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Abstract Background Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) are widespread, treatable sexually transmitted infections (STIs) of global significance, affecting millions annually. Left untreated, they pose significant risks, including pelvic inflammatory disease (PID), infertility, and complications during pregnancy. The U.S. Centers for Disease Control recommends annual chlamydial screening for sexually active women to address these risks. Responding to this global challenge, the World Health Organization (WHO) has formulated a global health sector strategy on sexually transmitted infections, outlining priority actions to strengthen STI responses in countries. However, STI epidemiological studies encounter challenges in developing nations like Egypt due to socio-cultural factors, poverty, and limited diagnostic facilities. In Egypt, STI diagnosis primarily relies on clinical presentations, lacking structured screening programs for CT and NG. This study’s main objective is to estimate the prevalence of Chlamydial and gonorrheal infections, advocating for supportive STI strategies in Egypt. Additionally, the study aims to provide a foundation for national prevalence estimates of CT and NG infections. Methods A cross-sectional study encompassed five antenatal clinics in different regions of Egypt. A total of 1040 pregnant women attending these clinics were consecutively sampled. Data collection involved structured questionnaires, and urine samples were subjected to the GeneXpert CT/NG qualitative real-time PCR test. Results The prevalence of CT infections was 0.29% (95% CI, 0.10–0.86%), with no detected NG infections. The three CT-positive cases were distributed across different recruitment centers, with no statistically significant differences observed between infected and non-infected participants. Notably, 40.3% of recruited women reported gynecological symptoms, primarily discharge. Additionally, 9.6% had undergone previous testing for sexually transmitted infections, with 8.2% receiving positive results. Conclusions This study provides valuable data on the prevalence of CT and NG infections among pregnant women attending ANC clinics in Egypt. The findings underscore the importance of ongoing surveillance, routine screening, and targeted interventions to ensure the reproductive health and well-being of pregnant women and their infants. Further research is warranted to explore the broader implications of STIs in different populations and to inform evidence-based guidelines for screening and management in diverse settings. Trial registration: IRB no.: 17,400,017; WHO ERC Protocol Id. A66005.

The occurrence of triple kidneys, involving a normal kidney and a malrotation horseshoe kidney, is an extremely infrequent condition. This case report demonstrates a triple, mal-rotated horseshoe kidneys coexist with an upper junction stone, alongside a normal left kidney showing normal Doppler vascularity, as observed in an ultrasound examination for 18-year-old male complaints of diffuse periumbilical pain and burning micturition. Laboratory investigation revealed normal creatinine level, and presence of urinary tract infection. Management option for this case are antibiotic therapy and surgical intervention for horseshoe kidney stone. Regular monitoring of kidney function, other radiographic imaging studies, and follow-up to assess the efficacy of the treatment, and detect any further complications are essential.

Summary: Staphylococcus aureus is a major human pathogen, yet the immune factors that protect against infection remain elusive. High titers of opsonic IgG antibodies, achieved in preclinical animal immunization studies, have consistently failed to provide protection in humans. Here, we investigate antibody responses to the conserved S. aureus surface glycan wall teichoic acid (WTA) and detect the presence of WTA-specific IgM and IgG antibodies in the plasma of healthy individuals. Functionally, WTA-specific IgM outperforms IgG in opsonophagocytic killing of S. aureus and protects against disseminated S. aureus bacteremia through passive immunization. In a clinical setting, patients with S. aureus bacteremia have significantly lower WTA-specific IgM but similar IgG levels compared to healthy controls. Importantly, low WTA-IgM levels correlate with disease mortality and impaired bacterial opsonization. Our findings may guide risk stratification of hospitalized patients and inform future design of antibody-based therapies and vaccines against serious S. aureus infection.

Introduction: Systemic lupus erythematosus (SLE) is an autoimmune disease that affects both men and women differently and has a variety of multisystemic symptoms. One of the diseases most often affected target organs is the skin. Different ethnic and racial groupings may display variations in disease incidence, clinical heterogeneity, and severity depending on environmental, cultural, or genetic factors. This study is conducted to determine the prevalence of SLE’s cutaneous symptoms and their relationship to organ involvement. Materials and Methods: Data were gathered for this study from the patient chart, the study design was the retrospective chart review after the consent of the patients and obtaining an ethical approval, The study was carried out in Aseer Central Hospital, Abha Saudi Arabia Results: Out of a total of 100 patients 92% were females while 8% were males. The mean (SD) of the age of the respondent was 38.3 (8.5). 89.2 of the respondents had skin manifestations Conclusion: A thorough understanding of SLE skin lesions will aid in the accurate identification of the condition and in the effective therapy of lupus patients. In order to more accurately diagnose cutaneous lesions in SLE patients, we need more dermatology and rheumatology clinics that combine expertise together.

BackgroundInflammatory cytokines play key pathogenic roles in liver fibrosis. IL-15 is a proinflammatory cytokine produced by myeloid cells. IL-15 promotes pathogenesis of several chronic inflammatory diseases. However, increased liver fibrosis has been reported in mice lacking IL-15 receptor alpha chain (IL-15Rα), suggesting an anti-fibrogenic role for IL-15. As myeloid cells are key players in liver fibrosis and IL-15 signaling can occur independently of IL-15Rα, we investigated the requirement of IL-15 and IL-15Rα in liver fibrosis.MethodsWe induced liver fibrosis in Il15–/–, Il15ra–/– and wildtype C57BL/6 mice by the administration of carbon tetrachloride (CCl4). Liver fibrosis was evaluated by Sirius red and Mason’s trichrome staining and α-smooth muscle acting immunostaining of myofibroblasts. Gene expression of collagens, matrix modifying enzymes, cytokines and chemokines was quantified by RT-qPCR. The phenotype and the numbers of intrahepatic lymphoid and myeloid cell subsets were evaluated by flow cytometry.ResultsBoth Il15–/– and Il15ra–/– mice developed markedly reduced liver fibrosis compared to wildtype control mice, as revealed by reduced collagen deposition and myofibroblast content. Il15ra–/– mice showed further reduction in collagen deposition compared to Il15–/– mice. However, Col1a1 and Col1a3 genes were similarly induced in the fibrotic livers of wildtype, Il15–/– and Il15ra–/– mice, although notable variations were observed in the expression of matrix remodeling enzymes and chemokines. As expected, Il15–/– and Il15ra–/– mice showed markedly reduced numbers of NK cells compared to wildtype mice. They also showed markedly less staining of CD45+ immune cells and CD68+ macrophages, and significantly reduced inflammatory cell infiltration into the liver, with fewer pro-inflammatory and anti-inflammatory monocyte subsets compared to wildtype mice.ConclusionOur findings indicate that IL-15 exerts its profibrogenic role in the liver by promoting macrophage activation and that this requires trans-presentation of IL-15 by IL-15Rα.

Abstract Salinity stress has detrimental effects on various aspects of plant development. However, our understanding of strategies to mitigate these effects in crop plants remains limited. Recent research has shed light on the potential of sodium acetate as a mitigating component against salinity stress in several plant species. Here, we show the role of acetate sodium in counteracting the adverse effects on oat (Avena sativa) plants subjected to NaCl-induced salinity stress, including its impact on plant morphology, photosynthetic parameters, and gene expression related to photosynthesis and antioxidant capacity, ultimately leading to osmoprotection. The five-week experiment involved subjecting oat plants to four different conditions: water, salt (NaCl), sodium acetate, and a combination of salt and sodium acetate. The presence of NaCl significantly inhibited plant growth and root elongation, disrupted chlorophylls and carotenoids content, impaired chlorophyll fluorescence, and down-regulated genes associated with the plant antioxidant defense system. Furthermore, our findings reveal that when stressed plants were treated with sodium acetate, it partially reversed these adverse effects across all analyzed parameters. This reversal was particularly evident in the increased content of proline, thereby ensuring osmoprotection for oat plants, even under stressful conditions. These results provide compelling evidence regarding the positive impact of sodium acetate on various plant development parameters, with a particular focus on the enhancement of photosynthetic activity.

