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This study aimed to assess the quality of water resources, and its suitability for the drinking uses in Red Sea State, Sudan. Particularly, with regard to international standards from the World Health Organization (WHO/2017), and the national standards from Sudanese Standard and Meteorology Organization for drinking water (SDS-044/2007). Twenty locations site were investigated to represent this important area, where its analysed for compliance with the national and international standards, furthermore, the suitability for drinking purpose was assessed by using water quality index (WQI) method. Artificial Neural Network (ANN) was applied to predict the QWI by using the algorithm of feed forward back propagation artificial neural networks (BP ANN) for optimization. Physio-chemical assessments indicated that, water resources did not conform to the safe limits, especially heavy metals likes cadmium, which has the highest concentrations-hazard in almost all samples. High lead levels were observed at nineteen sites, while a high concentrations of nickel, and Total dissolved solids were observed at seven locations. The microbial assessment indicated most of locations did not conform to the safe limits, a high bacteria –hazard for Total coliform and Escherichia coli were observed in fourteen, and seven locations, respectively. Computed WQI values ranged from 35.61 to 337.52. ANN model showed much high prediction accuracy of WQI modeling with R2 values greater than 0.95 during training, testing and validation. WQI spatial distribution shown that, Red Sea State has unsuitable water quality in most of study sites (70%). The effects of heavy pollutants dominated on the water quality, and spread in these regions. This study conducted the first full-scale survey of the drinking water sources (ground and surface) in the Red Sea State of Sudan. Based on these results, we recommended that, an urgent measures such as a chemical treatments to treat the pollution, with/or filters installation should be implemented as soon as possible to manage and protect the water resources.

Annual precipitation at 1 km2 spatial resolution have been produced over Syria for a referenced period of 1975–2010. The observations from 410 rain-gauges were interpolated over a regular grid by applying multivariate regression models (PSMRM) and local equations for sub-regions of the study area. This statistical method aims to model the influences of the essential geographical and topographical climatic factors, such as longitude, latitude, elevation, slopes, and aspects on the precipitation field in multiple local regions. The PSMRM is composed of two steps, (i) a potential surface of precipitation is calculated through multi-linear local regressions based on geographical and topographical information, then (ii) a kriging and IDW interpolation is applied to adjust the potential surface so as to better fit the station residuals (i.e. the difference between the observed values and the predicted values which are obtained from PSMRM). Ultimately, the models' accuracy was evaluated by 43 stations. The PSRMR-IDW-3 is found to be superior to all other models; the value of RMSE was 92.5 mm and the Nash-Sutcliffe efficiency NSE was 0.9187, while the Willmott index of agreement was 0.9808. In contrast, the PSMRM-OK-EXP was only superior to other models with the least mean absolute error (MEA) and the mean absolute percentage error (MAPE); the difference was 64.07 mm, i.e. 11.44%. However, all the proposed models were shown to be highly efficient compared to global models and can be considered an appropriate alternative to studying precipitation variability spatially over Syria.

Introduction: The present study aimed to evaluate the cephalometric changes in Class II Division I mandibular deficient patients treated with the Fränkel 2 and Farmand appliances as a new functional appliance. Methodology: Fifty-five subjects treated for Class II Division I malocclusion and mandibular deficiency were selected for the study. Twenty-seven of the subjects (17 girls, 10 boys) with the mean age of 11.1 (SD 1.4) years were treated with the Farmand appliance and twenty-eight of them (15 girls, 13 boys) with the mean age of 11 (SD 1.5) years were treated with the FR-2 appliance. T-test, paired t-test, Wilcoxon and Mann-Whitney test were used to evaluate the data. Results: A skeletal Class I relationship and a marked reduction in overjet were achieved in both treatment groups. ANB decreased significantly by 3.2 (SD 1.7) degrees in the Farmand appliance group and it decreased significantly by 3.5 (SD 1.6) degrees in the Fränkel group. Conclusion: Both Farmand and Fränkel appliances were successful in the correction of mandibular deficiency in Class II Division 1 patients.

The rapid increase of the number of motor vehicles, especially motorcycles, makes serious problem caused by the pollution from gas emission of fossil fuel combustion. The problems related to human health and the erosion on ozone layer is credited to its gas emission. Several dangerous and toxic gasses such as Hydrocarbon (HC), Carbon Monoxide (CO), and Nitrogen Oxide (NOx), Sulphur Dioxide (SO2), and Lead (Pb) are emitted during IC engine operation.To manage those dangerous gasses, catalytic converter which converts the gasses into more eco-friendly CO2H2O and N2 may be employed. In this research, a specially designed catalytic converter made from brass (CuZn) wire in the form of spider web pattern was fitted into exhaust system of a standard motorcycle. The performance of the converter for several engine rotation speeds was examined by measuring CO and HC of exhaust by using Gas Analyzer.By comparing the exhaust of a standard exhaust system and modified exhaust system (fitted with converter), it can be concluded that the converter was able to decrease the exhaust emission gas. For HC content, the percentage of decrease was as much as 36,88 % for converter fitted exhaust system compared to 61.12% for standard one. For CO content, the decrease percentage was 19.90% compared to 80.10% for standard one.

