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DNA nanotechnology holds great promise for development of a lab-on-a-DNA origami. We summarize the latest trends based on DNA origami focusing on light-harvesting nanoantennas and platforms for single-molecule optical spectroscopy and/or atomic force microscopy (AFM).

Background: Preterm birth is the leading cause of neonatal mortality and the most common reason for neonatal admission to the hospital. Although the causes of preterm labor are not well understood, the burden of preterm births is clear—preterm births account for approximately 70% of neonatal deaths and 36% of infant deaths as well as 25–50% of cases of long-term neurologic impairment in children. Objective: To compare the effectiveness of the tocolytic action of the standard protocol of Magnesium sulfate versus the combination of Nifedipine and 17 α hydroxyprogesterone injection in the term of acute tocolysis therapy on the perinatal outcome and to abrupt threatened preterm labor between 24 weeks to 33 weeks and 6 days. Patients and methods: A prospective randomized control trial study conducted at Zagazig Maternity Hospital, included 102 pregnant women who presented with threatened preterm labor at the Emergency Department of Zagazig University Maternity Hospital. The participants were divided into two groups, group (1) included 51 cases who received the standard protocol of Magnesium Sulfate: loading dose 4 g IV; maintenance 2 g/hr for 24 hrs.

In the inductive charging scenario of an electric vehicle (EV), the charger should have the capability to flexibly regulate the output power regardless of the misalignment and EV battery voltage. This paper proposes a hybrid voltage and frequency tuning strategy for a series-series (SS) inductive power transfer (IPT) system to regulate power through 0 to 3.3kW at any battery voltages and misalignment conditions without using additional converters. A voltage tuning is used to achieve full-power of 3.3kW and partly contribute to reducing the power. When the input voltage achieves the lower limit, a frequency tuning is used to further decrease the power to 0W, achieving the regulation through 0 to full power. The practical charging region is specified by 110mm airgap, 100mm misalignment in both x and y directions, and 180V-240V battery voltage range. Experiments are carried out at various conditions, and it shows that with an input voltage range of 180V-380V and a frequency of 82.5kHz~87.9kHz, the charging power can be regulated between 100W and 3.3kW at any case in the specified working region. In addition, a peak dc-dc efficiency of 95.7% is achieved at 3.29 kW.

In an inductive power transfer (IPT) system, the variations of passive parameters affect the system performance. This paper investigates the impact of the variation of resonant parameters on the system power and efficiency in a 5.7 kW LCC compensated IPT system for electric vehicle (EV) charging application. For the single-parameter variation, the sensitivity of power and efficiency to each parameter is investigated by LTspice simulation. For multi-parameter variations, exhaustive analysis and Monte-Carlo methods are applied to quantify the sensitivity issue. It indicates that with random multi-parameter variations within ±10%, the 5.7kW IPT system only has a 73.87% probability to satisfy a 10% power fluctuation of [5.13kW, 6.27kW] with efficiency above 92%. To mitigate the sensitivity issue, the cascade Monte-Carlo method is used to optimize the central values of parameters at the design stage, which can increase the yield rate in mass production from 73.87% to 82%. Furthermore, a frequency tuning method is proposed to regulate power and efficiency. Finally, a 5.7kW full-power prototype is implemented. Experiments are performed using three special parameter combinations, which validated the sensitivity concern and the feasibility of the proposed frequency tuning method.

BACKGROUND AND AIM: Gastric cancer (GC) is one of the top causes of cancer-related deaths worldwide. According to the Cancer Genome Atlas, there are four subtypes of GC, with the Epstein-Barr virus (EBV) subtype accounting for about 10% of cases. EBV infection causes EBV-associated GC (EBVaGC). The previous research suggested that the presence of the EBV viral genome in gastric carcinomas could be used as a surrogate marker for targeted therapy and optimal GC treatment. AIM: We aimed to explore the rate of EBV involvement in gastric carcinogenesis from molecular perspective view and to evaluate the role of the tumor-suppressor protein p16 as a marker for diagnosis in GC Egyptian patients in relation to EBV infection. METHODS: One hundred-four surgically resected GC cases were analyzed. Two methods including quantitative real-time polymerase chain reaction (qPCR) for detecting EBV-derived latent membrane protein-1 (LMP-1) and Epstein-Barr nuclear antigen-1 (EBNA-1) genes as well as immunohistochemistry (IHC) detection of LMP-1 protein and p16 protein on paraffinized tissue blocks were applied. RESULTS: Using IHC, p16 protein was presented in 90/104 (86.5%) of the GC cases, and EBV LMP-1 was detected in 4 cases (3.84%). qPCR detected 14 cases positive for EBV (13.46%). In EBV positive cases detected using qPCR, no expression of p16 was detected. CONCLUSION: EBVaGC has a low incidence in Egypt; loss of p16 expression was recognized in EBVaGC and could be considered as a promising biomarker of EBVaGC. The combination of the two methods IHC and qPCR in addition to p16 is recommended for improving the accuracy of identification of infected cancer.

The simultaneous kidney transplantation and ipsilateral native nephrectomy for autosomal dominant polycystic kidney disease does not seem to be associated with increased rates of comorbidity and complications. This outcome can efficiently be achieved when the indication and surgical approach of native nephrectomy are properly justified.

