Search

Introduction: Genetic testing is playing a greater part in contemporary medical practice. The ability of high throughput and parallel detection of variants that could predict the possibility of developing genetic diseases and to deliver personalized health care for individuals is slowly but most certainly gaining traction. This study was conceived to investigate the knowledge level and degree of awareness among youth in the United Arab Emirates, on the role of genetic testing in society, and the delivery of health care. Methods: Data from individuals were collected, and statistical analyses were performed to assess whether or not there were differences in people’s attitude toward genetic testing, depending on variables such as age, gender, and prior knowledge of genetic testing. Volunteers were recruited at the main campus of Khalifa University in Abu Dhabi via walk-ins to the recruitment desk or via an email which was circulated to both the staff and student population of the university. The survey that was circulated through email was also shared with friends and family, and through social media, to try to capture a larger and more diverse demographic population. Results: Results found that most of the participants were aware of genetic testing and showed a positive attitude toward the technology. However, there was an apparent lack of knowledge and understanding of regarding certain genetic concepts, such as the alternate sources of obtaining genetic information other than blood samples. The mean knowledge score was 6.3 ± 1.9 out of 9, and mean attitude score was 3.6 ± 1.3 out of 6. The main factors that affected knowledge and attitude were gender and prior knowledge of genetic testing. Conclusion: This study used surveys as an effective tool to evaluate the general knowledge of genetic testing of the general public. It is recommended to embed genetic topics in schools and universities to further increase people’s awareness regarding genetic testing.

Radical prostatectomy is a life saving treatment for localised prostate cancer but may come with debilitating consequences, such as incontinence and erectile dysfunction. Penile Prosthesis Implants (PPI) are the gold standard of treatment for patients with refractory Erectile Dysfunction (ED) resistant to conservative management. Likewise, an Artificial Urinary Sphincter (AUS) is gold standard for those with refractory severe urinary incontinence. This systematic review with cumulative analysis assesses the efficacy and complications rates for synchronous placement of PPI and AUS as a single-stage procedure. Systematic literature review was performed using the US National Library of Medicine’s life science database (MEDLINE) (2000 to May 2021), EMBASE (2000 to May 2021), Cochrane Central Register of Controlled Trials-CENTRAL (in the Cochrane Library-2021), Google Scholar and Individual journals. 5 studies were included for analysis, with total of 112 patients. The overall revision/replacement rate was 12.5% (n = 14). The revision rate for PPI alone was 4.5% (n = 5), for AUS was 6.5% (n = 9). The overall removal rate was 5.4% (n = 6). Removal rate for PPI alone was 0.9% (n = 1), for AUS was 1.4% (n = 3). There were only 2 case of dual prosthesis removal (1.4%). Our cumulative analysis has revealed that revision and removal rates for synchronous dual implants may be lower than previously believed. However, our review has highlighted the low quality of available data and stresses that more robust studies are required to validate the high satisfaction and low complication rates reported by small studies.

Limited evidence exists on the effect of xanthine oxidase inhibitors in nephrolithiasis patients on iron status markers, beyond their effects on urate. The aim of this study was to investigate whether allopurinol therapy was associated with a significant impact on parameters related to iron status, in patients with renal stones. Allopurinol treatment was associated with a nonsignificant decline in serum uric acid. There were no significant differences in serum levels of transferrin and ferritin after treatment with allopurinol compared to pre-treatment levels. A non-significant fall in serum levels of haptoglobin was registered. The drug was associated with a significant rise in serum iron levels. Serum uric acid and iron did not show a significant correlation with any parameter in the study. Allopurinol exerted an overall non-significant effect on iron metabolism in nephrolithiasis patients, save for serum iron, this entails lack of untoward effects in populations with-iron related conditions.

Purpose: To assess the feasibility and acceptability of implementing the MD Anderson Symptom Inventory–Head and Neck (MDASI-HN) module in cancer clinics and its effect on patient-reported experience. Methods: We conducted a prospective, longitudinal study at a tertiary cancer institution between September 2020 and August 2021. Patients with newly diagnosed head and neck (HN) cancer who were evaluated to receive radiation therapy with or without chemotherapy and could communicate in English were approached to participate. The primary outcome was feasibility and acceptability of the MDASI-HN implementation in the radiation oncology department assessed by patient and provider exit surveys. Secondary outcomes were patient-reported experience as recorded by a shortened Your Voice Matters survey (YVM) in 2 cohorts pre- and post-MDASI-HN implementation and symptom scores. Descriptive statistics were used for exit surveys and symptom scores. Mann-Whitney tests were used to assess differences in positive responses between pre- and postimplementation for each YVM question. Cochrane-Armitage tests were used to examine changes in patient-reported experience over time. Results: Fifty-one patients were enrolled in the postimplementation cohort and 29 (60%) responded to the exit survey. Eighty-nine percent of patients reported that MDASI-HN made it easier to remember symptoms, and 86% recommend its use in routine care. Four of the 5 radiation oncology HN providers (80%) responded to exit surveys; 75% felt the MDASI-HN provided clinically relevant information, improved communication with patients, and did not increase clinic time. The overall patient-reported experience was not affected by the implementation (P = .82). The probability of positive responses over time was significant (P = .025) in the clinic coordination domain for the postimplementation cohort. Conclusions: Implementation of MDASI-HN was feasible and acceptable by patients and providers. Although the overall patient-reported experience was not affected by implementation, some aspects improved as treatment progressed.