Objective The present study aimed to compare dentoskeletal changes in mandibular-deficient patients treated with Bionator and Farmand appliances. Methods This study included 54 subjects treated for class II division I malocclusion. All subjects fulfilled the following criteria: ANB>5°, SNB 5 mm. The Bionator group consisted of 27 patients (15 girls, 12 boys) with the mean age of 11 (SD 1) years and the Farmand group consisted of 27 patients (17 girls, 10 boys) with the mean age of 11.1 (SD 1.4) years. Statistical analyses were performed using t-test, paired t-test, Wilcoxon, and Mann-Whitney test. Results In the Farmand group, SNB significantly increased from 74.3° (SD 1.7) to 77.6° (SD 2.3) and ANB decreased by 3.2° (SD 1.7) (p

Background Elective cesarean delivery (C/D) under neuraxial anesthesia is commonly associated with shivering. Ondansetron is a widely used antiemetic during both pregnancy and surgery. Few controversial studies investigated its anti-shivering effect in C/D under spinal anesthesia. Objectives To study the efficacy of ondansetron to prevent post-spinal shivering in parturients underwent cesarean delivery under spinal Anesthesia. Methods This double-blinded, prospective, randomized, trial included 80 parturients underwent C/D under spinal anesthesia, randomized into two equal groups [40 patients each]; group O [Ondansetron]: received 8 mg/4 ml ondansetron and group S [Saline] received 4 ml normal saline as placebo. Post-spinal shivering and maximum shivering at any time were recorded on a (0–4) scale and total meperidine dose required to treat shivering at score ⩾ 3, was calculated. Maternal MAP assessed before spinal anesthesia (T0), just after spinal and lateral tilt positioning (T1), 2 min after positioning (T2), 5 min after positioning (T3), Just after delivery of the baby (T4), at the end of surgery (T5), together with total ephedrine (required to treat any hypotension) were recorded. Incidence of nausea and vomiting at any time during surgery was also recorded. Results Incidence of shivering, maximum shivering, total meperidine dose and incidence of nausea were lower in ondansetron group compared to saline group. Maternal MAP was lower at (T3) in placebo group, without difference in the total ephedrine dose between the two study groups. Conclusion Ondansetron (8 mg) was effective in reducing post-spinal shivering in parturients underwent elective cesarean delivery and decreasing the requirement to meperidine together with lower incidence of post-spinal hypotension and nausea when compared to placebo (saline).

Background and Aims: Ultrasound imaging before neuraxial blocks was reported to improve the ease of insertion and minimize the traumatic trials. However, the data about the use of ultrasound in thoracic epidural block are scanty. In this study, pre-insertion ultrasound scanning was compared to traditional manual palpation technique for insertion of the thoracic epidural catheter in abdominal operations. Subjects and Methods: Forty-eight patients scheduled to midline laparotomy under combined general anesthesia with thoracic epidural analgesia were included in the study. Patients were divided into two groups with regard to technique of epidural catheter insertion; ultrasound group (done ultrasound screening to determine the needle insertion point, angle of insertion, and depth of epidural space) and manual palpation group (used the traditional manual palpation technique). Number of puncture attempts, number of puncture levels, and number of needle redirection attempts were reported. Time of catheter insertion and complications were also reported in both groups. Results: Ultrasound group showed lower number of puncture attempts (1 [1, 1.25] vs. 1.5 [1, 2.75], P = 0.008), puncture levels (1 (1, 1) vs. 1 [1, 2], P = 0.002), and needle redirection attempts (0 [0, 2.25] vs. 3.5 [2, 5], P = 0.00). Ultrasound-guided group showed shorter time for catheter insertion compared to manual palpation group (140 ± 24 s vs. 213 ± 71 s P = 0.00). Conclusion: Preprocedural ultrasound imaging increased the incidence of first pass success in thoracic epidural catheter insertion and reduced the catheter insertion time compared to manual palpation method.

Agricultural lands are very sensitive to climate and human activity changes, which result in variations in regional agricultural resources and decreased production of total grain output and increased difficulty in producing grain yields. Multiple cropping is one of the simplest ways to increase grain production. The research aims is to analyze the spatial and temporal variations in the multiple cropping index and study the factors that influence the multiple cropping index. Based on the maximum multiple cropping index (MCI) and a &ldquo, heat-precipitation&rdquo, quantitative relation model, we analyzed the theoretical potential multiple cropping index (PMCI) and the spatiotemporal changes in the potential increase in the multiple cropping index (PIMCI). Our results are as follows: The MCI was significantly higher in the eastern region than in the western region and higher in the central region than in the northern and southern regions, in Yunnan Province, it showed a fluctuating downwards trend, further, it exhibited sudden declines from 2004 to 2006 and from 2012 to 2014 in Guizhou, while it exhibited an increasing trend in Sichuan Province. The PMCIs were the highest in the eastern and southern regions, especially in eastern Sichuan Province, and the PIMCI was significantly higher in Yunnan Province than in Guizhou and Sichuan. Climate change, human activities, and terrain had significant influences on the MCI changes in southwest China, especially the temperature change, which was the key factor affecting the MCI changes. The dominant land use types in southwest China were forest (46%), grass (28%), and farmland (23%) during 1980&ndash, 2015. Therefore, the adjustment of the planting structure in different terrain areas according to the temperature changes has become the main strategy to promote the sustainable development of cultivated land resources in the region, further, the results would help implement the plan to increase grain production capacity in southwest China.