BACKGROUND: Renal angiomyolipoma (RAML) is a rare benign neoplasm with a prevalence varying between 0.2% and 0.6% and a strong female predilection. They occur as sporadic, isolated entities in 80% of cases. The remaining 20% of angiomyolipomas (AMLs) develop in association with tuberous sclerosis complex or pulmonary lymphangioleiomyomatosis. AIM: We describe our 10-year experience with AML and discuss the treatment strategies employed at our center. METHODS: The medical records of all 33 patients with pathologically confirmed RAML treated either by nephrectomy or nephron-sparing surgery at our center over 10 years were reviewed for patient age and sex, tumor location and size, association with TBS. RESULTS: There were 28 females (84.8%) and 5 males (15.2%) with a median age that was 52 (range 22–74) years at the time of surgery. Thirty patients (90.9%) had sporadic isolated AML, and 3 patients (9.1%) had AML with TBS. The tumor was in the right kidney in 15 (45.5%) patients, in the left kidney in 17 (51.5%) patients, and bilateral in only 1 patient (3%) who was diagnosed with TBS. At presentation, flank pain was the main symptom in 23 patients (69.7%). CONCLUSIONS: Surgical resection of RAML provides short-term symptomatic relieve and long-term survival.

A variety of evaluation methods have been developed over recent decades, as well as a number of formal systems of evaluation have been developed by planners. These systems take into account cultural and aesthetic standards along with physical and economic ones. Some of these methods have been used to serve the reuse of valuable buildings. The reuse process is one of the most important methods of preserving valuable buildings, and the re-use policy requires changing the idea of converting these buildings into museums or cultural palaces in most cases, thinking that they serve the local community and be part of sustainable development processes, as historical buildings do not give the urban fabric a character. Only, but it integrates with it, providing the city with personality and heritage identity, adding value to it and enhancing its position. Choosing the optimal alternative to reuse a building of value creates problematic, as deciding how to use the historic building will result from the decision-making process. It is in this process that the best alternative to use is chosen from many options, taking into account the selection criteria. تم تطوير مجموعة متنوعة من أساليب التقييم على مدار العقود الأخيرة وکذلک تطوير عدد من النظم الرسمية للتقييم من قبل المخططين ، تراعي هذه الأنظمة المعايير الثقافية والجمالية جنبا إلى جنب مع تلک المادية والاقتصادية واستخدمت بعض هذه الأساليب لخدمة عملية إعادة استخدام المباني ذات القيمة. تعتبرعملية إعادة الاستخدام أحد أهم أساليب الحفاظ على المباني ذات القيمة ، وتتطلب سياسة إعادة الاستخدام تغيير فکرة تحويل هذه المباني إلى متاحف أو قصور ثقافية في أغلب الأحيان، والتفکير في کونها تخدم المجتمع المحلي وتکون جزء من عمليات التنمية المستدامة، فالمباني التاريخية لا تعطى النسيج الحضري الطابع فقط، ولکنها تتکامل معه، وتمد المدينة بالشخصية والهوية التراثية وتضفي عليها قيمتها وتعزز مکانتها. إن اختيار البديل الامثل لإعادة استخدام مبنى ذو قيمة يخلق إشکالية، حيث إن اتخاذ القرار بشأن طريقة استخدام المبنى التاريخي سينتج عن عملية صنع القرار. في هذه العملية يتم اختيار أفضل بديل للاستخدام من العديد من الخيارات، مع مراعاة معايير الاختيار.

Thyroid cancer is one of the common malignant conditions of the head and neck region, and it is considered as one of the most common cancers among endocrine tumors. Ultrasonography is widely used in order to assess thyroid nodules, Therefore, the aim of our study is to determine the accuracy of ultrasonography and fine needle aspiration biopsy (FNAB)-guided by ultrasonography in the diagnosis of thyroid malignancy among the population in the Ha'il region of Saudi Arabia.A retrospective evaluation of 137 patients was undertaken at King Salman Specialist Hospital, Ha'il, Kingdom of Saudi Arabia. Patients who presented with thyroid swellings underwent ultrasonography and FNAB.Our study results have concluded that the sensitivity of the ultrasonography in the confirmation of a malignant thyroid lesion is 59.4% and its specificity was found to be 74.3%.The study showed that ultrasonography using Thyroid Imaging Reporting and Data Systems (TIRADS) is a significant step in evaluating a thyroid nodule. Also, it is highly sensitive and specific, cost-effective, and convenient for the patient.

