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The conceptual cost estimation is a critical indicator of the future of the project's success at the initial process before submitting the project design. Pre-Design cost measuring is recognized as the very important procedure which affects the future of constructing proposed projects of roads. Pre-design cost is a preliminary cost measuring and is considered the prediction of the cost of a project during the planning and design phase. This evaluating and measure provides a great foundation for the process of financial support decisions and cost control. The aim of this study is to create pre-design cost measuring model for constructing road projects by utilizing linear regression technique. The research methodology consists of the data collected from public sectors which are the actual cost of the constructed road projects in Erbil governorate, then models have been developed by applying SPSS software, then the models summarized and selected. The mean absolute percentage error (MAPE) has been calculated using Excel program to calculate degree of the accuracy for the produced models. The accuracy was between -29% and +51%. As a result of the study regression models are useful and has a big advantage in predicting project cost in pre-design process and the planning stage of the project, by using either simplex computer scheme or any measuring tools.

Background and objective: Duodenal atresia and stenosis is considered a frequent cause of intestinal obstruction in the newborn, good prenatal work up and investigation make early diagnosis and better prognosis. This study aimed to evaluate the prenatal diagnosis, types, post-delivery management, associated anomalies, operative management and outcomes in neonates with congenital duodenal obstruction. Methods: A prospective study including 21 infants (13 female and eight male) with congenital duodenal obstruction were treated at Rapareen Teaching Hospital in Erbil from December 2011 to December 2015. Results: The mean age at presentation was 8.1 days (range 4 to 52 days), and the mean weight was 2.63 kilogram. Around 95% were term and 61.9% of patients delivered through cesarean section. The commonest presentation was bilious vomiting in 95.2% of cases. Associated anomalies were present in six cases in particular Down’s syndrome in five cases. Plain abdominal x-ray, ultrasound of abdomen and echocardiography done for all cases while upper gastrointestinal contrast study was done only in 5 cases. All managed operatively through laparotomy, and diamond shaped duodenoduodenostomy was the main procedure done in 17 cases, web resection in two cases, Ladd's procedure in one case and duodenojejunostomy in one case. The survival was 95.2%. Conclusion: Congenital duodenal obstruction is a common condition facing the pediatric surgeon. Associated anomalies is the first factor influencing the outcome. The most common causes of congenital duodenal obstruction were atresia, and annular pancreas and the most important warning sign is the bile stained vomiting. Treatment should be expedient and concurrent with ongoing resuscitation.

Solid waste disposal could be a major environmental problem in in Kurdistan region of Iraq because it is not managed properly. The main purpose of this study was to assess the influence of long term solid waste disposal on water and soil physicochemical properties. Soil and water samples were collected in and around the solid waste disposal area. The samples were analyzed for physicochemical characteristics and potentially toxic elements using ICPMS. The results revealed that some water parameters analysed well below WHO and EU standards for drinking water. Therefore, the surface and ground water samples in this study are good for drinking purposes. However, the application of water quality index (WQI) suggests that the ground and surface water around the open dumpsite are marked as good and poor water in quality respectively. High concentration of Ca in all soil samples is expected because the regional geology is calcareous. The concentrations of PTEs were found in order of Mn> Fe> Ni> Zn> Cr> Cu> Pb> Se> Cd. Although relatively high concentrations of Ni and Cr were found at all sampling points, mean concentrations of trace elements in the soil samples in the studied area were all below the soil guideline values (SGV). Enrichment factors (EFs), calculated using typical carbonate bedrock geologies, confirmed that there was typically significant enrichment in trace elements above expected background concentrations. Whereas concentrations of toxic elements were within the ‘safe’ limits in the studied agricultural areas, care should be taken because prolonged disposing of wastes in the outskirt of the city could lead to PTE accumulation in surrounding water soils.