Injection moulding process is one of the most important process in manufacturing plastic part. However, during injection process, many parameters are required to set-up at the injection machine monitor. Long time is needed to adjust the parameters in order to get high quality of product. Therefore, simulation software is essential to speed-up the setting process especially for producing new product. The objective of this research is to optimize the injection process parameters of melt temperature, mould temperature, injection time and cooling time. The responses of fill time and time to freeze are set the lowest the better meanwhile total part weight is set the higher the better. Taguchi method and analysis of variance (ANOVA) were performed to optimize all parameters. The plastic material used in this simulation analysis was polypropylene. The flat plastic part was designed using CATIA software and the design was transferred to the Moldflow simulation software. It found that, the lowest value for fill time and time to freeze is 0.2099 s and 12.21 s respectively. Meanwhile, the highest value of part weight is 4.5565 g. After optimization process, fill time shows no change. However, freeze time decreases for 0.4% to 12.16 s then total part weight increases for 0.12% to 4.620 g. ANOVA result shows that injection time was the most significant parameter for fill time meanwhile melt temperature was the most significant parameter for time to freeze and total part weight. Thus, these optimization parameters result can be used for future experimental work.

The Chelif basin is one of the basins in the Mediterranean that preserve sedimentary deposits that span the Miocene including evaporites from the Messinian Salinity Crisis (MSC). Mineralogical and geochemical analyses were integrated in this study and conducted on a set of fifteen samples, collected from a selected section (Amarna). The lithostratigraphic succession of this section is represented by three formations, which are, from bottom to top: the Tortonian Blue marls formation, the Messinian marls, including gypsy-calcareous beds, and the Zanclean Trubi marls formation. The integration of relating mineralogical and geochemical data allowed us to better constrain the noticeable transition in this region. The onset of the lower Pliocene is marked with a sudden appearance of an important content of a smectite mineral, the occurrence of an abnormal positive peak of a celestine mineral (30%), reflected in the important shift of SrO in the layer A9, along with an important sulphur content (10%) and reduced environmental conditions.

Prostate cancer (PCa) represents a huge worldwide health burden, according to 2019 statistics of the American cancer society1. As PCa is hormone dependent, the first line treatment for the advanced and metastatic tumour is androgen deprivation therapy (ADT). However, the majority of tumours develop a hormone refractory PCa phenotype (HRPC), and become resistant to hormone therapy. Herein, we investigated the development of the hormone refractory (AR-independent) phase of PCa with respect to metabolic and oncogenic modulations, and study the therapeutic effect of non-psychotropic phytocannabinoids, such as CBD and CBG (alone or in combination), by using a prostate cancer model (TRAMP) that resembles the human disease. First, we demonstrated that phytocannabinoids inhibit both primary and advanced PCa in TRAMP model. Remarkably, we developed in vivo and in vitro models of HRPC that showed unique metabolic features, and that were established from TRAMP mice and TRAMP-C2 cell line using the second-generation AR inhibitor, enzalutamide (MDV3100). Significantly, we found that CBD was particularly metabolically active in arresting the HRPC phase. In this context, CBD perturbed the metabolic programming of PCa cells especially by increasing glycolysis and by inhibiting mitochondria oxidative phosphorylation in HRPC cells. Here we showed how CBD acted on mitochondria by elevating level of mtROS and by decreasing ATP production. CBD-mediated release of mtROS is responsible for the consequent up regulation of the transcription factor HIF-1?, which contributes to sustain a hyper-glycolytic phenotype in HRPC cells, and it promotes acidosis-induced apoptosis via BNIP3 up regulation. Moreover, the low ATP production induced by CBD in HRPC cells was accompanied by up regulation of AMPK, which activates the autophagic activated protein ULK. As a consequence, the overall effect of CBD on metabolic reprogramming may disrupt the oncogenic signalling in HRPC tumour cells by activating PTEN and inhibiting pAkt. Our study establishes new in vivo and in vitro models of HRPC, which were achieved by using TRAMP mice and TRAMP cells, and sheds the light on novel metabolic targets and therapeutic interventions in HRPC. The study provides the basis for further investigations supporting the hypothesis that phytocannabinoids can be used for metabolic interventions and adjuvant therapy for HRPC.

Quantifying the relative influences of anthropogenic activities and climate change on soil erosion and deposition during the Holocene, when both forces have been interacting is a complex problem. Analysis of long-term patterns in soil erosion and lake deposition in a basin can provide the basis for untangling the complexities of climate and anthropogenic forcings. In this paper, sedimentary sequences from Xingyun Lake are compared with simulated soil erosion rates in the basin to explore the relationship between river basin soil erosion and lake deposition during the Holocene in Yunnan, China. Modern soil erosion rates are calculated using RUSLE, while Holocene soil erosion rates are estimated using modern rates with reconstructed precipitation and vegetation cover sequences. Through this investigation, we found the following results. First, Holocene vegetation in the lake basin was mainly affected by climate change, and the vegetation experienced the same pattern of changes as the climate. Soil erosion and lake deposition rates, along with changes to vegetation cover, were synchronous with precipitation trends during the Holocene. Second, soil erosion and lake deposition have been exacerbated by human activities, such as deforestation and land reclamation in the Xingyun Lake basin. Finally, this study provides new insights into the effects by anthropogenic impacts and climate forcing on the processes of soil erosion and lake deposition on the millennium scale.

