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Internationally, respirable crystalline silica (RCS) occupational exposure limits (OELs) are being reassessed and, in some jurisdictions, lowered, putting pressure on the capabilities of the analytical techniques used to achieve robust analyses and reliable detection limits. In preparation of a lower OEL, options for lowering the limit of detection (LoD) for RCS analysis have been assessed. Using a Direct-on-Filter X-Ray Diffraction (XRD) analysis under reduced scan speeds in combination with low-noise RCS sampling filters, an LoD of 0.25 µg/filter and a limit of quantification (LoQ) of 0.82 µg/filter can be achieved. Both limits would translate in an LoD of 0.24 µg/m3and LoQ of 0.78 µg/m3when sampling respirable dust for 8 h at 2.2 L/min, providing a technical solution to monitor exposures at the proposed OEL of 0.025 mg/m3(25 µg /m3) and below, with general sampling conditions as typically applied in Australia. This is the first report showing that the OEL of 0.025 mg/m3(25 µg /m3) is measurable by one of the standardized, direct-on-filter XRD methods.

Reducing carbon dioxide (CO2) emissions urgently requires the large-scale deployment of carbon-capture technologies. These technologies must separate CO2from various sources and deliver it to different sinks1,2. The quest for optimal solutions for specific source–sink pairs is a complex, multi-objective challenge involving multiple stakeholders and depends on social, economic and regional contexts. Currently, research follows a sequential approach: chemists focus on materials design3and engineers on optimizing processes4,5, which are then operated at a scale that impacts the economy and the environment. Assessing these impacts, such as the greenhouse gas emissions over the plant’s lifetime, is typically one of the final steps6. Here we introduce the PrISMa (Process-Informed design of tailor-made Sorbent Materials) platform, which integrates materials, process design, techno-economics and life-cycle assessment. We compare more than 60 case studies capturing CO2from various sources in 5 global regions using different technologies. The platform simultaneously informs various stakeholders about the cost-effectiveness of technologies, process configurations and locations, reveals the molecular characteristics of the top-performing sorbents, and provides insights on environmental impacts, co-benefits and trade-offs. By uniting stakeholders at an early research stage, PrISMa accelerates carbon-capture technology development during this critical period as we aim for a net-zero world.

Purpose:The aims of this research are to investigate the reasons for adopting big data (BD) and big data analytics (BDA), determine their extent of usage, and identify potential obstacles to their adoption in a developing country, Egypt.Motivation:Prior literature criticized the audit profession for the slow adoption of BDA, and little is known about the adoption of BD and BDA in developing countries. The reluctance to incorporate BD and BDA into auditing can be attributed to their potential obstacles. In addition, prior studies focused on the Big-4 audit firms in developed countries with little known about adopting BD and BDA in local audit firms and developing countries.Design/methodology/approach:To achieve the objectives of this study, 16 audit practitioners with various positions, specializations, and experience levels were interviewed. The 16 participants belong to audit firms of different sizes: international audit firms, local audit firms, and a governmental auditing agency. Thematic analysis was employed through using the MAXQDA software package to analyze the data.Main findings:The findings revealed that the reasons for using BD and BDA go beyond improving audit efficiency and effectiveness and satisfying clients. All audit firms collect and analyze large volumes of traditional accounting data. However, the Big-4 firms manage and analyze non-financial data and new data items as complementary audit evidence. Also, it was found that the type of audit firm affects the use of these technologies, with international firms being superior to other firms. The Accountability State Authority lags behind other audit firms in adopting BD and BDA. Furthermore, it was found that some obstacles to adopting BD and BDA arise due to the specific characteristics of the Egyptian context, while others are universal.Practical implications/Managerial impact:Determining the reasons for and obstacles to adopting BD BDA is useful for audit firms and regulators to remove these obstacles and encourage using such new audit technologies. The findings might help developers of BDA software packages to enhance their packages to meet auditor requirements. Moreover, academic scholars can benefit from the findings of this study by gaining an understanding of the main differences between developed and developing countries in relation to adopting BD and BDA.Novelty/Contribution:This study was conducted in Egypt, a developing country with a an underdeveloped audit environment. Therefore, this study enriches the relevant literature by providing information about BD and BDA in an unexplored developing environment. Besides, it delves deeper into the reasons and obstacles to using BD and BDA in external financial auditing in a developing country. Also, it adds to the literature by identifying the most common BDA software packages and techniques that auditors use in a developing country. Moreover, it considers audit practitioners’ viewpoints on audit firms of various sizes.

AbstractBackgroundConduction abnormality requiring the implantation of a permanent pacemaker (PPM) is a well-known and clinically important complication of transcatheter aortic valve replacement (TAVR). However, PPM implantation may result in lead-associated tricuspid valve regurgitation (TR). This study sought to determine the incidence and progression of TR following PPM implantation after TAVR.MethodsThis was a retrospective review of all echocardiograms of patients who underwent PPM following TAVR at the Baylor Scott & White hospitals from 2012 to 2021. The primary endpoint was TR progression at 30 days and 1 year. A subanalysis comparing the change in TR progression between small and large TAVR devices was also conducted. Secondary outcomes included all-cause death at 30 days and 1 year.ResultsOut of the 2744 patients who underwent TAVR between April 2012 and August 2021, 177 patients (6.5%) subsequently received a new PPM. There was a statistically significant progression of TR at 1-year follow-up (McNemar’s Pvalue = 0.02). TR progression rates were comparable between the small and large valve groups at 1-year follow-up (4% vs 11%, P = 0.09, respectively).ConclusionIn this single healthcare system study, we demonstrated a significant progression of TR in patients with PPM post TAVR at 1 year.