This research aims to present a holistic view of sustainable investments on firm performance by exploring the dimensions of sustainable investments and firm performance concerning Indian private and publicly listed companies. Panel data regression has been used to explore the relationship between sustainable investment and firm performance. The data of 75 BSE-listed companies has been extracted from Prowess IQ from 2012–2022.Two panels based on different ownership structures were created to observe the impact of sustainable investment and firm performance. The findings of this study indicate that sustainable investments positively impact firm performance in private ownership but negatively impact the firm's performance in public ownership. The study provides an extensive and holistic view of sustainable investments in Indian companies listed in the BSE, which can be helpful for researchers, professionals, and policymakers in the field. The findings of this research contribute to the solutions to socio-economic challenges and support sustainable development goals through sustainable investments. This research is one of the first attempts to provide a holistic view of sustainable investments by including various aspects of sustainability and firm performance in Indian listed companies and ownership. [ABSTRACT FROM AUTHOR]

Background and objective: RAS gene mutations, including Harvey RAS, are a biomarker in studying many types of cancer, including colorectal cancer. Studying the molecular and mutations of the HRAS gene help in understanding the nature of the tumor and helps to formulate a suitable plan for prevention and treatment. The aim of the present study is to identify HRAS mutations among a sample of colorectal cancer. Methods: The sample for the present study involved 20 Formalin fixed embedded tissue of colorectal carcinoma and 10 adjacent normal tissues were obtained from Rizgary Teaching Hospital in Erbil. Results: The sample of the present study involved 20 patients (60% males and 40% females) with CRC. The mean age was 54.20 years, with an SD ±19.80. The study found a single HRAS mutation in the sample study. The size of the tumor mutated by HRAS is significantly different than other tumors (P = 0.009). Conclusion: there was an HRAS mutation in a sample of colorectal cancers and the size of the tumor was different than other tumors in the study sample. Further studies needed about the mutation of the HRAS gene.

Background and aimFecal incontinence (FI) is defined as the unintended loss of solid or liquid stool. FI adversely affects the patient’s quality of life. However, due to stigma, lack of awareness, and underdiagnosis, there is a notable gap in the knowledge regarding its prevalence. This study aimed to conduct a systematic review and meta-analysis of published literature reporting on FI prevalence and estimate the number of people afflicted by FI.MethodsA systematic review was conducted following the PRISMA 2020 guidelines, using the Embase, MEDLINE, CINHAL, and PubMed databases to identify relevant publications in the English language. Two reviewers independently screened the articles and extracted data. The reference sections and content of the review papers were also evaluated. Thirty-two articles were selected and included. A meta-analysis of proportions was performed using RStudio software. A sub-analysis was conducted to account for the variation between sample population age groups to minimize heterogeneity. The pooled prevalence was extrapolated to the Canadian population and a sample of ten densely populated countries to estimate the number of people affected by FI.ResultsThe Mean pooled FI prevalence in men and women was 7% (95% CI: 6-9%) and 10% (95% CI: 8-12%), respectively. The sub-analysis mean pooled prevalence of FI in men and women was 8% (95% CI: 6-10%) and 10% (95% CI: 8-12%), respectively. The authors estimate that between 1 and 1.5 million Canadians and 320 to 500 million people in the ten most populous countries suffer from FI.ConclusionFecal incontinence is a prevalent underdiagnosed condition requiring appropriate and timely treatment to improve a patient’s quality of life.

Abstract Prenatal vitamin D (PVD) is a vital micronutrient for dental caries (DCs). The association between prenatal vitamin D deficiencies (PVDD) and DCs in children has been conflicting in different reports. This meta-analysis aimed to investigate the association between PVDD and DCs in children for the first time. We searched PubMed, Scopus, Web of Sciences, Embase, and Scholar databases to find relevant studies based on mesh terms from 2000 to October 2023. This study was conducted based on the 2020 version of the PRISMA checklist. Cochran’s Q and I2 tests were used to evaluate heterogeneity between studies. Egger’s test was used to evaluate publication bias. The effect size of the association between PVDD and DCs was reported by the odds ratio (OR) at the 95% confidence interval (95% CI).Twelve studies, including 11,021 participants, were reviewed. The pooled prevalence of PVDD was estimated at 4353 (32%). The prevalence of DCs in children of mothers with and without PVDD was 44% and 25%, respectively. PVDD was significantly associated with an increased risk of DCs in children (OR: 1.35, 95% CI (1.22, 1.47), I2 = 86.6%). The association of DCs with PVDD was different based on gestational age groups, children’s age groups, and vitamin D levels. This meta-analysis showed PVDD can be associated with an increased risk of DCs in children, especially in mothers with prenatal vitamin D levels ≤ 35 nmol/L. Adequate vitamin D levels throughout pregnancy can help prevent DCs in children.

