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It is challenging to place drones in the best possible locations to monitor all sensor targets while keeping the number of drones to a minimum. Strawberry optimization (SBA) has been demonstrated to be more effective and superior to current methods in evaluating engineering functions in various engineering problems. Because the SBA is a new method, it has never been used to solve problems involving optimal drone placement. SBA is preferred for optimizing drone placement in this study due to its promising results for nonlinear, mixed, and multimodal problems. Based on the references listed below, no study has investigated the need to develop a parallelized strategy version. Several studies have been conducted on the use of drones for coverage. However, no optimization algorithms have been evaluated regarding time complexity or execution time. Despite what has been said thus far, no study has looked into the significance of a systematic framework for assessing drone coverage techniques using test suits. An optimized drone placement algorithm based on strawberry optimization is presented in the paper. The strawberry optimization algorithm will solve the drone placement problem through parallelization. In addition, the authors deploy test suits that vary in size from small to large. The dataset consists of four categories with three problems each. Results indicate that strawberry optimizers outperform Genetic algorithms (GA) and particle swarm optimization algorithms (PSO) in the number of drones, convergence, and computation time. Furthermore, the proposed approach achieves the best solution in a finite number of steps. In small-scale problems, the performance of all algorithms is convergent. As the size of the data set increases, the superiority of Strawberry optimization algorithms becomes evident. Overall, Strawberry comes out on top for eleven out of twelve comparisons.

BACKGROUND: Assessment of the plantar flexion (PF) isokinetic performance has been greatly diverse and based on personal preferences rather than standardized guidelines. OBJECTIVE: To examine the performance of the plantar flexors under different settings including knee joint angle and subject position. METHODS: Thirteen women and 20 men took part in this study. The isokinetic protocol (60∘/s) was set to ankle movement between 10∘ dorsiflexion to 30∘ PF. Participants performed three repetitions of concentric PF in randomly-ordered knee angles; 15∘, 45∘ and 90∘, and in seated and supine positions. Surface electromyography (EMG) data were collected from the Soleus (SOL) and Gastrocnemius. RESULTS: Knee angle impacted the PF moment (P⩽ 0.001–0.026) and work (P⩽ 0.05) measures in both genders. The moment and work measures were significantly less in the 90∘ than those in the 45∘ and 15∘ positions. The 45∘ position had the highest values, particularly in sitting in the male participants. Only the GL EMG data was significantly impacted (P= 0.017) by the subject position. However, the difference was trivial (1.6%). The SOL muscle showed a consistent pattern of increased activity when the knee was in flexion. CONCLUSION: The 45∘ position seems to be optimal for obtaining the highest isokinetic PF scores.

The use of metal phosphides, particularly aluminum phosphide, poses a significant threat to human safety and results in high mortality rates. This study aimed to determine mortality patterns and predictive factors for acute zinc and aluminum phosphide poisoning cases that were admitted to Menoufia University Poison and Dependence Control Center from 2017 to 2021. Statistical analysis revealed that poisoning was more common among females (59.7%), aged between 10 and 20 years, and from rural regions. Most cases were students, and most poisonings were the result of suicidal intentions (78.6%). A new hybrid model named Bayesian Optimization-Relevance Vector Machine (BO-RVM) was proposed to forecast fatal poisoning. The model achieved an overall accuracy of 97%, with high positive predictive value (PPV) and negative predictive value (NPV) values of 100% and 96%, respectively. The sensitivity was 89.3%, while the specificity was 100%. The F1 score was 94.3%, indicating a good balance between precision and recall. These results suggest that the model performs well in identifying both positive and negative cases. Additionally, the BO-RVM model has a fast and accurate processing time of 379.9595 s, making it a promising tool for various applications. The study underscores the need for public health policies to restrict the availability and use of phosphides in Egypt and adopt effective treatment methods for phosphide-poisoned patients. Clinical suspicion, positive silver nitrate test for phosphine, and analysis of cholinesterase levels are useful in diagnosing metal phosphide poisoning, which can cause various symptoms.

