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The gastrointestinal (GI) tract is a continuous channel through the body that consists of the esophagus, the stomach, the small intestine, the large intestine, and the rectum. Its primary functions are to move the intake of food for digestion before storing and ultimately expulsion of feces. The mechanical behavior of GI tissues thus plays a crucial role for GI function in health and disease. The mechanical properties are characterized by a biomechanical constitutive model, which is a mathematical representation of the relation between load and deformation in a tissue. Hence, validated biomechanical constitutive models are essential to characterize and simulate the mechanical behavior of the GI tract. Here, a systematic review of these constitutive models is provided. This review is limited to studies where a model of the strain energy function is proposed to characterize the stress–strain relation of a GI tissue. Several needs are identified for more advanced modeling including: 1) Microstructural models that provide actual structure–function relations; 2) Validation of coupled electro-mechanical models accounting for active muscle contractions; 3) Human data to develop and validate models. The findings from this review provide guidelines for using existing constitutive models as well as perspective and directions for future studies.

Background: Brief educational trainings are often used for disseminating and implementing evidence-based practices (EBPs). However, many accessible trainings are ubiquitously standardized. Tailored training focused on modifying individual or contextual factors that may hinder EBP implementation is recommended, but there is a dearth of research comparing standardized versus tailored training. This study sought to: (a) assess the impact of MBC training on clinician intention to use measurement-based care (MBC); (b) compare the effect of standardized versus tailored training on clinician intention to MBC; and (c) identify clinician-level predictors of intention. Methods: Clinicians ( n = 152) treating adult clients with depression at 12 community mental health clinics were randomized to either tailored or standardized MBC training. Clinic-specific barriers and facilitators were used to inform training content and structure tailoring. Linear mixed modeling tested the association between training condition and post-training intention to use MBC, as well as hypothesized individual-level predictors of post-training intention (e.g., age, gender). Results: Clinician intention pre- and post-training increased across training conditions ( B = 0.38, t = −5.95, df = 36.99, p .05, Cohen's d = .15). Only baseline intention emerged as a predictor of post-training intention ( B = 0.39, SE = .05, p

Background: Porcine heart and bovine pericardium valves, which are collagen-based with relatively little elastin, have been broadly utilized to construct bioprosthetic heart valves (BHVs). With a larger proportion of elastin, the pulmonary visceral pleura (PVP) has greater elasticity and could potentially serve as an advantageous biomaterial for the construction/repair of BHVs. The question of how the aortic valve’s performance is affected by its bending rigidity has not been well studied.Methods: Based on the stress–strain relationships of the pericardium and PVP determined by planar uni-axial tests, a three-dimensional (3D) computational fluid–structure interaction (FSI) framework is employed to numerically investigate the aortic valve’s performance by considering three different cases with Young’s modulus as follows: E=375, 750, and 1500 kPa, respectively.Results: The stroke volumes are 112, 99.6, and 91.4 ml as Young’s modulus increases from 375 to 750 and 1500 kPa, respectively. Peak geometric opening area (GOA) values are 2.3, 2.2, and 2.0 cm2 for E=375, 750, and 1500 kPa, respectively. The maximum value of the aortic leaflet stress is about 271 kPa for E=375 kPa, and it increases to about 383 and 540 kPa for E=750 and 1500 kPa in the belly region at the peak systole, while it reduces from 550 kPa to 450 and 400 kPa for E=375, 750, and 1500 kPa, respectively, at the instant of peak “water-hammer”.Conclusion: A more compliant PVP aortic leaflet valve with a smaller Young’s modulus, E, has a higher cardiac output, larger GOA, and lower hemodynamic resistance. Most importantly, the aortic leaflet stresses are substantially lower in the belly region within the higher compliance PVP aortic valve tissue during the systole phase, even though some stress increase is also found during the fast-closing phase due to the “water-hammer” effect similar to that in the pericardial tissue. Future clinical studies will be conducted to test the hypothesis that the PVP-based valve leaflets with higher compliance will have lower fatigue or calcification rates due to the overall lower stress.

Introduction: Anemia is a global public health issue that affects mainly children aged less than 5 years. In Peru, despite the reduction in the prevalence of anemia between 2010 and 2018, anemia remains a major concern, especially in high-risk zones such as rural areas. Several sociodemographic factors have been associated with anemia in children; however, components contributing to the urban-rural gap have not been previously assessed. The purpose of this study was to evaluate the determinants of the difference in anemia prevalence between urban and rural areas, and its spatial distribution in Peruvian children aged 6-59 months. Methods: A secondary data analysis was conducted using the 2019 Peruvian Demographic Health Survey. The study population included 18 846 children aged 6-59 months. A multivariate decomposition analysis for non-linear response model was performed to identify the factors contributing to the gap in the prevalence of anemia across urban and rural areas. Global Moran´s I autocorrelation, Ordinary Kriging interpolation and Bernoulli-based purely spatial scan statistics were employed to assess the spatial pattern of anemia. Results: Nationwide, the prevalence of anemia in Peru was 29.47% (95%CI 28.63-30.33). In rural areas, it was 38.25%, and in urban areas 26.39%. The decomposition analysis revealed that 88.61% of the difference in the prevalence of anemia between urban and rural areas was attributed to the difference in the respondents' characteristics. Wealth index, mother´s education, mother´s employment status, number of living children and mother´s age were key determinants contributing to the rural-urban gap. Spatial heterogeneity of anemia prevalence in childhood was observed at both inter- and intradepartmental level. The SaTScan spatial analysis identified six significant cluster areas with high prevalence of anemia in childhood. Conclusion: A considerable gap of anemia prevalence between urban and rural areas was found. Targeted interventions are necessary to reduce geographic disparities.