BackgroundThe promise of artificial intelligence (AI) to transform health care is threatened by a tangle of challenges that emerge as new AI tools are introduced into clinical practice. AI tools with high accuracy, especially those that detect asymptomatic cases, may be hindered by barriers to adoption. Understanding provider needs and concerns is critical to inform implementation strategies that improve provider buy-in and adoption of AI tools in medicine. ObjectiveThis study aimed to describe provider perspectives on the adoption of an AI-enabled screening tool in primary care to inform effective integration and sustained use. MethodsA qualitative study was conducted between December 2019 and February 2020 as part of a pragmatic randomized controlled trial at a large academic medical center in the United States. In all, 29 primary care providers were purposively sampled using a positive deviance approach for participation in semistructured focus groups after their use of the AI tool in the randomized controlled trial was complete. Focus group data were analyzed using a grounded theory approach; iterative analysis was conducted to identify codes and themes, which were synthesized into findings. ResultsOur findings revealed that providers understood the purpose and functionality of the AI tool and saw potential value for more accurate and faster diagnoses. However, successful adoption into routine patient care requires the smooth integration of the tool with clinical decision-making and existing workflow to address provider needs and preferences during implementation. To fulfill the AI tool’s promise of clinical value, providers identified areas for improvement including integration with clinical decision-making, cost-effectiveness and resource allocation, provider training, workflow integration, care pathway coordination, and provider-patient communication. ConclusionsThe implementation of AI-enabled tools in medicine can benefit from sensitivity to the nuanced context of care and provider needs to enable the useful adoption of AI tools at the point of care. Trial RegistrationClinicalTrials.gov NCT04000087; https://clinicaltrials.gov/ct2/show/NCT04000087

IntroductionVitamin D deficiency and insufficiency are highly prevalent among several populations across the globe. Numerous studies have shown a significant correlation between body-mass-index (BMI) and Vitamin D status, however, some results differed according to ethnicity. Despite the abundance of sunshine throughout the year, vitamin D deficiency is prominent in the United Arab Emirates (UAE). In this study, we analyzed the UAE Healthy Future Study (UAEHFS) pilot data to investigate the association between serum 25-hydroxyvitamin D (25(OH)D) and % body fat (BF) composition as well as BMI.Material and methodsData from a total of 399 Emirati men and women aged ≥ 18 years were analyzed. Serum 25(OH)D and standard measures of weight and height were included in the analyses. Vitamin D deficiency was defined as serum 25(OH)D concentration

Background: Deep-fat fried foods are widely popular due to their distinct organoleptic and sensory characteristics. Deep-fat frying allows physical and chemical structural changes at the macro and micro levels. One of the greatest concerns regarding fried foods is their high oil content, and the excessive consumption of these foods has been linked to a range of metabolic diseases, including heart ailments, obesity, high cholesterol, and high blood pressure.Scope and approach: This review paper presents a comprehensive and up-to-date review of various innovative frying processes, such as vacuum frying (VF), microwave frying, microwave-assisted vacuum frying (MVF), ultrasound combined microwave vacuum frying (UMVF), air frying, and radiant frying. Additionally, it explains the oil uptake mechanism, oil quality, and the effects of different pretreatments and post-frying treatments on the frying process.Key findings and conclusions: Innovative frying processes are considered promising and capable of producing healthier fried foods compared to traditional frying; they reduce oil uptake without deteriorating organoleptic and sensory characteristics. Specifically, vacuum-assisted frying technologies, such as VF, MVF, and UMVF have significantly reduced oil uptake and acrylamide production while preserving oil quality. In addition, appropriate pretreatment and post-frying techniques play an essential role in reducing oil uptake and optimizing the frying process by saving energy.

The use of hydrophilic bentonite nanoclay to improve the geotechnical properties of expansive soils was studied. Sonic waves and manual mixing for two expansive soils (taken from two different locations in Jordan) were studied; thereafter, a comparison between the results obtained from both methods was carried out. Different percentages of nanoclay were added to the two soils: 0, 0.1, 0.3, 0.5, 0.8, 1, 1.5, and 2.5% by dry weight of soil. Their impacts on compaction, unconfined compression strength (UCS), and free swell index (FSI) were investigated. For both methods of mixing, adding nanoclay to the soils resulted in a significant enhancement in strength and a reduction in swell properties of the soils. The UCS results of sonicated samples treated with 0.5% of nanoclay addition showed an increase of 27%–57% and a reduction in FSI by 41%–46.5%. Nevertheless, the UCS of non-sonicated samples treated with 1% of nanoclay showed an increase of 19.3–28.5% and a reduction in FSI by 37.3–44.3%.

The modulation of molecular characteristics in metal-free organic dyes holds significant importance in dye-sensitized solar cells (DSSCs). The D-π-A molecular design, based on the furan moiety (π) in the conjugated spacer between the arylamine (D) and the 2-cyanoacrylic acid (A), was developed and theoretically evaluated for its potential application in DSSCs. Utilizing linear response time-dependent density functional theory (TDDFT) with the CAM-B3LYP functional, different donor and acceptor groups were characterized in terms of the electronic absorption properties of these dyes. All the studied dye sensitizers demonstrate the ability to inject electrons into the semiconductor’s conduction band (TiO2) and undergo regeneration through the redox potential triiodide/iodide (I3−/I−) electrode. TDDFT results indicate that the dyes with CSSH anchoring groups exhibit improved optoelectronic properties compared to other dyes. Further, the photophysical properties of all dyes absorbed on a Ti(OH)4 model were explored and reported. The observed results indicate that bidentate chemisorption occurs between dyes and TiO4H5. Furthermore, the HOMO–LUMO energy gaps for almost all dye complexes are significantly smaller than those of the free dyes. This decrease of the HOMO–LUMO energy gaps in the dye complexes facilitates electron excitation, and thus more photons can be adsorbed, guaranteeing larger values of efficiency and short-circuit current density.

DNA sensing is critical in various applications such as the early diagnosis of diseases and the investigation of forensic evidence, food processing, agriculture, environmental protection, etc. As a wide-bandgap semiconductor with excellent chemical, physical, electrical, and biocompatible properties, silicon carbide (SiC) is a promising material for DNA sensors. In recent years, a variety of SiC-based DNA-sensing technologies have been reported, such as nanoparticles and quantum dots, nanowires, nanopillars, and nanowire-based field-effect-transistors, etc. This article aims to provide a review of SiC-based DNA sensing technologies, their functions, and testing results.

