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Cilnidipine is a dihydropyridine calcium channel blocker used to improve the neurological outcome following subarachnoid hemorrhage. It belongs to BCS class II drugs that have a low oral bioavailability of 13%, thus preparation as nanoparticles would be expected to improve bioavailability. The aim of the study is to prepare Cilnidipine as nanoparticles using different carriers and co-carriers, concentrations, and types. Cilnidipine nanoparticles were prepared by a solvent anti-solvent method using different carriers (Soloplus®, Poloxamer 188, PVA cold) with co-stabilizers (PEG200, glycerol) at different ratios. Based on the obtained results, formula N4, which included Soloplus in a 1:1:1 weight ratio of drug to the polymer to co-stabilizer, exhibited a particle size of 88.89 nm when stirred at 1000 rpm with an injection speed of 1 ml/min. The polydispersity index (PDI) for this formula was measured at 0.2413. Furthermore, formula N4 demonstrated an impressive 92.2% drug content and an entrapment efficiency (EE) of 95.8%, giving 100% release in 30 min.

Satellite subsystems are becoming smaller and have extra power density. There are only two types of heat transport in space: conduction and radiation, making thermal management more difficult. For the thermal regulation of satellite subsystems, thermal energy storage materials are appropriate. In the present study, small satellite subsystems were controlled using a phase change material (PCM)-based heat sink. The design of the aluminium heat sink was according to the outside dimensions of the subsystem in a small satellite. The PCM material used in the work was RT 35. Integrated fins of various shapes were used to overcome PCM's poor thermal conductivity. Three fin geometries were investigated: parallel fins, cross fins, and pin fins. Three shapes of pin fins were evaluated: square pin, circular pin, and triangular pin fins. The heat sink was exposed to a thermal cycle with 80 min cooling and 10 min heating processes. The results reveal that pin fins have better thermal performance than cross and parallel fins. For pin fins, the triangular pin fin provides the best thermal performance among all cases. Maximum temperatures reported for triangular pin fin were 41.5 °C with a 10.8 % reduction. The results indicated a considerable improvement in thermal performance by increasing the number of pin fins.

Introduction Preeclampsia is a pregnancy-specific hypertensive disease that affects 3–5% of pregnant women all over the world and 1.3% of pregnancies among Jordanian women. Objectives This study aims to assess the cardiovascular disease risk factors awareness among women with a recent history of preeclampsia in Jordan and assess the role of healthcare providers in providing counseling about cardiovascular disease risk factors. Methods A descriptive cross-sectional design was used to recruit 180 women with a recent history of preeclampsia during the last 12 months. Data were obtained from patients’ medical records and the Attitude and Beliefs about Cardiovascular Disease Risk Questionnaires. Results The results revealed that 43.9% of women with a recent history of preeclampsia have hypertension, 6.7% have diabetes mellitus, 16.1% have dyslipidemia, 28.9% have a family history of cardiovascular disease, 66.1% are overweight or obese, and 7.2% are smokers. The mean total score of knowledge subscale was 5.5 (SD = 1.21) out of 8. Only 20% of the participants had good cardiovascular disease knowledge. The mean total score of risk perception was 15.47 (SD = 7.8). The mean score of perceived benefits and intention to change behaviors was 2.30 (SD = 0.62). The mean score of healthy eating intentions was 2.54 (SD = 0.81). Income, having diabetes mellitus, and receiving counseling about preeclampsia as cardiovascular disease risk factor were associated with some dimensions of cardiovascular disease risk factors awareness. Conclusion The prevalence of cardiovascular disease risk factors was relatively high among the study participants. The majority of participants had inadequate cardiovascular disease knowledge. In addition, the role of healthcare providers in providing counseling about cardiovascular disease and related risk factors, including PE was limited. Providing more counseling related to cardiovascular disease by nurses and doctors is essential to enhance women's cardiovascular disease knowledge and intention to change lifestyle.

The educational buildings within universities are the main spaces for students' academic activities and life during the daytime, students spend 80% of their time inside these buildings. Therefore, achieving student thermal comfort requires universities to spend time and cost to prepare these buildings to be comfortable. The University of Mosul (UoM) included 24 colleges with 117 scientific departments, which contained hundreds of educational buildings occupied by 65000 students in addition to 4099 faculty staff and 3170 administrative staff. The thermal comfortability in UoM educational buildings partially achieved using the traditional method of air-conditioning units and some of the buildings still use electrical and gasoline heaters, which cost and increase the air pollution with less efficiency function. Therefore, the study is a trial to find a guideline for designing and treating the educational building using the passive and active design focusing on the facades as most elements of the building facade the outside environments and affect the internal thermal comfortability. The methodology applied simulation and analysis of a successful double-skin façade to eliminate the main steps of the design. The case study selected the following criterion of uncomfortable buildings in the UoM considering the questionnaire thermal characteristics of educational buildings. The case study is the hostel building (Al-Zahraa residential Building) within the University of Mosul. The results show three main steps that should followed by the designers in the university to achieve thermal comfortability, additionally considering the possibility of redesigning the facades.

ABSTRACT Background: Although being a crucial strategy to improve newborn outcomes, many midwives must prepare to perform basic newborn resuscitation (BNR). Objectives: We assessed the midwives' knowledge and the quality of skills performance regarding BNR and the effectiveness of the educational program in improving midwives' knowledge and skills during the process of BNR. Methods: an observational quasi-experimental pretest-post test design was conducted. BNR educational program was adapted from the American Academy of Paediatrics (AAP) Neonatal Resuscitation Program (NRP). It was conducted through three days of workshops, including An overview lecture, Interactive video modules, and extensive hands-on teaching of basic resuscitation techniques. After that, assessments (pre- and post-tests) were performed. Data were analyzed using the t-test, way ANOVA, The Relative Importance Index analysis (RII), and the linear regression test, Findings:100 midwives attended the workshop. Their mean scores were: knowledge score before the program (M=68.40, SD= 13.4) to after (M=78.72, SD=10.3). Overall mean prioritization before was 2.71(out of 3) to after 2.9. The mean quality performance of skills (out of 4 points) before and after the educational program, respectively, were (M=2.2, SD=0.8), (3.64, SD=0.5). Discussion and Conclusions: The study results showed the significant impact of the BNR educational program, followed immediately by significant improvement in the midwives' knowledge and skills performance.