AbstractBackgroundIn March 2022, a COVID-19 outbreak disrupted the global supply of iodine contrast media (ICM). Healthcare systems implemented contrast-saving strategies to maintain their remaining ICM supplies. This study sought to determine the impact of contrast shortage on the incidence of contrast-associated acute kidney injury (CA-AKI).MethodsThis was a retrospective study of 265 patients undergoing 278 percutaneous coronary interventions (PCI) during 4-month periods prior to (9/1/2021 to 12/31/2021) and during (5/1/2022 to 8/31/2022) contrast shortage at a single center. The primary endpoint was the incidence of CA-AKI between study periods.ResultsA total of 148 and 130 PCIs were performed before and during contrast shortage, respectively. The incidence of CA-AKI significantly decreased from 11.5% to 4.6% during contrast shortage (P = 0.04). During the shortage, average contrast volume per PCI was significantly lower (123 ± 62 mL vs 88 ± 46 mL, P < 0.001), while coronary imaging was significantly higher (34.3% vs 50%, P = 0.009) compared to preshortage. All-cause mortality at discharge was comparable between study periods (2.8% vs 3.3%, respectively; P = 0.90).ConclusionThe scarcity of ICM for PCI procedures in this single-center experience was associated with a significant increase in the utilization of intravascular imaging and a significant reduction in CA-AKI.

Deep venous thrombosis (DVT) is a known surgical complication that can lead to pulmonary embolism with subsequent morbidity and mortality. The incidence of DVT following coronary artery bypass grafting is unclear. Prophylaxis regimens vary and some guidelines advocate against use of routine chemoprophylaxis in patients at low-moderate risk for venous thromboembolism. We utilized postoperative lower extremity venous ultrasound to determine the incidence of DVT following coronary artery bypass grafting in patients with low- to moderate-risk of venous thromboembolism receiving aggressive postoperative DVT prophylaxis.

Wire-actuated/tendon-actuated mechanisms suffer from discontinuity in their performance measures stemming from the limitation of unilateral actuation due to tendon actuation (pull-only actuation). Using traditional Jacobian-based performance measures ignores these limitations and can under-estimate the expected position/orientation (pose) uncertainty for a given design. In this paper, we put forth the notion of wire-tension transition zones, and we illustrate how these tension transition zones can be used to modify the definition of the traditional Jacobian when calculating the expected robot performance in terms of dexterity, end-effector pose uncertainty, and compliance. We use wire-actuated continuum robots as an illustrative robot architecture. We compare the expected performance of three-wire vs. four-wire designs while considering somewhat realistic design parameters drawn from surgical robotics as an application domain. The results of our simulation studies emphasize the importance of carefully using the reduced Jacobin with tension transition zones to capture the performance measure discontinuities due to wires/tendons going slack. Furthermore, the results show that the traditional approach underestimates the uncertainty in the position of the end-effector by as much as 50% (effects of joint-level uncertainty) and 206% (compliance performance analysis) in the case of a three-wire design alternative. We believe that this contribution supports medical robotic system designers in architecture selection and comparative design performance analysis while avoiding unpleasant surprises that would otherwise be encountered if traditional performance measures were used.

To rank the performance of materials for a given carbon capture process, we rely on pure component isotherms from which we predict the mixture isotherms. For screening a large number of materials, we also increasingly rely on isotherms predicted from molecular simulations. In particular, for such screening studies, it is important that the procedures to generate the data are accurate, reliable, and robust. In this work, we develop an efficient and automated workflow for a meticulous sampling of pure component isotherms. The workflow was tested on a set of metal–organic frameworks (MOFs) and proved to be reliable given different guest molecules. We show that the coupling of our workflow with the Clausius–Clapeyron relation saves CPU time, yet enables us to accurately predict pure component isotherms at the temperatures of interest, starting from a reference isotherm at a given temperature. We also show that one can accurately predict the CO2and N2mixture isotherms using ideal adsorbed solution theory (IAST). In particular, we show that IAST is a more reliable numerical tool to predict binary adsorption uptakes for a range of pressures, temperatures, and compositions, as it does not rely on the fitting of experimental data, which typically needs to be done with analytical models such as dual-site Langmuir (DSL). This makes IAST a more suitable and general technique to bridge the gap between adsorption (raw) data and process modeling. To demonstrate this point, we show that the ranking of materials, for a standard three-step temperature swing adsorption (TSA) process, can be significantly different depending on the thermodynamic method used to predict binary adsorption data. We show that, for the design of processes that capture CO2from low concentration (0.4%) streams, the commonly used methodology to predict mixture isotherms incorrectly assigns up to 33% of the materials as top-performing.

