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Table S2. Most frequently reported single- and multi-morbidities among adults with at least one NCD. (NÂ =â 1756). (DOCX 14 kb)

This paper presents the results of an experimental program conducted in order to investigate the behavior of Type-I beam-column Joints, where the beam was subjected to shear stresses due to combined effect of shear force and torsional moment (beam eccentric loading). Four beam-column joint specimens were constructed and tested up to failure in order to better understand the complicated behaviour due to combined loading transmitted from the beam to the column. The studied parameters were the configuration of beam side and secondary reinforcement and the existence of the joint reinforcing stirrups. Generally, the shear failure at the beam zone or at the joint panel was noticed to be the governing mode of failure for all tested specimens. The test results shed the light on the importance of longitudinal side reinforcing steel configuration, the inadequate embedded length of the beam side and secondary steel into the joint panel including stirrups led to decrease the beam capacity but it kept the failure away from the joint panel.

We performed a systematic review and meta-analysis of the risk of gastrointestinal (GI) toxicities associated with MEK inhibitors. Eligible studies included randomized Phase II and III trials of cancer patients on the three MEK inhibitors (trametinib, selumetinib and cobimetinib), describing events of stomatitis, diarrhea and vomiting. Our search strategy yielded 250 potentially relevant citations from Pubmed/Medline, Google scholar and CENTRAL Cochrane registry. After exclusion of ineligible studies, a total of 16 clinical trials were considered eligible for the meta-analysis. The relative risks of all-grade stomatitis, diarrhea and vomiting were 2.03 (95% CI 1.41-2.96; p = 0.002), 1.92 (95% CI 1.48-2.50; p0.00001) and 1.35 (95% CI 1.06-1.71; p = 0.01). Subgroup analyses according to agent used (trametinib vs Selumetinib), the regimen used (monotherapy vs combination) and the cancer treated (melanoma vs nonmelanoma) did not reveal any significant difference between the subgroups. Our meta-analysis has demonstrated that MEK inhibitor-based treatment is associated with an increased risk of stomatitis, diarrhea and vomiting compared to control. Clinicians should be aware of this risk and perform regular assessment.

Clinical manifestations of sickle cell disease (SCD) result from sickling of Hb S due to oxidation, which is augmented by accumulation of oxygen-free radicals. Deficiencies in normal antioxidant protective mechanism might lead to clinical manifestations of SCD like vaso-occlusive crisis (VOC) and acute chest syndrome (ACS). The glutathione system plays an important role in the removal of endogenous products of peroxidation of lipids, thus protecting cells and tissue against damage from oxidative stress. Impairment of the glutathione system due to genetic polymorphisms of glutathione S-transferase (GST) genes is expected to increase the severity of SCD manifestations. This report describes a case control study aimed at studying the ethnic-dependent variation in the frequency of GST gene polymorphisms among participants selected from the Egyptian population and to find out the association between GST gene polymorphisms and the severity of SCD manifestations.We measured the frequency distribution of the three GSTs gene polymorphisms in 100 Egyptian adult SCD patients and 80 corresponding controls. GSTM1 and GSTT1 genotypes were determined by multiplex polymerase chain reaction (PCR). GSTP1 genotyping was conducted with a PCR-restriction fragment length polymorphism assay.The GSTM1 null genotype was significantly associated with ACS and VOC (P = 0.03 and 0.01, respectively). The GSTT1 null genotype was associated with significantly increased requirement of blood transfusion (P = 0.01). Absence of both GSTM1 and GSTT1 genes was significantly associated with pulmonary hypertension (P = 0.04). The non-wild-type GSTP1 polymorphism was not associated with clinical manifestations of SCD.Some GST gene polymorphisms were significantly associated with the worsening of the clinical manifestations of SCD.

Registration Details Of The Current Study: The current study is a part of a research registered on www.clinicaltrial.gov NCT02630979. The study received approval from the Institutional Review Board (IRB) of the Clinical Oncology department. Faculty of Medicine, Ain Shams University in October 2015. Sources Of Support: There is no source of support of any type either financial or technical received by the authors of this study to implement this study. No source of funding from National Institutes of Health (NIH); Welcome Trust; Howard Hughes Medical Institute (HHMI); or other(s).

