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Background: The objective of warehouse processes is to satisfy customer’s desires and requirements whilst using house, equipment and labour effectively. However, in Nigeria studies have revealed operational problems in warehousing and a lack of customer satisfaction in the delivery of construction materials. Objectives: The aim of this study was to evaluate the level of customer satisfaction with the delivery of construction material from the manufacturers’ warehouses to customers or other terminals, with a view to improving the operations. Method: This article adopted a case study research design method in which quantitative data were collected and analysed. The target population was the North-Central geo-political zone of Nigeria. A total of 32 construction material manufacturers were purposively selected from the zone. The observation and measurement approaches were adopted for data collection. A total of 72 customers’ orders were observed and recorded to be representative of deliveries from the sampled (n = 32) manufacturers’ warehouses to other terminals. A customer quintile benchmark metric was also adopted for analysis and for comparing field results with best practices. Results: The findings revealed that the involved construction material manufacturers’ warehouse processes, were suboptimal and ineffective in terms of perfect order completion and total order cycle time. These results indicated major opportunities for improvement. Conclusion: This article concludes with providing construction material manufacturers with information about their warehouse processes that might help to ensure that the construction material arrives at its final destination in optimal quality, time and cost.

INTRODUCTION: Les maladies nosocomiales demeurent un problème majeur de santé publique en Afrique subsaharienne notamment au Burkina Faso. Cette étude avait pour but de déterminer la biodiversité de la flore fongique identifiée au service de réanimation du Centre Hospitalier Universitaire Souro Sanou (CHUSS) de Bobo-Dioulasso. METHODES: l'étude transversale descriptive s'est déroulée d'août 2016 à janvier 2017. La flore fongique a été recherchée dans l'air ambiant et les espaces de réanimation. Les prélèvements ont été ensemencés et incubés pendant 3 à 4 jours à 37°C à l'étuve. L'identification des colonies fongiques était macroscopique et microscopique pour les champignons filamenteux. Le test de blastèse, les milieux chromogéniques et le test d'agglutination au latex ont servi à l'identification d'espèces de Candida. RESULTATS: sur les 200 prélèvements collectés au total, 176 ont poussé sur la gélose Sabouraud-Chloramphénicol. La prévalence globale de la flore fongique était de 88% (176/200). Les moisissures étaient les agents fongiques majoritairement retrouvés (66,9%). Parmi les huit genres de moisissures identifiés, Aspergillus était le genre le plus représenté (48,9%) tandis qu'Aspergillus fumigatus était l'espèce la plus fréquemment rencontrée (32,9%). CONCLUSION: la décontamination régulière des niches fongiques devraient être systématiques dans le service de réanimation du CHUSS de Bobo-Dioulasso.

Objective: Our aim is to perform an analysis, using big data, of cases diagnosed with primary hypothyroidism and aged 18 and over who presented to our hospital, by evaluating the laboratory and socio-demographic data of the patients. Clustering analysis was performed in the big dataset for the purpose of structure-search study on the subject. Methods: According to ICD-10 diagnoses of hypothyroidism between 2005-2018 in our hospital 130159 patients aged 18 and over with E03 and E06 diagnosis codes were included in the study. Since drugs containing levothyroxine used in primary hypothyroidism treatment have an effect on the measured hormone levels, in our study, TSH, fT3 and fT4 laboratory values in the first diagnosis of cases who had not received any treatment as part of the diagnosis according to demographics were analysed. Patients with one or more missing laboratory values were excluded, and data of 2680 patients with complete data and TSH values above 4.94 mU/L were retained. Analysis was made with the k-means clustering technique, with the data separated into two sets. k-means clustering was performed by including age, TSH, fT3 and fT4 variables. Cliff’s Delta effect size coefficients and confidence intervals were calculated to perform size of the difference. Results: The higher prevalence of primary hypothyroidism in female and the peak in hypothyroidism at 4-5 decades in both genders were observed. In which ages were low, fT3 and fT4 values were higher, whereas TSH values were lower in male. In which ages were low, TSH values were higher, whereas fT4 values were lower in female. Conclusion: This study is the first big data analysis study carried out about primary hypothyroidism in our country. Despite the difficulties in implementation, it should not be forgotten that studies like these are important methods for enabling data to be created in our country.

Background: Most refugees are less than 18 years and at heightened risk of common mental disorders (CMDs) relative to other youth. Limited evidence exists for psychosocial programsfor youth in low-resource settings. Early Adolescent Skills for Emotions (EASE) was developed by the World Health Organization to address this gap. Objectives: This study tested the safety, feasibility, and trial procedures of the EASE intervention among Syrian refugee youth in preparation for a definitive randomized controlled trial (RCT). Methods: A feasibility RCT was conducted in Amman, Jordan with Syrian children aged 10–14 years who reported psychological distress. Following community screening, youth and their caregivers were randomized to receive either the EASE intervention or enhanced treatment as usual (ETAU). EASE comprised seven group sessions teaching children coping skills, and caregivers received three group sessions to augment the youth sessions. Assessments were conducted at baseline and 1 week following the last EASE session (8 weeks following baseline). Following the trial, a qualitative process evaluation with staff and beneficiaries took place. Primary outcomes were safety and feasibility indicators, and distress was measured by the Paediatric Symptom Checklist. Results: In November 2018, 179 children were screened; 61 (33%) met criteria for distress (34.1%), two were excluded for suicidal risk, and 59 were randomized (EASE = 33, ETAU = 26). Of those who received EASE, 26 children (79%) completed the intervention. Group attendance was high and no adverse events were reported in either arm. Psychological distress did not show signs of abating in either group over time. Conclusion: This feasibility trial demonstrated the safety and acceptability of the intervention. Important lessons were learnt regarding entry criteria into the study and engagement of caregivers in the intervention. A fully powered randomized controlled trial will be conducted to evaluate the efficacy of EASE.

Summary: Efficient electrocatalyst toward hydrogen evolution/oxidation reactions (HER/HOR) and oxygen reduction reaction (ORR) is desirable for water splitting, fuel cells, etc. Herein, we report an advanced platinum phosphide (PtP2) material with only 3.5 wt % Pt loading embedded in phosphorus and nitrogen dual-doped carbon (PNC) layer (PtP2@PNC). The obtained catalyst exhibits robust HER, HOR, and ORR performance. For the HER, a much low overpotential of 8 mV is required to achieve the current density of 10 mA cm−2 compared with Pt/C (22 mV). For the HOR, its mass activity (MA) at an overpotential of 40 mV is 2.3-fold over that of the Pt/C catalyst. Interestingly, PtP2@PNC also shows exceptional ORR MA which is 2.6 times higher than that of Pt/C and has robust stability in alkaline solutions. Undoubtedly, this work reveals that PtP2@PNC can be employed as nanocatalysts with an impressive catalytic activity and stability for broad applications in electrocatalysis.