The impacts of climate change on heritage collections in Mediterranean museums are serious and lead to accelerated material degradation, loss of value, increasing conservation costs and climatisation. Climate change scenarios and simulation models have been developed to predict the extreme and average future environmental conditions and to assess the future long-term risks caused by global warming for museum buildings and their collections in Mediterranean countries, with Egypt being particularly at risk. This paper presents the results of the risk analysis of the indoor and outdoor environments in Alexandria Museum of Fine Arts (AMFA) in Egypt to provide an overview of the current situation of conservation and museum management and to provide evidence-based data to support decision-making regarding preventive conservation given the museum's limited funding, capacity and resources. Unfortunately, the air quality in the museum cannot be considered satisfactory and specific measures need to be taken to improve the level of air quality and museum and building management. The results enabled an assessment of indoor air quality and provided information on potential risks to the museum building and collections, including variations in temperature (T) and relative humidity (RH), concentrations of NO2, SO2, O3, CO2, acetic and formic acid and lighting conditions, as well as the location and management of the museum. The results necessitate the development of a preventive conservation plan to address the challenges associated with high T/RH fluctuations and pollution pressure. This requires more regular use of the HVAC system within certain T/RH set points as well as minimising light exposure and the use of UV-filtering glazing. Care should be taken to ensure that housekeeping and emergency preparedness reduce the damping and salt florescence in the museum building. However, dealing with the impact of climate change on indoor and outdoor environments and museum collections in Mediterranean museums requires a holistic and adaptive approach that includes joint collaboration, research, training and strategic planning to ensure the long-term preservation of valuable cultural heritage collections in different climates with customised adaptations based on local environmental conditions, resources and needs. Resilience planning should be region-specific and take into account the potential impacts of extreme weather events, sea level rise and other climate-related challenges.

Women with congenital heart disease at high risk for sudden cardiac death have been poorly studied thus far.

Homozygous familial hypercholesterolaemia (HoFH) is a rare inherited disorder resulting in extremely elevated low-density lipoprotein cholesterol levels and premature atherosclerotic cardiovascular disease (ASCVD). Current guidance about its management and prognosis stems from small studies, mostly from high-income countries. The objective of this study was to assess the clinical and genetic characteristics, as well as the impact, of current practice on health outcomes of HoFH patients globally.

The aim of this study was to assess the persistence of left atrial (LA) lesions created by ethanol infusion in the vein of Marshall (EIVM) by electroanatomical mapping on repeat catheter ablation for recurrent atrial tachyarrhythmia.

The heat capacity of a material is a fundamental property of great practical importance. For example, in a carbon capture process, the heat required to regenerate a solid sorbent is directly related to the heat capacity of the material. However, for most materials suitable for carbon capture applications, the heat capacity is not known, and thus the standard procedure is to assume the same value for all materials. In this work, we developed a machine learning approach, trained on density functional theory simulations, to accurately predict the heat capacity of these materials, that is, zeolites, metal–organic frameworks and covalent–organic frameworks. The accuracy of our prediction is confirmed with experimental data. Finally, for a temperature swing adsorption process that captures carbon from the flue gas of a coal-fired power plant, we show that for some materials, the heat requirement is reduced by as much as a factor of two using the correct heat capacity.

The threat landscape is continuously evolving and attackers are improving their tactics and techniques. From worms and viruses, initially introduced in 1982, to advanced, targeted and persistent attacks that have emerged in recent years, many verdicts demonstrate that no architecture is invulnerable. Nowadays, malware and cyberthreats are penetrating many platforms and the growth is exponential and a corporate and politically-driven outbreak has surfaced worldwide. A continuous back-and-forth between vulnerabilities and controls directs the evolution of the information age. Besides, intelligent technologies are a dual-use and a new class of smart cyberthreats is arisen. This paper presents a state of the art in computer virology and explores how we leveraged the blockchain technology to create a new form of malware offering a new aspect to the cyber-vector.

We report on the enhancement of responsivity by more than one order of magnitude of a silicon-based sub-terahertz detector when a mesoscopic dielectric particle was used to localize incident radiation to a sub-wavelength volume and focus it directly onto the detector. A strained-silicon modulation field-effect transistor was used as a direct detector on an incident terahertz beam at 0.3 THz. A systematic study in which Teflon cubes were placed in front of the detector to focus the terahertz beam was performed. In this study, cubes with different sizes were investigated, and an enhancement of the responsivity up to 11 dB was observed for a cube with an edge length of 3.45 mm (or 3.45λ). Electromagnetic simulation results were in good agreement with the experimental ones and demonstrated that the size of the mesoscopic particle plays an important role in focalizing the electric field within an area below the diffraction limit. This approach provides an efficient, uncostly, and easy to implement method to substantially improve the responsivity and noise equivalent power of sub-terahertz detectors.

Stalled progress in controlling Plasmodium falciparummalaria highlights the need for an effective and deployable vaccine. RTS,S/AS01, the most effective malaria vaccine candidate to date, demonstrated 56% efficacy over 12 months in African children. We therefore assessed a new candidate vaccine for safety and efficacy.

