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Background and Aim: Efficient mosquito vectors are required to persist and propagate arthropod-borne diseases that seriously affect impoverished populations worldwide. Mosquito sensilla plays a crucial role in host-seeking and disease transmission to humans. This study aimed to distinguish between the several types of sensilla found on the antennae and maxillary palps of Culex pipiens and Aedes aegypti, matching this diversity with host preference and disease transmission. Materials and Methods: Overall, 1300 mosquitoes were collected and examined using dissection and light microscopy. Scanning electron microscopy was used to identify and describe the diverse types of sensilla found on the antennae and maxillary palps of C. pipiens and A. aegypti. Results: In total, 900 C. pipiens and 400 A. aegypti mosquitoes were identified. The antennae and maxillary palps of C. pipiens and A. aegypti carry both sensilla trichoidea and sensilla chaetica. The C. pipiens antenna has long and short grooved peg sensilla, whereas A. aegypti lacks long pegs and expresses only occasional short pegs. The maxillary palps express Capitate pegs in both mosquito species and exclusively show sensilla campaniform in A. aegypti. Conclusion: The lack of long-grooved pegs and the presence of few short pegs, along with campaniform sensilla, limit the host range of A. aegypti and reduce its susceptibility to many infections, unlike C. pipiens.

Water scarcity is one of the major critical affecting arid climate countries. In addition, population growth and climate change are threatening the sustainable development of water resources in the upcoming decades. Therefore, managing groundwater can solve water scarcity such that sustainable development is ensured for future generations. Hence, it is crucial to assess the current quantity of groundwater by analyzing groundwater variables. Thus, natural groundwater recharge could be utilized as an indicator to assess groundwater quantity conditions. This study aims to estimate natural groundwater recharge in an arid unconfined aquifer. El-Qaa plain in Sinai, Egypt was chosen as a case study. Recharge was estimated taking into consideration spatial and temporal variability. To accomplish this, the WetSpass (Water and Energy Transfer between Soil, Plants, and Atmosphere under quasi-Steady State) model was applied. The model was run using morphological, landuse – land cover and climate data from 1986 to 2015 with a monthly time step. To calibrate the model, the isotope signature of δ18O and δ2 H of water was analyzed to determine the natural groundwater recharge of the aquifer. The obtained recharge value was utilized as a reference value for the calibration process. The results were validated using a finite-difference groundwater flow model (MODFLOW). The recharge values were imported to MODFLOW followed via a transient run from 2000 to 2011. The validation was conducted by comparing the simulated groundwater level with the observed ones. After validation process, the inter-annual and seasonal variability of recharge were determined, and a relationship between recharge and other hydrological parameters was deduced. In addition, the recharge distribution was mapped to depict the recharge spatial variability. The results show that the current recharge rate ranges from approximately 8.10 to 16.62 mm/yr, with a mean annual recharge rate of nearly 12.36 mm/yr. The study might be useful for hydrogeologists for determining potential recharge in the study area, groundwater modelers for developing a reliable groundwater flow model, and decision-makers for planning appropriate future sustainable development through water resources management.

This study explores two primary categories of power generation: conventional methods reliant on fossil fuels and renewable energy methods. Fossil fuel-based approaches, including natural gas and heavy fuel oil, contribute to environmental concerns due to their carbon dioxide (CO2) emissions, which are responsible for the greenhouse effect and global warming. Many nations, particularly in Europe, have implemented stringent measures to restrict CO2 emissions, imposing fines on industries that exceed emission limits. In response to these concerns, this study focuses on a green building project that aims to meet its power requirements through renewable energy sources. Various renewable energy resources will be evaluated, considering the merits and drawbacks of each technology, to identify the most suitable option for the building under investigation. Additionally, a comprehensive thermodynamic analysis will be conducted, including calculations of electrical needs such as cooling load, lighting load, and equipment load. A customized power calculator will also be developed for application in similar projects. The ultimate objective of this study is to achieve complete autonomy from the electric grid by utilizing renewable energy resources, transforming the building into a green building. The results indicate that at an outside temperature of 22 °C, the total heat gain decreases from 157.3 to 39 kW, reducing the total cost of electricity from 20,000 to 5100 AED/year. Conversely, at an outside temperature of 50 °C, the total heat gain increases from 157.3 to 196 kW, raising the total cost of electricity from 20,000 to 26,000 AED/year. These findings demonstrate the significant influence of outside temperature on the building's energy requirements and costs, underscoring the importance of considering temperature variations in energy efficiency and cost optimization strategies.

