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The current state of the art on jamming detection relies on link-layer metrics. A few examples are the bit-error rate, the packet delivery ratio, the throughput, and the increase of the signal-to-noise ratio. As a result, these techniques can only detect jamming ex-post, i.e., once the attack has already taken down the communication link. These solutions are unfit in mobile scenarios, e.g., drones, which might lose the link to the remote controller, being unable to predict the attack. Our solution is rooted in the idea that a drone flying against a jammed area is experiencing an increasing effect of the jamming. Therefore, drones might use this phenomenon to detect jamming early, i.e., before it completely disrupts the communication link. Such an approach would allow drones and possibly their pilots to make an informed decision and maintain full control of the navigation, providing security and safety. In this paper, we propose Bloodhound+, a solution for early jamming detection on mobile devices. Our approach analyzes raw physical-layer information (I-Q samples) acquired from the channel. We assemble this information into grayscale images, and we use sparse autoencoders to detect image anomalies caused by jamming attacks. To test our solution against a wide set of configurations, we acquired a large dataset of indoor measurements using multiple hardware, jamming strategies, and communication parameters. Our results indicate that Bloodhound+ can detect indoor jamming up to 20 meters away from the jamming source at the minimum available relative jamming power, with a minimum accuracy of 99.7%. Our solution is also robust to various sampling rates adopted by the jammer, as well as to the type of signal used for jamming., 13 pages, 14 figures; Submitted and under review

Huge comets are considered as serious threat to Earth. Bernardinelli-Bernstein (BB) comet is one of such huge comets. Based on the gath-ered data using space telescopes, scientists and astronomers have confirmed the fact that, the BB comet (C/2014 UN271) is the biggest comet ever seen. In this paper, we give a short review about the BB comet and we are trying to answer the question, does the comet BB pose a real threat to Earth?

Background About 25–50% of multisystem inflammatory syndrome in children (MIS-C) patients meet the criteria for diagnosis of Kawasaki disease (KD). The differentiation of both conditions is so challenging on clinical practice as the management of both is time dependant and precise diagnosis is fundamental. Method Data were collected from children Results 72 patients with MIS-C and 18 with KD were included in the study. Patients with MIS-C had a higher prevalence of abdominal pain (p = 0.02), vomiting (p = 0.03), and cervical lymphadenopathy (p = 0.02) compared with KD cases. MIS-C patients had higher liver enzymes (aspartate aminotransferase (AST) (p = 0.04), alanine aminotransferase (ALT) (p = 0.03), serum creatinine (p = 0.03), and lower platelet count nadir (p = 0.02) than KD. Four variables were detected in the regression analysis model, and the independent predictors were utilized to generate a scoring model that distinguished MIS-C from KD with an area under the curve of 0.70. Conclusion This study constructed a prediction model for differentiation of MIS-C from KD based on clinical and laboratory profiles. This model will be valuable to guide clinicians in the treatment decisions. Key Points• Children with MIS-C are more likely to have gastrointestinal symptoms, cervical lymphadenopathy, and respiratory involvement than KD patients.• Elevated liver enzymes and lower platelet count are more pronounced laboratory findings in MIS-C than KD.• This study constructed a prediction model for differentiation of MIS-C from KD based on clinical and laboratory profiles. This model will be valuable to guide clinicians in the treatment decisions.

Background:Prostate cancer is the most commonly diagnosed cancer in men and responsible for about 10% of all cancer mortality in both Canadian and American men. Currently, serum PSA level is the most commonly used test for the detection of prostate cancer, though the levels can also be elevated in benign conditions, has limited specificity and has a high rate of overdiagnosis and treatment of indolent disease. Consequently, in recent years, several investigations have been conducted to identify novel cancer biomarkers capable of both effective screening and diagnosis, as well as assisting to shift the diagnostic and treatment paradigm of prostate cancer towards more patient-specific and targeted medicine. The goal of this narrative review paper is to describe eleven novel and promising tissue-based biomarkers for prostate cancer capable to account for individual patient variabilities and have the potential for risk assessment, early detection and diagnosis, identification of patients who will benefit from a particular treatment and monitoring patient response to treatment.Materials and methods:We searched several databases from August to December 2020 for relevant studies published in English between 2000 and 2020 and reporting on tissue-based biomarkers for screening and early diagnosis, treatment and monitoring of prostate cancer.Conclusions:Emerging prostate cancer biomarkers have the potential to guide clinical decision-making since they have the potential to detect the disease early, measure the risk of developing the disease and the risk of progression, provide accurate information of patient response to a specific treatment and are capable of informing clinicians about the likely outcome of a cancer diagnosis independent of the treatment received. Therefore, the future holds promise for personalised and targeted medicine from prevention to diagnosis and treatment that considers the individual patient’s variabilities in the management of prostate cancer.

