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Whether the design is done manually or by software, the designer will have difficulty choosing the economic and strength cross section. The designer, in this case, either relies on their experience or resorts to the method of trial and error. Especially for Cantilever beams with a long span as a result of risk deflections, it is exposed. The current theoretical study was performed on rectangular concrete cross sections of different dimensions and subjected to uniformly distributed loads. Based on a previous study, the sections are reinforced with a specific reinforcement ratio. Through an algorithm, Python 3.4 software, and an output file, the permissible deflections for each cross section were calculated according to the ACI 318M-19. Finally, the authors could draw a graph to choose the appropriate cross section for each required beam length in less time and effort.

Food waste raises severe concerns all around the globe. Thus, several researchers employed various food waste additives in the earthen matrix to improve their performance, decrease energy consumption, and efficient waste management. Therefore, this study evaluates the Tea Waste (T.W.) additive in producing unfired clay brick by adding different ratios in the brick clay mixtures 2.5 %, 5 %, 7.5 %, and 10 % of the weight. Samples were prepared and dried under natural laboratory conditions at 20o C for 7 days until weight and shrinkage stabilization, followed by oven-dried for 48 h at 60 oC. Several tests were performed to examine the physical and mechanical characteristics of the samples, including flexural strength, density, compressive strength, linear shrinkage, capillary water absorption, thermal conductivity, and the U.P.V. The results demonstrated that porosity and shrinkage slightly increased. While density, flexural strength, and compressive strength values decrease. In addition, the thermal conductivity increased depending on the T.W. content. In addition, samples containing 2.5 % and 5 % of T.W. give better compressive strength results above 3.5 MPa, which is the least limit required according to the Indian standards IS 1077, while T.W. additive of 7.5 % and 10 % did not fulfill the standard's strength requirement and therefore could be used for isolation only due to the increased amount of porosity that improves the thermal conductivity. The results indicated that samples with suitable mechanical and physical properties could achieve a suitable amount of T.W. it is recomenned that the porous structure of the clay brick body impacted the clay brick's properties and can be an effective alternative to porosity makers for lightweight insulating brick production.

This study examines the allocation of COVID-19 funding for Indigenous Peoples in Canada, Australia, New Zealand, and the United States during the pandemic’s first wave. Indigenous communities, already facing health disparities, systemic discrimination, and historical forces of colonisation, found themselves further vulnerable to the virus. Analysing the funding policies of these countries, we employed a Health Equity Impact Assessment (HEIA) tool and an Indigenous Lens Tool supplement to evaluate potential impacts. Our results identify three major funding equity issues: unique health and service needs, socioeconomic disparities, and limited access to community and culturally safe health services. Despite efforts for equitable funding, a lack of meaningful consultation led to shortcomings, as seen in Canada’s state of emergency declaration and legal disputes in the United States. New Zealand stood out for integrating Māori perspectives, showcasing the importance of consultation. The study calls for a reconciliation-minded path, aligning with Truth and Reconciliation principles, the UN Declaration on the Rights of Indigenous Peoples, and evolving government support. The paper concludes that co-creating equitable funding policies grounded in Indigenous knowledge requires partnership, meaningful consultation, and organisational cultural humility. Even in emergencies, these measures ensure responsiveness and respect for Indigenous self-determination.