Green building raw materials have become attractive alternatives for mitigating sustainability issues. Agricultural waste has been used as natural components in the production of alternative building products, and the use of burned clay bricks is a new waste disposal method. The main objective of the paper is to investigate the effects of agricultural waste (rice straw, sugarcane bagasse and wheat straw ashes) in clay bricks. This paper discusses the physical–mechanical properties and the micro-structure of clay bricks when incorporated with the sludge of water treatment plants (SWTP) to replace clay at a 50 % ratio. One mixture was prepared as a control mix without agriculture waste. Each group containing three mixes was used with 5 %, 10 % and 15 % by weight of SWTP content. The green bricks was air dried in sunlight for another 7 days and burnt at 900 °C, keeping them at the highest temperature for 3 h. Mechanical and physical properties of these bricks have been investigated. It was observed that clay bricks containing rice straw ash (RSA), sugar cane bagasse ash (SBA) and wheat straw ash (WSA) had lower compressive strength compared to non-RSA, SBA, and WSA clay bricks. The replacement 5–10 % of RSA, SBA and WSA by weight of SWTP into brick molding compound produces eco-friendly fired clay brick. Scanning electron microscopy (SEM) study confirms the porous microstructure of the brick specimens combining RSA, SBA and WSA resulting in lower bulk density resulting in lighter and more economical structures. Based on this analysis, it can be established that brick samples with lower doses of RSA, SBA and WSA (i.e. 5 % SWTP weight) will not only reduce the environmental pressure but will also lead to more efficient and economical development.

This study investigated the mechanical properties and elevated temperatures of lightweight concrete (LWC) incorporating polypropylene fibre (PPF) and glass fibre (GF). The experimental research used five types of concrete mixtures, which were produced to indicate the effects of PPF and GF. Fibres were added in two ratios (i.e. 0.2 % and 0.4 %) by volume of concrete. A lightweight pumice aggregate was used as a coarse aggregate with a ratio of 65 %. The fresh and hardened LWC properties, such as slump, unit weight, compressive, tensile and flexural strengths, of LWC were analysed. Compressive, flexural strengths and microstructural analysis were investigated under elevated temperatures at ambient temperature, 200 °C, 400 °C and 600 °C for 2 h of exposure time. Flexural and tensile strengths increased by 53 % and 38 % for mixtures containing 0.4 % GF, respectively. Compressive and flexural strengths of the LWC exposed to elevated temperature were improved by adding GF. PPF increased the number of pores of the concrete structure, and elevated temperature resulted in numerous cracks owing to the evaporation of numerous fibres and the replacement of air voids. Consequently, a considerable reduction in compressive and flexural strengths was observed.

Background: Corynebacterium striatum is a Gram-positive bacillus. It is one of the normal commensal flora of the skin and mucous membranes. It is generally considered to be a contaminant when grown in blood culture, however, it is increasingly recognized as a cause of infection in patients with prosthetic devices. Case report: We report a case of a 79-year old female with a prosthetic metallic mitral valve, who presented to our hospital with a four-day history of fever and chills. She was diagnosed with Corynebacterium striatum prosthetic valve endocarditis, in view of positive blood cultures for the microorganism, grown on two occasions, and the presence of a vegetation at the base of the prosthetic mitral valve on transesophageal echocardiography. The patient was treated with a four weeks course of intravenous benzylpenicillin with good outcomes. Conclusion: Corynebacterium striatum is an uncommon cause of prosthetic valve endocarditis. It should not be considered a contaminant, particularly when grown in a blood culture in immunocompromised patients or patients with prosthetic devices. More data is required to determine the optimal duration and treatment regimen for Corynebacterium striatum endocarditis.

Extensive research exists on female entrepreneurship in developed countries such as North America and Europe; however, there is limited research on women entrepreneurs in African nations, specifically in Sudan. This descriptive phenomenological research was designed to explore, discover, and describe the perceptions and lived experiences of successful Sudanese female entrepreneurs concerning overcoming the challenges and obstacles faced in the beginning and managing new businesses in the region of Khartoum, capital of Sudan. This article uses the salient theories and concepts of entrepreneurship value creation theory, social role theory, challenges, and barriers facing women entrepreneurs. All these theories and concepts have been instrumental in understanding the lived experiences of challenges and barriers facing women entrepreneurs in Khartoum, Sudan. Data gathered from 19 female entrepreneurs purposively selected across Khartoum, Sudan, revealed that women struggle (a) having to secure funds; (b) society’s perception of suitable work for women; (c) access to networking; and (d) inadequate support from the government. The research also revealed that factors that influence factors to be successful are women’s family support and motivation; adjusting to social expectations. In addition to the strategies used to manage a successful business, there is a need for training and development skills and being persistent and believing in oneself. The research results showed that women experience mixed feelings during establishing and operating the business. The experience of women with the barriers and challenges includes fear, frustration, stress, and anger when they begin to manage the business. However, women also experienced positive feelings include risk-taking, courage, passion for learning, empowerment, fearlessness, ambition, determination, persistence, and believing in oneself. The women in this research were creative and initiative and managed to begin and operate a successful business.

In September 2019, the Democratic Republic of the Congo implemented a new policy abolishing tuition fees in primary education. A few months later, schools closed for 4.5 months due to the COVID-19 pandemic. How did the lockdown affect the implementation of the free education policy? Did it reduce or enhance its effects? This article examines the experience of schools and teachers in two districts in South Kivu affected by armed conflict. Based on a survey of 752 teachers and 637 parents, as well as 157 qualitative interviews in 55 schools, we show that, supported by the free education policy, enrollment remained stable, and the relations between teachers and parents did not seem to deteriorate despite a near complete lack of teaching activity during the period of school closure. However, the hardships associated with the pandemic have made the financial circumstances of teachers on precarious contracts previously paid via tuition fees even more unsustainable. Their quitting the profession in increasing numbers threatens the stability of the school system. Thus, introducing free primary education is not a panacea in the context of a crisis. The sustainability of such reform requires an ambitious and comprehensive overhaul of human resources.

BACKGROUND: Strategic management of the wastage produced due to earthquakes has faced many challenges over the recent decade. Thus, the present study seeks to identify and explain the challenges in earthquake wastage strategic management. MATERIALS AND METHODS: The present qualitative study has been steered through a content analysis approach and conducted using semi-structured interviews and a purposive selection of 17 professors, experts, and managers experienced in the field of waste management in Kermanshah and Varzaghan-Ahar earthquakes over 2020-2021. Besides, the interviews were initially categorized using MAXQDA18 software. RESULTS: Analysis of the experiences and perception regarding the changes in strategic management of wastage produced due to Kermanshah and Varzaghan-Ahar earthquakes revealed 418 codes, 97 subcategories, 33 categories, and 8 main categories including management and leadership, organizational culture, planning, organizational learning, employee management, rules and regulations, resource management, and procedure management. CONCLUSION: Strategic waste management has not been implemented in a coherent, integrated, and well-planned manner in the cases of the Kermanshah and Varzaghan-Ahar earthquakes. The challenges of strategic waste management turned out to be due to various reasons which will result in many issues in achieving the goals and selecting the suitable method for resource and procedure management should they not be managed well. Hence, policymakers, managers, and executors in the field of crisis management and waste management in disasters -specifically earthquakes- must take the necessary measures to remove these barriers.

