all studied wells. Finally, the results show that the highest pore and fracture pressure values is existed in North dome, in comparison with that obtained in south dome of Mishrif reservoir at Buzurgan oilfield.

Therapeutic Area: ASCVD /CVD Risk Reduction Background: Over half of the US adults use Dietary supplements to improve their general health and prevent cardiovascular disease. We aimed to evaluate the effects of the above mentioned supplements on endothelial function, inflammation and cardiovascular risks over 90 days. Methods: A single-center, prospective, double-blinded, randomized, placebo-controlled (1:1 ratio) clinical trial was performed at the Lundquist institute at harbor-UCLA medical center. 53 asymptomatic volunteers aged ≥18 years, with SBP >120 or DBP >80 mmHg were enrolled. Each participant received 6 capsules daily for 90 days. The primary endpoint was changes from baseline in inflammatory markers including hypersensitive C - reactive protein (hsCRP), interleukin 6 (IL6) and Tumor Necrosis Factor Alpha (TNF-α), urine creatinine and F2-Isoprostane after 90 days. The secondary endpoint was change in endothelial function measured by Flow Mediated Dilatation (FMD) of brachial artery, Cardio-Ankle vascular index (CAVI) and blood pressure. Tertiary endpoint was changes from baseline in cholesterol, lipoprotein fractions (LDL and HDL), Triglycerides, and Omega fatty acids index. The final endpoint was supplement's safety. Results: 53 participants were randomized. 52 completed the trial with 26 in each group. The average age was 44.3±16.4 years and 52% were females. Both groups had similar demographics and risk factors, p>0.20.After taking the supplements for 90 days, the active group showed a significant increase in Omega-3 EPA, Omega-3 DPA and total Omega-3 levels, beside decrease in Omega-6 level, all P

Introduction The protocol presents the methodology of a scoping review that aims to synthesise contemporary evidence on the management and outcomes of intracranial fungal infections in Africa.Methods and analysis The scoping review will be conducted in accordance with the Arksey and O’Malley’s framework. The research question, inclusion and exclusion criteria and search strategy were developed based on the Population, Intervention, Comparator, Outcome framework. A search will be conducted in electronic bibliographic databases (Medline (OVID), Embase, African Journals Online, Cochrane Library and African Index Medicus). No restrictions on language or date of publication will be made. Quantitative and qualitative data extracted from included articles will be presented through descriptive statistics and a narrative description.Ethics and dissemination This study protocol does not require ethical approval. Findings will be reported in a peer-reviewed medical journal and presented at local, regional, national and international conferences.

Background: Bilateral tumors in double organs like bilateral adrenal neuroblastoma are highly rare. Few cases have been reported in the literature. Case reports: A full-term male infant, 11 months old, had an abdominal mass diagnosed by triphasic abdominal CT as bilateral adrenal neuroblastoma. The case was stage 1, and the management was bilateral adrenalectomy. Discussion: When the neuroblastoma mass measures less than 5 cm in diameter, the infant can likely be safely supervised without cytoreduction surgery or histological confirmation of the tumor, but if the tumour progressively increases in size or the size is greater than 5 cm, then surgery is essential. Conclusion: Surgery is the best option when an infant has bilateral large localized adrenal neuroblastoma.

Background: Enteropathy-Associated T-Cell Lymphoma (EATL) is a rare lymphoma of T-cell origin associated with celiac disease. There is limited evidence in the literature about the incidence and causes of death in patients with EATL. Methods: We performed a retrospective study through analyzing the Surveillance, Epidemiology, and End Results (SEER) data base to determine the incidence, trends and causes of death of patients with EATL in the U.S from 2000 to 2018. Baseline characteristics with treatment options (surgery, radiotherapy, and chemotherapy), status of patients either alive, dead due to cancer itself or other non-cancerous causes with listing of those non-cancerous causes was retrieved. Sub-group analysis based on sex was also done. Multiple latency periods (

PurposeCerebral vasospasm following aneurysmal subarachnoid hemorrhage (aSAH) is a significant complication associated with poor neurological outcomes. We present a novel, semi-automated pipeline, implemented in the open-source medical imaging analysis software ITK-SNAP, to segment subarachnoid blood volume from initial CT head (CTH) scans and use this to predict future radiological vasospasm.Methods42 patients were admitted between February 2020 and December 2021 to our tertiary neurosciences center, and whose initial referral CTH scan was used for this retrospective cohort study. Blood load was segmented using a semi-automated random forest classifier and active contour evolution implemented in ITK-SNAP. Clinical data were extracted from electronic healthcare records in order to fit models aimed at predicting radiological vasospasm risk.ResultsSemi-automated segmentations demonstrated excellent agreement with manual, expert-derived volumes (mean Dice coefficient = 0.92). Total normalized blood volume, extracted from CTH images at first presentation, was significantly associated with greater odds of later radiological vasospasm, increasing by approximately 7% for each additional cm3 of blood (OR = 1.069, 95% CI: 1.021-1.120; p < .005). Greater blood volume was also significantly associated with vasospasm of a higher Lindegaard ratio, of longer duration, and a greater number of discrete episodes. Total blood volume predicted radiological vasospasm with a greater accuracy as compared to the modified Fisher scale (AUC = 0.86 vs 0.70), and was of independent predictive value.ConclusionSemi-automated methods provide a plausible pipeline for the segmentation of blood from CT head images in aSAH, and total blood volume is a robust, extendable predictor of radiological vasospasm, outperforming the modified Fisher scale. Greater subarachnoid blood volume significantly increases the odds of subsequent vasospasm, its time course and its severity.