BackgroundChronic coronary retroperfusion to treat myocardial ischemia has previously failed due to edema and hemorrhage of coronary veins suddenly exposed to arterial pressures. The objective of this study was to selectively adapt the coronary veins to become arterialized prior to coronary venous retroperfusion to avoid vascular edema and hemorrhage.Methods and resultsIn 32 animals (Group I = 19 and Group II = 13), the left anterior descending (LAD) artery was occluded using an ameroid occlusion model. In Group I, the great cardiac vein was blocked with suture ligation (Group IA = 11) or with occlusion device (Group IB = 8) to arterialize the venous system within 2 weeks at intermediate pressure (between arterial and venous levels) before a coronary venous bypass graft (CVBG) was implemented through a left internal mammary artery (LIMA) anastomosis. Group II only received the LAD artery occlusion and served as control. Serial echocardiograms showed recovery of left ventricular (LV) function with this adaptation-arterialization approach, with an increase in ejection fraction (EF) in Group I from 38% ± 5% after coronary occlusion to 53% ± 7% eight weeks after CVBG, whereas in Group II the EF never recovered (41% ± 2%–33% ± 7%). The remodeling of the venous system not only allowed restoration of myocardial function when CVBG was implemented but possibly promoted a novel form of “collateralization” between the native arterioles and the newly arterialized venules, which revascularized the ischemic myocardium.ConclusionsThese findings form a potential rationale for a venous arterialization-revascularization treatment for the refractory angina and the “no-option” patients using a hybrid percutaneous (closure device for arterialization)/surgical approach (CVBG) to revascularize the myocardium.

ABSTRACT Metastatic gastric cancer traditionally hinders surgical treatment options, confining them to palliative procedures. The presence of metastases in these tumors is classified as M1, irrespective of their characteristics, quantity, or location. However, oligometastatic disease emerged as an intermediate state between localized and widely disseminated cancer. It exhibits diverse patterns based on metastatic disease extent, type, and location. Adequately addressing this distinctive metastatic state necessitates tailored strategies that surpass the realm of palliative care. Differentprimary tumor types present discernible scenarios of oligometastatic disease, including preferred sites of occurrence and chronological progression. Due to the novelty of this theme and the heterogeneity of the disease, uncertainties still exist, and the ability to provide confident guidelines is challenging. Currently, there are no effective predictors to determine the response and provide clear indications for surgical interventions and systemic treatments in oligometastatic disease. Treatment decisions are commonly based on apparent disease control by systemic therapies, with a short observation period and imaging assessments. Nonetheless, the inherent risk of misinterpretation remains a constant concern. The emergence of novel technologies and therapeutic modalities, such as immunotherapy, cellular therapy, and adoptive therapies, holds the potential to reshape the landscape of surgical treatment for the oligometastatic disease in gastric cancer, expanding the surgeon’s role in this multidisciplinary approach. Prospective tools for patient selection in oligometastatic gastric cancer are being explored. Using non-invasive, cost-effective, widely available imaging techniques that provide real-time information may revolutionize medical practice, ensuring precision medicine accessibility, even in resource-constrained small healthcare facilities. Incorporating molecular classifications, liquid biopsies, and radiomic analysis in a complementary protocol will augment patient selection precision for surgical intervention in oligometastasis. Hopefully, these advancements will render surgeries unnecessary in many cases by providing highly effective alternative treatments.

Background & aimsMetabolic syndrome (MetS) is associated with life-threatening conditions. Several studies have reported an association of vitamin B12, folic acid, or homocysteine (Hcy) levels with MetS. This systematic review and meta-analysis assessed the association of vitamin B12, folic acid, and Hcy levels with MetS.MethodsPubMed, Scopus, Embase, Ovid/Medline, and Web of Science were searched up to February 13, 2023. Cross-sectional, case-control, or cohort studies were included. A random-effects model was performed using the DerSimonian and Laird method to estimate the between-study variance. Effect measures were expressed as odds ratios (OR) with their corresponding 95% confidence intervals (95% CI). Between-study heterogeneity was evaluated using Cochran’s Q test and the I2 statistic.ResultsSixty-six articles (n = 87,988 patients) were included. Higher vitamin B12 levels were inversely associated with MetS (OR = 0.87; 95% CI: 0.81–0.93; p < 0.01; I2 = 90%). Higher Hcy levels were associated with MetS (OR = 1.19; 95% CI: 1.14–1.24; p < 0.01; I2 = 90%). Folate levels were not associated with MetS (OR = 0.83; 95% CI: 0.66–1.03; p = 0.09; I2 = 90%).ConclusionHigher vitamin B12 levels were inversely associated with MetS, whereas higher Hcy levels were associated with MetS. Studies assessing the pathways underlying this association are required.

Gas lift is deplored when the natural lift energy for matured well provides flow rate below the required value. Casing-heading instability removal, fault-tolerant control (FTC) and general operation of the system require the system model and its analysis. In this article, we present a simple approach to gas lift modelling from a tutorial perspective. We derive these gas-lifted system models comparing the models with existing models in the process. We also derive the pressure profile in the annulus and tubing. A simplified approach to the linearisation of the gas-lifted system that is a differential algebraic equation (DAE) system is also presented. The linearised result is used in simulation and analysis of the gas-lifted system where the phase portrait and the stability of the linearised system were considered. Also considered were behaviour of the linearised system and the nonlinear counterpart. The difference of 4kg, 4kg and 30kg corresponding to percentage difference of 0.16%, 0.29% and 2.38% respectively between the linearised and the nonlinear states observed implies convergence. The key objective of this work is to present a simplified approach to the modelling and analysis of the gas-lifted system.