En septembre 2019, la République démocratique du Congo a mis en place une nouvelle politique abolissant les frais de scolarité dans l'enseignement primaire. Quelques mois plus tard, les écoles fermaient pour 4.5 mois suite à la pandémie de Covid-19. Comment le confinement a-t-il affecté la mise en place de la politique de gratuité ? A-t-il atténué ou exacerbé ses effets ? Cet article étudie l'expérience des écoles et des enseignants dans deux territoires du Sud-Kivu affectés par les conflits armés. Sur base d'une enquête auprès de 752 enseignants et 637 parents d'élèves et sur 157 entretiens qualitatifs dans 55 écoles, nous montrons que, dopés par la gratuité, l'effectif scolaire reste stable et les relations enseignants-parents ne semblent pas se dégrader –et ce malgré une absence presque totale d'enseignement pendant la période de fermeture. Cependant, les privations liées à la pandémie rendent (encore plus) intenable la position des enseignants sous contrats précaires dont les salaires étaient antérieurement payés grâce aux frais de scolarité. Ceux-ci quittent la profession en nombre, menaçant la stabilité du système éducatif. Ainsi, l'introduction de la gratuité n'est pas une panacée en contexte de crise ; la durabilité d'une telle réforme nécessite une ambitieuse et inclusive refonte des ressources humaines.

The aim of the present study was to investigate the physicochemical and microbiological profile of indigenous sheep’s milk with the potential for the production of artisanal cheese. The data showed the changes in lactation stages (between April and August) up to 2 hours following manual milk production. The quality of raw milk in the production of brined cheese using traditional technology was assessed. The amount of dry matter was21.36% in April and 19.85% in August at the end of lactation. The fat content from April to August was between 8.62% and 8.03%, preserving the values reported. The protein composition of raw milk varied between 5.52 – 6.61%. In the microbiological evaluation of raw sheep’s milk after milking (35.3°C), the total microbial contamination was in the range of 1.3 x 106 to 1.4 x 106 CFU/mL under current conditions. The results obtained in this paper give rise to more in-depth studies on the application of raw sheep’s milk in the production of traditional artisanal cheeses.

The research deals with the text of Article (79) of the Jordanian Insolvency Law No. (21) of 2018 in force, which relates to the subject of the regular reorganization plan to rescue faltering economic projects. The text is based and its scope revolves around the legal means and procedures that faltering economic projects can resort to when declaring their insolvency. By submitting a reorganization plan to the competent court to arrange its economic conditions and continue the activity instead of judicial liquidation and the consequent liquidation of the project. This ensures that workers are kept in their business and creditors' interest is achieved by repaying their debts and the continuation of cash flows, and other effects that reflect positively on the investment environment and achieve economic and social development. We have pointed out the weakness of the legal mechanisms to rescue faltering economic projects in the Jordanian insolvency law as a result of the absence of an expert insolvency committee in the courts with the task of examining the project and the extent to which it is necessary to undergo restructuring, and the failure to provide for a role for the insolvency judge. The law also lacks simplified procedures for small and medium economic enterprises.

Premature births continue to rise globally with a corresponding increase in various morbidities among this population. Rates of respiratory distress syndrome and the consequent development of Bronchopulmonary Dysplasia (BPD) are highest among the extremely preterm infants. The majority of extremely low birth weight premature neonates need some form of respiratory support during their early days of life. Invasive modes of respiratory assistance have been popular amongst care providers for many years. However, the practice of prolonged invasive mechanical ventilation is associated with an increased likelihood of developing BPD along with other comorbidities. Due to the improved understanding of the pathophysiology of BPD, and technological advances, non-invasive respiratory support is gaining popularity; whether as an initial mode of support, or for post-extubation of extremely preterm infants with respiratory insufficiency. Due to availability of a wide range of modalities, wide variations in practice exist among care providers. This review article aims to address the physical and biological basis for providing non-invasive respiratory support, the current clinical evidence, and the most recent developments in this field of Neonatology.

In contemporary days, the research and development enterprises have been focusing to design intelligently the battery swap station (BSS) architecture having the prospects of providing a consistent platform for the successful installation of the large-scale fleet of hybrid and electric vehicles (i.e. xEVs). The BSS may calibrate its subsystem for the electric vehicle (EV) deployment by accomplishing similar idea as in existing gasoline refuelling stations, in which the discharged batteries are being replaced or swapped by partially or fully charged ones by spending a few minutes. The BSS approach has arisen as a promising technology to the traditional EV recharging station approach as it provides a broader experience of business prospects for the specific stakeholders. This work deals with the introduction to BSS including infrastructure, techniques, benefits over charging station and key challenges associated with BSS. Furthermore, an S34X-smart swapping station for xEVs is proposed and finally, the key thrust is research for BSS is discussed. To the authors’ knowledge, this is the first kind of review work on BSS.

INTRODUCTION: Au Burkina Faso, le seul foyer de leishmaniose cutanée (LC) avec confirmation biologique dans la littérature à notre connaissance est celui de Ouagadougou au centre. Nous rapportons les résultats épidémiologiques, cliniques et biologiques de l´investigation d´un nouveau foyer épidémique à Larama, à l´ouest du Burkina. METHODES: la méthode du camp a été utilisée pour recevoir les cas. Les données sociodémographiques et cliniques ont été recueillies à l´aide d´un questionnaire. La confirmation a été faite par la microscopie puis par réaction en chaîne par polymérase (PCR). RESULTATS: au total, 108 cas suspects ont été recensés à Larama, soit un taux d´attaque de 5,8%. Le sex ratio était de 1,08. Les patients concernés étaient le plus souvent des cultivateurs (35,2%) et des commerçants (33,3%). La population active (15 à 49 ans) représentait 51,9%. Le nombre de lésion variait entre 1 et 5 dans 91,7% des cas. Les lésions qui se présentaient sous formes ulcéro-crouteuses surélevées et infiltrées, étaient localisées sur les membres (87%) avec une durée d´évolution entre un et cinq mois dans 96,3% des cas. Sur les deux cas prélevés, la microscopie a montré des leishmanies et la PCR a confirmé l´espèce Leishmania major. CONCLUSION: nos résultats confirment l´existence d´une épidémie de leishmaniose cutanée à L. major dans l´ouest du pays. Des enquêtes complémentaires sont nécessaires pour préciser la charge de morbidité des leishmanioses au Burkina Faso.

BackgroundTrust in healthcare providers has been shown to improve several clinical and patient-reported outcomes. However, its relationship with depression and anxiety has not been investigated among patients with chronic health conditions, such as diabetes. Therefore, the aim of this study was to examine whether trust in primary care physicians among patients with diabetes is associated with their levels of depression and/or anxiety.MethodAdult patients (≥18 years) with a diagnosis of diabetes, confirmed through their electronic health records, were recruited and interviewed from the primary care clinics of three public hospitals. Patient trust in primary care physicians was assessed using the Health Care Relationship (HCR) Trust scale. Depression and anxiety were assessed using the Patient Health Questionnaire 9-item (PHQ-9) and Generalized Anxiety Disorder 7-item (GAD-7), respectively. Two multiple linear regression analyses were conducted to examine the association of HCR-Trust scores with PHQ-9 and GAD-7 scores controlling for age, sex, Charlson comorbidity index score, education, health literacy, annual income, nationality, duration of illness, and research site.ResultsThe number of patients who agreed to be interviewed was 367. Most of the participants were female (61.54%) and Saudi (92.86%). High HCR-Trust scores were negatively associated with PHQ-9 scores (β = -0.18; 95% CI: -0.23 --0.13; P = < .0001), and GAD-7 scores (β = -0.17; 95% CI: -0.22- -0.12; P = < .0001).ConclusionsTrust in primary care physicians among patients with diabetes was associated with lower levels of depression and anxiety. Therefore, healthcare providers should adopt a patient-centered care approach that fosters trust in the relationship between their patients and themselves. Further research should explore whether interventions that foster shared decision-making and trust in healthcare providers might also improve the health outcomes of patients with diabetes.