Mn3O4nanoparticles were prepared by co-precipitation method. The prepared samples had been characterized to find the compositional, structural, and functional properties, by means of EDX, XRD, and FTIR, respectively. The prepared manganese oxide nanoparticles (Mn3O4NPs) have average crystallite size of 30–35 nm. The effect of different parameters on the uptake of Eu(III) and Gd(III) by Mn3O4nanoparticles such as pH, initial metal concentration, shaking time, and temperature was examined. The shaking time for both adsorption and desorption was found to be 5 h. The sorption capacities at equilibrium with regards to Eu(III) and Gd(III) were 26.8 and 12.6 mg/g, respectively. Kinetically, the sorption of both elements fitted well to pseudo-second-order model. Sorption equilibrium isotherm obeys more favorably the Langmuir isotherm model. Desorption process of Eu(III) and Gd(III) from Mn3O4NPs was highly managed using 2.0 M HNO3. A preconcentration factor of 70 and 20 was obtained for Gd and Eu, respectively, using 0.1 g of the Mn3O4nanoparticles.

Potassium bromate (KBrO3), a strong oxidizing agent, is mainly used as a flour improver; it is classified as B2 (probable human) carcinogen and health organizations start banning it. However, it is still used in bakeries in large amounts. The aim of this study was to investigate the effect of KBrO3administration on the tongue of adult male albino rats. Sixty adult male albino rats weighting ~200 gm were divided equally into threegroups: control, experimental group I (gp I), and experimental group II (gp II). Control group received distilled water and the experimental gps. received 62 and 123 mg\kg KBrO3, respectively, dissolved in distilled water orally on a daily basis for 2 and 4 months. Histopathological examination of specimens in experimental groups revealed dysplastic and carcinogenic changes that were dose- and time-dependent to end in the epithelial invasion of connective tissue. The immunohistochemical results showed a significant increase in the immunoreactivity of PCNA in KBrO3treated groups compared to the control group. In conclusion, KBrO3long-term administration has a carcinogenic effect, so it is considered as a risk on public health.

Le syndrome de l’artère poplitée piégée (SAPP) est une maladie vasculaire rare et souvent mal diagnostiquée qui survient particulièrement chez les jeunes adultes actifs. La claudication intermittente est son principal symptôme et elle est due à la compression externe de l’artère poplitée pendant l’exercice.

Supplemental Digital Content is available in the text.

A mutation to serine of a conserved threonine (T634S) in the hERG K+channel S6 pore region has been identified as a variant of uncertain significance, showing a loss-of-function effect. However, its potential consequences for ventricular excitation and arrhythmogenesis have not been reported. This study evaluated possible functional effects of the T634S-hERG mutation on ventricular excitation and arrhythmogenesis by using multi-scale computer models of the human ventricle. A Markov chain model of the rapid delayed rectifier potassium current (IKr) was reconstructed for wild-type and T634S-hERG mutant conditions and incorporated into the ten Tusscher et al. models of human ventricles at cell and tissue (1D, 2D and 3D) levels. Possible functional impacts of the T634S-hERG mutation were evaluated by its effects on action potential durations (APDs) and their rate-dependence (APDr) at the cell level; and on the QT interval of pseudo-ECGs, tissue vulnerability to unidirectional conduction block (VW), spiral wave dynamics and repolarization dispersion at the tissue level. It was found that the T634S-hERG mutation prolonged cellular APDs, steepened APDr, prolonged the QT interval, increased VW, destablized re-entry and augmented repolarization dispersion across the ventricle. Collectively, these results imply potential pro-arrhythmic effects of the T634S-hERG mutation, consistent with LQT2.

Background: One of the most prevalent musculoskeletal issues in dentistry is forward head posture (FHP). Proprioception and core endurance are crucial for maintaining proper posture. Objective: The aim of this study was to compare dental students with and without FHP in terms of their core endurance and shoulder proprioception. Methods: Using kinovea software, a cross-sectional study was conducted on 30 dental students who had FHP with a craniovertebral angle less than 49 degrees. The control group consisted of 30 additional dental students without FHP. Trunk anterior flexor, posterior extensor, right and left flexors were tested using the McGill method to determine core endurance. The isokinetic Biodex system was used to measure shoulder proprioception. Results: Independent t-test results revealed that core endurance was significantly lower in the group with forward head posture compared to the control group (p0.05), while shoulder proprioception did not differ significantly between groups (p> 0.05). Conclusion: In comparison to dental students without forward head posture, male dental students with FHP have normal shoulder joint proprioception and impaired core endurance holding time. This could be a risk factor for a variety of musculoskeletal issues in dentists.

Muscle dysmorphic disorder (MDD) refers to an important muscularity-oriented dimension related to eating disorder (ED) symptoms and body image disturbances. One widely used self-report measure to assess the MDD construct is the Muscle Dysmorphic Disorder Inventory (MDDI). Despite its high clinical relevance, MDD has not been previously investigated in the Lebanese context and among the Arabic-speaking communities in general. Indeed, the multiple scales assessing ED symptomatology that have previously been translated to the Arabic language and adapted to the Lebanese population have been mainly focused on thinness-oriented ED; and no Arabic validation of muscularity-oriented body image and disordered eating symptoms measures, including the MDDI, exists so far to the best of our knowledge. To overcome this gap, the present study aimed to validate the Arabic version of the MDDI (Ar-MDDI) in a sample of Lebanese men university students. The findings showed that the AR-MDDI is robust in terms of reliability, factor structure, convergent and divergent validity. We, therefore, preliminarily recommend its use in clinical practice, preventive interventions and future research in Arab settings.