To improve power quality in power systems vulnerable to current disturbances and unbalanced loads, a hybrid control scheme is proposed in the present paper. A hybrid adaptive robust control strategy is devised for an SMIB power system equipped with a static VAR compensator to ensure robust transient stability and voltage regulation (SVC). High-order sliding mode control is combined with a dynamic adaptive backstepping algorithm to form the basis of this technique. To create controllers amenable to practical implementation, this method uses a high-order SMIB-SVC model and introduces dynamic constraints, in contrast to prior approaches. Improved transient and steady-state performances of the turbine steam-valve system are the goals of the dynamic backstepping controller. A Lyapunov-based adaptation law is developed to address the ubiquitous occurrence of parametric and nonparametric uncertainty in electrical power transmission systems due to the damping coefficient, unmodeled dynamics, and external disturbance. High-order sliding mode (HOSM) control is used for generator excitation and SVC devices to construct finite-time controllers. The necessary derivatives for HOSM control are calculated using high-order numerical differentiators to prevent simulation instability and convergence issues. Simulations demonstrate that the suggested method outperforms conventionally coordinated and hybrid adaptive control schemes regarding actuation efficiency and stability.

IntroductionThe aim of this research is to identify the effect of Small-sided games using the FITLIGHT training system on some of the harmonic abilities and some of the basic skills of basketball Players.MethodsThe researchers used the experimental method on 24 basketball players. They were randomly divided into two groups: one experimental (n = 12, age = 10.92 ± 0.79 years; height = 138.50 ± 2.78 cm; weight = 40.25 ± 2.01 kg) and a control group (n = 12, age = 11.17 ± 0. 72 years; length = 139.92 ± 3.53 cm; weight = 40.50 ± . 1.73 kg). The homogeneity between the two groups was calculated and showed that there were no differences between the two samples. In the research variables, the proposed program was applied for 10 weeks at the rate of 4 weekly training units.Results and DiscussionThe proposed training program had a positive impact on the harmonic abilities and basic skills of basketball players and the differences in improvement rates for all variables were in favor of the experimental group. Therefore, the research suggests that Small-sided games using FITLIGHT positively affect all the variables under research. This leads to significant differences between the post-tests and benefits the experimental group.

Background Following a diagnosis of a small unruptured intracranial aneurysm (sUIA), patients often experience psychological ailments which may be attributable to the neurovascular consultation, referral pathway, or long‐term imaging surveillance. Here, we aim to characterize the early sUIA patient journey and evaluate their psychosocial status. Methods A mixed‐methods analysis of sUIA patients attending a large tertiary neurosciences center was performed. For patients presenting to the neurovascular service in 2020, this included: (i) a thematic analysis of patient perspectives extracted from semistructured telephone interviews, (ii) a quantitative assessment of psychological status using the Hospital Anxiety and Depression Scale and (iii) an evaluation of functional independence using a customized activity of daily living questionnaire. The relationship between service or clinical factors, and Hospital Anxiety and Depression Scale subscale scores was statistically tested. Results The sUIA patient cohort (n=105) had a mean age of 56.8 years (SD=15.8, female=69). Thematic analysis of interview responses (n=33) identified 5 recurrent themes underpinning the sUIA patient experience: referral, diagnosis and information sharing, imaging surveillance, psychological impairment and coping strategies, and activities of daily living, all of which contributed to patient concerns. A total of 53.6% of patients achieved a Hospital Anxiety and Depression Scale score signifying at least mild anxiety and/or depression. Lifestyle changes most frequently affected after diagnosis included avoidance of straining‐intensive exercise, change in patterns of substance use, and work‐related performance. Multivariate analysis revealed no significant service or clinical predictors for anxiety or depression. Conclusion For some patients, an sUIA diagnosis appears to be associated, at least qualitatively, with a psychological burden. This is likely mediated through stressors related to the referral, diagnosis, neurosurgical consultation, and image surveillance. In the absence of evidence‐based guidelines regarding these aspects of the early patient journey, we offer suggestions aimed at improving both the neurovascular service and sUIA patient experience.

Microplastics are ubiquitous in Earth’s ecosystems and many efforts have begun to understand their distributions. Large rivers, like the Mississippi River, provide a unique system in which to look at large-scale patterns of microplastic distribution. In this study, we sampled four species of widely-distributed fishes from five sites along the mainstem Mississippi River, from Minnesota to Louisiana, United States. Microplastics were found in all fish species and at all sites; however, microplastics increased in occurrence in the Lower Mississippi River. Fragments were the most common morphologies and polypropylene was the most common polymer detected. We also examined the hypothesis that microplastic loads in fishes increased downstream, but found support for this hypothesis only when examining Largemouth Bass; Flathead Catfish, Shortnose Gar, and Bluegill were all found to have similar microplastic loads along the mainstem Mississippi River. It is clear that microplastics are heterogeneously distributed throughout ecosystems, and further understanding of microplastic distributional patterns and varying species burdens are needed to fully understand threats that microplastics present.