There is increasing concern about the impact of the COVID-19 pandemic and the lockdown's social and economic consequences on gender-based violence. This study aimed to assess the impact of the COVID-19 pandemic on gender-based violence by comparing the prevalence of spousal violence against women before and during the COVID-19 related lockdown periods. This study was conducted in the Kurdistan Region of Iraq using a self-administered online questionnaire survey after the COVID-19 lockdown period in June 2020. Data were collected from a sample of 346 married women about the occurrence, frequency, and forms of spousal violence before and during the lockdown period. Significant increases in violence were observed from the pre-lockdown period to the lockdown period for any violence (32.1% to 38.7%, p =.001), emotional abuse (29.5% to 35.0%, p =.005), and physical violence (12.7% to 17.6%, p =.002). Regarding emotional abuse, humiliation (24.6% to 28.3%, p =.041) and scaring or intimidation (14.2% to 21.4%, p <.001) significantly increased during the lockdown. For physical violence, twisting the arm or pulling hair (9.0% to 13.0%, p =.004) and hitting (5.2% to 9.2%, p =.003) significantly increased during the lockdown. Forcing to have sexual intercourse also significantly increased during lockdown (6.6% to 9.5%., p =.021). The concerned authorities and women's rights organizations should collaborate to enhance the prevention of violence against women. An effective prevention strategy should emphasize recognizing and acknowledging the extent of the problem, raising awareness about the problem and the available resources to address it, and ensuring social and economic stability. Lessons learned about the increased prevalence of spousal violence against women during the COVID-19 pandemic and the need to adopt appropriate strategies to prevent and address it will be valuable for similar future crises. [ABSTRACT FROM AUTHOR]

This study investigates the impact of incorporating TiC and TiB2 inoculants on the microstructure and corrosion performance of an arc-directed energy-deposited PH 13-8Mo martensitic stainless steel. The microstructural characterizations revealed partial dissolution of the incorporated ceramic-based nanoparticles, resulting in the formation of in situ TiC phase in the TiC-inoculated sample, while TiC and chromium-enriched M3B2 phases were formed in the TiB2-inoculated sample. Further investigations into the electrochemical response of the fabricated samples confirmed that the applied inoculation strategy slightly enhanced the corrosion resistance of the alloy, offering a valuable advantage for in-service performance for applications in harsher environments. The slight improvement in the corrosion resistance of the inoculated samples was found to be attributed to the formation of a higher fraction of low-angle grain boundaries and enhanced retained austenite content in the microstructure. However, it is essential to note that the formation of chromium-enriched M3B2 phases in the TiB2-inoculated sample led to a slight deterioration in its corrosion resistance compared to the TiC-inoculated counterpart.

Abstract This paper presents a comprehensive under frequency load shedding (UFLS) model that can be implemented in a multi‐area power system with real network characteristics. Conventional single‐area UFLS models operate on the basis of an equivalent center‐of‐inertia (COI) model, which ignores the local dynamics of system frequency response (SFR) and the impacts of load shedding location. Unlike the single‐SFR model, that is commonly utilized in previous works, the suggested multi‐area or multi‐SFR UFLS plan of this research has the distinct benefit of taking into account the dynamics of power transfer across different electric areas. The proposed multi‐area UFLS design incorporates a flywheel energy storage system (FESS) to support the inertial system frequency response and alleviate more than 30% load shedding while improving the frequency nadir by 25%. In order to investigate the performance of the proposed method under high penetrations of inertia‐free renewables, the inertia of the power network is reduced by around 30%; therefore the proposed UFLS scheme is assessed under a low inertia scenario. The proposed multi‐stage UFLS scheme is formulated as a mixed‐integer linear programming problem, and the optimal settings, including frequency set‐points and load shedding, are then optimized. The efficiency of the proposed model is verified using the IEEE‐118 Bus dynamic test system.