A new series of pyridothienopyrimidine derivatives was designed and evaluated as antimicrobial and anticancer agents. The target compounds were synthesized starting with 3-aminothieno[2,3-b]pyridine-2-carboxamide derivative 1 which underwent cyclocondensation reaction with aromatic aldehydes to give the key intermediates 2a,b. By further treatment of 2a,b with various reagents, the target 2,4-disubstituted-pyrido[3′,2′:4,5]thieno[2,3-d]pyrimidines 3a,b–11a,b were obtained. To evaluate the antimicrobial activity of the new compounds, they were tested against five bacterial and five fungal strains. Compounds 6c, 8b, 9a and 9b revealed the most significant antimicrobial activity against the tested microorganisms with MIC values range (4–16 μg/mL). Also, compounds 2a,b–11a,b were screened for their in vitro cytotoxic activity against HepG-2 and MCF-7 cancer cell lines compared with doxorubicin and cisplatin as references drugs. Moreover, compounds (2b, 4a, 6a, 7b, 7c and 9a) which exhibited the most potent anticancer activity, were further subjected to EGFRWT enzyme inhibition assay utilizing erlotinib as a standard drug. The compounds 6a, 7b, 7c and 9a which showed the most promising suppression effects were also evaluated as inhibitors against the mutant forms EGFRL858R and EGFRT790M. The 4-aminopyrazolone analogue 9a showed superior anticancer activity against both HepG-2 and MCF-7 cell lines (IC50 = 1.27, 10.80 μM, respectively) and more potent enzymatic inhibition activity against EGFRWT and its mutant forms EGFRL858R and EGFRT790M than that obtained by erlotinib (IC50 = 0.021, 0.053, 0.081 µM, respectively, IC50erlotinib; 0.027, 0.069, 0.550 µM, respectively). Finally, the molecular docking study showed good binding patterns of the most active compounds with the prospective target EGFRWT.

ObjectiveThis study aimed to determine the change of gastrointestinal (GI) emptying time after ileal interposition (IT) and elucidate the role of altered GI peristalsis in diabetic control.Materials and MethodsTwelve male Goto-Kakizaki rats were randomly divided into IT and sham groups. Body weight and food intake were recorded. Oral glucose tolerance test (OGTT), insulin tolerance test (ITT), plasma glucagon-like peptide-1 (GLP-1), and gastric emptying were measured at baseline and 4 and 8 weeks after operation. At 9 weeks postoperatively, the rats in the IT group were given atropine which can suppress the emptying of stomach and upper intestine, while sham rats were given metoclopramide (to expedite gastric emptying) for 1 week. At week 10 postoperatively, OGTT and GLP-1 were detected. The intestinal transit was tested at postoperative 12 weeks.ResultsNo differences were found between groups at baseline. After operation, the IT rats had lower body weight than sham rats. At 4 and 8 weeks postoperatively, the IT group showed better OGTT and ITT, with significantly elevated GLP-1 relative to sham. After administration of the GI motility drugs, however, the effect of diabetic control for the two groups became similar. The GI transit after IT was significantly slower than sham at all tested time points.ConclusionsAlthough IT inhibits the GI transit time, the earlier interaction between undigested nutrients and interpositioned ileum promotes gut hormone secretion and thus reduces body weight and alleviates hyperglycemia. A decrease of GI transit of IT rats exacerbates the antidiabetic effects.

Objective: The goal of the study is to determine the structural characteristics, mechanical properties, cytotoxicity, and biocompatibility of the pulmonary visceral pleura (PVP).Background: Collagen and elastin are the major components of the extracellular matrix. The PVP has an abundance of elastin and collagen that can serve as a potential biomaterial for clinical repair and reconstructions.Methods: The PVP was processed from swine and bovine lungs. Chemical analyses were used to determine collagen and elastin contents in the PVPs. Immunofluorescence microscopy was used to analyze the structure of the PVP. The stress–strain relationships and stress relaxation were determined by using the planar uniaxial test. The cytotoxicity of the PVP was tested in cultured cells. In in vivo evaluations, the PVP was implanted in the sciatic nerve and skin of rats.Results: Collagen and elastin contents are abundant in the PVP with larger proportions of elastin than in the bovine pericardium and porcine small intestinal submucosa. A microstructural analysis revealed that the elastin fibers were distributed throughout the PVP and the collagen was distributed mainly in the mesothelial basal lamina. The incremental moduli in stress–strain curves and relaxation moduli in the Maxwell–Wiechert model of PVP were approximately one-tenth of the bovine pericardium and small intestinal submucosa. The minimal cytotoxicity of the PVP was demonstrated. The axons proliferated in the PVP conduit guidance from proximal to distal sciatic nerves of rats. The neo-skin regenerated under the PVP skin substitute within 4 weeks.Conclusions: The PVP is composed of abundant collagen and elastin. The structural characteristics and mechanical compliance of the PVP render a suitable biological material for repair/reconstruction.

