Search

Background: Cosmetic and plastic surgery is becoming increasingly prevalent all over the world among both men and women. Saudi Arabia ranks 22nd among the top 25 countries with the world’s highest rates of cosmetic surgeries. This study aimed to assess the awareness of the population in the Jazan region regarding rhinoplasty surgery and to identify their main determinants. Material and Methods: A cross-sectional study of 425 participants was conducted at four randomly selected malls in Gizan City. A self-administered questionnaire was first developed to collect the data necessary to fulfill the research objectives, data were analyzed using Statistical Package for the Social Sciences (SPSS) version 22. The quantitative data were reported as a mean and standard deviation, and the qualitative data were reported as frequency and percentage. Regarding tests for significance, the Chi-square test used a P value less than 0.05 as an indicator of significance. Logistic regression was used to detect the predictors of poor knowledge of rhinoplasty surgery. Results: The mean age of the participants was 39.46 ± 10.08. Of the participants, 53.6% have poor knowledge while 36.0% have good knowledge regarding rhinoplasty surgery. Moreover, 60.2% have an unfavorable attitude while 23.6% have a favorable attitude toward rhinoplasty surgery. The most important predictors of poor knowledge of rhinoplasty surgery are as follows: (a) old age (OR = 4.89), (b) illiteracy (OR = 4.12), (c) intermediate education (OR = 3.65), and (d) male sex (OR = 1.18). Conclusion: There was a low level of knowledge regarding rhinoplasty surgery among the study participants, most of the participants had negative (unfavorable) attitudes toward rhinoplasty surgery. Mass media plays an important role as a source of information. We recommend further studies to find out other personal factors affecting knowledge and attitude toward rhinoplasty surgery.

Brain tissue is one of the softest parts of the human body, composed of white matter and grey matter. The mechanical behavior of the brain tissue plays an essential role in regulating brain morphology and brain function. Besides, traumatic brain injury (TBI) and various brain diseases are also greatly influenced by the brain's mechanical properties. Whether white matter or grey matter, brain tissue contains multiscale structures composed of neurons, glial cells, fibers, blood vessels, etc., each with different mechanical properties. As such, brain tissue exhibits complex mechanical behavior, usually with strong nonlinearity, heterogeneity, and directional dependence. Building a constitutive law for multiscale brain tissue using traditional function-based approaches can be very challenging. Instead, this paper proposes a data-driven approach to establish the desired mechanical model of brain tissue. We focus on blood vessels with internal pressure embedded in a white or grey matter matrix material to demonstrate our approach. The matrix is described by an isotropic or anisotropic nonlinear elastic model. A representative unit cell (RUC) with blood vessels is built, which is used to generate the stress-strain data under different internal blood pressure and various proportional displacement loading paths. The generated stress-strain data is then used to train a mechanical law using artificial neural networks to predict the macroscopic mechanical response of brain tissue under different internal pressures. Finally, the trained material model is implemented into finite element software to predict the mechanical behavior of a whole brain under intracranial pressure and distributed body forces. Compared with a direct numerical simulation that employs a reference material model, our proposed approach greatly reduces the computational cost and improves modeling efficiency. The predictions made by our trained model demonstrate sufficient accuracy. Specifically, we find that the level of internal blood pressure can greatly influence stress distribution and determine the possible related damage behaviors.

Abstract Cardiotoxicity limits the use of anthracyclines as potent chemotherapeutics. We employ classical molecular dynamics to explore anthracycline interactions with a realistic myocardial membrane and compare to an ideal membrane widely used in literature. The interaction of these two membranes with four anthracyclines; doxorubicin, epirubicin, daunorubicin, and idarubicin are studied. Careful analysis was conducted on three forms of each drug; pristine, primary metabolite, and cationic salt. By examining the molecular residence time near the membrane’s surface, the average number of molecule/membrane hydrogen bonds, the immobilization of the molecules near the membrane, and the location of those molecules relative to the mid-plane of the membrane we found out that salt forms exhibit the highest cardiotoxic probability, followed by the metabolites and pristine forms. Additionally, all forms have more affinity to the upper layer of the realistic myocardial membrane. Meanwhile, an ideal membrane consisting of a single type of phospholipids is not capable of capturing the specific interactions of each drug form. These findings confirm that cardiotoxic mechanisms are membrane-layer and drug-form dependent.