In this paper, green and facile synthesis of sulfur- and nitrogen-codoped carbon nanospheres (CNs) was prepared from the extract of Hibiscus sabdariffa L by a direct hydrothermal method. Finally, sulfur-carbon nanospheres (CNs) were used as the adsorbent to remove Pb+2 ions from aqueous solutions because of the high surface area of S-CNs from CNs and N-CNs. The synthesized nanospheres were examined by Fourier transform infrared (FTIR) spectroscopy, X-ray diffraction (XRD), field emission scanning electron microscopy, transmission electron microscopy (TEM), and nitrogen adsorption-desorption isotherms. The results show spherical shapes have a particle size of up to 65 nm with a high surface area capable of absorbing lead ions efficiently. Additionally, the factors affecting the process of adsorption that include equilibrium time, temperature, pH solution, ionic intensity, and adsorbent dose were studied. The equilibrium removal efficiency was studied employing Langmuir, Freundlich, and Temkin isotherm forms. The kinetic data were analyzed with two different kinetic models, and both apply to the adsorption process depending on the values of correlation coefficients. The thermodynamic parameters including Gibbs free energy (ΔG°), standard enthalpy change (ΔH°), and standard entropy change (ΔS°) were calculated for the adsorption process.

In this research, a prototype downdraft throatless gasifier was designed with a mechanical stirrer. The gasifier was designed for gasification of rice straw pellets. The diameter of the reactor was 350 mm and a nominal value for the heat power of biomass input was 70 kW. Rice straws which were collected from Thrace Region of Turkey gasified for determination of the designed gasifier performance in Namik Kemal University Biosystem Engineering Laboratories. The effects of airflow path and stirring process on the gasification efficiency during the gasification process were investigated. Temperatures and airflow rates observed and adjusted by controlling the air flow rate in the automation system constantly. Pellets were gasified using two different airflow paths with the same equivalence ratio of 0.2 and these were compared. Air inlet from the top showed better results than air inlet from tuyeres. For the air inlet from the top, the higher heating value of producer gas was determined as 5.047 MJ Nm-3 and cold gas efficiency was calculated as 65.4%. H2/CO ratio was found as 1.385 which was higher than the air inlet from tuyeres.

Abstract Background Disordered sleep breathing is a common complication of diabetic peripheral neuropathy (DPN) manifested by excessive daytime sleepiness, morning headache, morning dizziness, cognitive decline, and mood changes. Methods This study was performed on 30 non-obese type 2 diabetic patients; 20 with clinically evident DPN and 10 without. Ten age-, sex-, and body mass index-matched healthy control subjects were also included. Patients and control were subjected to history taking, neurological examination, glycated hemoglobin, and clinical assessment of the sensori-motor manifestations by the neuropathy symptom score and neuropathy disability score. The autonomic nervous system was evaluated clinically by the systolic blood pressure response to standing and heart rate response to each of standing, Valsalva, and deep breath. Finally, sleep was assessed by one-night polysomnogram (PSG) followed by multiple sleep latency test in the next day. Results The study showed significant increase in sleep apnea syndromes in diabetic peripheral neuropathy patients compared to diabetic neuropathy free patients and healthy control (p

Abstract Background Chromosomal microarray analysis is a first-stage test that is used for the diagnosis of intellectual disability and global developmental delay. Chromosomal microarray analysis can detect well-known microdeletion syndromes. It also contributes to the identification of genes that are responsible for the phenotypes in the new copy number variations. Results Chromosomal microarray analysis was conducted on 124 patients with intellectual disability and global developmental delay. Multiplex ligation-dependent probe amplification was used for the confirmation of chromosome 22q11.2 deletion/duplication. 26 pathogenic and likely pathogenic copy number variations were detected in 23 patients (18.55%) in a group of 124 Turkish patients with intellectual disability and global developmental delay. Chromosomal microarray analysis revealed pathogenic de novo Copy number variations, such as a novel 2.9-Mb de novo deletion at 18q22 region with intellectual disability and autism spectrum disorder, and a 22q11.2 region homozygote duplication with new clinical features. Conclusion Our data expand the spectrum of 22q11.2 region mutations, reveal new loci responsible from autism spectrum disorder and provide new insights into the genotype–phenotype correlations of intellectual disability and global developmental delay.

It is expected that the demand for Metal Matrix Composite (MMCs) will increase in these applications in the aerospace and automotive industries sectors, strengthened AMC has different advantages over monolithic aluminium alloy as it has characteristics between matrix metal and reinforcement particles. However, adequate joining technique, which is important for structural materials, has not been established for (MMCs) yet. Conventional fusion welding is difficult because of the irregular redistribution or reinforcement particles. Also, the reaction between reinforcement particles and aluminium matrix as weld defects such as porosity in the fusion zone make fusion welding more difficult. The aim of this work was to show friction stir welding (FSW) feasibility for entering Al 6061/5 to Al 6061/18 wt. % SiCp composites has been produced by using stir casting technique. SiCp is added as reinforcement in to Aluminium alloy (Al 6061) for preparing metal matrix composite. This method is less expensive and very effective. Different rotational speeds,1000 and 1800 rpm and traverse speed 10 mm \ min was examined. Specimen composite plates having thick 10 mm were FS welded successfully. A high-speed steel (HSS) cylindrical instrument with conical pin form was used for FSW. The outcome revealed that the ultimate tensile strength of the welded joint (Al 6061/18 wt. %) was 195 MPa at rotation speed 1800 rpm, the outcome revealed that the ultimate tensile strength of the welded joint (Al 6061/18 wt.%) was 165 MPa at rotation speed 1000 rpm, that was very near to the composite matrix as-cast strength. The research of microstructure showed the reason for increased joint strength and microhardness. The microstructural study showed the reason (4 %) for higher joint strength and microhardness. due to Significant of SiCp close to the boundary of the dynamically recrystallized and thermo mechanically affected zone (TMAZ) was observed through rotation speed 1800 rpm. The friction stir welded ultimate tensile strength Decreases as the volume fraction increases of SiCp (18 wt.%).

Abstract Background Nocturnal enuresis (NE) is a very common chronic pediatric problem with bad psychological consequences. Methods Forty primary monosymptomatic nocturnal enuresis (MNE) children and 20 healthy controls were recruited in the study and subjected to history taking, neurological and urological examinations, and psychological assessment using the Arabic-translated and validated version of child behavior checklist, sleep architecture studying through one-night polysomnography (PSG), and vasopressin levels determination both diurnal and nocturnal. Results Enuretic children had positive family history of NE in 42.5%, inverted vasopressin circadian rhythm in 52.5% and PSG changes in the form of increased N3 deep sleep % of total sleep time (TST), sleep stage transition index (SSTI), periodic limb movement index (PLMI), and snore index. Enuretic children PSG showed decreased deep sleep latency, N1% of TST, N2% of TST, and REM % of TST. The child behavior checklist showed higher anxious depressed symptoms, social problem, attention problems, and internalizing problems in enuretic children than control subjects. Conclusions MNE is a heterogeneous disorder with multiple factors interplay in its pathogenesis. So, the management must be tailored patient by patient according to the dominating etiology.