To study the feasibility and safety of One-Shot Dilatation (OSD), versus serial sequential dilatation in tubeless Percutaneous Nephrolithotomy (PCNL). One Hundred and Fifty patients were randomised into two groups; Group A (One-Shot Dilatation), Group B (Serial Dilatation). Twenty-one patients were excluded from the study. Detailed history was taken and full physical examination was performed. Pre-operative routine laboratory investigations were done. Also, non-contrast Computed Tomography of the Urinary Tract (CTUT) and plain urinary tract x-ray were done. Intra-operative assessments of dilatation, total operative, total fluoroscopy and fluoroscopy during dilatation durations were recorded, as well as estimated blood loss. Post-operatively haemoglobin, creatinine levels and CTUT were performed for all patients. Complications, as urinary leakage time, analgesic requirements and hospitalization time were measured. There were statistically significant differences in the intraoperative durations, where Group A had shorter dilatation time, fluoroscopy time during dilatation and total operative time. Group B had a higher complications rate than Group A; 37.9%, 11.3%, respectively. Also, Group B showed haemoglobin drop by 0.44 mg/dl higher than Group A. More doses of analgesia were required for Group B. Hospitalization time and rate of urinary leakage were both in favour of Group A. For patients undergoing Tubeless PCNL, we have concluded that one-shot dilatation seems to be a safer and more feasible technique than Serial dilatation.

Cervical pregnancy is a rare clinical entity that accounts for less than 1% of all ectopic pregnancies. It results from implantation of the blastocyst in the cervical canal below the level of the internal os. Although non-tubal ectopic pregnancies account for only 5% of ectopics, they contribute to a significant morbidity. The cornerstone in the management of cervical ectopic is early diagnosis by high index of suspension and a qualified sonographer. Management options for cervical ectopic pregnancies range from conservative drug treatment to radical hysterectomy. Over the last few years, the mortality and morbidity rates of ectopic pregnancies have been reduced. This is mainly due to the early recognition of the condition and the wide availability of minimally invasive surgical procedures. We present a case of a 33-year-old woman that was 16 weeks pregnant. She presented initially with recurrent vaginal bleeding followed by minimal lower abdominal pain. Her early US scans were misleading. Several weeks later, a follow up MRI scan suggested cervical ectopic. She was managed surgically with uterine preservation.

The research reviews the concept of value for sociologists and philosophers, and studies the relationship of value to architectural heritage according to Cullen's classification, explaining the difference between historical buildings and buildings of visual and related value, and then reviews the values ​​according to the classification of Worsket (historical value - architectural value - economic value - architectural value - value Political .....) and the concept of each. The research also clarifies the three main axes of values ​​according to the local classification and the indicators affecting each axis, and the guidelines for Egyptian Law No. 109 (for the year 2008) and the Civilization Coordination Manual issued by the National Authority for Urban Harmony (NOUH). The research aims to compare the classifications of values ​​previously presented through matrix Analyzing cultural values ​​according to four global and local classifications, analyzing them and presenting a new classification of heritage values. The research tried to reach a new classification of the value by which the buildings of heritage value can be classified, to determine the best way to deal with them. يستعرض البحث مفهوم القيمة لدى علماء الاجتماع والفلاسفة، ويدرس علاقة القيمة بالتراث المعماري طبقا لتصنيف کالن موضحا الفرق بين المباني التاريخية والمباني ذات القيمة البصرية والأخرى المرتبطة بإحداث او أشخاص مهمة ثم يستعرض القيم وفقا لتصنيف ورسکت t (قيمة تاريخية – قيمة معمارية – قيمة اقتصادية – قيمة عمرانية - قيمة سياسية .....) ومفهوم کل منها. وکذلک يوضح البحث المحاور الثلاثة الرئيسية للقيم طبقا للتصنيف المحلي والمؤشرات المؤثرة على کل محور، والمبادئ التوجيهية للقانون المصري رقم 109 (لعام 2008) ودليل التنسيق الحضاري الصادر عن الجهاز القومي للتنسيق الحضاري ويهدف البحث الي المقارنة بين تصنيفات القيم السابق عرضها من خلال مصفوفة تحليل القيم الثقافية طبقا لأربعة تصنيفات عالمية ومحلية وتحليلها وعرض تصنيف جديد للقيم التراثية. ولقد تم تطوير مجموعة متنوعة من أساليب التقييم على مدار العقود الأخيرة ويعتبر مبدأ التقييم من المبادئ الأساسية للوصول بسياسات التعامل مع الأبنية ذات القيمة إلى الواقعية المطلوبة للتطبيق وضمان تحقيق النجاح. وقد حاول البحث الوصول إلى تصنيف جديد للقيمة يمکن من خلاله تصنيف المباني ذات القيمة التراثية لإمکانية تحديد الأسلوب الأمثل للتعامل معها.

Background: The coronoid process is considered the keystone of bony elbow stability, in addition to its soft tissue attachment. Aim of the work: To compare conservative treatment versus fixation of type I coronoid fracture in terrible triad injuries as regard elbow stability, functional outcome, and possible complications. Patients and methods: We performed a prospective randomized control study on 20 patients with terrible triad injuries and were divided into two equal groups. Randomization was done using Microsoft Excel. Group (1) including 10 patients where the coronoidfracture was not repaired, and Group (2) including 10 patients where the coronoid fracture was repaired. All patients were operated using the lateral approach. In the second group, the coronoid fracture was fixed using pull-out sutures. In both groups, internal fixation was done for the radial head or neck fracture with reattachment of the lateral ulnar collateral ligament (LUCL) to its humeral origin by transosseous sutures. Postoperative patient assessment was done according to the Disabilities of the Arm, Shoulder and Hand (DASH) Score, and the Broberg-Morrey rating system. Results: In the first group, the mean Broberg-Morrey score was 91.2 (range, 85–98) with four excellent results and six good results. The average DASH score was 13 (range, 2.5–30). In the second group, the mean Broberg-Morrey score was 94.4 (range, 89–98) with seven excellent results and three good result. The average DASH score was 9.6 (range, 0–23.3).Two patients experienced postoperative complications in the first group, one implant failure of the radial neck fracture after 3 weeks follow up and the other did not reach complete union of his radial neck. Both patients refused a second operation.Conclusion: We conclude that fixation of type I coronoid fractures in terrible triad injuries did not show significant difference regarding elbow stability and clinical outcome at short-term follow up.

