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Background/objectives: The swift appearance of asymmetry in breast size and density has been associated with an increased risk of breast cancer and other pathological changes. However, the occurrence of breast asymmetry and the factors influencing it have not been extensively studied among healthy, screened women in the Saudi population. Thus, this study aims to explore bilateral breast asymmetry in breast size and density among healthy, screened Saudi women and factors affecting the asymmetry. Methods: Data of 1048 out of 1173 eligible women screened between 2012 and 2018 were extracted from Sheikh Mohammed Hussien AL-Amoudi Center of Excellence in Breast Cancer. The Laboratory for Individualized Radiodensity Assessment (LIBRA) software was used to measure percent density, dense area, and total area of breast from mammograms. Paired t-test was used to examine asymmetry between right and left breasts, and stratified analysis was performed to investigate the factors associated with breast asymmetry. Results: No significant differences were observed between the right and left breasts in percent density, dense area, and total breast area (p ≥ 0.2). However, for participants who never breastfed, the right breast area was slightly larger (average: 207.9 cm2) than the left breast (average: 202.8 cm2); p = 0.008. Conclusion: There were no significant differences found in the density, and size of the right and left breasts. However, women who breastfed tended to have slightly larger right breasts.

We challenge the dominant technology-centric narrative around clinical AI. To realise the true potential of the technology, clinicians must be empowered to take a whole-system perspective and assess the suitability of AI-supported tasks for their specific complex clinical setting. Key factors include the AI's capacity to augment human capabilities, evidence of clinical safety beyond general performance metrics and equitable clinical decision-making by the human–AI team. Proactively addressing these issues could pave the way for an accountable clinical buy-in and a trustworthy deployment of the technology.

This systematic review paper provides a comprehensive analysis of the recent advances in deep learning techniques for rice disease recognition. Rice is one of the most important crops in the world, providing food for more than half of the global population. However, rice diseases pose a major threat to rice production and can cause significant yield losses. In recent years, deep learning techniques have shown great potential in automating the process of rice disease recognition, which can help in early disease detection and management. This paper reviews the current trends in deep learning techniques for rice disease recognition, including various pre-processing and augmentation techniques, as well as popular deep learning models such as convolutional neural networks (CNNs) and their variants. The paper also provides an in-depth analysis of the different datasets used in the studies, along with their limitations and challenges. Furthermore, the paper discusses the future directions for research in this field, such as the need for larger and more diverse datasets, the development of novel deep learning architectures, and the integration of other data sources such as weather data and satellite imagery. The paper concludes by summarizing the key findings of the systematic review and highlighting the potential impact of deep learning techniques in rice disease recognition. In addition, the review provides a useful resource for researchers and practitioners in the field of agricultural technology and can help in the development of more accurate and efficient automated systems for rice disease detection and management.

Metaheuristic algorithms are commonly used in solving complex and NP-hard optimization problems in various fields. These algorithms have become popular because of their ability to explore and exploit solutions in various problem domains. Honey Badger Algorithm (HBA) is a population-based metaheuristic optimization algorithm inspired by the dynamic hunting strategy of honey badgers, utilizing honey and digging-seeking techniques. Since its introduction in 2020, HBA has garnered widespread attention and has been applied across various domains. This review aims to comprehensively survey the improvement and application of HBA in solving various optimization problems. Additionally, the survey conducts a meta-analysis of the HBA's improvements, hybridization and application since its introduction. According to the result of the survey, 52 studies presented improved HBA using chaotic maps, levy flight mechanism, adaptive mechanisms, transfer functions, multi-objective mechanism and opposition based learning techniques, 20 studies presented a hybrid HBA with other metaheuristics algorithms and 101 studies uses the original HBA for solving various optimization problems. According to the survey, the wide acceptance of the HBA within the research community stems from its straightforwardness, ease of use, efficient computational time, accelerated convergence speed, high efficacy, and capability to address different kind of optimization issues, distinguishing it from the well-known optimization approches presented.

Summary: The mandatory usage of extracellular matrix (ECM) gels in 3D cultures limits antibody penetration and increases background, while the removal of ECM gel causes disruption of morphology and sample loss. These factors pose challenges to effective immune labeling-based staining. Here, we present a protocol for whole-mount immunofluorescence staining of gel-embedded pancreatic organoids. We describe steps for sample fixation, blocking, and antibody incubation. We detail procedures for washing antibodies and mounting. : Publisher’s note: Undertaking any experimental protocol requires adherence to local institutional guidelines for laboratory safety and ethics.

