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Abstract Objective Maintaining normothermia is crucial for neonatal survival, especially in preterm infants prone to temperature instability. This study evaluates the correlation and variability between axillary and rectal temperatures at Neonatal Intensive Care (NICU) admission across gestational age ranges of 23–28, 29–32, 33–36, and ≥ 37 weeks, aiming to inform improved neonatal thermal management strategies. Methods This cross-sectional study was conducted at King Abdulaziz Medical City, Riyadh, from October 2023 to April 2024, involving 160 infants. Admission temperatures were measured using digital thermometers. Data analysis included ANOVA/Kruskal-Wallis for continuous variables, Chi-square tests for categorical data, Bland-Altman method for agreement assessment, and Pearson correlation coefficients to evaluate temperature correlations. Results Mean axillary temperature increased from 36.4 °C in the 23–28 weeks gestational group, to 36.5 °C in the 29–32 weeks group, and to 36.7 °C in the 33–36 weeks and ≥ 37 weeks groups, (p = 0.033). Rectal temperature increased from 36.5 °C in the 23–28 weeks group, to 36.6 °C in the 29–32 weeks group, and reached 36.8 °C in both the 33–36 weeks and ≥ 37 weeks groups (p = 0.006). Notable differences between measurement methods were observed in the 33–36 and ≥ 37 weeks groups (p

The LMWL was re-plotted from the isotopic analysis data (δ2H and δ18O) for rainwater samples collected from three stations in Baghdad city in the current study and data from previous studies. Four samples of shallow groundwater and five samples from the Tigris River were isotopically analyzed for 2H and 18O using a Liquid-Water Stable Isotope Analyzer (LWSIA). The samples were collected from the Al-Jaderia area within the University of Baghdad. The analysis was done against Vienna Standard Main Oceanic Water (VSMOW). The isotopic composition of groundwater ranges between -43.91‰ and -37.57 ‰ for 2H with an average of -40.06±2.7 ‰, while it ranges between -6.28‰ and -6.01‰ for 18O with an average of -6.14±0.1‰. These values are slightly more depleted compared to the isotopic composition of the Tigris River water (-38.79 ‰ to -37.87 ‰) for 2H with an average of -38.05±0.9‰ and between -6.23‰ to -5.11 ‰ for 18O with an average of -5.74±0.4 ‰. This is a logical result since the river is usually fed with fresh new rainwater, which isotopically is relatively more enriched. The current study confirms that the Local Meteoric Water Line (LMWL) has a formula of δ 2H‰ = 7.5 δ 18O‰ + 13. The LMWL is located above the Global MWL by +13.9‰ toward the Eastern Mediterranean (EMMWL δ2H‰ = 8 δ 18O‰ + 22), indicating the origin rainwater from the Mediterranean Sea and the Atlantic Ocean. The groundwater and surface water isotopic compositions were below the LMWL due to the evaporation of shallow groundwater. There is interconnection between river water and groundwater, directly or by recharge from irrigation water. Iraq may have two different MWLs, one for the northeastern region and the other for the middle, western and southern Iraq. The MWL for the northern eastern region of Iraq is close to that of the EMMWL, indicating Mediterranean climate and vapor source, while the rest of the areas of Iraq have MWL with various isotopic compositions affected by more hot climate in these regions and by the continental tropical air masses.

Objective. To examine the postnatal predictors of survival and adverse outcome among Congenital Diaphragmatic Hernia (CDH) infants. Method. Six-year retrospective review of CDH infants born at tertiary neonatal unit. Results. Forty infants with CDH were included; 27 (67.5%) survived to discharge. Non-survivors had a higher best, mean, and highest oxygenation index (OI) ( P