Background: Childhood idiopathic nephrotic syndrome is one of the most common conditions pediatric nephrologists encounter globally. Nephrotic syndrome is characterized by proteinuria, hyperlipidemia, and edema. The degree and duration of proteinuria have an impact on serum electrolyte levels. However, local data is limited. Objectives: To assess and compare the degree of electrolyte imbalance and its relationship to kidney function indicators during relapse and remission in children with idiopathic nephrotic syndrome. Methods: In this case-control study, blood samples were collected from 80 Iraqi children with an age range of (2-14) years. They were divided into three groups: Group I (20 individuals with steroid-sensitive nephrotic syndrome (SSNS)), Group II (20 individuals with steroid-resistant nephrotic syndrome (SRSN)), and Group III (40 healthy individuals as the control group). Serum electrolyte levels (Na, Ca, Cl, and K) were measured by an ion-selective electrode (9180 electrolyte analyzer). Blood creatinine and urea were measured by a Cobas c311 autoanalyzer during the relapse and remission phase. The patients were clients of the pediatric nephrology consultation center at the Children's Teaching Hospital / Baghdad Medical City and Al-Batoul Teaching Hospital for Women and Children from 15 February to 20 August 2022. The controls were healthy children whose medical history was reviewed to eliminate a history of kidney disease and underwent a comprehensive physical examination. Controls were recruited from a network of family, friends, relatives, and the National Autism Center/ Child Protection Teaching Hospital affiliated with Medical City/Baghdad. Results: Serum Calcium levels showed a clear decrease in all SSNS and SRSN patients compared to the control group. The levels of Sodium and Chloride were significantly lower than the control group during the relapse phase. The results of the relapse phase of SRNS patients indicated higher serum potassium concentration compared with the control group and the SSNS patient group, with a statistically significant difference). Conclusion: All children with idiopathic nephrotic syndrome had hypocalcemia in the relapse and remission phase. SRNS cases had hyperkalemia, Sodium, and chloride fluctuated between low levels during the relapse phase and normal levels during the remission phase.

The term end-stage kidney disease (ESKD) is often used to describe people who have the last stage of chronic kidney disease (CKD) and are undergoing dialysis or a kidney transplant for treatment. Hemodialysis (HD) is the most prevalent technique that is utilized to eliminate waste and other hazardous chemicals from the body. The study aims to assess the role of serum Urokinase plasminogen activator (UPA) levels among Iraqi hemodialysis patients. The study encompassed 50 patients aged 40–74 years (21 males and 29 females) admitted to the Iraqi dialysis center at Baghdad Teaching Hospital for the period from October 2022 to February 2023. They were diagnosed based on previous medical reports and laboratory and clinical tests by a consultant nephrologist. UPA, liver enzymes, blood urea, creatinine, albumin, total protein, sodium, potassium, total Ca, and PO4 levels were determined. This study demonstrates higher levels of UPA in HD patients with ESKD and correlates with ALP; also, UPA can be considered a good marker for the prevention of the development of kidney fibrosis.

Abstract The most common cause of end-stage renal disease (ESRD) and leading ultimately to hemodialysis (HD) is type 2 diabetes mellitus (T2DM). The current study aims to assess the role of serum urokinase plasminogen activator (UPA) levels among Iraqi hemodialysis patients with ESRD with type 2 diabetes. The study encompassed 50 patients aged 40–74 years (35 males and 15 females), admitted to the Iraqi dialysis center at Baghdad Teaching Hospital, Al-Hayat Center at Al-Karama Teaching Hospital, and Hamida Al-Misfah Dialysis Center in Imam Al-Kadhimin Medical City for the period from October 2022 to February 2023. Were diagnosed based on previous medical reports, and laboratory tests by a consultant nephrologist. UPA, Blood. Urea, Creatinine, fasting serum glucose (FSG), HbA1c, Insulin, HOMA-IR, and lipid profile levels were determined. The present study showed a significant increase in serum UPA levels in HD patients in ESRD with T2DM compared to control. In addition, there was an important negative correlation between UPA and Hb1AC, FSG, and a positive correlation with VLDL-C and TG in HD patients in ESRD with T2DM patients. This study demonstrates increased UPA serum levels in HD in ESRD with T2DM patients and associated with FSG, Hb1AC, TG, and VLDL this shows that it can be considered a good marker for the development of diabetes complications, the most important of which is diabetic kidney disease (DKD).

AbstractBackground: Acute renal colic is a severe and sudden form of loin pain that usually radiates from the flank towards the groin. Acute renal colic is one of the common causes of emergency department admission worldwide. Nefopam has a unique analgesic effect, that differs pharmacologically from nonsteroidal anti-inflammatory drugs, opioids, or paracetamol and has a potential role in multimodal analgesia. Furthermore, studies have found that nefopam has opioid-sparing effects postoperatively following urological surgery, making it a suitable option for urologists and emergency physicians. Aim: This review aims to survey the literature regarding the efficacy of nefopam in treating acute renal colic. Conclusion: This review revealed that the efficacy of nefopam in treating acute renal colic has not been established in any clinical trial, nor has it been included in any international guidelines. Nonsteroidal anti-inflammatory drugs and intravenous paracetamol are first-line agents in the management of acute renal colic.

