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Self-compacting concrete (SCC) uses a lot of natural resources, much like regular concrete, which results in unsustainable construction. Even though silica fume (SF) and other secondary cementitious materials are the subjects of a lot of studies, to determine the past, present, and future direction of research, information must first be reviewed. This paper compiles data on SSC with SF substations. Slump flow, slump T50, L-box, and V-funnel tests were used to investigate fresh SCC properties, such as filling and passing capabilities. Mechanical properties were examined using compressive, tensile, and flexure strength, while the durability characteristics of SCC were examined through water absorption, porosity, sorptivity, and chloride resistance. The internal structure of SCC, with and without SF, is reviewed through scan electronic microscopy (SEM). The results indicate that SF lacked the filling and passing ability of SCC, but is still within the limit defined by the technical specification for SCC. However, the study suggests a larger dosage of plasticizer for a higher dose of SF. Improvements in SCC’s strength and durability were also seen; however, greater doses had a negative impact on these attributes due to an absence of flowability. Researchers recommended the ideal SF dosage ranges from 10 to 15% by volume of cement. The assessment also reveals research gaps that need to be addressed.

Purpose Wilms tumor 1 (WT1) gene has recently shown a role in gliomagenesis, making it a potential immunotherapy target in glioblastomas. We aimed to investigate the most sensitive method to detect WT1 expression in glioblastoma and explore the relationship between WT1 expression, IDH1 mutation and recurrence interval. Patients and Methods Clinical data were collected from 44 patients with glioblastomas, treated with adjuvant therapies. WT1 expression was assessed in all cases using immunohistochemistry (IHC), while its gene expression was assessed in 13 clustered samples using polymerase chain reaction (qPCR). IDH1 mutation was assessed using IHC. The sensitivity between IHC and RT-qPCR was examined. Kaplan–Meier curves were used to compare the recurrence-free interval (RFI) between IDH1 and WT1 expression groups. Results IDH1wildtype was found in 26 cases (59.1%) and the remaining 18 cases (40.9%) were IDH1mutant. Through IHC, WT1 was overexpressed in 32 cases (72.7%), partially expressed in 9 cases (20.5%) and not expressed in only 3 cases. For the 13 cases tested by qPCR, 6 cases showed WT1 upregulation and 7 cases showed WT1 downregulation. There was no significant difference in WT1 expression among cases with different RNA concentrations regardless the testing method (p-value >0.05). However, the difference between IHC and qPCR was significant. IDH1mutant cases with WT1 overexpression showed significant difference in RFI (p-value =0.048). Conclusion Parallel testing for WT1 expression using IHC and qPCR is not reliable. However, IHC provides more accurate results. Moreover, IDH1mutant glioblastomas with WT1 overexpression are associated with late RFI particularly if temozolomide with additional chemotherapies are used.

Objectives To validate C-reactive protein (CRP), red cell distribution width (RDW), and neutrophil lymphocyte ratio (NLR) for both serious outcomes and length of hospital stay (LOS) among hospitalized coronavirus disease-19 (COVID-19) patients. Methods Laboratory data of adult COVID-19 patients (n=74) was collected in this retrospective cohort. Logistic regression was employed for risk factor evaluation and receiver operating curve was used for comparison of these risk factors for the prediction of serious outcome. Multiple regression was applied to determine the association between routine analytes and LOS. Results Higher levels of CRP (3 times), white blood cells (20%), and neutrophil counts (40%) were seen in the serious category. Odds ratio for CRP for the serious outcome was 1.052 (p=0.007) and RDW for the serious outcome was 1.218 (p=0.040) in unadjusted model and odds ratio for CRP for the serious outcome was 1.048 (p=0.024) and for RDW 1.286 (p=0.023) in adjusted model. In a multivariate regression analysis for the LOS of the unadjusted models consisting of NLR, monocyte lymphocyte ratio (MLR) and platelet lymphocyte ratio (PLR), the beta coefficients (BC) for the CRP were 0.006 (NLR), 0.005 (MLR) and 0.006 (PLR), whereas -0.029 (NLR), -0.034 (MLR) and -0.027 (PLR) were BCs for mean corpuscular hemoglobin concentration (MCHC). Additionally, in adjusted models, the BCs for MCHC were -0.044 (NLR), -0.047 (MLR) and -0.043 (PLR). However, the CRP was consistent with 0.004 (BC) in all models. Conclusion We observed that CRP is a better predictor than RDW and NLR for serious outcome among COVID-19 patients. Besides, CRP was positively, whereas MCHC was negatively associated with LOS.