Background: Myelodysplastic syndromes (MDS) are complex clonal hemopoietic progenitor cell disorders that result from the evolution of aberrant clones which lead to leukemia. Disorders of the immune system serve important functions in the pathophysiology and progression of this disorder. This study aimed to assess the bone marrow natural killer cells percentage as well as soluble TNF-α and sIL-32 concentration levels in MDS patients. Methods: Bone marrow samples were obtained from 34 MDS; 12 MDS-AML and 10 controls. The percentage of total NK cells and mature NK cells were determined by flowcytometry. Bone Marrow soluble TNF-α and sIL-32 concentration levels were measured by ELISA. Results: The percentage of total NK and mature NK cells were significantly lower in MDS patients as compared to controls (P

This study aimed to address the clinical impact of recombination-activating gene (RAG1) expression and tumor suppressor IKZF1 gene deletions in Philadelphia negative B-cell precursor acute lymphoblastic leukemia (B-ALL) patients. Fifty newly diagnosed pediatric Philadelphia negative B-ALL patients were included in this study. Using Bone Marrow samples, RAG1 expression was assessed by real time PCR and IKZF1 deletions were determined by multiplex real-time quantitative PCR. The expression of RAG1 was significantly higher in B-ALL patients as compared to the controls (

Background Ligation of intersphincteric fistula tract (LIFT) is a sphincter-saving procedure used for treatment of complex anal fistula. The current study aimed to assess the outcome of local injection of bone marrow mononuclear cells (BM-MNCs) in conjunction with LIFT as compared to LIFT alone in regards to healing rate, time to healing, and ultimate success rate. Methods This was a prospective randomized trial on patients with trans-sphincteric anal fistula. Patients were randomly allocated to one of two equal groups: LIFT and LIFT with BM-MNC injection. The main outcome measures were healing at 10 weeks of follow-up, recurrence after healing, and complications. Results Seventy patients (48 male and 22 female) of a mean age of 37.9 ± 10.4 years were included. The mean time to complete healing after LIFT + BM-MNCs was significantly shorter than after LIFT alone (20.5 ± 5.2 vs 28.04 ± 5.8 days; P P = 0.62). There was no significant difference in the mean operation time or complication rate between the two groups. Secondary extension and previous anal surgery were significant independent predictors of failure of healing. Conclusion LIFT combined with BM-MNC injection was associated with a shorter time to complete healing than LIFT alone. However, BM-MNC injection did not have a significant impact on the overall healing and ultimate success rate.

Background: To investigate the development of two-cell mouse embryos in vitro at different external environment factors (osmolarity) and demonstrate if the embryo at early stage of development is sensitive to osmotic stress or not. Methods: A total of 173 mouse embryos were collected during the period of January 2018 until July 2018. One NMRI male mouse was caged with the female mice CD1 for natural mating. Th e female mice were flushed of the two-cell embryos from the oviduct after 24 hours. Th e mating was confirmed by the presence of a plug in the vagina (whitish gelatine substance in the vagina) next day. Th e osmolarity values were measured by advanced micro-osmometer. One-way ANOVA test was used to compare between different values of osmolarity. Results: The findings indicated that the increased osmotic pressure can significantly affect the rate of development. The developmental rate of two-cell mouse embryos was significantly decreased when cultured in 310 milliosmole and significantly increased in 280 milliosmoles as compared to the 260 milliosmole control group (9.52 ± 16.49, P < 0.001; 83.3 ± 28.7 to 76.29 ± 31.92, P < 0.001). Conclusion: The study has concluded that the osmotic pressure can affect the rate of development and it depends on the quality of environment. Th e data observed from the mouse embryos might also be helpful in humans and shed light on the effect towards human embryos.

This study aimed to determine the clinical impact of CD25+/CD123+ coexpression in adult B-cell acute lymphoblastic leukemia (B-ALL) cases. One hundred and twenty newly diagnosed B-ALL patients (≤60 years old) were included in this study. CD123 and CD25 expression on leukemic blast cells were assessed using flow cytometry. CD25+/CD123+ coexpression was detected in 40/120 B-ALL patients (33.3%). All B-ALL patients showed CD25+/CD123+ coexpression had lower induction of remission response and shorter overall survival as compared to B-ALL cases lacking coexpression. In conclusion, CD25+/CD123+ positive coexpression is a reliable flow cytometry marker for prediction of the outcome of adult B-ALL patients and could be used as a novel parameter for risk stratification of adult B-ALL cases.

The crack scintillators are being replaced during long shutdown 2. They need replacement due to the high amount of radiation that they have received. In our project, we assemble the new crack scintillators, we study and optimize the Sr90 scans and we conduct them on the scintillators to assure their quality before their installation on ATLAS detector for the next run and beyond.

