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The Food and Drug Administration (FDA) approved the first SARS-CoV-2 mRNA vaccine (Pfizer-BioNTech) in December 2020. New adverse events have emerged since these vaccines have reached market. Although no clear association between messenger ribonucleic acid (mRNA) vaccines and autoimmunity has emerged, the significance of such an association warrants further exploration. After obtaining consent, a standardized survey on baseline characteristics and other relevant variables was conducted on unvaccinated individuals who were scheduled for vaccination and had not previously contracted COVID-19. Blood samples were collected from participants prior to the first dose, prior to the second dose, and 1 month after the second dose. All collected samples were tested for antinuclear antibody (ANA) titers using indirect immunofluorescence microscopy kits, and antiphospholipid (APS) immunoglobulin M (IgM) and immunoglobulin G (IgG) levels using an enzyme-linked immunoassay (ELISA) technique. ANA titers were positive for 9 participants out of 101 (8.9%) in the first pre-vaccination draw. For the second draw, the number of participants testing positive for ANA decreased to 5 (5%). For the last draw, 6 (5.9%) participants tested positive for ANA titers. One participant tested positive for APS IgM at the first pre-vaccination draw, 2 tested positive at the second draw, and 2 at the third draw. As for APS IgG titers, all participants tested negative in the three draws. McNemar's test for two dependent categorical outcomes was conducted on all variables and did not show a statistical significance. The McNemar test of these two composite variables (i.e., ANA/APS, first draw vs. ANA/APS, second and third draws) did not show statistical significance. The 2-sided exact significance of the McNemar test was 1.0. The Friedman test also showed no significance (p = 0.459). No association was found between BNT162b2 vaccine administration and changes in APS and ANA titers. The benefits of the BNT162b2 vaccine significantly outweigh any possible risk of autoimmune dysregulation considering the current evidence.

Background: Febrile convulsion (FC) in under five children is a common presentation in family medicine and pediatric clinics. Lack of parental knowledge regarding FC leads to anxiety and fear and improper management.Objective: To improve parental knowledge and practice regarding febrile convulsions through implementing health educational program.Patients and methods: A quasi experiment, one group pre/post-test study enrolled 300 parents 21-50 years old attended two family health facilities, Menoufia Governorate, Egypt, with their children (aged from birth to six years old). Data were collected through a predesigned questionnaire that included personal and socio-economic status, family history of febrile convulsions or epilepsy, questions about parental beliefs regarding causes of febrile convulsions, knowledge about febrile convulsions and recommended and non-recommended practices for febrile convulsion. Health educational program was implemented and parent's knowledge and practice about febrile convulsions was assessed before and after educational program.Results: Among 300 participants aged from 21-50 years old with a mean age of 31.57 ± 6.98 years, majority of them (85%) and (62%) had unsatisfactory knowledge and appropriate knowledge about home management of FC respectively. There was a statistically significant improvement in the perceptions of the participants regards to the causes of febrile convulsions pre- and post- intervention. There was a statistically significant improvement in the level of knowledge, practice and home management of convulsions before and after education. The mean level of knowledge and practice was statistically significantly higher after intervention.Conclusion: There was significant improvement of parental perception, knowledge and practice regarding FC in preschool children after educational program.

Purpose: This current study was conducted to investigate the influence of the variable techniques available for corneal suturing on visual outcomes in PKP. Methods: In this prospective study 40 cases underwent penetrating keratoplasty which were divided according to the technique of suturing into 2 groups each of 20 patients; first group that underwent continuous suturing and the second group underwent interrupted suturing and they were followed up along 1 year postoperative for BCVA, IOP, and both topographic & refractive astigmatism. Result: The results of the study showed comparable improvement between the two techniques regarding the BCVA, refractive astigmatism and topographic astigmatism along the 12 months of follow-up. The need for readjustment was higher in the cases underwent interrupted suturing. Conclusion: there were no significant visual or refractive differences between patients operated with continuous & interrupted suturing techniques though the patients of the interrupted technique needs more suture manipulation for favorable outcomes than that needed in continuous technique patients

