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This paper focuses on investigating the influence of creating an opening in the vicinity of a column area on the punching shear resistance of reinforced concrete bubbled slabs and the effectiveness of their strengthening with (CFRP) sheets. The experimental program was intended to study the effect of dimensions, position, and distance of the opening relative to the column; the location of bubbles relative to the two-way critical shear section; and the effectiveness of strengthening with CFRP sheets on the punching shear resistance of the slab-column connection in bubbled slabs. Fourteen slab specimens of 2000×2000x230 mm dimensions were cast and tested up to failure. The test results demonstrated the negative effect of the creation of an opening in the vicinity of the loaded area and the reduction in the load-carrying capacity of the bubbled slabs compared to the reference solid slab. Meanwhile, there is an improvement in the service and ultimate load capacities of the bubbled slab specimens with opening due to the implementation of CFRP strengthening sheets. Also, the developed model by finite element software program ANSYS showed that the results of analysis have an acceptable convergence with the results of experimental tests.

The research includes scientific analyses of the problems and difficulties that companies making the (spider frame s) in kirkuk University. This research these to put the suitable solution based on scientific bases on international limits (ACI/2003and ASTM)and also these slabs had been reanalysis &redesigned by using (STAAD Pro ) computer programs to compares the designing results . in order to make a clear view by the designer before designing . such find used grater than of steel reinforcement and used bigger diameter of steel reinforcement cussed difficulties during making , and find this frames are height cost and the sound and finishing are not study at the design.

To obtain a more recent and comprehensive insight into the prevalence of glomerular diseases in our patient population, medical records of 200 patients with biopsy proven glomerulonephritis (GN), between January 1994 and June 1999, at the King Khalid University Hospital, Riyadh, Saudi Arabia were analyzed. Primary glomerular disease was found to be the most prevalent, accounting for 63.5% of all glomerular diseases. Among primary glomerular diseases, focal and segmental glomerulosclerosis (FSGS) was the most common histological lesion (34.6%) and was associated with a high prevalence of hypertension (86.4%), nephrotic syndrome (68.18%), hematuria (63.6%) and renal functional impairment (27.3%). Mesangioproliferative GN was the second most common lesion (25.1%) followed by mesangiocapillary GN (15.7%), IgA nephropathy (10.2%), and minimal change disease (8.5%). Amongst secondary glomerular diseases, lupus nephritis was the most prevalent (24.5%). In conclusion, primary glomerular diseases constituted the commonest group encountered and the prevalence of FSGS was quite high with male sex and young adults predominating. FSGS was also associated with a high prevalence of end-stage renal disease. Further collaborative studies are necessary to explore the predisposing factors and associations of glomerular disease, especially FSGS.

Purpose Conduct six systematic reviews investigating for-profit private sector roles in NCD prevention and management in low- and middle-income countries (LMICs) through our a priori framework’s pillars. Methods Six systematic reviews and thematic syntheses were performed between March-August 2021, Six databases, websites of relevant organizations, and references lists of included studies were comprehensively searched. Studies published in English from 2000 onwards involving the pillar of interest, for-profit private sector, NCD prevention/management, and LMIC context were included. Results were synthesized using an inductive thematic synthesis approach. Results Ultimately, 25 articles were included in the PPP review, 33 in Governance and Policy, 22 in Healthcare Provision, 15 in Innovation, 14 in Knowledge Educator, and 42 in Investment and Finance. The following themes emerged: PPPs (coordination; financial resources; provision; health promotion; capacity building; innovation; policy); Governance/Policy (lobbying; industry perception; regulation); Healthcare Provision (diagnosis/treatment; infrastructure; availability/accessibility/affordability); Innovation (product innovation; process innovation; marketing innovation; research; innovation dissemination); Knowledge Educator (training; health promotion; industry framework/guideline formation); Investment and Finance (treatment cost; regulation; private insurance; subsidization; direct investment; collaborative financing; innovative financing; research). Conclusion These findings will be instrumental for LMICs considering private sector engagement. Potential conflicts of interest must be considered when implementing private sector involvement.