Background. Enjoying family life and interpersonal or marital relationships as well as feeling satisfied are among the main desires of every person. Numerous studies show that self-differentiation is one of the most important intrapersonal and interpersonal elements in families, especially in Iranian ones, which is also associated with other psychological phenomena. Methods. This study was performed using the meta-analysis technique by integrating the results of various studies conducted in the field of consequences and preconditions of their differentiation in Iranian families. To this end, 33 eligible and acceptable studies were selected and meta-analyzed. Data collection was performed using a meta-analysis checklist. This study was based on 6205 samples and 33 sizes of effect. Results. The findings indicated that the effect size of the predictors and consequences of self-differentiation in Iranian families had a large-sized average effect (r=0.46, SE=0.06,1, P

Abstract Introduction Elderly patients (≥80 years of age) with head and neck cancer (HNC) can prove a management challenge due to concerns regarding their suitability for surgery. This study aims to describe the characteristics and outcomes of elderly patients undergoing HNC surgery. Methods A retrospective review of elderly patients undergoing HNC surgery was conducted. Demographics, comorbidities, tumor characteristics, surgical procedure type, postoperative complications, and disposition were reviewed. Overall survival (OS) in the elderly cohort was compared against younger patients (80 years (71% male; mean age 84.8, range 80.0–98.8 years). The overall complication rate was 43%. When compared with younger patients (n = 509), elderly patients had reduced OS (risk ratio: 2.0, 95% CI: 1.3–3.2), higher 90‐day mortality (8.1% vs. 2.3%, p = .005), and lower 5‐year survival (43.5% vs. 64.1%, p 85 (n = 33) and 80–85 (n = 53) age groups. Conclusions Chronological age alone should not negatively influence decision‐making in HNC surgery the elderly. With careful preoperative selection and optimization, surgery can be performed at acceptable risk with good outcomes in elderly patients. Level of evidence IV

In developing countries like Pakistan, the preservation of the environment, as well as people’s economies, agriculture, and way of life, are believed to be hampered by climate change. Understanding how people perceive climate change and its signs is essential for creating a variety of adaptation solutions. In this study, we aim to bridge the gap in current research within this area, which predominantly relies on satellite data, by integrating qualitative assessments of people’s perceptions of climate change, thereby providing valuable ground-based observations of climate variability and its impacts on local communities. Field-based data were collected at different altitudes (upstream (US), midstream (MS), and downstream (DS)) of the Upper Indus Basin using both quantitative and qualitative assessments in 2017. The result shows that these altitudes are highly variable in many contexts: socioeconomic indicators of education, agriculture, income, women empowerment, health, access to basic resources, and livelihood diversifications are highly variable in the Indus Basin. The inhabitants of the Indus Basin perceive the climate changing around them and report impacts of this change as increase in overall temperatures (US 96.9%, MS 97%, DS 93.6%) and erratic rainfall patterns (US 44.1%, MS 73.3%, DS 51.0%) resulting in increased water availability for crops (US 38.6%, MS 39.7%, DS 54.8%) but also increasing number of dry days (US 56.7%, MS 85.5%, DS 67.1%). Communities at these altitudes said that agriculture was their primary source of income, making them particularly vulnerable to the effects of climate change and the dangers that go along with it. The insights are useful for determining what information and actions are required to support local climate-related hazard management in subtropical climate regions. Moreover, it is vital to launch a campaign to raise awareness of potential hazards, as well as to provide training and an early warning system.