Introduction: Bovine brucellosis is a significant public health problem in countries with economic and zoonotic implications. Although relevant, there are no previous systematic reviews about bovine brucellosis in Latin America. Methods: We performed a systematic literature review in five data-bases to assess the seroprevalence of Brucella in cattle. A meta-analysis with a random-effects model was performed to calculate the pooled prevalence and 95% confidence intervals (95%CI). In addition, measures of heterogeneity (Cochran's Q statistic and I2 test) were reported. Results: The literature search yielded 3,403 articles, of which 65 studies were fully valid for analysis. The pooled seroprevalence for Brucella in bovine (n ​= ​46,883,177) was 4.0% (95%CI: 3.0%–5.0%; p ​

Despite positive initial outcomes emerging from preclinical and early clinical investigation of alginate hydrogel injection therapy as a treatment for heart failure, the lack of knowledge about the mechanism of action remains a major shortcoming that limits the efficacy of treatment design. To identify the mechanism of action, we examined previously unobtainable measurements of cardiac function from in vivo, ex vivo, and in silico states of clinically relevant heart failure (HF) in large animals. High-resolution ex vivo magnetic resonance imaging and histological data were used along with state-of-the-art subject-specific computational model simulations. Ex vivo data were incorporated in detailed geometric computational models for swine hearts in health (n = 5), ischemic HF (n = 5), and ischemic HF treated with alginate hydrogel injection therapy (n = 5). Hydrogel injection therapy mitigated elongation of sarcomere lengths (1.68 ± 0.10μm [treated] vs. 1.78 ± 0.15μm [untreated], p99% accuracy and predicted small myofiber strain in the vicinity of the solidified hydrogel that was sustained for up to 13 mm away from the implant. These findings suggest that the solidified alginate hydrogel material acts as an LV mid-wall constraint that significantly reduces adverse LV remodeling compared to untreated HF controls without causing negative secondary outcomes to cardiac function. STATEMENT OF SIGNIFICANCE: Heart failure is considered a growing epidemic and hence an important health problem in the US and worldwide. Its high prevalence (5.8 million and 23 million, respectively) is expected to increase by 25% in the US alone by 2030. Heart failure is associated with high morbidity and mortality, has a 5-year mortality rate of 50%, and contributes considerably to the overall cost of health care ($53.1 billion in the US by 2030). Despite positive initial outcomes emerging from preclinical and early clinical investigation of alginate hydrogel injection therapy as a treatment for heart failure, the lack of knowledge concerning the mechanism of action remains a major shortcoming that limits the efficacy of treatment design. To understand the mechanism of action, we combined high-resolution ex vivo magnetic resonance imaging and histological data in swine with state-of-the-art subject-specific computational model simulations. The in silico models realistically simulated in vivo function with >99% accuracy and predicted small myofiber strain in the vicinity of the solidified hydrogel that was sustained for up to 13 mm away from the implant. These findings suggest that the solidified alginate hydrogel material acts as a left ventricular mid-wall constraint that significantly reduces adverse LV remodeling compared to untreated heart failure controls without causing negative secondary outcomes to cardiac function. Moreover, if the hydrogel can be delivered percutaneously rather than via the currently used open-chest procedure, this therapy may become routine for heart failure treatment. A minimally invasive procedure would be in the best interest of this patient population; i.e., one that cannot tolerate general anesthesia and surgery, and it would be significantly more cost-effective than surgery.

Sporadic gliomas in companion dogs provide a window on the interaction between tumorigenic mechanisms and host environment. We compared the molecular profiles of canine gliomas with those of human pediatric and adult gliomas to characterize evolutionarily conserved mammalian mutational processes in gliomagenesis. Employing whole-genome, exome, transcriptome, and methylation sequencing of 83 canine gliomas, we found alterations shared between canine and human gliomas such as the receptor tyrosine kinases, TP53 and cell-cycle pathways, and IDH1 R132. Canine gliomas showed high similarity with human pediatric gliomas per robust aneuploidy, mutational rates, relative timing of mutations, and DNA-methylation patterns. Our cross-species comparative genomic analysis provides unique insights into glioma etiology and the chronology of glioma-causing somatic alterations.

Background: Neisseria meningitidis meningitis is a dangerous, widespread illness in Egypt nowadays. Immunity lasts a long time. Worldwide, meningitis and meningococcemia, which are caused by Neisseria meningitidis, are the leading infectious causes of mortality in children. Aim of the work: The creation of a lipid nanoparticle [LNP]-RNA vaccine in Egypt against the Neisseria meningitidis cps gene locus has made it easier to produce capsular polysaccharide.Patients and Methods: This was an Experimental screening examination. In this investigation, we created an LNP-RNA vaccination against the cps gene locus, which facilitates the pathogenic bacterium's ability to synthesize capsular polysaccharide. Lipid nanoparticles with a particle size of 76 nanometers served as the vaccine delivery methodResults: The vaccine’s effectiveness was 93%. Compared to other conventional vaccinations, it had fewer side effects and higher biological activity. Due to the development of protective neutralizing antibodies similar to those elicited by earlier conventional vaccinations, the immunity was long-lasting.Conclusion: In the current trial, the vaccination was successful in preventing that bacterial illness. It must be regularly updated to avoid the issue of a high mutation rate.

Abstract Background Liver tumors exhibiting hepatocellular, cholangiocarcinoma, and neuroendocrine features are extremely rare, with only five cases reported in the literature. Case presentation We present an unusual case of a combined hepatocellular-cholangiocarcinoma (cHCC-CC) with neuroendocrine features in a pediatric patient. A 16-year-old presented with abdominal pain and a 21.0 cm mass in the right hepatic lobe with extension into the left lobe. Histology showed a poorly differentiated tumor with a solid, tubuloglandular, and microcystic architecture. Immunohistochemistry results were negative for hepatic markers, positive for markers of biliary differentiation, and positive for neuroendocrine differentiation. The neoplasm was reviewed at several institutions with differing diagnoses. Single nucleotide polymorphism (SNP) chromosomal microarray (CMA) showed large deletions within chromosomes 6q and 13q in both the hepatocellular-like areas and the cholangiocarcinoma-like areas, with additional large deletions in the cholangiocarcinoma-like areas, supporting origin from hepatocellular carcinoma. The final diagnosis was a cHCC-CC with neuroendocrine features. Conclusions Diagnosis of cHCC-CCs relies predominately on histomorphology, as per the 2018 International Consensus Group on the nomenclature of cHCC-CC. These findings in this case support that the pathological classification of these lesions be based on molecular data, which could better direct treatment. Further classification of cHCC-CCs and determination of their clinicopathological relevance will require more interobserver consistency and continued molecular profiling of these lesions.