Personality analysis allows the experts to get insights into an individual’s conduct, vulnerabilities, and prospective capabilities. Some common methods employed for personality prediction include text analysis, social media data, facial expressions, and emotional speech extraction. Recently, some studies have utilized the big five model to predict personality traits using non-verbal cues (gaze score, body motion, head motion). However, these studies mostly target only three aspects of the big five mode. None of the studies so far have used non-verbal cues to target all five traits (extraversion, openness, neuroticism, agreeableness, and conscientiousness) of the Big Five model. In this paper, we propose a multi-modal system that predicts all five personality traits of the Big Five model using non-verbal cues (facial expressions, head poses, body poses), 44-item Big Five Inventory (BFI) questionnaire, and expert analysis. The facial expression module utilizes the Face Emotion Recognition Plus (FER+) dataset trained with Convolution Neural Network (CNN) model achieving 95.14% accuracy. Evaluating 16 subjects in verbal interaction with humanoid robot NAO, we combined questionnaire feedback, human-robot interaction data, and expert perspectives to deduce their Big Five traits. Findings reveal 100% accuracy in personality prediction via expert insights and the system, and 75% for the questionnaire-based approach.

Purpose: A growing number of refugee groups are seeking care within the U.S. health care system for medical, psychological, and social needs. Research is limited in understanding refugee-specific conceptualizations of helping relationships and provider characteristics that improve interactions in health systems. This study aimed to identify provider characteristics that facilitate engagement and helpfulness in a refugee-specific population from refugee participant voices to inform future practices of health care clinics. Methods: Semi-structured interviews with refugee participants were conducted to assess 1) experiences moving on from difficult experiences, 2) engagement with the health system, and 3) provider characteristics that facilitated engagement and healing. Qualitative data were analyzed using a grounded theory approach. Results: An emergent theory was revealed on refugee-defined provider characteristics that facilitated healing and engagement in the health system. Providers who support an individual’s story to be told, show awareness of barriers to accessing resources and prioritization of addressing barriers, maintain cultural humility, and demonstrate compassion, empathy, warmth, and openness toward patient engagement were the primary characteristics that facilitated engagement and healing. Conclusions: Utilization of engagement strategies by providers at the onset of treatment is critical to providing culturally sensitive health care. Nonspecific but essential provider characteristics are thought to improve relational dynamics, trust-building, and overall engagement in the U.S. health care system from the perspective of refugee participants.

Abstract Background Access to essential medicines is a critical component of universal health coverage. However, the availability of essential medicines in Sudan isn’t well studied. As well, most Sudanese people lack health insurance, making out-of-pocket spending the primary source of drug financing. Therefore, the affordability of medicines in Sudan is questionable, with only 30% of the total population being covered by a public health service or public health insurance. We undertook this study to assess the availability and prices of essential medicines in public-sector health facilities in Khartoum state. Moreover, this study aims at assessing patients’ perceived affordability of essential medicines, and accommodation and acceptability of the public facility. Methods A cross-sectional study was carried out at 30 primary healthcare facilities’ drug dispensaries across three districts in Khartoum state. Within each Centre’s dispensary unit, a standardized checklist evaluated the availability and affordability of 21 essential medicines selected from Sudan’s national essential medicines list and assessed their storage conditions. Furthermore, 630 patients were selected from all dispensary units for an exit interview that assessed their perceived accessibility, acceptability, accommodation, and affordability of essential medicines. Data were collected through the Kobo toolbox and analyzed using SPSS version 26. Results Participants’ ratings of accessibility, affordability, accommodation, and acceptability were 3.7/5, 1.5/4, 5/6, and 5.4/6, respectively, with a 26.7% full access and weak correlation between some of the indices. The overall availability of adults and pediatric medicines was 36.8% 6.7%, respectively. Cost of a single course of treatment for 10 and 16 drugs out of the 19 drugs consumed exceeds the daily wage of insured and uninsured patients, with a median price ratio of 16.4 and 62.8, respectively. Moreover, the dispensary area conditions were found to be of good quality, yet the storerooms were not functioning in 40% of the outlets. Conclusion Patients had limited access to their needed drugs due to high prices and physical unavailability, and primary healthcare capacities are not meeting the demands of citizens. The outcomes for the patients’ access variables (accessibility, accommodation, acceptance, and affordability) are comparable to those in countries with low incomes. Ensuring access to free medicines is likely to improve patients’ satisfaction with healthcare services and reduce private expenditure on medicines, which is a long-term, sustainable way towards universal health coverage in Sudan.

Abstract Facilitated purification of proteins, at a low cost and a short time, is one of the key steps in the industrial production of recombinant proteins. In the current study, polydopamine nanoparticles (PDA-NPs) are considered in the synthesis of magnetic beads for purifying recombinant proteins due to advantages such as biocompatibility/ biodegradability, easy synthesis, as well as the ability to directly chelate metal ions. They were synthesized in Tris buffer (pH: 8:5), then chelated with Fe3+(20 mg) and Ni2+ ions at concentrations of 2, 3, 5, and 7 mg/ml. Prepared nanoparticles were characterized through scanning electron microscopy (SEM), ultraviolet-visible spectroscopy (UV-vis), dynamic light scattering (DLS), Inductively Coupled Plasma (ICP), and vibrating sample magnetometer (VSM). The size distribution of the particles was reported in the narrow range of 120–140 nm and 200 to 220 nm by the SEM image and DLS analysis, respectively. The chelation of ions on the surface of the nanoparticle was confirmed by the ICP technique with a magnetization of 35.42 emu/g. The highest adsorption rate of Ni2+ ions to polydopamine was obtained at a ratio of 1.4. The SDS-PAGE and western blot analysis confirmed the purification of eGFP and Hsp40 by PDA/Fe3+/Ni2+ at 26 and 40 kDa compared to the commercial nickel column. Moreover, the concentration of purified eGFP by PDA/Fe3+/Ni2+ was reported 138.83 µg/ml by the fluorescent signals, which is almost equal to or more than the protein purified by commercial Ni-NTA column (108.28 µg/ ml). The stability of PDA/Fe3+/Ni2+ has also been evaluated by ICP-OES for 10 days, and the result suggested that PDA magnetic beads were stable. Therefore, it can be concluded that PDA/Fe3+/Ni2+ have the ability to purify recombinant proteins in one less step and shorter time.

Periodontal disease is a common disease and may affect 90% of people, and is classified into gingivitis and periodontitis. The objective of this study was if the deficiency of some vitamins and trace elements affects the increase in exposure to periodontal diseases or to find out whether the periodontal disease can cause changes in the blood level of some nutrients and their role in reducing periodontal diseases. For this purpose, samples were taken from the University of Baghdad, College of Dentistry, Department of Periodontics, in the Periodontics clinic, including a group of 40 patients’ periodontitis, as well as another 40 patients’ gingivitis, and 40 healthy periodontium as control. There was no overall sickness in any of the groups. Periodontal clinical data were recorded, and serum parameter levels were assessed. The findings showed that plaque index, bleeding on probing, probing pocket depth, and clinical attachment loss were significantly greater (P< 0.01) in patients compared to the control. Levels of vitamin C and D were significantly decreased in patients compared with control (P

Pseudomonas aeruginosa, a gram-negative bacterium, is notorious for its innate resistance to many antibiotics. Carbapenems are broad-spectrum antibiotics often used to treat severe P. aeruginosa infections. However, the emergence and proliferation of carbapenem-resistant P. aeruginosa (CRPA) strains have become a grave global health concern. This study examined the co-occurrence of four major carbapenemase genes, namely blaNDM, blaVIM, blaKPC, and blaOXA-48, in clinical isolates of P. aeruginosa. Using standard microbiological methods,150 P. aeruginosa clinical isolates were collected and identified, and antimicrobial susceptibility testing was conducted following Clinical and Laboratory Standards Institute guidelines. Polymerase chain reaction (PCR) with gene-specific primers was used to detect the presence of carbapenemase genes. Among the 150 P. aeruginosa clinical isolates, 62(41.3%) were found to be carbapenem-resistant. The most detected carbapenemase genes were blaKPC (49%), blaNDM (31%), blaOXA-48 (22%), and blaVIM (9%). Notably 13(12.9%) isolates carried two carbapenemase genes. The combination of blaKPC and blaNDM genes was found in eight isolates, two isolates carried blaKPC and blaVIM, and three isolates carried blaOXA-48 and blaNDM. Four isolates (6.5%) harbored three carbapenemase genes. Co-occurrence of blaNDM, blaVIM, blaKPC, and blaOXA-48 was observed in four isolates (2.8%). Our findings highlight the alarming prevalence of carbapenemase genes, particularly blaNDM and blaKPC, in clinical isolates of P. aeruginosa. The co-occurrence of multiple carbapenemase genes in the same isolate raises concerns about the potential for horizontal gene transfer and dissemination of multidrug-resistant P. aeruginosa strains in clinical settings. Further research is needed to elucidate the molecular mechanisms underlying the co-occurrence of carbapenemase genes and their impact on the clinical outcomes of P. aeruginosa infections. Urgent measures, such as enhanced surveillance, infection control protocols, and antibiotic stewardship programs, are imperative to combat the emergence and spread of CRPA strains.