The study of squeezing fluids is considered to be one of the most important areas of scientific research due to its various engineering and bioapplications such as the squeezing processes that occur in the brake mechanisms in trucks and Piston’s systems, liquid metal lubrication systems, polymer processing and compression/injection molding as well as the contraction processes in the arteries and veins. This work deals with the study of one of these applications through modeling using the basic equations governing the squeezing fluids and their boundary conditions, and the presence of some external thermal influences such as the magnetic field and linear/nonlinear thermal radiation in its basic form as a nonlinear partial differential equations system, then converting this system into nonlinear ordinary differential equations that were solved numerically and analytically for special cases. The results focused on showing the thermal and flow behavior of the fluid at different concentrations of nanoparticles, which induce the effect of thermal forces represented by the magnetic field and thermal radiation. These results were demonstrated through a set of graphs and tables and discussed in detail, and in summary, some important results were found from the physical analysis. For some of these results, the use of different types and concentrations of particles increases the viscosity of the fluid, which causes an increase in temperature ranging between 17% and 45%. [ABSTRACT FROM AUTHOR]

In the past few decades, the transmission of data over an unsecure channel has resulted in an increased rate of hacking. The requirement to make multimedia data more secure is increasing day by day. Numerous algorithms have been developed to improve efficiency and robustness in the encryption process. In this article, a novel and secure image encryption algorithm is presented. It is based on a modified chaotic logistic map (CLM) that provides the advantage of taking less computational time to encrypt an input image. The encryption algorithm is based on Shannon’s idea of using a substitution–permutation and one-time pad network to achieve ideal secrecy. The CLM is used for substitution and permutation to improve randomness and increase dependency on the encryption key. Various statistical tests are conducted, such as keyspace analysis, complexity analysis, sensitivity analysis, strict avalanche criteria (SAC), histogram analysis, entropy analysis, mean of absolute deviation (MAD) analysis, correlation analysis, contrast analysis and homogeneity, to give a comparative analysis of the proposed algorithm and verify its security. As a result of various statistical tests, it is evident that the proposed algorithm is more efficient and robust as compared to previous ones.

The prevalence of mental health disorders is high among people with Cystic Fibrosis. The psychological symptoms in CF are associated with poor adherence, worse treatment outcomes, and greater health utilization/cost. Mental health and neurocognitive Adverse Events (AEs) have been reported with all available Cystic Fibrosis Transmembrane conductance Regulator (CFTR) modulators in small groups of patients. We report our experience with a dose reduction strategy in 10 of our patients on elexacaftor/tezacaftor/ivacaftor (7.9% of total number of patients) who self-reported developing intense anxiety, irritability, sleep disturbance and/or mental slowness after initiation of full dose treatment. Standard dose elexacaftor/tezacaftor/ivacaftor resulted in 14.3 points improvement in mean Percent Predicted Forced Expiratory Volume in 1 s (ppFEV1), and a mean difference in sweat chloride of −39.3 mmol/L. We initially discontinued and/or reduced therapy according to the AEs severity, with a subsequent planned dose escalation every 4–6 weeks guided by sustainability of clinical effectiveness, absence of AEs recurrence, and patients’ preferences. Clinical parameters including lung function and sweat chloride were monitored for up to 12 weeks to assess ongoing clinical response to the reduced dose regimen. Dose reduction resulted in resolution of self-reported mental/psychological AEs, without loss of clinical effectiveness (ppFEV1 was 80.7% on standard dose, and 83.4% at 12 weeks on reduced dose; sweat chloride was 33.4 and 34 mmol/L on standard and reduced dose, respectively). Furthermore, in a subgroup of patients who completed 24 weeks of the reduced dose regimen, repeat low dose Computed Tomography imaging showed a significant response when compared to pre-initiation of elexacaftor/tezacaftor/ivacaftor.