Background Due to weight regain and GIT symptoms associated with Vertical banded gastroplasty (VBG) revisional surgery is necessary, Roux-en-Y gastric bypass (RYGB) is one of the best options as a revision procedure but comes with a high complication rate. Methods This prospective study included eighty patients undergoing Roux-en-Y gastric bypass surgery at Ain Shams University Hospitals after failed VBG surgery, with up to 2 years of follow-up. Results Eighty patients underwent RYGB correction after VBG. The mean age was 42 ±6.45 (39–58) years and the mean preoperative body mass index (BMI) was 45.46±4.135 (38-55) kg/m2. The median length of hospital stay for the patients was 4.78 ±1.84 days. The early postoperative complication rate was 8.7% and the reoperation rate within thirty days was 3.75%. with no Mortality. Leakage and bowel injury was in two patients. After an average follow-up of two years, the percentage of EWL was 64.47±19.3, and complete resolution of VBG-related GIT symptoms was achieved in approximately all patients. Late complications occurred in 7.5% of patients, of whom 3.75% required surgery. Conclusion conversion to RYGB is feasible with a limited short-term complication and reoperation rate, long term results show a nearly complete resolution of VBG-related symptoms and a statistically significant positive impact on weight loss.

Background Vaccination and single-dose rifampin are the main proven effective intervention types for preventing leprosy among contacts of Mycobacterium leprae endemic areas. Currently, no high-quality evidence is available regarding the best prophylactic intervention. Objectives Our primary study aim is to detect the most effective prophylactic intervention for the prevention of leprosy. Methods In May 2019, 12 databases were searched systematically. Updated search terms were developed in March 2020 to complete an updated search. All randomized controlled trials (RCTs) comparing the different types of chemoprophylactic and immunoprophylactic interventions in leprosy prevention were included. Our participants were contacts of patients with leprosy or people residing in leprosy endemic communities. We searched for different types of chemoprophylactic and immunoprophylactic interventions used in leprosy prevention. We used network meta-analysis and meta-analysis. Quality assessment was performed using Cochrane Risk of Bias for included RCTs, in which all included RCTs were rated to be low to moderate risk. We registered our protocol in Prospero with ID CRD42019143207. Results Among 11 included studies (326 264 patients) from original and updated search terms, eight were eligible for network meta-analysis (NMA) while four were eligible for MA. Findings suggest that Bacillus Calmette–Guerin (BCG) vaccination was the most effective intervention compared to placebo (risk ratios (RRs) 0.49 (0.30, 0.80), p 0.77), followed by combined BCG vaccination and single-dose rifampicin (SDR) with similarly low values (RR 48%, p 0.77). BCG revaccination was the least effective intervention compared to placebo (RR 1.08 (0.36, 3.22), p 0.26). Conclusion Compared to placebo, the BCG vaccine was the most effective prophylactic intervention. The combination of BCG vaccination + SDR had nearly the same efficacy as BCG vaccination alone, while BCG revaccination was the least effective. Thus, vaccination proved to be a more effective treatment than SDR alone. A well-designed multicenter RCT is warranted to evaluate the safety of these vaccines.

The need for space missions is ever growing with the complexity of problems encountered, requiring experiments at different physical conditions. The cost and other factors experienced in each of the space missions are soaring, irrespective of the entanglements of these missions. Micro and Nano satellites have paved way in this regard, as they are cheap, feasible and provide a platform for new technologies to be tested and validated in space which can then be extended to larger satellites for enhanced applications. Orbital harsh conditions make thermal system design very big challenge to satisfy the different operation conditions required per satellite components. Thermal Control system (TCS) analysis of Hyper-Spectral Remote Sensing Micro-Satellite is crucial in its conceptual design phase. The thermal system design concept of the Micro-Satellite may be passive or active system working on a non-hermetic platform. Satellite thermal system shall provide suitable temperature envelop allow components to work in full performance. It consumes daily average power about 45 W. Battery is the most critical component because of its capacity sensitivity to temperature changes.