The process of improvement software quality began from early stages of software engineering development. It uses multiple quality metrics which are very important in software development. To calculate the standards quality of in software testing has been adopted. The software testing is focusing on the Software defect. In this paper is proposed new methods which combine the particle swarm optimization (PSO) to handle the best features Extraction with back-propagation networks to testing and evaluation of the data set . The paper depended database for NASA standards data. The result and experiment method improved quality performance for all classification methods used in the research"Combining Particle Swarm Optimization based Feature Selection and Bagging for Software Defect Prediction ".

ABSTRACT This study was designed to evaluate the effects of adding kefir on body measurements, giblet weight, and gut morphological patterns of geese through drinking water. A total of 54 birds were divided into three groups, each comprising 18 birds, and each group was further divided into three subgroups containing six birds each. One group served as the control group, while the other two groups were given kefir-treated drinking water at the ratios of 2.5 and 7.5%, respectively. No significant effects of kefir supplementation on body measurements, spleen weight, bursa weight, and gut morphology were observed. It is concluded that kefir may be used in poultry feed with an inclusion rate of 7.5% without imposing any adverse effect on the measurements of body structures, weights of visceral organs, and gut morphology.

This article presents a dataset for studying the detection of obfuscated malware in volatile computer memory. Several obfuscated reverse remote shells were generated using Metasploit-Framework, Hyperion, and PEScrambler tools. After compromising the host, Memory snapshots of a Windows 10 virtual machine were acquired using the open-source Rekall's WinPmem acquisition tool. The dataset is complemented by memory snapshots of uncompromised virtual machines. The data includes a reference for all running processes as well as a mapping for the designated malware running inside the memory. The datasets are available in the article, for advancing research towards the detection of obfuscated malware from volatile computer memory during a forensic analysis. Keywords: Memory snapshots, Forensic analysis, System security, Malware detection, Obfuscated malware

The current study was done to evaluate the effect of adding Jerusalem artichoke powder on growth of lactic acid bacteria (Lactobacillus. acidophlic and Lactobacillus. plant arum) as probiotic in single-strength carrot juice during fermentation at 37°cfor 48 hour. The obtained results showed that there increasing in titrable acidity (as lactic acid) and there is also increasing in number of probiotic bacteria and decreasing in pH value and content of total soluble sugars (non-reducing and reducing sugars) of packaged carrot juice. Treated with probiotic bacteria or sample treated with probiotic bacteria and probiotic as Jerusalem artichoke powder effect fermentation at 37°C for 48 hours. The number of probiotic and prebiotic is higher than their number in sample treated with only probiotic bacteria after incubation at 37°C for 48 hours. From the results, the study ends with the results that the normal carrot juice is suitable media and Jerusalem artichoke is suitable as probiotic for L. acidophilus and L. plant arum growth

This study investigated the relation educational justice and academic burnout in students. Research method is of an Explanatory mixed. The study population included of Mazandaran University in the academic. Using cluster and categorical random sampling Based on the Cochran formula of of 383 patients (241 females and 142 males) were selected as the statistical sample. Research tools consisted of Questionnaires educational justice Golparvar (2010) and academic burnout Berso’s (1997). Both of which questionnaires are valid and reliable. In the qualitative section data from 35 people to purposefully through semi-structured interviews were collected. For analyzing the data, descriptive statistics and inferential statistical tests (Pearson correlation coefficient, t-test, ANOVA and regression) is used. The results showed a positive and significant relationship between educational justice and is academic burnout. Between male and female students perceived Educational Justice and academic burnout level was no significant difference. No difference was observed between the faculties based on academic burnout, but in terms of educational justice the Faculty of Humanities and Social Sciences, art and architecture and Technology & Engineering there is a significant difference. The results showed that improving educational justice reduce academic burnout in component is academic apathy.

Abstract Malaria at international borders presents particular challenges with regards to elimination. International borders share common malaria ecologies, yet neighboring countries are often at different stages of the control-to-elimination pathway. Herein, we present a case study on malaria, and its control, at the border between Saudi Arabia and Yemen. Malaria program activity reports, case data, and ancillary information have been assembled from national health information systems, archives, and other related sources. Information was analyzed as a semi-quantitative time series, between 2000 and 2017, to provide a plausibility framework to understand the possible contributions of factors related to control activities, conflict, economic development, migration, and climate. The malaria recession in the Yemeni border regions of Saudi Arabia is a likely consequence of multiple, coincidental factors, including scaled elimination activities, cross-border vector control, periods of low rainfall, and economic development. The temporal alignment of many of these factors suggests that economic development may have changed the receptivity to the extent that it mitigated against surges in vulnerability posed by imported malaria from its endemic neighbor Yemen. In many border areas of the world, malaria is likely to be sustained through a complex congruence of factors, including poverty, conflict, and migration.

AbstractThis study aims at determining eighth graders’ views and thoughts of physical education courses in primary education schools through metaphors. The study group was composed of 58 students attending Altınşehir Primary Education school located in Adıyaman in the 2014-2015 academic year.The data were collected by asking each student to complete the sentence “physical education course is like……. because ……….”. In consequence, 24 metaphors created by 58 students were divided into four different categories – namely, (i) social development, (ii) physical development, (iii) psychological development, and (iv) mental development. The majority of the students (98.28%) were found to have created positive metaphors for the course while only 1.72% of them were found to have created negative metaphors.

Abstract Background The sensori-motor manifestations of Guillain Barré Syndrome (GBS) are usually severe enough to mask the psychiatric and sleep problems which are in need for more attention for better functional outcome. Methods This study was performed on 20 GBS patients and 10 healthy controls. Patients were evaluated initially before immunotherapy using the Overall Disability Sum Score (ODSS), Neuropathy Pain Scale (NPS), Hamilton Anxiety Scale (HAS), Montgomery–Åsberg Depression Rating Scale (MADRS) and one-night polysomnography (PSG) followed by the multiple sleep latency test (MSLT) to evaluate the mean sleep latencies. Reevaluation was done using the same parameters 1 month after completing immunotherapy. Results The study showed significant increase in HAS in GBS patients which were positively correlated with the degree of motor disability. The mean sleep latencies of MSLT were significantly shortened and PSG showed shortening of the total sleep time, sleep efficiency, lowest O2 saturation and pulse transit time with increased wake after sleep onset, sleep stage transition index, apnea hypopnea index, desaturation index, arousal index, snore index and periodic limb movement index. One month after immunotherapy, the anxiety symptoms and sleep abnormalities showed non-significant improvements which were not correlated with the improvements in the sensori-motor manifestations. Conclusions GBS patients usually have sleep and psychiatric abnormalities which may take longer time to improve than the sensori-motor manifestations. So, they need more attention in the management protocol for early patients’ independence and return to usual daily activities.