Water scarcity due to rainfall variability, and exacerbated by climate change, is prevalent in many regions of the world. Lack of precipitation and excessive water extraction contribute to the intensification of the problem. Among different mitigation measures, rain enhancement through cloud seeding could be a tool as part of a water management strategy to replenish ground water sources. However, implementation of this technology requires proper preliminary analysis of the available cloud data and specific meteorological conditions under which rainfall forms. The aim of this paper is to assess the potential of for rain enhancement in Minas Gerais State in Brazil. The paper focuses on analysis of multiyear climate reanalysis ERA-5, upper air sounding, weather radar and ground stations data. Analysis showed that, between 2000 and 2019, precipitation declined on average by 212 mm per annum or 21% compared to the long term climatological mean. The natural precipitation, however, remains sufficiently high to implement weather modification technology. Assuming an increase of 15–20% could be achieved on a catchment area basis, the increases would be significant and could offset the recently observed decline in natural precipitation. The methodology proposed in this study can be used as a baseline for similar analysis in other vulnerable regions of the world experiencing freshwater shortages or declines. Its shortcomings and uncertainties are also discussed.

Vision-based tactile sensors (VBTSs) have become the de facto method for giving robots the ability to obtain tactile feedback from their environment. Unlike other solutions to tactile sensing, VBTSs offer high spatial resolution feedback without compromising on instrumentation costs or incurring additional maintenance expenses. However, conventional cameras used in VBTS have a fixed update rate and output redundant data, leading to computational overhead.In this work, we present a neuromorphic vision-based tactile sensor (N-VBTS) that employs observations from an event-based camera for contact angle prediction. In particular, we design and develop a novel graph neural network, dubbed TactiGraph, that asynchronously operates on graphs constructed from raw N-VBTS streams exploiting their spatiotemporal correlations to perform predictions. Although conventional VBTSs use an internal illumination source, TactiGraph is reported to perform efficiently in both scenarios (with and without an internal illumination source) thus further reducing instrumentation costs. Rigorous experimental results revealed that TactiGraph achieved a mean absolute error of 0.62∘ in predicting the contact angle and was faster and more efficient than both conventional VBTS and other N-VBTS, with lower instrumentation costs. Specifically, N-VBTS requires only 5.5% of the computing time needed by VBTS when both are tested on the same scenario.

Abstract There is increasing attention focussed on the risks associated with mobile phones possibly serving as ‘Trojan Horse’ fomites for microbial transmission in healthcare settings. However, little is reported on the presence of microbes on community derived mobile phones which in 2021, numbered in the billions in circulation with majority being used on a daily basis. Identify viable microbial organisms swabbed from smartphones on a university campus. Entire surfaces of 5 mobile phones were swabbed and examined for their microbial content using pre-agar-based growths followed by downstream DNA metagenomic next-generation sequencing analysis. All phones were contaminated with viable microbes. 173 bacteria, 8 fungi, 8 protists, 53 bacteriophages, 317 virulence factor genes and 41 distinct antibiotic resistant genes were identified. While this research represents a pilot study, the snapshot metagenomic analysis of samples collected from the surface of mobile phones has revealed the presence of a large population of viable microbes and an array of antimicrobial resistant factors. With billions of phones in circulation, these devices might be responsible for the rise of community acquired infections. These pilot results highlight the importance of public health authorities considering mobile phones as ‘Trojan Horse’ devices for microbial transmission and ensure appropriate decontamination campaigns are implemented.

Purpose – The main objective of the study is to investigate the effect of COVID-19 on accounting education in the higher education (public and private universities) in the Gulf Cooperation Council (GCC). Design/methodology/approach – The study is explorative in nature conducted with quantitative survey approach and using purposive techniques in collecting data. The sample focuses on the teaching staff at public and private universities in (GCC), Kingdom of Saudi Arabia, United Arab Emirates, Bahrain, Kuwait, Oman and Qatar during the COVID-19. Findings – This study presumed to highlight some of the emergent issues faced during the pandemic pertaining the aspects of the COVID-19 and digitizing accounting education and its effect on future direction of digital education. Originality/value – To the best of the authors’ knowledge, this study is the first academic paper to study the effect of COVID-19 on accounting education in the higher education in the GCC.

Background: Zingiber officinale (ginger) is used widely as a herb and medicine. It contains among its constituents 6-Gingerol (a phenol) and quercetin (a flavonoid) that possess anxiolytic and antidepressant properties, but the potential biochemical mechanism(s) of these effects has not been assessed, particularly in relation to serotonin synthesis and neurotransmission. Aims and Objectives: We investigated the anxiolytic-like activity of an aqueous ginger extract by evaluating its influence on behavior, and its effects on serotonin metabolism and on metabolism and disposition of the serotonin precursor tryptophan (Trp) in rats. Materials and Methods: An aqueous ginger extract was given orally in a single daily dose equivalent to 500 mg of ginger material per kg body weight for 3 weeks. The elevated plus maze test of anxiety and Trp metabolism and disposition and brain serotonin synthesis and turnover were assessed in Ginger-treated and control rats. Results: When compared with controls, ginger-treated rats showed a significant increase in the time spent in the open arm, indicative of decreased anxiety. However there was no effect on locomotor activity in open field test. The extract caused significant decreases in activities of liver Trp 2,3-dioxygenase and significant increases in concentrations of serum Trp and corticosterone and brain Trp, serotonin and the major serotonin metabolite 5-hydroxyindoleacetic acid. Conclusion: An aqueous ginger extract exerts an anxiolytic effect in a behavioral model of anxiety, which may be caused by increased serotonin synthesis, and influences tryptophan metabolism and disposition in a manner analogous to antidepressant drugs.