Abstract Background Transarterial radioembolization (TARE) is increasingly used as an alternative to transarterial chemoembolization (TACE) for the treatment of hepatocellular carcinoma (HCC). We aimed to perform an overall and individual patient data (IPD) meta‐analysis of studies comparing TACE and TARE. Methods We performed a systematic literature search using pre‐specified keywords with the aid of an informationist for articles from inception to 3/2020. The primary endpoint was overall survival (OS), and the secondary endpoint was time to progression (TTP). Results Seventeen studies met inclusion criteria with 2465 unique patients, with one randomized trial, 4 prospective studies and 12 retrospective studies. Barcelona Clinic Liver Cancer (BCLC) stage B (42.8%) was the most common stage followed by BCLC A (30.3%) and BCLC C (29.0%). There was no difference in OS between the two modalities (−0.55 months, 95% CI −1.95 to 3.05). In three studies with available TTP data, TARE resulted in a longer TTP than TACE (mean TTP 17.5 vs. 9.8 months; mean TTP difference 4.8 months, 95% CI 1.3–8.3 months). IPD‐level meta‐analysis of 311 patients from three studies showed no difference in overall OS between the two modalities including among subgroups stratified by tumor stage and liver function. Limitations of the current literature include inconsistent length of follow‐up, inconsistency in response criteria, and safety reporting. Conclusions Current data suggest TARE provides significantly longer TTP than TACE, although the two treatments do not significantly differ in terms of OS. Given limitations of the current data, there is rationale for prospective studies comparing these modalities.

The study's goal was to create an in situ intrarectal mucoadhesive gel of sumatriptan (SMT) combining mucoadhesive polymer (xyloglucan) and thermosensitive polymers (poloxamer 407 and poloxamer 188) to prolong rectal residence time for treatment of migraines. Nine SMT mucoadhesive rectal in situ gel (RIG) formulas were created by mixing poloxamer 407 (18%, 19%, or 20%) with poloxamer 188 (5%), a mucoadhesive polymer at various doses (0.1, 0.2, and 0.3) as well as SMT (25 mg/ml). The prepared suppositories underwent for mucoadhesive force, gelation temperature, and gelation time. When SMT and mucoadhesive polymer were added to the poloxamer mixture, the gelation temperature dropped; however, poloxamer 188 had the opposite effect. These polymers supported the prepared liquids' ability to adhere to mucous membranes and form a strong gel. The transition gelation temperature of the poloxamer solution rose as a result of the addition of poloxamer 188. The findings showed that the formula RIG5 which is composed of poloxamer 407 (19%), poloxamer 188 (5%), and xyloglucan (0.2%) had an ideal transition temperature of 36.33°C, gel strength of 44.66°C, mucoadhesive force of 6409°C, and in vitro drug release of 93.98% over an 8-hour period. In light of this, it can be said that SMT was successfully manufactured as RIG without causing any chemical reaction with its additives.

The gas-lifted system has inherent ability to hide the effect of fault hence the system can inject gas into the annulus and oil will still be produced even in the presence of fault of significant value. This however affects the optimal operation of the system and could move the system towards the undesirable casing-heading instability. Faults of step decrease in the valves coefficients in addition to limitation on the valve affect the optimal flow of the liquids through the system. We detect and isolate these faults using generalised likelihood ratio test (GLRT) and Dedicated observer scheme (DOS) respectively. The states of the system are estimated using extended Kalman filter (EKF). Model predictive control based fault-tolerant control is then implemented on the system by using the robustness property of the zone control MPC and limiting the input bound in the optimiser. Both passive and active fault-tolerant control (FTC) were used to improve oil production or stabilise the system. Passive fault-tolerant control (FTC) provides more robustness but it does not change oil production noticeably enough. Reducing the upper control bound ensures stability but production could decline. Increasing the controller cost that prioritises the input target increases production but it is prone to casing-heading instability.

Worldwide, epilepsy is the second most prevalent neurological disorder. Disappointingly, various adverse effects are being observed with currently used antiepileptic drugs. Nanomedicine represents an effective strategy to overcome these limitations with a better central drug delivery. Hence, our work aimed to unravel the antiepileptic efficacy of rutin (Rut) loaded with selenium nanoparticles (SeNPs) against pentylenetetrazole (PTZ)-challenged mice. Ten days before PTZ (60 mg·kg−1) intraperitoneal injection, mice were orally administered Rut (100 mg·kg−1), sodium selenite (0.5 mg·kg−1), SeNPs (100 mg·kg−1), or sodium valproate (reference drug, 200 mg·kg−1). Remarkably, administration of Rut-loaded SeNPs (Rut-SeNPs) to epileptic mice markedly increased the latency time and decreased the severity and duration of seizures. Remarkable increases were also noticed in acetylcholinesterase, brain-derived neurotrophic factor, dopamine, and norepinephrine levels in epileptic mice treated with Rut-SeNPs. Furthermore, Rut-SeNPs boosted the cellular antioxidant defense by increasing superoxide dismutase, catalase, GSH, Nrf2, and HO-1, along with decreased malondialdehyde and nitric oxide levels. In addition, the nanotherapy successfully mitigated the inflammatory mediators (tumor necrosis factor-α, interleukin-6, cyclooxygenase-2, and nuclear factor kappa B) in mice hippocampus. Rut-SeNPs antagonized neuronal apoptosis by decreasing Bax and caspase-3 and increasing the levels of Bcl-2. Conclusively, the present work suggests Rut-loaded SeNPs as an effective antiepileptic therapy through correction of disturbed neurotransmitters, oxidative status, neuroinflammation, and apoptosis.