Background: Teratomas are composed of multiple tissues foreign to the organ or site from which they arise. Although teratomas are sometimes defined as having three embryonic layers (endoderm, mesoderm, and ectoderm), and are generally divided into gonadal and extragonadal types. The most common extragonadal type being sacrococcygeal teratomas which constitute the most prevalent childhood germ-cell cancers. Objective: To assess postoperative bowel and urinary dysfunction in babies with sacrococcygeal teratomas Patients and Methods: 23 patients having sacrococcygeal teratomas were received at the time between May 2014 to September 2022 at the department of pediatric surgery in Raparen Teaching Hospital in Erbil city.All recorded data from case note, operation notes together with demographic data and operative details obtained and recorded . The follow-up time span was between three months to seven years. Results: The age range was from 1 day to 4year, (median 3 days) , Presenting features include posterior sacral mass in 17 cases (73.9%), pelviabdominal mass in 5 cases (21.7%), urinary retention in 4 cases (17.4%), palpable rectal mass in 2 cases 98.7%), intestinal obstruction in 1 case (4.3%), and constipation in 4 cases (17.4%). Eight cases (34.8%) were type I, 6 cases (26.1%) type II and III, and 3 cases (13%) were type IV. postoperative complications were wound infection in 4 patients (17.4%), constipation in 5 cases (21.7%), 1 (4.3%) ugly scar arranged for aesthetic operation, fistula 1(4.3%) case, recurrence in 1(4.3%). Conclusion: Patients with sacrococcygeal teratoma were more likely to experience uncontrolled urination, difficulties emptying the bladder, pyelonephritis, and constipation than healthy children. Children with big and immature teratomas had a higher prevalence of dysfunctional outcomes.

Background: Tea (Camellia sinensis L.O. Kuntze) is one of the most commonly consumed beverages globally, with several beneficial health effects. The composition of leaves is affected by different factors such as climate and tea cultivar. Methods: In this study, the total phenolic, flavonoid, and tannin contents, and antioxidant activities of eight cultivars of tea growing in Iran were determined. The epigallocatechin gallate (EGCG) contents were measured by high-performance liquid chromatography (HPLC) analysis. The Fourier-transform infrared (FT-IR) spectra were used to construct a supervised pattern recognition model using a genetic algorithm-support vector machine (GA-SVM) for the classification of cultivars. Results: The results indicated a wide variation of total phenolic content (178.04 to 316.09 mg gallic acid equivalents (GAE)/g extract). Also, the flavonoid contents ranged from 25.54 to 41.1 mg quercetin equivalents )QE(/g extract. All the samples had close tannin amounts (ranging from 40.32 to 45.90 mg as tannic acid equivalent (TAE)/g extract). There was a significant linear relationship among total phenolic and flavonoid contents and antioxidant properties. The cultivars DN, PK2, and C.Y.9 had the highest content of phenolic and flavonoid content as well as the best antioxidant activity. The EGCG contents were from 2.66 to 4.12%. The highest amount of EGCG was found in cultivars 282, PK2, and C.Y.9. The discriminative region of FT-IR spectra (1350-1650 cm-1) was selected using a GA-SVM. This model showed 100% sensitivity and specificity for training and test sets. Conclusion: The leaves’ phytochemical compositions and antioxidant effect are deeply dependent on the type of tea cultivars. The cultivars PK2 and C.Y.9 can be considered richer sources of polyphenols, especially EGCG. The eight different cultivars can be classified based on chemical components using the recorded FT-IR spectra.

Background and objective: Retractile testis is relatively common in pediatric population. This study followed up boys with retractile testis to investigate the natural course and the need for hormonal therapy and surgical treatments. Methods: A total of 110 boys aged 1.5-10.1 years (mean: 3.2 years) diagnosed as retractile testes, 67 (60.9%) unilateral and 43 (39.09%) bilateral. The mean follow-up period was 4.9±1.3 years. The diagnosis is confirmed on history and examination and ultrasound was made for measuring the size of the testis. Results: A total of 47 (42.72%) cases received human chorionic gonadotropin (17 bilateral and 30 unilateral). Response occurred in 32 boys (68.1%),12 bilateral and 20 unilateral. Failure of response occurred in 15 boys (31.9%). Fourteen of 110 boys (12.72 %) were referred for orchiopexy, including 1 of 12 (8.3%) of bilateral cases and 2 of 20 (10%) of unilateral cases who responded to human chorionic gonadotropin injection, 2 of 5 bilateral cases (40%) and 1 in 10 unilateral cases (10%) in those did not respond to treatment. In those who did not receive treatment, orchiopexy was performed in 6 of 26 bilateral cases (23.1) and in 2 of 37 unilateral cases (5.4%). Conclusion: Although testicular descent was achieved by short-term hormone therapy, the study revealed that there is no significant statistical difference for the need for orchiopexy between those received and those did not receive human chorionic gonadotropin.