Chronic renal failure is a progressive disease, characterized by the destruction of the functional units of the kidney, the nephrons. In order to prolong life, hemodialysis is the treatment chosen as an artificial means of eliminating nitrogen products and other toxic metabolic substances in the blood. This study was designed to evaluate the periodontal condition of patients with chronic renal failure treated or not by hemodialysis, considering this therapeutic method as an aggravating or contributory factor, which may lead to an increase in the pathological evolution of periodontal disease. The study was conducted in two groups: patients with chronic renal failure receiving hemodialysis – test group (D) – 26 patients with chronic renal failure receiving hemodialysis – control group (C) – 19 patients with chronic renal insufficiency not receiving hemodialysis. Of the 45 patients, 26 were treated by hemodialysis and 19 were in the control group. It can be seen that the age for both groups studied is close to 50 years. The values of the parameters studied, namely: the plaque indices, gingival index and loss of attachment, presents similar values. The greatest difference in plaque index (PI) was recorded in the hemodialysis group, 2.5 ± 0.4, compared to the control group at which the index value was 1.7 ± 0.2. The results presented showed that patients with chronic renal insufficiency receiving dialysis therapy are more susceptible to periodontal disease than those with chronic renal insufficiency but who do not receive dialysis. For this reason, especially for the first group of patients mentioned above, it is very important to maintain an optimal level of oral hygiene.

Patient-reported experience is associated with improved patient safety and clinical outcomes. Quality improvement programs rely on validated patient-reported experience measures (PREMs) to design projects. This descriptive study compares the experience of cancer patients treated with radiation as recorded through the Ambulatory Oncology Patient Satisfaction Survey (AOPSS) or as recorded through Your Voice Matters (YVM) between February and August 2019. Six questions were compared (“overall experience with care”, “discussion of worries”, “involvement in decisions”, “trusting providers with confidential information”, “providing family with information”, and “knowing who to contact”). Positive experience scores were calculated by cohort and by tumor groups. Multivariable logistic regression models evaluated factors associated with positive experience. Two cohorts (220 and 200 patients) met the eligibility criteria for the AOPSS and YVM, respectively. Positive experience was reported similarly between the two PREMs for “overall experience with care”, “discussion of worries”, and “trusting providers with confidential information” with a score difference of 1–4% at the cohort level. Positive experience score difference ranged from 5% to 44% across questions at the tumor group level. Different experience gaps were identified with the two measures, mainly at the tumor group level. Programs interested in using these PREMS might consider this when designing projects.

Seagrass habitats are considered to be some of the most biodiverse ecosystems on the planet and safeguard some ecologically and economically important fauna, amongst which are some globally threatened species, including dugong. Malaysian seagrass ecosystems are not widespread, but their existence supports some significant marine fauna. A rigorous zooplankton study was conducted from May 2016 to February 2017, in the seagrass habitat of Lawas, Sarawak, Malaysia, to examine their temporal composition and diversity, together with their ecological influences. A total of 45 zooplankton species from 13 significant groups were recorded in the seagrass habitat. The population density of zooplankton ranged between 2,482 ind/m³ and 22,670 ind/m³ over three different seasons. A single zooplankton copepod was found to be dominant (47.40%), while bivalves were the second largest (31.8%) group in terms of total abundance. It was also noticed that the average relative abundance (0.62) and important species index (62.08) of copepods were higher than for other groups that exist in the seagrass meadow, whereas copepod Parvocalanus crassirostris showed both the highest average relative abundance (0.41) and the highest important species index (41.15). The diversity (H') and richness index of the intermediate season were found to be highest due to favourable physico-chemical conditions. Within the referred seasonal cluster, the wet and dry seasons were almost similar in terms of species abundance, while the intermediate season was distinct, with high species diversity backed by ANOSIM analysis results. Copepod and bivalves formed one group with a common similarity level of 0.80. The CCA (Canonical Correspondence Analysis) model established that abiotic factors, especially turbidity, NO2, rainfall, dissolved oxygen and pH were significantly correlated with abundance of individual groups of zooplankton. Zooplankton assemblage and abundance in Lawas were found to be very rich in multiple seasons, indicating that the productivity of uninterrupted seagrass habitat might be high and the system rich in biodiversity.

BackgroundFollowing the outbreak of COVID-19, several studies have reported that young adults encountered a rise in anxiety symptoms, which could negatively affect their quality of life. Promising evidence suggests that mobile apps with biofeedback, serious games, breathing exercises, and positive messaging, among other features, are useful for anxiety self-management and treatment. ObjectiveThis study aimed to develop and evaluate the usability of a biofeedback-based app with serious games for young adults with anxiety in the United Arab Emirates (UAE). MethodsThis study consists of two phases: Phase I describes the design and development of the app, while Phase II presents the results of a usability evaluation by experts. To elicit the app’s requirements during Phase I, we conducted (1) a survey to investigate preferences of young adults in the UAE for mobile games for stress relief; (2) an analysis of serious games for anxiety; and (3) interviews with mental health professionals and young adults in the UAE. In Phase II, five experts tested the usability of the developed app using a set of Nielsen’s usability heuristics. ResultsA fully functional biofeedback-based app with serious games was co-designed with mental health professionals. The app included 4 games (ie, a biofeedback game, card game, arcade game, and memory game), 2 relaxation techniques (ie, a breathing exercise and yoga videos), and 2 additional features (ie, positive messaging and a mood tracking calendar). The results of Phase II showed that the developed app is efficient, simple, and easy to use. Overall, the app design scored an average of 4 out of 5. ConclusionsThe elicitation techniques used in Phase I resulted in the development of an easy-to-use app for the self-management of anxiety. Further research is required to determine the app’s usability and effectiveness in the target population.

The goal of this research was to determine the impact of a pooled and flat stepped spillway on energy losses. FLOW3D, which is a computational fluid dynamics (CFD) program, with mesh size of 0.015 mm was used for this purpose. First, the code was tested against an available experimental model data for both water flow depth and inception point position. The outcome precisely shows agreement with the available laboratory work. Second, the energy dissipation and residual head of two different types of stepped spillways, flat and pool was computationally compared. The results show that in a pooled stepped spillway, energy dissipation is larger than in a flat step. In addition, the residual head reduces for pooled stepped chutes.