Cardiovascular diseases (CVDs) are the leading cause of death in the western world. With the current development of clinical diagnostics to more accurately measure the extent and specifics of CVDs, a laudable goal is a better understanding of the structure-function relation in the cardiovascular system. Much of this fundamental understanding comes from the development and study of models that integrate biology, medicine, imaging, and biomechanics. Information from these models provides guidance for developing diagnostics, and implementation of these diagnostics to the clinical setting, in turn, provides data for refining the models. In this review, we introduce multi-scale and multi-physical models for understanding disease development, progression, and designing clinical interventions. We begin with multi-scale models of cardiac electrophysiology and mechanics for diagnosis, clinical decision support, personalized and precision medicine in cardiology with examples in arrhythmia and heart failure. We then introduce computational models of vasculature mechanics and associated mechanical forces for understanding vascular disease progression, designing clinical interventions, and elucidating mechanisms that underlie diverse vascular conditions. We conclude with a discussion of barriers that must be overcome to provide enhanced insights, predictions, and decisions in pre-clinical and clinical applications.

Objetivos: Determinar la asociación entre los factores sociodemográficos y reproductivos con la fecundidad adicional no deseada (FAND) en el Perú. Materiales y métodos: Se realizó un estudio observacional, analítico transversal, a partir de la Encuesta Demográfica y de Salud Familiar (ENDES) 2018 en el Perú. La FAND es una variable que se creó a partir de la diferencia numérica entre la fecundidad obtenida y la fecundidad deseada. La variable FAND, se creó a partir de la diferencia numérica entre la fecundidad obtenida y la fecundidad deseada y se agrupó en dos categorías donde la diferencia numérica positiva correspondió a la presencia de FAND. Se realizó una regresión de Poisson, tanto cruda como ajustada. Resultados: Se analizaron los datos de 6944 mujeres entre 40 y 49 años, con una edad promedio de 44,3 años. Se halló una prevalencia de FAND de 72,5% (IC95%: 70,4%-74,4%). En el modelo ajustado, se observó que pertenecer al quintil superior de riqueza (RPa 0,80; IC95%: 0,69-0,93) disminuía la probabilidad de FAND con respecto al quintil intermedio. Por otro lado, provenir del ámbito rural (RPa 1,07; IC95%: 1,01-1,14), aumenta la probabilidad de FAND con respecto al provenir del ámbito urbano. Conclusiones: La prevalencia de FAND en mujeres peruanas de 40 a 49 años que participaron de la ENDES 2018 es alta. Provenir del área rural aumenta la probabilidad de FAND; y pertenecer al quintil superior de riqueza, la disminuye.

This study investigates the active flow control on NACA0012 airfoil numerically by introducing dielectric barrier discharge (DBD) plasma actuators. The flow over the airfoil simulations were performed using ANSYS program for free-stream velocity 14.6 m/s at wide range of angle of attacks (from 0 to 20 degrees) on NACA0012 airfoil with applied voltage 16 kV across the electrodes. There are several plasma actuator models, which simulate the effect of the plasma actuator. This paper focuses on two numerical methods: Shyy model and Suzen model. They depend on calculating the induced body force of the plasma and import it in Navier Stokes equation as an external body force. Mesh independence study is performed on the airfoil and validate the results without plasma activation with the experimental results. Two actuators were added at positions 0.1 and 0.3 of the chord length to the airfoil and an investigation is performed on the lift CL and drag Cd coefficients of the airfoil without and with the presence of the plasma. A comparison between the numerical results of the two different plasma simulation models is performed to check the accuracy of each model and the two simulation models give nearly the same results. Shyy model is recommended to simulate this type of flow due to its simplicity, faster convergence and accuracy.

This article argues that struggles for global leadership and soft power are at the center of gaining consent of the ruled. The United States once led the world in leadership. It is now facing serious challenges because of its own doing. The Iraq War (2003) was a disaster, not just for American power projection, but for its global standing. The political soft power vacuum was an opportunity for great powers. The rise of China and the resurgence of Russia opened new fronts in their quest for global leadership. Without followers, one cannot be a leader. This makes the battle for weak states part of the international system.

Abstract Background The Y chromosome polymorphism has been widely studied for human migrations, population genetics, forensic applications, and paternity analysis. However, studies regarding genetic lineage and population genetic structure of the Y chromosome in different regions of Saudi Arabia are limited. Aim This study aimed to analyze the distribution of Y chromosome haplotypes in a sample of 125 native Saudi males from different geographic regions of Saudi Arabia and compare to previously published Y chromosome haplotype data from Saudi Arabia and some neighboring Arab populations. Materials and methods Buccal swabs were collected from 125 healthy unrelated native Saudi males from different geographic regions of Saudi Arabia. Genomic DNA was extracted by Chelex®100; 17 Y-STR loci were amplified using the AmpFℓlSTR Yfiler PCR amplification kit and detected on the 3130 Genetic AnalyzerTM. Allele frequency and gene diversity were calculated with online tool STRAF. The Saudi population data were compared with the neighboring populations using pairwise genetic distances and associated probability values were calculated using the Y Chromosome Haplotype Reference Database Website (YHRD) software. Results and conclusion One hundred six YSTR haplotypes and 102 YSTR alleles (excluding 4 null alleles) were identified having a discrimination capacity (DC) of 85.8%. The highest haplotype diversity (HD) and gene diversity (GD) were observed at the loci DYS 458 (0.817) and DYS385b (0.807), respectively. According to our results, the Iraqi and Qena (Egypt) populations appeared to have closer relatedness to the Saudi population as compared with Yemen. The UAE and Kuwait populations showed the same degree of relatedness to the Saudi population followed by Bahrain. On the contrary, the Adnanit and Qahtanit populations of Jordan demonstrated low genetic distance from the Saudi population. In short, studying a population sample of pure Saudi ethnicity enabled us to identify a unique set of haplotypes which may help in establishing genetic relatedness between Saudi and the neighboring Arab populations. The present paper, therefore, highlights the importance of ensuring ethnic originality of the study sample while conducting population genetics studies.