ObjectiveTo explore the relationship between Oxygenation Index (OI) and Oxygen Saturation Index (OSI) among infants with Congenital Diaphragmatic Hernia (CDH), both within the first 24 h after birth and in extended observations in those who survived until their surgical intervention.MethodsSeven- years retrospective review of CDH cases at a single Level III neonatal intensive care unit. The correlations of various combinations of OI-OSI pairs were assessed using the Spearman's rho Correlation Coefficient. Additionally, during the initial 24 h, the correlations between admission (first), best (lowest), highest, and mean OI and OSI values were determined. The predictive ability of the first 24 h oxygen and oxygen saturation indices for mortality and other adverse outcomes were assessed using the Area Under the Curve (AUC) analysis.ResultsThirty-seven infants with CDH were included in the analysis. A strong correlation was observed between all pairs of OI/OSI (2,289) (Spearman's rho = 0.843), matched pairs of Postductal OI/OSI (1,232 pairs) (Spearman's rho = 0.835) and the unmatched pairs of Postductal OI and Preductal OSI (1,057 pairs) (Spearman's rho = 0.852). Using the regression equations for all pairs, matched and unmatched OI/OSI pairs, we deduced that for clinically pertinent OI thresholds of 10, 15, 20 and 40, the corresponding OSI values were 5, 8, 11, and 23, respectively. Furthermore, in the first 24 h, strong correlations were evident between OI/OSI: at admission (Spearman's rho = 0.783), best OI/OSI (Spearman's rho = 0.848), and highest OI/OSI (Spearman's rho = 0.921). The most robust correlation was observed between the mean OI/OSI with a Spearman's rho of 0.928. First (AUC = 0.849), best (AUC = 0.927), highest (AUC = 0.942) and mean day 1 OI (AUC = 0.946) were all predictive of mortality. Similarly, first (AUC = 1.00), best (AUC = 0.989), highest (AUC = 1.00) and the mean OSI in day 1 (AUC = 0.978) were all predictive of mortality. All of the OIs and OSIs in day 1 except for the admission OSI (AUC = 0.683) were predictive of pulmonary hypertension. Additionally, all of OI and OSI indices in the first 24-hour except for the best day 1 OI (AUC = 0.674) were predictive of the need for rescue HFOV.ConclusionThere were a strong correlation between the OI and OSI in infants with CDH. Oxygenation indices and OSI in the first 24 h were predictive of mortality and other adverse outcomes in infants with CDH.

ObjectivesThe purpose of this research was to evaluate the differences between rectal and axillary temperature measurements in preterm infants who were born less than 32 weeks’ gestation using digital thermometers upon their admission to the Neonatal Intensive Care Unit (NICU).MethodsProspective, observational, single centre study. Rectal and axillary temperatures measurements were performed using a digital thermometer. The study examined various maternal and neonatal factors to describe the study group, including the use of prenatal corticosteroids, the occurrence of maternal diabetes and hypertension, a history of maternal prolonged rupture of membranes (PROM), maternal chorioamnionitis, the mode of delivery, along with the neonate's gender, birth weight, and gestational age. The Pearson correlation coefficient (R) was calculated to ascertain the linear relationship between the temperatures taken at the rectal and axillary sites. The concordance between the two sets of temperature data was analyzed using the Bland-Altman method.ResultsEighty infants with a mean gestational age of 28.4 weeks (SD = 2.9) and a mean birth weight of 1,229 g (SD = 456) were included in the study. The mean axillary temperature was 36.4 °C (SD = 0.7), which was lower than the mean rectal temperature of 36.6 °C (SD = 0.6) (p = 0.012). Rectal temperatures surpassed axillary measurements in 59% of instances, while the reverse was observed in 21% of cases. Rectal and axillary temperatures had a strong correlation (Pearson correlation coefficient of 0.915, p