Introduction: Left heart failure (LHF) is commonly complicated by pulmonary hypertension (PH), increasing morbidity and mortality. The present study aimed to evaluate the prognostic value of inflammatory proteins in LHF with PH (LHF-PH). Materials and methods: The levels of 65 plasma proteins, analysed with proximity extension assay, were compared between healthy controls (n = 20), patients with LHF-PH (n = 67) comprising both HFpEF-PH (n = 31) and HFrEF-PH (n = 36), and in a LHF subpopulation before and after heart transplantation (HT, n = 19). Haemodynamic parameters were measured using right heart catheterization. Results: Plasma levels of Interleukin 6 (IL-6) and Pentraxin related protein PTX3 (PTX3) were elevated in LHF-PH vs. controls (p

Background: Bicuspid aortic valve (BAV) is associated with progressive aortic dilation. Studies in aortopathies have shown a correlation between increased aortic stiffness and aortic dilation. We aimed to evaluate aortic stiffness measures as predictors of progressive aortic dilation by cardiac magnetic resonance (CMR) in BAV patients. Methods: This is a retrospective study of 49 patients with BAV (median age 21.1 years at first CMR visit) with ≥2 CMR at the Wisconsin Adult Congenital Heart Disease Program (WAtCH). Circumferential aortic strain, distensibility, and β-stiffness index were obtained from CMR-derived aortic root cine imaging, and aortic dimensions were measured at aortic root and ascending aorta. A linear mixed-model and logistic regression were used to identify important predictors of progressive aortic dilation. Results: Over a median of 3.8 years follow-up, the annual growth rates of aortic root and ascending aorta dimensions were 0.25 and 0.16 mm/year, respectively. Aortic strain and distensibility decreased while β-stiffness index increased with age. Aortic root strain and distensibility were associated with progressive dilation of the ascending aorta. Baseline aortic root diameter was an independent predictor of >1 mm/year growth rate of the aortic root (adjusted OR 1.34, 95 % CI 1.03–1.74, p = 0.028). Most patients (61 %) had coexisting coarctation of aorta. Despite the higher prevalence of hypertension in patients with aortic coarctation, hypertension or coarctation had no effect on baseline aorta dimensions, stiffness, or progressive aortic dilation. Conclusion: Some CMR-derived aortic stiffness parameters correlated with progressive aortic dilation in BAV and should be further investigated in larger and older BAV cohorts.

Objective: Estimate sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of EEG findings: centrotemporal spikes, photoparoxysmal response, asymmetric photic driving, and asymmetric sleep spindles, for epilepsy phenotype and presence of structural brain abnormalities. Methods: In this case-control study we reviewed children referred for EEG over a 4-year period, with at least one of centrotemporal spikes, photoparoxysmal response, asymmetric photic driving, or asymmetric sleep spindles. This cohort was analyzed in combination with a research database of pediatric patients with seizures. Results: Centrotemporal spikes had 100% sensitivity for childhood epilepsy with centrotemporal spikes or atypical childhood epilepsy with centrotemporal spikes, but lower specificity (70%) and PPV (58%). Photoparoxysmal response had high specificity (92%) and NPV (92%) for genetic generalized epilepsy. Asymmetric photic driving had low sensitivity for structural brain abnormalities (17%), with specificity 80%. In contrast, asymmetric sleep spindles had much higher sensitivity and specificity, 44% and 97%, respectively. Conclusions: Although centrotemporal spikes are classically associated with childhood epilepsy with centrotemporal spikes, these discharges are seen in other conditions. Photoparoxysmal response is highly indicative of a genetic generalized epilepsy, though may be seen in other epilepsy phenotypes. Relative attenuation of sleep spindles is a more reliable indicator of structural brain malformation than asymmetric photic driving. Significance: The quantitative diagnostic utility of EEG findings should be considered when incorporating these results into clinical decision-making.

Objectives Older adults have a higher degree of multimorbidity, which may adversely affect longer term outcomes from non-ST elevation acute coronary syndrome (NSTE-ACS). We investigated the impact of multimorbidity on cardiovascular outcomes 5 years after invasive management of NSTE-ACS.Design Prospective cohort study.Setting Multicentre study conducted in the north of England.Participants 298 patients aged ≥75 years with NSTE-ACS and referred for coronary angiography, with 264 (88.0%) completing 5-year follow-up.Main outcome measures Multimorbidity was evaluated at baseline with the Charlson comorbidity index (CCI). The primary composite outcome was all-cause mortality, myocardial infarction, stroke, urgent repeat revascularisation or significant bleeding.Results Mean age was 80.9 (±6.1) years. The cohort median CCI score was 5 (IQR 4–7). The primary composite outcome occurred in 48.1% at 5 years, at which time 31.0% of the cohort had died. Compared with those with few comorbidities (CCI score 3–5), a higher CCI score (≥6) was positively associated with the primary composite outcome (adjusted HR (aHR) 1.64 (95% CI 1.14 to 2.35), p=0.008 adjusted for age and sex), driven by an increased risk of death (aHR 2.20 (1.38 to 3.49), p=0.001). For each additional CCI comorbidity, on average, there was a 20% increased risk of the primary composite endpoint at 5 years (aHR 1.20 (1.09 to 1.33), p