The study aimed to discover the relationship between psychological safety and smartphone among high school students in the Jazan Educational administration and to predict smartphone use addiction through the psychological safety among high school students in the Jazan Educational administration. and the researcher used the relational-descriptive method, and the Psychological Safety Scale was used by (Shukair: 2005), and smartphone Addiction Scale by (Alosaimai et, al.: 2016).The study sample consisted of (430) female students from the secondary stage of the Jazan Educational administration, they were randomly selected from the three general secondary grades of the schools affiliated to Jazan Educational Administration Where the arithmetic mean of their ages (16.074), The results indicated the high level of psychological safety among the study sample of high school students, and the high level of smartphone use addiction among secondary school students. It also indicated that there is a negative correlation between psychological safety and smartphone use addiction among secondary school students at the significance level (0.01), and the possibility of predicting smartphone use addiction among secondary school students through the dimensions of psychological safety at the level of significance (0.01) through each degree of (the individual mood, the individual composition, and his vision for the future). The study recommends educating mothers and fathers about the correct educational methods in dealing with cases of children's smartphone addiction.

Research paper

Background: Congenital leptin deficiency (CLD) is a rare autosomal recessive form of monogenic obesity caused by loss-of-function mutations in the leptin gene. Targeted therapy is available in the form of recombinant human leptin (metreleptin). Previous case series have reported dramatic weight loss and metabolic improvements with treatment, but metreleptin’s only FDA-approved indication is acquired generalized lipodystrophy (AGL). Metreleptin has a black box warning for risk of T-cell lymphoma, which has been reported in AGL patients, both treated and untreated with metreleptin. Clinical Case: Two sisters ages 18 yrs (sister A; BMI 45.2 kg/m2) and 20 yrs (sister B; 45.0 kg/m2) were referred for evaluation of obesity. They are of Pakistani origin with a family history of consanguinity. Birth weight was normal, but hyperphagia and excessive weight gain developed by age 3 months. They had been seen by endocrinologists, obesity specialists, and a geneticist during childhood but work-up for monogenic obesity was not pursued. They were treated with combination OCPs in adolescence due to primary amenorrhea and hypogonadotropic hypogonadism. Sister A was diagnosed with type 2 diabetes at age 15 years. Sister B had comorbidities of hydrocephalus s/p VP shunt, developmental delay, hyponatremia, autoimmune thyroid disease, growth hormone deficiency, and prediabetes. At the time of their present evaluation, serum leptin levels were obtained and were undetectable in both sisters. After discontinuing OCPs, testing confirmed hypogonadotropic hypogonadism. Both patients were homozygous for the pathogenic variant c398delG in exon 3 of the leptin gene (LEP), which causes a frameshift/premature stop codon. On MR elastography performed for hepatic steatosis, sister B had an incidental finding of axillary lymphadenopathy. Surgical biopsy and staging work-up confirmed diagnosis of nodular lymphocyte predominant Hodgkin lymphoma (a B cell lymphoma), Stage II disease. She was treated with R-ABVD with adjuvant radiation and achieved clinical remission, prior to treatment with metreleptin. The patients were enrolled in an observational treatment protocol, and responses to metreleptin therapy will be reported in future. Conclusion: To our knowledge, these are the first cases of CLD diagnosed in the U. S. In previous reports, CLD and other monogenic obesity disorders were prevalent among children with severe obesity in a consanguineous Pakistani population. Leptin deficiency should be considered in all patients with early onset obesity and hypothalamic amenorrhea. Furthermore, to our knowledge, this is the first report of lymphoma in a patient with CLD, occurring prior to any treatment with metreleptin. The risk for lymphoma associated with metreleptin may relate to preexisting autoimmune disease or immunologic abnormalities related to leptin deficiency rather than medication adverse effect.