Numerous deep beam design models have been proposed; however, even the most recent design manuals provide limited guidance for deep beam design, especially when the beams have complicated features such as web openings. The openings cause a geometric discontinuity, which makes the distribution of nonlinear stress along the depth of the beam more complicated. In this paper, the structural behavior of the deep beams with openings was investigated experimentally via a total of twenty concrete beam specimens and analytically in four themes. In the first theme, eleven concrete beam specimens with circular and rectangular openings, including the reference solid specimen, were tested to examine how the shape, size, and position of the openings affected the structural behavior of the deep beams. According to earlier studies, the crack patterns and modes of failure for the specimens were discussed in the first theme, and various techniques for strengthening the openings, whether circular or rectangular, were suggested in the second theme. Six concrete beam specimens with rectangular openings were strengthened; three of them were internally strengthened using various thickness plates around the openings, and the other three were strengthened using external fasteners subjected to torque moments. As for the concrete beam specimens with circular openings, these openings were strengthened with three different reinforcement techniques in the three tested beams. The load capacity, deflection, and crack patterns for the strengthened and unstrengthened specimens were recorded and discussed. The experimental results indicated that the load capacity and stiffness of the tested beams were significantly reduced by the presence of openings. Additionally, there was a distinct variety in how the size, position, and shape of the openings affected the beams performance. The results also demonstrated that concrete beam specimens with rectangular openings that were strengthened externally by the fasteners were the best, whereas the efficiency of the remaining strengthening was lower than expected. In the third theme, a numerical study using the nonlinear finite element model (NLFE), the program ANSYS V-19.2, 2018 was conducted on some of the tested strengthened and unstrengthened specimens. The analytical study's findings demonstrated the effectiveness of the NLFE model by comparing with load carrying capacity and load-deflection curve of the tested specimens. In the fourth theme, based on Bi-directional Evolutionary Structural Optimization (BESO), an algorithm developed in MATLAB and integrated with the FEA solver SAP software was used to build the optimal strut and tie model (OSTM) for two concrete beam specimens with rectangular and circular openings. This was undertaken with the objective of seeking and finding a strengthening technique that is more effective and is dependent on a clear methodology, not on trial and expectation. In agreement with the final obtained OSTM, new alternative strengthening techniques were proposed and evaluated using NLFE. In comparison to the other techniques that were described in this research, the proposed strengthening techniques based on BESO was the best and most effective, they increased the ultimate load in some cases by 72.7 %. BESO can be used efficiency for strengthening the deep beams with openings.

AbstractThe incorporation of eco and heritage handicrafts into interior design practice to achieve sustainability is the safeguard for such crafts. In Egypt, there is a wide range of local materials, cultural resources and craftsmen and craftswomen. Many craftsmen no longer find it economically viable to pursue craftsmanship as a primary profession, leading to their market exclusion. This paper attempts to clarify the relation between eco and heritage crafts and the development of sustainable interior spaces. In addition, this paper introduces a practical approach to develop interior spaces of schools buildings based on integration between heritage and eco crafts and interior design practice. Selecting school interiors to be a case study can add an additional potential to employ eco and heritage crafts for educational purposes. Accordingly, the experience of students who are enrolled with such important crafts will be improved.

The events that took place in Paris were a great tragedy (''All of France is suffering,'' Paris, Nov. 30). And once again, Islamic teachings are viewed as the fuel that [...]

Kidney Disease

This paper investigated the shear performance of internal embedded glass fiber reinforced polymer (GFRP) trusses as a novel shear reinforcement instead of conventional steel stirrups for concrete beams reinforced with top and bottom GFRP bars, and for this goal, different proposed patterns of embedded GFRP trusses were offered. In addition, the effect of GFRP stirrup spacing and the comparison with steel stirrups are also studied. For this purpose, an experimental program consisting of nine specimens was utilized that tested under one concentrated load with an unequal span-to-depth ratio up to failure. The program included one specimen with no stirrups in the studied shear zone as a control beam. The GFRP stirrups or proposed trusses were cut as single straight legs without bends or hooks, and they were then linked together with plastic ties to create the necessary shape. Besides, numerical analysis using the finite element program ANSYS V-19.2 was utilized for computational modelling as a 3-D model to examine the capability of the model to capture the observed shear behaviour and to obtain extra results in order to better comprehend the shear behaviour. Cracking patterns, ultimate loads, failure mechanisms, load-deflection relationships, load versus strain in GFRP bars, and strain distribution along the height of the GFRP truss member were evaluated. The shear capacity was enhanced via the use of internal GFRP embedded trusses by about 56–80 % compared to the control beam (BC) without stirrups, while these forms improved the capacity by about 29–50 % compared to the specimen that had only vertical stirrups. In addition, the normal strain distribution along the GFRP truss member height was non-uniform and significantly affected by the member location. The shear capacity was also increased by decreasing the GFRP stirrups' spacing, while the use of GFRP stirrups instead of steel stirrups decreased the ultimate load by about 3–10 %, according to stirrup spacing. Finally, the comparison between the results obtained from the numerical model and the experimental work showed a good agreement.