IntroductionMelanoma is the fifth most common cancer in US, and the incidence is increasing 1.4% annually. The overall survival rate for early-stage disease is 99.4%. However, melanoma can recur years later (in the same region of the body or as distant metastasis), and results in a dramatically lower survival rate. Currently there is no reliable method to predict tumor recurrence and metastasis on early primary tumor histological images.MethodsTo identify rapid, accurate, and cost-effective predictors of metastasis and survival, in this work, we applied various interpretable machine learning approaches to analyze melanoma histopathological H&E images. The result is a set of image features that can help clinicians identify high-risk-of-metastasis patients for increased clinical follow-up and precision treatment. We use simple models (i.e., logarithmic classification and KNN) and “human-interpretable” measures of cell morphology and tissue architecture (e.g., cell size, staining intensity, and cell density) to predict the melanoma survival on public and local Stage I–III cohorts as well as the metastasis risk on a local cohort.ResultsWe use penalized survival regression to limit features available to downstream classifiers and investigate the utility of convolutional neural networks in isolating tumor regions to focus morphology extraction on only the tumor region. This approach allows us to predict survival and metastasis with a maximum F1 score of 0.72 and 0.73, respectively, and to visualize several high-risk cell morphologies.DiscussionThis lays the foundation for future work, which will focus on using our interpretable pipeline to predict metastasis in Stage I & II melanoma.

Background: Intussusception of the appendix is a relatively rare condition with an estimated incidence of 0.01%. It can mimic several clinical conditions including acute appendicitis or be mistaken as a cecal polypoid lesion on radiological imaging making the diagnosis before or during surgery is very difficult. Case presentation: A 6-year-old female presented to our unit with complaining of colicky abdominal pain and repeated vomiting for 3 days with no history of constipation. Abdominal examination revealed mild right iliac fossa tenderness and mild abdominal distension. Abdominal ultrasound revealed subhepatic intussusception mass measuring about 3 × 4 cm suggesting underlying Meckel's diverticulum. Three trials of hydrostatic reduction under ultrasound guidance were failed. Abdominal exploration revealed appendiceal intussusception mimicking cecal mass with failed trial of reduction. Ileocecectomy done with primary ileocolic anastomosis. We discharged our patient on the seventh day postoperatively. Conclusions: We report a rare case of appendiceal intussusception that required ileocecectomy in young female child. appendiceal intussusception is very rare condition but it must be considered in children.

Background: In most cases, ingested foreign bodies pass in alimentary tract silently. Rarely, ingested foreign bodies enter vermiform appendix. However, when it happened, they cannot reenter alimentary tract and may result in an inflammatory process. We report a case of iliopsoas abscess secondary to ingested metallic foreign body penetrating appendix. Case presentation: A 2-year-old child presented to our unit with her mother complaining that her child developed fever, repeated vomiting, and abdominal distension after one week of accidently ingestion of a rusty veil pin. Abdominal examination revealed right iliac tenderness and rebound tenderness. Abdominal ultrasound and multi-slice computer topography (MSCT) with intravenous contrast and gastrograffin enema revealed right iliopsoas abscess and metallic foreign body piercing appendicular wall with its tip seen in the iliopsoas abscess. We do appendectomy via transabdominal approach with good drainage of the abscess cavity. We discharged our patient on the fifth day postoperatively. Conclusions: The ingestion of inedible and indigestible objects is frequent in children. In most cases, ingested foreign bodies (FB) pass in alimentary tract silently. Rarely, ingested foreign bodies enter vermiform appendix and if it happened it may result in devastating complications as iliopsoas abscess. The is necessary to increase awareness of potential complications of ingested foreign bodies, especially in children.

The effect of seed treatment of chickpea (Cicer arietinum L.) with biotic inducers such as Trichoderma viride, Trichoderma harzianum, Pseudomonas fluorescens and Bacillus subtilis in contrast to the fungicide Rizolex-T, were evaluated in the greenhouse and under field conditions during the 2017/2018 season to control the plant disease caused by Fusarium oxysporum, Rhizoctonia solani, or Sclerotinia sclerotiorum, at Giza Agriculture Research Station, Agricultural Research Center, Giza Governorate, Egypt. The tested strains significantly inhibit the mycelial growth of the three tested fungi for pathogenic growth. Compared to the untreated control under greenhouse and field conditions, all the biotic inducer treatments tested significantly decreased the percentages of damping-off, root rot, stem rot and/or wilt diseases. It was noticed that Rizolex-T and (Trichoderma viride + Trichoderma harzianum) have reached the highest percentage of surviving plants followed by (Pseudomonas fluorescens + Bacillus subtilis), Trichoderma viride, Trichoderma harzianum, Bacillus subtilis, Pseudomonas fluorescens and Serratia marcescens, respectively. As well as all the treatments of the checked biocontrol agents increased the growth and yield parameters of chickpea significantly, i.e., plant hight, branches number per plant, pods number per plant, seeds number per plant, seeds weight per plant, 100 seeds weight, and chickpea yield ton/fed. In the presence of the three studied pathogens, defense-related enzyme activities (β-1,3 glucanase, peroxidase, and polyphenoloxidase) have also been determined in all chickpea plants treated with tested biotic inducers compared to untreated infested and non-infested control. The treatment of (Trichoderma harzianum + Trichoderma viride) showed the highest increase in phenol content and the activities of defense-related enzymes.