In this study a frequency scaling law for 3D anatomically representative supravalvular aortic stenosis (SVAS) cases is proposed. The law is uncovered for stethoscopy's preferred auscultation range (70-120 Hz). LES simulations are performed on the CFD solver Fluent, leveraging Simulia's Living Heart Human Model (LHHM), modified to feature hourglass stenoses that range between 30 to 80 percent (mild to severe) in addition to the descending aorta. For physiological hemodynamic boundary conditions the Windkessel model is implemented via a UDF subroutine. The flow-generated acoustic signal is then extracted using the FW-H model and analyzed using FFT. A preferred receiver location that matches clinical practice is confirmed (right intercostal space) and a correlation between the degree of stenosis and a corresponding acoustic frequency is obtained. Five clinical auscultation signals are tested against the scaling law, with the findings interpreted in relation to the NHS classification of stenosis and to the assessments of experienced cardiologists. The scaling law is thus shown to succeed as a potential quantitative decision-support tool for clinicians, enabling them to reliably interpret stethoscopic auscultations for all degrees of stenosis, which is especially useful for moderate degrees of SVAS. Computational investigation of more complex stenotic cases would enhance the clinical relevance of this proposed scaling law, and will be explored in future research.

IntroductionStandard medical therapy (SMT) in children with functional abdominal pain disorders (FAPD) includes cyproheptadine and amitriptyline. While percutaneous electrical nerve field stimulation (PENFS) has shown benefit, no study has compared outcomes of PENFS to SMT. We aimed to examine changes in abdominal pain, nausea and disability before and after treatment and compare outcomes between treatments.MethodsThe records of FAPD patients ages 11–21 years, treated with 4 weeks of PENFS, cyproheptadine or amitriptyline were reviewed. Outcomes were evaluated using validated questionnaires [Abdominal Pain Index (API), Nausea Severity Scale (NSS), and the Functional Disability Inventory (FDI)] at baseline and follow-up within 3 months (FU).ResultOf 101 patients, 48% received PENFS, 31% cyproheptadine and 21% received amitriptyline. Median ages were 17 (15–19), 16 (15–18) and 15 (11–16) years respectively and the majority were females (75%, 90% and 52% respectively). In the PENFS group, API (p = 0.001), NSS (p = 0.059) and FDI (p = 0.048) were significantly lower at FU. API (p = 0.034) but not NSS and FDI (p > 0.05) decreased significantly at FU in the amitriptyline group. API, NSS and FDI did not change significantly with cyproheptadine at FU (p > 0.05). FU API scores were lower in PENFS vs. cyproheptadine (p = 0.04) but not vs. amitriptyline (p = 0.64). The FDI scores were significantly lower in the amitriptyline vs. cyproheptadine group (p = 0.03).ConclusionTherapy with PENFS showed improvements in abdominal pain, nausea and disability while amitriptyline showed improvements in abdominal pain within 3 months of treatment. PENFS was more effective than cyproheptadine in improving abdominal pain. Amitriptyline improved disability scores more than cyproheptadine and showed promise for treatment. PENFS may be a good non-pharmacologic alternative for FAPD.

