Search

Mohammed Suoub,1 Mohammad M Saleem,2 Fadi Sawaqed1 1Section of Urology, Department of Special Surgery, Faculty of Medicine, Mut’ah University, Karak, Jordan; 2Department of General Surgery, Faculty of Medicine, University of Jordan, Jordan University Hospital, Amman, JordanCorrespondence: Mohammed SuoubSection of Urology, Department of Special Surgery, Faculty of Medicine, Mut’ah University, Mu’tah, Karak 61710, JordanTel +962 798259007Email dr_suoub@yahoo.comAbstract: Urethral duplication (UD) is a rare-congenital anomaly that can affect the genito-urinary system. The aim of this case report is to show our experience in this case, including the investigation and operative techniques that we utilized. In the literature review, we will show that different types of duplication, radiological investigations, and surgical techniques have been used to treat this condition.Keywords: urethra, dorsal, congenital, double, duplication

The article discusses whether videolaryngoscopy is effective in difficult airways. Videolaryngoscopes have a video camera focused at the laryngeal outlet without the need for alignment of the axes and give a better view of the vocal cords. They can be useful when unexpected difficulty is encountered in intubation and in managing children with difficult airways. Case reports suggest that videolaryngoscopes can be useful in rescuing failed direct laryngoscopy in both adults and children.

This paper presents the design of a multi-axis capacitive tactile force sensor with a fully decoupled output response for input normal and shear forces. A patterned elastomer is used as a dielectric layer between capacitive electrodes of the sensor that allows to achieve relatively higher sensitivity. The sensor is fabricated utilizing a low-cost rapid prototyping technique and is characterized for normal and shear forces in the range of 0 ~ 10 N and 0 ~ 3.1 N respectively. The achieved force sensitivity for the normal axis is 2.03%/N and for shear axes is 1.67%/N. The difference between the estimated force from the sensor and actual force applied is negligible, which demonstrates the accuracy of the sensor. The reliability of the sensor is analysed by performing hysteresis and repeatability tests. The hysteresis error is found to be 4.94% and 4.69% for normal and shear forces respectively. The repeatability error of the sensor is less than 5%, which shows the stability of the sensor. The high sensitivity, linear output response, high force measurement range, reliability and low cost make the proposed tactile sensor suitable for the force feedback in the robotic surgical systems., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Hussain et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: A shallow active layer of soil above the permafrost thaws during the summer months which promotes microbial growth and releases previously confined pathogens which result in bacterial epidemics in circumpolar regions. Furthermore, these permafrost sources harbor several antibiotic resistance genes (ARGs) which may disseminate and pose a challenge for pharmacologists worldwide., Aims: The authors examined the potential association between climate change-induced permafrost thawing, and the resulting release of antibiotic-resistant pathogens, as well as the potential impact this can have on global healthcare systems in the long run., Methodology: A cursory abstract screening was done to rule out any articles that did not have to do with viral pathogens caused by melting permafrost. Articles that were not available in English or that our institutions library did not have full-text access were weeded out by a secondary screen., Results: A comprehensive analysis of 13 relevant studies successfully revealed a wide variety of bacterial genera, including Staphylococcus spp. , Pseudomonas spp. , Acinetobacter spp. , and Achromobacter spp. , along with a total of 1043 antibiotic resistance genes (ARGs), with most pertaining to aminoglycosides and beta-lactams, offering resistance via diverse mechanisms such as efflux pumps and enzymatic modifications, within the permafrost isolates. Additionally, mobile genetic elements (MGEs) housing antibiotic resistance genes (ARGs) and virulence factor genes (VFGs), including plasmids and transposons, were also discovered., Conclusion: Permafrost thawing is an underrated healthcare challenge warranting the need for further articles to highlight it alongside concerted efforts for effective mitigation., Competing Interests: The authors declare that they have no financial conflict of interest with regard to the content of this report.Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)

Protein S and C deficiency is a rare inherited thrombophilia that predisposes individuals to a hypercoagulable state, leading to clot formation in various locations, such as the deep veins of the legs, cerebral veins, and rarely the portal vein. We present the case of a 21-year-old male who came to the ER with hematemesis and melena secondary to chronic portal vein thrombosis (PVT) without any evidence of cirrhosis. Diagnostic investigations, including ultrasonography and computed tomography, confirmed the presence of thrombosis and cavernous transformation of the portal vein, splenic vein thrombosis, and splenomegaly. Coagulation profiling revealed diminished Protein S and C levels, thus confirming the diagnosis of a combined Protein S and C deficiency. Management involved indefinite anticoagulant therapy with direct oral anticoagulants to mitigate thromboembolic risks associated with the inherited thrombophilia. This case underscores the importance of considering rare coagulation disorders in young patients with unexplained thrombotic events, emphasizing the need for a comprehensive diagnostic approach and timely therapeutic interventions to minimize morbidity and mortality., (© 2024 The Authors. Published by Elsevier Inc. on behalf of University of Washington.)

Post-traumatic pulmonary embolism (PE) poses diagnostic complexities, especially with underlying lung pathologies and delayed symptoms. We report a 43-year-old male who presented with cough, frothy sputum, and dyspnea following blunt chest trauma 2 weeks ago. Due to a history of asthma, an asthma exacerbation was suspected but he failed to respond to bronchodilator therapy. Doppler USG (ultrasonography) was negative for deep venous thrombi, however, elevated D-dimer levels prompted further investigation with computed tomography pulmonary angiography (CTPA), confirming the diagnosis of PE. Prompt initiation of anticoagulation and thrombolysis resulted in clinical improvement. This case underscores the need to rule out posttraumatic PE, irrespective of age, type of, or time since injury, and underlying lung disease, to ensure timely diagnosis and intervention., (© 2024 The Authors. Published by Elsevier Inc. on behalf of University of Washington.)