Arteriovenous malformations (AVMs) are congenital high flow pathologic linkages between arteries and veins of different sizes that may occur in any part of the body. The clinical presentation is largely dependent on the size and location of AVMs and can range from an asymptomatic birthmark to congestive heart failure in extreme cases. In this report, we describe a 20-year-old male who presented with a large AVM of the right shoulder that resulted in significant cosmetic and physical impairment and treated with several sessions of endovascular embolization with good clinical outcomes. This case highlights the complexity of diagnosing and managing these AVMs. Most of these anomalies require a multi-disciplinary approach that integrates both trans-catheter and surgical interventions with trans-arterial lesion embolization being the cornerstone of the treatment.

The marine environment is a dynamic and diversified network of habitats and species. The more oil explorations occur in the marine environment, the more strategies of preparedness and response to oil spills should be designed.Once the oil is introduced to the marine environment, it undergoes a series of natural processes known as 'weathering.' For a successful response operations and protection, it is critical to precisely estimate the behavior of the spilled oil.Twenty-four simulated scenarios were created (12 Regular and 12 Worst Cases Scenarios) and run into the licensed Canadian SL-Ross predictive mathematical oil spill model, which successfully was used as a decision support and response tool to investigate the oil spill trajectory, beaching of oil, and its fate from the expected oil drilling rig source near Ras Gharib area in the Red Sea Region.Twenty-four oil spill trajectories maps were developed, which predicted all possibilities and probabilities of oil spill movements. Accordingly, the oil spill trajectories varied not only in magnitude and directions, but also in the shoreline interaction time (hrs.).The weathering processes are shown in ten graphs, which provided output data regarding the change in the spill's total area of slick (km2), the volume of slick (bbl.), the emulsion water content percentage, the rate of evaporation percentage, and the rate of natural dispersion percentage.

The neutrosophic mathematical linear programming in its duality fashion is originally exhibited in this manuscript. In accordance with this concept, the relationship of the duality between the neutrosophic objective functions and neutrosophic constraints is given, three versions of linear programming related to μD(x), σD(x), and vD(x) have been originated respectively, some important propositions have been discussed, two numerical examples were considered in the economic interpretation and in the hybrid renewable energy production.

Abstract Background Screening of β thalassemia among close relatives is more feasible in highly prevalent countries with limited resources. The purpose of this study is to determine the prevalence of β thalassemia carriers and iron deficiency anemia among relatives of β thalassemia patients in Mid Delta, Egypt. Methods This is a cross-sectional multi-center study conducted on 2118 relatives of patients with β thalassemia from different Egyptian governorates in the Mid Delta region. They were subjected to history taking with precise determination of geographic location, general examination, and the following investigations: complete blood counts, serum ferritin for those who showed microcytic hypochromic anemia, and high-performance liquid chromatography for those who were not diagnosed as iron deficiency anemia. Results The total prevalence of iron deficiency anemia among close relatives of confirmed β thalassemia patients in the Nile Delta region was 17.19%. The highest prevalence of iron deficiency anemia (45.05%) was reported in Al-Gharbia Governorate, followed by Al-Menoufia Governorate (21.67%), and the lowest prevalence was that of Al-Sharkia Governorate (4.91%). The differences were highly statistically significant (p < 0.001). β thalassemia carrier prevalence rate in the studied relatives was 35.84%, with the highest prevalence detected in Al-Sharkia Governorate (51.32%), followed by Kafr-Alsheikh and Al-Dakahilia Governorates (41.78%, 37.13%) respectively, while Al-Menoufia Governorate had the lowest prevalence rate (25.00%). These differences were also highly statistically significant (p < 0.001). Conclusion More than one-third of relatives of patients with β thalassemia are carriers of the disease, while 17.19% suffer from iron deficiency anemia. This study demonstrates the importance of tracing the high number of beta thalassemia carriers among relatives of patients with β thalassemia in Egypt.

The necessity for stable DC voltage in both removable and non-removable systems has been considerably desired recently. These systems have to be implemented efficiently in order to be responding rapidly based voltage variations. Under this act, the efficient power can extend the lifetime of the employed batteries in such systems. The presented efficiency can be realized with respect to buck and boost components that were implemented to generate what is called positive Buck-Boost converter circuits. The main functions of the positive Buck-Boost converter are identified by announcing the unchanged situation of output voltage polarity and indicating the level of the voltage rationally between the input and the output. It is worth mention, the positive Buck-Boost converter circuit was simulated based Proteus software, and the hardware components were connected in reality. Finally, the microcontroller type that employed in the proposed system is PIC_16F877A, which realizes the input voltage sensitively to generate Pulse Width Modulation (PWM) signals in order to feed the employed MOSFET element.