This article aims at identifying the predictive effect of Project Manager's assignment on multiple project management effectiveness in the case of information technology projects in the Lebanese banks. The multiple project management effectiveness was measured on 3 different levels: organizational, projects success and project manager. A survey-based analysis was conducted on a random sample of 43 project managers working in 19 different Lebanese commercial banks. The results showed that most of the project manager's assignment factors influence positively the multiple project effectiveness with some exceptions.

The negative effects of artificial lighting at night (ALAN) on insects are increasingly recognised and have been postulated as one possible cause of declines in insect populations. Yet, the behavioural mechanisms underpinning ALAN effects on insects remain unclear. ALAN interferes with the bioluminescent signal female glow-worms use to attract males, disrupting reproduction. To determine the behavioural mechanisms that underpin this effect of ALAN, we quantified the effect of white illumination on males' ability to reach a female-mimicking LED within a Y-maze. We show that as the intensity of illumination increases, the proportion of males reaching the female-mimicking LED declines. Brighter illumination also increases the time taken by males to reach the female-mimicking LED. This is a consequence of males spending more time: (i) in the central arm of the Y-maze; and (ii) with their head retracted beneath their head shield. These effects reverse rapidly when illumination is removed, suggesting that male glow-worms are averse to white light. Our results show that ALAN not only prevents male glow-worms from reaching females, but also increases the time they take to reach females and the time they spend avoiding exposure to light. This demonstrates that the impacts of ALAN on male glow-worms extend beyond those previously observed in field experiments, and raises the possibility that ALAN has similar behavioural impacts on other insect species that remain undetected in field experiments.

In order to favor the potential in improving both oncologic and cosmetic results in breast cancer therapy, an Ultrasound (US) probe that increases cancer ablation volume and preserves neighboring healthy tissues in a modeled realistic breast from being ablated is designed using a finite element analysis (FEA) tool in this work. The acoustic pressure field and focal point of the Focused Ultrasound (FUS) are characterized by optimizing the transducer's frequency at 1.3 MHz and the initial water temperature at 20 °C. These optimal conditions yield qualitative properties of the FUS at the focal point, which are extended to wider areas to achieve quantitative results by displacing the probe at reduced time intervals of less than 60s. An elliptical focal volume of 10.2 mm (along the beam axis) × 4 mm (in the transverse direction) at 50s of dosing for a tumor diameter of 10 mm has been generated. Furthermore, a fractional healthy tissue damage of 2.1%, a rise in temperature of 99 °C above the ablation threshold temperature (42 °C) at 100 s of sonication, and an increase in pressure oscillation (favoring cavitation) at the focus are achieved. The optimal conditions of the setup are subjected to sensitivity tests and are found to be mostly sensitive to variations of the transducer frequency on which depend the attenuation coefficient and thermal conductivity of the tissue as well as the surface intensity of the transducer.

Background: The optimum approach for managing terminal illnesses is organ transplantation. However, the transplant waiting list is long due to the very high demand and low supply of donated organs. One's willingness to donate is governed by their knowledge and attitude towards organ donation. The perception of organ donation among the Lebanese general population and their desire to donate organs has not been previously explored. This study aims to assess the attitudes of Lebanese to organ donation and evaluate the public’s relative knowledge about this particular notion and their willingness to donate organs.

Cardiac implantable electronic devices (CIED) are an important means of atrial fibrillation (AF) detection. However, the AF burden measurements and notifications transmitted by CIED are not directly related to the clinical classification of paroxysmal, persistent or permanent AF. Moreover, AF alerts are the most frequent form of notification, imposing a time-consuming review on the caregivers. We compared the incidence of standard AF burden-related notifications in remotely monitored (RM) patients with the incidence of events detected after filtering by a new proprietary algorithm implementing the standard European Society of Cardiology (ESC) classification of AF.