Assessing green and blue water evapotranspiration (GWET and BWET) is the key to water resources management and improving water productivity. This study focuses on assessing, evaluating and managing evapotranspiration in Egyptian Nile Delta over 1997–2017 for thirteen regions. The monthly data of minimum and maximum temperatures, precipitation and solar radiation from November to May were derived from open access data for calculation of reference evapotranspiration and rainfall accounts. Wheat crop coefficient (Kc) values were estimated using the air temperature and base temperature of crop. GWET and BWET were calculated and mapped for each region in the ArcGIS environment. Land use land cover (LULC) was analyzed during 1997, 2005, 2011, and 2017 using Landsat images. The main findings of the research are as follows: (1) average values of crop coefficients Kc-init, Kc-mid and Kc-end were 0.72, 1.13, and 0.41 through initial, middle, and end growing seasons, respectively; (2) the best regions for saving green and blue water were Sidi-Salim, Bilqas, Ar-Riyad, Al-Hamul, and Biyala; (3) the total water saved was 4.80% and 53.12% of blue and green water accounts; (4) high coefficients of determination between precipitation, GWET, and BWET proportions were 0.99 for both. Furthermore, relative irrigation supply is a good indicator for predicting GWET and BWET with determination coefficients of 0.99 and 0.76, respectively. It can be concluded that the data integration of geographic information and LULC changes is the best way for water management and sustainable agro system development under limited water resources.

Drought is a fundamental physical feature of the climate pattern worldwide. Over the past few decades, a natural disaster has accelerated its occurrence, which has significantly impacted agricultural systems, economies, environments, water resources, and supplies. Therefore, it is essential to develop new techniques that enable comprehensive determination and observations of droughts over large areas with satisfactory spatial and temporal resolution. This study modeled a new drought index called the Combined Terrestrial Evapotranspiration Index (CTEI), developed in the Ganga river basin. For this, five Machine Learning (ML) techniques, derived from artificial intelligence theories, were applied: the Support Vector Machine (SVM) algorithm, decision trees, Matern 5/2 Gaussian process regression, boosted trees, and bagged trees. These techniques were driven by twelve different models generated from input combinations of satellite data and hydrometeorological parameters. The results indicated that the eighth model performed best and was superior among all the models, with the SVM algorithm resulting in an R2 value of 0.82 and the lowest errors in terms of the Root Mean Squared Error (RMSE) (0.33) and Mean Absolute Error (MAE) (0.20), followed by the Matern 5/2 Gaussian model with an R2 value of 0.75 and RMSE and MAE of 0.39 and 0.21 mm/day, respectively. Moreover, among all the five methods, the SVM and Matern 5/2 Gaussian methods were the best-performing ML algorithms in our study of CTEI predictions for the Ganga basin.

Background Patients with septic shock commonly require endotracheal intubation under general anaesthesia in the operating theatre, the emergency department, and the intensive care unit. Hypotension is a serious complication after induction of general anaesthesia, especially in patients with circulatory failure. No randomised controlled trials had previously investigated protocols for induction of anaesthesia in septic shock patients. The aim of the current work is to compare two protocols, lidocaine–ketamine combination versus ketamine full-dose for rapid-sequence endotracheal intubation in patients with septic shock. Methods Forty-four adult patients, with septic shock, scheduled for emergency surgical intervention were enrolled in this randomised, double-blinded, controlled study. Patients were randomised to receive either 1 mg/kg ketamine (ketamine group, n = 22) or 0.5 mg/kg ketamine plus 1 mg/kg lidocaine (ketamine-lidocaine group, n = 22) for induction of anaesthesia in addition to 0.05 mg/kg midazolam (in both groups). Our primary outcome was the mean arterial pressure (MAP). Other outcomes included frequency of post-induction hypotension, heart rate, and cardiac output. Results Forty-three patients were available for final analysis. The average MAP reading in the first 5 min post-induction was higher in ketamine-lidocaine group than in the ketamine group {82.8 ± 5.6 mmHg and 73 ± 10.2 mmHg, P Conclusion Lidocaine–ketamine combination showed less incidence of hypotension compared to ketamine full-dose when used for rapid-sequence endotracheal intubation in patients with septic shock. Registration URL https://clinicaltrials.gov/ct2/show/NCT03844984?cond=NCT03844984&rank=1

The slug flow pattern is one of the most avoiding factors in piping systems due to its destructive characteristics. Research on the criteria of the slug formation is still the concern. The present study focused on finding out the influence of liquid hold-up toward the transition of the flow pattern from stratified to slug pattern. It was conducted on a 50 mm-diameter horizontal acrylic pipe. The visual data was obtained from a fully developed area (180-210 D) by variations of liquid superficial rate (JL) of 0,03-0,3 m/s and gas superficial rate (JG) from 0,7 to 3,77 m/s. The high-speed camera with 2000 fps recording speed was the instrument to obtain the visual data. The measurement of the liquid hold-up is made by Constant Electric Current Method (CECM). The drastic decrement of liquid hold-up value on the wave growth mechanism (JG ≤ 1,88 m/s) indicated the changes in flow patterns from the stratified to the slug pattern, while on the wave coalescence mechanism (JG > 1,88 m/s) the liquid hold-up remains increases. The pattern change from pseudo slug to the slug pattern was not decreasing on its film thickness, yet, it tends to increase the frequency and the liquid slug length.