Abstract Background B-lymphocyte-activating factor (BAFF) is a cytokine involved in regulating the development and maturation of B lymphocyte and has been shown to be up-regulated in patients with Graves’ disease (GD). However, the association of TNFSF13B variants (the gene that encodes BAFF) with the risk of GD has not been well explored. In this case–control study, the aim was to evaluate the role of BAFF, in terms of serum level and polymorphism, in the etio-pathogenesis of GD. Therefore, serum BAFF concentrations were analyzed in Iraqi women with GD and age-matched control women (n = 90 and 93, respectively) using an ELISA kit. In addition, two promoter variants of the TNFSF13B gene, rs9514827 (T > C) and rs9514828 (C > T), were genotyped using a PCR–RFLP-based assay. Results Median BAFF concentrations (interquartile range) were significantly elevated in GD patients compared to controls (1525 [1327–1840] vs. 689 [585–807] pg/mL; probability [p]

Background Food insecurity has direct and indirect negative outcomes on the physical and mental health of children, with impacts throughout adult life. Rates of food insecurity have increased dramatically since the start of the COVID-19 pandemic. The American Academy of Pediatrics recommends paediatricians screen and intervene to address food insecurity. We aimed to increase the percentage of patient encounters with food insecurity screening completion at the paediatric medical home from 0% to 85% by July 2020 with extension to the paediatric emergency department (ED) and paediatric specialty clinic in the following year.Methods This multicentre project occurred in three sites within our health system: a teaching safety-net, paediatric medical home; a paediatric ED; and five divisions within paediatric specialty medical clinics. A screening tool was created using the validated Hunger Vital Sign Questionnaire. A standard screening, documentation and referral process was developed. The Model for Improvement was used testing changes via Plan-Do-Study-Act cycles.Results The percentage of households screened for food insecurity increased from a median of 0% to 30% for all sites combined. There was significant variability in screening with the ED screening a median of 24% and the medical home screening 80% by the end of the study period. A total of 9842 households (20.9%) screened were food insecure. During the study period, 895 families with 3925 household members received 69 791 pounds of food from our primary community resource using our clinic’s food prescription. Of these families, 44% (398) also qualified for the US Department of Agriculture programme ensuring ongoing food distribution up to twice a month.Discussion Using quality improvement methodology to address a critical community need, we implemented food insecurity screening across a hospital system including multiple sites and specialties and provided critical resources to households in need.

Pediatric Differentiated Thyroid Cancer (pedDTC) is a rare pediatric malignancy with an increasing incidence over time. To date, there is a paucity of literature specifically addressing pedDTC within the context of Middle Eastern ethnicity. This retrospective study aimed to assess the risk-stratifying factors for overall survival (OS) and event-free survival (EFS) in pediatric DTC patients from Iraq and Jordan. The medical records of 81 patients from two tertiary cancer institutes were retrieved. Kaplan–Meier analysis was employed to investigate OS and EFS, and the Cox proportional hazards model was employed to estimate hazard ratios. All patients underwent surgery and radioactive iodine therapy, with a median age of 14 and an interquartile range of 12–15. Lymph node involvement was observed in 55% of cases, while distant metastases were present in 13.5%. After a median follow-up period of 68 months, the 10-year survival rate was determined to be 94%, while the 10-year EFS rate was 58%. EFS was negatively impacted by cervical lymph node metastases and early age of diagnosis (p ≤ 0.01, each). Therefore, pediatrics with initial cervical lymph node metastases and those diagnosed before puberty tend to experience poorer EFS, which may justify the need for more aggressive management plans.