Objectives Conduct a systematic review of existing frameworks to understand the for-profit private sector’s roles in non-communicable disease (NCD) control and management. Control includes population-level control measures that prevent NCDs and mitigate the magnitude of the NCD pandemic, and management includes treatment and management of NCDs. The for-profit private sector was defined as any private entities that make profit from their activities (ie, pharmaceutical companies, unhealthy commodity industries, distinct from not-for-profit trusts or charitable organisations).Design A systematic review and inductive thematic synthesis was performed. Comprehensive searches of PubMed, EMBASE, Cochrane Library, Web of Science, Business Source Premier and Proquest/ABI Inform were conducted on 15 January 2021. Grey literature searches were conducted on 2 February 2021 using the websites of 24 relevant organisations. Searches were filtered to only include articles published from the year 2000 onwards, in English. Articles that included frameworks, models or theories and the for-profit private sector’s role in NCD control and management were included. Two reviewers performed the screening, data extraction and quality assessment. Quality was assessed using the tool developed by Hawker et al for qualitative studies.Setting The for-profit private sector.Results There were 2148 articles initially identified. Following removal of duplicates, 1383 articles remained, and 174 articles underwent full-text screening. Thirty-one articles were included and used to develop a framework including six themes that outlined the roles that the for-profit private sector plays in NCD management and control. The themes that emerged included healthcare provision, innovation, knowledge educator, investment and financing, public–private partnerships, and governance and policy.Conclusion This study provides an updated insight on literature that explores the role of the private sector in controlling and monitoring NCDs. The findings suggest that the private sector could contribute, through various functions, to effectively manage and control NCDs globally.

BackgroundHypertension and diabetes are becoming increasingly prevalent worldwide. Telemedicine is an accessible and cost-effective means of supporting hypertension and diabetes management, especially as the COVID-19 pandemic has accelerated the adoption of technological solutions for care. However, to date, no review has examined the contextual factors that influence the implementation of telemedicine interventions for hypertension or diabetes worldwide. ObjectiveWe adopted a comprehensive implementation research perspective to synthesize the barriers to and facilitators of implementing telemedicine interventions for the management of hypertension, diabetes, or both. MethodsWe performed a scoping review involving searches in Ovid MEDLINE, Embase, CINAHL, Cochrane Library, Web of Science, and Google Scholar to identify studies published in English from 2017 to 2022 describing barriers and facilitators related to the implementation of telemedicine interventions for hypertension and diabetes management. The coding and synthesis of barriers and facilitators were guided by the Consolidated Framework for Implementation Research. ResultsOf the 17,687 records identified, 35 (0.2%) studies were included in our scoping review. We found that facilitators of and barriers to implementation were dispersed across the constructs of the Consolidated Framework for Implementation Research. Barriers related to cost, patient needs and resources (eg, lack of consideration of language needs, culture, and rural residency), and personal attributes of patients (eg, demographics and priorities) were the most common. Facilitators related to the design and packaging of the intervention (eg, user-friendliness), patient needs and resources (eg, personalized information that leveraged existing strengths), implementation climate (eg, intervention embedded into existing infrastructure), knowledge of and beliefs about the intervention (eg, convenience of telemedicine), and other personal attributes (eg, technical literacy) were the most common. ConclusionsOur findings suggest that the successful implementation of telemedicine interventions for hypertension and diabetes requires comprehensive efforts at the planning, execution, engagement, and reflection and evaluation stages of intervention implementation to address challenges at the individual, interpersonal, organizational, and environmental levels.

The unmanned aerial vehicle communication networks (UAVCNs) are composed of unmanned aerial vehicles (UAVs) connected in ad hoc mode to facilitate vertical communication in 5G and beyond networks. UAVs operating in an ad hoc mode of operation mostly use reactive routing protocols to establish routes in the network to reduce the energy consumption of the nodes. In this article, a route discovery method is presented to reduce the overhead faced by reactive routing protocols during the route discovery phase. The expanding ring search (ERS) method is mostly used by reactive routing protocols in the destination discovery phase of the routing algorithm. Although the performance of the ERS method is better than simple flooding, the presented method further reduces energy consumption and routing overhead as compared to the conventional ERS method. To achieve the task, the time to live (TTL) is modified to accommodate a large number of nodes in a search attempt. We proposed variants of the proposed techniques for diverse application requirements and compared the performance with the state-of-the-art ERS technique. It has been demonstrated with the help of simulations that the presented algorithm outperforms the ERS method in terms of reduced routing overhead and reduced energy consumption.

Using green biofilters can help eliminate air pollutants and improve urban air quality. In the current study, Prunus × Yedoensis capacity of phytoremediation was investigated as a bio filter of Particulate matter (PM) in spring and summer seasons in Japan. Two samples were analysed to extract three fractions of PM (coarse, fine and ultra-fine). Results showed lower deposition of PM in spring season with total of 20.2 μg.cm-2 and high proportion for fine fraction (2.5-10μm), comparing with summer season which showed a higher deposition of PM with total of 31.9 μg.cm-2. Ultra-fine fraction (0.2–2.5μm) recorded the highest values with a percentage of 23.9% of the total PM deposition. Leaf micromorphological characteristics such as, rough surface and serrated margin can enhance the Prunus × Yedoensis ability of particulate matter accretion. This study confirms that vegetation has an efficient role in improving the quality of urban air. Further structural analysis should be included to deepen the understanding of phytoremediation phenomena in plants.

