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Load frequency regulation in hybrid grid is a very crucial issue. This work introduces robust-adaptive control methodology to provide accurate response against any disturbances. Control scheme of two main parts has been introduced. The first one is a novel fractional order model reference adaptive controller where fractional calculus merits and e-modification robust algorithm have been merged with the adaptive skills creating the fractional order model reference robust-adaptive controller. This robust-adaptive controller has utilized output feedback approach that requires only the output state without detailed system model information. The fractional orders have been optimized using a nature-inspired algorithm named Artificial Rabbits. The second part of the control scheme is a disturbance rejection observer that is able to estimate and eliminate external and internal disturbances. For fair comparison, results of the proposed scheme have been compared to that of the most efficient controllers obtained from the literature named fractional order proportional integral derivative controller and integral controller. Furthermore, the integer version of the proposed controller has been tested and compared with the proposed controller to prove the robustness of the fractional modification. To validate the superiority of the proposed controller, five challenging scenarios have been considered, encompassing load fluctuations, integration of renewable energy sources, changes in system parameters and time delay attacks. The proposed controller effectively minimizes area control error achieving stability and showing cost function enhancement of 15% to 152% compared to other tested controllers in all scenarios. Thus, it is strongly recommended for load frequency regulation in multi-area power systems.

Abstract Background Sperm DNA fragmentation (SDF) can significantly impact male fertility, especially in cases where there is a substantial level of DNA damage. We aimed in the current study to assess seminal plasma (SP) levels of vaspin and visfatin in infertile men with an elevated SDF index (SDFI ≥ 30%) compared to infertile males with a normal SDFI (SDFI

Abstract Background Irisin is an exercise-induced myokine that alleviates endothelial dysfunction and reduces insulin resistance in type 2 diabetes mellitus (T2DM). The current study aimed to assess the serum level of irisin in T2DM men with erectile dysfunction (ED) compared to T2DM patients with normal erectile function and healthy controls, as well as investigate the association between serum irisin level and the severity of ED in T2DM patients. Patients and methods A cross-sectional study was conducted on 90 males, divided into three groups: 32 T2DM patients with ED, 24 T2DM patients without ED, and 34 healthy controls. Socio-demographic characteristics and scores of the validated Arabic version of the international Index of Erectile Function-5 (ArIIEF-5), Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9) were obtained. Furthermore, routine laboratory tests employed for diabetes monitoring and serum levels of total testosterone and irisin were assessed within these groups. Results T2DM men with ED had significantly lower serum levels of irisin and testosterone, as well as a lower ArIIEF-5 score, but their GAD-7 and PHQ-9 scores were significantly higher than those without ED or controls (p

Abstract Background Since the declaration of COVID-19 as a pandemic in 2020, its main symptoms have primarily affected the respiratory system. However, it also presents other systemic manifestations, including symptoms related to the larynx and pharynx. COVID-19 has evolved into subsequent variants, starting from the alpha variant and currently dominated by the Omicron variant, with the Delta variant being the most severe. The study aimed to elucidate the laryngo pharyngeal manifestations related to Delta and Omicron variants of COVID-19 as well as the associated risk factors. Results This study adopted a case–control design. The data were collected from patients who attended the phoniatric outpatient clinic at Menoufia University Hospital from January to December 2022. Patients were categorized into three groups (50 patients each). Group I consisted of patients who exhibited COVID-19 Laryngo pharyngeal symptoms during the Delta wave (Group 1) and the Omicron wave (Group 2). The control group included non-COVID-19 participants. The symptoms related to the larynx and pharynx were documented. In addition, laryngoscopic and stroboscopic examinations were done. The age of individuals affected by the Delta variant was higher. Delta cases exhibited a higher rate of smoking, diabetes, hypertension, and COPD compared to Omicron cases. Additionally, Delta cases displayed greater severity. Dysphagia, dysphonia, choking attacks related to swallowing, and stridor had significant higher rate in the Delta variant compared to the Omicron variant. The Delta variant primarily exhibited unilateral vocal fold paralysis in 38% of cases, as well as bilateral vocal fold paresis and paralysis in 20% and 22% of cases, respectively. In contrast, Omicron cases predominantly showed vocal fold congestion (80% of cases). Delta cases were more prone to experiencing abnormalities in amplitude, symmetry, and periodicity. Conclusions The Delta variant is more prone to neurologic affection of the vocal folds manifesting as paresis and paralysis, whereas the Omicron variant, which has maintained its dominance thus far, experiences milder affection, primarily manifesting as congestion. Consequently, laryngeal affection with various degrees of severity is still suspected.

Abstract Background Reading problems are the most prevalent type of specific learning disability. Reading problems usually result from phonological deficits; however, it is unclear how much other linguistic abilities are impacted as well. Objective To study different language parameters and cognitive skills in a group of Egyptian children with reading problems to better understand the difficulties that need to be considered in rehabilitation programs for those children. Methods A case–control study was conducted on 30 children with reading problems having IQs above 85 and 30 normal control children matched for age and gender (their ages ranged from 7 to 9 years and 11 months). They underwent testing for dyslexia by the Arabic dyslexia assessment test, language evaluation using the Receptive Expressive Arabic Language Scale (REAL scale), and the Stanford-Binet intelligence scale, fifth edition. Results There were highly significant correlations between the severity of dyslexia and total language scores, most of REAL scale subtests. Also, highly significant correlations were detected between the severity of dyslexia and the total IQ, verbal IQ, and verbal working memory subtests. The linear regression model revealed a highly significant association between dyslexia and expressive language scaled scores, total language scaled scores, and a significant association with expressive vocabulary and understanding oral instructions subtests of REAL scale. Additionally, a highly significant association has been detected between dyslexia and the verbal working memory subtest of the Stanford-Binet test. Correlations between total language scores and intellectual abilities (total IQ, verbal IQ, and non-verbal IQ) revealed highly significant positive results. Conclusion Deficits in both receptive and expressive language were observed in children with reading problems. Expressive vocabulary, listening comprehension, and verbal working memory subtests are the most affected language and cognitive skills.

Inhibition of α-glucosidase and α-amylase are key tactics for managing blood glucose levels. Currently, stronger, and more accessible inhibitors are needed to treat diabetes. Indeno[1,2-b] quinoxalines-carrying thiazole hybrids 1–17 were created and described using NMR. All analogues were tested for hypoglycaemic effect against STZ-induced diabetes in mice. Compounds 4, 6, 8, and 16 were the most potent among the synthesised analogues. These hybrids were examined for their effects on plasma insulin, urea, creatinine, GSH, MDA, ALT, AST, and total cholesterol. Moreover, these compounds were tested against α-glucosidase and α-amylase enzymes in vitro. The four hybrids 4, 6, 8, and 16 represented moderate to potent activity with IC50 values 0.982 ± 0.04, to 10.19 ± 0.21 for α-glucosidase inhibition and 17.58 ± 0.74 to 121.6 ± 5.14 μM for α-amylase inhibition when compared to the standard medication acarbose with IC50=0.316 ± 0.02 μM for α-glucosidase inhibition and 31.56 ± 1.33 μM for α-amylase inhibition. Docking studies as well as in silico ADMT were done.