Hybrid laminated composites are attracting a lot of attention these days. Indeed, mixing natural and synthetic fabrics in the same matrix completely exploits the components’ greatest properties. However, it has been proven that the use of particles such as clays increases the material performance. Hence, the aim of this study is to produce a new hybrid laminated composite system using the hand lay-up method and compression molding techniques. For this, a layering sequence of plain-woven jute fabrics and different architecture of E-Glass fibers (matt and plain-woven roving fabrics with different grammage) were selected to strengthen a polyester resin modified with a tiny amount of clays. The effects of hybridization, layering sequence, and weaving architecture were evaluated by means of mechanical tests. The dispersion and distribution of the charges in the polymeric matrix were also investigated by studying the material rheological properties. We conclude that the proposed hybridization may result in an optimal, superior, and cost-effective laminated composite that fits all the requirements of a given structure.

In 1995, Michael J. Sullivan questions whether China’s human rights violations would cease given increased trade with the democratic world. Today, the United States and the European Union import more from China than any other major power or state. The European Union, a defender of international human rights as enshrined in its constitution, is working on a major investment deal with China. However, China’s human rights record did not improve; rather, China continues to violate the rights of Uyghurs, Buddhists, and other ethnic and religious minorities like Falun Gong practitioners and Christians. It now has the potential to directly challenge the liberal order of the United States. The Russian invasion of Ukraine will only increase China’s power and influence. Russian isolation resulted from Western-backed sanctions generates an economic dependency on China. Thus, China’s military power and political influence will continue to increase, furnishing its position as a counter-hegemonic power to the United States. This article’s first task is to deconstruct liberal and neoliberal institutionalism theoretical frameworks that dominated American foreign policy architecture since the early 1980s. Its focus on absolute gains enabled China’s rise regardless of its totalitarian stance, specifically its human rights violations. China’s influence is now global as it exports its development model to developing states. Democratic states are thus responsible for the rise of China.

Abstract Background Access to electronic (E) resources has become an indispensable requirement in medical education and practice. Objective Our objective was to assess the effect of E-resources access during examination on end-course-exam scores of medical and dental students. Methods A quasi-experimental study which included two cohorts of medical (n = 106 & 85) and three cohorts of dental students (n = 66, 64 and 69) who took end-course- exams. Each exam was composed of two- parts (Part I and II), that encompassed equal number of questions and duration. Access to E-resources was allowed in part-II only. Items Difficulty Index (DI), Discrimination Index, (DisI), Point Biserial, (PBS) and cognitive level were determined. Results The study included 390 students. The proportion of items at various levels of DI, DisI, and PBS and the average values for item DI, DisI in both parts of each exam were comparable. The average scores in part-II were significantly higher than part-I (P

Abstract Background The use of contraceptive methods in Peru has remarkably increased in recent decades. Nevertheless, despite the completeness and accessibility of family planning methods, modern contraceptive methods utilization in Peru remains below the South American average. Thus, this study aimed to elucidate the factors associated with modern contraceptive use, as well as the presence of inequalities and the spatial distribution in Peruvian women aged 15–49 years in 2019. Methods A secondary data analysis was conducted using information from the 2019 Peruvian Demographic and Health Survey. We performed descriptive statistics, bivariate analysis, and Poisson multiple regression. Inequalities were estimated through concentration curves and Erreygers’ normalized concentration index. Spatial analysis included choropleth map, Global Moran’s I, Kriging interpolation and Getis-Ord-Gi* statistic. Results The prevalence of modern contraceptive use was 39.3% among Peruvian women of reproductive age. Modern contraceptive use was directly associated with youth (aPR 1.39), women having their first sexual intercourse before the age of 18 (aPR 1.41), and being married but not together (aPR 1.87). In addition, speaking Quechua or Aymara (aPR 0.87) and having no children (aPR 0.59) were inversely associated with utilization of modern contraceptives. We found the presence of inequalities in the use of contraceptive methods (pro-rich distribution), although the magnitude was low. Spatial analysis unveiled the presence of a clustered distribution pattern (Moran’s Index = 0,009); however, there was inter-departmental and intra-departmental heterogeneity in the predicted prevalence of the use of modern contraceptives. In addition, significant hot and cold spots were found in Peru. Conclusion Two out of five Peruvian women of reproductive age used modern contraceptives. It was associated with younger women’s age, younger age at first sexual intercourse, being married or cohabitant, among others. No substantial inequality was found in modern contraceptive use. The prevalence was heterogeneous at the intra- and inter-departmental level. Those departments located in the south, south-east, and north-east had the lowest prevalence. Therefore, nonfinancial barriers must be tackled through multi- and cross-sectoral efforts and continue to universally provide modern contraceptives.

A new series of co-drugs was designed based on hybridising the dihydropteroate synthase (DHPS) inhibitor sulphonamide scaffold with the COX-2 inhibitor salicylamide pharmacophore through biodegradable linkage to achieve compounds with synergistic dual inhibition of COX-2/PGE2 axis and DHPS enzyme to enhance antibacterial activity for treatment of septicaemia. Compounds 5 b, 5j, 5n and 5o demonstrated potent in vitro COX-2 inhibitory activity comparable to celecoxib. 5j and 5o exhibited ED50 lower than celecoxib in carrageenan-induced paw edoema test with % PGE2 inhibition higher than celecoxib. Furthermore, 5 b, 5j and 5n showed gastric safety profile like celecoxib. Moreover, in vivo antibacterial screening revealed that, 5j showed activity against S.aureus and E.coli higher than sulfasalazine. While, 5o revealed activity against E.coli higher than sulfasalazine and against S.aureus comparable to sulfasalazine. Compound 5j achieved the target goal as potent inhibitor of COX-2/PGE2 axis and in vivo broad-spectrum antibacterial activity against induced septicaemia in mice.