Financial markets are increasingly interlinked. Therefore, this study explores the complex relationships between the Tadawul All Share Index (TASI), West Texas Intermediate (WTI) crude oil prices, and Bitcoin (BTC) returns, which are pivotal to informed investment and risk-management decisions. Using copula-based models, this study identified Student’s t copula as the most appropriate one for encapsulating the dependencies between TASI and BTC and between TASI and WTI prices, highlighting significant tail dependencies. For the BTC–WTI relationship, the Frank copula was found to have the best fit, indicating nonlinear correlation without tail dependence. The predictive power of the identified copulas were compared to that of Long Short-Term Memory (LSTM) networks. The LSTM models demonstrated markedly lower Root Mean Squared Error (RMSE), Mean Absolute Error (MAE), and Mean Absolute Scaled Error (MASE) across all assets, indicating higher predictive accuracy. The empirical findings of this research provide valuable insights for financial market participants and contribute to the literature on asset relationship modeling. By revealing the most effective copulas for different asset pairs and establishing the robust forecasting capabilities of LSTM networks, this paper sets the stage for future investigations of the predictive modeling of financial time-series data. The study highlights the potential of integrating machine-learning techniques with traditional econometric models to improve investment strategies and risk-management practices.

The aim of the current study was to assess the association between the mean level of procalcitonin (PCT), demographic characteristics, and the symptoms, duration, and severity of COVID-19. Methods and Results: This cross-sectional study included patients with a confirmed COVID-19 infection who visited the Thumbay Hospital in Ajman (UAE) between March and June 2022. A total of 231 COVID-19-positive patient records (170[73.6%] males and 61[26.4%] females) were included in the study. PCT levels were measured upon admission using the Beckman Coulter – UniCel DxI 800 Access Immunoassay System. The mean patients’ age was 47.44±13.460 years, and the length of stay in the hospital was 11.21±8.145 days. The PCT mean level was 0.545±1.739 ng/ml with minimum and maximum values of 0.010 ng/ml and 16.667 ng/ml, respectively. In terms of COVID-19 severity, patients were categorized into mild (121[52.4%]), moderate (59[25.5%]), and severe 51(22.1%]). We found no association between age categories and COVID-19 severity. There was a statistically significant difference in the mean PCT level among the severity groups. The mean PCT level increased with increasing severity of COVID-19: 0.0569±0.0324, 0.1736±0.0594, and 2.134±3.254 ng/ml for mild, moderate, and severe COVID-19, respectively (P=0.0000) There was a statistically significant, moderate positive correlation between PCT level and disease severity (r=0.433, P=0.001). The linear regression results revealed that PCT level is a significant factor in COVID-19 severity. Conclusion: The current study demonstrates that the serum PCT level may be a marker of disease severity in patients infected with SARS-CoV-2.

The aim of this study was to compare the different imaging procedures (micturating cystourethrogram [MCUG], nuclear medicine [NM], and ultrasound [US]) in the evaluation of vesicoureteral reflux (VUR). Methods and Results: A retrospective study was conducted to compare different radiological investigations in the characterization and grading of VUR. In total, 93 patients (53 boys and 40 girls) with a mean age of 2.2 years were referred to the radiology department for exclusion or diagnosis of VUR. Age, sex, the pathway of obstruction, presence of VUR, degree of obstruction with VUR, presence of hydronephrosis, calcification, and grading according to MCUG were the main variables collected for US, NM, and MCUG. Our results show that according to the frequency distribution, MCUG showed a higher sensitivity for detecting VUR and the degree of obstruction than the other imaging tools. US showed a higher sensitivity for the presence of hydronephrosis. The grading of VUR was more effectively detected by MCUG than by US and NM grading. We revealed a statistical association between VUR grades and the gender of a study's population, with a higher frequency of grade 5 in boys than in girls (P=0.037). Grades 3-5 showed higher frequencies in MCUG, in which the younger patients (0–50 weeks old) were more affected by obstruction and VUR than the other age groups. Moderate hydronephrosis was higher in boys than in girls (P=0.006). Conclusion: The grading of VUR is more effectively detected by MCUG than by US and NM grading.

إنّ الكتابة النسائية –من زمن بعيد- تمثل مصطلحاً غير ثابت وغير مستقر، بسبب ما يثيره هذا المصطلح من اعتراضات وما يسجَّل حوله من تحفّظات، فقد ظهرت في القرن العشرين دعوات تنادي بالنسوية كنشاط اجتماعي ثقافي، وأُطلق على هذه الدعوات مصطلح "الأدب النسائي"، اعتماداً على الاختلاف القائم بين النقاد والدارسين حول تحديد مفهوم هذا المصطلح، إذ تساءل بعضهم هل المقصود به هو ذلك الأدب الذي انتجته أقلام نسائية حتى في الأغراض التي طرقها الرجل؟ أم هو ما تكتبه المرأة دعوةً منها إلى التمرّد على ذكورية المجتمع؟. وقد لفت هذا التساؤل تنبّه الباحثين والمفكرين إلى تاريخية هذا الموضوع، الذي يتضمّن نشأة هذه الظاهرة وتطورها عبر مرور الزمن. وهناك ثلاثة مواقف من مصطلح الأدب النسوي، فهي عند فريق تشير إلى النصّ الابداعي العارض لقضية المرأة والدفاع عن حقوقها من دون النظر إلى كون الكاتب امرأة أو رجل, وهي عند فريق آخر مصطلح يُستشف منه افتراض جوهر محدّد لتلك الكتابة بتمايز بينها وبين كتابة الرجل، أما الفريق الثالث فيرى أنّه الأدب المرتبط بحركة الابداعي العارض لقضية المرأة والدفاع عن حقوقها من دون النظر إلى كون الكاتب امرأة أو رجل, وهي عند فريق آخر مصطلح يُستشف منه افتراض جوهر محدّد لتلك الكتابة بتمايز بينها وبين كتابة الرجل، أما الفريق الثالث فيرى أنّه الأدب المرتبط بحركة تحرير المرأة وبصراع المرأة الطويل التاريخي للمساواة بالرجل في الميادين التي يمكن أن تثبت جدارتها فيها

BackgroundFollowing SARS-CoV-2 infection a significant proportion of convalescent individuals develop the post-COVID condition (PCC) that is characterized by wide spectrum of symptoms encompassing various organs. Even though the underlying pathophysiology of PCC is not known, detection of viral transcripts and antigens in tissues other than lungs raise the possibility that PCC may be a consequence of aberrant immune response to the viral antigens. To test this hypothesis, we evaluated B cell and antibody responses to the SARS-CoV-2 antigens in PCC patients who experienced mild COVID-19 disease during the pre-vaccination period of COVID-19 pandemic.MethodsThe study subjects included unvaccinated male and female subjects who developed PCC or not (No-PCC) after clearing RT-PCR confirmed mild COVID-19 infection. SARS-CoV-2 D614G and omicron RBD specific B cell subsets in peripheral circulation were assessed by flow cytometry. IgG, IgG3 and IgA antibody titers toward RBD, spike and nucleocapsid antigens in the plasma were evaluated by ELISA.ResultsThe frequency of the B cells specific to D614G-RBD were comparable in convalescent groups with and without PCC in both males and females. Notably, in females with PCC, the anti-D614G RBD specific double negative (IgD-CD27-) B cells showed significant correlation with the number of symptoms at acute of infection. Anti-spike antibody responses were also higher at 3 months post-infection in females who developed PCC, but not in the male PCC group. On the other hand, the male PCC group also showed consistently high anti-RBD IgG responses compared to all other groups.ConclusionsThe antibody responses to the spike protein, but not the anti-RBD B cell responses diverge between convalescent males and females who develop PCC. Our findings also suggest that sex-related factors may also be involved in the development of PCC via modulating antibody responses to the SARS-CoV-2 antigens.