Background: On 4 August 2020, an explosion shook Beirut, killing more than 200 people and leaving thousands injured or homeless. Aims: This study examined mental health of university students through a cross-sectional online survey between December 2020 and January 2021. Methods: The questionnaire consisted of the WHO-5, sense of coherence (SoC), future anxiety, self-developed subjective symptoms of mental strain (SSMS), and items assessing proximity to explosion, extent of injury and house damage. Gender, study level and social status were used as sociodemographic characteristics. Results: Of 1042 participants, 30.8% were at 0–7 km from explosion; 38.1% reported physical injuries; and 12.4% saw their home damaged. Two third (60.3%) reported ≥3 SSMS, and 73.4% reported low well-being. Students with low well-being were more often female and master students (p < 0.001). Females were more often affected by ≥3 SSMS (p < 0.001). Regression analysis with low well-being as dependent variable revealed significant associations with study level (OR: 2.30–2.94), future anxiety (OR: 2.72–4.34) and SoC (OR: 1.81–5.61). For ≥3 SSMS, females (OR: 3.09), moderate/very close distance (OR: 2.13–4.98), injury/death of family member or friend (OR: 2.07–2.06), house damage (OR: 1.72) future anxiety (OR: 1.97–3.11) and SoC (1.79–2.88) were significant predictors. Discussion: Preventive mental health strategies that strengthen SoC and outlook on future could protect against SSMS and low well-being following major trauma.

نبذة عن الدِّراسَة. هذا الدِّراسة مقارنة تحليليَّة. تقتفي مسمَّى فنّ الأوبريت في المملكة العربية السُّعودية؛ من حيث التَّصنيف الفنِّي (شكلاً ومضموناً). بمقابلته بجنس الأوبريت كما هو معروف لدى الحضارات الأُخرى - التي تشكَّل فيها هذا الفنّ وتطوَّر - التي اُعتبر فيها –كنصٍّ - جنساً أدبياً أصيلاً، وكنوع ضرباً من الفنون الأصيلة. تعتمد المُقابلة على جانبين: الأوَّل شكلي أسلوبي فنِّيّ (سمات الأوبريت وخصائصه وأساليبه الفنيَّة التي تُميِّزه عن غيره من الفنون، وتُميِّز نصوصه أسلوبياً وأدبياً)، والثَّاني مضموني (الموضوعات والقضايا وغاياتها). وعلى ضوء نتائج مقابلة السِّمات والخصائص؛ يُنظر في انتماء الأوبريت السُّعودي إلى جنس الأوبريت، أو إقصائه عن دائرته، والبحث عن تصنيف فنيٍّ جديد له.

A Hybrid Energy System (HES) is a mechanism that combines multiple sources of energy connected together to achieve synchronised energy output. However, increased energy consumption, operator energy expenses, and the potential environmental impact of increased emissions from the exhaustion of non-renewable energy resources (fossil fuel) pose major challenges to HES. This research is to conduct energy management strategy based on a demand response (DR) program and a hydrogen storage system by designing a Program Logic Controller (PLC) unit. The hybrid system is evaluated by comparing different scenarios such as a hydrogen energy system and demand response. The purpose of this research is to reducing peak demand, minimise the cost of the system and also to extract surplus power generation out of the rate of the battery. This can be achieved by improving the system performances and by eliminating any degradation at the early stages. Organisations or companies must be sure their systems are working properly and that their investments will pay off.