Context: COVID-19 has substantial effects on respiratory health and overall well-being. Recent studies suggest vitamin D as a potential treatment, but the results are inconclusive., Objective: The authors conducted a systematic review of randomized controlled trials (RCTs) to examine the link between vitamin D and patients with COVID-19., Data Sources: The authors searched electronic databases PubMed, Cochrane, CINAHL, EMBASE and Google Scholar from their inception till August 2023., Study Selection: Inclusion criteria used in our systematic review include: (1) patients who tested positive for COVID-19, (2) intervention was vitamin D supplementation, (3) the comparator was either a placebo, standard care of treatment, or, no treatment, (4) at least one of the clinical outcomes of interest were investigated, (5) study design being RCTs., Data Extraction: Two independent reviewers manually extracted information from selected articles, including study characteristics, patient characteristics, and the primary outcomes: all-cause mortality, ICU and hospital stay length and secondary outcomes: mechanical ventilation, supplemental oxygen, ICU admission, and adverse events. Risk ratios or mean differences and 95% CIs were calculated using a random-effects model., Data Synthesis: The authors' analysis included 14 RCTs with 2165 patients. Vitamin D significantly reduced ICU admissions and lowered the need for mechanical ventilation compared to placebo. However, it did not significantly affect hospital stay length, ICU stay length, mechanical ventilation duration, mortality, or the need for supplemental oxygen., Conclusion: Vitamin D does not significantly improve certain clinical outcomes, such as hospital and ICU stay length, for patients with COVID-19. However, it still may be significantly beneficial in decreasing the burden on intensive care services., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)

This study aimed to evaluate the effect of different environmental enrichment tools on behavior, welfare, productive performance, and egg quality traits of Naked Neck chickens. A total of 1080 Naked Neck female chickens (30 weeks old) were used in the present study. A completely randomized experimental design, with 3 treatments having 4 replicates of 90 birds each, was applied. Treatments consisted of 3 different range areas A (121.9 m 2 ), B (152.4 m 2 ), and C (190.5 m 2 ). Behavior (walking, feeding/foraging, sitting, aggressiveness wing flapping, perching, dust bathing, and range use), welfare (foot pad dermatitis, lameness, gait score, and feather pecking), productive performance (egg weight, egg production %, egg mass, and feed intake), egg quality traits (morphometry, egg weight, shell, albumen, and yolk characteristics) were evaluated. There was no influence (P > 0.05) of different range area on bird's behavior, and egg quality traits except walking and rang usage. The range area C promoted productive performance including egg weight, egg production %, egg mass and feed intake, but it did not influence welfare traits. It might be concluded that Naked Neck chicken when reared in free range with different range enrichments did not reveal any difference regarding behavioral parameters, egg morphometry, and egg quality traits. The range area within minimum length and effectively used environmental enrichments (perching and dust bathing area) should be used for backyard poultry to obtain ideal performance., (© 2024. The Author(s), under exclusive licence to Springer Nature B.V.)

This study investigated the habits and attitudes of individuals towards poultry consumption, utilizing primary data collected through a survey of 5 households from 285 localities in Tehsil Shakargarh, Punjab, Pakistan (n = 1425). Household selection was randomized, and personal visits were conducted for data collection via formal interviews employing a structured questionnaire. Coordinates for each site were obtained using a Garmin eTrex device, in conjunction with meteorological data, to determine global positioning system (GPS) coordinates. A notable portion of respondents (38.8 %) possessed basic knowledge, while the majority (61.2 %) demonstrated intermediate knowledge regarding commercial broilers (chickens raised for meat production). A significant proportion (70.3 %) harbored misconceptions about the inclusion of hormones/antibiotics in poultry feed, with a minority (0.2 %) misinformed about broiler chickens' leg weakness. Some respondents (17.3 %) held both misconceptions, while others (12.2 %) had none. The majority (97.6 %) favored egg consumption, with 51.7 % preferring commercial chicken eggs and 48.3 % opting for domestic chicken eggs. Preference for white-colored eggs (51.5 %) slightly outweighed that for brown-colored eggs (48.5 %). A minority (1.3 %) speculated that poultry consumption could be a potential cause of COVID-19, while the majority (65.7 %) disagreed, and a portion (33.0 %) remained uncertain. Nearly all respondents (99.9 %) believed in the immunity-boosting properties of protein intake, with 65 % associating such benefits with poultry meat and eggs. Similarly, 99.7 % did not encounter difficulties in accessing poultry products during lockdowns. Approximately half (46.3 %) of respondents believed that consuming well-cooked and safely handled poultry meat was safe during outbreaks. Poultry meat and eggs emerged as potentially efficient sources of nutrition during the COVID-19 pandemic, especially for protein-deficient populations like Pakistan. Therefore, initiatives should focus on enhancing commercial poultry production and educating the populace about its advantages., Competing Interests: No potential conflict of interest was found by the authors., (© 2024 The Authors.)