This study aims to compare meibomian gland (MG) dropout and MG dysfunction (MGD) between patients with diabetes mellitus (DM) with moderate–severe non-proliferative diabetic retinopathy (NPDR) and patients with no diabetes (NDM). This prospective, transversal, age, and gender-matched case–control study included 98 DM and 106 NDM eyes. Dry eye disease (DED) and MGD evaluations were performed, including meibography (Keratograph 5M®). The objective MG dropout percentage was obtained by analyzing meibography images with ImageJ software (v. 1.52o, National Institutes of Health, Bethesda, MD, USA) and was subsequently graded with Arita’s meiboscore. The DM duration was 18 ± 9 years. The mean meiboscore (3.8 ± 0.8 vs. 3.4 ± 1.0, p = 0.001), meiboscore severity (p = 0.016), and MG dropout (45.1 ± 0.1% vs. 39.0 ± 0.4%, p < 0.001) were greater in DM than in NDM. All patients showed MG dropout (meiboscore > 1). Lower eyelids showed greater MG dropout in both groups. A correlation with age (r = 0.178, p = 0.014) and no correlations with DM duration or gender (p > 0.005) were observed. Patients with diabetes showed greater corneal staining (1.7 ± 1.3 vs. 0.9 ± 1.1; p < 0.001), reduced corneal sensitivity (5.4 ± 1.1 vs. 5.9 ± 0.4; p < 0.001), lower MG expressibility (3. 9 ± 1.6 vs. 4.4 ± 2.1; p = 0.017), and worse meibum quality (1.9 ± 0.8 vs. 1.7 ± 0.5; p = 0.019). Tear breakup time, osmolarity, MMP-9, Schirmer, and the Ocular Surface Disease Index showed no significant differences. In conclusion, patients with DM with NPDR have greater MG dropout and meiboscore, as well as more severe MGD and DED parameters than persons with NDM.

Abstract Mini abstract This work studies the direct cost of hip fractures in Egypt. The direct cost was calculated based on the incidence of hip fracture in Egypt retrieved from the national database. The result of this work raises red flags to the policy makers in Egypt that such fragility fractures are preventable, should appropriate approaches be implemented. Background This study provides an analysis for the healthcare system in Egypt. It was carried out to assess the direct annual cost incurred to the Egyptian healthcare system in 2023 as a result of fragility hip fractures in older adult Egyptians. Results The direct costs of hip fractures incurred during the first year after the injury were estimated at 1,969,385,000 Egyptian pounds (US $63,734,142.4). Time from fracture to surgery was 2.2 + 0.5 days. The average hospital stay after hip fracture surgery was 5.2 + 2.6 days. 4.5% of patients died after surgery, on average 2.3 + 0.4 months. After being discharged from the hospital, all patients needed home care. Conclusion Hip fractures have a significant clinical and financial impact on patients and the healthcare system. This study raises red flags for the healthcare policy makers in Egypt, as the financial burden due to the direct costs of hip fractures justifies extensive prevention programs for osteoporosis and fragility fractures. There is an urgent need to implement diagnostic approaches and validated management protocols for bone health disorders and its associated fractures in Egypt.

Abstract Background Meta-analyses are on top of the evidence-based medicine pyramid, yet many of them are not completed after they are begun. Many factors impacting the publication of meta-analysis works have been discussed, and their association with publication likelihood has been investigated. These factors include the type of systematic review, journal metrics, h-index of the corresponding author, country of the corresponding author, funding sources, and duration of publication. In our current review, we aim to investigate these various factors and their impact on the likelihood of publication. A comprehensive review of 397 registered protocols retrieved from five databases was performed to investigate the different factors that might affect the likelihood of publication. These factors include the type of systematic review, journal metrics, h-index of the corresponding author, country of the corresponding author, funding sources, and duration of publication. Results We found that corresponding authors in developed countries and English-speaking countries had higher likelihoods of publication: 206/320 (p = 0.018) and 158/236 (p = 0.006), respectively. Factors affecting publications are the countries of corresponding author (p = 0.033), whether they are from developed countries (OR: 1.9, 95% CI: 1.2–3.1, p = 0.016), from English-speaking countries (OR: 1.8, 95% CI: 1.2–2.7, p = 0.005), update status of the protocol (OR: 1.6, 95% CI: 1.0–2.6, p = 0.033), and external funding (OR: 1.7, 95% CI: 1.1–2.7, p = 0.025). Multivariable regression retains three variables as significant predictors for the publication of a systematic review: whether it is the corresponding author from developed countries (p = 0.013), update status of the protocol (p = 0.014), and external funding (p = 0.047). Conclusion Being on top of the evidence hierarchy, systematic review and meta-analysis are the keys to informed clinical decision-making. Updating protocol status and external funding are significant influences on their publications. More attentions should be paid to the methodological quality of this type of publication.

This study aimed to provide environmental surveillance data for evaluating the risk of acquiring SARS-CoV-2 in public areas with high foot traffic in a university. Air and surface samples were collected at a university that had the second highest number of COVID-19 cases among public higher education institutions in the U.S. during Fall 2020. A total of 60 samples were collected in 16 sampling events performed during Fall 2020 and Spring 2021. Nearly 9800 students traversed the sites during the study period. SARS-CoV-2 was not detected in any air or surface samples. The university followed CDC guidance, including COVID-19 testing, case investigations, and contact tracing. Students, faculty, and staff were asked to maintain physical distancing and wear face coverings. Although COVID-19 cases were relatively high at the university, the possibility of acquiring SARS-CoV-2 infections at the sites tested was low.