The necessity to resolve the issue of rapid charge carrier recombination for boosting photocatalytic performance is a vigorous and challenging research field. To address this, the construction of a binary system of step-scheme (S-scheme) CuO@TiO2 heterostructure composite has been demonstrated through a facile solid-state route. The remarkably enhanced photocatalytic performance of CuO@TiO2, compared with single TiO2, which can consequence in the more efficient separation of photoinduced charge carriers, reduced the band gap of TiO2, improved the electrical transport performance, and improved the lifetimes, thus donating it with the much more powerful oxidation and reduction capability. A photocatalytic mechanism was proposed to explain the boosted photocatalytic performance of CuO@TiO2 on a complete analysis of physicochemical, DFT calculations, and electrochemical properties. In addition, this work focused on the investigation of the stability and recyclability of CuO@TiO2 in terms of efficiency and its physical origin using XRD, BET, and XPS. It is found that the removal efficiency diminishes 4.5% upon five recycling runs. The current study not only promoted our knowledge of the binary system of S-scheme CuO@TiO2 heterojunction composite photocatalyst but also shed new light on the design of heterostructure photocatalysts with high-performance and high stability.

Primary central nervous system lymphoma (PCNSL) is a rare subtype of extranodal non-Hodgkin's lymphoma that accounts for 4% of newly diagnosed central nervous system (CNS) tumors. Most primary lymphomas of the central nervous system are of the subtype of diffuse large B-cell lymphomas, which have highly aggressive behavior and may involve the brain, leptomeninges, eyes or spinal cord without evidence of systemic disease. Primary CNS lymphomas are very rare in immunocompetent patients, but their rates are increasing. So far, only 11 primary Gasser ganglion lymphomas have been reported, with an incidence of 2.5 cases per 30,000,000 inhabitants. However, B cell lymphomas of the marginal zone of the Gasserian ganglion have been very rarely reported. We report here a clinical presentation characteristic of B cell lymphoma of the marginal zone of the Gasser ganglion in an immunocompetent patient who was treated with surgery and radiotherapy, evolving with improvement of symptoms and without recurrence in 3 months of follow-up.

Light induced electron transfer reactions of molecules on the surface of noble metal nanoparticles (NPs) depend significantly on the electronic properties of the metal-organic interface. Hybridized metal-molecule states and dipoles at the interface alter the work function and facilitate or hinder electron transfer between the NPs and ligand. X-ray photoelectron spectroscopy (XPS) measurements of isolated AuNPs coated with thiolated ligands in a vacuum have been performed as a function of photon energy, and the depth dependent information of the metal-organic interface has been obtained. The role of surface dipoles in the XPS measurements of isolated ligand coated NPs is discussed and the binding energy of the Au 4f states is shifted by around 0.8 eV in the outer atomic layers of 4-nitrothiophenol coated AuNPs, facilitating electron transport towards the molecules. Moreover, the influence of the interface dipole depends significantly on the adsorbed ligand molecules. The present study paves the way towards the engineering of the electronic properties of the nanoparticle surface, which is of utmost importance for the application of plasmonic nanoparticles in the fields of heterogeneous catalysis and solar energy conversion.

Background Distal femur fractures account for less than 1% of all fractures and 3%– 6% of all femur fractures. Epidemiological studies indicate 2 primary distributions of patients: elderly individuals with low energy mechanisms such as a fall from standing, and younger patients with high-energy mechanisms such as motor vehicle accidents. Fixation of the distal femur fracture with lateral locked plate had a nonunion rate between 0 to 32%. The concept of “Dynamic” Locked Plates, has been proposed to decrease construct stiffness & improve callus formation. Objective A systematic review and meta-analysis of literature to assess the outcomes of dynamic locked plate of distal femora fractures. Data Sources Medline databases (PubMed, Medscape, ScienceDirect. EMF-Portal) and all materials available in the Internet till 2018. Data Extraction If the studies did not fulfill the inclusion criteria, they were excluded. Study quality assessment included whether ethical approval was gained, eligibility criteria specified, appropriate controls, and adequate information and defined assessment measures. Conclusion Our systematic review and meta-analysis showed different method of distal femur locked plate dynamyzation. DLP of distal femur increased interfragmentery micro motion, decrease construct stiffness and improve healing & union rate of distal femur fractures. Finally it should be noticed that the orthopedic surgeon should be qualified to utilize either techniques & the choice depends on the preoperative planning & method of fixation available which leads to fracture union on time without complications.