Abstract We investigated the random lasing process and Replica Symmetry Breaking (RSB) phenomenon in neodymium ions (Nd3+) doped lead-germanate glass–ceramics (GCs) containing MgO. Glass samples were fabricated by conventional melt-quenching technique and the GCs were obtained by carefully devitrifying the parent glasses at 830 °C for different time intervals. The partial crystallization of the parent glasses was verified by X-ray diffraction. Photoluminescence (PL) enhancement of $$\approx$$ ≈ 500% relative to the parent glasses was observed for samples with a higher crystallinity degree (annealed during 5 h). Powders with grains having average size of 2 µm were prepared by griding the GCs samples. The Random Laser (RL) was excited at 808 nm, in resonance with the Nd3+ transition 4I9/2 → {4F5/2, 2H9/2}, and emitted at 1068 nm (transition 4F3/2 → 4I11/2). The RL performance was clearly enhanced for the sample with the highest crystallinity degree whose energy fluence excitation threshold (EFEth) was 0.25 mJ/mm2. The enhanced performance is attributed to the residence-time growth of photons inside the sample and the higher quantum efficiency of Nd3+ incorporated within the microcrystals, where radiative losses are reduced. Moreover, the phenomenon of Replica Symmetry Breaking (RSB), characteristic of a photonic-phase-transition, was detected by measuring the intensity fluctuations of the RL emission. The Parisi overlap parameter was determined for all samples, for excitation below and above the EFEth. This is the first time, for the best of the authors knowledge, that RL emission and RSB are reported for a glass–ceramic system.

This work aims to investigate the impact of some antioxidants, i.e., zinc sulfate (ZnS) administration, vitamin E and selenium (E-Sel) injection on hematological parameters and thermoregulatory responses of Aberdeen Angus cows. Sixteen cows were randomly divided into 4 equal groups (4 cows each), First group served as a control (G1); second group was received E-Sel injection at rate of 15 ml/ head / 15day) (G2); third group was fed on ZnS with an average rate of 200 mg/head/ daily (G3) and the fourth one was fed on ZnS in combination with E-Sel injection (G4). All experimental cows were fed 60% of their requirements as CFM and the rest of other requirements was covered from wheat strew ad libitum. In addition, the AT and RH% were recorded during the experimental days to calculate the current THI. Blood samples were collected during experimental period from jugular vein. Physiological parameter measurements were recorded during the experimental days. The obtained results showed that the average values of THI were between 69.04 and 85.46 during the experimental period. Treated cows with E-Sel recorded the highest values of hematological parameters in terms of WBC, RBC, HB, HCT and PLT compared with other groups. Using antioxidant agents had significant decrease in RR, PR, and HT. While, slightly decrease in RT, ST and ET was recorded of experimental animal. It is concluded that some antioxidants could improve hematological parameters and thermoregulatory responses of Aberdeen Angus cows under hot climatic conditions.

Abstract Background Introducing radiological anatomy in the preclinical curriculum can increase the understanding of Anatomy. Regardless of the integration when teaching anatomy, it is essential to maintain oversight as to what and how much is being taught. In addition, the knowledge requirements for preclinical students should be considered. The purpose of this kind of integration is that the student should be able to apply the knowledge which can help them better understand anatomy and not to make the course more challenging. This study aimed to understand whether adding radiological images would increase the difficulty level of the questions. Methods We introduced radiological images, including X Rays, CT scans and MRIs, when teaching anatomy in the preclinical curriculum. A class of 99 students were tested using A-type MCQs (n = 84). All 84 questions were categorized on whether they were case-based with or without a radiological image. The item analysis of both groups of test questions was then compared based on their difficulty and discrimination index. A qualitative student perception regarding the inclusion of radiological images in anatomy was also measured using a questionnaire with a 5-point Likert scale. Results The results showed that the performance level of the students was similar when comparing the test questions in both groups. The item analysis of the MCQs in the two groups revealed that by integrating radiological images when teaching anatomy, the various parameters in both groups of test questions were in the same range. More than 80% of the students felt that radiological images facilitate the achievement of learning outcomes and help to apply their knowledge in clinical contexts. The study's findings reported that the rate of satisfaction by including radiological images when teaching anatomy is high. Conclusion Recognition and interpretation of images are essential in an undergraduate medical program. Students found it helpful when radiological images were introduced to them when teaching anatomy. Since the students' performance in summative exams in both groups of questions was in the same range, the findings also point out that adding radiological images when teaching anatomy does not increase the difficulty of the subject.

Due to its advantages, the air lift pump has many applications in real life. Therefore, the present study is dealing with the effect of some parameters on the air lift pump performance. The present study is a continuation of a program started years ago by the fluid mechanics group in Faculty of Engineering, Alexandria University. Beginning by validating the obtained results of the experiment set-up by comparing these experimental results with international accepted sets of data. After that the present experiments shed some lights on the inlet injection region of the air lift pump due to the significant effect of its initial conditions on the pump efficiency. Thus the study directed towards investigating the effect of some parameters including the inlet restrictor resistance, the injection direction and the injector riser diameter. The upward injection technique shows higher peak efficiency of 34.7% compared to 29.7% and 28.9% for downward and side injection respectively while the larger injector inner diameter shows maximum water capacity of 928 kg/h. compared to 823 kg/h. water mass flow rate for the smaller inner diameter injector. In all the above experimental tests, flow visualization is used extensively giving a good agreement with well recognized flow pattern map.