This paper presents the developmental process of ultra-high performance concrete (UHPC), the most advanced form of concrete. The entire process exclusively utilized locally available materials. The mixes were prepared without using any specialized mixer or treatments, such as elevated pressure, etc. The primary objective of the research was to develop low-cost non-proprietary version of UHPC by optimizing both cementitious and non-cementitious materials to attain the highest levels of workability, compressive strength, flexural strength and durability. The research utilizes a trial-and-error approach, subjecting specimens to curing in both regular and heated water. The findings validate the viability of producing self-compacting UHPC with compressive strength ranging from 120 to 160 MPa, employing local materials and manufacturing methods. Raw materials and mixing sequence had a significant influence on the fresh and hardened properties of UHPC. The inclusion of steel fibers and the application of heat treatment remarkably enhanced the compressive strength. Furthermore, cost analysis revealed that this particular UHPC is only slightly over four times more expensive than conventional concrete, in contrast to commercially available UHPC, which is approximately 10 times expensive than traditional concrete., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)

Migraine is a complex neurological disorder characterized by recurring episodes of severe headaches. The pathophysiology of migraine involves abnormalities in neuronal networks, cortical spreading depression, and sensitization of trigeminovascular pathways. The global prevalence of migraine has increased substantially, warranting advancements in treatment strategies. A significant trigger in migraine pathophysiology is calcitonin gene-related peptide (CGRP). Several drugs, such as gepants and monoclonal antibodies (MABs) targeting CGRP or its receptor, have been developed to antagonize CGRP signaling. Zavegepant (Zavzpret), a novel CGRP receptor antagonist, has recently been approved by the FDA for the acute treatment of migraine. Clinical trials have demonstrated its efficacy in providing headache and symptom relief, with a statistically significant percentage of patients achieving freedom from headaches and most bothersome symptoms. Despite mild adverse effects, such as taste disorders and nausea, Zavzpret's overall safety profile remains acceptable., Competing Interests: None of the authors declare any conflicts of interest.Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)

This paper presents a deep neural network (DNN) based design optimization methodology for dual-axis microelectromechanical systems (MEMS) capacitive accelerometer. The proposed methodology considers the geometric design parameters and operating conditions of the MEMS accelerometer as input parameters and allows to analyze the effect of the individual design parameters on the output responses of the sensor using a single model. Moreover, a DNN-based model allows to simultaneously optimize the multiple output responses of the MEMS accelerometers in an efficient manner. The efficiency of the proposed DNN-based optimization model is compared with the design of the computer experiments (DACE) based multiresponse optimization methodology presented in the Literature, which showed a better performance in terms of two output performance metrics, i.e., mean absolute error (MAE) and root mean squared error (RMSE).

Background and objectives : Endodontic surgery has evolved over the last two decades. The use of state-of-the-art guided endodontic surgical procedures produces a predictable outcome in the healing of lesions of endodontic origin. The main objective of this review paper is to define and characterize guided surgical endodontics as well as its benefits and drawbacks by reviewing the most recent relevant scientific literature. Methods : A literature search was conducted using multiple databases comprising of MEDLINE (via PubMed), EMBASE, and Web of Science. The terms used for the search were 'guided endodontics', 'surgical endodontics', and 'endodontic microsurgery'. Results : In total, 1152 articles were obtained from the analysis of the databases. Unrelated articles from the available full text of 388 articles were excluded. A total of 45 studies were finally included in the review. Conclusions : Surgical-guided endodontics is a relatively new area of study that is still maturing. It has many applications such as root canal access and localization, microsurgical endodontics, endodontic retreatment, and glass fiber post removal. Additionally, it does not matter how experienced the operator is; the procedure can be completed for the patient in less time and provides greater accuracy and safety than conventional endodontics.

This observational study was conducted to evaluate the clinical signs and symptoms of maxillary sinus tumors and to propose a clinical examination sieve and a unique risk alarm score to be used for timely patient referral and vigilance. The study consisted of 70 patients between 20 to 82 years of age from both sexes. The clinical information gained was collected from the upper dentoalveolar segment, orbit, and nasal sites. Regarding the early clinical sign and symptoms of patients, nasal obstruction was found in 67 patients (95.7%), facial swelling in 69 patients (98.6%), paresthesia in 41 patients (58.6%), and epistaxis in 50 patients (71.4%). Furthermore, in terms of the late signs and symptoms, a palpable mass in buccal sulcus was observed in 65 (92.9%) of the patients, lymphadenopathy in 24 (34.3%), paresthesia in 38 (54.3%), and diplopia in 22 (31.4%). Furthermore, general sign and symptoms like exophthalmos was present in 35 patients (50%), anosmia was observed in 37 patients (52.9%), and oroantral fistula was noted in 37 patients (55.9%). Additionally, 67 (95.7%) of the patients complained of nasal obstruction. Similarly, facial asymmetry was observed in 69 (98.6%) of the patients and double vision was observed in 24 (34.4%). Tumors of the maxillary sinus have a very insidious course of spread and uncertain clinical signs and symptoms. What makes diagnosis worse is the fact that the symptoms of these tumors are so well hidden in the sponge-like nature of the midfacial region that they are easily misinterpreted by patients. Therefore, diagnoses must be made early, dentists must be vigilant, and patients must be fully investigated at the slightest suspicion of a tumor, albeit benign.

Objectives: This study aimed to describe clinical outcomes and medical expenditures associated with COVID-19 admissions. In addition, this study aimed to investigate the impact of patients' characteristics and baseline comorbidities on intensive care unit (ICU) admission, mortality, and medical expenditures for hospitalized patients with COVID-19., Methods: This retrospective cohort study included all hospitalized patients with confirmed COVID-19 in Prince Hamza Hospital and King Abdullah University Hospital, during the period from March 2020 to June 2021. Medical records and pharmacy data were followed and reviewed throughout their admissions. The ICU admission, inpatient mortality, hospital length of stay, and inpatient charges were described. Predictors of ICU admission and inpatient charges were evaluated., Results: A total of 7694 COVID-19 hospital admissions were included. Approximately 1189 patients (15.5%) were admitted to ICU and 21.4% died in the hospital. The fatality rate among those admitted to ICU was 82.6% compared with 10.2% for non-ICU admitted patients. The average admission charge and charge per admission day were 1598.2 and 200.2 Jordanian dinar, respectively, and both charges were higher in ICU admitted patients than non-ICU admitted patients. Being older in age, smoker or ex-smoker, and having chronic diseases were all significantly associated with a higher likelihood of ICU admission and mortality among admitted patients., Conclusions: ICU admission in patients with COVID-19 is associated with poor clinical outcomes and substantial medical expenditures and is more likely among older adults, smokers, and those with chronic diseases., (Copyright © 2022 International Society for Health Economics and Outcomes Research. Published by Elsevier Inc. All rights reserved.)