Epilepsy is a medical condition characterized by seizures. While antiepileptic drugs can effectively control seizures in most epilepsy patients, there exists a subtype known as resistant epilepsy in which drugs prove ineffective in managing seizure activity. Furthermore, some patients experience undesirable side effects from these medications, leading to the discontinuation of antiepileptic drug use. In such situations and others like them, the ketogenic diet is recommended as an alternative treatment approach, one that does not rely on pharmacological interventions The fundamental rationale supporting the potential efficacy of the ketogenic diet in epilepsy treatment lies in the fact that, in certain circumstances such as fasting, ketone bodies are utilized as the primary energy source for neurons, as opposed to glucose. To facilitate the generation of ketone bodies while ensuring ease and flexibility of implementation, various types of ketogenic diets have been developed. The choice of ketogenic diet approach in the treatment of epilepsy can be tailored based on the individual tolerability of patients. This meta-analysis aims to consolidate the evidence regarding the impact of ketogenic diets on patients with epilepsy in clinical practice.

Due to soils from arid regions with high lime and low organic matter content, farmers receive low yields along with high costs of agricultural inputs, which causes them to look for a solution. In this context, Arbuscular mycorrhizal fungi (AMF) have great potential to reduce fertilizer use by mediating soil nutrient cycles. However, little is known about studies of AMF inoculum on microbial biomass carbon (C), nitrogen (N), and phosphorus (P) cycling during vetch plant vegetation in calcareous areas. In this study, changes in soil biogeochemical properties related to soil C, N, and P cycling were investigated with five different AMF inoculations under vetch (common Vetch (CV; Vicia sativa L.) and Narbonne Vetch (NV; Vicia narbonensis L.) growing conditions. For the field study, a total of five different mycorrhizae were used in the experiment with the random plots design. AMF inoculation decreased the lime content of the soil, and the highest decrease was observed in NV with Glomus (G.) intraradices + G. constrictum + G. microcarpum inoculation (24.41 %). The highest MBC content was recorded in CV vetch G. intraradices (1176.3 mg C kg−1) and the highest MBN content in NV vetch G. intraradices + G. constrictum + G. microcarpum (1356.9 mg C kg−1). CAT activity of soils was highest in CV vetch G. intraradices (31.43 %) and lowest in NV vetch G. intraradices + G. constrictum + G. microcarpum (72.88 %), urease enzyme activity decreased in all treatments except G. constrictum + Gigaspora sp. and G. mosseae inoculations in CV. The highest DHG activity was detected in GF (15.72 %) AMFs in CV and GI (21.99 %) in NV. APA activity was highest in Glomus constrictum + Gigaspora sp. (23.33 %) in CV and Glomus fasciculatum (10.08 %) in NV. In CV plots, G. intraradices + G. constrictum + G. microcarpum (91.67 %) isolates had the highest and G. intraradices community had the lowest RC% (97.33 %) in mixed mycorrhiza species, while in NV plots G. fasciculatum inoculum had the highest and G. intraradices community had the lowest RC%. This study has important implications for the application of AMF for sustainable agriculture. When the results of the study were evaluated, the most effective AMF isolates in terms of C, N, and P cycles were G. constrictum + G. fasciculatum + Gigaspora sp. in Common vetch variety, and G. intraradices in Narbonne vetch variety.

Plasticizers are employed to stabilize films by safeguarding their physical stability and avoiding the degradation of the loaded therapeutic drug during processing and storage. In the present study, the plasticizer effect (glycerol) was studied on bioadhesive films based on sodium alginate (SA), carboxymethyl cellulose (CMC) and gelatin (GE) polymers loaded with amphotericin B (AmB). The main objective of the current study was to assess the morphological, mechanical, thermal, optical, and barrier properties of the films as a function of glycerol (Gly) concentration (0.5–1.5 %) using different techniques such as Scanning Electron Microscope (SEM), Texture analyzer (TA), Differential Scanning Calorimeter (DSC), X-Ray Diffraction (XRD), and Fourier Transforms Infrared Spectroscopy (FTIR). The concentration increase of glycerol resulted in an increase in Water Vapor Permeability (WVP) (0.187–0.334), elongation at break (EAB) (0.88–35.48 %), thickness (0.032–0.065 mm) and moisture level (17.5–41.76 %) whereas opacity, tensile strength (TS) (16.81–0.86 MPa), and young's modulus (YM) (0.194–0.002 MPa) values decreased. Glycerol incorporation in the film-Forming solution decreased the brittleness and fragility of the films. Fourier Transform Infrared (FTIR) spectra showed that intermolecular hydrogen bonding occurred between glycerol and polymers in plasticized films compared to control films. Furthermore, molecular docking was applied to predict the binding interactions betweem AmB, CMC, gelatin, SA and glycerol, which further endorsed the stabilizing effects of glycerol in the complex formation between AmB, CMC, SA, and gelatin. The Findings of the current study demonstrated that this polymeric blend could be used to successfully prepare bioadhesive films with glycerol as a plasticizer.

