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Sedation Practice in Intensive Care Evaluation (SPICE-III) trial reported significant heterogeneity in mortality with dexmedetomidine treatment. Supplemental propofol was commonly used to achieve desirable sedation.to quantify the association of different infusion rates of dexmedetomidine or propofol, given in combination, with mortality and if this is modified by age.We included 1177 patients randomized in SPICE-III to receive dexmedetomidine and given supplemental propofol, stratified by age (65 or ≤65 years). We used double stratification analysis to produce quartiles of steady infusion rates of dexmedetomidine, while escalating propofol dose and vice versa. We used Cox proportional hazard and multivariable regression, adjusted for relevant clinical variable to evaluate the association of sedative dose with 90-day mortality.Younger patients 598/1177(50.8%) received a significantly higher dose of both sedatives compared with older patients, to achieve comparable sedation depth. On double stratification analysis, escalating infusion rates of propofol to 1.27 mg/kg/h at a steady dexmedetomidine infusion rate (0.54 mcg/kg/h) was associated with reduced adjusted mortality in younger, but not older patients. This was consistent with multivariable regression modelling [hazard ratio: 0.59(95% Confidence Interval 0.43-0.78),P0.0001], adjusted for baseline risk and interaction with dexmedetomidine dose. In contrast, among younger patients using multivariable regression, escalating dexmedetomidine infusion rate was associated with increased adjusted mortality [HR:1.30(95%CI 1.03-1.65), P=0.029].In patients ≤ 65 years sedated with dexmedetomidine and propofol combination, preferentially increasing the dose of propofol was associated with decreased adjusted 90-day mortality. Conversely, increasing dexmedetomidine may be associated with increased mortality. Clinical trial registration available at www.gov, ID: NCT01728558.

New magnet design of a magnetic bottle electron spectrometer allowing the detection of multiply charged ions in coincidence with n electrons. Electrons spectra obtained without and with filtering by coincidence with Xen+ ions.

The high demand for compact heat exchangers has led researchers to develop high-quality and energy-efficient heat exchangers at a lower cost than conventional ones. To address this requirement, the present study focuses on improvements to the tube/shell heat exchanger to maximize the efficiency either by altering the tube’s geometrical shape and/or by adding nanoparticles in its heat transfer fluid. Water-based Al2O3-MWCNT hybrid nanofluid is utilized here as a heat transfer fluid. The fluid flows at a high temperature and constant velocity, and the tubes are maintained at a low temperature with various shapes of the tube. The involved transport equations are solved numerically by the finite-element-based computing tool. The results are presented using the streamlines, isotherms, entropy generation contours, and Nusselt number profiles for various nanoparticles volume fraction 0.01 ≤ φ ≤ 0.04 and Reynolds numbers 2400 ≤ Re ≤ 2700 for the different shaped tubes of the heat exchanger. The results indicate that the heat exchange rate is a growing function of the increasing nanoparticle concentration and velocity of the heat transfer fluid. The diamond-shaped tubes show a better geometric shape for obtaining the superior heat transfer of the heat exchanger. Heat transfer is further enhanced by using the hybrid nanofluid, and the enhancement goes up to 103.07% with a particle concentration of 2%. The corresponding entropy generation is also minimal with the diamond-shaped tubes. The outcome of the study is very significant in the industrial field and can solve many heat transfer problems.

In this paper, a pendulum model is represented by a mechanical system that consists of a simple pendulum suspended on a spring, which is permitted oscillations in a plane. The point of suspension moves in a circular path of the radius (a) which is sufficiently large. There are two degrees of freedom for describing the motion named; the angular displacement of the pendulum and the extension of the spring. The equations of motion in terms of the generalized coordinates $$\varphi$$ φ and $$\xi$$ ξ are obtained using Lagrange’s equation. The approximated solutions of these equations are achieved up to the third order of approximation in terms of a large parameter $$\varepsilon$$ ε will be defined instead of a small one in previous studies. The influences of parameters of the system on the motion are obtained using a computerized program. The computerized studies obtained show the accuracy of the used methods through graphical representations.