The innovation system emphasizes on importance of adapting university to environment and the need to reengineer the organizational structure, roles, and functions of higher education. However, this study aimed to provide a comprehensive and operational model for development of entrepreneurial university at state universities in Iran. This was a qualitative study which used Grounded Theory. The statistical population consisted of policy makers and professors in higher education and entrepreneurship, managers of entrepreneurship growth centers and science and technology parks, industry department authorities, and PhD candidates. Using purposeful sampling method, 20 people were selected as key informants. The data were collected through a generalized and semi-structured interview. Two methods including reviewing the participants and reviewing non-participating experts in research were used to obtain valide and reliable data. The data were analyzed by open, axial, and selective coding. At initial stage, 462 conceptual propositions were obtained; in second stage, they were classified in 126 categories. At axial coding stage, 22 key items were counted. The major categories and key categories in the form of causal conditions (commitment and tendency of management and leadership to entrepreneurship, internationalization), contextual (flexibility of laws and regulations, financial support, and entrepreneurial investment), intervener (university and industry commitment, and over-­organizational support), strategies (curriculum with entrepreneurship approach, formal and informal education for entrepreneurship, and coordination of entrepreneurship corridors), and outcomes (quality improvement, social and economic development, and student satisfaction) were promoted to a higher abstract level and a research paradigmatic model was provided.

Objective: The apnea-hypopnea index (AHI) does not provide information about the apnea depth and length. We aimed to evaluate the correlation of the oxygen desaturation index (ODI) with AHI and the subjective symptoms because it is known that hypoxia plays an important role in morbidity and complications of obstructive sleep apnea syndrome (OSAS).Methods: We reviewed the data of patients who applied to our clinic between 2010 and 2014 and underwent polysomnography (PSG) with a diagnosis of suspected sleep apnea. The demographic and anthropometric data of the patients were recorded. Epworth sleepiness scale (ESS) and values of AHI and ODI were analyzed in PSG.Results: A total of 321 patients were divided into four groups, according to AHI as follows: 82 (25.5%) common snoring, 77 (24%) mild obstructive sleep apnea (OSA), 71 (22.1%) moderate OSA, and 91 (28.3%) severe OSA. A strong correlation was detected between AHI and ODI (p

Arriving at brotherly and unifying point in Muslim World demands special attention to mechanisms of approximation for consolidating unity and integration of the Islamic nations. Regretfully, conflict of ideas among religions have opened way to public arena from specialized areas given the grounds paved by joint adversaries. Return to ideas of Imam Khomeini (ra) would solve the problem when such necessities appear on the ground. This article intends to study practical guidelines of Imam Khomeini (ra) and introduce their epistemological enterprises in this regard. Recognition of origin of those in disunity, necessity for transition from populism, realization of joint adversary, considering goals of enemies, recognition of attitude of the Saint Imams (a’) towards Sunnis, Reliance on commonalities of Islamic ummah, transition from motto of unified ummah and attempt for its materialization, brotherhood, recognition of exigencies of time, considering common principles and benefits, necessary awakening, considering interests of people and return to religion are among the issues of study.

Abstract Background Limited real-world data are currently available on hypoglycemia in diabetes patients. The International Operations Hypoglycemia Assessment Tool (IO HAT) study was designed to estimate hypoglycemia in insulin-treated type I (T1DM) and type II (T2DM) diabetes mellitus patients from 9 countries. The data from Turkey cohort are presented here. Methods A non-interventional study to determine the hypoglycemia incidence, retrospectively and prospectively, in Turkish T1DM and T2DM patients using a 2-part self-assessment questionnaire. Results Overall, 2348 patients were enrolled in the Turkey cohort (T1DM = 306 patients, T2DM = 2042 patients). In T1DM patients, 96.8% patients reported hypoglycemic events (Incidence rate [IR]: 68.6 events per patient-year [ppy]), prospectively, while 74.0% patients reported hypoglycemic events (IR: 51.7 events ppy), retrospectively. In T2DM patients, 95.9% patients (IR: 28.3 events ppy) reported hypoglycemic events, prospectively, while 53.6% patients (IR: 23.0 events ppy) reported hypoglycemic events, retrospectively. Nearly all patients reported hypoglycemia during the prospective period. Conclusions This is a first patient-reported dataset on hypoglycemia in Turkish, insulin-treated diabetes patients. A high incidence of patient-reported hypoglycemia confirms that hypoglycemia remains under-estimated. Hypoglycemia increased healthcare utilization impacting patients’ quality of life. Hypoglycemia remains a common side effect with insulin-treatment and strategies to optimize therapy and reduce hypoglycemia occurrence in diabetes patients are required. Trial registration Clinicaltrials.gov, NCT02306681 (Date of registration: 12 Nov 2014; retrospectively registered).

Photonic data routing in optical networks is expected to overcome the limitations of electronic routers with respect to data rate, latency, and energy consumption. However, photonics-based routers suffer from dynamic power consumption, and nonsimultaneous usage of multiple wavelength channels when microrings are deployed and are sizable in footprint. Here, we show a design for the first hybrid photonic-plasmonic, nonblocking, broadband 5 × 5 router based on 3-waveguide silicon photonic-plasmonic 2 × 2 switches. The compactness of the router (footprint 2) results in a short optical propagation delay (0.4 ps) enabling high data capacity up to 2 Tb/s. The router has an average energy consumption ranging from 0.1 to 1.0 fJ/bit depending on either DWDM or CDWM operation, enabled by the low electrical capacitance of the switch. The total average routing insertion loss of 2.5 dB is supported via an optical mode hybridization deployed inside the 2 × 2 switches, which minimizes the coupling losses between the photonic and plasmonic sections of the router. The router's spectral bandwidth resides in the S, C, and L bands and exceeds 100 nm supporting wavelength division multiplexing applications since no resonance feature is required. Taken together this novel optical router combines multiple design features, all required in next-generation high data-throughput optical networks and computing systems.

Sleep is a fundamental and vital physiological function. Getting enough quality sleep is necessary to a person's mental health, physiological well-being, quality of life, and safety. Sleep-disordered breathing, specifically obstructive sleep apnea can result in serious health issues, including hypertension and stroke. The current approaches for diagnosing sleep disorders are burdensome, intrusive, and can affect the patient's sleep quality. As a result, there is a crucial need for less cumbersome systems to diagnose sleep-related problems. In this paper, we evaluated the capacity of the microbend fiber optic sensor to monitor heart rate and respiration in a nonintrusive manner. In addition, we tested the capacity of the sensor in discriminating between shallow breathing and no breathing. The proposed sensor was compared with the three-channel portable monitoring device (ApneaLink) in a clinical setting during a drug-induced sleep endoscopy. Across all ten patients recruited for our study, the system achieved satisfactory results in the mean heart rate and the mean respiratory rate with an error of 0.55 ± 0.59 beats/minute and 0.38 ± 0.32 breaths/minute, respectively. Besides, the Pearson correlation coefficient between the proposed sensor and the reference device was 0.96 and 0.78 for heart rate and respiration, respectively. On the contrary, the proposed sensor provided a very low sensitivity (24.24 ± 12.81%) and a relatively high specificity (85.88 ± 6.01%) for sleep apnea detection. It is expected that this preliminary research will pave the way toward unobtrusive detection of vital signs in real time.

Abstract Embryos have evolved a remarkable capacity to find implantation site. The impressive navigation ability of natural blastocysts may rely on highly sensitive signals arising from embryos and specialized signal processing strategies in the endometrium. Navigation capabilities may be compromised in ICSI embryos because of altered biochemical signaling. The design and delivery of artificial blastocyst (AB) carrying strong chemical signals may allow ICSI embryos to more easily locate to and be retained in the implantation zone. ICSI embryos will attach easily to the implantation zone after it is found by the AB. Co-transfer of the AB together with the ICSI embryo may overcome potential difficulties in implantation due to impaired embryo-maternal communication in cases with implantation failure.