To evaluate whether cystatin C levels can be a surrogate marker of creatinine clearance and reflect the characteristics of peritoneal membrane in dialysis patients, we performed peritoneal equilibration tests (PET) in 18 anuric adult chronic peritoneal dialysis (PD) patients with a mean age of 39.7 ± 20 years. All the samples were analyzed for urea, creatinine, and cystatin C. Peritoneal transport, mass transfer, and peritoneal clearance of cystatin C were calculated. Correlation and regression analysis was done using cystatin C as a dependent variable and age, sex, height, weight, body surface area, and creatinine as independent variables. Cystatin C demonstrated a significant time dependent increase of dialysate concentration and decline in the serum concentrations during PET, and a strong correlation between serum creatinine and serum cystatin C concentrations(r: 0.62, p= 0.008). The trans-peritoneal clearance (mL/min/1.73 m 2 ) of cystatin C was related to its serum concentration and was similar to creatinine in its pattern but of smaller magnitude. Peritoneal mass transfer (mg/4 hr per 1.73 m 2 ) for cystatin C serum creatinine was 1.68 ± 0.67 and 73.3 ± 29.8, respectively. The dialysis/plasma D/P cystatin C concentration was > 0.1 at 4 hrs of PET denoted high peritoneal transport, while the values of < 0.1 denoted low transport type. We conclude that cystatin C follows the same pattern of peritoneal exchange as creatinine but the magnitude of transfer is many folds lower than creatinine. At present clinical utility of cystatin C in the evaluation of solute clearance is probably limited due to the minute amounts transferred across the membrane and the high renal clearance in the presence of residual renal function.

This study was aimed at determining the median survival and most frequent causes of death in patients with the Autosomal Dominant Polycystic Kidney Disease (ADPKD). A retrospective, observational analysis was made on patients registered with a diagnosis of ADPKD, in the computer records of the Sheffield Kidney Institute (SKI), United Kingdom, during the years 1981 to 1999. Data on 363 patients were analyzed from these computer records and further infor-mation, if any, was obtained from the patients′ clinical notes. During this period, 88 patients died. The median age of the patients who died was 60.5 years, with the youngest being 37 years old and the oldest being 82 years. The major causes of death in this study group were cardiovascular (46.6%), infection (15.9%), central nervous system (CNS) disorders (11.36%), and miscellaneous causes (11.36%). Our study suggests that the major cause of death in patients with ADPKD was cardiovascular followed by infection, of which 42% of the deaths were due to septicemia. CNS causes of death comprised 11.36% of whom 60% had cerebrovascular events including sub-arachnoid hemorrhage in 20% of the patients. Uremia was the cause of death in only 2.2% of the patients in this series.

Predictive equations provide a rapid method of assessing glomerular filtration rate (GFR). To compare the various predictive equations for the measurement of this parameter in the Saudi population, we measured GFR by the Modification of Diet in Renal Disease (MDRD) and Cockcroft-Gault formulas, cystatin C, reciprocal of cystatin C, creatinine clearance, reciprocal of creatinine, and inulin clearance in 32 Saudi subjects with different stages of renal disease. We com-pared GFR measured by inulin clearance and the estimated GFR by the equations. The study included 19 males (59.4%) and 13 (40.6%) females with a mean age of 42.3 ± 15.2 years and weight of 68.6 ± 17.7 kg. The mean serum creatinine was 199 ± 161 μmol/L. The GFR measured by inulin clearance was 50.9 ± 33.5 mL/min, and the estimated by Cockcroft-Gault and by MDRD equations was 56.3 ± 33.3 and 52.8 ± 32.0 mL/min, respectively. The GFR estimated by MDRD revealed the strongest correlation with the measured inulin clearance (r= 0.976, P= 0.0000) followed by the GFR estimated by Cockcroft-Gault, serum cystatin C, and serum creatinine (r= 0.953, P= 0.0000) (r= 0.787, P= 0.0001) (r= -0.678, P= 0.001), respectively. The reciprocal of cystatin C and serum creatinine revealed a correlation coefficient of 0.826 and 0.93, respectively. Cockroft-Gault for-mula overestimated the GFR by 5.40 ± 10.3 mL/min in comparison to the MDRD formula, which exhibited the best correlation with inulin clearance in different genders, age groups, body mass index, renal transplant recipients, chronic kidney disease stages when compared to other GFR predictive equations.