This work demonstrates a mixed-dimensional piezoelectric-gated transistor in the microscale that could be used as a millinewton force sensor. The force-sensing transistor consists of 1D piezoelectric zinc oxide (ZnO) nanorods (NRs) as the gate control and multilayer tungsten diselenide (WSe 2 ) as the transistor channel. The applied mechanical force on piezoelectric NRs can induce a drain-source current change (Δ I ds ) on the WSe 2 channel. The different doping types of the WSe 2 channel have been found to lead to different directions of Δ I ds . The pressure from the calibration weight of 5 g has been observed to result in an ∼30% I ds change for ZnO NRs on the p-type doped WSe 2 device and an ∼-10% I ds change for the device with an n-type doped WSe 2 . The outcome of this work would be useful for applications in future human-machine interfaces and smart biomedical tools.

This paper presents a multi-axis low-cost soft magnetic tactile sensor with a high force range for force feedback in robotic surgical systems. The proposed sensor is designed to fully decouple the output response for normal, shear and angular forces. The proposed sensor is fabricated using rapid prototyping techniques and utilizes Neodymium magnets embedded in an elastomer over Hall sensors such that their displacement produces a voltage change that can be used to calculate the applied force. The initial spacing between the magnets and the Hall sensors is optimized to achieve a large displacement range using finite element method (FEM) simulations. The experimental characterization of the proposed sensor is performed for applied force in normal, shear and 45° angular direction. The force sensitivity of the proposed sensor in normal, shear and angular directions is 16 mV/N, 30 mV/N and 81 mV/N, respectively, with minimum mechanical crosstalk. The force range for the normal, shear and angular direction is obtained as 0-20 N, 0-3.5 N and 0-1.5 N, respectively. The proposed sensor shows a perfectly linear behavior and a low hysteresis error of 8.3%, making it suitable for tactile sensing and biomedical applications. The effect of the material properties of the elastomer on force ranges and sensitivity values of the proposed sensor is also discussed.

Energy poverty is a critical policymaking problem in the world, while the outlined solutions in academic and policy literature talks about the solutions, without addressing the possible cause of the problem. The interaction between labor and energy market might pave a way to address the issue. Within the context of energy poverty, this interaction might turn out to be a major roadblock in the way to attain the objectives of Sustainable Development Goals (SDGs). From this perspective, this study aims at analyzing the constituents of inequality in access to energy, and in that pursuit, it has employed Kaya-Theil Decomposition method. The study is carried out at the global level over the period of 1990-2019. The study outcomes demonstrate all the inequality components to be rising during the study period. Presence of a possible feedback loop in the association might create the Vicious Circle of Energy Poverty around the globe. This study contributes to the literature by addressing the demand-side dimension of the energy poverty issue, while using the Kaya-Theil Decomposition method as an estimator of demand-side factors. Based on the study outcomes, a policy framework has been recommended, and it is aimed at helping the nations to achieve the objectives of SDG 7, SDG 8, and SDG 10., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Newcastle disease (ND) is an infectious, highly contagious and lethal disease of avian species. It is considered that ducks are natural reservoir or carrier for Newcastle disease virus (NDV) and are resistant against different strains of NDV. Current study was designed to evaluate the pathogenesis of Newcastle disease in domestic ducks through histopathology, immunohistochemistry (IHC) and serum biochemical changes. For this purpose, eighty ducks were reared for 42 days and divided in two groups A and B. Ducks in group A were challenged with (NDV) at rate of 0.1 ml of ELD50 (virus titer 107.32/100µl) on second week of age, whereas Group B was control negative. Splenomegaly, atrophy of thymus and necrotic lesion in kidney were observed on 9th day of post infection. Hepatic degeneration and mononuclear cell infiltration were noticed in proventriculus and intestine in challenged ducks. Viral antigen detected in lungs, intestine, proventriculus and lymphoid organs of infected ducks through IHC. Albumin and total protein values were significantly low in infected groups A as compared to control group B. ALT, AST, and ALP values were significantly high in infected group A. On 5th and 7th day of post infection oropharyngeal swabs were negative for NDV and cloacal swabs were positive for NDV through Reverse transcriptase polymerase chain reaction. It is concluded that ducks are susceptible to NDV and virulent strain of NDV caused disease in ducks.

This paper presents a systematic and efficient design approach for the two degree-of-freedom (2-DoF) capacitive microelectromechanical systems (MEMS) accelerometer by using combined design and analysis of computer experiments (DACE) and Gaussian process (GP) modelling. Multiple output responses of the MEMS accelerometer including natural frequency, proof mass displacement, pull-in voltage, capacitance change, and Brownian noise equivalent acceleration (BNEA) are optimized simultaneously with respect to the geometric design parameters, environmental conditions, and microfabrication process constraints. The sampling design space is created using DACE based Latin hypercube sampling (LHS) technique and corresponding output responses are obtained using multiphysics coupled field electro-thermal-structural interaction based finite element method (FEM) simulations. The metamodels for the individual output responses are obtained using statistical GP analysis. The developed metamodels not only allowed to analyze the effect of individual design parameters on an output response, but to also study the interaction of the design parameters. An objective function, considering the performance requirements of the MEMS accelerometer, is defined and simultaneous multi-objective optimization of the output responses, with respect to the design parameters, is carried out by using a combined gradient descent algorithm and desirability function approach. The accuracy of the optimization prediction is validated using FEM simulations. The behavioral model of the final optimized MEMS accelerometer design is integrated with the readout electronics in the simulation environment and voltage sensitivity is obtained. The results show that the combined DACE and GP based design methodology can be an efficient technique for the design space exploration and optimization of multiphysics MEMS devices at the design phase of their development cycle.