Background: Several factors in the family profile contribute significantly to determining the effective policy when heading the family. This study aims to evaluate the sociodemographic and economic burdens on parents-headed families in Ramadi City, west of Iraq. Methods: A prospective cross-sectional household-based survey was conducted from 1st to 28th February 2019 among Iraqi people residents in Ramadi city, Anbar province. A multistage sampling technique was recruited to identify the eligible sample. A semi-structured questionnaire was used to interview (face-to-face) the respondents. Data from 267 households have undergone univariate and bivariate analyses. Multiple logistic regression, odds ratio (OR), and confidence intervals (CIs) were estimated to explore the predicting variables. The statistically significant is considered at less than 0.05. Results: The mean age of respondents was 43.88 (± 12.1) years (range: 25 to 69 years). Out of the total surveyed people, 52.8% were young (less than 44 years), male-headed families (59.6%), low educated level (65.5%), unemployed (52.4%), married (67.4%) and headed big families of seven members and above (43.1%). History of chronic diseases and smoking habits was positive among 46.4% and 45.7% of respondents, respectively. Findings of the binary logistic regressions showed that history of smoking (OR = 7.201, 95% CI: 3.254 to15.936), families of 7 members and above (OR = 6.239, 95% CI: 2.938 to 13.250), unhappy (OR = 5.237, 95% CI: 2.140 to 12.818), aged 44 years and above (OR = 3.518, 95% CI: 1.581 to 7.829), being single (unmarried, divorced, widow) (OR = 2.697, 95% CI: 1.230 to 5.914), and had a monthly income of less than USD400 (OR = 2.333, 95% CI: 1.112 to 4.859) are significantly associated with female-headed family. Conclusion: Priority must be given to some elements such as genetic, physical differences, biopsychosocial factors, and the economic situation when discussing parents' behavior in heading the family.

This study used a continuous photo-Fenton-like method to remediate textile effluent containing azo dyes especially direct blue 15 dye (DB15). A Eucalyptus leaf extract was used to create iron/copper nanoparticles supported on bentonite for use as catalysts (E@B-Fe/Cu-NPs). Two fixed-bed configurations were studied and compared. The first one involved mixing granular bentonite with E@B-Fe/Cu-NPs (GB- E@B-Fe/Cu-NPs), and the other examined the mixing of E@B-Fe/Cu-NPs with glass beads (glass beads-E@B-Fe/Cu-NPs) and filled to the fixed-bed column. Scanning electron microscopy (SEM), zeta potential, and atomic forces spectroscopy (AFM) techniques were used to characterize the obtained particles (NPs). The effect of flow rate and DB15 concentration on the photo-Fenton-like degradation of DB15 in continuous fixed-bed systems was investigated. To optimize both studied systems, the response surface methodology using the central composite design (CCD) was used. The analysis shows that the removal efficiency for GB-E@B-Fe/Cu-NPs was 81% and for glass beads-E@B-Fe/NPs was 62.6%.

This research paper studies the use of an environmentally and not expensive method to degrade Orange G dye (OG) from the aqueous solution, where the extract of ficus leaves has been used to fabricate the green bimetallic iron/copper nanoparticles (G-Fe/Cu-NPs). The fabricated G‑Fe/Cu-NPs were characterized utilizing scanning electron microscopy, BET, atomic force microscopy, energy dispersive spectroscopy, Fourier-transform infrared spectroscopy and zeta potential. The rounded and shaped as like spherical nanoparticles were found for G-Fe/Cu‑NPs with the size ranged 32-59 nm and the surface area was 4.452 m2/g. Then the resultant nanoparticles were utilized as a Fenton-like oxidation catalyst. The degradation efficiency of OG dye highly depends on H2O2 concentration (1.7-5.28 mM), catalyst dose (0.4-1.6 g/L), pH (2-7), initial OG concentration (25-75 mg/L), and temperature (20-50 ℃). Batch experiments showed that 94.8 % of 50 mg/L of OG dye was removed within the optimum peroxide concentration, dose, pH and temperature which were 3.52 mM, 1 g/L, 3, and 40℃ respectively along with 30 min contact time. The results of kinetic models showed that OG removal followed the second-order model. Finally, the thermodynamic study of reaction was also examined and concluded to endothermic reaction with 29.725 kJ/mol activation energy.

Category: Ankle Arthritis; Ankle Introduction/Purpose: Total ankle arthroplasty (TAA) utilization is increasing in the United States. As the incidence of this procedure grows, it is important for providers to understand the future projections for ankle arthroplasty and more importantly revision total ankle arthroplasty (rTAA). Methods: The national inpatient sample (USA) was queried from 2005 to 2017 for all TAA and rTAA. Poisson and linear regression analyses were performed to project annual incidence of TAA and rTAA to 2030, with subgroup analyses on septic rTAA. Results: There were 5315 TAAs performed in 2017, a 564% increase when compared to the TAAs performed in 2005. From 2017 to 2030, the incidence of TAAs is projected to increase from 110% to 796%. There were 1170 rTAAs performed in 2017, a 155% increase when compared to rTAAs performed in 2005. There was a 256% increase in the incidence of septic rTAAs from 2005 to 2017 with a projected increase between 22% and 120% by 2030. Conclusion: The incidence of both TAAs and rTAAs are projected to significantly increase over the next decade. Given the known risk factors of TAA and rTAA, these findings reinforce the need for thoughtful consideration when selecting patients for TAA.