To evaluate the diabetic complications and fate of diabetic nephropathy in Saudi population, we studied 184 diabetic nephropathy (DN) patients who were referred to nephrology clinic of King Khalid University Hospital, Riyadh, Saudi Arabia from January 2003-June 2006. The patients had mean age of 61.9 ± 13.1 years, included 128 (69.6%) males, and were followed up for a mean period of 10.2 ± 1.5 years. The mean duration of diabetes mellitus (DM) was 19.5 ± 5.8 years, and duration of nephropathy was 7.7 ± 3.3 years. Family history of DN was documented in 52 (28.2%) patients. At initial visit, the mean systolic blood pressure was 164 ± 14.5 mmHg, the mean diastolic blood pressure was 97.9 ± 10.4 mmHg. Thirty-seven (20%) patients had normal BMI, 88 (48%) were overweight, while 55 (30%) were obese. Mean creatinine clearance was 51.7 ± 26.3 mL/min, 24 hrs urinary proteins 1.99 ± 2.48 gm/day, HbA1C 9.2 ± 1.8 %, triglyceride 2.1 ± 1.3 mmol/L, and cholesterol 5.17 ± 1.54 mmol/L. Diabetic complications included angiography proven coronary artery disease in 106 (57.6 %) patients, stroke in 21 (11.4%), myocardial infarction (MI) in 27(14.6%), angina in 87 (47.2 %), retinopathy in 82 (44.5%), Blindness in 3 (1.6%), peripheral vascular disease in 121 (65.7%), Neuropathy in 123 (66.8%), hypertension in178 (96.7%), diabetic foot in 25 (13.5%), Amputation in 10 (5.4%), and end-stage renal disease in 70 (38%). Total of 13 (7.05%) patients died in the hospital. Thirty-seven percent of patients developed > 6 concomitant complications. 28% developed 5, 17% developed 4, and the rest developed < 3. DN was relatively refractory to therapy and progressive; 123 (66.8%) patients doubled their serum creatinine in 3.59 ± 2.88 years, 32 (17.3%) maintained stable renal function, 136 (73.6 %) deteriorated, and 12 (6.52%) improved. we conclude that the prevalence of diabetic complications is high among Saudi patients, and many had multiple complications. Baseline creatinine clearance and proteinuria, high systolic blood pressure, advanced age, and longer duration of diabetes were the most significant risk factors for developing complications.

This is the first report from Saudi Arabia studying the normal reference intervals in adult Saudi subjects and evaluating serum cystatin C as a prospective marker for the assessment of the glomerular filtration rate (GFR). Three hundred healthy adult Saudi subjects including 156 males (52%) and 144 females (48%), with a mean age of 31.21 ± 9.82 years were prospectively studied to establish normal reference ranges for cystatin C. A total of 68.34% of the study patients were in the age-group of 21-40 years. The mean serum cystatin C in the 300 healthy subjects was 0.751 ± 0.11 mg/L (0.50 - 1.09), increasing gradually with age: it was 0.738 ± 0.11 mg/L (0.51 - 1.09) in the age-group 21 - 30 years and 0.807 ± 0.12 (0.51 - 1.09) among subjects who were > 50 years of age. The mean serum cystatin C in females (0.778 ± 0.118 mg/L) was significantly hig-her than in males (0.726 ± 0.095 mg/L) (p < 0.0001). The serum cystatin C level was within the defined reference range of 0.53 - 0.95 mg/L in 95% of the subjects with a mean value of 0.74 ± 0.097 mg/L, and was falling within the 95% confidence interval of 0.73865 - 0.7637 mg/L, and with 98.84% area under the curve (AUC). All the other renal function markers (urea, serum crea-tinine, calculated GFR, BMI) among the studied subjects were within the normal reference ranges for adult Saudi population. The serum cystatin C level had a significant correlation with the body mass index (BMI) (r = 0.155; p = 0.007) and a correlation with serum creatinine as well (r = 0.009; p = 0.873). It showed a negative correlation with calculated GFR as per Cockroft-Gault equation (r = - 0.101; p = 0.083).