Abstract Background The cornea of various vertebrate is considered a major part in the glop, which acts as a powerful lens, providing a sharp retinal image, and meantime acts as an excellent defensor for other corneal layers. Results The four reptilian families [Scincidae (Chalcides ocellatus); Chamaeleontidae (Chameleon chameleon); Cheloniidae (Chelonia mydas) and Testudiniae (Testudo kleinmanni)] investigated in the current study were gathered across Egypt. After being taken out of the orbit, the cornea under inquiry was ready for light, specific stain and scanning electron microscopy. The epithelium, stroma, and endothelium are the three corneal layers that are common to all four species of reptiles. All other species lack Bowmen's and Descemet's membranes, with the exception of C. ocellatus and T. kleinmanni. The latter layers of Chalcides ocellatus display a strong affinity for Periodic Acid Schiff stain. Epithelial cells with a variety of forms, from hexagonal to atypical polygonal cells, cover the outer corneal surface. These epithelial cells are coated in short microplicae, microvilli, and microholes of varied diameters. There are a few blebs scattered around their surface. Conclusion The current study concluded that various habitats have various significant effects on the cornea's microstructure characteristics and its physiological trends to accommodate different environmental surroundings.

Abstract Background Myopia is the most prevalent form of refractive error that has a major negative impact on visual function and causes blurring of vision. We aimed to determine if Repeated Low-Level Red Light (RLRL) treatment is beneficial in treating childhood myopia in terms of axial length (AL), spherical equivalent refraction (SER), and sub foveal choroidal thickness (SFCT). Methods This systematic review was performed on RLRL for treatment of myopia in children compared to single vision spectacles (SVS). We employed the search strategy with key terms myopia and low-level light therapy then we searched PubMed, Scopus, Cochrane, and Web of Science databases. The mean differences (MD) were used to evaluate the treatment effects. Heterogeneity was quantified using I2 statistics and explored by sensitivity analysis. Results Five randomized controlled trials (RCTs) were included in our meta-analysis with a total of 833 patients, 407 in treatment group and 426 in control group. At a 3 month follow up period, pooled studies show a statistical difference in AL between RLRL and SVS group (MD = -0.16; 95% CI [-0.19, -0.12], SER (MD = 0.33; 95% CI [0.27, 0.38]), and SFCT (MD = 43.65; 95% CI [23.72, 45.58]). At a 6 month follow up period, pooled studies show a statistical difference in AL between RLRL and SVS group (MD = -0.21; 95% CI [-0.28, -0.15]), SER (MD = 0.46; 95% CI [0.26, 0.65]), and SFCT (MD = 25.07; 95% CI [18.18, 31.95]). At a 12 month follow up period, pooled studies show a statistical difference in AL between RLRL and SVS group (MD = -0.31; 95% CI [-0.42, -0.19]) and SER (MD = 0.63; 95% CI [0.52, 0.73]). Conclusion This is the first systematic review and meta-analysis investigating only RCTs evidence supporting the efficacy of 650 nm RLRL for myopia control in the short term of 3, 6, and 12 months follow up. The present review revealed the clinical significance of RLRL as a new alternative treatment for myopia control with good user acceptability and no documented functional or structural damage. However, the effect of long-term RLRL treatment and the rebound effect after cessation require further investigations.

DC-DC buck converters in automotive and aerospace applications are often required to handle large disturbances in their input supply and abrupt variations in their loads. This paper proposes a systematic method to combine input-voltage feedforward (IVFF) and voltage-mode feedback (VFB) controllers, aiming to enhance the closed-loop performance of these DC-DC converters. This method relies on the stability boundary locus approach to help select the proper control parameters that achieve strong dynamic stability across the full operating range regardless of practical implementation challenges. Also, an optimization approach is employed to minimize the passive components’ area within the compensator, achieving a 79% reduction in integration size compared to conventional designs. The controller was fabricated in a 0.35- $\mu \text{m}$ CMOS technology, occupying a core area of 0.438 mm2. The prototype chip was experimentally tested to regulate a buck converter that leverages an e-GaN half-bridge while operating at 1 MHz. Measurement results show a remarkable closed-loop performance against line and load variations, reaching up to ±80 V/ms and ±535 mA per 150 $\mu \text{s}$ , respectively. The output remains stable, showcasing very small ( $ < 100\mu \text{s}$ ) with small overshoots (

Abstract A new chitosan Schiff base was developed via the reaction of chitosan (CH) with 2-chloro-3-formyl-7-ethoxy quinoline (Q) derivative. The alteration in the chemical structure and morphology of CHQ derivative was confirmed by 1H NMR, FT-IR spectroscopy and SEM analysis. The antibacterial activity was considerably promoted with increasing quinoline concentration up to 1 M with maximal inhibition reached 96 and 77% against Staphylococcus haemolyticus and Escherichia coli, respectively. Additionally, CHQ derivative afforded higher ABTS·+ radical scavenging activity reached 59% compared to 13% for native chitosan, approving its acceptable antioxidant activity. Moreover, the developed CHQ derivative can stimulate the glucose uptake in HepG-2 and yeast cells, while better inhibition of α-amylase and α-glucosidase was accomplished with maximum values of 99.78 and 92.10%, respectively. Furthermore, the molecular docking simulation clarified the binding mode of CHQ derivative inside the active site of α-amylase and α-glucosidase, suggesting its potential use as diabetes mellitus drug. The DFT calculations indicated an improvement in the electronic properties of CHQ with a lower energy band gap reached 4.05eV compared to 5.94eV for CH. The cytotoxicity assay revealed the safety of CHQ towards normal HSF cells, hypothesizing its possible application as non-toxic antibacterial, antioxidant, and antidiabetic agent for biomedical applications.

Airborne laser scanning (ALS) data has been widely used for total aboveground tree biomass (AGB) modelling, however, there is less research focusing on estimating specific tree biomass components (wood, branches, bark, and foliage). Knowledge about these biomass components is essential for carbon accounting, understanding forest nutrient cycling, and other applications. In this study, we compare additive AGB estimation (sum of estimated components) with direct AGB estimation using deep neural network (DNN) and random forest (RF) models. We utilise two point cloud DNNs: point-based Dynamic Graph Convolutional Neural Network (DGCNN) and Octree-based Convolutional Neural Network (OCNN). DNN and RF models were trained using a dataset comprised of 2336 sample plots from a mixed temperate forest in New Brunswick, Canada. Results indicate that additive AGB models perform similarly to direct models in terms of coefficient of determination (R2) and root-mean square error (RMSE), and reduced the mean absolute percentage error (MAPE) by 22% on average. Compared to RF, the DNNs provided a small improvement in performance, with OCNN explaining 5% more variation in the data (R2 = 0.76) and reducing MAPE by 20% on average. Overall, this study showcases the effectiveness of additive tree AGB models and highlights the potential of DNNs for enhanced AGB estimation. To further improve DNN performance, we recommend using larger training datasets, implementing hyperparameter optimization, and incorporating additional data such as multispectral imagery.