Jhancy Malay,1 Salah Eldin Kassab,2,3 Tarig Hakim Merghani,4 Ramya Rathan,5 Anusha Sreejith6 1Department of Pediatrics, RAK Medical and Health Sciences University, Ras Al Khaimah, United Arab Emirates; 2Department of Medical Education, Gulf Medical University, Ajman, United Arab Emirates; 3Department of Physiology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt; 4Department of Physiology, RAK Medical and Health Sciences University, Ras Al Khaimah, United Arab Emirates; 5Department of Anatomy, College of Medicine, Gulf Medical University, Ajman, United Arab Emirates; 6Department of Demography, College of Medicine, Gulf Medical University, Ajman, United Arab EmiratesCorrespondence: Jhancy Malay, Department of Pediatrics, RAK College of Medical Sciences, RAK Medical and Health Sciences University, PO Box 11172, Ras Al Khaimah, United Arab Emirates, Tel +971 72043000, Fax +971 7 226 9997, Email jhancy@rakmhsu.ac.aeIntroduction: An unprecedented disruption in medical education worldwide was caused due to the Covid 19 pandemic. Online teaching has become one of the primary forms of education. In this paper, we aimed to understand the faculty and students’ perceptions about the teaching styles adopted by the faculty during online large group teaching from two universities in the United Arab Emirates.Patients and Methods: This is a cross-sectional opinion survey-based study. A pre-validated teaching style inventory in higher education (TSIHE) questionnaire was emailed to the students and faculty involved in large group online learning and teaching activities during the lock-down period of the COVID 19 pandemic from two different medical Universities in the United Arab Emirates. A total of 423 students and 57 faculty participated in the study. Descriptive and Inferential statistics were used to analyze the data.Results: There was a significant difference between the faculty and students on the perception of faculty online teaching styles. The difference was significant in teacher-student interaction and teacher structuring styles. In contrast, faculty and students’ perceptions were comparable for decision-making negotiation and behavioral control teaching styles.Conclusion: The study found that there was a significant perception differences between the faculty and students on the faculty teaching style during online large group teaching. Importantly, faculty perceived that they were more emotionally attached and more flexible in teacher-student interaction and teaching structuring during online teaching than the student perceived.Keywords: COVID 19, medical education, online large group teaching, medical students, faculty perception

Abstract Simultaneous wireless information and power transfer (SWIPT) has recently attracted researchers and may help to satisfy future technology demands. SWIPT allows wireless power transfer (WPT) and wireless information transfer (WIT) to coexist based on shared resources. Recent studies have shown that, due to the nonlinearity of the rectifiers, high-PAPR (peak to average power ratio) waveforms provide better performance in terms of energy harvesting, making the design of power signals essential. In addition, these power signals should consume the smallest amount of resources for the WIT. In this paper, a new waveform design is proposed where the information and power signals are superposed using the same frequency and time resources. The power signal is composed of a high peak modulated rectangular wave sent during the cyclic prefix of the orthogonal frequency-division multiplexing (CP-OFDM) system, which is discarded at the information receiver, such that it does not interfere with the OFDM data symbol. Although the pulse is restricted to be within the cyclic prefix, there might be a small amount of interference caused by channel dispersion. Simulations and measurements show that a good choice of signal parameters can minimize interference on the information symbols and simultaneously provide good performance in terms of energy harvesting.

تمت دراسة وسط مائي عذب هو مصب نهر رميلة في مدينة جبلة – محافظة اللاذقية، حيث جُمعت العينات المائية والحيوانية مرّة واحدة كل شهر لمدة عام ابتداءً من27/9/2021 إلى15/8/2022، وقد تمت دراسة الخصائص اللاحيوية والحيوية للوسط المذكور، كما تم التعرف على 14نوع من الرخويات، منها 13نوع ينتمي إلى صف بطنيات القدم 6) Gastropoda منها ينتمي إلى تحت صف أماميات الغلاصم Prosobranchiaو7 منها ينتمي إلى تحت صف الرئويات Pulmonata) ونوع واحد ينتمي إلى صف ثنائيات المصراع Bivalvia. وقد دُرست الصفات الفيزيائية والكيميائية لمياه هذه المحطة إذ تبيّن أن المياه متوسطة القساوة، وتميزت هذه المحطة بارتفاع نسبة شوارد الكلور مقارنة مع باقي أجزاء النهر، وانخفاض كمية الأوكسجين المنحل بالماء في بداية الربيع تزامناً مع ارتفاع كمية الأوكسجين المستهلك COD وهذا يعكس وجود تلوث عضوي من أصل بشري (صرف صحي).

Infective endocarditis is a complex heterogeneous condition involving the infection of the endocardium and heart valves, leading to severe complications, including death. Surgery is often indicated in patients with infective endocarditis but is associated with elevated risk compared with other forms of cardiac surgery. Risk models play an important role in many cardiac surgeries as they can help inform clinicians and patients regarding procedural risk, decision-making to proceed or not, and influence perioperative management; however, they remain under-utilized in the infective endocarditis settings. Another crucial role of such risk models is to assess predicted versus found mortality, thereby allowing an assessment of institutional performance in infective endocarditis surgery. Traditionally, general cardiac surgery risk models such as European System for Cardiac Operative Risk Evaluation (EuroSCORE), EuroSCORE II, and Society of Thoracic Surgeon’s score have been applied to endocarditis surgery. However, there has been the development of many endocarditis surgery-specific scores over the last decade. This review aims to discuss clinical characteristics and applications of all contemporary risk scores in the setting of surgical treatment of infective endocarditis.

ObjectiveBovine pericardium is common biological material for bioprosthetic heart valve. There remains a significant need, however, to improve bioprosthetic valves for longer-term outcomes. This study aims to evaluate the chronic performance of bovine pulmonary visceral pleura (PVP) as bioprosthetic valve cusps.MethodsThe PVP was extracted from the bovine lung and fixed in 0.625% glutaraldehyde overnight at room temperature. The PVP valve cusps for the bioprosthetic valve were tailored using a laser cutter. Three leaflets were sewn onto a nitinol stent. Six PVP bioprosthetic valves were loaded into the test chamber of the heart valve tester to complete 100 million cycles. Six other PVP bioprosthetic valves were transcardially implanted to replace pulmonary artery valve of six pigs. Fluoroscopy and intracardiac echocardiography were used for in vivo assessments. Thrombosis, calcification, inflammation, and fibrosis were evaluated in the terminal study. Histologic analyses were used for evaluations of any degradation or calcification.ResultsAll PVP bioprosthetic valves completed 100 million cycles without significant damage or tears. In vivo assessments showed bioprosthetic valve cusps open and coaptation at four months post-implant. No calcification and thrombotic deposits, inflammation, and fibrosis were observed in the heart or pulmonary artery. The histologic analyses showed complete and compact elastin and collagen fibers in the PVP valve cusps. Calcification-specific stains showed no calcific deposit in the PVP valve cusps.ConclusionsThe accelerated wear test demonstrates suitable mechanical strength of PVP cusps for heart valve. The swine model demonstrates that the PVP valve cusps are promising for valve replacement.