One of the most significant step in building structure maintenance decision is the physical inspection of the facility to be maintained. The physical inspection involved cursory assessment of the structure and ratings of the identified defects based on expert evaluation. The objective of this paper is to describe present a novel approach to prioritizing the criticality of physical defects in a residential building system using multi criteria decision analysis approach. A residential building constructed in 1985 was considered in this study. Four criteria which includes; Physical Condition of the building system (PC), Effect on Asset (EA), effect on Occupants (EO) and Maintenance Cost (MC) are considered in the inspection. The building was divided in to nine systems regarded as alternatives. Expert's choice software was used in comparing the importance of the criteria against the main objective, whereas structured Proforma was used in quantifying the defects observed on all building systems against each criteria. The defects severity score of each building system was identified and later multiplied by the weight of the criteria and final hierarchy was derived. The final ranking indicates that, electrical system was considered the most critical system with a risk value of 0.134 while ceiling system scored the lowest risk value of 0.066. The technique is often used in prioritizing mechanical equipment for maintenance planning. However, result of this study indicates that the technique could be used in prioritizing building systems for maintenance planning

Background: The current research examines the molecular terrain of celiac disease (CD) through microRNA (miRNA) and cytokines as potential new diagnostic and therapeutic markers. Gluten-appropriate immune response is a key feature of an autoimmune clinical entity known as CD that leads to inflammation and degeneration of small intestine mucosa. However, the mechanisms responsible for this remain unclear., Methods: Quantitative reverse transcription polymerase chain reaction (RT-qPCR ) was carried out on serum samples obtained from patients with CD and control groups to unravel their pathogenesis. Assessing miR-155, miR-15b, interleukin (IL)-2, IL-7, IL-35and IL-37 levels in expression might be useful in diagnosing or treating the disorder., Results: A significant dysregulation of these molecular players in patients with CD compared with healthy controls has been evidenced by results from this study. For instance, miR-155 was up-regulated, whereas miR-15b was significantly down-regulated in CD, illustrating their roles in immune responses and inflammation-mediated processes. Besides, there was an over-expression of IL-2 and an under-expression of IL-37 in patients with CD, indicating these biomolecules' role in immuno-dysregulation and inflammatory process underlying CD. In addition, a positive correlation between IL-2 and miRNA 155 expression levels was observed in patients with CD, suggesting that they could be involved together with other cytokines, showing the interplay between immune response pathways and inflammatory cascades during CD pathogenesis., Conclusion: These molecular signature discoveries might result in new and revolutionary diagnostic modalities and molecular-targeted therapies for CD pathogenesis. When used with the scientific understanding of miRNAs and cytokines associated with CD pathophysiology, it creates a basis for personalized medicine based on the individualized molecular profile of all patients. This will undoubtedly increase the efficacy of CD treatment strategies. In brief, more research on molecular pathways' workings should be done to harness their potential in CD diagnosis and treatment., Competing Interests: Competing Interests The authors declare no conflict of interest related to this work., (© 2024 Middle East Journal of Digestive Diseases.)

Follicular occlusion tetrad (FOT) is a clinical syndrome consisting of hidradenitis suppurativa (HS), acne conglobata (AC), dissecting cellulitis of the scalp (DCS), and pilonidal cyst (PC). These entities typically occur independently, but occasionally present simultaneously comprising FOT. The four components share similar pathophysiology affecting the apocrine glands, follicular hyperkeratinization being the hallmark of each entity. Understanding shared similarities of each disease is paramount for the treatment approach as the relapsing and chronic nature of this syndrome can be burdening to patients. We present the case of a 22-year-old obese Hispanic man with a history of tobacco use who presented with worsening skin lesions. The patient developed extensive facial cystic acne 5 years before presentation, followed by left axillary hidradenitis suppurativa lesions two years before the presentation and right axillary involvement one year after. Skin manifestations then expanded to include the lower back, gluteal and perineal areas. The patient was diagnosed with FOT and despite conservative medical management, his lesions failed to improve. He ultimately underwent multiple staged excisional debridement surgeries and skin grafts. Our case underlines the presence of a syndromic association of cutaneous lesions that share a common pathogenesis and emphasizes that this entity requires a multidisciplinary approach. New biologic therapies continue to emerge and may potentially prevent the need for surgical intervention and the burden associated with it., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Ng-Wong et al.)