Femtosecond laser (FSL) applications in corneal surgery have increased since its inception. Corneal surgery has undergone a tremendous transformation thanks to the introduction of FSL technology. This laser makes precise, three-dimensional incisions while causing minimal damage to surrounding tissue. This review updates and summarizes current and upcoming FSL applications in corneal surgery, current commercially available FSL, and its respective applications. Refractive surgery applications include laser in-situ keratomileusis flaps, refractive corneal lenticule extraction such as small incision lenticule extraction, astigmatic keratotomy, intracorneal ring segments tunnels for keratoconus including corneal allogenic intrastromal ring segments, and presbyopia treatments with intrastromal pockets for corneal inlays and intrastromal incisions (INTRACOR). Keratoplasty applications include penetrating keratoplasty trephination; superficial and deep anterior lamellar keratoplasty trephination, lamellar dissection, and tunnel creation; posterior lamellar keratoplasty donor and recipient preparation; Bowman layer transplantation donor, and recipient preparation; and stromal keratophakia. Other applications include conjunctival graft preparation in pterygium surgery, and keratopigmentation (corneal tattooing). FSL is a surgical instrument widely used in corneal surgery because it improves reproducibility and safety in many procedures.

Islamic banking is a financial structure based on Islamic law (Sharia law) and driven by Islamic economics. The Islamic financial system, which offers alternative funding sources, is supported by four major pillars: the Islamic banking system, the Islamic money market, Islamic insurance, or takaful, and the Islamic capital market. On the other hand, social banks are founded on using financial services to “create a positive impact on the society and the environment; respectively, customers see Islamic banks, depositors, and the broader community as having a social as well as an economic role. In this respect, the main pillars of the United Nations Sustainable Development Goals (SDGs) include ending poverty and promoting sustainable development. This paper will investigate the similarities between Islamic and social banks. Furthermore, this research will highlight the contribution of the two banks toward achieving the UN Sustainable Development Goals (SDGs).

Objective: To compare the outcome of off-pump and on-pump coronary artery bypass graft surgery in patients with left main coronary artery disease. Method: The randomised, controlled, prospective, multicentric study was conducted in 2020 during the period from January 2020 to December 2020 at Kafrelsheikh University Hospital, International Cardiac Centre and Alexandria New Medical Centre, Egypt, and comprised patients with left main coronary artery disease who underwent coronary artery bypass graft surgery. The patients were randomised to on-pump surgery group I (Control Group) and off-pump surgery group II(Interventional Group). All patients were assessed pre-operatively for the presence of comorbid conditions and post-operatively for myocardial infarction, acute kidney injury, pneumonia, sternal dehiscence and 3-month mortality. Data was analysed using SPSS 20. Results: Of the 60 patients, 44(73.3%) were men and 16(26.6%) were women. The overall mean age was 66.4±9.2 years. There were 30(50%) patients in each of the two groups. There were 2(6.7%) cases of myocardial infarction in group I and 1(3.3%) in group II. There was 1(3.3%) case of acute kidney injury in group I and none in group II. There were 3(10%) cases of pneumonia in group 1 compared to 1(3.3%) in group II. There was 1(3.3%) case of sternal dehiscence in group I and none in group II. Mortality at 3 months was 2(6.7%) in group I and 1(3.3%) in group II. There was no significant difference with respect to outcome between the groups (p>0.05). Conclusion: Off-pump coronary artery bypass graft surgery was found to be efficient and non-inferior to on-pump procedure in patients with left main coronary artery disease. Keywords: Coronary artery, Bypass, Myocardial infarction, Kidney, Diabetes, Myocardium, Pneumonia