Current leading managements for diverticular disease cannot prevent the recurrence of diverticulitis, bleeding and/or other complications. There is an immediate need for developing new minimal invasive therapeutic strategies to prevent and treat this disease. Through a biomechanical analysis of porcine colon with diverticular lesions, we proposed a novel adhesive patch concept aiming at mechanical reconstruction of the diseased colon wall. This study aims to evaluate the surgical feasibility (safety and efficacy) of pulmonary visceral pleura (PVP) patch therapy using a pig model of diverticulosis. Six female Yucatan miniature pigs underwent collagenase injection (CI) for the development of diverticular lesions. The lesions in each animal either received patch implantation (treated group, n = 40 for 6 pigs) or left intact (untreated group, n = 44 for 6 pigs). The normal colonic wall in each animal received patch implantation at two spots to serve as control (n = 12 for 6 pigs). After 3 months of observation, the performance and safety of the patch treatment were evaluated through macroscopic and histological examination. We found that 95% of pouch-like herniation of the mucosa was prevented from the colon wall with the treatment. The pouch diameter was significantly reduced in the treated group as compared to the untreated group (p < 0.001). The patch application caused a significant increase in the levels of collagen of the colon tissue as compared to the untreated and control groups (p < 0.001). No difference was found in the lymphocyte and macrophage inflammatory infiltrate between the groups. Our results suggest that patch treatment efficiently inhibits the diverticular pouch deformation and promotes the healing of the colon wall with a normal inflammatory response, which may minimize the risk of diverticulosis reoccurrence and complications over time.

Abstract Machine‐as‐a‐Service (MaaS) is an emerging service model for industrial appliances. With MaaS, machines are rented instead of being acquired, and their lifecycle is handled by an ecosystem of specialized actors, such as different independent maintenance companies certified for interventions on specific hardware. As the number of actors, clients, and providers involved in a MaaS ecosystem grows, maintaining mutual trust relationships between all involved parties and orchestrating MaaS operations in centralized fashion quickly becomes intractable. We present a blockchain‐based approach to providing MaaS in industrial settings where rented machines are equipped with IoT sensors, and where MaaS operations are orchestrated in a transparent, decentralized, and scalable way using a collection of smart contracts deployed over an infrastructure combining the Ethereum and InterPlanetary File System decentralized services. We detail the operations of MaaS, such as the lifecycle of management operations, and report on the performance of a prototype implementation deployed in the cloud.

Background: The burden of pain in newborns has been investigated in several studies, but little is known about the appropriateness and effectiveness of using pain scales according to the specific type of pain or the condition of the infant. Our purpose was to conduct a meta-analysis to assess and report on the effectiveness of the used procedural pain scale to measure pain in a child over 0-1years reflecting that by using the non-pharmacological interventions in pain reduction in randomized trials. Methods: A systematic search was performed up to October 2021 in PubMed and Cochrane Library The current review enrolled randomized clinical trials (RCTs). It was also conducted according to PRISMA guidelines. Cochrane's risk of bias assessment was used to assess the studies' quality and risk of bias. Meta-analyses were performed by calculating the standardized mean difference (SMD) at a 95% confidence interval (CI) using Review Manager Software Results: 50 trials were found 8 trials were included in this meta-analysis. Most of the studies related to procedural pain (heel lance and vaccination), Three validated pain scales were used in all trials (neonatal infant pain scale NIPS, premature infant pain profile PIPP, AND neonatal pain, agitation, and sedation scale NPASS. The Meta-analysis showed significant effect of non- pharmacological interventions (swaddling, mother holding, sucrose) in pain reduction compared with control group (SMD 1.2, 95% CI -1.88 to -.52, P =0.0005), I` = 95%, P> 0.00001. The 8 studies with 918 infant’s participants entered into analysis used effective pain scales (NIPS, PIPP, and NPASS) to measure procedural pain effectively Conclusions: overall the non-pharmacological interventions show positively effect in pain reduction, these mean the pain scales that are used in studies appropriate to assess pain when measure procedural pain (heel lice, vaccination), however, there is no consistency about the best tool to use in children related to several factors.

Objectives. To determine the prevalence of COVID-19 infection and to identify the lifestyle factors and nutritional status associated with the epidemiological profile of COVID-19 patients. Materials and Methods. This cross-sectional survey was carried out in the eighteen Iraqi governorates, from 1st August to 20th of October 2020. At the end of this study, 433 participants were recruited. Results. The prevalence of coronavirus infection was 37.18%. Smoking and active physical activity were relatively higher for COVID-19 patients who are male, and belonged to the under-45 age range were 91.3%. It notices that COVID-19 patients who smoked and had active physical activity were married, residents in urban, and worked. Likewise, COVID-19 patients who had equal or more than an institute/college level of education are smokers and had active physical activity. Obesity prevalence was higher for patients aged 45 (92.2%), and higher for females (51%). The proportion of obesity was generally higher for married and for those living in urban areas (92.2%). Obesity was significantly more common among those in worked (70.6%). Conclusions. Of note is the high prevalence of COVID-19 infection observed. A strong correlation between the prevalence of active physical activity among COVID-19 patients and gender, marital status, residence, education, and occupation. Unexpectedly, the prevalence rate of obesity among COVID-19 patients correlating with socio-demographic status did not yield a significant difference.

Objective: To assess the correlation between COVID-19 vaccination coverage and the Human Development Index (HDI) at the provincial level in Peru. Study design: Ecological study. Methods: We conducted a cross-sectional ecological study based on secondary data analysis. Coverages of the first, second, and third doses of the vaccine against COVID-19 and the HDI were evaluated. The magnitude of the correlations was assessed using Spearman's rank correlation coefficients with their corresponding bootstrapped 95% confidence intervals (95% CI). Scatter plots were also constructed. Results: A total of 196 provinces were included. There was a moderate correlation between the first dose of the COVID-19 vaccine and the HDI (r = 0.3807 [95% CI 0.2585–0.5030], p