This multicenter study aims to describe the injury patterns, emergency management and outcomes of the blast victims, recognize the gaps in hospital disaster preparedness, and identify lessons to be learned.On August 4th, 2020, the city of Beirut, Lebanon suffered the largest urban explosion since Hiroshima and Nagasaki, resulting in hundreds of deaths and thousands of injuries.All injured patients admitted to four of the largest Beirut hospitals within 72 hours of the blast, including those who died on arrival or in the emergency department (ED), were included. Medical records were systematically reviewed for: patient demographics and comorbidities; injury severity and characteristics; prehospital, ED, operative, and inpatient interventions; and outcomes at hospital discharge. Lessons learned are also shared.An estimated total of 1818 patients were included, of which 30 died on arrival or in the ED and 315 were admitted to the hospital. Among admitted patients, the mean age was 44.7 years (range: 1 week-93 years), 44.4% were female, and the median injury severity score (ISS) was 10 (5, 17). ISS was inversely related to the distance from the blast epicenter (r = --0.18, P = 0.035). Most injuries involved the upper extremities (53.7%), face (42.2%), and head (40.3%). Mildly injured (ISS9) patients overwhelmed the ED in the first 2 hours; from hour 2 to hour 8 post-injury, the number of moderately, severely, and profoundly injured patients increased by 127%, 25% and 17%, respectively. A total of 475 operative procedures were performed in 239 patients, most commonly soft tissue debridement or repair (119 patients, 49.8%), limb fracture fixation (107, 44.8%), and tendon repair (56, 23.4%). A total of 11 patients (3.5%) died during the hospitalization, 56 (17.8%) developed at least 1 complication, and 51 (16.2%) were discharged with documented long-term disability. Main lessons learned included: the importance of having key hospital functions (eg, laboratory, operating room) underground; the nonadaptability of electronic medical records to disasters; the ED overwhelming with mild injuries, delay in arrival of the severely injured; and the need for realistic disaster drills.We, therefore, describe the injury patterns, emergency flow and trauma outcome of patients injured in the Beirut port explosion. The clinical and system-level lessons learned can help prepare for the next disaster.

Probabilistic programming allows artificial systems to better operate with uncertainty, and stochastic arithmetic provides a way to carry out approximate computations with few resources. As such, both are plausible models for natural cognition. The authors' work on the automatic design of probabilistic machines computing soft inferences, with an arithmetic based on stochastic bitstreams, allowed to develop the following compilation toolchain: given a high-level description of some general problem, formalized as a Bayesian Program, the toolchain automatically builds a low-level description of an electronic circuit computing the corresponding probabilistic inference. This circuit can then be implemented and tested on reconfigurable logic. This paper describes two circuits as validating examples. The first one implements a Bayesian filter solving the problem of Pseudo Noise sequence acquisition in telecommunications. The second one implements decision making in a sensorimotor system: it allows a simple robot to avoid obstacles using Bayesian sensor fusion.

Survivin is specific antiapoptotic gene product expressed in a variety of human neoplasmswhose overexpression might assist in early diagnosis and as a prognostic marker. Objectives: The aim was to evaluate the plasma levels of survivin and alpha fetoprotein in patients with chronic hepatitis C viral infection (HCV) with and without hepatocellular carcinoma (HCC). Subjects : 70 subjects were divided into: a control group (Group I) ( 20 healthy volunteers ) and two patients groups: Group II, HCV group (20 patients); and Group III, HCC with HCV(30 patients ). Methods: Thorough physical examination, ultrasonography of the abdomen, laboratory investigations (liver profile, anti-HCV antibodies, hepatitis B surface antigen, Alpha fetoprotein (chemiluminometry) and Survivin (ELISA)) were performed. Results: There was a significant increase in survivin level in HCV patients (Group II) when compared to the control group (p=0.039), along with a significant increase in AFP in Groups II and III when compared to Group I (P