This is the first time that radiological assessment achieved in the Baghdad International Airport (BIA) in Iraq. Twenty-three sites were sampled from upper 5 cm of the surface soil within the BIA to be analyzed for the radioactivity of natural radionuclides Ra-226, Th-232 and K-40 and the artificial radionuclide, Cs-137 using gamma spectroscopy based on Hyper pure Germanium detector (HPGe). Ten samples out of the 23 samples were analyzed for U-238, U-235 using the Neutron Activation Analysis method. To determine the percentage of DU [DU (%)] which is calculated from the 235U/238U isotope ratio. The study showed that there is a possibility of slight contamination with depleted uranium in two sites out of the 23 sites that were examined. The average activities of Ra-226, Th-232, and K-40 in the study area are within the limits of world averages, while there are evidences that new feeding of Cs-137 in the region, reaches about 19 Bq/kg, from the new global fallout after Chernobyl accident. The measured and calculated absorbed doses in the study area were within international limits and no need for farther monitoring. Annual effective dose equivalent due to resuspension of Ra-226 is estimated to be 1.0E-10Sv, and this value is negligible compared with 1 mSv permissible value for public recommended by ICRP.

Objective . To describe heated humidified high-flow nasal cannulas (HHHFNC) utilization in level III neonatal intensive care units (NICUs) in Saudi Arabia. Methods . A prospective cross-sectional study using an electronic web-based questionnaire. The survey targeted level III NICUs hospitals using HHHFNCs, covering HHHFNC availability, protocols, patient characteristics, and indications. It also collected opinions on the benefits of HHHFNCs compared to nasal continuous positive airway pressure (nCPAP). Results . Out of 47 government-level III neonatal intensive care units, 35 (74%) responded to the survey. Among the included units, 46% had guidelines for HHHFNC use. Additionally, 51% reported using HHHFNC in infants of all gestational ages. The primary indication for HHHFNC use was weaning off nCPAP (34%), with 60% of the respondents noting its advantages for kangaroo care and breastfeeding. Conclusion . HHHFNC are increasingly prevalent in NICUs in Saudi Arabia. However, there remain no clear policies or guidelines regarding their use in preterm infants.

Disruptive technology is used to describe innovations that design and improve a product or service in ways that neither the market nor consumers expect, but which are highly attractive to both.Industrial design is not far from this accelerating explosion of knowledge in what modern sciences and advanced technologies have created in various fields, which in turn led to changing consumer purchasing habits, so the consumer always needs to replace the product and acquire the latest technology from it without a productive exit from the market or the end of its lifespan, but because the product The new one works with new and different technological techniques and carries new formal efficiencies and new engineering and use functions resulting from the use of advanced materials that are completely different from traditional materials.Advanced materials are materials with advanced properties in terms of physical, chemical, mechanical, thermal and metallurgical thanks to nanotechnology, where scientists were able to develop and discover a range of methods for the production of materials with distinctive characteristics such as shape memory alloys, liquid metal, structural colorsThe research believes that the industrial designer must identify these advanced materials and study their characteristics, advantages, strengths and weaknesses so that he can use them in creating his designs for the industrial product and provide new functional, usable and formal solutions that are unfamiliar to the products.Keywords: disruptive technology - advanced materials - industrial design

Radiological assessment for the East Baghdad oilfield-southern part was conducted in the current study. 10 samples (scale, soil, sludge, water, and oil) from the different stages of oil production were collected. 232Th, 226Ra, and 40K in the samples were analyzed with 40% efficiency for Gamma spectrometry. system based on HPGe. The findings indicated that the examined sites exhibit comparatively lower levels of NORM contamination, in contrast to other global oilfields. Nevertheless, certain areas, particularly those within separation stages, demonstrate relatively elevated NORM concentrations exceeding the global average in soil and sludge. The maximum value of 226Ra, 232Th, was found in sludge sample the findings indicated that over 70% of the sampled locations exhibited concentrations of Norm that surpassed the worldwide average values. The highest exposure dose rate readings within the study areas reached 0.13 µSv/h, which exceeds the worldwide dose rate of 58 nGy/h as reported by UNSCEAR. Radiation exposure dose and hazard indices were calculated using the concentrations of 232Th,226Ra and 40K within samples. Indeed, the indices encompass various factors, these metrics provide a comprehensive understanding of the radiation exposure and associated risks. The study indicated that the relatively more contaminated stages within the oil production stages are the 1st separation stage, desalter stage and the waste pit stage where the higher concentrations of 226Ra, 232Th and exposure rates are recorded. Generally, the site exposes dose rate within an acceptable rate. Generally, the values of all hazard indices indicate that samples of some locations have values higher than the values recommended by UNSCEAR and ICRP.