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Embryonic thermal manipulation was known as an effective protocol for improving post-hatch growth performance and thermotolerance acquisition among avian species. Previously, we evaluated the impact of embryonic thermal manipulation of Japanese quail on embryonic development, hatchability, and post-hatch performance. We conducted the current study to furtherly elucidate the effects of thermal manipulations of Japanese quail embryos on internal organ weights, carcass traits, and meat quality parameters at post-hatch day 35. Quail eggs of control group were incubated at 37.7 °C and relative humidity (RH) 55%. Three thermally manipulated groups of quail eggs were incubated intermittently at 41°C and 65% RH intermittently (3 hours/day): the early embryonic group (TM1) was thermally challenged at embryonic day (ED6) to ED8, the late embryonic group (TM2) was thermally challenged at ED12-14, and early/late embryonic group (TM3) was thermally challenged in both time windows. Quail meat quality parameters, carcass traits, and internal organ weights were evaluated at post-hatch day 35. The results revealed that early embryonic thermal manipulation (TM1 group) is an effective protocol for decreasing fat pad accumulation. The pH value of breast meat in all TM treatments revealed significant (P < 0.05) decreases by 5% in comparison with that of control without any negative effects on breast meat composition or sensory criteria. Early embryonic thermal manipulation would be recommended as an enhanced protocol that can be used to reach the favored lucrative effects of the thermal treatment in meat-type quail. UČINKI TOPLOTNE MANIPULACIJE ZARODKOV JAPONSKIH PREPELIC NA LASTNOSTI TRUPA PO IZVALITVI, TEŽO NOTRANJIH ORGANOV IN KAKOVOST PRSNEGA MESA Izvleček: Toplotna manipulacija zarodka različnih vrst ptic je znana kot učinkovit protokol za izboljšanje rasti po izvalitvi in pridobivanje odpornosti na povišano temperaturo. Predhodno smo ocenili vpliv embrionalne toplotne manipulacije zarodkov japonskih prepelic na embrionalni razvoj, valilnost in uspešnost po izvalitvi. V tej študiji smo natančneje pojasnili učinke toplotne manipulacije zarodkov japonskih prepelic na težo notranjih organov, lastnosti trupa in parametre kakovosti mesa na 35. dan po izvalitvi. Jajca prepelic kontrolne skupine so bila inkubirana pri 37,7 °C in 55-odstotni relativni vlažnosti. Tri preiskovane skupine prepeličjih jajc so bile občasno izpostavljene temperaturi 41 °C in relativni vlagi 65 % (3 ure/dan): zgodnja embrionalna skupina (TM1) je bila izpostavljena toploti 6.– 8. embrionalni dan (ED), pozna embrionalna skupina (TM2) 12.–14. ED, zgodnja/pozna embrionalna skupina (TM3) pa v obeh časovnih intervalih. Parametre kakovosti mesa prepelic, lastnosti trupa in težo notranjih organov smo ocenili na 35. dan po izvalitvi. Rezultati so pokazali, da je toplotna manipulacija v zgodnjem embrionalnem obdobju (skupina TM1) učinkovit protokol za zmanjšanje kopičenja maščobnih blazinic. Vrednost pH prsnega mesa pri vseh toplotno manipuliranih skupinah se je znatno (P < 0,05) znižala za 5 % v primerjavi s kontrolno skupino, brez negativnih učinkov na sestavo prsnega mesa ali senzorične kriterije. Zgodnjo embrionalno toplotno manipulacijo bi bilo priporočljivo uporabiti kot izboljšan protokol, s katerim bi bilo mogoče doseči prednostne donosne učinke pri mesnih prepelicah. Ključne besede: Coturnix japonica; mesna prepelica; lastnosti prsnega mesa; toplotna biologija

New guitarists face multiple problems when first starting out, and these mainly stem from a flood of information that they are presented with. Students also typically struggle with proper pitch frequency recognition and accurate left-hand motion. A variety of relevant solutions have been suggested in the existing literature; however, the majority have ultimately settled on two approaches. The first is finger motion capture, wherein researchers focus on extracting finger positions through analyzing images and videos. The second is note frequency recognition, wherein researchers focus on analyzing notes and frequencies from audio recordings. This paper proposes a novel hybrid solution that includes both finger motion capture and note frequency recognition in order to conduct a full assessment and give feedback on a guitarist’s performance. To classify hand positions, several classification algorithms are tested. The random forest algorithm obtained superior results, with an accuracy of 99% for overall hand movement and an average of 97.5% for the classification of each finger. Meanwhile, two algorithms were tested for note recognition, where the harmonic product spectrum (HPS) approach obtained the highest accuracy of 95%.

Objectives: Because the detection of SARS-CoV-2 RNA in aerosols but failure to isolate viable (infectious) virus are commonly reported, there is substantial controversy whether severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can be transmitted through aerosols. This conundrum occurs because common air samplers can inactivate virions through their harsh collection processes. We sought to resolve the question whether viable SARS-CoV-2 can occur in aerosols using VIVAS air samplers that operate on a gentle water vapor condensation principle. Methods: Air samples collected in the hospital room of two coronavirus disease-2019 (COVID-19) patients, one ready for discharge and the other newly admitted, were subjected to RT-qPCR and virus culture. The genomes of the SARS-CoV-2 collected from the air and isolated in cell culture were sequenced. Results: Viable SARS-CoV-2 was isolated from air samples collected 2 to 4.8 m away from the patients. The genome sequence of the SARS-CoV-2 strain isolated from the material collected by the air samplers was identical to that isolated from the newly admitted patient. Estimates of viable viral concentrations ranged from 6 to 74 TCID50 units/L of air. Conclusions: Patients with respiratory manifestations of COVID-19 produce aerosols in the absence of aerosol-generating procedures that contain viable SARS-CoV-2, and these aerosols may serve as a source of transmission of the virus.