Microarray data represents a valuable tool for the identification of biomarkers associated with diseases and other biological conditions. Genes, in particular, are a type of biomarker that holds great importance for the identification and understanding of various types of tumors, including brain, lung, and breast cancers. However, a significant portion of these cancer genes are not directly associated with the target disease, which can lead to challenges during analysis, such as increased computational complexity, poor generalization, and decreased classification accuracy, among others. To address this issue, a range of techniques and algorithms have been developed to optimize the selection of the most relevant subset of cancer genes. One highly effective approach to handle this challenge is the use of Swarm Intelligent (SI) algorithms, which are known for their efficiency and effectiveness as global search agents. In this paper, we present two distinct but related sections. First, we conduct a survey of current literature from 2019 to the present, on the use of SI algorithms for optimizing the selection of an optimal subset of cancer genes. Secondly, based on the analysis and findings from the first part, a presentation of an experimental study that evaluates the efficacy of four classical SI algorithms - Particle Swarm Optimization (PSO), Salp Swarm Optimization (SSA), Firefly Algorithm (FA), and Cuckoo Search (CS) – for optimizing the selection of relevant genes in three different cancer datasets. For the experimental study, we used the Chi-square, Mutual Information, and ANOVA filter methods to individually select 100, 200, and 500 relevant genes from the identified cancer datasets. We then passed these genes as input to each of the SI algorithms. The results of the study indicate that diverse filter-wrapper combinations can effectively address the challenge of selecting cancer genes across various datasets.

This study examines time-varying connectedness between agricultural commodities and geopolitical risk in terms of volatility. In this context, we employ the time- and frequency-based network connectedness approaches based on a time-varying parameter vector autoregression (TVP-VAR) model and use data from January 1, 2020, to January 4, 2023. Our findings indicate that (1) overall time-varying connectedness indexes are sharply amplified around geopolitical stress episodes; (2) wheat and the daily geopolitical risk index (GPRD) transmit notable volatility shocks starting in March 2022 because of the Russian invasion of Ukraine (RIU) on February 24, 2022; (3) persistent connectedness is sharply amplified around the RIU; and (4) temporary linkages dominate most of the period studied. Our findings have implications for investors, stakeholders, and policymakers in terms of their investment strategies and risk monitoring.

Background: Marginal Zone Lymphoma (MZL) is a type of non-Hodgkin lymphoma (NHL) originating from B-lymphocytes. It is characterized as a slow-growing or indolent lymphoma and is considered a rare disease. The report focuses on a case of MZL diagnosed in childhood, which relapsed after initial treatment and subsequently went into remission following ibrutinib-obinutuzumab treatment. Case Report: In 2010, a 9-year-old girl with no previously known systemic illnesses was diagnosed with stage 4B nodal marginal zone lymphoma outside a pediatric center. Initially, she achieved remission following treatment with rituximab-bendamustine but experienced a relapse in 2012. Subsequent to lymph node excision and Methotrexate, Ifosfamide, Etoposide, and Dexamethasone (MIED) therapy, all conducted outside the pediatric center, she received an autologous stem cell transplant in 2013.Five years after the transplantation, she applied to our center when she was 18 years old, exhibiting widespread lymphadenopathy and suffering a relapse of stage 4B nodal MZL. Treatment with ibrutinib-obinutuzumab was commenced, leading to a full response after six cycles, without any adverse effects. Maintenance therapy with ibrutinib was initiated to avert further recurrence. Conclusion: The treatment of relapsed nodal MZL continues to be challenging. In patients who have previously received repeated cytotoxic chemotherapy, the combination of ibrutinib-obinutuzumab may be an effective and safe option to avoid cumulative toxicity of chemotherapy. Further studies with more cases in R/R nodal MZL will contribute to the management of the disease.