Probabilistic programming allows artificial systems to better operate with uncertainty, and stochastic arithmetic provides a way to carry out approximate computations with few resources. As such, both are plausible models for natural cognition. The authors' work on the automatic design of probabilistic machines computing soft inferences, with an arithmetic based on stochastic bitstreams, allowed to develop the following compilation toolchain: given a high-level description of some general problem, formalized as a Bayesian Program, the toolchain automatically builds a low-level description of an electronic circuit computing the corresponding probabilistic inference. This circuit can then be implemented and tested on reconfigurable logic. This paper describes two circuits as validating examples. The first one implements a Bayesian filter solving the problem of Pseudo Noise sequence acquisition in telecommunications. The second one implements decision making in a sensorimotor system: it allows a simple robot to avoid obstacles using Bayesian sensor fusion.

fieldThe field, located 120 km offshore in the Malaysian deep water, was discovered in December 2003 and put on production in November 2012. As per the Field Development Plan (FDP), Reservoir Management Plan (RMP) for G-K field is to inject water and gas from the beginning of oil production in Pink1/2 and UK1 reservoirs. The objective of the study was to optimize the voidage replacement by WI, so as to maximize the up-dip oil recovery. The study was conducted on a sector model. A compositional PVT model, having 17 pseudo components, was developed. To explain the compositional variation in reservoir, the PVT variation has been incorporated. The SCAL data, same as used in FDP, have been used for the study. Two producers were considered in the sector model so as to study the oil movement between the two wells. One Injector each was placed in GCG and aquifer. For UK1 reservoir, the plan is to re-inject 60% of the produced gas from UK1. For PINK1/2, it is planned to re-inject all the produced gas from PINK 1/2 plus any remaining gas left after internal usage. The total VRR target for both the reservoirs is 1.0, and the remaining part of the voidage replacement is made up by water injection. The FDP RMP was reviewed, because it was thought that in view of the small gas cap size (m ratio about 0.2 for PINK1/2 and 0.18 for UK1) and limited Gas Injection capacity, making up VRR equal to one by WI may not allow GC to expand rapidly. During the study, the whole process of Gas Injection and water Injection was divided in two parts, viz, Pre-Gas Breakthrough period and Post-Gas Breakthrough period so as to separately assess the impact of limited gas injection capacity after gas breakthrough. For PINK1/2 reservoirs, WI at 25% of the Instantaneous Voidage Rate (IVR) provides the best recovery before gas breakthrough. To avoid gas flaring after gas breakthrough, WI rate has to be increased to 40% of the IVR. For UK-1 reservoir, WI at 35% of the IVR provides the best recovery. Due to this study, there is an improvement of about 10% oil recovery over FDP study, which is equivalent to over 70 MMSTB of oil. In UK1 even after this improvement, a significant amount of up-dip oil still remains un-swept. This may require additional gas injection or drilling infill wells up-dip to the present location. During FDP the study was conducted on a Black Oil model, the present study was conducted on a compositional model.

Production optimization and improved recovery efficiency while reducing operating and capital expenditure has been the main goal of the operators, and makes it imperative under the current oil prices. Reservoir Management Programme (RMP) is a comprehensive and integrated process of establishing control over hydrocarbons appraisal, extraction, voidage replacement, and optimizing production and reservoir performance, and it is the key to achieving maximum recovery. Monitoring well and reservoir performance from initial completion to abandonment is critical to ensure efficient operation, optimum economics, and safe environment. Tracking production rates, water cut, wellhead pressure, casing pressure, well integrity, and planning recompletion, workovers, sidetracks, in-fill drilling, enhanced oil recovery etc. will require close watch, accurate analysis, and timely execution at considerable cost and effort. Therefore, it is critical to stay up-to-date on the latest developments in technological advancements in this area, be judicious in the methods used in acquiring the right data at the right time, and more importantly, integrating all acquired data to discern performance patterns, predict future behavior, and avert any problems. More detailed understanding of reservoir characterization and reservoir physics are the need of the hour to be efficient and successful in the various stages of the exploitation of the reservoir. Furthermore, advances in horizontal drilling, smart well completions, deep-sea drilling, and highly complex operation, have changed the playing field and rendered many old conventional tools inadequate to meet the new challenges. For example, rates from some intervals along a horizontal well can be too low to be measured by a typical flowmeter. The cost of measuring reservoir pressure in individual layers can be cost prohibitive, especially once the completion is in place. Reservoir characterization, understanding lateral continuity, and permeability anisotropy can be time consuming and expensive. Locating the source of a casing pressure accurately, quickly, and without having to mobilize special equipment (rig-less) is critical. This paper illustrates the application of the above principles by showing actual cases, methodology of data acquisition and processing, focusing on the added value from the new information.