Category: Basic Sciences/Biologics; Other Introduction/Purpose: Tranexamic acid (TXA) use is increasing in Orthopedic practice specially among arthroplasty surgeons. It was proven to decrease the estimated blood loss and need for blood transfusion in hip, knee and shoulder arthroplasty as well as pelvis and acetabulum surgery. There was no reported increase risk of thromboembolic events with the use of TXA in orthopedic practice. This systematic review and meta analysis aimed on reporting on the available evidence on the use of TXA in foot and ankle surgery. Methods: The current meta-analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Electronic-based search on MEDLINE (PubMed), EMBASE, Google Scholar, SCOPUS, and Cochrane databases to November 2021. Clinical studies on tranexamic acid use in foot and ankle surgeries reporting at least one of the desired outcomes; estimated blood loss (EBL), Hemoglobin difference between pre- and post-op, or complications were included. To assess risk of bias, the Joanna Briggs institute critical appraisal tool was used for case series and the Newcastle Ottawa scale for comparetive studies. The level of evidence was assigned according to the Cochrane Book Review Group. Results: A total of 718 foot and ankle procedures were included. Out of those, 491 (68.38%) procedures received tranexamic acid while 221 (31.64%) served as controls and did not receive tranexamic acid. In the TXA group, 34 (6.92%) procedures received local TXA injection in one study, while the remaining majority of 457 (93.08%) procedures received intravenous (IV) TXA. Among the control group, saline was used a placebo in 113 (51.13%) controls in 3 studies, while no placebo was used in the remaining 108 (48.87%) controls. The pooled mean EBL for the TXA group was 57.75 mL [95% CI: 44.80 to 70.70, I2 = 98.31%] while the pooled mean EBL for the control group was 299.26 mL [95% CI: 212.43 to 386.09, I2= 98.96%] with statistical significance Figure 1. No significant difference was found between the two groups in terms of change of hemoglobin and risk of thromboembolic events and other complications. Figure 2,3 Conclusion: This systematic review and metaanalysis showed that the use of TXA in foot and ankle surgery was safe with no increased risk in thromboembolic events. The lower risk of bleeding using TXA despite being stastically significant, did not reach clinical significance and did not affect the post operative hemoglobin level. TXA can be considered in foot and ankle surgery in special cases with higher risk of bleeding or in cases where the use of tourniquet is contraindicated.

This work aimed to assess how Portulaca oleracea extract (POE) affected Japanese quail's growth, carcass features, blood parameters, digestibility coefficients, and microbiological aspects. A total of two hundred twenty-five 7-days-old Japanese quails were allotted into 5 experimental groups. Birds were divided as follows: group 1) received only the base diet (control), while groups 2, 3, 4, and 5 received the basal feed supplied with 1.0, 2.0, 3.0, and 4.0 mL POE/kg diet, respectively. The findings cleared those quails’ fed diets supplemented with POE had significantly (P > 0.01) higher body weight (BW) and body weight growth (BWG) than the control group. The treatment with POE significantly affected digestive enzymes (amylase and lipase) and digestion coefficients for ether extract (EE). The treated groups had decreased serum urea and malonaldehyde (MDA) and increased Immunoglobulin G (IgG), Immunoglobulin M (IgM), superoxide dismutase (SOD), total antioxidant capacity (TAC), glutathione (GSH), and catalase (CAT) concentrations than the control. All bacterial counts in dietary cecal samples declined with increasing POE levels. In conclusion, POE supplementation improved quails’ performance and nutrient digestibility. Moreover, POE did not harm birds' liver and kidney functions. In addition, this extract promoted the immunity and antioxidant status and minimized the harmful microbial load in quails' intestines, the total bacterial count was decreased by 90% in diet samples supplemented with purslane addition level (4 mL/g), while decreased by 74% in cecal samples supplemented with purslane addition level (4 mL/g) and Salmonella don't appear in all addition levels. However, lactic acid bacteria increased by 70%, indicating beneficial of POE in reducing the pathogenic microorganisms.

BackgroundCOVID-19 is a respiratory disease caused by SARS-CoV-2, a new coronavirus discovered in December 2019 in China. COVID-19 symptoms are similar to those of viral flu but may be more severe, these symptoms can be defended by vaccines, the most distributed 6 candidate vaccines are Pfizer, BioNTech, Moderna, Johnson & Johnson/Janssen AstraZeneca, Sinopharm, Sinovac. In Sudan, the virus has rapidly spread in the country, causing a total of 37,138 confirmed cases with 2,776 deaths till July 21, 2021. We are targeting health workers, medical students, and the general public to assess their behavior regarding COVID-19 vaccines in Sudan, recognize the determinants of their behavior, and identify the factors increasing vaccine acceptance among them.MethodsWe conducted a pretested cross-sectional online survey involving healthcare workers, medical students, and the general population in Sudan in July and August. We collected the data by sending the survey to social media platforms (e.g., Facebook and WhatsApp). The survey was conducted anonymously without identity-related data. We used both convenience sampling and snowball sampling methods as the participants were asked to forward the survey link to their contacts. The sample size was calculated using Slovin's formula and we estimated the sample size to be 400.ResultsOf our 400 participants, 36.8% (n = 147) were males and 63.2% (n = 253) were females, the mean age of the participants was 24.17 ± 8.07. The overall vaccine acceptance rate was 48.2% (n = 193) and “Occupation” was the only sociodemographic domain significantly associated with vaccine acceptance, showing a higher acceptance rate among health care workers (p = 0.009). “Afraid of unknown side effects” was the most commonly reported barrier to vaccination (p = 0.33).ConclusionThe vaccine acceptance rate is low, and public health authorities and the government in Sudan have a heavy mission for implementing successful vaccination programs with high coverage.