Background Tackling the high non-communicable disease (NCD) burden among Syrian refugees poses a challenge to humanitarian actors and host countries. Current response priorities are the identification and integration of key interventions for NCD care into humanitarian programs as well as sustainable financing. To provide evidence for effective NCD intervention planning, we conducted a cross-sectional survey among non-camp Syrian refugees in northern Jordan to investigate the burden and determinants for high NCDs prevalence and NCD multi-morbidities and assess the access to NCD care. Methods We used a two-stage cluster design with 329 randomly selected clusters and eight households identified through snowball sampling. Consenting households were interviewed about self-reported NCDs, NCD service utilization, and barriers to care. We estimated the adult prevalence of hypertension, diabetes type I/II, cardiovascular- and chronic respiratory conditions, thyroid disease and cancer and analysed the pattern of NCD multi-morbidities. We used the Cox proportional hazard model to calculate the prevalence ratios (PR) to analyse determinants for NCD prevalence and logistic regression to determine risk factors for NCD multi-morbidities by calculating odds ratios (ORs). Results Among 8041 adults, 21.8%, (95% CI: 20.9–22.8) suffered from at least one NCD; hypertension (14.0, 95% CI: 13.2–14.8) and diabetes (9.2, 95% CI: 8.5–9.9) were the most prevalent NCDs. NCD multi-morbidities were reported by 44.7% (95% CI: 42.4–47.0) of patients. Higher age was associated with higher NCD prevalence and the risk for NCD-multi-morbidities; education was inversely associated. Of those patients who needed NCD care, 23.0% (95% CI: 20.5–25.6) did not seek it; 61.5% (95% CI: 54.7–67.9) cited provider cost as the main barrier. An NCD medication interruption was reported by 23.1% (95% CI: 20–4-26.1) of patients with regular medication needs; predominant reason was unaffordability (63.4, 95% CI: 56.7–69.6). Conclusion The burden of NCDs and multi-morbidities is high among Syrian refugees in northern Jordan. Elderly and those with a lower education are key target groups for NCD prevention and care, which informs NCD service planning and developing patient-centred approaches. Important unmet needs for NCD care exist; removing the main barriers to care could include cost-reduction for medications through humanitarian pricing models. Nevertheless, it is still essential that international donors agencies and countries fulfill their commitment to support the Syrian-crisis response. Electronic supplementary material The online version of this article (10.1186/s13031-018-0168-7) contains supplementary material, which is available to authorized users.

Background In chronic immune thrombocytopenic purpura (ITP), rituximab removes the harmful autoantibodies through antibody-dependent cellular cytotoxicity. The response to rituximab in ITP is variable; the effectiveness of rituximab is influenced by the process of activation of effector fragment C gamma receptors (FcγRs). Genetic factors may affect the response to rituximab. Objectives The influence of FcγRIIa (H131R) and FcγRIIIa (V158F) gene polymorphisms on the response to rituximab in ITP. Methods One hundred ITP patients were genotyped for FcγRIIa (H131R) and FcγRIIIa (V158F) gene polymorphisms using the polymerase chain reaction-restriction fragment length polymorphism assay. The response at the end of the third month was assessed by direct platelets count. Polymorphisms were analyzed in relation to the response. Results The mean platelets count at end of weeks 1-4 of rituximab was statistically significantly higher in patients who achieved complete response (CR) than partial response or no response (P-value = .001). Although RR (44.4%) and HR (38.9%) genotypes were observed to be higher in patients who achieved CR compared with the wild (HH) genotype (16.7%), it was not statistically significantly different (P-value = .648). Conclusion The higher platelet count achieved early is predictive for a better response to rituximab later. FCγRIIA polymorphisms did not significantly influence response to rituximab in ITP.

Objective To emphasize the added value of 3-dimensional (3D) in the prenatal assessment of agenesis of the corpus callosum (ACC). Methods Volume data sets of the brain of a fetus with ACC, as suspected previously by 2D-US, were stored. A retrospective offline analysis of the stored volume was performed. Results From the stored volume, complete ACC was diagnosed, and it was confirmed by a postnatal computed tomographic scan. Conclusion A combination of 2Dand 3D-US has considerable advantage over 2D-US in the diagnosis of fetal ACC. 3D-US provides an invaluable tool for the prenatal diagnosis and management of ACC, and its offline networking capabilities may improve healthcare delivery systems by extending the benefits of prenatal diagnosis of cerebral malformations to poorly served areas where an MRI is not available.

Background Hepatocellular carcinoma [HCC] is the third leading cause of death from cancer worldwide. In Egypt, HCC accounts for about 4.7% of chronic liver disease. To date, no controlled studies have evaluated the Sorafenib efficacy in comparison to no treatment in HCC patients whose etiology of HCV genotype 4 (The most prevalent hepatitis C virus genotype in Egypt). Methods A multicenter prospective controlled interventional study. 110 Patients were evaluated for overall survival [OS], Progression-free survival [PFS], safety and quality of life [QOL] using FACT Hepatobiliary Symptom Index [FHSI-8] questionnaire. NCT02971696. Results Out of 110 patients enrolled, only 55 completed the trial; sorafenib [n = 35], no-treatment control group [n = 20]. The one year OS was 0.0% versus 75.5% [p = 0.008] in control and sorafenib respectively. Median PFS was 5 months versus 12 months in control group and sorafenib respectively [p = 0.008]. Sorafenib group HR for developing progression was 2.35; [95% [CI], 1.19 to 4.62; P = 0.014]. QOL scores [FHSI-8] was significantly different between the 2 groups [F = 4.455, p = 0.047]. Most observed side effects of sorafenib were; Diarrhea [n = 15] and hand-foot syndrome [n = 12]. Conclusions Sorafenib treatment showed a better outcome OS, PFS and QOL as compared to no-treatment in Egyptian patients with advanced Hepatocellular Carcinoma. Legal entity responsible for the study The authors. Funding Has not received any funding. Disclosure All authors have declared no conflicts of interest.