This paper questions how to respond to the publication of political dreams in relation to efforts to reduce radicalism in Indonesia according to Sadd al-Dzari'ah's study. This research is qualitative in nature and its presentation uses descriptive analysis method. Publication of dreams is a common thing in society, moreover dreams that are disseminated are good dreams. However, sometimes the publication of a dream, according to people who experience it, is suitable for public consumption, on the other hand it may have an impact on the emergence of radicalism in a country. An example that recently occurred was the dream of Haikal Hassan who met Rasulullah SAW regarding the shooting of the Islamic Defenders Front (FPI) laskar by the police in Mega Mendung, West Java. The publication of this dream seemed to have political nuances and caused turmoil among the FPI, because in this dream Rasullullah SAW seemed to blame the police for handling the FPI laskar and on the contrary defending the FPI laskar who was killed. This paper concludes that the act of publishing dreams which was previously immutable is not permitted if the publication creates a radicalism movement that may threaten the integrity of the country. In the study of siyasah syar'iyyah, security and public order (maslahah) is a very important part of state politics. Therefore, according to Sadd al-Dzari'ah's study, the legal position of publishing dreams, which has so far been converting, can become haram if it causes harm to a country.

To understand disease, scientists are producing comprehensive omics datasets. However, the majority of these are Eurocentric. Recently, the inclusion of patients from Asia and the Middle East in genomic analyses uncovered unique loci linked to COVID-19 severity. This demonstrates that focusing on diversity and underrepresented populations can benefit all.

To evaluate the efficacy of mixed oral prednisolone and intratympanic dexamethasone (ITID) injection in labyrinthitis, due to COVID 19.Seventy-five post-COVID-19 labyrinthitis patients were included. Those patients were treated with systemic oral prednisolone for two weeks and ITID. Patients who refuse ITID were ordered to continue oral prednisolone treatment. Assessment of outcome and audiometry for hearing evaluation was done 1, 2 and 4 weeks as well as 3 months post-treatment.Patients in oral steroid only group were 26 patients, while patients in oral steroid and ITID group were 49 patients. In oral steroid group; 11/26 patients showed complete recovery, 3/26 had partial recovery and 12/26 not recovered. In other group; 38/46 patients had complete recovery, 6 had partial recovery and 5/49 patients not recovered.Combined systemic corticosteroid with ITID showed a marked improvement of post-COVID vestibular disorder and hearing loss than only using oral corticosteroid therapy.

Theranostic nanomaterials hold the potential to revolutionize future disease management. Recent progress in nanomaterials technology and aptamer-base- -targeting molecules have promoted efficient theranostics models. Aptamers are unique three-dimensional structures consisting of oligonucleotide (25-80 nt) polymers. They are comparable to monoclonal antibodies in their receptor-driven binding efficacy toward specific target receptors and binding ability to specific target molecules with high affinity and specificity. Aptamers have several other advantages, including prolonged shelf life, little or no variation from batch to batch, and ease of chemical modifications for enhanced stability and targeting capacity. Owing to the advantages mentioned above, aptamers are attracting great attention in diverse applications ranging from therapy, drug delivery, diagnosis, and functional genomics as well as biosensing. Herein, the aim is to give an overview of aptamers, highlight the opportunities of their application as means of effective therapeutic tools as well as functionalize them as potential diagnostic probes. Furthermore, the diverse modifications of aptamers for theranostic purposes, including therapeutic agents and targeted delivery nanomaterials, are comprehensively summarized.