The necessity to resolve the issue of rapid charge carrier recombination for boosting photocatalytic performance is a vigorous and challenging research field. To address this, the construction of a binary system of step-scheme (S-scheme) CuO@TiO

Objective: To evaluate the factors affecting the success of metformin in management of GDM. Methods: A prospective cohort study was done for 94 patients diagnosed with GDM from April 2019 to March 2020 who needed pharmacological treatments in addition to diet and lifestyle modification. Cases treated with metformin monotherapy were compared with others who needed insulin in addition to metformin for glycemic control. Patient characteristics, glycemic control data and neonatal outcome were evaluated. Univariate and multivariate analysis was done to find the independent factors affecting the success of metformin. Results: Of 94 patients with GDM who needed pharmacological treatment, 73 (77.6%) used only metformin for treatment of GDM and 21 (22.4%) needed insulin to be added to metformin. Multivariate analysis revealed that BMI was the only significant factor that affects the success of metformin alone in control of GDM (p = 0.03). ROC curve of BMI showed that the cut off value of the highest sensitivity is 32.1 above which metformin monotherapy failed to control GDM. Conclusion: Metformin can be considered as a safe and effective drug for treatment of GDM. Obesity was found as a predictive factor for failure of metformin monotherapy.

Intraoperative cholangiogram (IOC) is routinely used during cholecystectomy (either open or laparoscopic) in cases of cholelithiasis with history of obstructive jaundice (OJ). It is performed in such cases with no preoperative imaging that confirms the patency of biliary tree and during exploration of common bile duct. Intraoperative ultrasound (IOUS) has recently become a visualizing tool for anatomy and pathology of biliary tree which is safe, faster and less invasive compared to IOC. This is a prospective controlled randomized trial, conducted on 60 patients undergoing laparoscopic cholecystectomy for cholelithiasis with history of OJ, with no present OJ. It was held in the surgery department in Faculty of Medicine, Menoufia University and Theodor Bilharz Research Institute, from 2014 to 2017. Each patient underwent IOUS then, IOC during laparoscopic cholecystectomy. The study compared between both imaging techniques regarding procedure time, visualization of biliary tree, detection of any common bile duct (CBD) stone, biliary or vascular anomalies, and intra-or postoperative complications in the form of obstructive jaundice or iatrogenic biliary injury. The results showed a significant difference in time of the procedure with a mean time (min) of 9.60±1.224 (3-25) in IOUS and 14.391±1.356 (5-30) in IOC. Mean CBD diameter (mm) is 5.280±0.6957 (2.8-18) in IOUS & 7.010±0.7162 (3.5-22) in IOC without significant differences. IOUS has 100% sensitivity and 96.7% specificity while IOC has 100% sensitivity and 100% specificity. A case with vascular anomaly and one with duct anomaly were detected by IOUS. The vascular anomaly could not be detected with IOC. There was no post-operative complication in the form of missed CBD stones or bile leakage.

Duloxetine hydrochloride (DH) is a serotonin-norepinephrine reuptake inhibitor (SSNRI) indicated for the treatment of depression. Duloxetine suffers from reduced oral bioavailability (≈50%) due to hepatic metabolism. DH buccoadhesive lyophilized tablets were prepared adopting the solvent casting/freeze drying method using HPMC, chitosan and carbopol alone or in combination with PVA. The prepared tablets were evaluated for uniformity of weight, drug content, pH, swelling behavior, mucoadhesion strength and drug release and the data was analyzed using Design-Expert® Software. DSC, FTIR studies and scanning electron microscopy (SEM) were performed for the selected tablets. Accelerated stability and bioavailability studies in healthy human volunteers were also performed. Results showed that (T7) tablets showed the optimum physicochemical characters. DSC and FTIR studies showed the drug compatibility with the tablet components. SEM micrographs revealed that the selected tablets were porous and homogenous. Accelerated stability studies revealed that DH remained stable throughout the experiment time. Bioavailability results showed that Cmax and AUC0-72 for T7 was higher than the market product (Cymbalta® 30 mg capsules), while, Tmax was shorter. The percentage relative bioavailability of DH was 308.17%. These results reveal the possibility of T7 tablets to deliver the drug via the buccal route with improved drug bioavailability.

Background: During the last decades, anatomical studies on skin vascularization provided the base for the development of flaps nourished by perforating arteries and preserving major vessels. In the last years, perforator flaps have become an appealing option for coverage of a large range of defects as they allow for great freedom in design and for reconstruction of difficult wounds with minimal donor-site morbidity, but doubts regarding their reliability have overshadowed its safety in clinical practice. Aim of the Work: This prospective clinical study is conducted to assess the reliability and efficacy of local perforator flaps in coverage of hand, wrist, and forearm skin defects. Patients and methods: We conducted a prospective study involving 20 patients with hand, wrist, and forearm skin defects and were covered with local radial and ulnar arteries perforator flaps. Postoperative complications were recorded and assessment of patients’ satisfaction as regards donor site morbidity and aesthetic outcome of the flap was done by a questionnaire at the outpatient clinic and the results were classified as unsatisfactory, satisfactory, good, and very good. Vancouver Scar Scale was applied as an objective tool for scar assessment postoperative. Three-month follow up was the end point of this study. Results: Radial artery perforator flaps were done in 11 cases (55 %) and ulnar artery perforator flaps in 9 cases (45%).Temporary venous congestion happened in 19 cases, distal tip necrosis in 10 cases, superficial epidermolysis in 8 cases, and arterial insufficiency in one case. Mean operative time was 63.8 min., 70.64 min. in RA perforator flaps and 55.44 min. in UA perforator flaps. Conclusion: Perforator flaps are a reliable tool for upper extremity coverage, with a low rate of failure and secondary surgery. These flaps are particularly useful for covering small and medium sized defects in the distal one third of the forearm, wrist, and hand; and they represent a reliable and effective alternative to free flaps.