Abstract Background Endoscopic papillary large balloon dilation (EPLBD) after sphincterotomy (EST) was introduced for the removal of large (≥ 10 mm) or multiple bile duct stones. This method combines the advantages of EST and EPLBD by increasing the efficacy of stone extraction while minimizing complications of EST and EPLBD when used alone. This prospective study aimed to compare between EPLBD with prior limited EST and sole sphnicterotomy for extraction of multiple and/or large common bile duct stones. Results Statistical analysis revealed insignificant difference between the studied groups as regards the presence of periamullary diverticulum (23% vs. 19%, P > 0.05) and the use of mechanical lithotripsy (4% vs. 9%, P > 0.05). The rates of overall and initial stone clearance were not significantly different between both groups [94% vs. 90%), P > 0.05; and 84% vs. 78%, P > 0.05, respectively]. The procedure-related pancreatitis and bleeding in EST/EPLBD group were lower compared to EST group (3% vs. 5%, P > 0.05; and 2% vs. 6%, P > 0.05, respectively). None of the studied groups’ patients died or developed procedure-related perforation or cholangitis. Conclusion Endoscopic large balloon dilation with prior limited sphincterotomy is an effective and safe endoscopic technique for removing multiple and/or large CBDSs.

Analysis of industrial data imposes several challenges. These data are acquired from heterogeneous sources such as sensors, cameras, IoT, etc, and are stored in different structures and formats with different sampling frequencies. They are also stored in isolated silos in different locations which hinders their exploitation. Therefore, there is a clear need to integrate these disconnected data silos at different processing levels and make them clean, easily accessible, and fully exploitable. This paper proposes a data fusion method that merges heterogeneous sources of data at raw, information, and decision levels using polygon generation and deep learning (DL) techniques. An innovative polygon generation technique is proposed to preprocess each data source and convert it into powerful representations that capture all possible relationships in the data, thus extracting the maximum knowledge and achieving better prediction accuracy of the corresponding DL method. The proposed method is targeting challenging data modeling problems found in industrial processes. It is validated successfully using a case study in the realm of process system engineering. The results obtained demonstrate that the proposed fusion method is more accurate, with a minimum of 20% improvement, compared to other methods previously used in the literature.

The purpose of this research is to explore the extent to which internal corporate social responsibility activities affect employees’ normative organizational commitment during the COVID-19 crisis and to survey the role of the administrative level as a moderator between the two of them. A survey in the form of a self-completed questionnaire was conducted on a sample of employees in hospitality and tourism establishments in Hail city, Kingdom of Saudi Arabia. 213 employees voluntarily participated in the current study. Their responses were examined by using linear regression and exploratory factor analyses. The findings revealed that internal corporate social responsibility is a positive predictor of normative organizational commitment. The total effect of internal corporate social responsibility on normative organizational commitment could not be enhanced through the moderation of the administrative position. This study has important implications for both academics and professionals. Theoretical and managerial implications, contributions, limitations, and future study objectives were reviewed in light of the findings.

The utilization of fuel cells (FC) in automotive technology has experienced significant growth in recent years. Fuel cell hybrid electric vehicles (FCHEVs) are powered by a combination of fuel cells, batteries, and/or ultracapacitors (UCs). By integrating power converters with these power sources, the FCHEV system can overcome the limitations of using them separately. The performance of an FCHEV is influenced by the efficiency of the power electronics converter controller, as well as the technical efficiency of the power sources. FCHEVs need intricate energy management systems (EMSs) to function effectively. Poor EMS can lead to low efficiency and accelerated fuel cell and battery degradation. The literature discusses various types of EMSs such as equivalent consumption minimization strategy, classical PI controller, fuzzy logic controller, and mutative fuzzy logic controller (MFLC). It also discusses a systematic categorization of FCHEV topologies and delves into the unique characteristics of these topologies. Furthermore, it provides an in-depth comparative study of EMSs applied in FCHEVs, encompassing rule-based, optimization-based, and advanced learning-based approaches. However, comparing different EMSs can be challenging due to the varying vehicle and system parameters, which might lead to false claims being made regarding system performance. This review aims to categorize and discuss the various topologies of FCHEVs, highlighting their pros and cons, and comparing several EMSs based on performance metrics such as state of charge (SOC) and FC deterioration. This paper seeks a deeper comprehension of the recent advancements in EMSs for FCHEVs. It offers insights that can facilitate a more comprehensive grasp of the current state of research in this field, aiding researchers in staying up to date with the latest developments.

Abstract Objective Many studies still dispute the identification of independent risk factors that influence outcome after neonatal cardiac surgery. We present our study to announce the contemporary outcomes and risk profile of neonatal cardiac surgery at our institute. Methods We designed a retrospective study of neonatal patients who underwent surgery for congenital heart diseases between June 2011 and April 2020. Demographic, operative, and postoperative data were collected from medical records and surgical databases. The primary outcome was the operative mortality (in-hospital death) and secondary outcomes included hospital length of stay, intensive care unit stay, duration of mechanical ventilation. Results In total, 1155 cardiac surgeries in children were identified; of these, 136 (11.8%) were performed in neonates. Arterial switch operations (48 cases) were the most frequent procedures. Postoperatively, 11 (8.1%) patients required extracorporeal membrane oxygenation, and 4 (2.9%) patients had complete heart block. Postoperative in-hospital mortality was 11%. The median postoperative duration of mechanical ventilation, intensive care unit stay, and hospital length of stay were 6, 18, and 24 days, respectively. Conclusion The early outcomes of neonatal cardiac surgery are encouraging. The requirement of postoperative extracorporeal membrane oxygenation support, postoperative intracranial hemorrhage, and acute kidney were identified as independent risk factors of mortality following surgery for congenital heart defects in neonates.

Abstract Background Light is the critical factor that affects the eye's morphology and auxiliary plans. The ecomorphological engineering of the cornea aids the physiological activities of the cornea during connections between photoreceptor neurons and light photons. Cornea was dissected free from the orbit from three avian species as ibis (Eudocium albus), duck (Anas platyrhynchus domesticus) and hawk (Buteo Buteo) and prepared for light and scanning electron microscopy and special stain for structural comparison related to function. Results The three investigated avian species are composed of three identical layers; epithelium, stroma, and endothelium, and two basement membranes; bowman's and Descemet’s membrane, separating two cellular layers, except for B. buteo which only has a Descemet’s membrane. The corneal layers in the investigated species display different affinity to stain with Periodic Acid Schiff stain. The external corneal surface secured by different normal epithelial cells ran from hexagonal to regular polygonal cells. Those epithelial cells are punctured by different diameter microholes and microplicae and microvilli of various length. Blebs are scarcely distributed over their surface. The present investigation utilized histological, histochemical and SEM examination. Conclusions The study presents a brief image/account of certain structures of cornea for three of Avian’s species. Data distinguish the anatomic structures of the owl's eye. The discussion explains the role of some functional anatomical structures all through the vision.