The present trial explained the effect of alternative production systems on growth, morphometric and carcass traits of four different chicken genotypes. The second generation of two genotypes RNN (Rhode Island Red × Naked Neck) and BNN (Black Australorp × Naked Neck) obtained by two self-crosses (RNN × RNN = RR and BNN × BNN = BB) and two reciprocal crosses (RNN × BNN = RB and BNN × RNN = BR) were evaluated in three alternative production systems (conventional cages, enriched cages, and aviary). At the 6th week of age after sexing, a total of 600 birds, comprising 150 from each crossbred with a total of 300 pullets and 300 cockerels were divided into conventional cages, enriched cages, and aviary systems having 200 birds in each.Birds were organized into 3×4 factorial arrangements under Completely Randomized Design (3 production systems × 4 genotypes × 2 sexes × 25 birds = 600 birds). Regarding genotypes, RB and BR males showed higher (p < 0.01) carcass yield, drumstick weight, breast weight, and thigh weight than BB and RR genotypes. Females of BR genotype showed higher (p < 0.01) breast weight, thigh weight and drumstick weight. As far as production systems are concerned, higher (p < 0.01) liver weight, heart weight, breast weight, intestinal weight, drumstick weight, and thigh weight were observed in the males reared in enriched cages compared with conventional cages and aviary system. Females reared in enriched cages showed higher (p < 0.01) heart weight, breast weight, intestinal weight, drumstick weight, and thigh weight when compared with those reared in conventional cages and aviary. It is concluded that chickens (both sexes) of BR and RB genotypes had better morphological measurements and carcass traits than those of RR and BB genotype chickens. Among alternative production systems, chickens reared in enriched cages had better traits than those of reared in conventional cages and aviary during the growing phase.

World Health Organization articulated 9.8 million casualties globally in 2018 due to cancer. Cancer, as the world's second most fatal disease, can be recuperated well if diagnosed at an early stage. In this work, a gradient-based impedance synthesis of normal and cancerous cells of breast and lungs, is demonstrated numerically for early-stage cancer detection. Low-voltage single-cell level examination is employed for indomitable diagnosis. MCF-7 and MCF-10A are utilized as breast cancer and breast normal cells, respectively; likewise, SK-MES and NL-20 are utilized as lung cancer and lung normal cell. Pre-examination numerical setup validity ensured with multiple test regimes. Micro-scaled planar and nano-structured electrodes are employed individually to witness the effect of the electrode's structure during electrical impedance examination of cancer and non-cancer cell. Frequency range, at which differential impedance effect is found detectable, for breast and lung cancer cell pairs is determined to be 10 7  Hz and 10 8  Hz, respectively. By surpassing the conventional impedance spectroscopy with tedious data fitting formalities, the gradient synthesis technique for cancer detection is introduced. The gradient synthesis for cancer detection is found independent of electrode shape effect. Gradient for breast cancer cell is found to be 2 times greater than the normal breast cell while for lung cancer cell it is found to be 1.5 times greater than the normal lung cell. Our results suggest that as the frequency of applied electrical stimulus increases, impedance of cancerous cell falls at the rate almost double than its counterpart normal cell. This work provides a theoretical basis for further experimental exploration of gradient-based impedance synthesis in cancer therapy and serves as a design tool for performance optimization. Figure 1 (a) Represents electrical Impedance analysis of breast normal cell MCF-10A and breast cancer cell MCF-7 using micro-scaled planar and nano-structured electrodes. (b) Gradient impedance synthesis performed, for breast normal cell (MCF-10A) and breast cancer cell (MCF-7) likewise for lungs normal cell (NL-20) and lungs cancer cell (SK-MES), which assures clear differential effect for cancer screening. Surpassing the conventional and tedious data fitting impedance spectroscopies, a novel gradient-based impedance spectroscopy for early cancer detection is introduced. It clearly detects cancer without any data fitting formalities to find parameter of identification. Planar and nano structure electrodes are used to witness the impact of electrode shape on cell impedance. Breast normal MCF-10A and cancer cell MCF-7 as well as lungs normal NL-20 and cancer cell SK-MES are examined to reflect the efficacy of our work. Single cell level examination is performed for authenticated results., (© 2021. International Federation for Medical and Biological Engineering.)

In this work, we present a novel force-sensing device with zinc oxide nanorods (ZnO NRs) integrated with a metal-oxide-semiconductor (MOS) capacitor and encapsulated with Kapton tape. The details of the fabrication process and working principle of the integrated ZnO NRs-MOS capacitor as a force sensor and nanogenerator have been discussed. The fabricated ZnO-MOS device is tested for both the open-circuit and resistor-connected mode. For an input force in the range of 1-32 N, the open-circuit output voltage of the device is measured to be in the range of 60-100 mV for different device configurations. In the resistor-connected mode, the maximum output power of 0.6 pW is obtained with a 1 MΩ external resistor and input force of 8 N. In addition, the influence of different seed layers (Ag and ZnO) and the patterning geometry of the ZnO nanorods on the output voltage of ZnO-MOS device have been investigated by experiments. An equivalent circuit model of the device has been developed to study the influence of the geometry of ZnO NRs and Kapton tape on the ZnO-MOS device voltage output. This study could be an example of integrating piezoelectric nanomaterials on traditional electronic devices and could inspire novel designs and fabrication methods for nanoscale self-powered force sensors and nanogenerators., (Creative Commons Attribution license.)