Background: Actin stress fibers are abundant in cultured cells, but little is known about them in vivo . In podocytes, much evidence suggests that mechanobiologic mechanisms underlie podocyte shape and adhesion in health and in injury, with structural changes to actin stress fibers potentially responsible for pathologic changes to cell morphology. However, this hypothesis is difficult to rigorously test in vivo due to challenges with visualization. A technology to image the actin cytoskeleton at high resolution is needed to better understand the role of structures such as actin stress fibers in podocytes., Methods: We developed the first visualization technique capable of resolving the three-dimensional cytoskeletal network in mouse podocytes in detail, while definitively identifying the proteins that comprise this network. This technique integrates membrane extraction, focused ion-beam scanning electron microscopy, and machine learning image segmentation., Results: Using isolated mouse glomeruli from healthy animals, we observed actin cables and intermediate filaments linking the interdigitated podocyte foot processes to newly described contractile actin structures, located at the periphery of the podocyte cell body. Actin cables within foot processes formed a continuous, mesh-like, electron-dense sheet that incorporated the slit diaphragms., Conclusions: Our new technique revealed, for the first time, the detailed three-dimensional organization of actin networks in healthy podocytes. In addition to being consistent with the gel compression hypothesis, which posits that foot processes connected by slit diaphragms act together to counterbalance the hydrodynamic forces across the glomerular filtration barrier, our data provide insight into how podocytes respond to mechanical cues from their surrounding environment., (Copyright © 2022 by the American Society of Nephrology.)

Background and Objective: Molecular genetic methods show conclusive turn in phylogeny investigations and therefore, understanding the allocation and extension of genetic diversity inside and among species. The current study aims to evaluate genetic diversity using molecular markers (5 SSR and 5 ISSR) on 13 sunflowers (Helianthus annuus) genotypes from different regions., Materials and Methods: The data acquired with the highest degree of polymorphism were confirmed. Polymorphic bands (24 and 55) were demonstrated totally through SSR and ISSR, respectively. Nevertheless, ISSR was superior in exhibiting polymorphism rate (97.37%) compared to SSR markers (90.83%). A range from 2-21 of amplified fragments, with molecular weights varying from 34-1331 bp, was noticeable. The genetic similarity coefficient was employed to set UPGMA dendrogram., Results: Dissimilarity was found in genotypes clustering within groups, whilst the manner of clustering in genotypes kept adjacent in ISSR and aggregated results of SSR and ISSR. Dice similarity ranged from 0.058-0.792, 0.168-0.770 and 0.154-0.847 with SSR, ISSR and the combined phylogeny dendrogram, respectively. The genetic variance of sunflower accessions of wild and cultivated cultivars from different geographic regions was established., Conclusion: Knowledge of these results could be applied to confirm a wide genetic basis for outlook sunflower and manage germplasm breeding programs.

Objective: To determine the role of apoptosis inhibition in the prevention of diabetic neuropathy using the antiFas cell surface death receptor (Fas) antagonistic monoclonal antibody ZB4., Methods: This prospective study enrolled patients with type 2 diabetes with and without neuropathy and a group of healthy controls. The serum concentrations of Fas and Fas ligand (FasL) were measured in all study participants using an enzyme-linked immunosorbent assay. The ability of serum from study participants to induce apoptosis was evaluated in a human neuronal cell line using flow cytometry., Results: A total of 28 healthy subjects and 57 patients with diabetes were enrolled in the study. Serum Fas concentrations were significantly increased in diabetes patients with and without neuropathy compared with the controls. Cells treated with the serum from diabetes patients with neuropathy had significantly higher rates of early apoptosis compared with cells treated with control serum. Monoclonal antibody ZB4 was able to block serum-induced apoptosis., Conclusions: Serum-induced apoptosis of a human neuronal cell line appeared to be mediated via Fas, which suggests that targeting and inhibiting Fas might offer a therapeutic target for diabetic neuropathy., (© The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.)