Background: Candidemia and disseminated candidiasis are major causes of morbidity and mortality in hospitalized patients especially in ICU, the incidence of invasive candidiasis is on a steady rise because of increasing use of multiple antibiotics and invasive procedures carried out in the ICUs. Risk factors for invasive candidiasis & candidaemia include prior antimicrobial therapy, central venous catheters, urinary catheters, ICU admission, parenteral nutrition, major surgery and immunosuppressive therapies. Candida species were the most frequently isolated organism from any sites and comprise 85% of total number of cultures.Aim of Study: Assessing the rate of fungal infections after hepatobiliary surgery and identification of the risk factors associated with the development of fungal infections in such patients.Patients and Methods: A prospective cohort hospital based study was carried out at National Liver Institute. The studied group consisted of 210 patients. All of them were examined thoroughly, their data were registered and sampled at two times, one at day of admission to be sure that they are free of fungal infection and the second was after hepatobiliary surgery pre-designed questionnaire was used which include data about personal history, medical history and suggested risk factors for fungal infections.Results: In the present study the incidence rate of fungal infection among patients undergone hepatobiliary surgeries in NLI is (45.2%) and the main predictors of fungal infection were age (p-value 0.001), antibiotic use (p-value 0.05), liver disease (p-value 0.006), CVC (p-value 0.043), urinary catheter (p-value 0.05), and ICU hospitalization more than 48 hours (p-value 0.000008).Conclusions: High incidence of fungal infection after hepatobiliary surgeries may reach 45% due to type of patient doing such surgeries. The great prevalence of fungal coloni-zation inside ICU which is easily transmissible emphasizes very strongly on the importance of infection- control guidelines.Recommendations: Aggressive antibiotics shouldn't be used outside ICU and only antibiotics according to culture and sensitivity should be used to lessen down emergence of resistant strains and fungal flourishment.

This paper proposes a highly symmetrical inductive power transfer (IPT) system based on double-sided Z-impedance compensation networks. The double-sided Z-impedance networks are designed with symmetrical configuration and could achieve load-independent CC output with zero-phase angle (ZPA) of input impedance. Compared to the conventional LCC circuit, the proposed Z-network can reduce current stresses on compensation components, which contributes to high-power applications. Meantime, compensation inductors are integrated with main coils to make the whole system compact and eliminate unwanted cross couplings. The proposed IPT system is validated by experiments and 2.3kW power could be transferred with 96.93% dc-dc efficiency across an air gap of 120mm.

This digest proposes a power control strategy using a voltage boosting and frequency detuning approach in an S-S compensated EV IPT system. voltage is increased to increase output power, and frequency is increased from the resonant frequency to decrease output power, reducing the voltage range requirement of the input. The system is designed to maintain full power range control despite fluctuating load and misalignment condition. A prototype is developed that achieves 0.0–3.3kW power control across all battery load and x-y misalignment combinations. The proposed strategy is tested by constructing an experimental prototype, that achieves a peak DC/DC efficiency of 95.7%

This digest proposes a cross-coupled LCC-P coil structure to improve the misalignment tolerance of a Z-class compatible inductive wireless power transfer system for electric vehicles (EVs) described in J2954. The standard specifies the misalignment distances in the x-y-z plane to which the system will be exposed. Misalignment induces large variations in coupling coefficients between the primary and secondary sides of the coupler, resulting in proportionally large power fluctuations. The design uses a reversed coupled filter inductor to improve misalignment performance. Compared to previously proposed designs, the proposed LCC-P topology offers good performance, while reducing the size and complexity of the vehicle side coupler. Additionally, all the coils in the coupler are unipolar, further reducing the overall system complexity. A prototype is designed and constructed to validate the proposed solution. Experiments have achieved 3kW power transfer with 95.8% efficiency.

DNA origami technology allows for the precise nanoscale assembly of chemical entities that give rise to sophisticated functional materials. We have created a versatile DNA origami nanofork antenna (DONA) by assembling Au or Ag nanoparticle dimers with different gap sizes down to 1.17 nm, enabling signal enhancements in surface-enhanced Raman scattering (SERS) of up to 1011. This allows for single-molecule SERS measurements, which can even be performed with larger gap sizes to accommodate differently sized molecules, at various excitation wavelengths. A general scheme is presented to place single analyte molecules into the SERS hot spots using the DNA origami structure exploiting covalent and noncovalent coupling schemes. By using Au and Ag dimers, single-molecule SERS measurements of three dyes and cytochrome c and horseradish peroxidase proteins are demonstrated even under nonresonant excitation conditions, thus providing long photostability during time-series measurement and enabling optical monitoring of single molecules.