Abstract Background Sleep disorders (SDs) are a symptom of the prodromal phase of neurodegenerative disorders that are mechanistically linked to the protein α-synuclein (α-syn) including Parkinson’s disease (PD). SDs during the prodromal phase could result from neurodegeneration induced in state-controlling neurons by accumulation of α-syn predominant early in the disease, and consistent with this, we reported the monomeric form of α-syn (monomeric α-syn; α-synM) caused cell death in the laterodorsal tegmental nucleus (LDT), which controls arousal as well as the sleep and wakefulness state. However, we only examined the male LDT, and since sex is considered a risk factor for the development of α-syn-related diseases including prodromal SDs, the possibility exists of sex-based differences in α-synM effects. Accordingly, we examined the hypothesis that α-synM exerts differential effects on membrane excitability, intracellular calcium, and cell viability in the LDT of females compared to males. Methods Patch clamp electrophysiology, bulk load calcium imaging, and cell death histochemistry were used in LDT brain slices to monitor responses to α-synM and effects of GABA receptor acting agents. Results Consistent with our hypothesis, we found differing effects of α-synM on female LDT neurons when compared to male. In females, α-synM induced a decrease in membrane excitability and heightened reductions in intracellular calcium, which were reliant on functional inhibitory acid transmission, as well as decreased the amplitude and frequency of spontaneous excitatory postsynaptic currents (sEPSCs) with a concurrent reduction in action potential firing rate. Cell viability studies showed higher α-synM-mediated neurodegeneration in males compared to females that depended on inhibitory amino acid transmission. Further, presence of GABA receptor agonists was associated with reduced cell death in males. Conclusions When taken together, we conclude that α-synM induces a sex-dependent effect on LDT neurons involving a GABA receptor-mediated mechanism that is neuroprotective. Understanding the potential sex differences in neurodegenerative processes, especially those occurring early in the disease, could enable implementation of sex-based strategies to identify prodromal PD cases, and promote efforts to illuminate new directions for tailored treatment and management of PD.

Abstract Background With the advances in neonatal intensive care, the survival rate of extremely preterm infants is increasing. However, bronchopulmonary dysplasia (BPD) remains a major cause of morbidity among infants in this group. This study examined the changes in respiratory support modalities, specifically heated humidified high-flow nasal cannula (HHHFNC), and their association with BPD incidence among preterm infants born at

Objective. To compare mortality and major neonatal morbidities between singleton preterm infants and preterm infants of multiple gestations born

3D printers have been the focus of many researchers in recent years. Many thin-walled structures can be produced using 3D printers. One of the thin wall structures that can be made with 3D printers is the core of sandwich panels. In this research, cores with rectangular cross section have been made using Acrylonitrile Butadiene Styrene (ABS) and Polylactic Acid (PLA) filaments. These cores were reinforced using aluminum and composite face sheets and subjected to a three-point bending test. Glass fibers with a density of 200 g/m2 were used to make composite shells. The results showed that the addition of aluminum and composite face sheets, although increasing the flexural strength, greatly reduces the flexibility of the core.

Wildland fires are diminishing air quality on a seasonal and regional basis, raising concerns about respiratory health risks to the public and occupational groups. This American Thoracic Society (ATS) workshop was convened in 2019 to meet the growing health threat of wildland fire smoke. The workshop brought together a multidisciplinary group of 19 experts, including wildland fire managers, public health officials, epidemiologists, toxicologists, and pediatric and adult pulmonologists. The workshop examined the following four major topics: 1) the science of wildland fire incidence and fire management, 2) the respiratory and cardiovascular health effects of wildland fire smoke exposure, 3) communication strategies to address these health risks, and 4) actions to address wildland fire health impacts. Through formal presentations followed by group discussion, workshop participants identified top priorities for fire management, research, communication, and public policy to address health risks of wildland fires. The workshop concluded that short-term exposure to wildland smoke causes acute respiratory health effects, especially among those with asthma and chronic obstructive pulmonary disease. Research is needed to understand long-term health effects of repeated smoke exposures across fire seasons for children, adults, and highly exposed occupational groups (especially firefighters). Other research priorities include fire data collection and modeling, toxicology of different fire fuel sources, and the efficacy of health protective measures to prevent respiratory effects of smoke exposure. The workshop committee recommends a unified federal response to the growing problem of wildland fires, including investment in fire behavior and smoke air quality modeling, research on the health impacts of smoke, and development of robust clinical and public health communication tools.