Abstract Background Floating right heart thrombi (RHT) represent an underdiagnosed, potentially hazardous, and to some extent rare phenomenon in patients presenting with acute pulmonary embolism (APE). Emergent treatment is usually required for such a condition. Case presentation A 19-year-old young lady presented with progressive shortness of breath, marked renal impairment, thrombocytopenia, and a highly oscillating huge right atrial mass. After she was admitted to the intensive care unit, she arrested in asystole and was resuscitated, and her electrocardiogram (ECG) showed evidence of acute anterior myocardial infarction. Urgent cardiac surgery to remove the right atrial mass was proposed by the heart team as the best option of management. Surgery was emergently performed with extra-corporeal membrane oxygenator (ECMO) as a support. Following surgery, mechanical support and vasopressors were successfully weaned and the patient achieved a good recovery. Conclusions A pulmonary embolism response team (PERT) approach should always be considered where a multidisciplinary team involving a cardiologist, radiologist, cardio-thoracic surgeon, radiologist, and intensivist shall determine the management strategy for a challenging presentation of a massive pulmonary embolism or floating right heart thrombi causing the hemodynamically unstable clinical condition.

The use of optical coherence tomography (OCT) technology in anterior segment diseases allows for precise assessment of the changes following anterior segment surgery. Advances in microscope-integrated OCT systems have allowed the utilization of intraoperative OCT (iOCT) in anterior segment surgeries, i.e., cornea, cataract, and refractive surgery. iOCT has enabled real-time precise visualization of anterior segment tissues as well as interactions between surgical instruments and ocular tissue; thus, the device can facilitate surgical procedures and provide valuable information for decision-making during anterior segment surgeries. In this review, the authors will introduce studies regarding the development of iOCT technology and its application in various anterior segment surgeries. Multiple studies have shown the efficacy of the iOCT for intraoperative assistance and guidance, suggesting the potential of the device for optimizing the surgical outcomes after cornea, cataract, and refractive surgery.

Purpose: To assess the relationship and prognostic value of the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) with poor final best-corrected visual acuity (BCVA) after surgical repair of open globe injuries (OGI) in adults.Design: Retrospective analysis of data from an ongoing prospective cohort of consecutive patients.Methods: In a tertiary university hospital, 197 eyes of 197 patients were included between 2013 and 2017. NLR and PLR were obtained from pre-operative blood tests to analyze its relationship with poor final BCVA.Results: Severe visual impairment (SVI) was defined as ≤20/200, and was observed in 96 (48.7%) patients after surgical repair of OGI. SVI patients had higher NLR (7.4 ± 6.6 vs. 4.0 ± 3.2, p < 0.001), and PLR (167 ± 92 vs. 139 ± 64; p = 0.021) than non-SVI. NLR ≥ 3.47 and PLR ≥ 112.2 were the best cut-off values for SVI, were univariate risk factors for SVI, and had sensitivity: 69.0, 71.4, and specificity: 63.6, 44.8, respectively. In multivariate analysis, only OTS, athalamia, and hyphema remained as risk factors. NLR had significant correlation with ocular trauma score (OTS) (r = −0.389, p < 0.001) and final BCVA (r = 0.345, p < 0.001).Limitations: Simultaneous trauma in other parts of the body that could influence the laboratory findings.Conclusion: Patients with SVI after a repaired OGI had increased pre-operative NLR and PLR levels. High NLR and PLR are risk factors for SVI in univariate analysis. It is confirmed that low OTS is a risk factor for SVI. High NLR and PLR could be used as a prognostic tool to identify patients at higher risk for SVI after repair of OGI.

The article “Factors causing rework and their impact on projects’ performance in Egypt” by Assim Muwafaq Al-Janabi, Mohamed Shawky Abdel-Monem, Karim Mohamed El-Dash, published in the research journal Journal of Civil Engineering and Management, 26(7), 666-689, https://doi.org/10.3846/jcem.2020.12916 contained following errors: 1. Some confusion related to ($) value against (EGP) appeared at Research method paragraph, page 670. Instead of ($1 = 1.65 EGP) the value should read: ($ 1 ≅ 16.5 EGP) 2. A mistake in establishing the correct contract value for the automatic multistorey car parking project appeared at Research method paragraph page 670, Table 2. The value 2.49 billion should read: 249 million. Corrected version of the article is available online. The authors regret the errors.

Advances in imaging technology and computer science have allowed the development of newer assessment of the anterior segment, including Corvis ST, Brillouin microscopy, ultrahigh-resolution optical coherence tomography, and artificial intelligence. They enable accurate and precise assessment of structural and biomechanical alterations associated with anterior segment disorders. This review will focus on these 4 new techniques, and a brief overview of these modalities will be introduced. The authors will also discuss the recent advances in research regarding these techniques and potential application of these techniques in clinical practice. Many studies on these modalities have reported promising results, indicating the potential for more detailed comprehensive understanding of the anterior segment tissues.