Purpose The aim was to present the common A-B scan ultrasonography (US) and ultrasound biomicroscopy (UBM) signs in Egyptian patients with blunt ocular trauma and compare them with the clinical findings. Materials and methods This prospective study included consecutive patients with blunt ocular injury attending the outpatient clinic of Mansoura Ophthalmic Center during the period from October 2013 to October 2014. All patients were subjected to thorough ophthalmic examination. All patients underwent US to assess the posterior segment of the globe and UBM for evaluation of the anterior segment. Results A total of 95 eyes of 95 patients were recruited in the study. Overall, 68% of them were males, and 73.7% were younger than 40 years. Stick and stone injuries were the causes of blunt ocular injury in 27.4 and 23.2%, respectively, and 42.1% of the patients had visual acuity between hand motion (HM) and perception of light (PL). Using UBM, traumatic hyphema was detected in 47.4% of patients whereas iridodialysis was seen in 26.3% of patients. The commonest findings in B-scan US were vitreous hemorrhage and retinal detachment (21.1% each). B-scan US and UBM detected structural changes that were missed or could not be detected by clinical examination especially with opaque media, which was statistically significant in cases of angle recession. Conclusion The findings of this study support the combined use of B-scan US and UBM in the evaluation of eye with blunt trauma.

A method of constructing high productivity and high wellbore dynamic stability wells has been developed for EOR field development application. It integrates a heuristic reservoir engineering modelling method for determining optimum drainage points with high dynamic flow and a 3D coupled reservoir geomechanical modelling method for identifying low sanding propensity regions within the entire reservoir. The reservoir geomechanical method couples dynamic reservoir modelling with geomechanical modelling. It can account for in-situ stress changes associated with reservoir pressure change, and predict any potential geomechanical-related physical events for the remaining life of the field. Correspondingly, the generated drainage map and 3D sand production critical drawdown cubes can then be combined to identify global optimum well placement locations within the reservoir, layer by layer. Drainage points selected by this heuristic reservoir modelling method can be correlated with their respective EUR (Estimated Ultimate Recovery) values, while the 3D critical drawdown cubes can identify reservoir regions with low sanding propensity. This combined approach can therefore lead to the development of multi-layer commingle wells having various angles of reservoir penetration, for optimizing well productivity and EUR value without the requirement of sand control. Illustrated by a case study in brownfield reservoirs, a non-linear well trajectory which maximizes reservoir fluid contact in a prolific sand layer can be designed without any sand control completion for sanding mitigation through optimization and management of production plan.

The work presented in this paper is part of the BAMBI project, which aims at better understanding natural cognition by designing non Von Neumann machines with biologicaly plausible hardware. Probabilistic programming allows artificial systems to better operate with uncertainty, and stochastic arithmetic provides a way to carry out approximate computations with few resources. As such, both are plausible models for natural cognition. Our work on the automatic design of probabilistic machines computing soft inferences with an arithmetic based on stochastic bitstreams allowed us to develop the following compilation toolchain: given a high level description of some general problem (typically to infer some knowledge from a model given some observations), formalized as a Bayesian Program, our toolchain automatically builds a low level description of an electronic circuit computing the corresponding probabilistic inference. This circuit can then be implemented and tested on reconfigurable logic.We designed as a validating example a circuit description of a Bayesian filter solving the problem of Pseudo Noise sequence acquisition in telecommunications.