Abstract Background & Aims The BioNTech‐Pfizer vaccine is the only vaccine offered to children among all available vaccines. However, limited evidence is available about the clinical outcomes of COVID‐19 vaccines, especially among children and adolescents. This review offers a comprehensive and up‐to‐date overview of the BioNTech‐Pfizer vaccine's current information on children and adolescents. Methods The review was conducted following the PRISMA guidelines; a comprehensive search was performed in PubMed, Scopus, MEDLINE, and EMBASE databases for research publications COVID‐19 published between December 2019 and October 2021. All studies reporting on the outcomes of vaccinating children in their respective institutes were included. Results A total of 78 vaccinated children and adolescents from six studies were included. The majority of symptomatic vaccinated pediatrics were males (71%). The mean age was 15.6 years, and the BMI was 24.1. The most common clinical symptoms were found in chest pain (35%), fever (32%), and myalgia (17%). The most common cardiac symptom in the EKG results was ST elevation, and 35% of vaccinated pediatrics had elevated serum troponin. The hospitalization, including ICU admission, was lower than in unvaccinated groups. Statistically significant associations (p ≤ 0.05) were found in two symptoms (fever and headache) between the vaccinated and nonvaccinated pediatric groups. Conclusions Although we found better outcomes in the vaccinated group versus the nonvaccinated pediatric group, more studies are still crucial to further understand the specific etiology underlying postvaccination, particularly myocarditis, psychological impact, and other cardiac clinical symptoms in children and adolescents after receiving the BioNTech‐Pfizer vaccine.

In less agroecological parts of the Asian, Arabian, and African deserts, Camelus dromedarius play an important role in human survival. For many years, camels have been employed as a source of food, a tool of transportation, and a means of defense. They are becoming increasingly important as viable livestock animals in many desert climates. With the help of camel genetics, genomics and proteomics known so far, this review article will summarize camel enzymes and proteins, which allow them to thrive under varied harsh environmental situations. An in-depth study of the dromedary genome revealed the existence of protein-coding and fast-developing genes that govern a variety of metabolic responses including lipid and protein metabolism, glucoamylase, flavin-containing monooxygenase and guanidinoacetate methyltransferase are other metabolic enzymes found in the small intestine, liver, pancreas, and spleen. In addition, we will discuss the handling of common medications by camel liver cytochrome p 450, which are different from human enzymes. Moreover, camels developed several paths to get optimum levels of trace elements like copper, zinc, selenium, etc., which have key importance in their body for normal regulation of metabolic events. Insulin tolerance, carbohydrate and energy metabolism, xenobiotics metabolizing enzymes, vimentin functions, behavior during the rutting season, resistance to starvation and changes in blood composition and resistance to water loss were among the attractive aspects of camel enzymes and proteins peculiarities in the camels. Resolving the enigma of the method of adaptation and the molecular processes linked with camel life is still a developing repository full of mysteries that need additional exploration.

Populus euphratica Oliv. (Euphrates poplar), as the dominant tree species of desert riparian forests along the Central Asian inland rivers, plays a critical role in protecting arid land ecosystems. In recent decades, climate change and excessive water resources utilization activities have led to the environmental degradation of desert riparian forests along the Tarim River in northwest China. Understanding the forest stand structure and spatial distribution pattern provide important guidance for monitoring forest dynamics in support of sustainable management. However, few studies have examined how riparian forests stand attributes differ in response to environmental heterogeneity. In this study, terrestrial laser scanning (TLS) was applied to acquire a total of 1648 individual P. euphratica tree’s 3D structure attributes within 18 plots along the upper, middle, and lower reaches of the Tarim River, which included tree height (TH), diameter at breast height (DBH), crown diameter (CD), crown projection area (CPA), stand density index (SDI), age structure ratios, and spatial pattern. The results showed that the average tree segmentation and structure determination accuracies of TLS were 93.2 and 94.6%. From the upper to the lower reaches, the average TH and CD decreased by 3.8 and 0.3 m, while the DBH increased by 4.2 cm. The SDI and CPA exhibited the following order: upper reaches (454 n ha–1, 82.3%) > middle reaches (382 n ha–1, 67.3%) > lower reaches (263 n ha–1, 39.1%), the differences were significant at 0.05 level. The population age structure changed from growing population in the upper reaches to stable population in the middle and a temporarily stable population in the lower reaches. The pair correlation g(r) function determined random distribution pattern in the upper reaches [g(r) = 1.2], an aggregated pattern in the middle [g(r) = 3.1], and lower reaches [g(r) = 9.7]. The decline in groundwater depth and soil moisture increased aggregated distribution pattern (R = 0.67 and 0.56, P < 0.05) of the P. euphratica along the mainstream of Tarim River. The results enrich our understanding of the current development stage of P. euphratica, which is important for optimizing management strategies and realizing the sustainability of floodplain ecosystems.

Previous research suggests that environment can play an important role in encouraging or discouraging creative expression and productivity. Additional research has uncovered a discrepancy between the creativity students express at school and the creativity they express outside of school. The fact that, in previous research, students expressed more creativity outside of school than when in school implies that school discourages creativity. So far, the creativity gap has only been studied with nongifted students. One objective of the present investigation was to check for a similar discrepancy among gifted learners. Four hundred and eighty-seven middle school and high school students from the State of Kuwait (240 gifted and 247 nongifted) were recruited. The "Creativity Activities and Accomplishment Checklist" (CAAC) was administered to compare students' creative activities at home and school. The primary finding of this investigation was that the strength of the relationship between creativity at home and creativity at school differed in gifted and nongifted students. What was called a creativity "gap" existed in both groups, but it was smaller in the gifted group. A second finding was that gifted students expressed more creativity at school compared with the nongifted group, in particular CAAC domains. There were no differences between the gifted and the nongifted groups in the creativity expressed at home, except for one subscale, namely everyday creativity. Although gifted students expressed more creativity at school, compared with their nongifted peers, they were nonetheless more creative at home compared with school. Finally, hierarchical regression analyses indicated that measure of personality significantly moderated the relationship between creativity at home and creativity at school. Limitations and future directions are discussed.

Higher education institutions have a key role in forming the specialists of the future. In fulfilling their role there is need for transformational leadership, culture of excellence, and academic leadership development. The purpose of this study is to investigate the link between transformational leadership, shaping a culture of educational excellence, and leadership development, as perceived by tertiary education leaders in the UAE. The qualitative approach is of focus groups, using semi-structured questions, with leaders in academia. The main finding is that in the initial stages of an organization life cycle, leadership development precedes transformational leadership and a culture of excellence. In later stages, leadership development is a mediator of transformational leadership and a culture of excellence. In the mature stages of organization life cycle, the three elements engage in an ongoing spiral and synergistic process.