BACKGROUND: Sedation is fundamental to the management of patients in the intensive care unit (ICU). Its indications in the ICU are vast, including the facilitating of mechanical ventilation, permitting invasive procedures, and managing anxiety and agitation. Inhaled sedation with halogenated agents, such as isoflurane or sevoflurane, is now feasible in ICU patients using dedicated devices/systems. Its use may reduce adverse events and improve ICU outcomes compared to conventional intravenous (IV) sedation in the ICU. This review examined the effectiveness of inhalational sedation using the anesthetic conserving device (ACD) compared to standard IV sedation for adult patients in ICU and highlights the technical aspects of its functioning. METHODS: We searched the PubMed, Cochrane Central Register of Controlled Trials, The Cochrane Library, MEDLINE, Web of Science, and Sage Journals databases using the terms “anesthetic conserving device,” “Anaconda,” “sedation” and “intensive care unit” in randomized clinical studies that were performed between 2012 and 2022 and compared volatile sedation using an ACD with IV sedation in terms of time to extubation, duration of mechanical ventilation, and lengths of ICU and hospital stay. RESULTS: Nine trials were included. Volatile sedation (sevoflurane or isoflurane) administered through an ACD shortened the awakening time compared to IV sedation (midazolam or propofol). CONCLUSION: Compared to IV sedation, volatile sedation administered through an ACD in the ICU shortened the awakening and extubation times, ICU length of stay, and duration of mechanical ventilation. More clinical trials that assess additional clinical outcomes on a large scale are needed.

Sign language recognition (SLR) enables the deaf and speech-impaired community to integrate and communicate effectively with the rest of society. Word level or isolated SLR is a fundamental yet complex task with the main objective of using models to correctly recognize signed words. Sign language consists of very fast and complex hand, body, face movements, and mouthing cues that make the task very challenging. Several input modalities; RGB, optical Flow, RGB-D, and pose/skeleton have been proposed for SLR. However, the complexity of these modalities and the state-of-the-art (SOTA) methodologies tend to be exceedingly sophisticated and over-parametrized. In this paper, our focus is to use the hands and body poses as an input modality. One major problem in pose-based SLR is extracting the most valuable and distinctive features for all skeleton joints. In this regard, we propose an accurate, efficient, and lightweight pose-based pipeline leveraging a graph convolution network (GCN) along with residual connections and a bottleneck structure. The proposed architecture not only facilitates efficient learning during model training providing significantly improved accuracy scores but also alleviates computational complexity. With the proposed architecture in place, we are able to achieve improved accuracies on three different subsets of the WLASL dataset and the LSA-64 dataset. Our proposed model outperforms previous SOTA pose-based methods by providing a relative improvement of 8.91%, 27.62%, and 26.97% for WLASL-100, WLASL-300, and WLASL-1000 subsets. Moreover, our proposed model also outperforms previous SOTA appearance-based methods by providing a relative improvement of 2.65% and 5.15% for WLASL-300 and WLASL-1000 subsets. For the LSA-64 dataset, our model is able to achieve 100% test recognition accuracy. We are able to achieve this improved performance with far less computational cost as compared to existing appearance-based methods.

Background: Fast and accurate diagnosis plays an important role in controlling and further preventing COVID-19. This study was conducted in the Thumbay laboratory of Gulf Medical University (Ajman, UAE) to assess the correlations between DPI (Diffractive Phase Interferometry), COVID-19 RT-PCR, and CRP tests in COVID-19 patients of different ages and to compare the effectiveness of each parameter. Methods and Results: A cross-sectional analytic study was conducted among 150 patients diagnosed with COVID-19 who were admitted to the Thumbay University Hospital. Their general data was collected from the LDM system, and from among the suspected patients who came to do the RT-PCR test, 230 were selected as volunteers to participate in this study, and further laboratory tests like CRP level and DPI test were done for them. The nasal swab was collected for a PCR test. Out of 230 nasal swab samples, 150 were positive and 80 were negative for SARS-CoV-2 RNA by real-time RT-PCR assay. Among the 150 positive RT-PCR, 90 false negative DPI tests were from a sample with a high real-time RT-PCR. While 60 true positive DPI tests were positive real-time RT-PCR for swab specimens. Among the 80 negative RT-PCR, 79 were true negative and 1 was a false positive. The predictive positive value of the DPI test was 40% and the predictive negative value of the test was 98%. DPI has at least one tie between the positive actual state group and the negative actual state group. The results show weak and moderate positive correlations between CRP and the age groups. Conclusion: The combined detection of the three indicators (RT-PCR, DPI, and CRP) are positively related to COVID-19 infection; therefore, these indicators will enable effective intervention measures to be implemented in time and the rates of severe illness and mortality to be reduced.

Background: Most COVID-19 patients experience a mild form of the disease, but there is a certain percentage of patients who progress to a very severe disease state that requires intensive care and invasive ventilation. In order to ensure better patient management and improved outcomes, early identification of patients who may be at a higher risk of severe infection can play an important role. The aim of this study was to assess the association between the mean procalcitonin (PCT) level and comorbidity in hospitalized patients with COVID-19. Methods and Results: A total of 231 COVID-19-positive patients aged between 20 and 82 years (170[73.6 %] males and 61[26.4%] females) were included in this study. Serum PCT was accessed by procalcitonin assay using the Beckman Coulter UniCel DxI 800 instrument. Eighty-seven (37.7%) patients had no chronic disease, while 144(62.3%) had comorbidities: hypertension (37[16.0%]), diabetes mellitus (44[19.0%]), a combination of diabetes mellitus with hypertension (32[13.9%]), asthma (6[2.6%]), hyperlipidemia (4[1.7%]), renal disease (1[0.4%]), and COPD (1[0.4%]). COVID-19 patients with diabetes in combination with hypertension had a statistically greater PCT level than COVID-19 patients without comorbidities (P=0.0273). However, there were no statistically significant differences in the mean PCT level between different age categories (P=0.7390). The serum PCT measurement could evaluate the prognosis of the disease in some COVID-19 patients.

Background: Acinetobacter baumannii is a pleomorphic aerobic Gram-negative bacillus that is notorious for having multidrug resistance traits. Carbapenem-resistant Acinetobacter baumannii (CRAB) is a global concern due to its ability to retain and disseminate resistance genes, which poses a threat to the spread of resistance among bacterial communities in hospital settings. The aim of our study was to evaluate the existence of the blaVIM-2 gene in carbapenem-resistant Acinetobacter baumannii clinical isolates from Sudanese hospitals. Methods and Results: Forty clinical isolates of Acinetobacter baumannii were collected from June 2021 to April 2022. All isolates of Acinetobacter baumannii were identified via BioMérieux's Vitek-2 automated system (Marcy l'Étoile, France) and evaluated for phenotypic resistance to carbapenem, using imipenem and meropenem. The enzymatic mode of resistance was assessed by the Modified Hodge test (MHT). A real-time PCR was used to detect the presence of the blaVIM-2 gene. Of 40 isolates, 32(80%) were resistant to imipenem, 4(10%) were moderately resistant, and 4(10%) were susceptible to imipenem; 24(60%) were resistant to meropenem, 10(25%) were moderately resistant, and 6(15%) were susceptible to meropenem. MHT was 70% positive with imipenem use and 55% positive with meropenem use. Real-time PCR revealed that only 30% of the samples were positive for the blaVIM-2 gene. All blaVIM-2-positive isolates were resistant to both imipenem and meropenem. Conclusion: Resistance to carbapenem poses a serious threat, denying patients treatment options. It is essential to make continuous surveillance of these strains to prevent the development of resistant strains.