Abstract Introduction Tibia valga, an extra-articular valgus deformity of the tibia, is common in valgus knees and can result in component misplacement and early total knee arthroplasty (TKA) failure. However, the prevalence and importance of tibia valga in TKA have been seldom reported. This study aims to describe the prevalence and characteristics of tibia valga morphology in valgus knees and describe implications for surgical planning in primary TKA. Methods We prospectively examined pre-operative weightbearing whole-body EOS digital radiographs of patients with knee osteoarthritis listed for TKA between December 2018 and December 2020. Hip–knee–ankle angle (HKA), mechanical lateral distal femoral angle (mLDFA), mechanical medial proximal tibial angle (mMPTA), joint line convergence angle (JLCA) and tibial morphology with centre of rotation of angulation of tibia (CORA-tibia) were measured and analysed. Results In 830 knees, 253 (30%) and 577 (70%) were classified as valgus and varus, respectively. In valgus knees, 89 knees (35%) had tibia valga. Median CORA-tibia was 2.8° (range 0.2°–10.9°). Tibia valga knees had no difference in mLDFA, higher HKA (5.0o versus 3.0°, p = 0.002) and mMPTA (89.6° versus 88.1°, p

Background and aim: The TP53 gene encodes an important class of cell cycle and tumor-suppressing factors that play critical roles in maintaining genomic stability. The TP53 Arg72Pro (rs1042522 C>G) polymorphism has been reported to be associated with the risk of several types of adult cancers. Objective of this study was to investigate the possible association between TP53 Arg72Pro polymorphism with colorectal cancer and to examine its correlation with age groups, Tumor type, Nodal state, and Duck stage of individual. Patients and methods: The study involved 50 patients with colorectal cancer (25 males and 25 females). This study was conducted to estimate the distribution of colorectal cancer within age groups, Tumor type, Nodal state, and Duck stage of individual also to investigate the distribution of TP53 Arg72Pro SNPs genotype in colorectal cancer, and determine whether TP53 Arg72Pro polymorphism is a possible relevance in susceptibility to colorectal cancer using RFLP-PCR analysis. Results: The present study shows there were no statistically significant differences between the different age groups and Dukes states with gender. Additionally, tumor types and nodal states (either positive or negative) of colorectal cancer were significantly different with gender. Also, this study revealed that 10 (20.0%) colorectal cancer patients had a 152 bp undigested PCR product fragment representing homozygotes for proline, 8 (16.0%) had two 50 and 102 bp fragments representing homozygotes for arginine, and 32 (64.0%) had three 50, 102, and 152 bp fragments representing heterozygotes for proline. The results of control genotypes showed 14 (28.0%) people with a fragment of 152 bp indicating homozygotes proline, 20 (40.0%) with two fragments representing homozygotes arginine, and 14 (28.0%) with three bands showing heterozygotes for codon 72. Conclusion: No substantial differences (P>0.05) between the frequency of Arg72allele and Pro72allele in colorectal cancer -affected males as opposed to the frequency of Arg72allele and Pro72allele in the control groups. In relation to the frequency of Arg72allele and Pro72allele in females, indicates substantial differences (P>0.05).