Abstract In view of the worldwide coronavirus disease 2019 (COVID-19) pandemic, hospitals need contingency planning. This planning should include preparation for an unexpected patient surge. This measure is evolving concomitantly with the implementation of the needed infection control rules. Here, we present our experience in contingency planning at four large tertiary hospitals in Saudi Arabia during this global pandemic, with a focus on dealing with COVID-19 patients who need to undergo surgery. The planning covers response measures required in the operating room and supporting units, including the administrative department, intensive care unit, and different sections of the surgical department. Furthermore, it covers the role of education and simulation in preparing health care providers and ensuring smooth workflow between all sections. We additionally discuss the guidelines and policies implemented in different surgical specialties. These measures are necessary to prevent the transmission of COVID-19 within healthcare facilities. Throughout the COVID-19 pandemic, the healthcare system should develop a comprehensive pandemic plan and set guidelines addressing the management of urgent and malignant cases. The guidelines should be in concordance with internal guidelines.

Xiaona Yuan,1 Zhenshuai Fu,2 Pengfei Ji,3 Lubo Guo,4 Ali O Al-Ghamdy,5 Ali Alkandiri,4,6 Ola A Habotta,7 Ahmed E Abdel Moneim,8 Rami B Kassab8 1Department of Emergency, The First Affiliated Hospital of Zhengzhou University, Zhengzhou City, Henan Province 450000, People’s Republic of China; 2Department of ICU, Sunshine Union Hospital, Weifang City, Shandong Province 261000, People’s Republic of China; 3Department of Ophthalmology, Zhengzhou Second Hospital, Zhengzhou City, Henan Province 450000, People’s Republic of China; 4Department of Pharmacy, Central Hospital Affiliated to Shandong First Medical University, Jinan City, Shandong Province 250013, People’s Republic of China; 5Biology Department, Faculty of Science and Arts, Al Baha University, Almakhwah, Saudi Arabia; 6Laboratory Technology Department, College of Technological Studies, Safat 13092, Kuwait; 7Forensic Medicine and Toxicology Department, Faculty of Veterinary Medicine, Mansoura University, Mansoura, Egypt; 8Department of Zoology and Entomology, Faculty of Science, Helwan University, Helwan 11795, EgyptCorrespondence: Lubo GuoDepartment of Pharmacy, Central Hospital Affiliated to Shandong First Medical University, Jinan City, Shandong Province 250013, People’s Republic of ChinaTel +86 18331125851Email guo700777@sina.comIntroduction: Epilepsy is a chronic neurological condition characterized by behavioral, molecular, and neurochemical alterations. Current antiepileptic drugs are associated with various adverse impacts. The main goal of the current study is to investigate the possible anticonvulsant effect of selenium nanoparticles (SeNPs) against pentylenetetrazole (PTZ)-mediated epileptic seizures in mice hippocampus. Sodium valproate (VPA) was used as a standard anti-epileptic drug.Methods: Mice were assigned into five groups (n=15): control, SeNPs (5 mg/kg, orally), PTZ (60 mg/kg, intraperitoneally), SeNPs+PTZ and VPA (200 mg/kg)+PTZ. All groups were treated for 10 days.Results: PTZ injection triggered a state of oxidative stress in the hippocampal tissue as represented by the elevated lipoperoxidation, heat shock protein 70 level, and nitric oxide formation while decreased glutathione level and antioxidant enzymes activity. Additionally, the blotting analysis showed downregulation of nuclear factor erythroid 2-related factor 2 (Nrf2) and heme oxygenase-1 (HO-1) in the epileptic mice. A state of neuroinflammation was recorded following the developed seizures represented by the increased pro-inflammatory cytokines. Moreover, neuronal apoptosis was recorded following the development of epileptic convulsions. At the neurochemical level, acetylcholinesterase activity and monoamines content were decreased in the epileptic mice, accompanied by high glutamate and low GABA levels in the hippocampal tissue. However, SeNP supplementation was found to delay the onset and decreased the duration of tonic, myoclonic, and generalized seizures following PTZ injection. Moreover, SeNPs were found to provide neuroprotection through preventing the development of oxidative challenge via the upregulation of Nrf2 and HO-1, inhibiting the inflammatory response and apoptotic cascade. Additionally, SeNPs reversed the changes in the activity and levels of neuromodulators following the development of epileptic seizures.Conclusion: The obtained results suggest that SeNPs could be used as a promising anticonvulsant drug due to its potent antioxidant, anti-inflammatory, and neuromodulatory activities.Keywords: epilepsy, selenium nanoparticles, oxidative stress, neuroinflammation and apoptosis, monoamines, GABA and glutamate

Background and aim: The effect of anticoagulation control on overall Health-Related Quality of Life (HRQoL) in patients taking warfarin in Malaysia has not been explored yet. Therefore, this study aimed to evaluate HRQoL among patients on warfarin in Malaysia. Methods: HRQoL among patients on warfarin was measured using WHOQOL-BREF (World Health Organization Quality of life Assessment: Brief Version). Descriptive and inferential statistical analysis was done using Statistical Package for the Social Sciences (SPSS) version 22. Results: Out of 319 patients, more female patients were observed than the males (n = 221, 69.3%, and n = 98, 30.7% respectively). Mean scores for the physical (61.14 ± 15.96), psychological (68.58 ± 16.11), social (63.55 ± 27.06) and environmental domains (62.78 ± 17.58) were observed. Statistically, a significant association was found between the comorbidities other than CVDs with health satisfaction (p = 0.002), physical (p = 0.001), psychological (p