Members of the genus Pulicaria have been used in traditional medicine for alleviating several complaints as they have a rich pool of biometabolites. Acute lung injury (ALI) is a serious disease with an elevated mortality rate. The present investigation aimed to evaluate the total phenolic and flavonoid contents and antioxidant capacity of the methanolic extract of P. petiolaris Jaub. and Spach. (PP) (Asteraceae). Moreover, the potential protective potential of PP against lipopolysaccharide-(LPS)-induced ALI was assessed. PP is a rich source of phenolics and flavonoids. The total phenolic content (TPC) was 68.05 mg gallic acid equivalent (GAE)/g dried extract, and the total flavonoid content (TFC) was 45.86 mg quercetin equivalent (QE)/g dried extract. Additionally, PP possessed a promising DPPH-scavenging activity, with an IC50=27 μg/mL. Our results showed that PP lessened LPS-induced lung injury. PP effectively reduced pulmonary edema as it lowered total protein and the lung wet/dry weight (W/D) ratio in the bronchoalveolar lavage fluid (BALF). It also significantly ameliorated the level of lactate dehydrogenase (LDH) in the BALF and improved the histopathological lesions in the lung tissue. LPS-induced inflammatory cell infiltration was greatly depressed in PP-treated animals. PP showed antioxidant capacity as it reduced the LPS-induced increase in the lipid peroxidation marker, malondialdehyde (MDA). It also increased the activity of superoxide dismutase (SOD) and the content of reduced glutathione (GSH). This study indicates that PP significantly decreased LPS-induced inflammation in the LPS-mediated ALI murine model, suggesting that it may become a significant preventive strategy for treating nonspecific inflammation of the lungs.

Abstract Background Inflammation has been implicated in many disorders, including cancer and available therapies elicit adverse effects. Plants of the family Rubiaceae have shown potency against inflammation. The anti-inflammatory and anti-oxidant potential of Feretia apodanthera was investigated in this study to evaluate its effectiveness. Methods The phytochemical, antioxidant and anti-inflammatory potential of root bark (n-Hexane, diethyl ether, ethanol and aqueous) extracts of Feretia apodanthera was investigated in this study. The extracts were subjected to various chemical tests for phytochemical constituents; their antioxidant activity was determined using in-vitro DPPH radical scavenging activity assay and their anti-inflammatory activity was determined using carrageenan induced paw oedema model. FTIR and GCMS analysis was done to determine the compounds present. Results Phytochemical screening of extracts revealed the presence of unsaturated steroids, triterpenes, cardiac glycosides, tannins, saponin and alkaloids. Vitamin C had a median inhibitory concentration (IC50) of 0.038 mg/ml which was lower than IC50 of all the extracts. Of all the extracts, ethanol extract had the lowest IC50 (0.044 mg/ml) which is comparable to vitamin C. Anti-inflammatory studies showed that the inflammation inhibition potential of 400 mg/kg body weight of all the extracts was significantly lower (p

Background: Hyperprolactinemia is an extremely common disorder, especially among reproductive age women, affecting about one-third of infertile females. There is a paucity of data on the pattern of clinical presentation of hyperprolactinemia among infertile female patients in Nigeria. This study, therefore, aimed to determine the pattern of clinical presentation of hyperprolactinemic infertile female patients in Ahmadu Bello University Teaching Hospital (ABUTH), Zaria, Northern Nigeria. Materials and Methods: Blood sample of 120 infertile female patients aged 15–45 years attending the infertility clinic at ABUTH over 9 months was taken. Data on clinical signs and symptoms were collected using interview-administered questionnaire. Serum prolactin was assayed by microwell enzyme-linked immunosorbent assay technique based on the noncompetitive sandwich principle. Data obtained were analyzed using SPSS version 20 (Syntron Bioresearch. Inc. California, United States of America (USA)). Results: The mean serum level of prolactin concentration at presentation was 31 ng/ml (range, 2.5–109 ng/ml). Sixty-two patients (51.7%) had hyperprolactinemia and 58 (48.3%) had normal prolactin level. The majority of those with hyperprolactinemia 58.6% were in the 25–34 years' age group. Of those with hyperprolactinemia, majority (27.4%) presented with galactorrhea and others presented with symptoms such as menstrual abnormalities, recurrent abortion, hirsutism, and mixed presentations. However, 25.8% of them were symptomless. Conclusion: Galactorrhea was the most common mode of presentation among infertile hyperprolactinemic females in ABUTH, and a larger proportion were symptomless.

Objective: To test the coalescence effect of two chemotherapy drugs at low effective dose (cisplatin and taxotere) combined with pomegranate juice on A549 cancer cells. Methods: Infrared spectroscopy method is a qualitative test that was performed to ensure the existence of the phytochemicals providing the antioxidant activity through the presence of the hydroxyl group (-OH). The viability of A549 cell line and normal MCs was tested using the neutral red uptake, Clonogenic survival, XTT and Cell migration assays. Results: Our results showed that this combination firstly led to a greater decrease in the viability of cells comparing to those treated with chemotherapy drugs alone, and secondly led to a significant reduction in cell migration. Conclusions: These data suggest a synergistic effect between the pomegranate and cisplatin which makes probably this combination a powerful option for treating lung adenocarcinoma and in parallel minimizing the systemic side effects.

Linagliptin is a member of “Dipeptidyl Peptidase-4” (DPP-4) inhibitors and may be preferred for certain advantages. We present a type 2 diabetes case with developed skin findings after initiation of linagliptin. A 66-year-old type 2 diabetic woman with coronary heart disease for 10 years was admitted to our clinic with dry mouth, polydipsia and polyuria. She was on metformin, acetylsalicylic acid and nitrate treatment. The physical examination was unremarkable. On admission, blood glucose was 319 mg/dL, urine ketone was negative, serum biochemistry and arterial blood gas results were within normal limits. Linagliptin was added to treatment after glycemic regulation was achieved with intensive insulin regimen. On the second day of linagliptin treatment, palpable purpuralike lesions were seen in the lower and upper extremities. Linagliptin was considered as an etiological factor. After discontinuation of linagliptin, the lesions gradually regressed. DPP-4 inhibitors may lead to some dermatological side effects due to inhibition of other DPP enzymes. To the best of our knowledge, our case is the first case in the literature to develop palpable purpura after linagliptin treatment.