Other languages have influenced Arabic because of several factors, such as geographical nearness, trade communication, past Islamic conquests, science and technology, new devices, brand names, models, and fashion. As a result of these factors, foreign words are used in Arabic text and are known as Arabised words. Arabised words affect the Arabic natural language processing (NLP) task because identifying a correct stem or root from an Arabic word becomes more difficult. Therefore, a more efficient Arabic NLP can be developed if Arabised word removal is part of a pre-processing task. In this paper, we propose an algorithm for detecting and extracting Arabised words as a pre-processing task for an Arabic stemming task. This algorithm is a combination of lexicon-based and rule-based approaches. The lexicon list has been developed based on various sources of Arabic text resources, and the rule-based algorithm has been designed to cater to Arabised words with definite articles and use pattern matching on prefixes and suffixes. To evaluate the effectiveness of the proposed Arabised word removal algorithm on the Arabic NLP task, we use Arabised word removal as part of pre-processing in Arabic stemmers. Three Arabic stemmers are used in our evaluation, namely, light stemming, condition light and ARLS, on three types of Arabic standard datasets. Comparisons were made by measuring the performance of precision, recall and IFC on the stemmers with or without our Arabised word removal pre-processing. Results show that the performance on all the stemmers improves if Arabised word removal is included as part of the stemming's pre-processing. Therefore, an efficient Arabic NLP application or task can be developed if Arabised word removal is included in the pre-processing stage for Arabic NLP application, mainly Arabic stemming.https://dorl.net/dor/20.1001.1.20088302.2022.20.4.6.5

Background: Busulfan is a frequently used chemotherapeutic agent. It exerts harmful effects on male reproduction. Azoospermia is a major cause of male infertility, and stem cell therapy may be a reasonable treatment option.The aim of the work: The present study aimed to examine the potential role of mesenchymal stem cell transplantation for treatment of busulfan–induced azoospermia.Methodology: A total of 45 mice were used and divided equally into three groups; the control groups that received none and used for provision of bone marrow mesenchymal stem cells. Other 30 received intraperitoneal busulfan [10 mg/kg] in two doses of with 21 days interval to induce azoospermia. Then 15 received stem cell transplantation 35 days after last busulfan injection. Animals were followed for 35 days, with blood cell count, measurement of testosterone levels and oxidative stress markers and testes were examined for histomorphometric changes. Results: Body weight in busulfan group was significantly increased than the stem cells group [35.93±1.39 vs 26.87±1.18 respectively), but it still lower than the control group. The luminal diameter of seminiferous tubules was significantly increased in the busulfan than the control or stem cells-treated groups [148.0±8.8 vs 58.0±10.8 and 115.3±9.2 respectively). All blood cells were reduced by busulfan injection and partially regained by stem cell therapy. Spermatogenic potential was significantly reduced in busulfan than the control group (0.6667±0.487 vs 6.60±0.507). It was significantly regained by stem cell therapy, but still lower than control group (5.53±0.516 vs 6.60±0.507). Testosterone, glutathione reductase, superoxide dismutase and glutathione peroxidase were significantly reduced, while lactate dehydratase and malondialdehyde were increased by busulfan and partially regained by stem cell therapy, with significant differences between groups.Conclusion: Busulfan-induced azoospermia and harmful effects on male mouse reproduction system and it mainly affected spermatogenic potential. These effects could be restored by mesenchymal stem cell transplantation.