The antidiabetic and hepato-renal protective effects of Citrullus colocynthis and Momordica charantia ethanol extracts were investigated in streptozotocin (STZ) induced diabetic male albino rats. Diabetic rats were treated with C. colocynthis, M. charantia or C. colocynthis + M. charantia mixed extract at a dose of 250 mg /kg body weight per oral per day for 21 days. The mean body weight of all the diabetic rat groups on day 1 of treatment (day 10 of diabetes) was significantly lower than the normal control rat group (P 200 mg/dl) than the normal control rat group (95.5 ± 2.7). At the end of treatment (day 21), the diabetic rats treated with plant extracts showed significant increase (P 200 mg/dl) do que o grupo de ratos controle normal (95,5 ± 2,7). Ao final do tratamento (dia 21), os ratos diabéticos tratados com extratos vegetais apresentaram aumento significativo (P < 0,05) no peso corporal e redução significativa (P < 0,05) na glicemia quando comparados aos animais controle diabéticos. Aumento significativo (< 0,05) foi observado nos níveis séricos de bilirrubina, alanina transaminase (ALT), aspartato transaminase (AST), fosfatase alcalina (ALP), ureia e creatinina do grupo controle diabético. Os níveis séricos desses parâmetros hepáticos e renais de ratos diabéticos tratados com extrato vegetal foram significativamente menores quando comparados ao grupo controle de ratos diabéticos (p < 0,05). Fotomicrografias de microseções de fígado e rim de ratos diabéticos tratados com esses extratos vegetais mostraram melhora nas histoarquiteturas hepatorrenais. Concluiu-se que os extratos metanólicos de C. colocynthis e M. charantia são antidiabéticos e hepatorrenais protetores em ratos machos diabéticos induzidos por STZ. O tratamento de ratos diabéticos com extrato misto de C. colocynthis + M. charantia é mais eficaz na melhora do diabetes e lesões hepatorrenais em ratos machos diabéticos induzidos por STZ.

This study investigated the electric field distribution of underground cable insulation in cross-linked polyethylene/zinc oxide (XLPE/ ZnO) nanoparticles (NPs) for medium-voltage (MV) cables. The ZnO NPs that were obtained by three methods of preparation were classified using transmission electron microscopy (TEM). The obtained ZnO NPs were semi-spheres with sizes of 35–55 nm on TEM images. XLPE/ ZnO films with various ZnO NP weight contents (i.e., 0, 1, 3, and 5%) were exposed to varied dosages of 3-MeV electron beam (EB); 0 kGy, 15 kGy, 20 kGy, and 25 kGy. The optimum film XLPE/ 5-ZnO, which has ZnO NP content (5 wt%), irradiated at 25 kGy, according to alternating current (AC)/ DC conductivity (AC: 1 × 10−4 S/m; DC: 12.44 × 10−2 S/m) in minimum relative permittivity (2.24), was obtained. COMSOL Multiphysics was used to simulate the electric field distribution within an MV cable of 25-kGy XLPE/ 5-ZnO insulation. The maximum uniform electric field was found in the middle of the 25-kGy XLPE/5-ZnO film sample, rather than at the top or bottom, which might be attributed to the significantly low relative permittivity of the new 25-kGy XLPE/5-ZnO film cable.

The main purpose of this work is to use a low-cost DC plasma discharge to enhance the material properties. The source of the DC glow discharge plasma was the Batorm device. By using a low-pressure argon gas, the best operating conditions of the plasma were obtained at a pressure [Formula: see text] and a breakdown voltage of 160 V. Electrical parameters of the plasma have been experimentally estimated at two different pressures [Formula: see text] and [Formula: see text]. Tantalum material has been chosen to be treated along this work due to its great importance in industry. In addition, it is used as a cathode for the ion source inside the Egyptian cyclotron at the Egyptian Atomic Energy Authority (EAEA). A U-shaped tantalum sample, exactly like the cyclotron filament, was exposed to plasma created from [Formula: see text] and 250 V for 30 min. At these low conditions, the obtained results were promising where the surface treatment of the sample caused cleaning and increased its hardness.