The shear zone characterization is a substantial task for understanding the influencing tectonic movements. In this study, an integrated approach of remote sensing and aeromagnetic data is introduced to imagine and trace the subsurface shear zone between the Central (CED) and Southern (SED) domains of the Egyptian Eastern Desert in comparison with the previously proposed approaches mainly using only surface criteria. To produce an enhanced geological map reflecting the different lithological units along both sides of the surficial shear zone, Landsat-8 images are processed and interpreted using False Color Composite (FCC), Color Ratio Composites (CRC). Moreover, the associated lineaments and their trends are extracted from Digital Elevation Model (DEM) data using the lineaments extraction approaches. For delineating the subsurface structures pattern and tracking the probable subsurface CED/SED boundary, aeromagnetic datasets are reduced to magnetic pole (RTP) and, then, interpreted by applying significant techniques comprising upward continuation, Gaussian separation filter, horizontal gradient magnitude (HGM), and tilt derivative angle (TDR). The best path of the shear zone line at depths was imagined; this path agrees with some geologists' opinion regarding the superficial description of the CED/SED separating shear zone. On the other hand, trend analysis was applied on the subsurface and surface data, reflecting a positive matching between the resulting trends from the magnetic and remote sensing data. The NW direction represents both data's major trend and less common NNW NS, NNE, and ENE trends. This relation reflects the extension and effect of the subsurface structures on the surface in the study area.

Abstract Background Inhaled nitric oxide (iNO) is used as rescue therapy in patients with refractory hypoxemia due to severe COVID-19 acute respiratory distress syndrome (ARDS) despite the recommendation against the use of this treatment. To date, the effect of iNO on the clinical outcomes of critically ill COVID-19 patients with moderate-to-severe ARDS remains arguable. Therefore, this study aimed to evaluate the use of iNO in critically ill COVID-19 patients with moderate-to-severe ARDS. Methods This multicenter, retrospective cohort study included critically ill adult patients with confirmed COVID-19 treated from March 01, 2020, until July 31, 2021. Eligible patients with moderate-to-severe ARDS were subsequently categorized into two groups based on inhaled nitric oxide (iNO) use throughout their ICU stay. The primary endpoint was the improvement in oxygenation parameters 24 h after iNO use. Other outcomes were considered secondary. Propensity score matching (1:2) was used based on the predefined criteria. Results A total of 1598 patients were screened, and 815 were included based on the eligibility criteria. Among them, 210 patients were matched based on predefined criteria. Oxygenation parameters (PaO2, FiO2 requirement, P/F ratio, oxygenation index) were significantly improved 24 h after iNO administration within a median of six days of ICU admission. However, the risk of 30-day and in-hospital mortality were found to be similar between the two groups (HR: 1.18; 95% CI: 0.77, 1.82; p = 0.45 and HR: 1.40; 95% CI: 0.94, 2.11; p= 0.10, respectively). On the other hand, ventilator-free days (VFDs) were significantly fewer, and ICU and hospital LOS were significantly longer in the iNO group. In addition, patients who received iNO had higher odds of acute kidney injury (AKI) (OR (95% CI): 2.35 (1.30, 4.26), p value = 0.005) and hospital/ventilator-acquired pneumonia (OR (95% CI): 3.2 (1.76, 5.83), p value = 0.001). Conclusion In critically ill COVID-19 patients with moderate-to-severe ARDS, iNO rescue therapy is associated with improved oxygenation parameters but no mortality benefits. Moreover, iNO use is associated with higher odds of AKI, pneumonia, longer LOS, and fewer VFDs.

Abstract Laser drilling on polymers has many applications in various industries, such as sensors, aerospace, medical devices, and microelectronics. In this research, a CO2 laser machine was employed for micro-drilling PC samples. Design–Expert analysis was applied to understand the laser drilling process better. Based on a Box–Behnken design (BBD) of the experimental software, 17 experiments were designed to examine the laser parameters’ influence on the micro-drilling process. The impact of parameters, such as power (P), exposure time (t), and focal plane position (FPP), on the depth, entry diameter, and heat-affected zone (HAZ) was investigated using analysis of variance (ANOVA). Quadratic regression models were applied to model different hole factors throughout the process. The experiments were optimized using the developed objective model as a function to attain the best hole. The outcomes revealed that a full hole with a 351-μm diameter and 102-μm HAZ was obtained at 0 FPP, with a laser power of 4 W, and at 0.15 s. To conduct virtual tests alongside the experimental study, simulation of the drilling mechanism’s temperature distribution was achieved via the COMSOL Multiphysics program. The simulation’s refined accuracy was able to predict the hole’s geometry and presented outcomes that favorably corresponded with the experimental results. A numerical optimization technique was used to generate an ideal hole by minimizing or maximizing the objective function, achieving full holes of 350-μm diameter and 90-μm HAZ, obtained at 0 FPP, with 3.6 W, and at 0.1 s.