Vitamins and omega-3 fatty acids (Ω3FA) modulate periodontitis-associated inflammatory processes. The aim of the current investigation was to evaluate associations of oral nutrient intake and corresponding serum metabolites with clinical severity of human periodontitis. Within the Food Chain Plus cohort, 373 periodontitis patients—245 without (POL) and 128 with tooth loss (PWL)—were matched to 373 controls based on sex, smoking habit, age and body mass index in a nested case-control design. The amount of oral intake of vitamins and Ω3FAs was assessed from nutritional data using a Food Frequency Questionnaire. Oral intake and circulatory bioavailability of vitamins and Ω3FA serum metabolomics were compared, using ultra-high-resolution mass spectrometry. Periodontitis patients exhibited a significantly higher oral intake of vitamin C and Ω3FA Docosapentaenoic acid (p < 0.05) compared to controls. Nutritional intake of vitamin C was higher in PWL, while the intake of Docosapentaenoic acid was increased in POL (p < 0.05) compared to controls. In accordance, serum levels of Docosapentaenoic acid were also increased in POL (p < 0.01) compared to controls. Vitamin C and the Ω3FA Docosapentaenoic acid might play a role in the pathophysiology of human periodontitis. Further studies on individualized nutritional intake and periodontitis progression and therapy are necessary.

The Egyptian construction industry suffers from severe delays and cost overruns. Rework is a prime cause of this challenge. Therefore, the objective of this study to identify the root causes of rework for Egyptian construction projects and their impact on the project duration and cost. An extensive literature review has been done to identify the most common factors affecting rework. Hence, eighty-seven factors were identified and categorised into ten groups. Structured interview technique was adopted to get the opinions of 67 Egyptian construct professionals for nineteen different construction projects. Total Importance Index of Rework Impact (T.I.I.R.I%) was used to analyse and rank rework factors. Accordingly, the most critical five rework factors are economic situation for the country, schedule compression, design changes, specifications change, and inadequate feasibility study. Based on the survey results, the project stakeholders should consider the critical rework factors during the planning stage and before the project execution, to eliminate or reduce the occurrence and impact of rework causes and to improve the performance of the projects. This paper provides state of the art for rework causes and their effects on construction projects performance, and it can be beneficial for both practitioners and researchers for future work.

Femtosecond laser (FSL) is a near-infrared laser that can create reliable and reproducible tissue cutting with minimal damage to adjacent tissue. As the laser can also create incisions with various orientations, depths, and shapes, it is expected to be a useful tool for anterior segment surgery, such as cornea, refractive, and cataract surgery. In this review, the authors will introduce the application of FSL in various anterior segment surgeries and discuss the results of studies regarding the efficacy and safety of FSL in cornea, refractive, and cataract surgery. Experimental studies regarding the potential use of FSL will also be introduced. The studies discussed in this review suggest that FSL may be a useful tool for improving the prognosis and safety of surgeries of the anterior segment.

Traditional diagnostic tests for dry eye disease (DED), such as fluorescein tear film break-up time and the Schirmer test, are often associated with poor reproducibility and reliability, which make the diagnosis, follow-up, and management of the disease challenging. Advances in ocular imaging technology enables objective and reproducible measurement of changes in the ocular surface, tear film, and optical quality associated with DED. In this review, the authors will discuss the application of various imaging techniques, such as, noninvasive tear break-up time, anterior segment optical coherence tomography, in vivo confocal microscopy, meibography, interferometry, aberrometry, thermometry, and tear film imager in DED. Many studies have shown these devices to correlate with clinical symptoms and signs of DED, suggesting the potential of these imaging modalities as alternative tests for diagnosis and monitoring of the condition.

Abstract Background With over 230 million surgical procedures performed annually worldwide, better application of evidence in anesthesia and perioperative medicine may reduce widespread variation in clinical practice and improve patient care. However, a comprehensive summary of the complete available evidence has yet to be conducted. This scoping review aims to map the existing literature investigating perioperative anesthesia interventions and their potential impact on patient mortality, to inform future knowledge translation and ultimately improve perioperative clinical practice. Methods Searches were conducted in MEDLINE, EMBASE, CINAHL, and the Cochrane Library databases from inception to March 2015. Study inclusion criteria were adult patients, surgical procedures requiring anesthesia, perioperative intervention conducted/organized by a professional with training in anesthesia, randomized controlled trials (RCTs), and patient mortality as an outcome. Studies were screened for inclusion, and data was extracted in duplicate by pairs of independent reviewers. Data were extracted, tabulated, and reported thematically. Results Among the 10,505 publications identified, 369 RCTs (n = 147,326 patients) met the eligibility criteria. While 15 intervention themes were identified, only 7 themes (39 studies) had a significant impact on mortality: pharmacotherapy (n = 23), nutritional (n = 3), transfusion (n = 4), ventilation (n = 5), glucose control (n = 1), medical device (n = 2), and dialysis (n = 1). Conclusions By mapping intervention themes, this scoping review has identified areas requiring further systematic investigation given their potential value for reducing patient mortality as well as areas where continued investment may not be cost-effective given limited evidence for improving survival. This is a key starting point for future knowledge translation to optimize anesthesia practice.