Several optimization problems can be abstracted into many-objective optimization problems (MaOPs). The key to solving MaOPs is designing an effective algorithm to balance the exploration and exploitation issues. This paper proposes a novel many-objective African vulture optimization algorithm (MaAVOA) that simulating the African vultures’ foraging and navigation behaviours to solve the MaOPs. MaAVOA is an updated version of the African Vulture Optimization Algorithm (AVOA), which was recently proposed to solve the MaOPs. A new social leader vulture for the selection process is introduced and integrated into the proposed model. In addition, an environmental selection mechanism based on the alternative pool is adapted to improve the selection process to maintain diversity for approximating different parts of the whole Pareto Front (PF). The best-nondominated solutions are saved in an external Archive based on the Fitness Assignment Method (FAM) during the population evolution. FAM is based on a convergence measure that promotes convergence and a density measure that promotes variety. Also, a Reproduction of Archive Solutions (RAS) procedure is developed to improve the quality of archiving solutions. RAS has been designed to help reach out to the missing areas of the PF that the vultures easily miss. Two experiments are conducted to verify and validate the suggested MaAVOA’s performance efficacy. First, MaAVOA was applied to the DTLZ functions, and its performance was compared to that of several popular many-objective algorithms and according to the results, MaAVOA outperforms the competitor algorithms in terms of inverted generational distance and hypervolume performance measures and has a beneficial adaptation ability in terms of both convergence and diversity performance measures. Also, statistical tests are implemented to demonstrate the suggested algorithm’s statistical relevance. Second, MaAVOA has been applied to solve two real-life constrained engineering MaOPs applications, namely, the series-parallel system and overspeed protection for gas turbine problems. The experiments show that the suggested algorithm can tackle many-objective real-world applications and provide promising choices for decision-makers.

Long-term load forecasting (LTLF) is an essential process for strategical planning of the future needed extension in the power systems of any country. Besides, deep learning has become the heart of the machine learning paradigm, which is wildly used nowadays in many fields, and it also has become the current revolution in Artificial Intelligence (AI). In this paper, an optimized deep learning model based on Stacked Long Short-Term Memory Network (SLSTMN) is proposed. The architecture of the model is optimized to get the best configuration using Genetic Algorithm (GA). In addition, the hyperparameters of the model network are optimized using many deep learning techniques. During the optimization process, hundreds of model configurations are tested. The accuracy of this model is compared with many deep learning models and is compared against the related work in the field of LTLF. The dataset of the South Australia State (SA) power system is used to test the compared models. This data includes maximum daily load, daily maximum temperature, daily minimum temperature, weekday, the month, and holidays for 12 years from 2005 to 2016. SLSTMN achieves excellent accuracy and the lowest error value (almost 1%) when compared with other models on the same dataset and with related work models on different datasets.

Detection of transformer faults avoids the transformer’s undesirable loss from service and ensures utility service continuity. Diagnosis of transformer faults is determined using dissolved gas analysis (DGA). Several traditional DGA techniques, such as IEC code 60599, Rogers’ ratio method, Dornenburg method, Key gas method, and Duval triangle method, but these DGA techniques suffer from poor diagnosis transformer faults. Therefore, more research was used to diagnose transformer fault and diagnostic accuracy by combining traditional DGA techniques with artificial intelligence and optimization techniques. In this paper, a proposed Adaptive Dynamic Polar Rose Guided Whale Optimization algorithm (AD-PRS-Guided WOA) improves the classification techniques’ parameters that were used to enhance the transformer diagnostic accuracy. The results showed that the proposed AD-PRS-Guided WOA provides high diagnostic accuracy of transformer faults as 97.1%, which is higher than other DGA techniques in the literature. The statistical analysis based on different tests, including ANOVA and Wilcoxon’s rank-sum, confirms the algorithm’s accuracy.