In this paper, we identify a new (acoustic) frequency-stenosis relation whose frequencies lie within the recommended auscultation threshold of stethoscopy (< 120 Hz). We show that this relation can be used to extend the application of phonoangiography (quantifying the degree of stenosis from bruits) to widely accessible stethoscopes. The relation is successfully identified from an analysis restricted to the acoustic signature of the von Karman vortex street, which we automatically single out by means of a metric we propose that is based on an area-weighted average of the Q-criterion for the post-stenotic region. Specifically, we perform CFD simulations on internal flow geometries that represent stenotic blood vessels of different severities. We then extract their emitted acoustic signals using the Ffowcs Williams-Hawkings equation, which we subtract from a clean signal (stenosis free) at the same heart rate. Next, we transform this differential signal to the frequency domain and carefully classify its acoustic signatures per six (stenosis-)invariant flow phases of a cardiac cycle that are newly identified in this paper. We then automatically restrict our acoustic analysis to the sounds emitted by the von Karman vortex street (phase 4) by means of our Q-criterion-based metric. Our analysis of its acoustic signature reveals a strong linear relationship between the degree of stenosis and its dominant frequency, which differs considerably from the break frequency and the heart rate (known dominant frequencies in the literature). Applying our new relation to available stethoscopic data, we find that its predictions are consistent with clinical assessment. Our finding of this linear correlation is also unlike prevalent scaling laws in the literature, which feature a small exponent (i.e., low stenosis percentage sensitivity over much of the clinical range). They hence can only distinguish mild, moderate, and severe cases. Conversely, our linear law can identify variations in the degree of stenosis sensitively and accurately for the full clinical range, thus significantly improving the utility of the relevant scaling laws... Future research will investigate incorporating the vibroacoustic role of adjacent organs to expand the clinical applicability of our findings. Extending our approach to more complex 3D stenotic morphologies and including the vibroacoustic role of surrounding organs will be explored in future research to advance the clinical reach of our findings.

This study explores the negative impact of cyclophosphamide (CP) on cardiac contractility by specifically examining its effect on the active and passive tension of the cardiac muscle in-vitro and revealing the mechanism through which CP induces myocardial insult in-vivo. In young male Sprague-Dawley rats, cardiac toxicity was induced by a single intraperitoneal injection of CP (150 mg/kg body weight). Axial heart tissue slices were electrically stimulated, and the total isometric contraction force was measured at varying pretension levels. Blood and tissue biochemical assays, and histological/ immuno-histological assessments were conducted to evaluate the underlying molecular mechanisms. Statistical analysis shows that there is a significant difference between the drugged and the control groups in terms of the active tension values. Moreover, the pre-tension stress significantly affects both the active and passive tension values. CP altered heart, body, and heart-to-body weight, desolated cardiac muscle architecture, surged cardiac enzymes (CK-MB, LDH, and cTn l), augmented myocardial oxidative stressors (MDA), and weakened myocardial antioxidant status (SOD and GSH). Mechanistically, cyclophosphamide prompted the necroptotic trajectory evidenced by the activation of RIPK1, RIPK3, MLKL and TRPM7, the inhibition of caspase 8 and BCL2 and the upregulation of the protein/mRNA expression of TNF-α and TNFR1. This study identifies necroptosis as a key factor in cyclophosphamide-evoked myocardial contractility impairment, highlighting its potential as a target for alleviating antitumor-related myocardial damage. This innovative approach to investigating the underlying mechanisms of CP-induced cardiac toxicity offers valuable insights into the potential of developing new therapies to mitigate cyclophosphamide’s negative impact.