Outcomes of kidney transplant (KT) patients with pre-transplant pulmonary hypertension (PH) are poorly understood. PH patients are often considered high risk and excluded from KT. We investigated the association of pre-transplant PH with KT recipient's outcomes. A single-center, retrospective study that reviewed all patients transplanted from 2010 to 2016, who had a transthoracic echocardiogram (TTE) before KT and at least one TTE post-KT. The TTE closest to the KT was used for analyses. PH is defined as pulmonary artery systolic pressure (PASP) ≥ 40 mm Hg. Of 204 patients, 61 had PASP ≥ 40 mm Hg (with PH) and 143 had PASP < 40 mm Hg (without PH) prior to KT. No statistically significant differences existed between the two groups in baseline demographics, renal failure etiologies, dialysis access type, and cardiovascular risk factors. The mean difference in pre-KT PASP was 18.1 ± 7 mm Hg (P < 0.001). Patients with PH had a statistically significant decrease in PASP post-KT compared to the patients without PH with a mean change of -7.03 ± 12.28 mm Hg vs. + 3.96 ± 11.98 mm Hg (p < 0.001), respectively. Moderate mitral and moderate-severe tricuspid regurgitation were the only factors found to be independently associated with PH (p = 0.001) on multivariable analysis. No statistically significant difference was notable in patient survival, graft function, and creatinine post-KT in both groups. PH pre-KT particularly mild-moderate PH did not adversely affect intermediate (90-day) and long-term allograft and patient survival. Patients with mild-moderate PH should not be excluded from KT.

This research paper presents design and analysis of the multi-jaw microgripper that can manipulate microbiological organisms and species, cell probing and measurement, biomedical sample sorting, and preparation. Four jaws, actuated with a single thermal chevron actuator, can grip microbiological species ranging from 300 to 700 μm, 1 to 340 μm, 100 μm pool, and 1 to 120 μm spongy cells, respectively. Jaws are designed in such a way that they can grip regular, irregular, and spongy shaped biological species and their organelles. Parametric analysis of the microgripper exhibited that at 10 V, the efficiency of the thermal actuator is at maximum with respect to displacement, force, and temperature. To enhance displacement to voltage ratio and increase the energy efficiency, a class 3 lever mechanism has been incorporated. The amplification factors at four jaws are 17.21, 13.82, 4.02, and 4.93, respectively. For controlled application of the force to microspecies, two electrostatic force sensors have been amalgamated with jaws having capacitive sensitivities of 1.59 nf/μm, 1.91 nf/μm, 17 nf/μm, and 14.5 nf/μm, respectively. Electrothermal, static, and electrostatic analyses have been carried out with the finite element methods based software IntelliSuite ® . Stress magnitudes are within the limits of structural integrity of silicon having a factor of safety 2.5. Thermal analysis revealed that at a differential voltage of 10 V, the maximum temperature goes up to 425 °C. Buckling analysis results depicted that the critical load for the thermal actuator is 241 μN with the buckling load factor greater than unity. This paper focuses on microbiological applications only; however, the designed microgripper can be used to manipulate micro-objects, microstructures, microelectronics parts, and micro assembly.

This paper presents a new design of microelectromechanical systems (MEMS) based low-g accelerometer utilizing mode-localization effect in the three degree-of-freedom (3-DoF) weakly coupled MEMS resonators. Two sets of the 3-DoF mechanically coupled resonators are used on either side of the single proof mass and difference in the amplitude ratio of two resonator sets is considered as an output metric for the input acceleration measurement. The proof mass is electrostatically coupled to the perturbation resonators and for the sensitivity and input dynamic range tuning of MEMS accelerometer, electrostatic electrodes are used with each resonator in two sets of 3-DoF coupled resonators. The MEMS accelerometer is designed considering the foundry process constraints of silicon-on-insulator multi-user MEMS processes (SOIMUMPs). The performance of the MEMS accelerometer is analyzed through finite-element-method (FEM) based simulations. The sensitivity of the MEMS accelerometer in terms of amplitude ratio difference is obtained as 10.61/g for an input acceleration range of ±2 g with thermomechanical noise based resolution of 0.22 μμg/Hz and nonlinearity less than 0.5%.

This paper presents microfabrication process-driven design of a multi-degree of freedom (multi-DoF) non-resonant electrostatic microelectromechanical systems (MEMS) gyroscope by considering the design constraints of commercially available low-cost and widely-used silicon-on-insulator multi-user MEMS processes (SOIMUMPs), with silicon as a structural material. The proposed design consists of a 3-DoF drive mode oscillator with the concept of addition of a collider mass which transmits energy from the drive mass to the passive sense mass. In the sense direction, 2-DoF sense mode oscillator is used to achieve dynamically-amplified displacement in the sense mass. A detailed analytical model for the dynamic response of MEMS gyroscope is presented and performance characteristics are validated through finite element method (FEM)-based simulations. The effect of operating air pressure and temperature variations on the air damping and resulting dynamic response is analyzed. The thermal stability of the design and corresponding effect on the mechanical and capacitive sensitivity, for an operating temperature range of -40 °C to 100 °C, is presented. The results showed that the proposed design is thermally stable, robust to environmental variations, and process tolerances with a wide operational bandwidth and high sensitivity. Moreover, a system-level model of the proposed gyroscope and its integration with the sensor electronics is presented to estimate the voltage sensitivity under the constraints of the readout electronic circuit.