Salah Eldin Kassab,1 Mubarak Bidmos,1 Michail Nomikos,1 Suhad Daher-Nashif,2 Tanya Kane,2 Srikant Sarangi,3 Marwan Abu-Hijleh1 1Department of Basic Medical Sciences, College of Medicine, QU Health, Qatar University, Doha, Qatar; 2Department of Population Medicine, College of Medicine, Qatar University, QU Health, Doha, Qatar; 3Danish Institute of Humanities and Medicine (DIHM), Aalborg University, Aalborg, DenmarkCorrespondence: Salah Eldin KassabPhysiology & Medical Education, College of Medicine, QU Health, Qatar University, PO Box 2713, Doha, QatarTel +974 – 4403 7843Email skassab@qu.edu.qaPurpose: Assessment of reflective writing for medical students is challenging, and there is lack of an available instrument with good psychometric properties. The authors developed a new instrument for assessment of reflective writing-based portfolios and examined the construct validity of this instrument.Methods: After an extensive literature review and pilot testing of the instrument, two raters assessed the reflective writing-based portfolios from years 2 and 3 medical students (n=135) on three occasions. The instrument consists of three criteria: organization, description of an experience and reflection on the experience. We calculated the reliability of scores using generalizability theory with a fully crossed design and two facets (raters and occasions). In addition, we measured criterion validity by testing correlations with students’ scores using other assessment methods.Results: The dependability (Φ) coefficient of the portfolio scores was 0.75 using two raters on three occasions. Students’ portfolio scores represented 46.6% of the total variance across all score comparisons. The variance due to occasions was negligible, while the student–occasion interaction was small. The variance due to student–rater interaction represented 17.7%, and the remaining 27.7% of the variance was due to unexplained sources of error. The decision (D) study suggested that an acceptable dependability (Φ = 0.70 and 0.72) can be achieved by using two raters for one and two occasions, respectively. Finally, we found moderate to large effect-size correlations between students’ scores in reflective writing-based portfolios and communication skills (r = 0.47) and PBL tutorials (r = 0.50).Conclusion: We demonstrated the presence of different sources of evidence that support construct validity of the study instrument. Further studies are warranted before utilizing this instrument for summative assessment of students’ reflective writing-based portfolios in other medical schools.Keywords: G-theory, validity, reflective writing, portfolio, reliability, student assessment

Societal impact considerations play an increasingly important role in research evaluation. In particular, in the context of publicly funded research, proposal templates commonly include sections to outline strategies for achieving broader impact. Both the assessment of the strategies and the later evaluation of their success are associated with challenges in their own right. Ever since their introduction, altmetrics have been discussed as a remedy for assessing the societal impact of research output. On the basis of data from a research center in Switzerland, this study explores their potential for this purpose. The study is based on the papers (and the corresponding metrics) published by about 200 either accepted or rejected applicants for funding by the Competence Center Environment and Sustainability (CCES). The results of the study seem to indicate that altmetrics are not suitable for reflecting the societal impact of research that was considered: The metrics do not correlate with the ex ante considerations of an expert panel.

Mount Achernar moraine is a terrestrial sediment archive that preserves a record of ice-sheet dynamics and climate over multiple glacial cycles. Similar records exist in other blue ice moraines elsewhere on the continent, but an understanding of how these moraines form is limited. We propose a model to explain the formation of extensive, coherent blue ice moraine sequences based on the integration of ground-penetrating radar (GPR) data with ice velocity and surface exposure ages. GPR transects (100 and 25 MHz) both perpendicular and parallel to moraine ridges at Mount Achernar reveal an internal structure defined by alternating relatively clean ice and steeply dipping debris bands extending to depth, and where visible, to the underlying bedrock surface. Sediment is carried to the surface from depth along these debris bands, and sublimates out of the ice, accumulating over time (>300 ka). The internal pattern of dipping reflectors, combined with increasing surface exposure ages, suggest sequential exposure of the sediment where ice and debris accretes laterally to form the moraine. Subsurface structure varies across the moraine and can be linked to changes in basal entrainment conditions. We speculate that higher concentrations of debris may have been entrained in the ice during colder glacial periods or entrained more proximal to the moraine sequence.

Molecular markers are the most ideal approach to study genetic diversity. Consequently, we utilized both ISSR and RAPD markers to assess genetic diversity and relationships among three different populations of Farafra, Ossimi and Rahmani Egyptian sheep breeds. Both ISSR and RAPD gave moderate polymorphism 41.3% and 48.51%, respectively. Besides, this value was consistent with the moderate value of the mean of polymorphism information content (0.16 and 0.20, respectively). Farafra-F and Farafra-D populations had the highest similarity which was 0.92 for ISSR and 0.90 for the RAPD marker. Furthermore, ISSR and RAPD constructed dendrogram separated all the studied sheep into two main clusters. All the three populations of Farafra breed combined into one main cluster, while the second cluster contained both Rahmani and Ossimi breeds. The used molecular markers were able to discriminate among evaluated sheep and displayed that Farafra breed more closely related to Ossimi than Rahmani breed.