The methods of detecting objects and tracking their movements are among the methods that are relied upon in many fields, whether medical or industrial, and others. One of these areas that will rely on deep learning meth-ods in discovering and distinguishing the player's movements is the sports field and is very useful in games in which the player's degree depends on the accura-cy of the performance of the movement, such as the gymnastics game, where it was applied to the static ring gymnastics game, where the distinction of move-ments was discovered the stability in this game is based on a convolutional neu-ral network. Models. The neural network was trained on five of the most im-portant stability movements in this game after creating the data set based on a set of videos of tournaments held in the period from 2016-2022, where an aver-age of 1500 images were obtained for each stability movement, which was di-vided into 80% for training and 20 % for testing, after training the convolution-al neural network model, it was applied to a group of video clips for different tournaments. Many criteria were adopted to measure the efficiency of the model after training and practical application, which showed the efficiency of the pro-posed system.

Pan-African basement rocks cover the study area along the boundary between Central and Southern Eastern Desert with small exposed sedimentary sequences. Several vein-type gold mineralization with hydrothermal alteration zones have long been known in the study area. Aeromagnetic and remote sensing imagery data were integrated for mapping the structural elements and hydrothermal alteration zones related to gold mineralization. By aeromagnetic imagery inspection, the structural complexity and porphyry intrusions density maps have been effectively constructed by applying Enhanced Center for Exploration Targeting (CET) techniques. Major NW shear zones along with NNW-SSE, WNW-ESE, NS, and NE-SW are the main trends controlling gold mineralization. On the other hand, applying band ratios and constrained energy minimization (CEM) technique on Landsat-8 data pointed out alteration minerals associated with the hydrothermal fluids. Calcite, sericite, and chlorite are the common alteration minerals detected, while goethite and epidote are less common in alteration zones of the area under study. A combination of CET structural complexity, circular features, and alteration zones produced a potential mineralization map pointing out numerous prospective zones for mineralizing gold. The predictive map was validated by projecting the known gold prospects at the study area, reflecting an agreement between the known gold occurrences and the higher classes of the predictive zone. The discussed techniques in the current research can be adopted as a direct indicator for structural mapping and detecting the alteration zones related to gold mineralization elsewhere.

ABSTRACT Introduction Methods Results Discussion Early child development occurs within an interactive environment, initially dominated by parents or caregivers, and is heavily influenced by the dynamics of this social context. The current study probed the neurobiology of “family personality”, or family functioning, in the context of parent–child dyadic interaction using a two‐person neuroimaging modality.One hundred and five parent–child dyads (child mean age 5 years 4 months) were recruited. Functional near‐infrared spectroscopy (fNIRS) hyperscanning was employed to measure neural synchrony while dyads completed a mildly stressful interactive task. Family functioning was measured through the Family Adaptability and Cohesion Scale IV (FACES‐IV).Synchrony during stress was significantly greater than synchrony during both baseline and recovery conditions for all dyads. A significant interaction between neural synchrony in each task condition and familial balanced flexibility was found, such that higher levels of balanced flexibility were associated with greater changes in frontal cortex neural synchrony as dyads progressed through the three task conditions.Parent–child dyads from families who display heightened levels of balanced flexibility are also more flexible in their engagement of neural synchrony when shifting between social conditions. This is one of the first studies to utilize a two‐person imaging modality to explore the links between family functioning and interbrain synchrony between parents and their children. [ABSTRACT FROM AUTHOR]

A mucocele is a slowly progressive cystic lesion of paranasal sinuses secondary to obstruction of the sinus ostium. It is an extremely rare condition in the pediatrics age group. The symptoms usually result from lesion expansion, inflammation, or compression of the adjacent structures. We report a case of an 11-year-old boy who presented with a right-side ethmoid mucocele with no known etiology and no history of cystic fibrosis. The patient underwent endoscopic sinus surgery for mucocele excision and abscess drainage. Clinicians are recommended to suspect paranasal mucoceles in patients presenting with progressive non-specific headache and orbital manifestations.