The aim of this study was to evaluate the therapeutic effects of the Sabbagh Universal Spring 2 (SUS 2) fixed functional appliance compared to the premolar extraction method in correcting class II/1 malocclusion in patients who had passed their peak of postpubertal growth (stages 4–6 of Cervical Vertebral Maturation Index). In all, 40 class II/1 patients were randomized to receive SUS 2 application (7 males, 13 females, age 15.75 ± 1.02 years) or maxillary premolar extraction (8 males, 12 females, age 15.40 ± 0.99 years). Pre- and posttreatment digital cephalographs were traced at least twice. A paired t test was used to compare the pre- and posttreatment measurements. Treatment changes were compared using an independent samples t test (P ≤ 0.05). The extent of change was significant in the following variables: ANB, nasolabial angle, Mand1-ML, 1L-NB, anterior and posterior facial heights, N-A-Pog, 1U-NF, 6L-MP, Ar-Go, OP-HP, A-B, A-Sn, B-Sm, APDI, NAPog, AB-NPog, POr-DOP, SN-OcP, POr-OcP, Wits, 1 l-APog, 1LMeLm, S-Go:N-Me, N-ANS-Pog, Ap1LAp1u-DOP, ANS-Cond, Pog-Cond, SS-Ls, A-N-Pog, Pog–Pog′, MeGoOcP, 1L-Npog, Go-Me, Go-Me:N-S, S-Me, Ls-(Sn-Pog′), Stms–Stmi, N′-Gn′, N′NsPog′, 6u-PTV, 1u-NA, FMIA, and IMPA. SUS 2 corrected class II/1 malocclusion of patients in the postpubertal growth period by inhibiting the maxilla’s forward growth, advancing the mandible, decreasing the nasolabial and interincisal angles, proclining the incisors, increasing the facial height, and clockwise rotation of the occlusal plane. Extraction reduced the interincisal angle and protruded the lower incisors. However, it did not change the soft tissue thickness and did not cause a clockwise rotation in the occlusal plane.

Background and Aim: The aim of the present study was to evaluate the cephalometric changes in Class II division 1 mandibular deficient patients treated with Farmand functional appliance. Methods and Materials: Twenty-seven subjects (17 girls and 10 boys) with the mean age of 11.1±1.4 years were involved in the present study. All the subjects were treated with Farmand functional appliance. Paired t-test and Wilcoxon test were used to evaluate the data. The significance level was set at P

Background: Anxiety is a concern in obstetrics, especially in preeclamptic mothers. Sedation is not commonly used in parturients for fear of adverse neonatal effect. We investigated maternal and neonatal outcome of midazolam as an adjuvant to spinal anesthesia for elective cesarean delivery. Methods: A prospective randomized controlled trial, in which eighty preeclamptic parturients received either an intravenous dose of 0.035 mg/kg of midazolam or an equal volume of normal saline, 30 min before spinal anesthesia. Maternal anxiety was assessed using Amsterdam Preoperative Anxiety and Information Scale (APAIS); postoperative maternal satisfaction was assessed using Maternal Satisfaction Scale for Cesarean Section (MSSCS). Newborns were assessed using Apgar score, Neonatal Neurologic and Adaptive Capacity Score (NACS), and umbilical artery blood gases. Results: Mothers premedicated with midazolam showed a lower level of preoperative anxiety and a higher degree of postoperative satisfaction than the control group. There were no between-group differences regarding the neonatal outcome. Conclusion: Preeclamptic parturients premedicated with midazolam (0.035 mg/kg) before spinal anesthesia have lower anxiety and higher postoperative satisfaction levels, with no adverse effects on the newborns.

Mineralogical investigations of clay and nonclay minerals were conducted on the Miocene sediments from three sections ofthe lower Chelif basin, northern Algeria. Bulk rock analyses of Miocene sediments show that these clastic sediments are dominated byvariable mineralogical compositions and concentrations. Quartz is the dominant mineral through the three stratigraphic intervals andcalcite (except in the upper layers) and dolomite are lacking in the Messinian deposits. The clay mineralogy is dominated by smectite(24%) and mixed-layer illite-smectite (I-S) (22%) during the Burdigalian-Langhian, illite (36%) and kaolinite (28%) in the Tortonian,and illite (49%) and I-S (20%) in the Messinian stratigraphic range. The smectite-(kaolinite+chlorite)-illite ternary diagram shows that,in general, Miocene sediments originated from a mixed mafic and felsic source and were influenced by physical erosion and chemicalweathering processes.