AIM: To compare the effectiveness of intravitreal bevacizumab and subthreshold macular photocoagulation (SMP), for the treatment of non-center involved diabetic macular edema (non-CI DME). METHODS: Prospective, randomized, controlled clinical study included patients with type 2 diabetes, non-CI DME and best-corrected visual acuity (BCVA) of 0.30 logMAR or better. Each eye was randomized into three groups: group 1, monthly intravitreal bevacizumab; group 2, single SMP; group 3, single SMP and monthly bevacizumab. Main outcome measures were BCVA, and macular thickness measured with optical coherence tomography as macular central subfield thickness (CST), macular area of greater thickness (MAGT) and total macular volume (TMV). Results were analyzed after 3mo. RESULTS: A total of 32 eyes were included. Group 3 improved in BCVA (0.19±0.16 to 0.12±0.14 logMAR; P=0.041) and in TMV (7.90±0.57 to 7.65±0.73 mm3; P=0.025). Group 1 improved in MAGT (325±26.26 to 298.20±44.85 μm; P=0.022) and TMV (7.79±0.57 to 7.50±0.56 mm3, P=0.047). Group 2 didn’t show significant improvement of any variable. CONCLUSION: The loading phase of bevacizumab as monotherapy or combined with SMP is superior to SMP as monotherapy in providing short-term visual and anatomical improvement in non-CI DME.

An 82-year-old man presented with a left eye elevated single ocular surface squamous neoplasia. The tumor involved 360° of limbus, three quadrants of cornea and conjunctiva; this was compatible with the diagnosis of giant ocular surface squamous neoplasia. Topical 5-fluorouracil 1% was planned four times daily for 1 week followed by 3 weeks off-treatment. Patient inadvertently continued 5-fluorouracil, four times daily for 4 weeks, presenting with clinical resolution of the ocular surface squamous neoplasia and subtotal corneal epithelial defect associated with 5-fluorouracil toxicity. One month later, we observed a transparent cornea and no signs of toxicity. Total tumor resolution was observed for at least 6 months of follow-up.

Purpose: To report the case of a 50-year-old woman with diabetes that presented with corneal melting and perforation 6 weeks after collagen cross-linking (CxL) for keratoconus (KC) and postoperative use of nepafenac eye drops, a nonsteroidal anti-inflammatory drug (NSAID). Methods: This is a case report of a patient with diabetes, KC and a thin cornea that had undergone left eye corneal CxL at a different hospital followed by postoperative use of nepafenac eye drops for 6 weeks. Results: The patient presented for the first time to our clinic with left corneal melting, perforation and iris prolapse 6 weeks after corneal CxL and topical nepafenac use. She was treated with a left eye tectonic penetrating keratoplasty, extracapsular cataract extraction, intraocular lens implantation and pupilloplasty. Conclusions: The corneal melting and perforation in this patient was associated with multiple risk factors: (1) nepafenac eye drop use, (2) CxL in a cornea thinner than 400 µm and (3) diabetes. The recommended corneal thickness limits should be respected. Topical NSAIDs should be used with caution if used as postoperative treatment after corneal CxL and in patients with diabetes, epithelial defect or delayed healing, because of the possible increased risk for corneal melting when multiple risk factors are observed.

Corneal transplantation has been the only treatment method for corneal blindness, which is the major cause of reversible blindness. However, despite the advancement of surgical techniques for corneal transplantation, demand for the surgery can never be met due to a global shortage of donor cornea. The development of bioengineering and pharmaceutical technology provided us with novel drugs and biomaterials that can be used for innovative treatment methods for corneal diseases. In this review, the authors will discuss the efficacy and safety of pharmacologic therapies, such as Rho-kinase (ROCK) inhibitors, blood-derived products, growth factors, and regenerating agent on corneal cell regeneration. The promising results of these agents suggest that these can be viable options for corneal reconstruction and visual rehabilitation.

Allergic rhinitis (AR) is a globally increasing health problem affecting the quality of life. Specific immunotherapy is an available causal treatment changing the basic allergic mechanisms of the disease. Over one hundred years, subcutaneous immunotherapy (SCIT) was developed and proved its efficacy but many adverse effects were recorded including anaphylaxis. In 1986, sublingual immunotherapy (SLIT) was introduced as an alternative solution to solve this problem. Our study aims to discuss SLIT from the points of efficacy, safety, adherence and guidelines developed. A literature search was conducted in Medline/PubMed and the Cochrane Library in January 2013 using the keywords "allergic rhinitis, sublingual immunotherapy, efficacy, safety, compliance, adherence, guidelines." All types of publications were included. We augmented our study by searching the reference lists of identified reviews. SLIT has been established in many guidelines as an evidence-based effective treatment in AR with safer profile than SCIT. The meta-analyses confirmed its efficacy and showed a significant reduction in both symptoms and medication scores. The most common recorded adverse effects were minor local effects in the mouth, gastrointestinal reactions with few cases of anaphylaxis and no fatality. Adherence is more favorable for SLIT mainly because it is safe, noninvasive and easily taken at home. We support the call to conduct large multi-centric studies to gain more statistical power and overcome the problem of heterogeneity observed in the meta-analyses.