With increasing wind farms scale, the practical problems become more complicated. One of the prominent problems is over-voltage production due to frequent switching activity. The over-voltage cruelty mainly depends on the wind farm topology, defined for an arrangement of the wind farm feeders between the turbines. In this paper, the switching over-voltages in different wind farm topologies are presented by simulating ZAAFRANA wind farm in Egypt with the support of DIGSILENT. First, the four different topologies named radial, single-sided ring, double-sided ring, and star, are examined by measuring the generated over-voltages. Finally, based on the more accurate and comprehensive analysis of the over-voltage produced by the four topologies, an effective methodology is proposed for reducing the amount of the over-voltage peaks, in the low-cost radial topology, by splitting the switching process into two stages. The proposed methodology is applied to ZAAFRANA wind farm and found that the destructive effects are reduced remarkably.

Background: 4-Aminoquinoline derivatives possess various potential biological properties.The introduction of additional piperazine heterocyclic pharmacophoric moiety tends to haveprofound impact in increasing the activity. The present work was undertaken to investigate thein-vitro and in-vivo anti-inflammatory activity as well as the peripheral and central analgesicactivities of compound 1-(4-(7-chloroquinoline-4-yl)piperazin-1-yl)-2-(4-phenylpiperazin-1-yl)ethanone (5) in experimental models. Methods: The percentage inhibition of the lipopolysaccharide induced NO release of 7-chloro-4-(piperazin-1-yl)quinoline derivatives 1-9 was determined in RAW 264.7 murine macrophagemodel. Western blot analysis was performed to evaluate the effect of compound 5 on proteinexpression of inducible nitric oxide synthase (iNOS). Gene expression of inflammatory markerswas evaluated using real-time polymerase chain reaction. The peripheral and central analgesicactivities of compound 5 were evaluated in mice using writhing and hot-plate tests, respectively.Anti-inflammatory activity was assessed using carrageenan-induced paw edema assay in miceand serum NO and COX-2 levels were measured. Results: Compound 5 demonstrated the highest NO inhibitory activity that was accompaniedby inhibition of iNOS protein expression and decreased gene expression levels of inflammatorymarkers. It revealed a potential peripheral analgesic effect through inhibition of abdominalwrithing in mice treated with doses of 15 and 30 mg/kg and its effect was comparable to diclofenacsodium. Compound 5 possessed an analgesic activity starting from 15 min post administrationand reached its peak at 45 min which was significantly higher than that of tramadol hydrochloridesuggesting its potential as central analgesic agent. It also showed percentage of inhibition ofedema of 34, 50 and 64% at 1, 2, and 3 h respectively, post carrageenan challenge together with asignificant decrease in serum NO and COX-2 levels. Conclusion: The remarkable anti-inflammatory and analgesic activities of compound 5 couldbe attributed to the advantageous introduction of the heterocyclic 7-chloro-4-(piperazin1-yl)quinoline scaffold incorporated with N-phenylpiperzine functional groups linked together withthe ethanone pharmacophoric chain.

Abstract Background Different treatment options are available for the management of BPH. Our study aimed to compare the surgical outcomes of a holmium laser enucleation of the prostate (HoLEP) and a bipolar transurethral resection of the prostate (Bipolar-TURP) after 2 years. Methods Our prospective randomized study included 114 patients: 55 patients underwent HoLEP procedure and 59 patients underwent bipolar TURP procedure. All patients underwent a complete preoperative assessment and a physical examination. The postoperative follow-up data included Q max and IPSS recordings at 1, 3, 6, 12, and 24 months and PVR urinary volume recordings at 6 and 12 months. Any postoperative complications were also recorded. Results There were no statistically significant differences between both groups regarding IPSS and Q max scores at one and 24 months postoperative. Also, there were no statistically significant differences between both groups regarding postoperative PVR at 6 and 12 months. One patient in the HoLEP group developed total incontinence after surgery. Conclusion Our study did not show a significant difference between HoLEP and bipolar TURP regarding postoperative Q max and IPSS scores at 24 months of follow-up.

Abstract Background Diabetes is a risk factor for infection with coronaviruses. This study describes the demographic, clinical data, and outcomes of critically ill patients with diabetes and Middle East Respiratory Syndrome (MERS). Methods This retrospective cohort study was conducted at 14 hospitals in Saudi Arabia (September 2012–January 2018). We compared the demographic characteristics, underlying medical conditions, presenting symptoms and signs, management and clinical course, and outcomes of critically ill patients with MERS who had diabetes compared to those with no diabetes. Multivariable logistic regression analysis was performed to determine if diabetes was an independent predictor of 90-day mortality. Results Of the 350 critically ill patients with MERS, 171 (48.9%) had diabetes. Patients with diabetes were more likely to be older, and have comorbid conditions, compared to patients with no diabetes. They were more likely to present with respiratory failure requiring intubation, vasopressors, and corticosteroids. The median time to clearance of MERS-CoV RNA was similar (23 days (Q1, Q3: 17, 36) in patients with diabetes and 21.0 days (Q1, Q3: 10, 33) in patients with no diabetes). Mortality at 90 days was higher in patients with diabetes (78.9% versus 54.7%, p

Foot-and-mouth disease (FMD) vaccine does not afford early effective protection until adaptive immune protection caused by the vaccination occurs. Therefore, an alternative prophylactic application of antiviral agents for inhibition of the FMD virus is needed, and this is the scope of this study. In this study, we tested nine adamantane-pyrazole derivatives that could exhibit antiviral activity against FMDV infection either in vitro through baby hamster kidney cells (BHK-21 cells) infected with FMD virus serotypes O pan Asia. Cytotoxicity Concentration 50 (CC50) activity of pyrazole derivatives (1, 2, 3, 4, 5a,b, 6a-c) were detected on BHK-21 cells and ranged between 500 to 3000µg/ml. Inhibitory Concentration 50 (IC50) on BHK-21 was achieved only for the most promising three derivatives 6a-c and exhibited an antiviral activity with a therapeutic index of 30, and that was reflected on the antiviral activity response in baby mice with different concentrations where a concentration of 50 µg/ml for pyrazole derivatives 6a and 6c compounds and 40 µg/ml for bis-tolyl pyrazole 6b that achieve 100% protection and this results was as effective as 50 µg/ml of amantadine. Specifically, diaryl pyrazole derivatives 6a-c that protected for six days following FMDV challenge. These results suggested that pyrazole derivatives 6a-c could be used as an effective antiviral agent against FMD virus infection. Molecular docking simulation of the target compounds 6a-c had good binding energy and the tested compounds recommended being an excellent 3C protease inhibitor compared to Amantadine and Ribavirin. These findings may explain the antiviral activity of the target compounds.