To quantify our decision for the removal of glucose and the use of mannitol as a substitute osmotic agent in the cardiopulmonary bypass prime, we conducted a prospective clinical audit to evaluate the effects of this change on patient outcomes. Data were prospectively collected for 172 consecutive routine cardiac surgery patients. The first 85 patients (Surgeon A, 42 patients [Group 1], Surgeon B, 43 patients [Group 2]) received 1000 mL Plasmalyte 148 + 5% glucose as per institutional protocol. The remaining priming volume for each group consisted of 500 mL hemaccel or 4% albumin, 50 mL 8.4% sodium bicarbonate, 100 mL Hartmann’s solution. The change to a glucose-free prime was then initiated, substituting Plasmalyte 148 (without 5% glucose) for the Plasmalyte 148 + 5% glucose, in addition 12.5 g mannitol was administered following delivery of cardioplegia to the patients operated on by Surgeon B. Surgeon A would not include mannitol at this time. Forty-one patients operated by Surgeon A (Group 3) subsequently received Plasmalyte 148, and 46 patients operated on by Surgeon B (Group 4) received Plasmalyte 148 plus mannitol. Analysis was performed stratified by surgeon to quantify the effects of removing glucose from the prime. Comparisons were made between groups 1 and 3, and 2 and 4. Net fluid changes were recorded from pre-CPB, up to 24-h postoperatively. Intraoperative data collection included serum glucose, hematocrit, osmolality, return to rhythm, arrhythmias, and blood transfusions. Post-operative variables, including cardiac enzymes, arrhythmias, intubation time, length of stay, and mortality were also collected. Removal of glucose from the CPB prime resulted in a lower serum glucose concentration (mmol/L) during CPB (Gp 1 [13.6] vs. Gp 3 [5.4]; Gp 2 [14.7] vs. Gp 4 [5.4], p< .05). The addition of 12.5 g of mannitol to the CPB prime resulted in a significantly lower net fluid gain (mL) 24 h postoperatively (Gp 2[2792] vs. Gp 4 [1970], p< .05) and greater CPB hematocrit (%) (Gp 2 [24.3] vs. Gp 4 [26], p< .05). No other results were found to be significant (except CPB plasma osmolality (Groups 2 and 4) and sodium concentration [Groups 1 and 3]). The results of our audit provide an evidence base to support our change in practice to utilize nonglucose primes.

Neuroblastoma (NB) is a neoplasm of the sympathetic nervous system, and is the most common solid tumor of infancy. NBs are very heterogeneous, with a clinical course ranging from spontaneous regression to resistance to all current forms of treatment. High-risk patients need intense chemotherapy, and only 30–40% will be cured. Relapsed or metastatic tumors acquire multi-drug resistance, raising the need for alternative treatments. Owing to the diverse mechanisms that are responsible of NB chemoresistance, we aimed to target epigenetic factors that control multiple pathways to bypass therapy resistance. We found that the SWI/SNF-related, matrix-associated, actin-dependent regulator of chromatin, subfamily a, member 4 (SMARCA4/BRG1) was consistently upregulated in advanced stages of NB, with high BRG1 levels being indicative of poor outcome. Loss-of-function experiments in vitroand in vivoshowed that BRG1 is essential for the proliferation of NB cells. Furthermore, whole-genome transcriptome analysis revealed that BRG1 controls the expression of key elements of oncogenic pathways such as PI3K/AKT and BCL2, which offers a promising new combination therapy for high-risk NB.

Lung cancer, considered one of the most common causes of cancer deaths worldwide, is a complex disease with its own challenges. The coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), compounded these challenges and forced the medical healthcare system to alter its approach to lung cancer. This narrative review aims to identify the effect of the COVID-19 pandemic on lung cancer screening, diagnosis and management. During this public health crisis, various medical societies have worked on developing guidelines to protect patients with lung cancer from the deleterious effects of SARS-CoV-2 infection, as well as from the complications imposed by treatment delays. The different therapeutic approaches, such as surgery, radiation oncology and immune checkpoint inhibitor therapy, along with the latest international recommendations, will be discussed. Protecting patients with lung cancer from COVID-19 complications, while avoiding barriers in treatment delays, has brought unique challenges to healthcare facilities. Prompt modifications to guidelines, and constant evaluation of their efficacy, are thus needed.

Depuis 1995, nous avons modifié la technique de Latarjet-Patte en associant à la butée coracoïdienne une retension capsulaire « sud-nord » et une réinsertion de celle-ci au ras du rebord glénoïdien.

Les cotyles sans ciment avec metal-backont de bons résultats à long terme mais posent des problèmes liés à la rigidité du metal-back, à la modularité et aux couples de frottement qu’ils imposent. Le cotyle RM Pressfit®est un cotyle monobloc sans ciment, en polyéthylène recouvert d’une fine couche de titane permettant une ostéo-intégration sans les contraintes liées à la rigidité du metal-back. Très peu de publications concernent les résultats de cet implant récent et innovant. Le but de ce travail était d’apprécier le résultat clinique et radiologique d’une série continue de 91 cotyles, chez 85 malades à un recul minimum de 48 mois. Aucun malade n’a été perdu de vue. Les résultats cliniques étaient exprimés selon le score de Harris. L’analyse radiologique, sur clichés numérisés, étudiait la position du cotyle, l’ostéo-intégration ; l’usure était mesurée selon la technique de Livermore. Les résultats cliniques étaient excellents avec un score de Harris en moyenne à 94, avec 82 % de score excellent ou bon. Trois cotyles avaient été changés pour luxations liées à un défaut de positionnement. L’étude radiologique mettait en évidence un recalage de 3 implants dans les 6 premières semaines, avec des implants stables par la suite. L’ostéo-intégration radiologique était toujours satisfaisante sans ostéolyse et la trame osseuse traduisait une transmission harmonieuse des contraintes entre l’implant et l’os spongieux péri-cotyloïdien. L’usure du polyéthylène en regard des têtes en céramique était de 0,07mm/an. Les résultats de cette série sont concordant avec les séries récentes sur le RM Pressfit®.