Objective : To assess the perception and expectation of students about the quality of educational services and identify the gap in educational services. Methods : This cross-sectional study was conducted at King Saud bin Abdulaziz University for Health Sciences (KSAU-HS) colleges across all regions (Riyadh, Jeddah, and Al-Ahsa) within one academic year (September 2017- April 2018). The difference between the students’ perceptions and expectations was calculated to identify the gap between these 2 opinions. Results : A total of 416 (83.2%) questionnaires were completed with an almost equal ratio of male to female (51% and 49%). There was a significant difference in mean (gap) between students’ expectations and perceptions of educational service quality at KSAU-HS (p less than 0.05). The results showed negative values for most of the items. It revealed that there is a significant difference between male and female in responsiveness, empathy, and tangible. Conclusion : The findings of this study showed that all the dimensions were not up to the expectations of students. The results will help the higher management to initiate a protocol to address all weaknesses. Saudi Med J 2019; Vol. 40 (6): 595-600 doi: 10.15537/smj.2019.6.24189 How to cite this article: Aldarmahi A, Algahtani H, Alrabia M, Abuarab N, Shirah B . Determination of quality gap for educational services in undergraduate medical education: A cross-sectional study in Saudi Specialized Health Sciences University. Saudi Med J 2019; 40 (6): 595-600. doi: 10.15537/smj.2019.6.24189.

Moyamoya disease is a rare condition affecting the circle of Willis and its branching arteries. While the pathogenesis is unclear, it causes progressive occlusion of multiple cerebral vessels leading to severe strokes. We report a case of a 47-year-old Hispanic woman with HTN presented with altered mental status and bilateral upper and lower extremity weakness with dystonic-like upper extremity movement. Serial brain CTs and angiography were performed which showed massive frontal and parietal cerebral infarcts with radiological evidence of moyamoya disease.

Chronic histoplasmosis is typically diagnosed in patients who are immunocompromised or severely debilitated and who either live in or who have travelled to endemic areas. We report the case of a young, otherwise immunocompetent male patient who presented to a New York hospital with lobar consolidation and was found to have chronic pulmonary histoplasmosis. He described no history of travel to an endemic area. Immunological workup later revealed selective immunoglobulin M (IgM) deficiency. The literature has suggested a link between IgM deficiency and fungal infections. Recent research has also proposed a link between autoimmunity and IgM deficiency. Our clinical vignette describes the case of a patient with selective IgM deficiency who was diagnosed with pulmonary histoplasmosis without any clinical evidence of autoimmune disease.

The clinical behavior of systemic mastocytosis (SM) is strongly associated with activating mutations in KIT (D816V in >80% of cases), with the severity of the phenotype influenced by additional somatic mutations, e.g. in SRSF2, ASXL1 or RUNX1. Complex molecular profiles are frequently associated with the presence of an associated hematologic neoplasm (AHN) and an unfavorable clinical outcome. However, little is known about the incidence and prognostic impact of cytogenetic aberrations. We analyzed cytogenetic and molecular characteristics of 109 patients (KIT D816V+, n=102, 94%) with indolent (ISM, n=26) and advanced SM (n=83) with (n=73, 88%) or without AHN. An aberrant karyotype was identified in SM-AHN (16/73, 22%) patients only. In patients with an aberrant karyotype additional somatic mutations were identified in 12/16 (75%) patients. Seven of 10 (70%) patients with a poor-risk karyotype, e.g. monosomy 7 or complex karyotype, and 1/6 (17%) patients with a good-risk karyotype progressed to secondary acute myeloid leukemia (n=7) or mast cell leukemia (n=1) within a median of 40 months (range 2-190, P=0.04). In advanced SM, the median overall survival (OS) of poor-risk karyotype patients was significantly shorter than in good-risk/normal karyotype patients (4 vs. 39 months; hazard ratio 11.7, 95% CI 5.0-27.3; P

Objective. To describe a case of emphysematous hepatitis which is a rare clinical entity, characterized by a fatal, rapidly progressive infection of the liver with a radiological appearance simulating emphysematous pyelonephritis and to help provide more data about the causative organisms and precipitating factors of this pathology. Data Sources and Synthesis. Relevant literature was reviewed and, to the best of our knowledge, there is limited data regarding the pathogenesis, causative organisms, and management of this condition. Conclusion. Emphysematous hepatitis is a rapidly progressive infection that can be fatal in the absence of appropriate therapeutic intervention. Initial clinical manifestations are usually subtle and thus high clinical suspicion is required for early diagnosis and management of this condition to help decrease the mortality rates.