Abstract In regions with limited potable water availability, membrane desalination is being employed to filter water using a pressure-driven approach. Because of the high energy consumption required to produce the pressure differential needed for this method, researchers have been trying different geometric designs of spacer filaments to enhance the amount of permeate flux in terms of energy utilization. The purpose of spacer filaments is to support membranes structurally and induce turbulent mixing in spiral wound membrane desalination. In this paper, the improvement of mass transfer in desalination driven by reverse osmosis has been studied using Computational Fluid Dynamics (CFD) with the introduction of spiral wound membranes that are lined with spacer filaments in a zig-zag formation having alternating diameters for strands. The fluid flow characteristics for a 2-dimensional geometric model were resolved using the open-source program OpenFOAM by changing the Reynolds number to just before the inception of instabilities. Ratios of alternate strand diameters were also varied between one and two. Based on a detailed analysis of velocity contours, pressure distribution, wall shear stresses, and steady-state vortex systems, the research findings offer guidance for employing alternating strand design in zig-zag formation for optimum mass transfer and minimal pressure drop when accounting for concentration polarization.

Background: Type-2 Diabetes Mellitus (T2DM) is a significant health condition that is becoming more prevalent worldwide. Uncontrolled diabetes can lead to various complications, including peripheral artery disease (PAD). Duplex ultrasonography is critical to identify the stage of the disease and the patient's suitability for treatment procedures.Purpose: to assess Doppler blood flow parameters and morphologic alterations of dorsalis pedis artery (DPA) and posterior tibial artery (PTA) in T2DM. Materials and methods: A cross-sectional single-center study was conducted in Khartoum State. One hundred adult diabetic patients with average ankle-brachial index and reasonable glycemic control were selected randomly and enrolled in the study. Their age ranged from 27 to 86 years. A Duplex ultrasound examination was performed using a high-frequency ultrasound probe to assess the Doppler indices, arterial diameters, and wall thickness of the DPA and PTA. The data were analyzed using SPSS program version 23. Results: Increased duration of type-2 diabetes cause a significant increase in arterial wall thickness and pulsatility index (PI) of the DPA and PTA; (p-value < 0.05). The PI values decreased significantly in diabetic patients with trophic skin foot changes (p-value < 0.001), while the blood resistive index (RI) increased significantly in these patients (p-values < 0.01). Despite the reasonable glycemic control, a positive linear relationship was found between glycosylated hemoglobin (HA1c) levels and RI values of both DPA and PTA (R2 = 0.642). Conclusion: The study concluded that in type 2 diabetes with reasonable glycemic control, the arterial wall thickness of DPA and PTA increased as the duration of diabetes increased. The PI values of DPA and right PTA increased significantly with the increased time of the disease. The RI increased, and PI decreased in a subgroup with trophic skin changes. There is a positive linear relationship between glycosylated hemoglobin (HA1c) levels and RI values of both DPA and PTA.

Skin and soft tissue infections caused by methicillin-resistant S. aureus (MRSA) are among the most common bacterial infections. Linezolid is a cortisone drug for the treatment of infections caused by MRSA. However, developing resistance to linezolid creates a hurdle in the treatment of these infections. The present study aimed to determine the activity of linezolid alone and in combination with zinc oxide nanoparticles (ZnO-NPs) for the purpose of reducing resistance and enhancing its efficacy. For this study, MRSA isolates were taken and confirmed by using the antibiotic susceptibility testing method. The minimum inhibitory concentration (MIC) of both antibiotics and nanoparticles against MRSA clinical isolates was done by using the broth microdilution method. A checkerboard assay has used the determination of the combined activity of linezolid and ZnO-NPs. ZnO-NPs displayed a spherical shape with smooth surface morphology and had a mean size of 10 nm to 20 nm, with a zeta potential of 3.57 mV. The activity of ZnO-NPs against MRSA clinical isolates was 200 µg/ml. Almost 81% of isolates were found sensitive to linezolid with MIC lower than 4 µg/ml, and 19% were resistant, having MIC greater than 4 µg/ml. The combination of an antibiotic and nanoparticles reduced the activity of each of them twofold. The current study revealed that both linezolid and ZnO-NPs have antimicrobial activity against MRSA when used alone. The combination of both medications reduces each other's MIC twofold and has an antagonistic impact. Further research is needed to determine the mechanism through which these medications inhibit each other's activity.

OBJECTIVES To assess systemic immune-compromised comorbidities in patients presenting with odontogenic infections that extend to fascial spaces. This study was designed to investigate the incidence of immune-compromising systemic comorbidities among patient presenting with odontogenic infections. METHODOLOGY This cross-sectional study was performed at the Department of Maxillofacial Surgery, Hayatabad Medical Complex (HMC) Peshawar from October 2018 through April 2019. However, patients older than 10 years of age, presenting with fascial space infections other than odontogenic cause, secondary fascial space infections and patients with multiple organ failure were excluded. The odontogenic infections were categorized according to their anatomical location. The prevalence of comorbidities was also assessed. RESULTS A total of 145 patients were included, where the male to female ratio was 3.8:1, mean age ~ 56 ± 14.74 years (range: 12-80 years) and mean duration of the odontogenic infections was 5± 1.2 days. The submandibular space was the most frequent site involved in odontogenic infections with a frequency of 60 (41.4%), followed by buccal space with 44 (30.3%) patients & canine space with 31 (21.4%) patients. Of the 79 patients with comorbidities out of total 145 patients, diabetes mellitus was recorded in 60 patients. Other comorbidities included hypertension, renal and hepatic impairment. CONCLUSION Diabetes mellitus was the most common immune compromising comorbidity presented in patients with odontogenic infections extending in fascial spaces. Assessment of diabetes in routine dental practice is emphasized to avoid exacerbation of the odontogenic infections.

Key points The strains containing truncated forms of SeHAS enzysme are able to produce HA. The HA from all recombinant strains was the same and low Mw. Deletion of C-terminal region of SeHAS was not effective on Mw.

تم في هذا العمل دراسة تأثير المعالجة بمحاليل HCl و NaOH و AlCl3 في خواص البنية النسيجية للخام السوري الطبيعي الحاوي على الزيوليت من منطقة تل أم أذن . أظهرت النتائج ازدياد حجم المسام الكلي للعينتين المعالجتين ب HClو NaOH وانخفاض هذه القيمة للعينة المعالجة ب AlCl3 مقارنة مع العينة الخام غير المعالجة . ازدادت نسبة المسامية الدقيقة في العينة المعالجة ب HCl لتصل إلى أكثر من 50% مقارنة مع العينة غير المعالجة, وانخفاض في نصف قطر المسام الوسطي إلى 1.5nm, كما بينت الدراسة ازدياداً كبيراً في قيمة المساحة السطحية النوعية للعينات المعالجة ب HCl و NaOH لتصل إلى 200.92m2/g و 96.05m2/g على التوالي مقارنة مع العينة الخام 55.25m2/g. تحصل عملية امتزاز غاز النتروجين بسهولة وبشكل فيزيائي لأن طاقة الامتزاز أقل من 20KJ/mol .

Introduction Early recognition and appropriate management of paediatric sepsis are known to improve outcomes. A previous system’s biology investigation of the systemic immune response in neonates to sepsis identified immune and metabolic markers that showed high accuracy for detecting bacterial infection. Further gene expression markers have also been reported previously in the paediatric age group for discriminating sepsis from control cases. More recently, specific gene signatures were identified to discriminate between COVID-19 and its associated inflammatory sequelae. Through the current prospective cohort study, we aim to evaluate immune and metabolic blood markers which discriminate between sepses (including COVID-19) from other acute illnesses in critically unwell children and young persons, up to 18 years of age.Methods and analysis We describe a prospective cohort study for comparing the immune and metabolic whole-blood markers in patients with sepsis, COVID-19 and other illnesses. Clinical phenotyping and blood culture test results will provide a reference standard to evaluate the performance of blood markers from the research sample analysis. Serial sampling of whole blood (50 μL each) will be collected from children admitted to intensive care and with an acute illness to follow time dependent changes in biomarkers. An integrated lipidomics and RNASeq transcriptomics analyses will be conducted to evaluate immune-metabolic networks that discriminate sepsis and COVID-19 from other acute illnesses. This study received approval for deferred consent.Ethics and dissemination The study has received research ethics committee approval from the Yorkshire and Humber Leeds West Research Ethics Committee 2 (reference 20/YH/0214; IRAS reference 250612). Submission of study results for publication will involve making available all anonymised primary and processed data on public repository sites.Trial registration number NCT04904523.