A series of 6-(morpholinosulfonyl)quinoxalin-2(1H)-one based hydrazone, hydrazine, and pyrazole moieties were designed, synthesized, and evaluated for their in vitro antimicrobial activity. All the synthesized quinoxaline derivatives were characterized by IR, NMR (1H /13C), and EI MS. The results displayed good to moderate antimicrobial potential against six bacterial, and two fungal standard strains. Among the tested derivatives, six quinoxalin-2(1H)-one derivatives 4a, 7, 8a, 11b, 13, and 16 exhibited a significant antibacterial activity with MIC values (0.97–62.5 µg/mL), and MBC values (1.94–88.8 µg/mL) compared with Tetracycline (MICs = 15.62–62.5 µg/mL, and MBCs = 18.74–93.75 µg/mL), and Amphotericin B (MICs = 12.49–88.8 µg/mL, and MFC = 34.62–65.62 µg/mL). In addition, according to CLSI standards, the most active quinoxalin-2(1H)-one derivatives demonstrated bactericidal and fungicidal behavior. Moreover, the most active quinoxaline derivatives showed a considerable antibacterial activity with bactericidal potential against multi-drug resistance bacteria (MDRB) strains with MIC values ranged between (1.95–15.62 µg/mL), and MBC values (3.31–31.25 µg/mL) near to standard Norfloxacin (MIC = 0.78–3.13 µg/mL, and MBC = 1.4–5.32 µg/mL. Further, in vitro S. aureus DNA gyrase inhibition activity were evaluated for the promising derivatives and displayed potency with IC50 values (10.93 ± 1.81–26.18 ± 1.22 µM) compared with Ciprofloxacin (26.31 ± 1.64 µM). Interestingly, these derivatives revealed as good immunomodulatory agents by a percentage ranging between 82.8 ± 0.37 and 142.4 ± 0.98 %. Finally, some in silico ADME, toxicity prediction, and molecular docking simulation were performed and showed a promising safety profile with good binding mode.

Nowadays, searching for new anti-infective agents with diverse mechanisms of action has become necessary. In this study, 16 pyrazole and pyrazolo[1,5-a]pyrimidine derivatives were synthesized and assessed for their preliminary antibacterial and antibiofilm activities. All these derivatives were initially screened for their antibacterial activity against six clinically isolated multidrug resistance by agar well-diffusion and broth microdilution methods. The initial screening presented significant antibacterial activity with a bactericidal effect for five compounds, namely 3a, 5a, 6, 9a, and 10a, compared with Erythromycin and Amikacin. These five derivatives were further evaluated for their antibiofilm activity against both S. aureus and P. aeruginosa, which showed strong biofilm-forming activity at their MICs by >60%. The SEM analysis confirmed the biofilm disruption in the presence of these derivatives. Furthermore, anti-QS activity was observed for the five hybrids at their sub-MICs, as indicated by the visible halo zone. In addition, the presence of the most active derivatives reduces the violacein production by CV026, confirming that these compounds yielded anti-QS activity. Furthermore, these compounds showed strong inhibitory action against human carbonic anhydrase (hCA-I and hCA-II) isoforms with IC50 values ranging between 92.34 and 168.84 nM and between 73.2 and 161.22 nM, respectively. Finally, radiosterilization, ADMET, and a docking simulation were performed.

This review presents a systematic and comprehensive survey of the method of preparation and the chemical reactivity of 1-(4-substituted-aminophenyl) ethanones. The target compounds are important intermedi-ates for the synthesis of a variety of synthetically useful and novel heterocyclic systems with different ring sizes such as thiophene, oxazole, triazole, pyrimidine, pyridine, quinolone, coumarin, imidazopyrimidine, pyridoimidazole and triazolo[1,5-a] pyridine.

The current study investigated the cytotoxic effect of ten sulfonamide-derived isatins, following molecular hybridization, based on the association principles, on hepatocellular carcinoma (HCC) HepG2 and Huh7 cell lines, compared for safety using human normal retina pigmented epithelial (RPE-1) cells. The ten compounds showed variable in vitro cytotoxicity on HepG2 and Huh7 cells, using the MTT assay. Four compounds (4/10) were highly cytotoxic to both HepG2 and HuH7. However, only 3 of these 4 were of the highest safety margin on RPE-1 cells in vitro and in the in vivo acute (14-day) oral toxicity study. These later, superior three compounds’ structures are 3-hydroxy-3-(2-oxo-2-(p-tolyl)ethyl)-5-(piperidin-1-ylsulfonyl)indolin-2-one (3a), N-(4-(2-(2-oxo-5-(piperidin-1-ylsulfonyl)indolin-3-ylidene)acetyl)phenyl)acetamide (4b), and N-(3-(2-(2-oxo-5-(piperidin-1-ylsulfonyl)indolin-3-ylidene)acetyl)phenyl)acetamide (4c). The half-maximal inhibitory concentration (IC50) of the tested compounds (3a, 4b, and 4c) on HepG2 cells were approximately 16.8, 44.7, and 39.7 μM, respectively. The 3a, 4b, and 4c compounds significantly decreased the angiogenic marker epithelial growth factor receptor (EGFR) level and that was further confirmed via molecular docking inside the EFGR active site (PDB: 1M17). The binding free energies ranged between −19.21 and −21.74 Kcal/mol compared to Erlotinib (−25.65 Kcal/mol). The most promising compounds, 3a, 4b, and 4c, showed variable anticancer potential on “hallmarks of cancer”, significant cytotoxicity, and apoptotic anti-angiogenic and anti-invasive effects, manifested as suppression of Bcl-2, urokinase plasminogen activation, and heparanase expression in HepG2-treated cells’ lysate, compared to non-treated HepG2 cells. In conclusion, compound “3a” is highly comparable to doxorubicin regarding cell cycle arrest at G2/M, the pre-G0 phases and early and late apoptosis induction and is comparable to Erlotinib regarding binding to EGFR active site. Therefore, the current study could suggest that compound “3a” is, hopefully, the most safe and active synthesized isatin sulfonamide derivative for HCC management.