Abstract Aims Right ventricular dysfunction may arise because of pulmonary arterial hypertension (PAH). Development of new diagnostic methods able to identify PAH and allow for earlier treatment initiation, before the development of vascular remodelling and manifest right heart failure (HF), could potentially improve prognosis. Proteoglycans and inflammatory proteins are involved in vascular remodelling. We aimed to investigate their potential as biomarkers to differentiate PAH in a dyspnoeic population. Methods and results Plasma from 152 patients with PAH (n = 48), chronic thrombo‐embolic pulmonary hypertension (n = 20), pulmonary hypertension due to HF with reduced (n = 36) or preserved (n = 33) ejection fraction, and HF without pulmonary hypertension (n = 15) and 20 healthy controls were analysed with proximity extension assays. Haemodynamics were assessed in the patients with right heart catheterization. Plasma prolargin levels in PAH were lower compared with all the other studied disease groups (P

The purpose of this research is examining the performance of rectangular broad and sharp crested weirs in terms of cavity index and discharge coefficient. For this purpose, a computational fluid dynamics CFD code FLUENT is applied. Firstly, the code verified by applies on the experiments work of Hagre et al 1994 the results show excellent agreements between CFD and Hager et al 1994. Secondly the code applied on both broad and sharp crested weirs. The results demonstrate that broad crested weirs have a lower discharge coefficient than sharp crested weirs, implying that broad crested weirs have a lower ability to discharge flow than sharp crested weirs. While the cavity index of a broad crested weir is lower than that of a sharp crested weir, the risk of cavitation is lower for a broad crested weir. Finally, designers should use caution when deciding which type of crest to use in their

Abstract Background Patients discharged against medical advice (DAMA) act as a high-risk population for the Emergency Department (ED), regardless of their presentations, and can pose a serious burden for the hospital. This study examines the prevalence, demographic and clinical characteristics, reasons, and clinical outcomes of a small sample of DAMA patients in a teaching university hospital, including readmission, morbidity, and mortality. Methods A prospective, descriptive cross-sectional study was conducted in the ED of King Hamad University Hospital (KHUH) with 98,992 patient visits during a 1-year period from June 2018 to June 2019. Consenting DAMA patients were asked to complete a data collection form. Results Patients (n = 413) had a mean age of 44.1 years with a female majority (57.1%). The majority were categorized as triage level-3 (87.7%). The main reasons for DAMA included refusal of the procedure/operation (23.2%), long ED waiting time (22.2%), subjective improvement with treatment (17.7%), and children at home (14.8%), whereas the least selected reason was dissatisfaction with medical care (1.2%). Follow-up of DAMA patients revealed that 86 cases (20.8%) were readmitted to the ED within 72 h of which 41 (47.7%) cases were morbidity and 2 (2.3%) were mortality. Marital status was a predictor of DAMA patients who revisit the ED within 72 h. Conclusion The results act as a pilot study to examine a small sample of DAMA patients’ characteristics, diagnosis, and ED revisits. Hospitals should investigate further the DAMA population on a larger scale, reasons for refusing procedures, and utilize this knowledge to improve the healthcare process.

Abstract The COVID-19 pandemic has affected more than 100 million cases and caused immense burdens on governments and healthcare systems worldwide. Since its emergence in December 2019, research has been focused on treating the infected, identifying those at risk and preventing spread. There is currently no known biological biomarker that predicts the risk of infection. Several studies emerged suggesting an association between ABO blood group and the risk of COVID-19 infection. In this study, we used retrospective observational data in Bahrain to investigate the association between ABO blood group and risk of infection, as well as susceptibility to severe ICU-requiring infection. We found a higher risk associated with blood group B, and a lower risk with blood group AB. No association was observed between blood group and the risk of a severe ICU-requiring infection. We extended the analysis to study the association by antibodies; anti-a (blood groups B and O) and anti-b (blood groups A and O). No association between antibodies and both risk of infection or susceptibility to severe infection was found. The current study, along with the variation in blood group association results, indicates that blood group may not be an ideal biomarker to predict risk of COVID-19 infection.

Background: In December 2018, routine surveillance identified an autochthonous outbreak of dengue fever in Muscat Governorate, Oman, a region previously free of dengue fever. Methods: Routine surveillance confirmed locally acquired cases in the second week of December, leading to a rapid public health response including case management guidance and epidemiological investigations. The main activity was the vector survey using systematic sampling to assess extent of previously unreported Aedes aegypti presence followed by a campaign aimed to eliminate breeding sites of A. aegypti”. Results: During a 5-month period, 343 suspected cases were reported from Muscat Governorate with 122 from the outbreak affected area. Out of 207 probable cases eligible for laboratory testing as per guidelines issued, 59 cases were confirmed. The vector elimination campaign started on January 8, 2019 after a media advocacy using television and social media and concluded on January 23. By the end of campaign, the case load had decreased significantly in the affected area with no reports of locally acquired cases from adjoining areas of Muscat Governorate, indicating no further spread. Conclusions: Rapid notification and early community-wide, extensive vector control activities effectively contained the autochthonous dengue fever virus outbreak. Keywords: Dengue fever, Autochthonous outbreak, Oman, Aedes aegypti, Vector-borne illness, Disease surveillance