Background: Low ADAMTS13 activity has been suggested to be an interplaying factor in the pathogenesis of COVID-19, considering that it is a thromboinflammatory disease with high risk of microthrombosis. Objectives: The study aimed to explore the correlation between ADAMTS13 activity and the pathophysiological pathway of COVID-19. Methods: We carried out a retrospective observational study of 87 patients with COVID-19 in NMC Royal Hospital, Abu Dhabi, UAE. ADAMTS13 activity was measured and compared with patients’ characteristics and clinical outcomes. Results: Low ADAMTS13 activity was associated with pneumonia (p = 0.007), severity of COVID-19 (p

Objective: To determine the magnitude and classification of cases of ambiguous genitalia presenting to our setup. Study Design: Cross-sectional study. Place and Duration of Study: Department of Haematology, Armed Forces Institute of Pathology, Rawalpindi Pakistan, from Aug 2018 to Feb 2019. Methodology: All the patients with ambiguous genitalia referred for cytogenetic analysis, were included in the study. The patients were subjected to a detailed history and physical examination. The record of radiological investigations was were obtained. Cytogenetic analysis was performed using the conventional G-banding technique. Hormonal testing included 17- hydroxyprogesterone (17-OHP) levels was also performed. Results: Fifty-one cases of ambiguous genitalia were studied. The median age was 15 months. Thirty-three patients (64.7%) had a 46XY karyotype, 17 (33.3%) had a 46XX karyotype while 1 (1.9%) had 45X/46, XY mosaic karyotype. Thirty patients (58.8%) were products of consanguineous marriage. Congenital adrenal hyperplasia was diagnosed in 12 cases (70.5%) of 46 XX karyotype and in 3 cases (9%) of 46XY karyotype. Conclusion: Ambiguous genitalia, currently categorized as disorders of sex development, are not uncommon in our populartion. Increased awareness and early diagnosis are crucial to prevent life threatening complications of congenital adrenal hyperplasia, to determine sex of rearing, and to counsel the parents or patients.

Many recent studies have focused on the manipulation of the epigenome to understand the mechanistic programming in health and some disease phenotypes. These studies are designed to provide suitable drug targets to cure and/or prevent the outcome of a disease condition. Autoimmune diseases (ADs), including obesity and diabetes, are of major health concern nowadays and are the root cause of several diseases of the heart, lungs, and liver. There are several epigenetic mechanisms underlying the manifestation of autoimmune disorders. The recent advances in today’s sequencing technology and genome editing have uncovered the role of epigenetic modifications in ADs. In this review, we will cover the recent discoveries and their possible application in the control of ADs by improving the long-term use of such technologies. The potential drawbacks will also be discussed so that future experiments may be designed to reduce or eliminate the risk factors associated with the use of recent discoveries in the field of medicine.

Solar load is one of the key inputs in thermal analysis of all solar based applications using ray tracing. Commercial and academic Computational Fluid Dynamics (CFD) codes incorporate different solar load models for ray tracing, i.e., Solar Position and Intensity (SOPLOS) theoretical maximum function, American Society of Heating, Refrigeration, and Airconditioning Engineers (ASHRAE) fair weather and constant solar load models. However, solar load depends largely on weather conditions of the site whereas the solar load models in CFD software do not accommodate changing weather patterns and hence the CFD simulation results obtained are not representative of an extended period of time. This paper studies the effect of changing weather patterns on solar load assessment, using bifacial solar panels as a case study. In this study, on-site data of a humid sub-tropical region for monsoon season, mid-June to mid-August, has been used as an input for solar ray tracing due to large temperature variations and cloud cover for longer duration. Comparative study of SOPLOS and ASHRAE models with in situ model shows that they over predict front side solar load, with only 0.5% and 13% matching in situ data respectively, while both models under predict rear side solar load in the studied time period, with 2% and 24% solar load estimation agreeing with in situ data respectively.

Introduction Childhood cancer is a leading cause of death. It is unclear whether the COVID-19 pandemic has impacted childhood cancer mortality. In this study, we aimed to establish all-cause mortality rates for childhood cancers during the COVID-19 pandemic and determine the factors associated with mortality.Methods Prospective cohort study in 109 institutions in 41 countries. Inclusion criteria: children

Seawater desalination is an affordable and viable solution to the growing freshwater scarcity problem in water scarce regions. The current study focuses on cost analysis of Vacuum Membrane Distillation (VMD) setup for removing salts from water. The membrane used in the flat sheet VMD module was Polytetrafluoroethylene (PTFE) with 250 mm × 200 mm dimensions and 165 µm thickness. The experiments were carried out with variations in parameters such as velocity, pressure, concentration, and temperature. For the cost analysis, the operational, maintenance, instrumentation, and capital cost of the lab model was considered and then upscaled. A range of experiments was performed for NaCl and KCl under variations of operating parameters. It was noted that, for the NaCl solution, the increase in temperature from 50 °C to 70 °C doubled the permeate flux. However, for the conditions tested, the concentration shift from 0.25 M to 0.75 M decreased the permeate flux by 1.4% because the increase in ion concentrations along the membrane lowers the vapor pressure, restricting the permeate flux. The results trend for the KCl solution was similar to the NaCl; at temperature T1, it was noted that increased concentration from 0.25 M to 0.75 M significantly reduces the permeate flow. The reduction in permeate flow was nonlinear for a given pressure 30 kPa and velocity 5.22 m/s, but linear for all other variables. It was also observed that with an increase in temperature from 60 °C to 70 °C, the permeate flux for concentration 0.25 M was 49% for all the combinations of pressure and velocity. In addition, permeate flow increased 53% from temperature 50 °C to 60 °C and 49% from temperature 60 °C to 70 °C for both the solutions at a concentration of 0.25 M. This shows that the temperature also had a profound impact on the permeate flux. The economic analysis and market survey shows that the cost of clean water at the lab level was high which can be significantly reduced using a large-scale setup providing 1,000,000 L/H of distilled water.

Cystic fibrosis (CF) is the most common potentially lethal and life-shortening genetic disease caused by mutations of the cystic fibrosis transmembrane conductance regulator (CFTR) gene. Clinical consequences of the CFTR defect are site-specific and range from severe (lungs, pancreas, male reproductive tract) to mild (intestine) to asymptomatic (sweat glands). In many developing countries CF has remained largely unrecognized, and inadequately managed, resulting in avoidable death or suffering in infancy, childhood, and adulthood. Delivering adequate CF services is met by substantial difficulties as the spectrum and distribution of CF in Egypt are still not well known. Against this background, the aim of this work is to emphasize the challenges facing initiation of a CF center in low privileged settings with the objectives of improving diagnosis, survival, and to eventually provide optimum management. Strategies for the implementation and development of CF services, as well as proper collection and documentation of patient data are therefore of vital importance. The characterization of the prevalence and molecular genetics of CF in Egypt is of utmost importance so that appropriate genetic counseling to CF patients and their families can be achieved and to pave the way for new treatment modalities.

Introduction: It was observed that compared to the general population, mentally challenged subjects have higher rates of poor oral hygiene. Gingivitis is a common finding with moderate or severe variety reported most commonly. Periodontal disease is the most significant oral health problem, which can even lead to mobility of tooth and tooth loss. It is essential to generate oral health precautionary agendas and familiarize it with them. Materials and Methods: Four Centres of rehabilitation in the Aseer region of Saudi Arabia were included and subjects of 3–24 year age group was examined. Written informed consent was obtained from directors of Centres. Caries, oral hygiene status, soft-tissue and hard-tissue lesions were evaluated and statistically analyzed. Results: Higher Decayed, Missing and Filled Teeth score was observed in the present study in contrast to many other studies. Periodontal disease was seen in higher age group with higher percentages. Poor oral hygiene was seen in 27.3% of males and 66.7% of females. Tongue lesions comprised 85.7%, which accounted for the major part of soft-tissue abnormality. Various occlusal abnormalities (75%) and developmental tooth disturbances (53.6%) constitute the higher portion in hard-tissue abnormality. Conclusion: Dentists should be conscious of the range of oral anomalies that can manifest in this group of the patients. The microbial or serological investigation was not done which could have explained the etiology behind these lesions. In spite of these confines, the survey result have provided information regarding the oral health status of Down's syndrome subjects and the necessity of focusing on oral health need.