The first outbreak in Wuhan, China, in December 2019 was reported about severe acute coronaviral syndrome 2 (SARS-CoV-2). The global coronavirus disease 2019 (COVID-19) pandemic in 2020 resulted in an extremely high potential for dissemination. No drugs are validated in large-scale studies for significant effectiveness in the clinical treatment of COVID-19 patients, despite the worsening trends of COVID-19. This study aims to design a simple and efficient cyclo-condensation reaction of 6-aminouracil derivatives 2a–e and isatin derivatives 1a–c to synthesize spiro-oxindoles 3a–d, 4a–e, and 5a–e. All compounds were tested in vitro against the SARS-CoV-2. Four spiro[indoline-3,5′-pyrido[2,3-d:6,5-d’]dipyrimidine derivatives 3a, 4b, 4d, and 4e showed high activities against the SARS-CoV-2 in plaque reduction assay and were subjected to further RNA-dependent-RNA-polymerase (RdRp) and spike glycoprotein inhibition assay investigations. The four compounds exhibited potent inhibitory activity ranging from 40.23 ± 0.09 to 44.90 ± 0.08 nM and 40.27 ± 0.17 to 44.83 ± 0.16 nM, respectively, when compared with chloroquine as a reference standard, which showed 45 ± 0.02 and 45 ± 0.06 nM against RdRp and spike glycoprotein, respectively. The computational study involving the docking studies of the binding mode inside two proteins ((RdRp) (PDB: 6m71), and (SGp) (PDB: 6VXX)) and geometrical optimization used to generate some molecular parameters were performed for the most active hybrids.

Objective: The aim of this study was to assess apical root resorption (RR) following the application of micro-osteoperforation (MOP) and piezocision (PzC) assisted orthodontics for the acceleration of tooth movement (TM). Materials and Methods: A total number of 16 patients seeking orthodontic therapy were included in this study. All patients had undergone 1st premolars extraction and were indicated for canine retraction. These patients were divided into two groups; one was treated using MOP in one side while the other side served as control. In the other group PzC was performed in one side with no intervention done on the other side. Cone-beam Computed Tomography (CBCT) scans were obtained for every patient before and after canine retraction in order to evaluate amount of RR. Results: In the MOP group, there was no significant difference in canine root length between experimental and control sides. Whereas, in the PzC group, there was a statistically significant decrease in root length in the experimental side compared with the control side. When comparing both groups, the experimental PzC side showed a statistically significant decrease in root length compared to experimental MOP side postoperatively. Conclusion: Experimental PzC showed statistically significant decreases in canine root length compared to both experimental MOP and control side after canine retraction.

The impact of zinc oxide nanoparticles (ZnO-NPs) on the pathogenesis of coccidiosis in broiler chickens was tested. A total of 160 1-day-old broiler chicks (Ross 308) were randomly allocated into 4 groups (n = 40). Group 1: unchallenged, unmedicated; Group 2: challenged, unmedicated; Group 3: challenged, supplemented with diclazuril (1 ppm); Group 4: challenged, supplemented with ZnO-NPs (20 ppm). Mixed Eimeria species (E. maxima, E. acervulina, E. mivati, and E. tenella) of a commercial coccidial vaccine (FORTEGRA®) were used to perform the coccidial challenge by 15× of its vaccinal dose on the 14th day of age. Diclazuril and ZnO-NPs supplementation in Group 3 and 4, respectively, reduced the mortality rate due to coccidial challenge to 5.8% compared to 11.9% in Group 2. The growth performance was improved by ZnO-NPs in coccidiosis-infected group (p ≤ 0.05) compared to Group 2 and was comparable to that of Group 3 (p ≥ 0.05). The average oocyst count was lower in Groups 3 and 4 (7.8 × 103 and 14.3 × 103, respectively) than in Group 2 (67 × 103 oocysts). Group 3 had a decreased gross lesion score in duodenum and caecum (p ≤ 0.05) as well as jujenum and ileum (p ≥ 0.05) compared to Group 2; while the average lesion scores of all intestinal parts in Group 4 were significantly decreased (p ≤ 0.05). However, diclazuril was superior to ZnO-NPs in reducing caecal lesion score (p ≤ 0.05). Plasma carotenoids levels were increased by diclazuril (p ≥ 0.05) and ZnO-NPs (p ≤ 0.05) supplementation compared to Group 2. Oxidative stress appeared on the fourth week post-challenge (pc) in Group 2 (p ≤ 0.05) compared to Group 1, while the dietary supplementation with either diclazuril or ZnO-NPs numerically decreased Malondialdhyde (p ≥ 0.05) and statistically increased antioxidant activity (p ≤ 0.05). Both medications significantly improved the PCV%, Hb% and RBCs count on the 6th-day and 4th-week pc (p ≤ 0.05) compared to Group 2, though this improvement was higher significantly in Group 4 than Group 3 on the 6th day pc (p ≤ 0.05). Neither coccidial challenge nor medications had an impact on the total WBCs count as well as organ index, except Bursa of fabricious index that significantly improved by ZnO-NPs on the 4th-week pc compared to Group 2. Coccidial challenge reduced total protein and globulin levels and increased the serum alanine aminotransferase, serum cholesterol, and low-density lipoprotein levels (p ≤ 0.05) compared to Group 1, while those of both medicated groups (Group 3 and 4) were comparable to Group 1 (p ≥ 0.05). In conclusion, ZnO-NPs were found to be as effective as diclazuril against coccidiosis. However, further research is needed to fully comprehend its anticoccidial mechanisms.

Aims: The aim of this study is to compare between transrectal ultrasound (TRUS)-guided aspiration and transurethral (TU) deroofing in the treatment of prostatic abscess regarding safety and efficacy. Settings and Design: This prospective randomized study was done during the period between April 2009 and March 2015 and included 32 patients with prostatic abscess. Subjects and Methods: All patients were enrolled in the study after obtaining a written informed consent and approval of the local ethical committee. The patients were randomly allocated into two groups; Group A treated by TRUS-guided aspiration, saline wash, and local injection of antibiotics and Group B treated by TU deroofing of the abscess. All patients received broad-spectrum antibiotics during the period of treatment, and the follow-up was done on the 5th day by TRUS to ensure complete resolution of the abscess. Statistical Analysis Used: Statistical analysis was done using online social science statistical calculators http://www.socscistatistics.com/Default.aspx using t-test for two independent means, Chi-square test, and Mann–Whitney U-test with P < 0.05 considered statistically significant. Results: The mean age was 59 ± 11.46 and 60 ± 13.65 years for Groups A and B, respectively. Diabetes mellitus was detected in 9 (56.25%) and 6 (37.5%) patients in Groups A and B, respectively, hypertension in 7 (43.75%) and 6 (37.5%) patients in Groups A and B, respectively, and two patients (12.5%) with liver cirrhosis in each group. The mean size of the abscess was 3.36 ± 0.86 and 3.04 ± 0.86 cm in Groups A and B, respectively (P = 0.29). The abscess recurred in five patients (31.25%) and one patient (6.25%) in Groups A and B, respectively (P = 0.08). TRUS-guided aspiration was done for all recurrent cases except for two patients (12.5%) in Group A required trans urethral deroofing of the recurrent abscess. The mean hospital stay was 12.9 ± 4.05 and 7.25 ± 2.40 days for Groups A and B, respectively (P = 0.000). In Group A, one patient (6.25%) was complicated by urethrorectal fistula, whereas in Group B, one patient (6.25%) was complicated by septic shock, three patients (13.75%) with epididymo-orchitis and two patients (12.5%) with urethral stricture. Conclusion: Patients with prostatic abscess treated with TRUS-guided aspiration show less morbidity, higher recurrence rate, and longer hospital stay than those treated with TU deroofing.