Objective: To compare Fs-LASIK and Fs-SMILE in terms of efficacy, safety, predictability. Also comparing the effect of both procedures in dry eye parameters, corneal higher order aberrations and corneal asphericity. Methods: Our study is a prospective, non-randomized, comparative clinical study will be applied on patients with myopia or myopic astigmatism. This study includes 60-eyes that were recruited from El Mashreq Eye Hospital presented for refractive error correction. Fs- LASIK group included 30-eyes and SMILE group included 30-eyes. Results: There was a non-statistically significant difference between both procedures in efficacy, safety and predictability. 86.67% of treated eyes in the SMILE group, and 93.33% of treated eyes in the FS-LASIK group, respectively, had 20/20 or better UDVA. Dry eye was manifested in less degree after SMILE procedure in comparison with Fs-LASIK. Both Fs-LASIK and Fs-SMILE increased total corneal higher order aberrations, spherical aberrations and coma aberration, but there was a non-statistically significant difference between both procedures. Fs-SMILE induced more coma aberration, probably due to the decentration and Fs-LASIK induced more spherical aberrations, but these results were statistically non-significant. Conclusion: The results in both procedures are matching and comparable but a further contralateral fellow eye studies is needed to have a homogenous preoperative matching and avoid bias. Keywords: Femtosecond Assisted LASIK; Lenticule Extraction (SMILE); Myopia

DNA origami technology allows for the precise nanoscale assembly of chemical entities that give rise to new functional materials. We have created a versatile DNA Origami Nanofork Antenna (DONA) by assembling Au or Ag nanoparticle dimers with 1.17 ± 0.67 nm gap size, enabling signal enhancements in surface-enhanced Raman scattering (SERS) of up to 1011. This allows for single-molecule SERS measurements, which can even be performed with larger gap sizes to accommodate differently sized molecules, and at various excitation wavelengths. A general scheme is presented to place single analyte molecules into the SERS hot spots using the DNA origami structure exploiting covalent and non-covalent coupling schemes. By using Au and Ag dimers, single-molecule SERS measurements of three dyes and cytochrome c and horseradish peroxidase proteins are demonstrated even under non-resonant excitation conditions, thus providing long photostability during time-series measurement, and enabling unprecedented optical monitoring of single molecules and DNA origami based nanomachines.

BackgroundGiant hydronephrosis is rare with a controversy about the complete loss of renal functions. Our objective is to present our center’s experience with the management of cases of clinically visible giant hydronephrosis considering the potential residual functions. Our study is a retrospective case series of clinically visible giant hydronephrosis which was managed during the period July 2001–June 2016. Demographic and clinical variables were studied with specific considerations to the potential residual functions.ResultsOf more than 82,000 urological interventions, only 47 cases (0.057%) were operated upon for clinically visible giant hydronephrosis. Group 1 included 21 patients (mean age = 50.43 ± 13.71 years) who were treated initially by nephrostomy tube, and group 2 included 26 patients (mean age = 42.96 ± 15.16 years) who were treated primarily by nephrectomy. The main clinical presentation was abdominal distention (61.7%), while 13 patients (27.7%) were unaware of the swellings. The commonest underlying causes of hydronephrosis were urolithiasis (68.1%) and bilharzial ureteral strictures (23.4%). The contralateral kidney was diseased in 22 cases (46.8%) including the bilateral clinically visible hydronephrosis in 7 cases (15%). Indications of placement of a nephrostomy tube included uremia, infections, and evaluation of renal functions, where 5 cases of group 1 regained significant split function ranged 14–33%.ConclusionsClinically visible giant hydronephrosis is an extreme form of renal dilatation with different etiologies such as urolithiasis and bilharziasis. Initial placement of a nephrostomy tube may save significant residual functions in these kidneys.

Aim of the work: this study aimed to display the role of imaging by MRI in early detection and accurate diagnosis of chemotherapeutic neurotoxicity in neoplastic patients under chemotherapy. Patients and methods: this study included 50 cases of different cancers with CNS radiological manifestations. It included any cancer patient, regarding the age, sex and primary cancer and received any type of chemotherapy. The entire patients were evaluated by CEMRI technique, MR venography as well as diffusion weighted MRI. Results: our result showed different forms of neurotoxicity that occur in cancer patients due to the effect of chemotherapy such as posterior reversible encephalopathy syndrome and cerebral venous sinus thrombosis. Conclusion: all survivors of cancer patients should have lifelong follow-up, preferably with magnetic resonance imaging which provided greater anatomic detail and early detection of any abnormality.