Abstract Poly(ADP-ribosyl)ation (PARylation) mediated by poly ADP-ribose polymerases (PARPs) plays a key role in DNA damage repair. Suppression of PARylation by PARP inhibitors impairs DNA damage repair and induces apoptosis of tumor cells with repair defects. Thus, PARP inhibitors have been approved by the US FDA for various types of cancer treatment. However, recent studies suggest that dePARylation also plays a key role in DNA damage repair. Instead of antagonizing PARylation, dePARylation acts as a downstream step of PARylation in DNA damage repair. Moreover, several types of dePARylation inhibitors have been developed and examined in the preclinical studies for cancer treatment. In this review, we will discuss the recent progress on the role of dePARylation in DNA damage repair and cancer suppression. We expect that targeting dePARylation could be a promising approach for cancer chemotherapy in the future.

Two novel gesture-based Human-UAV Interaction (HUI) systems are proposed to launch and control a UAV in real-time utilizing a monocular camera and a ground computer. The first proposal is an end-to-end static Gesture-Based Interaction (GBI) system based on classifying the interacted user poses while discarding the gesture interpreting component to boost the system performance up to 99 % with a speed of 28 fps. On the other hand, the second proposal is a dynamic one that adopts a simple model to detect three parts (face and two hands) of the interacted person and tracks them for a certain number of frames till a specific dynamic gesture is recognized. The proposed dynamic method is efficient, decreases the complexity, and speeds the interaction up to 27 fps comparing with the recent multimodel ones. Its backbone is a simplified Tiny-You Only Look Once (YOLO) network saves the resources and speeds the detection process up to 120 fps. Moreover, a comprehensive new gestures dataset was established to facilitate the learning process and aid the research work. A comparative study is carried out to show the performance and efficiency of the proposed dynamic HUI system in terms of detection accuracy and speed with the baseline detector on the human gesture public dataset. Finally, a non-expert volunteer examines the proposed HUIs by launching and driving a Bebop 2 micro UAV through a set of real flights.

Background: The purpose of the present study was to assess saliva reliability in diagnosis and monitoring type 2 diabetes instead of blood. Methods: Blood and unstimulated whole saliva were collected from 300 type 2 diabetic subjects and 300 healthy controls in fasting. Then, the salivary flow rate was calculated. All parameters including glucose, urea, amylase, total protein, albumin, C-reactive protein (CRP), immunoglobulin A (IgA), potassium, calcium and chloride were assessed in the supernatant, using an autoanalyzer. Oral exam was conducted by a single examiner on full mouth excluding third molars. Statistical analysis was performed by the SPSS 20.0 version. Results: Saliva screening showed that glucose, urea, amylase, total protein, potassium, calcium and chloride were significantly higher in patients compared to controls (p < 0.05). Whereas, the IgA level and salivary flow rate were significantly reduced in patients (p < 0.05). No significant difference was found in albumin and CRP levels (p > 0.05). There was a significant positive correlation between salivary and plasma glucose levels (r = 0.887, and r = 0.900, p < 0.001), as well as, salivary and blood urea (r = 0.586, and r = 0.688, p < 0.001) in patients and controls, respectively. Conclusions: From this study, saliva could be suggested as a useful diagnostic tool for type 2 diabetes.

Two simple, precise, accurate and robust UV zero and first derivative orders spectrophometric methods have been developed and validated for the simultaneous determination of oxytetracycline (OTC) associated either with diclofenac sodium (DICLO) or with piroxicam (PIRO) in veterinary pharmaceuticals, without prior separation of the drugs. These proposed methods are also suitable for individual estimation of each drug in pharmaceutical products for human use. The first method is a zero order spectrophotometry for estimation of OTC at 360 nm in the association with DICLO. The second one employs a first derivative at 339 nm, using a zero-crossing technique to measure the OTC content in the association with PIRO. Both nonsteroidal anti-inflammatory drugs (DICLO and PIRO) were analyzed by first derivative spectrophometric at 298.5 nm (OTC zero-crossing point) in their respective associations. All measurements were carried out in acetronitrile:water (50:50, v/v; pH 2.5) and at room temperature (25 ± 2 °C). Analytical curves were linear (r > 0.9996) in the concentration range of 10.0–80.0 μg mL−1 for OTC, 1.5–25.0 μg mL−1 for DICLO and 2.5–30.0 μg mL−1 for PIRO. The limits of quantification were lower than 1.50 μg mL−1 and the mean of recoveries were within the acceptable limits of 98–102% for all three drugs. The developed methods can be successfully applied in the quality control routine for the simultaneous or individual determination of OTC, DICLO and PIRO in pharmaceutical dosage forms. Keywords: Zero order and derivative spectrophotometry, Veterinary pharmaceuticals, Quality control, Validation

Objectives: To determine the rate of functionally significant (fractional flow reserve, FFR ≤ 0.80) coronary bifurcation stenoses that are considered anatomically significant based on angiographic estimation and to define predictors of functional significance of stenoses in main vessel and side branch. Background: To date, the rate of functionally significant stenoses in angiographic significant coronary bifurcation stenoses has not been specifically determined. Methods: Patients with significant angiographic bifurcation lesions defined as diameter stenosis >50% in main vessel and/or side branch were included. FFR was performed in main vessel (MV) and side branch (SB) before and after percutaneous coronary intervention (PCI). The protocol was approved by the local ethics committee. Results: Overall, 171 patients with bifurcation lesions were included. Mean FFR in MV was 0.80 ± 0.01 and 0.84 ± 0.09 in SB. 46% (n = 78) of bifurcation lesions were functionally significant when assessed with FFR. Diameter stenosis in main vessel, lesion length, side branch territory and SYNTAX score (SS) were found as predictors for lesion functional severity (main vessel FFR ≤ 0.80). At the time of follow-up, there were no differences between the treated and deferred group regarding rates of all-cause death, cardio-vascular death, MACEs and POCE. Conclusion: Less than half of all angiographic significant bifurcation lesions were functionally significant when assessed with FFR. There was no difference in clinical outcomes at mean time of three years follow-up in treated and deferred lesion.