Background Post-extubation laryngospasm is a dangerous complication that should be managed promptly. Standard measures were described for its management. We aimed to compare the efficacy of propofol (0.5 mg.kg-1) vs. lidocaine (1.5 mg.kg-1) for treatment of resistant post-extubation laryngospasm in the obstetric patients, after failure of the standard measures. Method This study was conducted over 2 years on all obstetric patients scheduled for cesarean delivery. Post-extubation laryngospasm was initially managed with a standard protocol (removal of offending stimulus, jaw thrust, positive pressure ventilation with 100% oxygen). When this protocol failed, the tested drug was the second line (lidocaine in the first year and propofol in the second year). Lastly, succinylcholine was used when the tested drug failed. Results In lidocaine group, 5% of parturients developed post-extubation laryngospasm, 31.9% of them were successfully treated via standard protocol, and 68.1% required lidocaine treatment. Among these, 65.6% of patients treated with lidocaine responded successfully and 34.4% required succinylcholine to relieve laryngospasm. In propofol group, 4.7% of parturients developed post-extubation laryngospasm, 30.1% of them were successfully treated via standard protocol, and 69.9% required propofol treatment. Among these, 82.8% of patients treated with propofol responded successfully and 17.2% required succinylcholine to relieve laryngospasm. Conclusion Small dose of propofol (0.5 mg.kg-1) is marginally more effective than lidocaine (1.5 mg.kg-1) for the treatment of resistant post-extubation laryngospasm in obstetric patients, after failure of standard measures and before the use of muscle relaxants. Resumo Justificativa O laringoespasmo pós-extubação é uma complicação perigosa que deve ser prontamente tratada. Medidas padrão para o seu manejo foram descritas. O nosso objetivo foi comparar a eficácia de propofol (0,5 mg.kg-1) versus lidocaína (1,5 mg.kg-1) no tratamento de laringoespasmo resistente pós-extubação em pacientes obstétricas após falha das medidas padrão. Método Este estudo foi conduzido ao longo de dois anos em todas as pacientes obstétricas programadas para cesariana. O laringoespasmo pós-extubação foi inicialmente tratado com um protocolo padrão (remoção do estímulo ofensivo, protrusão mandibular, ventilação com pressão positiva com oxigênio a 100%). Ao constatar a falha desse protocolo, o fármaco testado foi a segunda opção (lidocaína no primeiro ano e propofol no segundo ano). Por fim, succinilcolina foi usada quando houve falha do fármaco testado. Resultados No grupo lidocaína, 5% das parturientes desenvolveram laringoespasmo pós-extubação, 31,9% delas foram tratadas com sucesso via protocolo padrão e 68,1% precisaram de tratamento com lidocaína, das quais, 65,6% responderam com sucesso ao tratamento com lidocaína e 34,4% precisaram de succinilcolina para alívio do laringoespasmo. No grupo propofol, 4,7% das parturientes desenvolveram laringoespasmo pós-extubação, 30,1% delas foram tratadas com sucesso via protocolo padrão e 69,9% precisaram de tratamento com propofol, das quais, 82,8% responderam com sucesso ao tratamento com propofol e 17,2% precisaram de succinilcolina para alívio do laringoespasmo. Conclusão Uma pequena dose de propofol (0,5 mg.kg-1) é marginalmente mais eficaz do que lidocaína (1,5 mg.kg-1) no tratamento de laringoespasmo resistente pós-extubação em pacientes obstétricas, após falha das medidas padrão e antes do uso de relaxantes musculares.

In a world where pathogenic bacteria, viruses, as well as cancer develop resistance to drugs on faster pace than discovering new ones, researchers bear the heaviest weight to design new drugs to overcome such phenomenon of drug resistance. Drug design is one of the most challenging tasks in computational and structural biology, which aims at developing new drugs or enhancing currently known drugs against certain diseases based on the knowledge of a biological target. This thesis is about accelerating drug design work flow, through accurate acceleration of molecular docking tools, proper selection of candidates for Multiple Receptors Conformation (MRC) docking, and molecular dynamics (MD) simulation. In this work, I first developed QuickVina 2, a fast, accurate, and reliable molecular docking tool that depends on the powerful scoring function of AutoDock Vina and accelerated search of QuickVina. QuickVina 2 was tested against the 195 protein-ligand complexes of the core set of PDBbind 2014, using default exhaustiveness level of 8. It successfully attained up to 20.49-fold acceleration over Vina with tendency for higher acceleration when the number of dimensions/variables increases. Meanwhile, 70% of its predicted modes were equal to or better than original Vina in terms of binding energy. The remaining 30% had average Energy difference only 0.58 Kcal/mol. The Pearson’s correlation coefficient (r) between AutoDock Vina’s and QuickVina 2’s binding energy was 0.967 for the first predicted mode and 0.911 for the sum of all predicted modes. QuickVina 2 was found to be more accurate than GOLD 5.2 and is only slightly less accurate than Dock 6.6. QuickVina 2 was employed to propose drug fragments for Dengue Virus Non-Structure Protein 5 (DENV-NS5), and the result was compared to AutoDock Vina result as a measure of double confirmation. Both QuickVina 2 and AutoDock Vina detected the same 13 fragments with slight differences in their estimated binding energies while QuickVina 2 detected three additional fragments. Two of the fragments were subjected to MD simulations for in silico validation. The simulation results suggest that the proposed ligands are plausible and could be considered for further computational and experimental validation, as well as lead optimization. The work also involved refining the selection criteria of receptor conformation candidates that undergo MRC docking, in order to ensure diversity and increase sensitivity (decrease false negative rate) of detection. QuickVina 2 was taken then to another dimension by enabling it to search wide search spaces, after introducing inter-process spatio-temporal integration between the searching threads to communicate their collective wisdom. That work resulted in the release of QuickVina-W, a tool suitable for Blind Docking. QuickVina-W explores four folds the number of points that Vina explores, in a more efficient way. It proved to be faster than QuickVina 2 (with average and maximum normalized overall time accelerations of 3.60 and 34.33 folds in relation to Vina versus 1.98 and 18.02 respectively), yet better than AutoDock Vina in terms of binding energy (78% of predictions with binding energy better than or equal to Vina) and RMSD (Root Mean Square Distance) to experimental data (with success rate of 72% by QuickVina-W versus 63% by Vina). It was based on the observation that the Average Sum of Proximity relative Frequencies (ASoF) of searching threads is ever increasing with search progression, and on the theory that allowing a searching thread to communicate with other nearby threads to make use of their wisdom, would increase the speed and sensitivity of that searching thread, in a way relevant to the increasing ASoF. This work monitored the ASoF and proved its direct relation to decision taking increased speed and accuracy which are reflected in turn on the search process. Doctor of Philosophy