Background: Ureteral amyloidosis is a unique and infrequent form of amyloidosis characterized by the deposition of amyloid proteins within the ureters.These tubes, responsible for transporting urine from the kidneys to the bladder, can become obstructed due to this protein accumulation, potentially leading to renal complications. We are presenting a case ureteral amyloidosis. Case Report: A 48-year-old male with no known prior medical conditions presented with a three-month history of right-sided pain, frequent and painful urination, reduced urine output, and hematuria. Blood tests showed a hemoglobin level of 12.8 g/dL and MCV of 73. Urinalysis revealed pyuria and hematuria. An upright abdominal X-ray indicated hydronephrosis, and an abdominal CT scan detected grade 2 hydronephrosis on the right side and a suspicious mass in a 1 cm segment of the distal right ureter outside the bladder. The mass was excised, and histological examination with crystal violet and Congo red staining showed a strong positive reaction for amyloid. Immunohistochemical analysis confirmed the diagnosis of lambda light chain amyloidoma. Systemic screening for amyloid deposition was negative except for the ureter. Nine months post-operation, the patient returned with recurrent pain and oliguria. A CT scan revealed a mass at the excision site, consistent with lambda light chain amyloidoma. Considering it a recurrent disease, the patient underwent intensity-modulated radiation therapy (IMRT) with a total dose of 20 Gy in 10 fractions of 2 Gy each. Two months post-radiation, with recurring symptoms, the patient received four cycles of bortezomib-dexamethasone treatment. Post-treatment, the patient's symptoms improved, and CT imaging showed the disappearance of the mass lesion. Conclusion: Ureteral amyloidosis, though rare, can present with significant clinical symptoms. Early detection and a combination of surgical and medical interventions, as demonstrated in this case, can lead to symptom resolution and improved patient outcomes.

Background: Rhabdomyosarcoma (RMS) is a rare type of cancer that originates in the skeletal muscle cells. It's most commonly found in children but can occur at any age. The cancer is characterized by the presence of cells that resemble immature muscle cells, and it can grow and spread rapidly.Rhabdomyosarcoma (RMS) is a rare cancer that originates in skeletal muscle cells and can be found in various parts of the body, including the head and neck, genitourinary tract, extremities, and other less common areas such as the trunk and retroperitoneum. Bone marrow infiltration in Rhabdomyosarcoma (RMS) is a relatively rare occurrence. We are presenting a case Rhabdomyosarcoma with Bone Marrow Involvement and cervical Mass. Case Report: A 17-year-old female patient with no known previous illnesses presented to an external center with complaints of coughing, difficulty swallowing, weight loss, and fatigue that had begun a month prior. During a physical examination, a 2 cm mass was observed in the left cervical region, along with an enlarged appearance of the thyroid gland. Complete blood count revealed hemoglobin at 10.6 g/dL, leukocytes at 1000 mm3, neutrophils at 200 mm3, and platelets at 70000 mm3, leading to a referral to a hematology clinic. Upon repeated observation of pancytopenia, early myeloid precursors were seen in a peripheral smear. Due to a high suspicion of lymphoma, a bone marrow biopsy was performed, revealing widespread mononuclear cell infiltration. Immunohistochemical analysis showed desmin(+), myogenin(+), and Ki67 80% positivity, leading to a diagnosis of rhabdomyosarcoma. A PET-CT scan to determine the extent of the disease revealed multiple involvements in the bone and lungs. Treatment with Vincristine, doxorubicin, cyclophosphamide, and dexamethasone was initiated, resulting in a significant regression of the masses and an improvement in the cytopenia picture. Conclusion: The presence of RMS in the bone marrow can complicate both the diagnosis and treatment of the disease. It may require additional diagnostic procedures, such as bone marrow biopsy, to confirm the presence of RMS cells. Treatment may also need to be more aggressive, approaches. Bone marrow involvement in RMS is considered a more advanced stage of the disease and may be associated with a more challenging prognosis. Early detection and tailored treatment are crucial for managing RMS with bone marrow infiltration.