Ahmed Seri,1,2 Hala Kamal Ali Mohamed,3– 5 Mohammed Elmujtba Adam Essa,6 Elnour Mohammed Elagib,7,8 Noha Ibrahim Ahmed Eltahirm,7,8 Salma Mohammed Alfatih Mansour,9 Abdelkareem A Ahmed6 1Department of Clinical Immunology, Royal Care International Hospital, Khartoum, Sudan; 2Department of Immunology, Institute of Endemic Disease, University of Khartoum, Khartoum, Sudan; 3Department of Microbiology, Faculty of Medicine, African International University (AIU), Khartoum, Sudan; 4Department of Clinical Immunology, Sudan Medical Specialization Board (SMSB), Khartoum, Sudan; 5Faculty of Medicine, Sudan University of Science and Technology, Khartoum, Sudan; 6Department of Clinical Medicine, Medical and Cancer Research Institute, Nyala, Sudan; 7Department of Rheumatology, Omdurman Military Hospital, Khartoum, Sudan; 8Department of Medicine, Faculty of Medicine, Karary University, Khartoum, Sudan; 9Department of Medicine, Faculty of Medicine, University of Khartoum, Khartoum, SudanCorrespondence: Mohammed Elmujtba Adam EssaDepartment of Clinical Medicine, Medical and Cancer Research Institute, Nyala, SudanTel +249 90700938Email Awadali818@yahoo.comIntroduction: Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by inflammation of the synovial membrane. RA is classified as seropositive or seronegative, according to the absence or presence of primarily IgM RF, RF, and/or ACPA. The aim of this study is to identify the relationship between the serotype of rheumatoid arthritis and the level of ESR.Methods and Materials: This is a descriptive, cross-sectional study done in Omdurman military hospital, Khartoum, Sudan. Conducted with 60 patients with RA, data were collected through a designated questionnaire which included demographic, age, gender, duration of the disease, laboratory finding. All the patients in the study were treated with conventional DMARDs and diagnosed according to the 2010 ACR/EULAR criteria; their disease activity status was assessed by DAS28/ESR. Data were analyzed using SPSS version 23.Results: The study found that 91.7% of the patients were females, patients of age group between 36 and 50 years had the highest percentage at 38.3% followed by those between 51 and 70 years and the least age group between 20 and 35 years, 36.7% and 15%, respectively. Of all the patients 61.7% were found to be SPRA, while the remaining 38.3% were seronegative (SNRA). Altogether 55% of the patients had moderate disease activity, followed by 16.7% who had a remission, 15% had high disease activity and the remaining 13.3% had low disease activity. The metacarpophalangeal (MCP) joint was found to be the only joint that was significantly associated with DAS28 and its involvement was greater among seropositive patients. The most affected joints were found to be shoulders, knees, wrist, MCP, PIP and elbow, in that order.Conclusion: Females, middle-age group and shoulder joint were the most affected. Most RA was found to be SPRA, and the seropositive group was found to be more associated with high disease activity, while the seronegative group was associated with remission and low disease activity.Keywords: seropositive, seronegative, RA, female, high disease activity

Abstract Background Diabetes is one of the most common associated comorbidity with severe acute respiratory syndrome coronavirus (SARS‐CoV‐2) pneumonia patients. Coagulation disorders with D‐dimer levels are increased in both diseases. This study aimed to compare the levels of D‐dimer in DM and non‐DM patients with coronavirus disease (COVID‐19) and correlate it with the disease severity. Methods This is a cross‐sectional hospital‐based study. It was conducted at royal care hospital, isolation COVID‐19 Centre in 2021. The study included 130 patients with COVID‐19 who fulfilled the inclusion criteria. Data were collected through a structured datasheet. The disease was diagnosed by a nasal swab polymerase chain reaction (PCR) Participants were divided into diabetics and non‐diabetics depending on the history from the datasheet. The data were analysed with Statistical Package of Social Science (SPSS) version 23. Results The study showed that 73.1% of the participants were males and 26.9% were females. The most frequent age group was >65 years. The percentages of diabetics and non‐diabetics, among the study participants, were found to be 41.5% and 58.5%, respectively. Moreover, 52.3% were admitted to the intensive care unit (ICU). This study revealed that D‐dimer was higher compared with diabetes mellitus. The diabetics were associated with higher levels of D‐dimer compared to non‐diabetics. Regarding the correlation between the level of D‐dimer and severity of COVID‐19, it was found that there is a significant association, as the ICU patients were associated with higher levels of D‐dimer in comparison with non‐ICU patients. Conclusion This study concluded that there is a significant association between the high D‐dimer level and severity of COVID‐19 among diabetic patients.