Background: Breast milk adiponectin could play a role in the regulation of infants' growth during lactation. Aim of Work: The aim is to evaluate adiponectin concentration in human milk and to investigate its relationship with serum adiponectin concentration in lactating mothers and their breastfed infants and with anthropometric parameters of infants and mothers. Materials and Methods: Sixty healthy term infants and their healthy lactating mothers are included at infant age of 1 month then repeated again at the age of 4 months. All subjects included in this study were subjected to history, clinical examination, investigations including serum level of adiponectin of infants and their mothers by RIA test, human milk level of adiponectin by ELISA test. Results: There was a significant decrease in serum adiponectin of infant and mothers and maternal breast milk at the age of 4 months when compared to them at the age of 1 month. There was a significant positive correlation between infant serum adiponection, maternal serum adiponectin and breast milk adiponectin at infant's age of 1 month and at infant's age of 4 months. There was a significant negative correlation between maternal serum adiponectin and BMI of mothers. There was a significant negative correlation between infant serum adiponectin and their weight and length of infants at the age of 1 month and at the age of 4 months. Conclusions: There's a metabolic link between mothers and their infants through breast milk during the first 6 months of life. A gradual decline in adiponectin level in maternal breast milk is associated with a gradual increase in infant growth up to 6 months of age.

Herein, a series of novel hybrid sulfaguanidine moieties, bearing 2-cyanoacrylamide 2a–d, pyridine-2-one 3–10, and 2-imino-2H-chromene-3-carboxamide 11, 12 derivatives, were synthesized, and their structure confirmed by spectral data and elemental analysis. All the synthesized compounds showed moderate to good antimicrobial activity against eight pathogens. The most promising six derivatives, 2a, 2b, 2d, 3a, 8, and 11, revealed to be best in inhibiting bacterial and fungal growth, thus showing bactericidal and fungicidal activity. These derivatives exhibited moderate to potent inhibition against DNA gyrase and DHFR enzymes, with three derivatives 2d, 3a, and 2a demonstrating inhibition of DNA gyrase, with IC50 values of 18.17–23.87 µM, and of DHFR, with IC50 values of 4.33–5.54 µM; their potency is near to that of the positive controls. Further, the six derivatives exhibited immunomodulatory potential and three derivatives, 2d, 8, and 11, were selected for further study and displayed an increase in spleen and thymus weight and enhanced the activation of CD4+ and CD8+ T lymphocytes. Finally, molecular docking and some AMED studies were performed.

Objective: To investigate risk factors of ectopic pregnancy (EP) in nulliparous women and the main lines of treatment offered. Methods: A case-control study was conducted from January 2013 to December 2014 at Mansoura University Hospitals, Egypt. A total of 36 cases of EP in nulliparous women were included. Each case was matched to 2 healthy subsequent pregnant nulliparous women. Data were gathered by using a questionnaire. Odds ratios were adjusted for the confounding factors using multiple logistic regression models. The main outcome measures were predictors of EP. Results: There were no significant differences in age and gravidity between cases and controls (p > 0.05). The main predictors of EP were history of pelvic inflammatory diseases (PID) (OR = 10.14, 95% CI = 3.382–30.435, p

A series of Bis-pyrazole Schiff bases (6a–d and 7a–d) and mono-pyrazole Schiff bases (8a–d and 9a–d) were designed and synthesized through the reaction of 5-aminopyrazoles 1a–d with aldehydes 2–5 using mild reaction condition with a good yield percentage. The chemical structure of newly formed Schiff bases tethered pyrazole core was confirmed based on spectral and experimental data. All the newly formed pyrazole Schiff bases were evaluated against eight pathogens (Gram-positive, Gram-negative, and fungi). The result exhibited that, most of them have good and broad activities. Among those, only six Schiff bases (6b, 7b, 7c, 8a, 8d, and 9b) displayed MIC values (0.97–62.5 µg/mL) compared to Tetracycline (15.62–62.5 µg/mL) and Amphotericin B (15.62–31.25 µg/mL), MBC values (1.94–87.5 µg/mL) and selectivity to tumor cell than normal cells. Immunomodulatory activities showed that the promising Schiff bases increase the immunomodulator effect of defense cell and the Schiff base 8a is the highest one by (Intra. killing activity = 136.5 ± 0.3%) having a pyrazole moiety as well as amide function (O=C-NH2) and piperidinyl core. Furthermore, the most potent one exhibited broad activity depending on both MIC and MBC values. Moreover, to study the mechanism of these pyrazole Schiff bases, two active Schiff bases 8a and 9b from six derivatives were introduced to study the enzyme assay as dihydrofolate reductase (DHFR) on E. coli organism and DNA gyrase with two different organisms, S. aureus and B. subtilis, to determine the inhibitory activities with lower values in the case of DNA gyrase (8a and 9b) or nearly as DHFR compound 9b, while pyrazole 8a showed excellent inhibitory against all enzyme assay. The molecular docking study against dihydrofolate reductase and DNA gyrase were performed to study the binding between active site in the pocket with the two Schiff bases (8a and 9b) that exhibited good binding affinity with different bond types as H-bonding, aren-aren, and arene-cation interaction as well as study the physicochemical and pharmacokinetic properties of the two active Schiff bases 8a and 9b.

BACKGROUND:Middle East Respiratory Syndrome Coronavirus (MERS-CoV) leads to healthcare-associated transmission to patients and healthcare workers with potentially fatal outcomes. AIM:We aimed to describe the clinical course and functional outcomes of critically ill healthcare workers (HCWs) with MERS. METHODS:Data on HCWs was extracted from a multi-center retrospective cohort study on 330 critically ill patients with MERS admitted between (9/2012-9/2015). Baseline demographics, interventions and outcomes were recorded and compared between survivors and non-survivors. Survivors were approached with questionnaires to elucidate their functional outcomes using Karnofsky Performance Status Scale. FINDINGS:Thirty-Two HCWs met the inclusion criteria. Comorbidities were recorded in 34% (11/32) HCW. Death resulted in 8/32 (25%) HCWs including all 5 HCWs with chronic renal impairment at baseline. Non-surviving HCW had lower PaO2/FiO2 ratios 63.5 (57, 116.2) vs 148 (84, 194.3), p = 0.043, and received more ECMO therapy compared to survivors, 9/32 (28%) vs 4/24 (16.7%) respectively (p = 0.02).Thirteen of the surviving (13/24) HCWs responded to the questionnaire. Two HCWs confirmed functional limitations. Median number of days from hospital discharge until the questionnaires were filled was 580 (95% CI 568, 723.5) days. CONCLUSION:Approximately 10% of critically ill patients with MERS were HCWs. Hospital mortality rate was substantial (25%). Patients with chronic renal impairment represented a particularly high-risk group that should receive extra caution during suspected or confirmed MERS cases clinical care assignment and during outbreaks. Long-term repercussions of critical illness due to MERS on HCWs in particular, and patients in general, remain unknown and should be investigated in larger studies.