Background: Blood banking relies heavily on deferral policies for safety. Recognizing current academic themes can highlight research opportunities, encourage collaboration, ensure funding, understand audience interests, steer public sentiment, and inspire productive competition, thereby prompting impactful studies. Materials and Methods: We analyzed 1034 blood deferral papers from Web of Science and Scopus, focusing on publication count, uniqueness, timeline, and themes like Men who have Sex with Men (MSM), HIV, COVID-19, anemia, and machine learning. We also assessed the global distribution of these studies to understand prevalence and associations with geography, demographics, and economic factors. Results and Conclusions: The study uncovered 1037 articles; MSM (107), HIV (234), Anemia (201), COVID-19 (40), and machine learning (59). Most papers were from the US, UK, Canada, reflecting their robust research capabilities. The US led in HIV and anemia studies, with India significantly contributing to anemia research. India led in COVID-19 studies, with substantial participation from the US. Machine learning research primarily came from the US and India, with significant Chinese contributions. The trending literature on blood deferral underscores the need to comprehend evolving blood banking dynamics. Machine learning, with its transformative capacity, is a prime research area. These insights could guide future studies and policymaking, maintaining blood safety.

Background: Richter syndrome (RS) is typified by the emergence of an aggressive lymphoma in individuals who have been previously or simultaneously diagnosed with chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL). Although it is relatively rare, appearing in 2% to 10% of CLL patients, RS often proves to be lethal due to its rapid progression and the scarcity of specific therapies. Venetoclax, a BCL2 inhibitor, has demonstrated efficacy in CLL but its role remains less explored in RS. Hence, there is a paucity of information regarding the direct employment of Venetoclax in the treatment regimen for RS. This study presents a case of Richter transformation being managed under treatment with Venetoclax. Case report: Case: A 51-year-old female patient, diagnosed with CLL with negative 17p deletion following investigations in 2015 due to autoimmune immune thrombocytopenia (ITP) and lymphocytosis, was given 6 cycles of FCR (fludarabine, cyclophosphamide, rituximab) due to steroid-resistant autoimmune thrombocytopenia, and complete response (CR) was achieved according to iwCLL criteria. After remission, the patient was monitored without treatment, and in 2020, full blood count, biochemical analysis, and peripheral smear were performed due to fatigue symptoms. The complete blood count showed leukocytes: 44600/mm3, lymphocytes: 39000/mm3, MCV: 86 fl, and hemoglobin: 9.5 g/dL. The patient, with no signs of hemolytic anemia, had no nutritional (Fe, B12, folate) deficiency, and normochromic normocytic anemia was detected. There were no mutations in the immunoglobulin heavy chain variable region (IGHV) genes. The patient, evaluated as relapsed stage 3 disease, was started on venetoclax-rituximab treatment.In the 11th month of the treatment, due to symptoms of fatigue, fever, night sweats, and weight loss, a bone marrow biopsy was performed after pancytopenia was observed, and a diagnosis of diffuse large B-cell lymphoma was made. Due to Richter transformation, DA-R-EPOCH (dose-adjusted rituximab, etoposide, prednisolone, vincristine, cyclophosphamide, doxorubicin) treatment was initiated. After 4 cycles of DA-R-EPOCH treatment, single-agent ibrutinib was started due to treatment-resistant disease and an ECOG performance score of 2. The patient, whose disease continued to progress under ibrutinib treatment, died from septic shock. Conclusions: This case underscores the complexities in treating Richter syndrome, particularly with venetoclax, and emphasizes the need for careful monitoring and understanding of potential transformations. The development of Richter transformation under venetoclax treatment highlights an area that requires further investigation and consideration in the management of CLL. Prospective studies and a comprehensive approach are vital to enhancing treatment strategies and improving outcomes for patients with this aggressive form of lymphoma.

Backround: Enhancing blood safety and donor eligibility are vital in blood banking. We analyze our blood center's approach and Turkey's general strategy in this domain, focusing on identifying and mitigating the reasons for donor deferral. Materials and Method: We retrospectively evaluated data from 169,410 donors visiting Çukurova University Medical Faculty Blood Center from 2015 to 2021, including demographic, clinical, and laboratory information. We also compared this data with historical records from 2009 and 2011 obtained from Turkish conference papers. Results and Conclusions: Our analysis covered donors aged 18-65 years (mean 38 years) consisting of 91.1% males and 8.9% females. Blood type distribution was A Rh(+) 36.7%, O Rh(+) 29.5%, B Rh(+) 14.8%, and AB Rh(+) 7.6%. Only 3.6% of donors volunteered, while the rest had different donation reasons. A 72.3% successful donation rate was observed, but there was a 27.7% deferral rate, surpassing 2011′s 25.3% and 2009′s 18.2%. Deferrals were mostly due to anemia, recent medication use, elevated blood pressure, and vaccination history.Donor deferral aims to safeguard both donors and recipients against potential risks, underlining the importance of continual evaluation and management strategies to minimize deferral rates.