Cancers 14(5), 1261 (2022). doi:10.3390/cancers14051261, Published by MDPI, Basel

Background: Cigarette smoking has been identified as one of the most significant risk factors for incident chronic kidney disease (CKD).Cigarette smoking was associated with an elevated risk of incident CKD/end stage renal disease (CKD) in the adult general population. This association were independent of well-established risk factors for CKD such as age, hypertension, DM and BMI. Objective: To compare between tobacco smoking active and passive effect on the kidney functions in a cross section observational study. Patients and Methods: One Hundred fifty (age and sex matched) patients will be enrolled in a cross section study. The study will be conducted in Nephrology Unit Al-Hussein University Hospital and Air Forces General Hospital. Results: Comparative study between the 3 groups revealed. Spearman's correlation analysis shows that; SBP, DBP, HR and smoking index, had significant negative correlation with eGFR; with significant statistical difference (p 291) predicted patients with CKD, with good (83%) accuracy, sensitivity= 73% and specificity= 100% (p 30 pack/year), is an important risk factor to the development of CKD. The association was strongest for CKD classified as hypertension and diabetic nephropathy. These results raise the importance of smoking cessation to decrease the incidence of CKD and other preventable diseases as COPD;coronary artery diseases;and cancers.

The main aim of this research was to study the influence of sweet potato powder on diabetic rats. A total of 24 adult male albino rats of "Sprague Dawley" strain (150 ±5g) were used and randomly divided into 4 equal groups including negative control group, positive control group, while the other two groups were treated with 10% raw potato and 30% cooked potato depending on sensory evaluation of biscuits supplemented with raw and cooked sweet potato powder. The experiment lasted for 28 days. Measurements included determining glucose, liver functions, kidney functions and lipid profile in serum and pancreas histopathology. The results indicated that induced alloxan resulted in significant increases in glucose in urine and serum, in addition to a significant increase in liver and kidney functions, lipid profile expect HDL-C were decreased compared with a negative control group and abnormal histopathological changes were noticed in pancreas dysfunction resulted from abnormal histopathology was observed. Like raw and cooked sweet potato induced anti-diabetic effects and decreased glucose in blood serum. Moreover, they alleviated alloxan-induced abnormalities in body weight, liver and kidney functions. Accordingly, this study recommends diabetic patients to regularly consume sweet potato and its leaves with a suitable dose since they can induce an improvement in increase blood sugar الملخص العربى يهدف البحث لمعرفة تأثير العلاج بمسحوق البطاطا الحلوة النيئة والمطبوخة على الفئران المصابة بأرتفاع فى سکر الدم. تم استخدام ما مجموعه 24 من الفئران البيضاء الذکور البالغين من سلالة5±150) "Sprague Dawley"جم) وتم تقسيمها عشوائيا إلى أربع مجموعات متساوية,المجموعة القياسية السالبة ، المجموعة القياسية الإيجابية ، في حين تم علاج المجموعتين الأخريين بنسبة 10 ٪ من البطاطس الخام و 30٪ البطاطس المطبوخة حسب التقييم الحسي للبسکويت. استمرت التجربة لمدة 28 يوما. وشملت القياسات تقدير الجلوکوز ، وظائف الکبد ، وظائف الکلى والکوليسترول الکلى والجليسريدات الثلاثية والليبوبروتين منخفض ومرتفع الکثافةوتحليل الأنسجة البنکرياسية. أشارت النتائج إلى المجموعة القياسية الإيجابية زاد زيادات کبيرة في الجلوکوز في المصل ، بالإضافة إلى زيادة کبيرة في وظائف الکبد والکلى ، والکوليسترول الکلى والجليسريدات الثلاثية وانخفاضالليبوبروتين مرتفع الکثافةمقارنا مع المجموعة القياسية السالبية, کما لوحظت تغييرات نسيجية غير طبيعية فى البنکرياس بسبب أرتفاع سکر الدم. البطاطا الحلوة الخام والمطبوخة کان لها تأثيرات مضادة للسکري وانخفاض الجلوکوز في مصل الدم. علاوة على ذلک ، خففت من التشوهات التي يسببهاالألوکسانفي وزن الجسم ، وظائف الکبد والکلى. وبناء على ذلک ، توصي هذه الدراسة مرضى السکري بتناول البطاطا الحلوة بانتظام على 10% والبطاطا الامطهية بنسب 30% حيث يمکنهم إحداث تحسن في زيادة نسبة السکر في الدم.