Abstract Brown tumors (BTs) are due to a proliferation of multinucleated giant cells in osteolytic lesions. They complicate the course of hyperparathyroidism. Thanks to an early screening of bone metabolism disorders; BTs are nowadays rare bone manifestations. We demonstrate through these two cases reports unusual locations of BTs in hyperparathyroidism.

Background. Lactic acidosis is a well-known complication of metformin accumulation in diabetic patients with kidney failure. However, it is not usual to raise the diagnosis of metformin-associated lactic acidosis when patients have normal kidney function. The causes of metformin-induced high lactate include the accumulation of normal doses of metformin in chronic kidney disease, an overdose of this drug without kidney failure, or an increase in lactate production due to the inhibition of liver gluconeogenesis. Case Presentation. We report the case of a 61-year-old diabetic man who was brought to the emergency room in a comatose state. His family reported abdominal pain with diarrhea in the last two days. He was found to have severe lactic acidosis with normal serum creatinine. He was on a regular dose of metformin, and his family denied any other medical history or any alcohol abuse. He showed no signs of infection, his liver enzymes were slightly elevated, and he had severe anemia. His hemodynamics deteriorated quickly within hours, and an abdominal computed tomography scan revealed no abnormalities. He underwent a laparotomy that ruled out mesenteric ischemia and revealed an abnormal liver. The liver biopsy later confirmed the diagnosis of cirrhosis. Conclusions. We discuss here the probable causes of severe lactic acidosis and the role of metformin in exacerbating this acid-base disturbance in cirrhotic patients. Future research is needed to determine whether these patients might benefit from dialysis.

Introduction: Cervical cancer is the second most common type of cancer among women all over the world. Objectives: This study was conducted to demonstrate the effect of intrauterine devices (IUDs) on cervical cancer and precancerous lesions development. Patients and Methods: This study was conducted in two different hospitals in Isfahan on 200 samples, since 100 of them had results indicating cervical cancer, and the rest had no abnormal lesions. For both groups, a questionnaire was filled out for IUD users and some related risk factors such as age, parity, abortions, smoking, previous Pap smear results contained sexually transmitted diseases (STDs) infections and the contraception method. Results: In this study, more cases of IUD use were recorded in the control group. We found that the use of natural methods did not prevent the development of precancerous lesions. In the results of the Pap smear, a large number were recorded as having a history of human papillomavirus (HPV). Additionally, a high percentage of cervical cancer patients’ smoking or passive smoking. We also recorded that 53% had more than two children, while the percentages of women at the birth of their first child and who did not have an abortion were almost equal in the two groups. Conclusion: Our analysis demonstrated that IUD use is a contraceptive method with the capability of lowering the risk of cervical cancer progression. There is also an association between HPV infection, smoking, age, the number of parity and the usage of natural birth control methods with the development of cancerous lesion development.

Meckel's diverticulum is a remnant of the omphalomesenteric duct and is the most common congenital anomalies of the gastrointestinal tract. The complications of MD include hemorrhage, perforation, intestinal obstruction, and inflammation. Torsion is one of the rarest complications of MD, and only a few reports exist that discuss this complication. We report a case of a 2.5-year-old male who presented with signs of acute abdomen. Dilated small bowel loops, gangrenous and axially torsional Meckel's diverticulum were found intraoperatively. Diverticulectomy was performed without ileal resection. The patient was discharged in good condition with no complications occurring during follow-up for 2 months. In the English literature, About 6 cases in children and less than 20 cases in adults of MD with axial torsion have been reported.

Background and study aims Endoscopic mucosal resection (EMR) of laterally spreading tumors (LSTs) > 20 mm in size can be challenging. Piecemeal EMR of these lesions results in high rates of adenoma recurrence at first surveillance colonoscopy (SC1). Snare tip soft coagulation (STSC) of post resection margins is a safe and effective technique to prevent adenoma recurrence. We conducted a systematic review and meta-analysis to evaluate the effectiveness and safety of this technique. Patients and methods Multiple databases were searched through April 2021 for studies that reported on outcomes of post EMR STSC for LSTs > 20 mm in size. Meta-analysis was performed to determine pooled odds of adenoma recurrence as well as pooled proportion of adverse events including intraprocedural and delayed bleeding as well as intraprocedural perforation events. Results Six studies including two randomized controlled trials (RCT) and four cohort studies with 2122 patients were included in the final analysis. Overall pooled odds of adenoma recurrence at SC1 with post EMR STSC compared to no STSC was 0.27 (95 % 0.18–0.42; I2 = 0 %), P 20 mm is a safe and effective technique in reducing the incidence of adenoma recurrence.

Abstract The sacroiliac joint is rarely affected by tuberculosis. Only few cases have been reported. Consequently, the diagnosis is often delayed. This case report highlights the importance of continued awareness for early detection and treatment of a tuberculous sacroiliac joint infection.