L'anémie constitue un problème majeur de la santé publique à travers le monde malgré l'amélioration remarquable des conditions de vie. Elle est classée par l'OMS comme l'un des dix problèmes les plus sérieux du monde. Notre objectif est de décrire les profils épidémiologique et étiologique des cas d'anémies prises en charge dans notre formation. Il s'agit d'une étude rétrospective menée durant 5 ans, allant de Janvier 2011 à décembre 2015 et portant sur 150 patients. L'âge moyen de nos patients est de 48,8ans et les femmes sont les plus touchées avec un sex-ratio de 1,78. Le taux moyen de l'hémoglobine est de 8 g/dl avec des extrêmes allant de 3,4 à 11,4 g/dl. L'anémie ferriprive est le diagnostic étiologique dominant étant retrouvée dans 60% des cas, suivie par l'anémie mégaloblastique observée chez 21% des patients puis les anémies hémolytiques dans 7,33% des cas. La survenue d'une anémie chez l'adulte peut représenter un véritable défit diagnostique pour l'interniste et cela parfois dans un contexte d'urgence. Le recours à des examens spécialisés peut s'imposer.

Purpose/Background. This study reports the degree of burden and the proportion at risk for depression among individuals who provide care to visually impaired patients. Study Design. This is clinic-based, cross-sectional survey in a tertiary care hospital. Methods. Caregivers were considered unpaid family members for patients whose sole impairment was visual. Patients were stratified by vision in their better seeing eye into two groups: Group 1 had visual acuity between 6/18 and 6/60 and Group 2 were those who had 6/60 or worse. Burden was evaluated by the Burden Index of Caregivers and the prevalence of being at risk for depression was determined by the Center for Epidemiologic Studies Depression scale. Results. 236 caregivers of 236 patients were included. Total mean BIC scores were higher in Group 2. Female caregivers, caregivers providing greater hours of care, and caregivers of patients who have not completed vision rehabilitation programs are at higher risk for depression.

Optical coherence tomography (OCT) is a noncontact technology that produces high-resolution cross-sectional images of ocular tissues. Anterior segment OCT (AS-OCT) enables the precise visualization of anterior segment structure; thus, it can be used in various corneal and ocular surface disorders. In this review, the authors will discuss the application of AS-OCT for diagnosis and management of various corneal and ocular surface disorders. Use of AS-OCT for anterior segment surgery and postoperative management will also be discussed. In addition, application of the device for research using human data and animal models will be introduced.

The main objective of this study is to evaluate the effect of nanosilica (NS) concentration on the rutting parameter of based asphalt binder using the multiple stress creep and recovery (MSCR) test. NS with concentrations between 1% to 5% (1% increment) was used to modify asphalt binder. The nanosilica modified asphalt binder (NSMB) were aged using rolling thin film oven (RTFO) before tested. MSCR test was conducted at 64°C with two stress level (100 Pa and 3200 Pa). The results found that the addition of NS reduced the accumulative strain of NSMB. Besides that, non-recoverable creep compliance decreased and recovery strain increased, which indicates an improvement of rutting resistance and elasticity of the binder, respectively. The grade of asphalt binder also improved from heavy (H) grade to extreme (E) grade. Overall, NSMB 2% show the best improvement in terms of Jnr and %R, thus NSMB 2% considered as a optimum percentage.

Objectives: Esthetic crown lengthening (ECL) is commonly advocated to treat patients with altered passive eruption (APE). Since the introduction of the minimally invasive surgical concept, a limited number of studies have investigated this technique in a standardized manner, with further studies required to verify the validity and predictability of the minimally invasive FL‐technique. The current randomized trial compares a minimally invasive (ECL), using piezosurgery with flapless‐approach (FL), versus an open‐flap (OF) approach in the management of patients with APE Type 1B. Materials and Methods: Twenty‐four patients diagnosed with APE Type 1B were randomly assigned into test (FL) with tunneling approach or control (OF) group with minimally invasive flap reflection (n = 12/group). Postoperative pain was assessed during the first 48 h. Gingival margin (GM) level relative to a custom‐made stent (rGM) and patient satisfaction were assessed preoperative, immediately after surgery, at 3 and 6 months postsurgically. Postoperative swelling was reported for the first week postsurgically. Plaque index (PI), bleeding on probing (BoP), clinical attachment level (CAL), pocket depth (PD) and pink esthetic score (PES), were evaluated at baseline and 6 months. Linear regression analysis was conducted for pain. Results: OF‐group reported significantly higher pain and swelling scores than FL‐group during the first 48 h (p < 0.05). FL‐group showed no significant differences regarding rGM between 3 and 6 months, in contrast to OF‐group, where a significant decrease in rGM was notable (p < 0.05). No significant differences in PI, BoP, CAL, PD, PES, and patient satisfaction scores were evident between groups (p > 0.05). Regression analysis demonstrated that treatment and gender were significant predictors for pain (p < 0.05). Conclusions: Within the current study's limitations, piezo‐surgical ECL with FL‐approach presented significantly lower postoperative pain, swelling, and early GM stability compared to OF‐approach. Clinical Significance: Piezosurgical ECL with a FL‐approach can be considered a predictable technique with advantages over the OF‐approach in the management of patients with APE Type1B. [ABSTRACT FROM AUTHOR]