Autism spectrum disorder (ASD) affects a variety of social skills in children. One of the most important social skills that are affected by ASD is the ability to pay attention; ASD introduces unnecessary temporal delays in the attentional behavior of children toward external stimuli. This research focuses on identifying the effect of different social stimuli from robotic agents to assess the attentional behavior of children with ASD. Latencies in shifting attention and the number of attentions paid to a stimulus are defined as indexes of attentional behaviors for children with ASD. Nine children with ASD (seven males and two females, mean: 7.57 ± 2.57 years) that had minimal to no symptoms of autism participated in this study. Two robotic agents presented visual, speech, and motion social stimuli to the participants. Regarding social stimuli, a significant effect on the latency in shifting attention ( $\chi ^{2}(2)=9.55$ , $\text {p} = 0.008$ ) and the number of attentions paid ( $\chi ^{2}(2)=9.56$ , p = 0.008) was observed in children with ASD. The speech stimulus captured the children’s attention faster than the visual and motion stimuli in terms of latency in shifting attention and the number of attentions paid. Moreover, significant positive correlations were found for some pairs of stimuli among visual, speech, and motion stimuli for latencies in shifting attention, as well as the number of attentions paid using Pearson’s correlation analysis. This study contributes to the literature in terms of the impact of robotic stimuli on the attentional behavior of children with ASD.

Objectives Paediatric cancer is a leading cause of death for children. Children in low-income and middle-income countries (LMICs) were four times more likely to die than children in high-income countries (HICs). This study aimed to test the hypothesis that the COVID-19 pandemic had affected the delivery of healthcare services worldwide, and exacerbated the disparity in paediatric cancer outcomes between LMICs and HICs.Design A multicentre, international, collaborative cohort study.Setting 91 hospitals and cancer centres in 39 countries providing cancer treatment to paediatric patients between March and December 2020.Participants Patients were included if they were under the age of 18 years, and newly diagnosed with or undergoing active cancer treatment for Acute lymphoblastic leukaemia, non-Hodgkin’s lymphoma, Hodgkin lymphoma, Wilms’ tumour, sarcoma, retinoblastoma, gliomas, medulloblastomas or neuroblastomas, in keeping with the WHO Global Initiative for Childhood Cancer.Main outcome measure All-cause mortality at 30 days and 90 days.Results 1660 patients were recruited. 219 children had changes to their treatment due to the pandemic. Patients in LMICs were primarily affected (n=182/219, 83.1%). Relative to patients with paediatric cancer in HICs, patients with paediatric cancer in LMICs had 12.1 (95% CI 2.93 to 50.3) and 7.9 (95% CI 3.2 to 19.7) times the odds of death at 30 days and 90 days, respectively, after presentation during the COVID-19 pandemic (p

Coronavirus Disease (COVID-19) is a newly emerged infectious disease that first appeared in China. Vitamin D is a steroid hormone with an anti-inflammatory protective role during viral infections, including SARS-CoV-2 infection, via regulating the innate and adaptive immune responses. The study aimed to investigate the correlation between serum 25-hydroxyvitamin D (25[OH]D) levels and clinical outcomes of COVID-19. This was a retrospective study of 126 COVID-19 patients treated in NMC Royal Hospital, UAE. The mean age of patients was 43 ± 12 years. Eighty three percentage of patients were males, 51% patients were with sufficient (> 20 ng/mL), 41% with insufficient (12–20 ng/mL), and 8% with deficient (

This research article presents a preliminary longitudinal study to check the improvement in multi-human communication of children with Autism Spectrum Disorder (ASD) using a standardized multi-robot therapy. The research is based on a 3 step framework: 1) Human-Human Interaction, Stage-1 (HHI-S1), 2) Human-Robot Interaction, Stage-2 (HRI-S2), and 3) Human-Human Interaction, Stage-3 (HHI-S3). All three stages of the therapy consist of two command sets: 1) Controls commands and 2) Evaluation commands (auditory commands, visual commands, and combination of both). The concept of multiple robots is introduced to help multi-human communication and discourage isolation in ASD children. The joint attention of an ASD child is improved by the robotic therapy in stage 2 considering it as a key parameter for a multi-human communication scenario. The improvement in joint attention results in better command following in a triad multi-human communication scenario in stage 3 as compared to stage 1. The proposed intervention has been tested on 8 ASD subjects with 10 sessions over a period of two and a half months (10 weeks). Each session of human-human interaction (stage 1 and 3) consisted of 14 cues whereas 18 cues were presented by each robot for human-robot interaction (stage 2). The results indicate an overall 86% improvement in the social communication skills of ASD children in case of a multi-human scenario. Validation of results and effectiveness of the therapy has been further accomplished through the use of the Childhood Autism Rating Scale (CARS) score.

The human sense of touch is an integral part of daily life. For tasks involving grasping and manipulation of objects, force feedback is a key requirement. Most of the systems give contact point or complete grasping force feedback; for precision grasping and other physical interactions, finger awareness and force feedback from independent fingers is essential. In this study a novel, wearable proprioceptive rehabilitation system is designed which restores the ability of identifying and distinguishing between individual fingers of a prosthetic hand or an exoskeleton in a non-invasive manner. Moreover, it provides different levels of force feedback from every finger as well, which enables the user to distinguish and control force in precision grasping activities. For testing the system accuracy, classical psychophysical methods were used on a group of 14 voluntary disabled subjects. The tests were conducted in both, ideal and real-world conditions i.e. without and with distractions and accuracies were calculated accordingly. A p-test was also conducted to observe significance between the samples of with and without distraction datasets. The system performed with an overall accuracy of 82.04% which was well above the min. performance measure of 60%. Vi-HaB is standalone system and can be mounted on any upper limb rehabilitation (prosthesis, exoskeleton) system for finger awareness and force feedback.

Recent research has shown reliability in robotic therapies for improvement in core impairments of autism. To improve the efficiency of communication using robots, this study evaluates the effectiveness of three different stimuli in a robotic intervention for children with autism spectrum disorder. Three different reinforcement stimuli presented in least-to-most (LTM) order introduced in this therapy using NAO robot are: visual (color variation), auditory and motion cues. The therapy was tested on 12 ASD children, 4 out of 12 children fall under mild category whereas 8 fall under the minimal category of autism. The experimentation was conducted for 2 months. Total 8 experiments were conducted with 1 trial per week. Total 12 cues were given per trial, 4 cues corresponding to each category. In total 96 cues were given per subject, 32 cues from each category. The results indicate a general trend for linking a particular autism category with the most effective stimulus for that category. It can be concluded that visual cue (color variation) is the most effective reinforcement stimulus for children with minimal autism as 8 out of 8 i.e., 100% were more responsive to visual cues whereas for children with mild autism category, 3 out of 4 i.e., 75% are more receptive towards the motion stimulus. The parameters used for assessment were joint attention and the time eye contact is maintained. Single factor ANOVA was used for the statistical analysis of results with alpha is 0.05 and p-value 0.0342, F value is 3.7456 and F critical value is 3.2834. The test was performed on 96 (8×12) trails in total, therefore ensuring the significance and reliability of our results.

Spring Loaded Pantographs (SLPs) are frequently used in designing lightweight limbs for multi-legged robots. Quadruped robots that incorporate cable-pulled SLP legs have proven to be agile, robust and capable of conserving energy during their gait cycle. In such designs, the extension of the distal segments via the knee joint is dependent upon the length of the cable. In this article we propose the use of an Elastically Loaded Scissors Mechanism (ELS Mechanism or ELSM), which is a variant of the SLP. Driven by 'pulling' onto the proximal joint of the scissors as opposed to the distal joint, this proposed leg utilizes the increased mechanical advantage of the scissors mechanism to 'amplify' input angles to larger output displacement by the knee joint. Analysis and Simulations reveal that the proposed mechanism achieves increased motion speed as compared to the SLP mechanism. This, however, comes at the cost of higher load on the actuator which serves as an engineering trade-off. This is validated by experimentation using motion capture and load motor techniques of the SLP and ELS configurations in a physical quadruped robot.