Background This study focused on the development of biocompatible and biodegradable homoporous chitosan scaffolds containing nano-bioactive glass 58S for dental tissue regeneration. For this aim, we developed a new chemical route to obtain homoporous scaffolds that mimic cancellous bone by utilizing H2O2. Materials and methods Different properties of the prepared powder of 58S were analyzed by transmission electron microscopy, thermogravimetric analysis (TGA)/differential scanning colometric (DSC), X-ray diffraction, and Fourier transform infrared spectroscopy. The developed scaffolds were analyzed by X-ray diffraction, Fourier transform infrared spectroscopy, and scanning electron microscope in comparison with heteroporous scaffolds prepared in the absence of H2O2. Stem cells from dental pulp were seeded onto the prepared scaffolds for different periods of time. The ability to differentiate toward an odontogenic lineage was studied for the loaded cells with the prepared scaffolds. Results The size of the prepared nano-bioglass 58S nanoparticles was in the range of 23.9–98.18 nm. The scaffolds prepared using H2O2 exhibited homogenous porous scaffolds in the range of 250–450 μm size when compared with scaffold synthesized in the absence of H2O2, which demonstrated heterogeneous scaffolds in the range of 350–700 μm. The cell studies showed better cell growth and biomineralization with the heterogeneous scaffolds compared with homogenous microarchitecture. Conclusion The microarchitecture of heterogeneous scaffolds plays a significant role in dental pulp stem cell differentiation and calcified tissue development as well as provides new possibilities for dental tissue engineering.

This paper presents a novel approach for designing a decentralized controller for load frequency control of interconnected power areas. The proposed fuzzy logic load frequency controller (FLFC) has been designed to improve the dynamic performance of the frequency and tie line power under a sudden load change in the power areas. The effect of generation rate constraint (GRC) for both areas has been considered in the controller design. The proposed FLFC consists of two internal fuzzy logic controllers namely, the PD- like fuzzy logic controller and the PI-like fuzzy logic controller. The FLFC has been co-coordinated with the conventional integral controller. Time-domain simulations using MATALB/SIMULINK program has been performed to demonstrate the effectiveness of the proposed FLFC. The simulation results show that the proposed FLFC can provide good damping and reduce the overshoot even in the presence of the GRC.

Objectives: Previously, our research group has investigated the effect of alendronate (ALN) and simvastatin (SV) in their minimum inhibitory dose (IC50) on oral squamous cell carcinoma cell line where inhibition of angiogenesis has been demonstrated. In the present study, we further investigate the effect of the previously calculated IC50 of SV and ALN and their combination on two different types of stem cells to show that the same drug may have different effects on different cells.Methods: Stem cells were isolated from rat adipose tissue and oral mucosa. After passaging, cells were subjected to Aln, Sv separately as well as combined in their half maximal inhibitory concentration (IC50). 3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyl tetrazolium bromide assay was performed to evaluate cytotoxicity. After seven days, osteogenic differentiation was evaluated using alizarin stain. Real time polymerase chain reaction was used to evaluate Osteopontin gene expression.Results: Our results demonstrated that the proposed combination of Aln and Sv in their IC50 enhanced the osteogenic differentiation of both types of stem cells.Conclusion: The combined effect of Aln and Sv may represent a novel pharmacological approach in treating bone metastasis and at the same time treating the cancer itself.

This paper describes an artificial neural network (ANN) model developed to predict the total voltage on mitigated pipelines due to the effect of the inductive and conductive AC interference under fault conditions. The pipeline shared right-of-way with high voltage power lines and it is mitigated by gradient control wires. In particular, the developed ANN predicts the mitigated pipeline voltage under different soil resistivities, fault currents and separation distances. The results showed that the R2 value for the training and testing sets were 0.9978 and 0.996, respectively. This indicates that results from the ANN model compared well with the calculated values demonstrating the capability of the ANN simulation techniques. The results also demonstrate that the ANN-based model developed in this work can predict the voltage after applying mitigation system with high accuracy. The accuracy of the predicted voltage is very important to protect the overall pipeline integrity and make the pipeline and a...

Some 4-phenylthiazole derivatives were tested as corrosion inhibitors for 304L stainless steel in 3.0 M HCl using weight loss and galvanostatic techniques. The results showed that the inhibition efficiency increases with increasing the concentration of the 4-phenylthiazole derivatives. Polarization measurements showed that these derivatives act as mixed-type inhibitors. The adsorption of these inhibitors on the surface of stainless steel follows Temkin’s adsorption isotherm and kinetic model. The effect of temperature on the corrosion was investigated by the weight loss method and some thermodynamic parameters were calculated. The synergistic influence caused by thiocyanate ion on the inhibition of corrosion of 304L stainless steel in 3.0 M HCl in the presence of 4-phenylthiazole derivatives has been studied using weight loss method. The inhibition action of these 4-phenylthiazole derivatives was discussed in terms of its adsorption on the metal surface.