Multidrug resistance (MDR) is a critical hindrance to the success of cancer chemotherapy. The main thing responsible for MDR phenotypes are plasma-membranes associated with adenosine triphosphate (ATP) Binding Cassette (ABC) drug efflux transporters, such as the P-glycoprotein (Pgp) transporter that has the broadest spectrum of substrates. Curcumin (CURC) is a Pgp inhibitor, but it is poorly soluble and bioavailable. To overcome these limitations, we validated the efficacy and safety of CURC, loaded in biocompatible solid lipid nanoparticles (SLNs), with or without chitosan coating, with the goal of increasing the stability, homogeneous water dispersibility, and cellular uptake. Both CURC-loaded SLNs were 5−10-fold more effective than free CURC in increasing the intracellular retention and toxicity of doxorubicin in Pgp-expressing triple negative breast cancer (TNBC). The effect was due to the decrease of intracellular reactive oxygen species, consequent inhibition of the Akt/IKKα-β/NF-kB axis, and reduced transcriptional activation of the Pgp promoter by p65/p50 NF-kB. CURC-loaded SLNs also effectively rescued the sensitivity to doxorubicin against drug-resistant TNBC tumors, without signs of systemic toxicity. These results suggest that the combination therapy, based on CURC-loaded SLNs and doxorubicin, is an effective and safe approach to overcome the Pgp-mediated chemoresistance in TNBC.

Nanocomposites of natural bone that show some benefits in terms of both composition and microstructure were synthesized by an in situ precipitation method. Hydroxyapatite (Hap) was prepared from cost-effective precursors within chitosan (CS) dissolved in aqueous acetic acid solution. The nanocomposite was synthesized for the removal of brilliant green dye (BG) from a contaminated water solution. The compositional and morphological properties of the nanocomposite were studied by means of FTIR spectroscopy, X-ray diffraction (XRD), SEM, and TEM analysis. Batch experiments were carried out to investigate the effects of pH, contact time, and initial concentration, as well as the adsorbent dosage and zero point charge for the sorbent to determine a suitable medium for the adsorption process. The sorption models using Mories-Weber, Lagrange, and Bangham equations were used to identify the mechanism and reaction order. The isotherm model was carried out using Langmuir, Freundlich, and Dubinin-Radusekevisch-Kanager equations to calculate the adsorption capacity and type of adsorption. Thermodynamic parameters, enthalpy change (∆Ho), entropy change (∆So), and Gibbs free energy (∆Go) were evaluated. All of the results suggest the feasibility of using nanocomposites as a sorbent for brilliant green dye removal.

Objective(s): The aim of this study was to review the frequency, indication, associated risk factors, rates of maternal morbidity and mortality as well as neonatal outcome after emergency peripartum hysterectomy at a tertiary care referral hospital. Study design: A retrospective observational study carried out from November 2008 to 2011. Patients and methods: The study comprised of 29 patients at Mansoura University Hospitals a tertiary referral hospital Egypt. Frequency, indications, associated risk factors and maternal morbidity and mortality were reported as well as neonatal survival and outcome. Results: The frequency of emergency peripartum hysterectomy in our study period was (29/10000 deliveries = 0.29%) and the mean age and parity of the patients were 36.4 ± 8.9 years and 2.9 ± 1.56 respectively. The mean gestational age at the time of delivery was 35.45 ± 2.9 weeks. Twenty-five patients (86.2%) had a history of previous cesarean delivery(ies) meanwhile the others (4/29 = 13.8%) had vaginal delivery(ies). Abnormally adherent placenta and severe postpartum hemorrhage were the main indication for the procedure (11/29 = 37.9%). Other indications included rupture uterus (7/29 = 24.1%), severe uterine atony (7/29 = 24.1%), multiple uterine fibroid (3/29 = 10.3%) and 1 case with severe uterine infection (1/29 = 3.4%). All women received blood transfusion, 5 cases (17.2%) required intensive care unit admission, and 3 cases (10.3%) developed intraoperative arrest, 5 patients (17.2%) had urinary bladder injuries and 2 cases (6.8%) had wound infection. The maternal mortality occurred in 4 cases (13.8%) while overall neonatal survival rate was 86.2% (25/29). Conclusion: Emergency peripartum hysterectomy is still high in our locality representing a significant risk for the mother and the baby; hence health care authorities should raise the problem to decrease this burden.

Background/Aim: Major surgery performed as a day surgery procedure is not uncommon. The aim of this study is to evaluate the feasibility of day surgery procedures in laparoscopic cholecystectomy (LC). Patients and Methods: A total of 210 patients scheduled for elective LC between 2006 and 2008 were included in our study. The mean age was 40.63 years (range, 25 - 70 years). The indication for surgery was symptomatic cholelithiasis confirmed by ultrasonography without clinical or radiological evidence of acute cholecystitis. All patients were informed about the same-day discharge policy and received the postoperative instruction form on discharge. Preoperative work-up included history taking and physical examination in addition to standard laboratory and radiological tests. Patients above 35 years of age had an ECG done. All patients were examined in the outpatient clinic by a consultant anesthesiologist the night before surgery. Operative time, hospital stay, and complications were recorded. Telephonic feedback, on the morning after surgery was routinely done as an early follow-up. Results: Out of the total number of patients, 140 patients were ASA (I) and 70 were ASA (II) (40 patients were controlled hypertensives and 30 were controlled diabetics). Conversion rate was 1.4%. The mean hospital stay was 6.7 hours (range, 6 - 8 hours). The mean operative time was 31.2 minutes (range, 20 - 60 minutes). None of the patients required an abdominal drain. No morbidities or mortalities were reported in this series. Conclusion: LC may be done as a day surgery procedure with optimal patient satisfaction and without complications.

High-speed links which employ source synchronous clocking architectures have the ability to track correlated jitter between clock and data channels up to high frequencies. However, system timing margins are degraded by channel skew between clock and data signals and high-frequency loss. This paper describes how these key channel effects impact the jitter performance and influence the clocking architecture of high-speed source synchronous links. Tradeoffs in complexity and jitter tracking performance of common per-channel de-skew circuits are discussed, along with how band-pass filtering can be leveraged to provide additional jitter filtering at the receiver. Jitter tolerance analysis for a 10 Gb/s system shows that a near all-pass delay-locked loop (DLL) and phase-interpolator- (PI-) based de-skew performs best under low skew conditions, while, at high skew, architectures which leverage band-pass clock filtering or a phase-locked loop (PLL) for increased jitter filtering are more suitable. De-skew based on injection-locked oscillators (ILOs) offer a reduced complexity design and competitive jitter tolerance over a wide skew range.