تسلط هذه الدراسة الضوء على الجانب الدستوري في تفعيل القوة الناعمة، وعلى الدور الذي قد يلعبه الدستور والتشريعات في رسم صورة عن دولة قطر لدى الجمهور الزائر في حدث استضافة كأس العالم 2022، تدرس الورقة الهُوية الدستورية لدولة قطر من الناحيتين الثقافية والاجتماعية، من خلال الوقوف على المحددات الدستورية للهوية الثقافية الاجتماعية للبلاد، وعناصر القوة الناعمة المتضمنة في الدستور، وتأثيرها الممكن على تنظيم كأس العالم 2022، اعتمدت الدراسة على المنهج الاستقرائي التحليلي إلى جانب المقابلة مع نخبة من المتخصصين، قُسمت الدراسة إلى مبحثين أساسيين: يتناول المبحث الأول محدّدات الهوية الثقافية في الدستور القطري وانعكاساتها على كأس العالم 2022؛ حيث يعرض المطلب الأول لبيان جوهريّة الانتماء العربي في الهُوية الثقافية لدولة قطر وانعكاسها على الحدث، ويعرض المطلب الثاني لبيان جوهريّة الانتماء الإسلامي في الهوية الثقافية لدولة قطر وانعكاسها على الحدث، أما المبحث الثاني فيتناول المحددات الاجتماعية في الدستور القطري وانعكاسها على تنظيم كأس العالم 2022، ويعالج المسألة من خلال مطلبين: يكشف الأول عن مكونات النسيج الاجتماعي الدستوري لدولة قطر وانعكاسها على الحدث، ويبيّن المطلب الثاني ركائز النظام الاجتماعي في دولة قطر وانعكاسها على الحدث، وخلصت الدراسة إلى العديد من النتائج والتوصيات أهمها ما يتعلق بانعكاس البعدين العرقي والديني على الحدث، وانعكاس ركائز النظام الاجتماعي كذلك على الحدث، لتخلص إلى مجموعة من التوصيات أبرزها ضرورة توعية الجمهور الزائر بالتشريعات، وإعمال مبدأ الموازنة بين المنافع والمضار وتأسيسه على منطلقات قانونية.

This study reports on the impact of elevated recovery (i.e., 80%, 85%, and 90%) on the fouling and performance of air gap membrane distillation (AGMD) with real seawater and landfill leachate wastewater samples using polytetrafluoroethylene (PTFE) polymer membranes. Increasing the feed temperature from 55 °C to 65 °C improved the water flux of seawater and wastewater and shortened the operating time by 42.8% for all recoveries. The average water flux in the 80%, 85%, and 90% recovery experiments at the 65 °C feed temperature was 32%, 37.32%, and 36.7% higher than the case of 55 °C for the same recoveries. The water flux decline was more severe at a higher temperature and recovery. The highest flux decline was observed with a 90% recovery at 65 °C feed temperature, followed by an 85% recovery at 65 °C. Close examination of the foulants layer revealed that seawater formed a cake fouling layer made predominantly of metal oxides. In contrast, the landfill leachate fouling was a combination of pore blocking and cake formation, consisting mainly of carbonous and nitrogenous compounds. Physical cleaning with deionized (DI) water at 55 °C and 65 °C and chemical cleaning with hydrogen peroxide (H2O2) were investigated for their efficiency in removing membrane foulants. Analytical results revealed that seawater fouling caused membrane pore blockage while wastewater fouling formed a porous layer on the membrane surface. The results showed that membrane cleaning with hydrogen peroxide restored >97% of the water flux. Interestingly, the fouling factor in seawater tests was 10%, while it was 16% for the wastewater tests.

Robot-mediated therapies for autism spectrum disorder (ASD) have shown promising results in the past. We have proposed a novel mathematical model based on an adaptive multi-robot therapy of ASD children focusing on two main impairments in autism: 1) joint attention and 2) imitation. Joint attention intervention is based on three different least-to-most (LTM) cues, whereas the adaptive imitation module uses joint attention for activation of the robot. The proposed model uses a multi-robot system as a therapist without any external stimuli (from the environment) to improve the skills of the ASD child. Another novel aspect of this paper is the deployment of a multi-robot system for introducing the ASD child to the concept of multi-person communication. This is particularly useful as, unlike humans, robots can be more consistent and relatively immune to fatigue. Two different therapies of human-robot interaction (i.e., with and without inter-robot communication) have been conducted. The model has been tested on 12 ASD children, eight sessions for each intervention over a period of six months. The effectiveness of the model is validated by analyzing the cognitive state of the brain before and after the intervention with electroencephalogram (EEG) neuroheadsets. Moreover, results obtained using the childhood autism rating scale (CARS) to measure the effectiveness of therapy also support the conclusions firmly. The statistical results with the p-value = 3.79E-07 3.28 show reliability and significance of the data. The results strongly indicate significant improvements in both modules, along with a notable improvement in multi-communication skills of the participating children.

The focus of this research is to study: 1) the distribution of joint attention of autistic (ASD) children in their left and right visual space, 2) the corresponding dominance of either left or right hemisphere of brain using electroencephalography (EEG), and 3) the relationship between the dominance of visual space and hemisphere of brain. The proposed multi-robot system includes sequential and simultaneous actuations of robots dealing with single and multi-robot communication. Results indicate that most of the autistic children initiate joint attention from right to left vision space. Similarly, for imitation, robot at right visual space is imitated and focused more. These findings are also supported by the results obtained from the dominance of brain and number of eye contacts. Eight participants, five males and three females, participated in this research. Six participants belong to minimal while two belong to mild case on autism spectrum. Minimal cases of autism indicated proper dominance of either left or right visual space and hence the respective dominance of hemispheres of brain too. While mild cases of autism showed balanced performance in visual space but distinguishable dominance of hemispheres of brain. The overall average followed imitation accuracy for robot at right visual space is 83.49 % while for robot at left visual space is 61.53 %. Similarly, overall average eye contacts with robot at right visual space are 16.47 and for robot at left visual space are 14.95 per minute. Power spectral density (PSD) values of EEG data also indicate the dominance of right hemisphere of brain. F value is 2.93, F-critical value 4.60, and p-value is 0.108.

Most of the recent research on distributed formation control of unmanned aerial vehicle (UAV) swarms is founded on position, distance, and displacement-based approaches; however, a very promising approach, i.e., bearing-based formation control, is still in its infancy and needs extensive research effort. In formation control problems of UAVs, Euler angles are mostly used for orientation calculation, but Euler angles are susceptible to singularities, limiting their use in practical applications. This paper proposed an effective method for time-varying velocity and orientation leader agents for distributed bearing-based formation control of quadcopter UAVs in three-dimensional space. It combines bearing-based formation control and quaternion-based attitude control using undirected graph topology between agents without the knowledge of global position and orientation. The performance validation of the control scheme was done with numerical simulations, which depicted that UAV formation achieved the desired geometric pattern, translation, scaling, and rotation in 3D space dynamically.

(1) Background: The association between ABO blood groups and COVID-19 outcomes was investigated in several studies. The results were controversial. This study aimed to explore the association between ABO blood groups and COVID-19 outcomes. (2) Methods: This retrospective study included 303 COVID-19 patients treated at the NMC Royal Hospital in the United Arab Emirates between 8 April 2020 and 30 June 2020. (3) Results: The mean age of patients included in the study was 39.3 ± 10.7 years, and 72.9% of patients were males. The prevalence of blood groups O, A, B, and AB was 40.3%, 27.7%, 25.1%, and 6.9%, respectively. The correlation between ABO blood groups and COVID-19 outcomes was insignificant except in the AB group, with significantly higher odds of disease severity. Increased age, higher body mass index (BMI), and being of male gender increased the risk for pneumonia among all blood groups. Both increased age and higher BMI increased the risk of mortality, and increased age increased the risk of disease severity. Troponin and platelet counts were significantly different in the A group compared to the non-A groups. Time to viral clearance was not different among blood groups. However, adjustment for Rh groups resulted in a significantly shorter time in the B group. (4) Conclusions: There was no significant association between ABO blood groups and COVID-19 outcomes, with the exception of group AB.