Cellulose demonstrates unique properties and suitable for many different applications. In the present study an acetic acid bacterial strain has been isolated from rotten apple and investigated as cellulose producer. The strain was identified using morphological, biochemical characterization and 16s rRNA gene sequencing and named as Komagataeibacter hansenii (K. hansenii AS.5) under identity percentage 99%. Culture conditions for BC production by AS.5 were screened and compared with reference one Gluconacetobacter hansenii ATCC 23769 under static condition. Optimization of key production parameters has been carried out using OVAT (One Variable At Time) approach. Effect of media composition, inoculum size, pH, temperature, incubation time, different carbon and nitrogen sources were evaluated. The highest production of cellulose (3.75 g/l) was obtained after 10 days, 8% inoculum size, incubation 25◦C by K. hansenii AS.5 using Yamanaka medium with glucose and yeast extract as a sole carbon and nitrogen source, respectively. On contrast, G. hansenii ATCC 23769 exhibits the maximal BC production (2.18 g/l) under the modified GEM medium composed of mannitol and yeast extract as the optimum carbon and nitrogen source after 7 days at 25 ◦C and inoculum size 6%. It is clearly noticed the Cellulose production by the local isolate is higher than the reference one by 1.7- fold.

Background Factor X (FX) deficiency (FXD) is an extremely rare autosomal recessive hereditary hematologic disorder, affecting approximately one in 1,000,000 of the general population. Case report This case report describes an infant with hereditary severe FXD who presented with a spontaneous, life-threatening intracranial hemorrhage and was treated with the first licensed plasma-derived FX (pdFX) concentrate. On admission, laboratory assays showed severe coagulopathy of unknown cause; the patient was empirically treated using a multimodal hemostatic approach with prothrombin complex concentrate, fresh-frozen plasma, and tranexamic acid. Subsequent single-factor coagulation and genetic analyses confirmed the hereditary FXD diagnosis, and the therapeutic regimen was changed to a targeted regimen of 250 IU pdFX daily. Based on careful monitoring of the coagulation profile, pdFX administration frequency was increased to twice daily, followed by a reduction to once every 18 hours. The patient was discharged after 7 weeks of hospitalization in good clinical condition and now receives prophylactic pdFX three times weekly.

Objective Spontaneous bacterial peritonitis (SBP) is considered the paradigmatic model of infection in patients with liver cirrhosis. Therefore, there is a need for an accurate and rapid method for SBP diagnosis. The aim of this study was to evaluate the validity of serum-ascites 25-hydroxyvitamin D (25-OH vitamin D) gradient (SADG) as a marker for diagnosing SBP in patients with cirrhotic ascites. Methods We conducted a cross-sectional analytic study of 88 patients with portal hypertensive ascites resulting from liver cirrhosis of any etiology. The demographic, clinical, and laboratory characteristics of the patients were recorded. The level of 25-OH vitamin D in serum and ascitic fluid was measured using high-performance liquid chromatography autoanalyzer. The SADG was calculated with the formula: 25-OH vitamin D in serum − 25-OH vitamin D in ascites. Results Vitamin D deficiency was detected in 89.8% of the studied patients. The SADG values ranged between 0 and 69.2 ng/mL, with a median value of 5.58 ng/mL. It was significantly lower in patients with SBP than in those without SBP (P = .004). The area under the curve for SADG in exclusion of SBP was 0.67 at a cutoff value of ≥5.57 ng/mL. Conclusion We found that SADG may be a valid marker of SBP in patients with cirrhotic ascites.