Background Short acting inhalational anesthetic (Desflurane) produces emergence agitation (EA) in pediatrics with an incidence up to 80%. The aim of the present study was to examine the role of Gabapentin oral solution in attenuating desflurane associated EA in children after strabismus surgery under general anesthesia. Methods Seventy patients, 2–6 years old, scheduled for strabismus surgery were randomly allocated into two groups (35 each); Control group (c): received 5 ml of oral strawberry juice (placebo) and Gabapentin group (G) received 5 mg/Kg gabapentin oral solution in 5 ml strawberry juice, 1 h before anesthesia. Patient separation, cooperation, emergence incidence and emergence severity were assessed. Also time to extubation and time to emergence, duration of PACU stay, PONV and number of patients required meperidine postoperatively were recorded. Results Duration to extubation and duration to emergence were statistically prolonged in gabapentin group compared to the control group. The incidence of EA and its severity were reduced in gabapentin group with more tendencies to be asleep and less attentive. More patients in the control group required postoperative meperidine to reduce crying and agitation. Conclusion Oral gabapentin 5 mg/kg reduced the incidence and severity scoring of emergence agitation (by 20%) with more tendencies for sleeping with preserved response to stimuli in PACU. Trial registration Number: NCT03347916, date: November 17, 2017, retrospectively.

Background: Radical prostatectomy is a major surgical procedure that is associated with marked inflammatory response and impairment of the immune system which may affect the postoperative outcome. The aim of this study was to evaluate the effect of preincision single or multiple doses of S(+) ketamine on the pro-inflammatory cytokines, namely tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6). Patients and Methods: This is a randomized controlled trial including 60 American Society of Anesthesiologists Physical Status I and II patients scheduled for radical prostatectomy under combined general-epidural anesthesia in Cairo university Teaching Hospital. Patients were randomly divided into three groups each of twenty patients: Group I received no S(+) ketamine (control group), Group II received S(+) ketamine as a single preincision dose, and Group III received preincision and repeated doses of S(+) ketamine. S(+) ketamine was injected as a single intravenous dose of 0.5 mg/kg in Group II and III, repeated as 0.2 mg/kg at 20 min interval until 30 min before the end of surgery. Results: The three groups were comparable in age, weight, and duration of the operation. The study also revealed that a single preincision dose of S(+) ketamine decreased TNF-α to reach 1027.04 ± 50.13 μ/ml and IL-6 to reach 506.89 ± 25.35 pg/ml whereas the repeated doses of S(+) ketamine decreased TNF-α to reach 905.64 ± 35065 μ/ml and IL-6 to reach 412.79 ± 16.5 pg/ml (P < 0.05). Conclusion: S(+) ketamine suppresses pro-inflammatory cytokine production, especially when given in repeated doses.

Kecamatan Nawangan adalah salah satu wilayah di Kabupaten Pacitan yang sebagian besar merupakan wilayah pertanian dan bukan daerah pantai, mempunyai luas wilayah 124,06 km2 terdiri dari 9 desa, 130 RW dan 428 RT. Jumlah Penduduk 52.144 orang. Dua dari sembilan desa yang ada yaitu Desa Sempu dan Desa Jetis Lor merupakan wilayah pertanian padi yang pada tahun 2010 produksi padi di Desa Sempu mencapai 1.441,89 ton (GKG) dengan rata-rata produksi 55,03 Kw/Ha, sedang Desa Jetis Lor 1443,4 ton (GKG), rata-rata produksi 57,05 Kw/Ha. Namun, kondisi ini belum bisa memberikan dampak positif pada petani khususnya pendapatan yang diperoleh dari hasil bertani dan buruh tani. Oleh karena itu, Ipteks bagi Wilayah (IbW) Kecamatan Nawangan telah melakukan inovasi teknologi berbasis limbah perpadian yaitu sekam padi menjadi produk - produk yang mempunyai nilai ekonomis dengan menggunakan teknologi tanpa limbah yaitu Teknologi Pyrolisis Berdasarkan kondisi eksisting wilayah, ada dua Aspek yang dikembangkan dalam kegiatan ini yaitu Aspek Ketahanan Pangan dan Aspek Kemandirian Energi. Dua aspek ini dapat dikerjakan dan dapat bersinergi dengan kegiatan lainnya melalui pemberdayaan masyarakat. Kegiatan ini telah dapat menumbuh-kembangkan usaha ekonomi produktif, munculnya kepedulian memperbaiki sarana prasarana fisik lingkungan desa dan meningkatkan partisipasi dalam mengorganisasi diri dan menemu-kenali kebutuhan dalam perencanaan dan pembangunan Kata kunci : Pertanian padi, Ipteks bagi Wilayah, pyrolisis.