Abstract Objective The present study aimed to explore the opinion and ethical consideration of vulvovaginal aesthetics procedures (VVAPs) among health professionals and medical students in Saudi Arabia. Methods This is a cross-sectional study performed between January 2020 and April 2020. Data was collected through electronic media, WhatsApp, and emails. The results were analyzed by applying the Students t-test, and correlations were considered significant if they presented a p-value

There is no single biomarker to detect lupus nephritis (LN) activity. Renal biopsy is still the gold standard method but it is invasive and mainly used in the initial assessment of the patients. Urinary tumor necrosis factor-like weak inducer of apoptosis (uTWEAK) and urinary monocyte chemo-attractant protein-1 (uMCP-1) can be secreted in the urine of active LN. The aim of the study is to assess the potential role of uTWEAK and uMCP-1 in lupus patients and to determine their correlation with disease activity. This is a case-control study conducted on a total of 114 subjects; 92 systemic lupus erythematosus (SLE) patients and 22 healthy volunteers. The patients were recruited from the rheumatology unit at the internal medicine department, Tanta University Hospital, Tanta, Egypt. The patients and controls were subjected to full history taking, complete clinical examination, routine laboratory tests, uTWEAK and uMCP-1 measurement, assessment of the disease activity using SLE Disease Activity Index (SLEDAI), and renal SLEDAI (rSLEDAI) scores. uTWEAK and uMCP-1 levels were higher in SLE with active nephritis group than those of other SLE groups and controls. There was a significant positive correlation between uTWEAK and uMCP-1 levels in lupus patients with proteinuria, anti-dsDNA, SLEDAI and r-SLEDAI and a negative correlation with C3 and C4. TWEAK showed a sensitivity of 80.43% and 100% and specificity of 50% and 100% in detecting lupus activity and LN activity, respectively. Furthermore, uMCP-1 showed a sensitivity of 82.6% and 100% and specificity of 50% and 100% in detecting lupus activity and LN activity, respectively. uTWEAK and uMCP-1 are new, easily obtained, accurate markers with high sensitivity and specificity in the detection of LN activity.

Abstract In the next-generation heterogeneous wireless networks, designing authentication protocols that meet the demand of mobile users/applications is a challenge. This paper proposes authentication and re-authentication protocols for 4G wireless networks, in particular, LTE-Advanced (LTE-A), WLAN, and WiMAX-Advanced (WiMAX-A) interworking architecture. The proposed protocols are applicable to 5G networks. With the consideration of the existing standard authentication protocols, a new set of authentication and re-authentication protocols has been reinvented to provide fast and secure handovers (HO) in the current 4G and the next 5G networks. The proposed authentication protocols can be invoked when the users perform a vertical HO (between different networks) for the first time, whereas the re-authentication protocols can be invoked when the users perform a horizontal HO (within the same network domain). These protocols provide an efficient method to protect user identity and reduce the burden on the authentication server (AS) during the sequential handovers. The results of the analytical model show that the proposed protocols achieve better performance than standard and other protocols. The reduction of handover cost, handover delay, and energy consumption in the proposed protocols reaches up to 22%, 44%, and 17%, respectively. In addition, the verification tools show that the proposed protocols are secure, dependable, and prevent all types of authentication and secrecy attacks.