This study showed the anti-candida, biofilm inhibitory, antioxidant, anticoagulant, and thrombolytic properties of biogenic silver nanoparticles (AgNPs) fabricated by using the supernatant of Penicillium fimorum (GenBank accession number OQ568180) isolated from soil. The biogenic AgNPs were characterized by using different analytical techniques. A sharp surface plasmon resonance (SPR) peak of the colloidal AgNPs at 429.5 nm in the UV–vis spectrum confirmed the fabrication of nanosized silver particles. The broth microdilution assay confirmed the anti-candida properties of AgNPs with a minimum inhibitory concentration (MIC) of 4 μg mL−1. In the next step, the protein and DNA leakage assays as well as reactive oxygen species (ROS) assay were performed to evaluate the possible anti-candida mechanisms of AgNPs representing an increase in the total protein and DNA of supernatant along with a climb-up in ROS levels in AgNPs-treated samples. Flow cytometry also confirmed a dose-dependent cell death in the AgNPs-treated samples. Further studies also confirmed the biofilm inhibitory performance of AgNPs against Candia albicans. The AgNPs at the concentrations of MIC and 4*MIC inhibited 79.68 ± 14.38% and 83.57 ± 3.41% of biofilm formation in C. albicans, respectively. Moreover, this study showed that the intrinsic pathway may play a significant role in the anticoagulant properties of AgNPs. In addition, the AgNPs at the concentration of 500 μg mL−1, represented 49.27%, and 73.96 ± 2.59% thrombolytic and DPPH radical scavenging potential, respectively. Promising biological performance of AgNPs suggests these nanomaterials as a good candidate for biomedical and pharmaceutical applications.

Background: Assess the efficacy of combining fiber and lactulose in the treatment of constipation in the pediatric age group. Objective: To assess the efficacy of combining fiber and lactulose in the treatment of constipation in the pediatric age group. Patients and Methods: One hundred forty-six patients with fuctionalconstipation were chosen in a non-randomized superiority trial manner as they were convenient to enroll due to their presentation to the outpatient clinic during the period from August 2019 to February 2022.Patient received either a solution of lactulose 3.3g/5ml in group A or a solution of 4.005g Inulin fiber and 4.005g lactulose per 20ml in group B. Results: Total of 146 children were included; all, 146 patients completed the study. In the lactulose group, 19 patients were on therapy for less than 6 months, and 48 were on therapy for more than 6 months. In the lactulose + fiber group, 59 patients were on therapy for less than 6 months, and 20 were on therapy for more than 6 months. No serious adverse effects were registered but 18 (27%) of children in the lactulose group encountered side effects, while 11 (14%) of children in the lactulose + fiber group encountered side effects. Conclusion: A solution of Lactulose + fiber is superior to a solution of Lactulose alone in terms of efficacy for the treatment of constipation in the pediatric age group. It also has a lower side effects profile.

Nurses have an important role in caring for patients with intentional self-poisoning. This study was attempted to explore the emergency department nurses' perception of caring for patients with intentional self-poisoning. The present qualitative study was performed using phenomenological method. This study was done on 14 emergency department nurses with experience in caring for patients with intentional self-poisoning. Data were collected through semi-structured interviews and transcribed verbatim. Data were analyzed using Colaizzi's method. Following data analysis, two themes and five sub-themes were extracted, which included being reluctant to provide care for patients with intentional self-poisoning (discomfort in providing care, and lack of desire to care for these patients) and comprehensive patient support (providing complete care and emotional support). Given that emergency department nurses are the first medical staff who face with intentional self-poisoning patients and play an important role in the care and treatment of these patients, it is necessary to improve their understanding of caring for these patients. In addition, their comprehensive support for these patients should be strengthened. Psychological support for nurses and training them on how to communicate with intentional self-poisoning patients and their families are also recommended.

Clays generally have a low strength and capacity, and additives are usually used to stabilize them. In recent years, using fly ash to stabilize soil has decreased environmental pollution while also having an economic benefit. The objective of this study is to perform a comparative investigation on the effect of class C and class F fly ashes on geotechnical properties of high-plasticity clay using the Atterberg’s limit, compaction, California Bearing Ratio (CBR), and unconfined compressive strength tests. The results showed that with an increase in the amount of fly ash, there was a decrease in the maximum dry density and an increase in the optimum moisture content. Moreover, an addition of fly ashes of up to 25% caused a reduction of the liquid limit and plasticity index, and an increase in the maximum unconfined compressive strength and CBR. Lengthening the curing time had a positive impact on the unconfined compressive strength of the soil. The soil samples with class C fly ash were seen to possess more efficient geotechnical properties as compared to class F fly ash.