Maternal hypotension is a common complication after spinal anesthesia for cesarean delivery. Prevention and treatment of post-spinal hypotension (PSH) in cesarean delivery has been frequently investigated. Fluid loading is superior to no-fluid regimen; however, the incidence of PSH is still high with all fluid loading protocols; thus, the use of fluid loading as a sole method for prophylaxis might be not satisfactory for many anesthetists. Phenylephrine is the preferred vasopressor for prevention and management of PSH in most cases. Ephedrine may be more beneficial in patients with bradycardia, patients with uteroplacental insufficiency and pre-eclamptic patients. Norepinephrine infusion was recently investigated as an alternative for prophylaxis of PSH with minimal cardiac side effects. The high incidence of PSH with most of the pharmacological and non-pharmacological methods suggests the need for multimodal protocols for prevention and management of this problem. PSH in cesarean delivery is a common daily situation facing all anesthetists; thus, future research should focus on simple and rapid protocols that can be easily applied by anesthetists with moderate and low experience with minimal need to complex devices or costly drugs.

Movement of the heliostat tracking sun is able to achieve through simple four bar mechanism. Design methods for four bar linkage encompass a mathematical approach, trial and error method, function generation, motion synthesis and path synthesis. The paper presents a study of motion synthesis of four bar slider mechanism applies to heliostat movement. Mathematical equations used for the synthesis are presented and the results are compared with the graphical method. Procedure of various methods to determine the length and position of the links in case of desired positions of the coupler are presented. As a conclusion, both methods are able to achieve wanted results with an acceptable degree of accuracy. However, the graphical method is helpful to provide better insight of the system during designing the solution compared to the mathematical method.

Objective The aim of the current study is to assess and compare the effect of using phenylephrine and ephedrine for the prevention and treatment of maternal hypotension associated with induction of spinal anaesthesia in pre-eclamptic women undergoing a caesarean section. Study design This was a prospective randomized-controlled study. Patients and methods Sixty full-term pre-eclamptic patients, undergoing caesarean section under spinal anaesthesia, were divided into four groups: group 1 was administered 5 mg ephedrine intravenously and 5 mg boluses whenever there was maternal hypotension. Group 2 was administered 25 µg intravenous bolus phenylephrine and 25 µg boluses whenever there was maternal hypotension. Group 3 was administered a phenylephrine infusion at 25 µg/min; subsequently, the rate of infusion was adjusted according to systolic blood pressure (SBP). Group 4 was administered 15 ml/kg lactated ringer solution before spinal anaesthesia; subsequently, the rate of infusion was adjusted according to SBP. Results There was no statistically significant difference in the maternal heart rate changes, SBP changes, Doppler study of the uterine arteries, newborn blood pH and Apgar scores at 1 and 5 min between the four groups. Conclusion The use of an ephedrine or a phenylephrine infusion for the treatment of hypotension induced by spinal anaesthesia in pre-eclamptic patients yields comparable maternal and neonatal outcomes; further studies on a larger sample study are recommended to confirm our results.

Manual handling is the primary cause of musculoskeletal disorders, such as sprains and strains and joint disorders, which account for more than half of all injury claims. If motions are repeated frequently, such as in every few seconds, and for prolonged periods such as an eight-hour shift, fatigue and muscle strain can acquire. Working hours is lost every year by means of injury, and personal injury situations and compensation packets are costly. Employers could boost productivity by training their workers to handle loads the right way, or by providing materials-handling equipment to aid them with the job.  Index Terms—manual handling, lower-back pain, productivity.

Nowadays, the resources of roofing materials are abundant, which are the essential materials to build houses. It is of great significance to develop the roofing material with absorbing function for shielding electromagnetic radiation. This study is conducted to design a corrugated bamboo roofing microwave absorber that can absorb electromagnetic wave for frequencies 1 to 12 GHz. Three types of roofing bamboo with different designs namely Model A, Model B and Model C has been developed. The size of all types of proposed roofing bamboo is 60 cm width x 60 cm in length. The design is simulated using Computer Simulation Technology (CST) Microwave Studio software. The arch method is used to analyse microwave absorber performance. It contains of a wooden structure in the shape of semi-circular for enabling the proper positioning towards transmitting and receiving the two horn antennas. Bamboo can be used as an absorbent material. The expected result for bamboo roofing microwave absorber is to get a high performance of microwave absorption which is above 20 dB. The third model or Model C has recorded the highest value of an absorption level.