During the ongoing COVID-19 pandemic, face masks are among the most common and practical control measures used globally in reducing the risk of infection and disease transmission. Although several studies have investigated the efficacy of various face masks and respirators in preventing infection, the results have been inconsistent. Therefore, we performed a systematic review and network meta-analysis (NMA) of the randomized-controlled trials (RCTs) to assess the actual efficacy of face masks in preventing respiratory infections. We searched nine electronic databases up to July 2020 to find potential articles. We accepted trials reporting the protective efficacy of face masks against respiratory infections, of which the primary endpoint was the presence of respiratory infections. We used the ROB-2 Cochrane tool to grade the trial quality. We initially registered the protocol for this study in PROSPERO (CRD42020178516). Sixteen RCTs involving 17 048 individuals were included for NMA. Overall, evidence was weak, lacking statistical power due to the small number of participants, and there was substantial inconsistency in our findings. In comparison to those without face masks, participants with fit-tested N95 respirators were likely to have lesser infection risk (RR 0.67, 95% CI 0.38–1.19, P-score 0.80), followed by those with non-fit-tested N95 and non-fit-tested FFP2 respirators that shared the similar risk, (RR 0.73, 95% CI 0.12–4.36, P-score 0.63) and (RR 0.80, 95% CI 0.38–1.71, P-score 0.63), respectively. Next, participants who donned face masks with and without hand hygiene practices showed modest risk improvement alike (RR 0.89, 95% CI 0.67–1.17, P-score 0.55) and (RR 0.92, 95% CI 0.70–1.22, P-score 0.51). Otherwise, participants donning double-layered cloth masks were prone to infection (RR 4.80, 95% CI 1.42–16.27, P-score 0.01). Eleven out of 16 RCTs that underwent a pairwise meta-analysis revealed a substantially lower infection risk in those donning medical face masks (MFMs) than those without face masks (RR 0.83 95% CI 0.71–0.96). Given the body of evidence through a systematic review and meta-analyses, our findings supported the protective benefits of MFMs in reducing respiratory transmissions, and the universal mask-wearing should be applied—especially during the COVID-19 pandemic. More clinical data is required to conclude the efficiency of cloth masks; in the short term, users should not use cloth face masks in the outbreak hot spots and places where social distancing is impossible.

The coronavirus “COVID-19” pandemic crisis has made a fundamental change in all over the world. In particular, education has been disrupted temporarily which has impacted almost 90% of the world's students in several countries. The pandemic has imposed many changes in the landscape of education systems worldwide. It will be essential to study and measure these changes to rethink design, use, and dealing with the “New Normal”. The educational spaces will witness significant changes during and post-COVID-19. The main question of this paper is: Will we return to the traditional schools' design in Egypt or move to a new path focused on student wellbeing and reducing upcoming pandemics impacts? This study aims to highlight the concerns about the condition of public schools in Egypt and investigate the potential changes and challenges facing the government now and in the future.

This article aims to shed light on an essential approach to maximize the output power of a wind turbine by highlighting the components and control of the electric system. The primary component of the system is the permanent magnet synchronous generator. The mentioned generator is selected based on the blade aerodynamics design, which outputs the rated power and rotational speed. The power output and rotational speed of the blade at any wind speed is given in a curve called Cp-lambda curve. The wind turbine generator is promptly followed by power electronics stages of rectifier –to convert the generator’s AC output voltage DC voltage- and consequently DC/DC boost converter to augment the output voltage to 60V. The Maximum power point tracking algorithm extracts the maximum output power of the turbine by means of the current controller. Additionally, a pitch mechanism is implemented to control the wind turbine once it passes the rated wind speed. Sensors such as rotational velocity, temperature and current sensors are employed to perform data acquisition for the controllers and to enable the user to have full control of the wind turbine. The wind turbine system has been simulated on SIMULINK and the power results were compared to the output of the real hardware setup.

Sagittal spinal deviation has been reported to be a significant musculoskeletal problem affecting both genders and could develop at any age. Factors triggering this issue are still not well defined. The purpose of this study was to investigate the relationship between sagittal spine angles and isokinetic peak, average torque, and power of trunk muscles in asymptomatic adults. A convenient sample of 79 subjects with asymptomatic spine participated in this study. Thoracic and lumbar curves angles were measured using the Formetric 4D device. Thoracolumbar (T/L) ratio was calculated as an indicator of spine balance. Isokinetic peak and average torque and average power for trunk flexors and extensors were measured at 60°/s in seated and semi-standing test positions. Lumbar curve angle was moderately inversely correlated (p