Les guides de coupe personnalisés (GCP), pour la réalisation de prothèses totales de genou (PTG), sont une matérialisation de la planification préopératoire. Nous avons analysé leur utilisation et évalué son bénéfice sur l’alignement du membre inférieur en postopératoire.

Intima-media thickness (IMT) is a well-described marker of cardiovascular disease. In this study we aim to determine whether low-density lipoprotein (LDL) levels and disease-related mutation status can predict IMT in patients with severe familial hypercholesterolemia (FH) referred for or on LDL apheresis.

TASK3 (TWIK-related acid-sensitive K+channel 3) potassium channels are members of the two-pore–domain potassium channel family. They are responsible for background leak potassium currents found in many cell types. TASK3 channels are genetically imprinted, and a mutation in TASK3 (G236R) is responsible for Birk Barel mental retardation dysmorphism syndrome, a maternally transmitted developmental disorder. This syndrome may arise from a neuronal migration defect during development caused by dysfunctional TASK3 channels. Through the use of whole-cell electrophysiologic recordings, we have found that, although G236R mutated TASK3 channels give rise to a functional current, this current is significantly smaller in an outward direction when compared with wild-type (WT) TASK3 channels. In contrast to WT TASK3 channels, the current is inwardly rectifying. Furthermore, the current through mutated channels is differentially sensitive to a number of regulators, such as extracellular acidification, extracellular zinc, and activation of Gαq-coupled muscarinic (M3) receptors, compared with WT TASK3 channels. The reduced outward current through mutated TASK3_G236R channels can be overcome, at least in part, by both a gain-of-function additional mutation of TASK3 channels (A237T) or by application of the nonsteroidal anti-inflammatory drug flufenamic acid (FFA; 2-{[3-(trifluoromethyl)phenyl]amino}benzoic acid). FFA produces a significantly greater enhancement of current through mutated channels than through WT TASK3 channels. We propose that pharmacologic enhancement of mutated TASK3 channel current during development may, therefore, provide a potentially useful therapeutic strategy in the treatment of Birk Barel syndrome.

TWIK-related K+1 (TREK1) potassium channels are members of the two-pore domain potassium channel family and contribute to background potassium conductances in many cell types, where their activity can be regulated by a variety of physiologic and pharmacologic mediators. Fenamates such as FFA (flufenamic acid; 2-{[3-(trifluoromethyl)phenyl]amino}benzoic acid), MFA [mefenamic acid; 2-(2,3-dimethylphenyl)aminobenzoic acid], NFA [niflumic acid; 2-{[3-(trifluoromethyl)phenyl]amino}nicotinic acid], and diclofenac [2-(2-(2,6-dichlorophenylamino)phenyl)acetic acid] and the related experimental drug BL-1249 [(5,6,7,8-tetrahydro-naphthalen-1-yl)-[2-(1H-tetrazol-5-yl)-phenyl]-amine] enhance the activity of TREK1 currents, and we show that BL-1249 is the most potent of these compounds. Alternative translation initiation produces a shorter, N terminus truncated form of TREK1 with a much reduced open probability and a proposed increased permeability to sodium compared with the longer form. We show that both forms of TREK1 can be activated by fenamates and that a number of mutations that affect TREK1 channel gating occlude the action of fenamates but only in the longer form of TREK1. Furthermore, fenamates produce a marked enhancement of current through the shorter, truncated form of TREK1 and reveal a K+-selective channel, like the long form. These results provide insight into the mechanism of TREK1 channel activation by fenamates, and, given the role of TREK1 channels in pain, they suggest a novel analgesic mechanism for these compounds.

Background:Recommended medications are under-prescribed in elderly patients with atrial fibrillation (AF), coronary artery disease (CAD), and congestive heart failure (CHF). The relationship between under-prescribing and comorbidity is unclear.Design:Single-day observational study.Methods:Analysis of medications taken by patients aged 80 years or over at the time of their admission to cardiology units of 32 French hospitals. Comorbidity was measured using the Charlson comorbidity index (CCI).Results:The study included 510 patients (57% men, mean age 85 years). History of AF, CHF, and CAD was present in 213 (42%), 199 (39%), and 187 (37%) patients, respectively. CCI was 0 in 110 (22%), 1–2 in 215 (42%), and ≥3 in 185 (36%) patients. Vitamin K antagonists (VKA) were prescribed to 105 (49%) and aspirin to 86 (40%) patients with AF. CCI did not influence VKA prescription but influenced aspirin use, with lower prescription rates in patients with CCI 1–2 than CCI 0 or CCI ≥3 (p = 0.02). In CHF, angiotensin-converting enzyme inhibitors (ACEI) and β-blockers were prescribed to 80 (40%) and 96 (48%) patients, respectively. Rates of prescription of ACEI, β-blockers, statins, and aspirin in patients with CAD were 43%, 56%, 56%, and 66%, respectively. CCI level did not influence any medication use in CHF and CAD.Conclusion:Even in the absence of comorbidity, elderly patients with major cardiovascular diseases are denied from indicated medical treatments probably because of their age alone. Implementing measures to enhance awareness of treatment benefits and promote appropriate prescribing is necessary.