Universities worldwide are adopting quality-assurance programmes to improve the quality of their services, however, the value of Western quality-management models developed for stable contexts, in conflict-affected contexts is questionable. This study sought to review the quality management strategies, policies and practices of two higher education institutions (HEIs) in the non-regime conflict-affected northwest of Syria (NWS), selected as representative of the emerging HE sector in the area since 2015, and to explore the potential benefits of a risk-management approach to quality assurance, a model that places context at its heart to help mitigate identified risks that might undermine delivery of quality HE. A mixed-method approach, was adopted, combining an analysis of the two HEIs administrative documents, with fourteen semi-structured interviews with senior administrative and teaching staff, and a survey of 120 of their 2019/20 graduates. Findings indicated that a risk-management approach would allow HEIs in NWS to develop strategies, policies and practices that would better respond to their conflict-affected realities, and the need for a more transparent and democratic management approach to decision-making and management/staff/student relations and communication. A set of risk-management quality assurance recommendations are offered for consideration by all Syrian HEIs in NWS, to allow the development of management policies, strategies and practices that mitigate risks to delivery of quality HE services. Equally important is to acknowledge the resilience and adaptability of the two study universities, and their commitment to sustaining access to HE for local and displaced communities, despite ongoing insecurity and deteriorating economic and social conditions .

AimTo evaluate disparities in the frequency of scientific activity between medical doctors and nurses in Peru.MethodsWe carried out a secondary data analysis of the National Health Services Users' Satisfaction Survey (ENSUSALUD), 2016. This nationally representative survey evaluates doctors and nurses working in clinical settings. We defined scientific activity as i) having published an original article (journal indexed in Web of Science, Scopus or Medline); and ii) having authored an abstract in a national or international conference. We estimated crude and adjusted disparities prevalence ratios (aDPR) and 95% confidence intervals (95%CI).ResultsWe included 2025 doctors and 2877 nurses in the analysis; 71% of doctors doctor were male, and 93% of nurses were female (pConclusionsThere are important disparities in scientific activity between doctors and nurses working in clinical settings in Peru. Disparities are more significant for article publication than for authoring in conference abstracts. We suggest public policies that promote research dissemination between health professionals, with emphasis on nurses.

Nd3+-doped GeO2-PbO glass with silver (Ag) nanoparticles (NPs) are produced with double line waveguides through fs laser processing for photonic applications. A Ti:sapphire fs laser at 800 nm was used to write the waveguides directly into the glass 0.7 mm beneath the surface. This platform is based on pairs of parallel lines with spacing of 10 µm, each pair being formed by two identical written lines but in two different configurations of 4 or 8 separately processed lines, which are coincident. The results of optical microscopy, absorbance measurements, refractive index change, beam quality factor (at 632 and 1064 nm), photoluminescence, propagation losses, and relative gain at 1064 nm are presented. The structural changes in the glass due to the presence of Ag NPs were investigated by Raman spectroscopy. At 632 and 1064 nm, x,y-symmetrical guiding was observed, and for both kinds of overlapping pulses, a refractive index alteration of 10−3 was found in both directions. Photoluminescence growth of ~47% at 1064 nm was observed due to the plasmonic effect of Ag NPs. In dual waveguides containing Ag NPs, the relative gain obtained increased by 40% and 30% for four and eight overlapping lines, respectively, at 600 mW of 808 nm pump power, when compared to waveguides without those metallic NPs. We highlight the resultant positive internal gains of 5.11 and 7.12 dB/cm that showed a growth of ~40% and ~30%, respectively, with respect to the samples without Ag NPs. The increase in photoluminescence and relative gain were related to the local field growth produced by Ag NPs. The present results show that the addition of Ag NPs impacts positively on the optical performance at 1064 nm of double line waveguides processed by fs laser writing in Nd3+-doped GeO2-PbO glass, opening news perspectives for photonics.

Single ventricle (SV) anomalies account for one-fourth of all congenital heart disease cases. The existing palliative treatment for this anomaly achieves a survival rate of only 50%. To reduce the trauma associated with surgical management, the hybrid comprehensive stage II (HCSII) operation was designed as an alternative for a select subset of SV patients with the adequate antegrade aortic flow. This study aims to provide better insight into the hemodynamics of HCSII patients utilizing a multiscale Computational Fluid Dynamics (CFD) model and a mock flow loop (MFL). Both 3D-0D loosely coupled CFD and MFL models have been tuned to match baseline hemodynamic parameters obtained from patient-specific catheterization data. The hemodynamic findings from clinical data closely match the in-vitro and in-silico measurements and show a strong correlation (r = 0.9). The geometrical modification applied to the models had little effect on the oxygen delivery. Similarly, the particle residence time study reveals that particles injected in the main pulmonary artery (MPA) have successfully ejected within one cardiac cycle, and no pathological flows were observed.

Abstract Background Fibroadenoma is the most prevalent benign breast lesion that generally affects middle-aged women; it is rare in adolescents and younger children. The transformation into malignancy is not common. However, multiple recurrences of rapidly enlarging fibroadenomas suggest a high possibility of transforming into phyllodes tumors, which are uncommon fibroepithelial lesions that account for 0.3–0.5% of female breast tumors and typically present in premenopausal women. Case presentation We report a case of a 17-year-old Syrian girl who previously had three episodes of recurrence of multiple rapidly enlarging fibroadenomas in her left breast and underwent three operations for complete resection of the lesions. However, a few months later, she was readmitted with multiple large masses in the same breast, and pathological findings confirmed a surprising combination of multiple fibroadenomas for the fourth time with a malignant phyllodes tumor (cystosarcoma phyllodes). The patient underwent lumpectomies followed by adjuvant radiotherapy. Long-term follow-up was recommended. Conclusion Our patient had an extraordinary number of episodes of recurrence at a young age and a rare combination of malignant and benign lesions in the same breast with multiple recurrences. We present her unique, very challenging case with the aim of highlighting the importance of clinical correlation, detailed diagnosis, and careful follow-up.