Islam is the fastest growing religion in the world. The Muslim population increases as Islam spreads around the world, which leads to an increasing demand for Islamic buildings such as mosques and Islamic centres. Mosques play an important role in Islam and Muslim life. In several countries, in particular, the Western mosques are seen as a newcomer whose building type is both unique and foreign to local people who are unaccustomed to the visual expression of Islam in the West.The mosque is one of the most visual expressions of global Muslim religious identity in non-Muslim context. The significant numbers of countries have a lot of different architecture styles of their Islamic buildings. Each mosque has its own individual touch. The most important factors behind this variation in form and styles can be divided into nature impacts as (local materials and environment), followed by man-made impacts by (Muslim immigrants, colonialism, funding, and laws, culture, and traditions).The study aims to examine each factor and their influences on the architecture of mosques and Islamic centers in non-Muslim context through analysis and a comparison of a number of examples. Keywords: Mosques, Islamic centers, Colonialism, Immigrants

Stair negotiation is a daily functional activity that poses greater mechanical burden as compared with level walking. Few studies have investigated the biomechanical demands of stair walking tasks. However, sex-based biomechanical differences of such tasks, in terms of joint movement and muscle activity, have not been previously reported. The aim of this study was to investigate sex-based differences in lower extremity joint kinematics and muscular electromyography (EMG) in healthy adults during stair ascent and descent. A total of 20 participants (10 males and 10 females), with mean±SD age of 21.7±2.7 years, ascended and descended a two-sided staircase. Sagittal movements of the hip, knee, and ankle joints were measured using a Qualisys motion analysis system. Peak amplitude of surface EMG activity for gluteus medius, rectus femoris (RF), vastus lateralis, and soleus muscles was collected using a Biopack EMG system. Each participant performed three repetitions, and an average was calculated for analysis. Female participants demonstrated significantly higher hip and knee angles (P=0.01) during stair ascent and higher hip angles and ankle dorsiflexion (P=0.01) during stair descent than male participants. Female participants also exerted higher normalized muscular activity than male participants for RF, vastus lateralis, and soleus muscles during ascent. However, only RF muscle had significantly higher readings for female participants during stair descent. Female participants perform stair negotiation using greater angular excursion and muscle activation than male participants. This could impose greater mechanical burden on lower extremity structures and, consequently, increase energy consumption. Therefore, sex-based differences should be considered when planning a stair-negotiation rehabilitation program.

Background Factor X (FX) deficiency (FXD) is an extremely rare autosomal recessive hereditary hematologic disorder, affecting approximately one in 1,000,000 of the general population. Case report This case report describes an infant with hereditary severe FXD who presented with a spontaneous, life-threatening intracranial hemorrhage and was treated with the first licensed plasma-derived FX (pdFX) concentrate. On admission, laboratory assays showed severe coagulopathy of unknown cause; the patient was empirically treated using a multimodal hemostatic approach with prothrombin complex concentrate, fresh-frozen plasma, and tranexamic acid. Subsequent single-factor coagulation and genetic analyses confirmed the hereditary FXD diagnosis, and the therapeutic regimen was changed to a targeted regimen of 250 IU pdFX daily. Based on careful monitoring of the coagulation profile, pdFX administration frequency was increased to twice daily, followed by a reduction to once every 18 hours. The patient was discharged after 7 weeks of hospitalization in good clinical condition and now receives prophylactic pdFX three times weekly.

The aim of this study was to evaluate the main and interaction effects of mass knowledge and mass magnitude on trunk muscular activity and lumbosacral kinematics. Eighteen participants performed symmetric box lifts of three different mass magnitudes (1.1 kg, 5 kg, 15 kg) under known and unknown mass knowledge conditions. Outcome measures were normalized peak electromyography of four trunk muscles in addition to three dimensional lumbosacral angles and acceleration. The results indicated that three out of four muscles exhibited significantly greater activity when handling unknown masses (p.05). Meanwhile, only sagittal angular acceleration was significantly higher when handling unknown masses (115.6 ± 42.7°/s(2)) compared to known masses (109.3 ± 31.5°/s(2)). Similarly, the mass magnitude and mass knowledge interaction significantly impacted the same muscles along with the sagittal lumbosacral angle and angular acceleration (p.05) with the greatest difference between knowledge conditions being consistently occurring under the 1.1 kg mass magnitude condition. Thus, under these conditions, it was concluded that mass magnitude has more impact than mass knowledge. However, handling objects of unknown mass magnitude could be hazardous, particularly when lifting light masses, in that they can increase mechanical burden on the lumbosacral spine due to increased muscular exertion and acceleration.