Objectives: Placenta accreta spectrum (PAS) significantly increases the complexity of childbirth and frequently involves urologic organs. Multidisciplinary team (MDT) care is paramount to ensure optimal outcomes. We aimed to evaluate urologic interventions in patients with PAS at a centralised, tertiary referral centre. Methods: An analysis of a prospectively collected data set, consisting of all women presenting with PAS at our institution between November 2013 and June 2019. Patients who required urological intervention were identified, and perioperative details were retrieved. Results: Forty-two cases of PAS were identified. The mean maternal age was 35 years, and mean gestational age at delivery was 34 weeks. Thirty-seven cases were managed electively, with 5 cases managed conservatively (no hysterectomy) and 5 requiring emergency management. Fifteen patients (36%) had suspected bladder invasion on MRI. A total of 36 patients (86%) had ureteric catheters inserted, 14 (33%) required bladder repair, and 2 had ureteric injurie s (5%). Conclusions: PAS frequently requires urological intervention to prevent and repair injury to the urinary bladder and ureter. PAS is a rare condition that is best managed in an MDT setting in a centralised, tertiary, high-volume centre with access to a variety of medical and surgical sub-specialities

This study examines the allocation of COVID-19 funding for Indigenous Peoples in Canada, Australia, New Zealand, and the United States during the pandemic's first wave. Indigenous communities, already facing health disparities, systemic discrimination, and historical forces of colonisation, found themselves further vulnerable to the virus. Analysing the funding policies of these countries, we employed a Health Equity Impact Assessment (HEIA) tool and an Indigenous Lens Tool supplement to evaluate potential impacts. Our results identify three major funding equity issues: unique health and service needs, socioeconomic disparities, and limited access to community and culturally safe health services. Despite efforts for equitable funding, a lack of meaningful consultation led to shortcomings, as seen in Canada's state of emergency declaration and legal disputes in the United States. New Zealand stood out for integrating Māori perspectives, showcasing the importance of consultation. The study calls for a reconciliation-minded path, aligning with Truth and Reconciliation principles, the UN Declaration on the Rights of Indigenous Peoples, and evolving government support. The paper concludes that co-creating equitable funding policies grounded in Indigenous knowledge requires partnership, meaningful consultation, and organisational cultural humility. Even in emergencies, these measures ensure responsiveness and respect for Indigenous self-determination. [ABSTRACT FROM AUTHOR]

Traumatic brain injury (TBI) is common among justice-involved persons, creating substantial health and economic burdens owing to its association with a range of adverse psychosocial outcomes. No study to date has synthesised extant knowledge about TBI across the whole criminal justice pathway. We aimed to conduct a systematic review of the literature on TBI across this pathway, from arrest through to release from custody. Following PRISMA guidelines, five key electronic databases (PubMed, PsychInfo, Medline, Embase, Cinahl), Proquest Dissertations & Theses Global, Cochrane Database of Systematic Reviews, Web of Science, and grey literature were searched up to May 2023. Fifty-six reports met inclusion criteria. Three more reports were added after review. TBI prevalence rates ranged from 5.65% to 100% with higher rates among persons experiencing federal incarceration, justice-involved adolescents, and justice-involved veterans in the US. Severity of TBI was mostly mild. Studies reported positive associations between TBI and many psychosocial outcomes including violence, incarceration rates, cognitive impairment, mood disorders, psychosis, substance use disorders, and socioeconomic deprivation. Other adverse outcomes included reduced participation in educational activities and increased utilisation of mental health services. More research is needed to establish the true prevalence of TBI in criminal justice systems and the relationship between TBI and psychosocial as well as criminogenic outcomes. [ABSTRACT FROM AUTHOR]

Complex training, which is of great importance in the development of physical capabilities through change in the motor path and diversity of exercises for the same muscle groups working during the motor performance, which depends on the ability of the muscular and nervous systems in the process of compatibility, and work to apply it in the intermittent training method that works on the continuous change in the degree of difficulty of exercise (intensity of training) coordinated with rest periods and designed to develop the ability of special forces for archers to push weight and achievement, and The aim of the study is to prepare complex exercises in the intermittent method over a period of 6 weeks (12) training units during the special preparation stage, on a sample of young people under 20 years of age (5) elite athletes effectively push the weight, the study variables measured two variables for maximum strength of the arms and chest, explosive force of the two men, rapid force of the arms and achievement by pushing the weight. Through pre and posttests, the researchers concluded the effectiveness of combined training, which is regulated by intermittent training, in the development and improvement of the special ability of the weightlifting archers (the explosive power of the two men, the maximum strength and the rapid strength of the shoulders and arms) and the exercises have made a clear progress in the achievement of weight propulsion for young people under 20 years. [ABSTRACT FROM AUTHOR]