This study aims to share the results of haemorrhoidal artery ligation under direct vision in the management of symptomatic haemorrhoids. We conducted a case series of 70 patients at Combined Military Hospital Rawalpindi & Quetta, from January 2015 to October 2017. All patients underwent Haemorrhoidal Artery Ligation (HAL) and Recto Anal Repair (RAR). Ligation of superior haemorrhoidal artery was done under direct vision following manual palpation. Patients were followed up postoperatively at 1, 3 and 6 months. At 1 month follow up, all 70 (100%) patients were pain free. Post operative bleeding was observed in 7 (10%) patients but did not require surgical intervention. Sixty two (89%) patients were able to return to their daily activities 1 week after surgery and 57 (81%) resumed military duties or joined their work place at 2 weeks. 70 (100%) patients were asymptomatic and 45 (64%) highly satisfied with their surgery at 3 months. This increased to 53 (75%) at 6 months. 48 (69%) said that they would recommend this procedure to someone else. Prolapse recurrence was observed in 1(1.42%) patient 6 months post operatively which was dealt by band ligation. All patients completed follow-up at 1, 3 and 6 months. HAL is a simple yet safe technique with few complications, acceptable patient satisfaction and early return to work.

Introduction: Anchorage conservation in orthodontics has always been a challenge., Objective: The aim of this current study was to find out the failure rate of miniscrews inserted in the maxillary tuberosity (MT) region., Methods: This pilot study consisted of 40 patients (23 female, 17 male; mean age = 20.1±8.9 years) that had received 60 MT miniscrews for orthodontic treatment. Clinical notes and pictures were used to find out the primary outcome of miniscrew failure. Independent failure factors were also investigated. Logistic regression analysis was done for predictor's relation with MT miniscrews failure., Results: There was no significant correlation in failure rate according to various predictor variables, except for miniscrews installed by lesser experienced operators, which showed significantly more failure. The odds ratio for miniscrew failure placed by inexperienced operators was 4.16., Conclusion: A 26.3% failure rate of mini-implants inserted in the MT region was observed.

Objective: Anchorage reinforcement is an important issue in orthodontic treatment. There is a lack of evidence regarding the failure rate of mini-implants inserted in the retromolar (RM) area, therefore the purpose of this present study was to evaluate the failure rates of mini-implants inserted in the RM area and to evaluate the factors affecting their stability., Material and Methods: This retrospective cohort study of 102 patients (52 female, 55 male; mean age: 18.6years; SD: 5.2years) that had received 110 RM mini-implants for orthodontic treatment from 1.2.2012 to 1.6.2017 was conducted after IRB approval at the department of orthodontics. Clinical notes and photographic images of the patients were analysed to evaluate the dependent and independent variables. The primary outcome was mini-implant failure. Independent variables of patient related factors, mini-implant related factors, orthodontic related factors, surgical related factors, and maintenance-related factors were evaluated by logistic regression models for association to failure rates., Results: A 23.2% failure rate of mini-implants inserted in the RM area was observed. The patient's right side and inflammation were significantly associated with RM mini-implant failure. The odds ratios (relative risk) for mini-implant failure in the right side, and in mini-implants with inflammation around them were 0.166 and 0.188, respectively., Conclusions: Failure rate for RM mini-implants were found to be 23.2%. To minimize RM mini-implant failure, clinicians should attempt to reduce inflammation around the mini-implants, especially for mini-implants placed on the right RM area., (Copyright © 2019 Elsevier Masson SAS. All rights reserved.)

Background: Exponentially increasing numbers of NGS-based epigenomic datasets in public repositories like GEO constitute an enormous source of information that is invaluable for integrative and comparative studies of gene regulatory mechanisms. One of today's challenges for such studies is to identify functionally informative local and global patterns of chromatin states in order to describe the regulatory impact of the epigenome in normal cell physiology and in case of pathological aberrations. Critically, the most preferred Chromatin ImmunoPrecipitation-Sequencing (ChIP-Seq) is inherently prone to significant variability between assays, which poses significant challenge on comparative studies. One challenge concerns data normalization to adjust sequencing depth variation., Results: Currently existing tools either apply linear scaling corrections and/or are restricted to specific genomic regions, which can be prone to biases. To overcome these restrictions without any external biases, we developed Epimetheus, a genome-wide quantile-based multi-profile normalization tool for histone modification data and related datasets., Conclusions: Epimetheus has been successfully used to normalize epigenomics data in previous studies on X inactivation in breast cancer and in integrative studies of neuronal cell fate acquisition and tumorigenic transformation; Epimetheus is freely available to the scientific community.

Introduction: We compared the pre and post-treatment quality of life in head and neck cancer (HNC) patients and identified factors that could improve the quality of life in such patients.   Methods: The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30 (EORTC QLQ-C30) questionnaire was administered to 84 patients' pre and post-treatment. Patients who had non-metastatic, measurable, and untreated HNCs were invited, provided that their age was below 80 years. We did not discriminate based on treatment modality, stage of cancer, or co-morbidities. Patients who were mentally incapacitated, with secondary or recurrent HNC, distant metastasis, skin cancer, congenital anomaly of the head and neck, chronic illness, or any previous or current psychiatric illness were excluded from the study. A high mean score on the functional scale and a low score on symptom scale signify a better quality of life. We used the dependent t-test to compare pre and post-treatment scores., Results: We found no statistically significant differences in any variables, except the four symptom scales of diarrhoea, constipation, nausea/vomiting, and financial difficulty. All of these variables had increased mean scores with p values of < 0.001. Also, we found no statistical significance (p = 0.250) when comparing the pre-treatment (59.4 ± 18.3) and post-treatment (61.2 ± 16.2) scores for the global health status., Conclusion: We found no improvement in the quality of life in HNC patients despite intervention. In fact, diarrhoea, constipation, nausea/vomiting, and financial difficulty of these patients worsened post-treatment., Competing Interests: The authors have declared that no competing interests exist.