Duloxetine hydrochloride (DH) is a serotonin–norepinephrine reuptake inhibitor (SSNRI) indicated for the treatment of depression. Duloxetine suffers from reduced oral bioavailability (≈50%) due to hepatic metabolism. This study aims to develop DH buccoadhesive films to improve its bioavailability. DH buccoadhesive films were prepared adopting the solvent casting method using hydroxypropyl methylcellulose (HPMC) and polyvinyl alcohol (PVA). The prepared films were evaluated for weight uniformity, drug content, surface pH, swelling index, mucoadhesion strength and drug release percentages. Accelerated stability and bioavailability studies in healthy human volunteers were also performed for the selected films. Results of the evaluation tests showed that the optimum physicochemical characters were obtained by the films prepared with 2% HPMC using 10% propylene glycol (F2 films). Accelerated stability studies revealed that DH showed proved stability throughout the experiment time. DH bioavailability from F2 films was determined and compared with that of the marketed oral capsules (Cymbalta® 30 mg). The pharmacokinetic results showed that Cmax for F2 was higher than the market product. In addition, ANOVA analysis showed that a Tmax of F2 film was significantly lower, while, the AUC0–72 of F2 was significantly higher than that of Cymbalta capsules. The percentage relative bioavailability of DH from F2 was found to be 296.39%. Therefore, the prepared buccal films offer an alternative route for the administration of DH with the possibility of improving its bioavailability.

The term ‘Livability’ had emerged for a holistic, systemic strategy in an attempt to reverse some of the 20th century urban planning techniques and had applied very broadly; however, ambiguity still characterizes the term. The study tries to give a clear explanation of this term; investigating the linkage between the term ‘Livability’ and other terms in addition to codifying different studies that are testing new methodologies for analysing cities in terms of being livable. Finally, the paper discusses how to make any built urban environment whether a city, a town or a neighbourhood truly livable. Keywords: Urban Livability, Livability Rankings, Satisfaction, Quality of Life, Well-being

This paper presents emotion recognition models using facial expression features. By detecting the face in videos and extracting local characteristics (landmarks) to generate the geometric-based features to discriminate between a set of five emotion expressions (amusement, anger, disgust, fear, and sadness) for videos from BioVid Emo database. The classification operation is done using different machine learning models including random forest (RF), support vector machines (SVM), k-nearest neighbors (KNN) and recurrent neural network (RNN), then the evaluation operation is done to generate different discrimination rates that reached up to 82% to discriminate between anger and disgust emotions.

The increasing demand for solid organs has necessitated the use of ABO and Rhesus (Rh) D minor mismatched transplants. The passenger lymphocyte syndrome (PLS) occurs when donor lymphocytes produce antibodies that react with host red blood cell (RBC) antigens and result in hemolysis. Our aim was to evaluate prospectively the role of PLS in post transplant anemia and hemolysis in ABO and RhD minor mismatched recipients of liver and kidney grafts and to study the association of PLS with donor lymphocyte microchimerism. We examined 11 liver and 10 kidney recipients at Day +15 for anemia, markers of hemolysis, direct antiglobulin test and eluates, and serum RBC antibodies. Microchimerism was determined in peripheral blood lymphocytes by genotyping of simple sequence length polymorphisms encoding short tandem repeats. Immune hemolytic anemia and anti-recipient RBC antibodies were observed in 2 out of 11 liver (18.2%) and 2 out of 10 kidney (20%) transplants. RBC antibody specificity reflected the donor to recipient transplant, with anti-blood group B antibodies identified in 2 cases of O to B and 1 case of A to AB transplants while anti-D antibodies were detected in 1 case of RhD-negative to RhD-positive transplant. Donor microchimerism was found in only 1 patient. In conclusion, passenger lymphocyte mediated hemolysis is frequent in minor mismatched liver and kidney transplantation. Recognizing PLS as a potential cause of post transplant anemia may allow for early diagnosis and management to decrease the morbidity and mortality in some patients.

Infantile hemangioma (IH) is the most common benign vascular neoplasm of infancy, occurring in 1.0–2.5% of white infants, especially girls. Steroids and propranolol are the most widely used drugs as a primary treatment for IH. Although their mechanism of action is not well understood, their beneficial effect is documented. Our purpose was to compare the clinical efficacy of propranolol alone and propranolol combined with steroids on the outcome of IH. A total of 450 children (median age: 9 months; range: 7 days to 3 years) were included in this randomized controlled study, being treated with combined steroid and propranolol (Group A: 230 children) compared to those treated with propranolol plus placebo (Group B: 220 children). The steroid was given as a loading dose of 2–3 mg/kg/day and then gradually tapered over 6 months, whereas propranolol was given as an incremental dose starting at 0.16 mg/kg/day and reaching a maximum of 2 mg/kg/day maintained for 18 months (duration of therapy). Frequent monitoring of the blood sugar level was mandatory in the first 2 months: electro- and echocardiograms were recorded initially but not repeated. A more rapid involution rate, recognized by color fading and flattening of the lesions, was noted in Group A compared to Group B, with the peak response reached after 10 months of therapy followed by a slower but steady rate of further improvement. No major adverse effects were observed in Group A with regard to hypoglycemia or hypotension. On the other hand, ten cases of vomiting and diarrhea, one case of fungal infection and twelve cases of somnolence and fatigue were observed in Group B. Steroid induction seems to cover the gap at initiation of therapy where propranolol cannot be given as a full dose, especially in neonates. Steroid combination minimizes the adverse effects of propranolol, namely, hypoglycemia, hypotension and bradycardia. Children treated with a combined regimen showed more effective clearing of lesions, were less likely to require surgery for residual lesions and had minimal adverse effects compared to the single-drug group. In both groups there was a faster clearing rate for the head and neck lesions than elsewhere in the body, which can be explained by the higher blood flow to this region, magnifying the level of medication to these lesions and achieving a better response.