Basin ecosystems are vulnerable to natural resource depletion, ecological damage, and environmental pollution due to their fragile natural environment. Assessing the value of basin ecosystem services (ES) can facilitate informed decision making by policy makers and stakeholders in the context of competing resource use. The Konqi River Basin in China, an arid inland river basin, has suffered from degraded ecosystems due to overexploitation of soil and water resources. In response, the local government launched an ecological water conveyance (EWC) project in 2016 to enhance ecological restoration efforts. This paper analyzes and evaluates the value of ES in the Konqi River Basin based on land use and land cover (LULC) change characteristics before and after EWC in 2013 and 2020, respectively. Remote sensing data and related socioeconomic statistics data are used to assess a typical river basin from three unique locations in the Konqi River Basin, divided into upper and lower reaches. The results show that cropland and unused land are the most important land use types in the upper and lower reaches. The characteristics of ecosystem service value (ESV) changes in the study area are consistent with land use structure changes. The total ESV shows a decreasing trend in the upper reaches from 2013 to 2020, while the lower reaches show an increasing trend. The total ESV increases in the typical river reaches of the Konqi River Basin. Spatially, low-ESV areas are mainly located in ecologically fragile areas that are difficult to develop and use. The sensitivity indexes of the study area are all less than 1, making the results of this study credible. The Moran index shows a significant spatial correlation in the study area, indicating that the distribution characteristics of high-ESV areas are agglomerative. Hot spot areas in the upper reaches show an overall increasing trend, while in the lower reaches, former sub-hot spot areas transform into hot spot areas. Due to data limitations, this study is limited to demonstrating that the value of ES in the area changes due to a combination of EWC policies and other factors. Nevertheless, the analysis shows that EWC policies actively change the ESV of a typical river basin in Konqi. This study can provide a reference for evaluating ESV in inland river basins in the northwest arid region and a scientific basis for the rational development and utilization of water and soil resources in the study area, located in an arid and ecologically fragile area.

Nowadays, despite all the conducted research and the provided efforts in advancing the healthcare sector, there is a strong need to rapidly and efficiently diagnose various diseases. The complexity of some disease mechanisms on one side and the dramatic life-saving potential on the other side raise big challenges for the development of tools for the early detection and diagnosis of diseases. Deep learning (DL), an area of artificial intelligence (AI), can be an informative medical tomography method that can aid in the early diagnosis of gallbladder (GB) disease based on ultrasound images (UI). Many researchers considered the classification of only one disease of the GB. In this work, we successfully managed to apply a deep neural network (DNN)-based classification model to a rich built database in order to detect nine diseases at once and to determine the type of disease using UI. In the first step, we built a balanced database composed of 10,692 UI of the GB organ from 1782 patients. These images were carefully collected from three hospitals over roughly three years and then classified by professionals. In the second step, we preprocessed and enhanced the dataset images in order to achieve the segmentation step. Finally, we applied and then compared four DNN models to analyze and classify these images in order to detect nine GB disease types. All the models produced good results in detecting GB diseases; the best was the MobileNet model, with an accuracy of 98.35%.

Forest aboveground biomass (AGB) is not simply affected by a single factor or a few factors, but also by the interaction between them in complex ways across multiple spatial scales. Understanding the joint effect of stand structural characteristics and climate factors on AGB on large scales is critical for accurate forest carbon storage prediction and sustainable management. Despite numerous attempts to clarify the relationships between stand structural characteristics (tree density/TD, diameter at breast height/DBH, basal area/BA), climate factors (mean annual temperature/MAT, mean annual precipitation/MAP), and AGB, they remain contentious on a large scale. Therefore, we explored the relationships between stand structural characteristics, climate factors, and AGB at a biome level by meta-analyzing datasets contained in 40 articles from 25 countries, and then answered the questions of how stand structural characteristics influence AGB at the biome level and whether the relationships are regulated by climate on a large scale. Through using regression analysis and the establishment of a structural equation model, the results showed that the influence of basal area on AGB at the biome level was more substantial than that of tree density and DBH, and the significant relationship between basal area and AGB was relatively stable regardless of biome variation, but the effects of tree density and DBH was non-negligible within the biome. Climatic factors (e.g., temperature and precipitation), should be considered. Our meta-analysis illustrated the complicated interactions between climate factors, stand structural characteristics, and the AGB of forests, highlighting the importance of climate effects on regulating stand structural characteristics and AGB relationships. We suggest that basal area be preferred and considered in forest sustainable management practice to optimize stand structure for increasing carbon storage potential, with close attention to local climate conditions. Overall, our meta-analysis will crucially aid forest management and conservation in the context of global environmental changes, and provide novel insights and a scientific reference to lead to future carbon storage research on large scales.

Globally, water contamination by heavy metals is a serious problem that affects the environment and human health. Adsorption is the most efficient way of water treatment for eliminating heavy metals. Various hydrogels have been prepared and used as adsorbents to remove heavy metals. By taking advantage of poly(vinyl alcohol) (PVA), chitosan (CS), cellulose (CE), and the process for physical crosslinking, we propose a simple method to prepare a PVA-CS/CE composite hydrogel adsorbent for the removal of Pb(II), Cd(II), Zn(II) and Co(II) from water. Structural analyses of the adsorbent were examined by Fourier transform infrared (FTIR) spectroscopy, scanning electron microscopy-energy dispersive X-ray (SEM-EDX) analysis, and X-ray diffraction (XRD). PVA-CS/CE hydrogel beads had a good spherical shape together with a robust structure and suitable functional groups for the adsorption of heavy metals. The effects of adsorption parameters such as pH, contact time, adsorbent dose, initial concentration of metal ions, and temperature on the adsorption capacity of PVA-CS/CE adsorbent were studied. The adsorption characteristics of PVA-CS/CE for heavy metals may be completely explained by pseudo-second-order adsorption and the Langmuir adsorption model. The removal efficiency of PVA-CS/CE adsorbent for Pb(II), Cd(II), Zn(II), and Co(II) was 99, 95, 92, and 84%, respectively, within 60 min. The heavy metal’s hydrated ionic radius may be crucial in determining the adsorption preference. After five consecutive adsorption–desorption cycles, the removal efficiency remained over 80%. As a result, the outstanding adsorption-desorption properties of PVA-CS/CE can potentially be extended to industrial wastewater for heavy metal ion removal.