Ali Hakamy,1,2 Tricia M McKeever,2 Michael C Steiner,3 C Michael Roberts,4 Sally J Singh,3 Charlotte E Bolton1 1Nottingham Respiratory Research Unit, NIHR Nottingham Biomedical Research Centre, 2Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, 3Leicester Respiratory Biomedical Research Unit, Institute for Lung Health, University Hospitals of Leicester NHS Trust, Leicester, 4Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK Abstract: Our aim was to evaluate the use and impact of the practice walk test on enrolment, completion, and clinical functional response to pulmonary rehabilitation (PR) using the 2015 UK National Chronic Obstructive Pulmonary Disease (COPD) Pulmonary Rehabilitation audit data. Patients were assessed according to whether a baseline practice walk test was performed or not. Study outcomes included use of the practice walk test, baseline and change in incremental shuttle walk test distance (ISWD) or 6-minute walk test distance (6MWD), and enrolment to and completion of PR program. Of 7,355 patients, only 1,666 (22.6%) had a baseline practice test. At baseline, the practice walk test group walked further as compared to the no practice walk test group: ISWD, 17.9m [95% confidence interval (CI) 8.2–27.5m] and 6MWD, 34.8m (95% CI 24.7–44.9m). The practice walk test group were 2.2 times (95% CI 1.8–2.6) more likely to enroll and 17% (95% CI 1.03–1.34) more likely to complete PR. Although the change in ISWD and 6MWD with PR was lower in the practice walk test group, they walked further at discharge assessment. Only 22.6% of the patients in the 2015 National PR audit had a practice walk test at assessment. Those who did had better enrolment, completion, and better baseline walking distance, from which the prescription is set. Keywords: pulmonary rehabilitation, COPD, functional performance test, functional exercise test

Cement nanocomposites reinforced with hemp fabrics and calcined nanoclay (CNC) have been fabricated and investigated. The treated hemp fabric-reinforced cement composites and nanocomposites were subjected to 3 wetting and drying cycles and then tested at 56 and 236 days. The influences of CNC dispersion on the durability of these composites have been characterized in terms of porosity, flexural strength, stress-midspan deflection curves and microstructural observation of hemp surface. The microstructure of matrix was investigated using X-ray Diffraction. Results indicated that the CNC effectively mitigated the degradation of hemp fibre. The durability and the degradation resistance of hemp fibre enhanced due to the addition of CNC into the cement matrix and the optimum content of CNC was 1 wt.%. Keywords: Nanoclay-cement composites, Hemp fabric, Durability, Microstructure

Cement nanocomposites reinforced with hemp fabrics and calcined nanoclay (CNC) have been fabricated and investigated. CNC is prepared by heating nanoclay (Cloisite 30B) at 900°C for 2h. The influences of CNC dispersion on the mechanical properties and thermal properties of these composites have been characterized in terms of porosity, density, water absorption, flexural strength, fracture toughness, durability impact strength, and thermal stability. The microstructure is investigated using quantitative X-ray diffraction analysis and high-resolution transmission electron microscopy. The effects of alkali (NaOH) treatment of hemp fabric on the mechanical properties of hemp fabric-reinforced cement composites with different fabric contents of 4.5, 5.7, 6.9, and 8.1 wt% are also investigated. Results show that the optimum hemp fabric content is 6.9 wt% (i.e., six fabric layers). Results also indicated that physical, mechanical, and thermal properties enhanced because of the addition of CNC into the cement matrix and the optimum content of CNC was 1 wt%. The treated hemp fabric–reinforced nanocomposites containing 1 wt% CNC exhibited the highest flexural strength, fracture toughness, impact strength, and thermal stability than their counterparts and good fiber–matrix interface. Results also indicated that the CNC effectively mitigated the degradation of hemp fiber. The durability and the degradation resistance of hemp fiber were enhanced due to the addition of CNC into the cement matrix and the optimum content of CNC was 1 wt%. This environmentally friendly nanocomposite can be used for various construction applications such as ceilings and roofs.