Phosphodiesterase 5 (PDE5) inhibitors presented themselves as important players in the nitric oxide/cGMP pathway, thus exerting a profound impact on various physiological and pathological processes. Beyond their well-known efficacy in treating male erectile dysfunction (ED) and pulmonary arterial hypertension (PAH), a plethora of studies have unveiled their significance in the treatment of a myriad of other diseases, including cognitive functions, heart failure, multiple drug resistance in cancer therapy, immune diseases, systemic sclerosis and others. This comprehensive review aims to provide an updated assessment of the crucial role played by PDE5 inhibitors (PDE5-Is) as disease-modifying agents taking their limiting side effects into consideration. From a medicinal chemistry and drug discovery perspective, the published PDE5-Is over the last 10 years and their binding characteristics are systemically discussed, and advancement in properties is exposed. A persistent challenge encountered with these agents lies in their limited isozyme selectivity; considering this obstacle, this review also highlights the breakthrough development of the recently reported PDE5 allosteric inhibitors, which exhibit an unparalleled level of selectivity that was rarely achievable by competitive inhibitors. The implications and potential impact of these novel allosteric inhibitors are meticulously explored. Additionally, the concept of multi-targeted ligands is critically evaluated in relation to PDE5-Is by inspecting the broader spectrum of their molecular interactions and effects. The objective of this review is to provide insight into the design of potent, selective PDE5-Is and an overview of their biological function, limitations, challenges, therapeutic potentials, undergoing clinical trials, future prospects and emerging uses, thus guiding upcoming endeavors in both academia and industry within this domain.

Oxidative stress plays a significant role in the development of cancer. Inhibiting the protein-protein interaction (PPI) between Keap1 and Nrf2 offers a promising strategy to activate the Nrf2 antioxidant pathway, which is normally suppressed by the binding of Keap1 to Nrf2. This study aimed to identify natural compounds capable of targeting the kelch domain of KEAP1 using structure-based drug design methods. A pharmacophore model was constructed based on the KEAP1-inhibitor complex, leading to the selection of 6178 compounds that matched the model. Subsequently, docking and MM/GBSA analyses were conducted, resulting in the identification of 10 compounds with superior binding energies compared to the reference compound. From these, three compounds (ZINC000002123788, ZINC000002111341, and ZINC000002125904) were chosen for further investigation. Ligand–residue interaction analysis revealed specific interactions between these compounds and key residues, indicating their stability within the binding site. ADMET analysis confirmed that the selected compounds possessed desirable drug-like properties. Furthermore, molecular dynamics simulations were performed, demonstrating the stability of the ligand–protein complexes over a 100 ns duration. These findings underscore the potential of the selected natural compounds as agents targeting KEAP1 and provide valuable insights for future experimental studies.

The wild vegetation of the Eastern Desert is characterized by openness and comprises perennials and ephemerals. The current study investigated the relationship between the edaphic factors of the natural vegetation along El Sheikh Fadl–Ras Gharib Road, Southwest Suez Gulf, in the northern sector of the Eastern Desert. The vegetation structure of the study area is relatively simple. The surveyed plants included 93 species from 22 families (51 perennials and 42 annuals). Asteraceae, Brassicaceae, Amaranthaceae, and Fabaceae were the richest families, constituting the majority of plant species (53.76%). Therophytes were the most frequent life forms. About 83.87% of the total flora were pluriregional elements of different affinities. Most of the recorded taxa occupied the Irano-Turanian/Mediterranean/Saharo-Sindian/Sudano-Zambezian chorotypes. The application of TWINSPAN classification resulted in grouping the vegetation into three main vegetation groups (A, B, and C), representing distinct microhabitats. The CCA ordination indicates diversity in vegetation group A. Group B was highly associated with Na, Mg, CaCO3, silt, clay, and C/N. Group C showed a high correlation with sand, K, and N. The differences in wild plant life forms, richness, and diversity along the studied desert roadsides, in association with the soil differences, provide a good indication of plant biodiversity.

Oil contamination in soils causes several geotechnical problems that must be considered during construction. The contamination occurs due to oil seepage which could happen during oil explorations and production processes or oil transportation. The site of West Qurna oilfield in Basrah was selected for this study because it has witnessed oil seepages many times. In order to study the significant impact on geotechnical properties of soils in the West Qurna site, as uncontaminated bulk soil sample was taken at a depth of 1 m, and crude oil was added at weight ratios of 2, 4, 6, 8, and 10 %. Laboratory tests were performed on all samples; these tests included particle size distribution, moisture content, Atterberg’s limits, consolidation, unconfined compressive strength, and water absorption. The results show that soil at the West Qurna site is clayey silt with little sand and the moisture content is 29.21%. The values of liquid limit and plasticity index were gradually decreased, while the plastic limit was increased with increasing of crude oil in the soil of study. There was an increase in consolidation coefficients [compressive index, swelling index, pre-consolidation pressure, and coefficient of consolidation] with an increase in the percentages of crude oil in the soil. The results also show that there was a decrease in the values of unconfined compressive strength and absorption of water as the crude oil was increased in the soil.