Introduction and aim Polycystic ovary syndrome is one of the most common causes of female infertility, affecting 5–10% of the population. Women with PCOS manifest hyperandrogenism, hyperinsulinemia, low-grade systemic inflammation, and polycystic ovaries. Unfortunately, current available medications are only symptomatic without relevant reported treatment. Therefore, a pressing need for alternative safe approaches is necessitated. To this end, the present study is designed to investigate therapeutic merits of the edible plant: Ocimum kilimandscharicum (Ok), in a letrozole PCOS rat model, and compare it to metformin. Material and methods PCOS rats were treated with Ok total extract and its different fractions at 100 mg/kg orally for 10 consecutive days. Moreover, phytochemical characterization was applied using HPLC/PDA/ESI-MS to identify different secondary metabolites in the bioactive fractions. Key findings Results revealed that the total extract (Ok) and ethyl acetate (EA) fraction improved insulin sensitivity and restored normal hormonal and lipid profiles as well as normal morphological structure of the reproductive system. Furthermore, elevation of SOD and reduction of VEGF levels in comparison with metformin were recorded. Significance These results suggest that Ok extract and EA fraction halt letrozole-induced reproductive dysfunctions and restore normal morphological and physiological functions in PCOS rats, even superior to metformin.

In this study, the concept of magnetically charged black hole is discussed through calculating the angular momentum (L) of its interaction with an electric test charge. Results confirm that the angular momentum form will agree with the prediction of no-hair theorem and we will show that L will depend on the distance between the charge and the black hole.

Systemic mastocytosis (SM) usually arises as a consequence of an acquired mutation in the receptor tyrosine kinase KIT, usually KIT D816V (>80-90% of patients). The presence of additional molecular aberrations, e.g. in SRSF2, ASXL, or RUNX1 (S/A/Rpos), has a strong adverse impact on disease phenotype and prognosis in patients with advanced SM (advSM) (Jawhar et al., Leukemia 30, 2016). However, little is known about the frequency and prognostic impact of cytogenetic aberrations and potential interactions between cytogenetic and molecular aberrations in the context of prognostication. We therefore analyzed clinical, morphological, cytogenetic and molecular characteristics of 109 patients (KIT D816V, n=102, 94%; KIT D816H, n=2, 2%; no KIT mutation, n=5, 5%) with indolent SM (ISM, n=27) and advSM (n=82) with or without an associated hematologic neoplasm (AHN) [SM-AHN, n=60; aggressive SM, n=3; mast cell leukemia (MCL), n=9; MCL-AHN, n=10)]. Next-Generation Deep Amplicon Sequencing (NGS) was performed to investigate 18 candidate genes as previously described (Schwaab et al., Blood 122, 2013). All ISM patients had a normal karyotype. In advSM, an aberrant karyotype was identified in 16/82 (18%) patients. By analogy with other myeloid neoplasms, e.g. MDS or AML, patients were classified according to their karyotype into two groups. The good-risk group (n=73) included patients with a normal karyotype (n=66) plus those with a favorable karyotype (n=7; del(5q), n=4; trisomy 8, n=1; del(1q), n=1; del(12p), n=1), while the poor-risk group (n=9) included patients with a complex karyotype (defined as ≥3 abnormalities; n=8) or monosomy 7 (n=1). Seven of 9 (78%) patients with a poor-risk karyotype and 2/7 (29%) patients with a favorable karyotype progressed to secondary AML (n=7) or MCL (n=2) within a median observation time of 13 months (range, 0-26). Overall, the median overall survival (OS) of patients with a poor-risk karyotype was significantly shorter than in patients with a good-risk karyotype (4 vs. 41 months; hazard ratio, HR, 9.6, 95% CI 3.9-23.2; P Figure Kaplan-Meier estimates of overall survival (OS) in patients with advanced systemic mastocytosis depending on the karyotype and the mutation status in the SRSF2/ASXL1/RUNX1 gene panel (S/A/R). Pairwise significantly different OS probabilities were observed for the comparison good-risk karyotype + S/A/Rneg (n=27) vs. good-risk karyotype + S/A/Rpos (n=31) vs. poor-risk karyotype (n=9). Figure. Kaplan-Meier estimates of overall survival (OS) in patients with advanced systemic mastocytosis depending on the karyotype and the mutation status in the SRSF2/ASXL1/RUNX1 gene panel (S/A/R). Pairwise significantly different OS probabilities were observed for the comparison good-risk karyotype + S/A/Rneg (n=27) vs. good-risk karyotype + S/A/Rpos (n=31) vs. poor-risk karyotype (n=9). Disclosures Valent: Novartis: Honoraria, Research Funding; Ariad: Honoraria, Research Funding; Amgen: Honoraria; Celgene: Honoraria, Research Funding; Deciphera Pharmaceuticals: Research Funding. Haferlach:MLL Munich Leukemia Laboratory: Employment, Equity Ownership. Meggendorfer:MLL Munich Leukemia Laboratory: Employment.