Background: The current study aimed to design a novel combination of lansoprazole (LNS) and curcumin (CUR) solid oral dosage form using bioactive self-nanoemulsifying drug delivery systems (Bio-SSNEDDS). Methods: Liquid SNEDDS were prepared using the lipid-excipients: Imwitor988 (cosurfactant), Kolliphor El (surfactant), the bioactive black seed (BSO) and/or zanthoxylum rhetsa seed oils (ZRO). Liquid SNEDDS were loaded with CUR and LNS, then solidified using commercially available (uncured) and processed (cured) Neusilin® US2 (NUS2) adsorbent. A novel UHPLC method was validated to simultaneously quantify CUR and LNS in lipid-based formulations. The liquid SNEDDS were characterized in terms of self-emulsification, droplet size and zeta-potential measurements. The solidified SNEDDS were characterized by differential scanning calorimetry (DSC), X-ray powder diffraction (XRD), scanning electron microscopy (SEM), in vitro dissolution and stability in accelerated storage conditions. Results: Liquid SNEDDS containing BSO produced a transparent appearance and ultra-fine droplet size (14 nm) upon aqueous dilution. The solidified SNEDDS using cured and uncured NUS2 showed complete solidification with no particle agglomeration. DSC and XRD confirmed the conversion of crystalline CUR and LNS to the amorphous form in all solid SNEDDS samples. SEM images showed that CUR/LNS-SNEDDS were relatively spherical and regular in shape. The optimized solid SNEDDS showed higher percent of cumulative release as compared to the pure drugs. Curing NUS2 with 10% PVP led to significant enhancement of CUR and LNS dissolution efficiencies (up to 1.82- and 2.75-fold, respectively) compared to uncured NUS2-based solid SNEDDS. These findings could be attributed to the significant (50%) reduction in the micropore area% in cured NUS2 which reflects blocking very small pores allowing more space for the self-emulsification process to take place in the larger-size pores. Solid SNEDDS showed significant enhancement of liquid SNEDDS stability after 6 months storage in accelerated conditions. Conclusions: The developed Bio-SSNEDDS of CUR and LNS using processed NUS2 could be used as a potential combination therapy to improve the treatment of peptic ulcers.

Background: Medication non-adherence is a complex multifactorial phenomenon impacting patients with various health conditions worldwide. Therefore, its detection can improve patient outcomes and minimize the risk of adverse consequences. Even though multiple self-reported medication adherence assessment scales are available, very few of them exist in Arabic language. Therefore, the aim of this study was to validate a newly translated Arabic version of the Adherence to Refills and Medications Scale (ARMS) among patients with chronic health conditions. Methods: This is a single-center cross-sectional study that was conducted between October 10th 2018 and March 23rd 2021. ARMS was first translated to Arabic using the forward-backward translation method. The translated scale was then piloted among 21 patients with chronic health conditions (e.g., diabetes, hypertension, etc.…) to examine its reliability and comprehensibility using the test-retest method. Thereafter, the Arabic-translated ARMS was self-administered to adult patients aged ≥18 years with chronic health conditions visiting the primary care clinics of a university-affiliated tertiary care hospital in Riyadh, Saudi Arabia. Construct validity was examined using factor analysis with varimax rotation. Results: Of the 264 patients who were invited to participate, 202 (76.5%) consented and completed the questionnaire. Most of the participants were males (69.9%), married (75.2%), having a college degree or higher (50.9%), retired or unemployed (65.2%), aged ≥ 50 years (65.2%), and are diabetic (95.9%). The 12-item Arabic-translated ARMS mean score was 17.93 ± 4.90, and the scale yielded good internal consistency (Cronbach’s alpha = 0.802) and test-retest reliability (Intraclass correlation coefficient = 0.97). Two factors were extracted explaining 100% of the of the total variance (factor 1 = 52.94% and factor 2 = 47.06%). Conclusions: The 12-item Arabic version of ARMS demonstrated good validity and reliability. Therefore, it should help in the detection of medication non-adherence among Arabic-speaking patient population and minimize the risk of adverse consequences.

Material waste and cost overrun have been identified as common problems in the construction industry. These problems occur at both pre- and post-contract stages of a construction project. As a result of a dearth of empirical research and low level of awareness, the majority of managers of construction projects in Nigeria pay hardly any attention to material waste issues that affect cost overrun. This article examines the material waste issues that affect cost overruns at the post-contract stage of building projects. The study covers building construction projects in Abuja, Nigeria. In-depth interviews were conducted with professionals using purposive sampling technique. It is purposive, because only building professionals handling projects that are worth over eight million USD are consulted/interviewed. The professionals included 15 project managers, nine quantity surveyors, five site engineers and one senior technical officer of a waste management department/unit. The interviews were on issues relating to material waste and cost overruns at the post-contract stage of a project. The collected data were analysed manually, using the deductive approach. This involves constant comparative analysis of the data to generate common patterns on material waste and cost overrun. The research found that poor quality-of-procurement management, construction management, and site management would cause material waste, which contributes to project cost overruns. A good-quality procurement management entails procuring the appropriate materials, at the right time and in accordance with specifications. Rework, site accidents, inadequate site security/fencing, poor site organisation and discipline, construction-site disputes, lack of experience, and lack of co-ordination among the parties all contribute to material waste and cost overruns. It can be concluded that proper attention to material waste issues has the potential to minimise the rate of cost overrun at the post-contract stage of a project. It is recommended that careful attention should be paid to the issues identified in this study, as they would help reduce the rate of material waste and cost overrun for projects.

Background: Polycystic ovary syndrome (PCOS) puts patients at higher risk for obesity and diabetes. Poor health literacy is also associated with these conditions. Notably, weight loss is associated with improved ovulation and pregnancy rates for women with PCOS. In this study the association between health literacy and body mass index (BMI) among women with PCOS was examined. Methods: The health literacy of women with PCOS was measured using the Arabic version of the single item literacy screener (SILS) at a university medical center. Sociodemographic and medical information was collected by interviewing the participants and reviewing their medical records, respectively. The relationship between health literacy and BMI was assessed by multiple logistic regression analysis. Results: Health literacy was assessed in 127 women with PCOS from September 2015 to February 2016. Only 16.54% of participants had limited health literacy. The mean BMI for all participants was 30.57 (kg/m2), and the mean age was 27.40 years. Further, most of the participants (74%) had a high school diploma or a higher degree. Almost 56% of the participants were taking metformin, and 11.81% had hypothyroidism. After controlling for age, education, hypothyroidism diagnosis, and the use of metformin, participants with high BMI were 10% less likely to have a good health literacy level (OR = 0.904; 95% CI = 0.829–0.987; P = 0.0238). Conclusion: Improving the health literacy of patients with PCOS may have a positive impact on their BMI and eventually lead to favorable health outcomes.

This study was conducted to assess the in vivo and ex vivo immunomodulatory effect of the ethanol leaves extract of Moringa peregrina in Balb/c mice. For this study, five groups of 5 Balb/c mice were given a single acute subtoxic oral dose of the ethanolic extract at 1.13, 11.30, 23.40 and 113.4 mg/kg and the immunomodulatory effect was assessed on the 6th day following the ingestion. In the (non-functional) assessment, the effect of the extract on the body weight, relative lymphoid organ weight, splenic cellularity and peripheral blood hematologic parameters were evaluated. While in the immunomodulation assessment (functional), we investigated the effect of the extract on the proliferative capacity of splenic lymphocytes and peripheral T and B lymphocytes using mitogen blastogenesis, mixed allogeneic MLR and IgM-Plaque forming cells assays. The ingestion of M. peregrina extract caused a significant increase in the body weight, weight and number of cells of spleen and lymph nodes of the treated mice. Furthermore, the count of RBCs, WBCs, platelets, hemoglobin concentration and PCV % were increased by the extract treatment in a dose-dependent manner. M. peregrina enhanced the proliferative responses of splenic lymphocytes for both T cell and B-cell mitogens. Likewise, the mixed lymphocyte reaction MLR assay has revealed a T-cell dependent proliferation enhancement in the extract treated mice. Moreover, the oral administration of M. peregrina leaves extracts significantly increased PFCs/10 6 splenocytes in a dose-dependent manner. In conclusion, subtoxic acute doses of M. peregrina extract demonstrated significant potential as an immunomodulatory agent even at the lowest dose of 1.13 mg/kg.