Abstract Background The use of the hookah-smoking device is increasing at a large scale in the Eastern Mediterranean region. Hookah users are exposed to an array of chemical compounds and may suffer several chronic diseases as a result. The purpose of this study was to determine the prevalence of hookah use among male high school students in the region and to study different associated factors in order to provide local tobacco control officials with an understanding of this public health problem. Methods A convenient non-probability sampling study was conducted among students in three high schools in Al-Karkh district, Baghdad. The study period was from October 2017 till January 2019 and included 847 male students aged 15–18 years old. Using a simple random technique to select the high schools from a list of schools we chose one school from each directorate. Descriptive, chi-square test of significance, bivariate, and multivariate logistic regression analyses of data were carried out for identifying the risk factors associated with hookah smoking among these high school adolescent males. Results The overall prevalence of hookah smoking in the last 30 days among male high school students was 46.1% while in the past 6 months it was as high as 85.7%. More than two-thirds (70.6%) of the students thought that hookah smoking was more socially acceptable than cigarette smoking. Factors such as having first heard about it from friends, the media, or the presence of a hookah café near their residence were significantly associated (p > 0.05) with hookah smoking among the students. Similarly, being surrounded by friends who used hookah was also found to be significantly associated with hookah smoking, with an odds ratio of 0.18, 95% CI (0.087–0.394). Hookah smokers were less likely than non-hookah smokers to report its use as forbidden in Islam and more likely to say it is allowed in Islam. Conclusions We found an alarmingly high use of hookah smoking among male high school students in this study. Family members and peers had an important role in the prevention of hookah smoking among these students. There is a need for students to be educated about the toxicity of hookah tobacco smoking and its direct effect on their health.

Abstract Background Guillain–Barre syndrome (GBS) is an inflammatory polyradiculoneuropathy characterized by rapidly evolving weakness and areflexia, reaching nadir within 4 weeks. Data on the characteristic of GBS in Saudi Arabia are limited. This study aimed to describe the clinical, electrophysiological, and laboratory characteristics and outcome of a multicenter cohort of patients with GBS. Methods This is a retrospective multicenter nationwide study. Patients who had GBS, identified through Brighton Criteria, between January 2015 and December 2019 were included. Data collected included demographics, clinical features, cerebrospinal fluid profile, reported electrophysiological patterns, treatment, and outcome. Reported GBS subtypes were compared using chi-square, Fisher's exact, or Mann–Whitney U tests, as appropriate. Results A total of 156 patients with GBS were included (men, 61.5%), with a median age of 38 (interquartile range, 26.25–53.5) years. The most commonly reported antecedent illnesses were upper respiratory tract infection (39.1%) and diarrhea (27.8%). All but two patients (98.7%) had weakness, 64.1% had sensory symptoms, 43.1% had facial diplegia, 33.8% had oropharyngeal weakness, 12.4% had ophthalmoplegia, and 26.3% needed mechanical ventilation. Cytoalbuminological dissociation was observed in 69.1% of the patients. GBS-specific therapy was administered in 96.8% of the patients, of whom 88.1% had intravenous immunoglobulin, and 11.9% had plasmapheresis. Approximately half of the patients were able to walk independently within 9 months after discharge, and a third regained the ability to walk independently thereafter. Death of one patient was caused by septicemia. Acute inflammatory demyelinating polyradiculoneuropathy was the most commonly reported GBS subtype (37.7%), followed by acute motor axonal neuropathy (29.5%), and acute motor-sensory axonal neuropathy (19.2%). Conclusion The clinical and laboratory characteristics and outcome of GBS in the Arab population of Saudi Arabia are similar to the international cohorts. The overall prognosis is favorable.

Autism spectrum disorder (ASD) is a complex neurodevelopmental disorder that affects approximately 1% of the population and causes significant burdens. ASD’s pathogenesis remains elusive; hence, diagnosis is based on a constellation of behaviors. Structural magnetic resonance imaging (sMRI) studies have shown several abnormalities in volumetric and geometric features of the autistic brain. However, inconsistent findings prevented most contributions from being translated into clinical practice. Establishing reliable biomarkers for ASD using sMRI is crucial for the correct diagnosis and treatment. In recent years, machine learning (ML) and specifically deep learning (DL) have quickly extended to almost every sector, notably in disease diagnosis. Thus, this has led to a shift and improvement in ASD diagnostic methods, fulfilling most clinical diagnostic requirements. However, ASD discovery remains difficult. This review examines the ML-based ASD diagnosis literature over the past 5 years. A literature-based taxonomy of the research landscape has been mapped, and the major aspects of this topic have been covered. First, we provide an overview of ML’s general classification pipeline and the features of sMRI. Next, representative studies are highlighted and discussed in detail with respect to methods, and biomarkers. Finally, we highlight many common challenges and make recommendations for future directions. In short, the limited sample size was the main obstacle; Thus, comprehensive data sets and rigorous methods are necessary to check the generalizability of the results. ML technologies are expected to advance significantly in the coming years, contributing to the diagnosis of ASD and helping clinicians soon.