Fibrillary glomerulonephritis (FGN) is a rare glomerular deposition disease and a rare cause of nephrotic syndrome. The patients usually present with renal insufficiency, nephrotic range proteinuria and microscopic hematuria. The electron microscopy study is the only means of diagnosis. The clinical course of the disease is generally unpredictive and the patients inevitably progress to ESRD. Here, we describe a case of FGN, which presented with nephrotic syndrome and impaired renal function. Renal biopsy showed that 26 out of 30 glomeruli were completely sclerosed. Remaining showed mesangial expansion and double contour consistent with a membranoproliferative pattern, with 70 % interstitial fibrosis and tubular atrophy. Immunofluorescence revealed C3 (2+) diffuse mesangial deposits. Electron microscopic showed subendothelial dense deposits with organized tubular structures. During follow-up, the patient underwent renal transplantation from a living unrelated kidney donor. Later on, as the renal allograft function showed deterioration, renal biopsy was performed and showed recurrence of FGN in the renal allograft.

Background and Objectives: To evaluate differences in erythropoietin requirements between diabetic and non-diabetic patients on hemodialysis and peritoneal dialysis., Design and Settings: This was a retrospective, cross-sectional study conducted between January 2010 and December 2011, at King Khalid University Hospital Riyadh, Saudi Arabia, with 47 peritoneal and 57 hemodialysis patients., Methods: A total of 24 (51%) peritoneal dialysis and 30 (52.6%) hemodialysis patients were suffering from diabetes. We compared demographics, hemoglobin, ferritin, transferrin saturation, C-reactive protein, parathyroid hormone, and weekly erythropoietin dose., Results: The mean weekly dose of erythropoietin was 5391.3 (4692.7) units in peritoneal dialysis (diabetic and non-diabetic) patients compared to 9869.7 (5631.7) units in hemodialysis (diabetic and non-diabetic) patients, with a difference of 4478.3 (6615) units (P=.001). The mean weekly dose in diabetic peritoneal dialysis patients was 3818.2 (4489.5) units, compared to 8814.8 (5121.9) units in hemodialysis (P=.001) patients. The mean weekly dose in non-diabetic peritoneal dialysis patients was 6545.4 (3863.5) units compared to 12 222 (6210) units in non-diabetic hemodialysis patients (P=.02). Diabetic peritoneal dialysis patients required a lower dose of erythropoietin compared to non-diabetic peritoneal dialysis patients (3818.2 [4489.5] units vs 6545.4 [3863.5] units per week) (P=.036). In hemodialysis patients, the mean erythropoietin dose was lower in diabetic patients compared to non-diabetic patients (8814.8 [5121.9] units vs 12 222 [6210] units per week) (P=.043)., Conclusion: The diabetic patients in both groups (hemodialysis and peritoneal dialysis) required less erythropoietin than non-diabetic patients. Diabetic patients on peritoneal dialysis required less erythropoietin diabetic patients on hemodialysis.

Objective. To determine the prevalence and risk factors for anemia in child bearing age women in Riyadh, Saudi Arabia. Design. Cross-sectional survey was conducted using two-stage cluster sampling. 25 clusters (primary health care centers (PHCC)) were identified from all over Riyadh, and 45-50 households were randomly selected from each cluster. Eligible women were invited to PHCC for questionnaire filling, anthropometric measurements, and complete blood count. Blood hemoglobin was measured with Coulter Cellular Analysis System using light scatter method. Setting. PHCC. Subjects. 969 (68%) women out of 1429 women were included in the analysis. Results. Mean hemoglobin was 12.35 (±1.80) g/dL, 95% CI 12.24-12.46 with interquartile range of 1.9. Anemia (Hb <12 g/dL) was present in 40% (390) women. Mean (±SD) for MCH, MCV, MCHC, and RDW was 79.21 (±12.17) fL, 26.37 (±6.21) pg, 32.36 (±4.91) g/dL, and 14.84 (±4.65)%, respectively. Multivariate logistic regression revealed that having family history of iron deficiency anemia (OR 2.91, 95% CI 1.78-4.76) and infrequent intake of meat (OR 1.54, 95%CI 1.15-2.05) were associated with increased risk of anemia, whereas increasing body mass index (OR 0.95, 95% CI 0.92-0.97) was associated with reduced risk of anemia. Conclusion. Women should be educated about proper diet and reproductive issues in order to reduce the prevalence of anemia in Saudi Arabia.