UreA is an important virulence factor of Helicobacter pylori that, along with UreB and UreC, produces urease. Urease enzyme helps the bacterium to colonize the human stomach through metabolizing urea in order to neutralize the gastric environment. The current study aimed to detect the prevalence of the H. pylori’s ureA virulence factor gene, and to investigate the influence of this gene on the result of the rapid urease test (RUT). Eighty stomach biopsy samples were isolated from participants who were suspected to be infected with H. pylori in Erbil city. Participants were 36 males and 44 females, aged between 18 and 67 years. The results showed that 42 (52.5%) of the participants were positive for H. pylori when tested by RUT, while 59 (73.8%) of the patients showed positive H. pylori infection when tested by polymerase chain reaction (PCR) targeting the 16S rRNA gene. The results of the PCR test based on the ureA gene revealed that 42 (52.5%) of the samples were positive. The important finding of this research is the presence of 100% compatibility between positive samples of RUT and ureA genes. It can be concluded from this study that a person may be infected with H. pylori, but the RUT test fails to detect the infection if the bacteria lack the ureA gene, indicating a direct impact of this gene on the result of RUT, which is a defect of RUT.

Abstract Management of diabetes-related foot ulceration (DFU) includes pressure offloading resulting in a period of reduced activity. The metabolic effects of this are unknown. This study aims to investigate changes in bone mineral density (BMD) and body composition 12 weeks after hospitalisation for DFU. A longitudinal, prospective, observational study of 22 people hospitalised for DFU was conducted. Total body, lumbar spine, hip and forearm BMD, and total lean and fat mass were measured by dual-energy X-ray absorptiometry (DXA) during and 12 weeks after hospitalisation for DFU. Significant losses in total hip BMD of the ipsilateral limb (− 1.7%, p

Abstract Background Templating for total knee arthroplasty (TKA) is routinely performed on two-dimensional standard X-ray images and allows template-directed instrumentation. To date, there is no report on one-dimensional (1D) anteroposterior (AP) templating not requiring specific templating software. We aim to describe a novel technique and explore its reliability, accuracy and potential cost-savings. Methods We investigated a consecutive series of TKAs at one institution between January and July 2019. Patients with preoperative low-dose linear AP EOS radiography images were included. Implant component sizes were retrospectively templated on the AP view with the hospitals imaging viewing software by two observers who were blinded to the definitive implant size. Planning accuracy as well as inter- and intra-observer reliability was calculated. Cost-savings were estimated based on the reduction of trays indicated by the 1D templating size estimations. Results A total of 141 consecutive TKAs in 113 patients were included. Accuracy of 1D templating was as follows: exact match in 53% femoral and 63% tibial components, within one size in 96% femoral and 98% tibial components. Overall 58% of TKA components were planned correctly and 97% within one size. Inter- and intra-rater reliability was good (κ = 0.66) and very good (κ = 0.82), respectively. This templating process can reduce instrumentation from six to three trays per case and therefore halve sterilisation costs. Conclusions The new 1D templating method using EOS AP imaging predicts component sizes in TKA within one size 97% of the time and can halve the number of instrumentation trays and sterilisation costs.

In cereals with hollow internodes, lodging resistance is influenced by morphological characteristics such as internode diameter and culm wall thickness. Despite their relevance, knowledge of the genetic control of these traits and their relationship with lodging is lacking in temperate cereals such as barley. To fill this gap, we developed an image analysis–based protocol to accurately phenotype culm diameters and culm wall thickness across 261 barley accessions. Analysis of culm trait data collected from field trials in seven different environments revealed high heritability values (>50%) for most traits except thickness and stiffness, as well as genotype-by-environment interactions. The collection was structured mainly according to row-type, which had a confounding effect on culm traits as evidenced by phenotypic correlations. Within both row-type subsets, outer diameter and section modulus showed significant negative correlations with lodging (