Congenital massive hiatus hernia (CMHH) is an uncommon disorder during childhood. It can be associated with grave complications especially if presented in the highest grade; type IV, when the hernia contains other intra-peritoneal organ beside the stomach through a large hiatus defect. The insidious form of clinical presentation can be deceptive in diagnosis and may mimic congenital diaphragmatic hernia or other chest pathologies. The basic principle of surgical repair is to reduce the herniated organs, excise the hernia sac, and repair the crural defect and to add anti-reflux procedure with or without gastropexy. Traditionally, this has been done by open approach. Nowadays, the minimally invasive approach is the preferred method of treatment. A sixteen-month-old boy with history of recurrent respiratory symptoms was diagnosed with CMHH type IV for which laparoscopic repair was performed. Few reports in using minimally invasive technique in the management of CMHH in the pediatric age group are present in the literature, to the best of our knowledge type IV had never been described in young infants. We present a new case repaired by laparoscope in a young infant with CMHH type IV from the Middle East.

Aim: In the literature, there is evidence suggesting an association between substance use and psychosis. However, little is known about substance use in those who may be in the pre-psychotic phase, that is, those who are putatively prodromal are considered to be at clinical high risk (CHR) of developing psychosis., Methods: We conducted a review of publications measuring patterns and rates of substance use in CHR for psychosis individuals and the effects on the transition to psychosis., Results: Of 5527 potentially relevant research papers, 10 met inclusion criteria of CHR subjects and specifically mentioned substance use in the sample. The results of these studies varied. Cannabis, alcohol and tobacco/nicotine were reported as the most commonly used substances. There was limited information on the changes in patterns of use over time. Two out of the ten studies found a significant association between the use of substances and subsequent transition to psychosis. In one of these studies, substance abuse was a predictor of psychosis when included as a variable in a prediction algorithm. In the other study, the abuse of cannabis and nicotine was associated with transition to psychosis., Conclusions: We found limited evidence to suggest that increased rates of substance use may be associated with transition to psychosis. However, further prospective research examining the association between substance use and transition to psychosis is required before any firm conclusions can be made., (© 2013 Wiley Publishing Asia Pty Ltd.)

Aim: There is evidence to suggest that perceived discrimination may be associated with psychosis. Less is known about its potential impact on those at clinical high risk (CHR) for psychosis. The aim of this study was to determine the prevalence of perceived discrimination in a CHR sample and its possible relationship to attenuated positive symptoms and negative self-beliefs., Methods: Participants were 360 CHR individuals and 180 healthy controls. Assessments included a self-report measure of perceived discrimination, the Scale of Prodromal Symptoms and the Brief Core Schema Scale., Results: CHR participants reported significantly more perceived discrimination. Perceived discrimination was significantly associated with negative schemas, but not with attenuated positive symptoms., Conclusions: These results suggest that individuals at CHR for psychosis endorse a higher level of perceived discrimination, which is associated with increased negative schemas, but not attenuated positive symptoms., (© 2013 Wiley Publishing Asia Pty Ltd.)

Background: Cognitive deficits are a core symptom of schizophrenia, severely debilitating and untreated by current medication. However, to date there is limited research focusing on the precise nature of the cognitive disturbances at first episode in ethnic populations. Improved understanding of this will allow improved approaches to therapy. The aim of this study was to investigate cognitive function with a first episode of psychosis South Asian patients., Methods: Twenty South Asian first episode psychosis patients and 15 healthy South Asian matched controls were recruited. All were second generation South Asian people living in the UK. Subjects who took part in the study completed the Positive and Negative Syndrome Scale (patient group), the Wechsler Test of Adult Reading and a battery of neuropsychological assessments to assess specific domains of cognition of relevance to Measurement and Treatment Research to Improve Cognition in Schizophrenia using the Cambridge Neuropsychological Test Automated Battery (CANTAB) (all groups)., Results: Results show that first episode patients performed significantly worse than controls across all cognitive domains tested using CANTAB. Significant impairments were found in tests of visual and spatial memory, executive function, working memory, spatial planning and attention. Importantly, a number of cognitive performance indices (visual memory, spatial memory, executive function) were positively correlated with the severity of negative symptoms., Conclusion: We demonstrate that first episode South Asian patients display significant and specific cognitive deficits with evidence to support an association between negative symptoms and certain cognitive domains at first episode in this patient population.

Introduction: The aim of the study was to look into the feasibility, safety, efficacy and cost-effectiveness of utilising the remains of central venous catheters in infants from a developing country., Methods: Between June 2005 and December 2006, 96 neonates and infants with various illnesses and required the insertion of central venous access, were divided into two groups; those who required it for a short to medium term (44 patients) received a piece of the remains of catheters, and those who required conventional catheter insertion intended for long-term use (52 patients) received a regular catheter. The same principle of insertion was used as for regular central venous access. The external jugular vein was used when possible or the internal jugular vein was used otherwise. After appropriate insertion, the catheter was mounted on an appropriately-sized cannula. A three-way stopcock connection was used to minimise manipulation of the cannula. Postoperative care was the same as for routine central venous lines. Complications encountered in the two groups were recorded and analysed., Results: Of the short- and medium-term catheters, 32 out of 44 patients (72.7 percent) completed the intended course of treatment successfully, and of the long-term catheters, 42 out of 52 patients (80.8 percent) completed the treatment successfully. Recorded complications were dislodgement, thrombosis and infection. These were, in the short-term group, as follows: five (11.4 percent), three (6.8 percent) and four (9.1 percent), respectively; and for the long-term group, two (3.8 percent), four (7.7 percent) and four (7.7 percent), respectively., Conclusion: Utilisation of the remains of venous catheters in properly-selected patients for short- and medium-term treatment is feasible, cost-effective and safe, and the rates of complications are comparable to cases with conventional catheter insertion.