The influence of calcined nanoclay (CNC) and chemical treatment on the microstructure and mechanical properties of treated hemp fabric-reinforced cement nanocomposites has been investigated. The optimum hemp fabric content for these nanocomposites is 6.9 wt% (i.e. 6 fabric layers). Alkali-treated hemp fabric-reinforced cement composites exhibit the highest flexural strength when compared to their non-treated counterparts. In addition, mechanical properties are improved as a result of CNC addition. An optimum replacement of ordinary Portland cement with 1 wt% CNC is observed through reduced porosity and increased density, flexural strength and fracture toughness in treated hemp fabric-reinforced nanocomposite. It is shown that CNC behaves not only as a filler to improve the microstructure, but also as the activator to facilitate the pozzolanic reaction and thus improved the adhesion between the treated hemp fabric and the matrix.

Cement nanocomposites reinforced with hemp fabrics and calcined nanoclay (CNC) have been fabricated and investigated. CNC is prepared by heating nanoclay (Cloisite 30B) at 900 °C for 2 h. The influences of CNC dispersion on the mechanical properties and thermal properties of these composites have been characterized in terms of porosity, density, water absorption, flexural strength, fracture toughness, impact strength and thermal stability. The microstructure is investigated using Quantitative X-ray Diffraction Analysis (QXDA) and High Resolution Transmission Electron Microscopy (HRTEM). The effects of alkali (NaOH) treatment of hemp fabric on the mechanical properties of hemp fabric-reinforced cement composites with different fabric contents of 4.5, 5.7, 6.9 and 8.1 wt% are also investigated. Results show that the optimum hemp fabric content is 6.9 wt% (i.e. 6 fabric layers). Results also indicated that physical, mechanical and thermal properties were enhanced due to the addition of CNC into the cement matrix and the optimum content of CNC was 1 wt%. The treated hemp fabric-reinforced nanocomposites containing 1 wt% CNC exhibited the highest flexural strength, fracture toughness, impact strength and thermal stability by virtue of good fibre–matrix interface. This environmentally friendly nanocomposite can be used for various construction applications such as ceilings and roofs.

The influence of nanoclay (NC) and calcined nanoclay (CNC) on the mechanical and thermal properties of cement nano-composites presented. Calcined nanoclay is prepared by heating nanoclay (Cloisite 30B) at 900 °C for 2 h. Characterisation of microstructure is investigated using Quantitative X-ray Diffraction Analysis (QXDA) and High Resolution Transmission Electron Microscopy (HRTEM). Estimation of Ca(OH)2 content in the cement nanocomposite is studied by the combination of QXDA and thermogravimetry analysis (TGA) techniques. Results showed that the mechanical and thermal properties of the cement nanocomposites are improved as a result of NC and CNC addition. An optimum replacement of ordinary Portland cement with 1 wt% CNC is observed through reduced porosity and water absorption as well as increased density, compressive strength, flexural strength, fracture toughness, impact strength, hardness and thermal stability of cement nanocomposites. The microstructural analyses from QXRA and SEM indicate that the CNC acted not only as a filler to improve the microstructure, but also as the activator to support the pozzolanic reaction. Cost-benefit analysis indicates that nanoparticles are expensive but from economic point of view nanoclay is used in very small amount (i.e. 1 wt. %) in cementitious materials. As a result nanoclay does not add any significant cost but improves the mechanical properties significantly.