This study investigates the linkage between portfolio investment and economic growth in 18 developed and 27 developing countries. Furthermore, it compares and analyzes interest-bearing and non-interest-bearing assets and the economic development level. The results of our analysis show that long-term portfolio investment is positively associated with economic growth in developing countries. Long-term portfolio investment through non-interest-bearing assets contribute more to economic growth in developing countries. However, stocks and long-term bond portfolio investment are unrelated to economic growth in developed countries. Moreover, capital accumulation positively affects growth in developing and developed countries, but trade openness decreases growth in developing countries. Our policy recommendation is for the relation between long-term portfolio investment and economic growth to be evaluated by the characteristics of their assets, instead of a general framework, and for decision makers to adapt their policies accordingly. In addition, non-interest-bearing portfolio investment is encouraged for better growth performance in developing countries.

In this article, an enhanced maximum power point tracking (MPPT) technique for photovoltaic (PV) systems is presented. The proposed MPPT is designed for fast-changing operating conditions, where the conventional methods suffer from divergence (drift) under such conditions. Mainly, the reason for divergence in the traditional methods is the confusion between power change due to the perturbation of the control parameter and power variation because of the atmospheric conditions. Therefore, and to differentiate between these cases, additional control loops are added to the conventional perturb and observe (P&O) method to enhance its behavior. Furthermore, in our suggested scheme, the finite-set model predictive control (FS-MPC) principle is integrated with the proposed algorithm to enhance its transient performance. However, and to decrease the computational effort, the prediction stage (including cost function calculation) is eliminated. The suggested methodology is compared with the conventional FS-MPC for evaluation using experimental results at different atmospheric conditions (static and dynamic radiation).

This study investigated the protective characteristics of caffeic acid phenethyl ester (CAPE) and thymoquinone (TMQ) against the effects of cigarette smoke in recovery from bone fractures. Sixty Wistar albino rats were divided into six groups (n = 10). The rats’ femur bones were fractured and then fixed with microplates and microscrews. In the CAPE group, CAPE was given by intraperitoneal injection for 30 days at a dose of 10 μmol/kg once a day. In the TMQ group, TMQ was given orogastrically for 30 days at a dose of 10 mg/kg once a day. In the cigarette groups, CAPE was given by intraperitoneal injection for 30 days at a dose of 10 μmol/kg once a day (CAPE-CG), TMQ was given orogastrically for 30 days at a dose of 10 mg/kg once a day (TMQ-CG), and controls were exposed to cigarette smoke three times a day for 8 min each time for 30 days. The controls received no postoperative treatment. The rats were sacrificed on the 30th day following surgery. According to the histopathological and immunohistochemical results, cigarette smoke had a negative impact on bone healing. TMQ and CAPE increased bone formation and reduced bone destruction. Therefore, TMQ and CAPE were found to be partially protective against the adverse effects of smoking on bone tissue.

The powerful combination of steady state isotopic transient kinetic analysis (SSITKA) and operando infrared spectroscopy (IR) was applied to study the CO oxidation reaction on Pd-supported Al2O3 catalyst at low temperature. The aim was to reveal the true role of hydrogen‑carbonate species in the reaction mechanism. The SSITKA-IR experiments, conducted in presence and absence of CO2 in the gas feed, have confirmed that hydrogen‑carbonate species behave as spectator species in the reaction. Its formation was due to re-adsorption of the CO2 product itself on the alumina surface as confirmed by the direct 12CO2/13CO2 exchange observed on the bare support.

Background: Understanding SARS-CoV-2 seroprevalence among health care personnel is important to explore risk factors for transmission, develop elimination strategies and form a view on the necessity and frequency of surveillance in the future. Methods: We enrolled 4927 health care personnel working in pediatric units at 32 hospitals from 7 different regions of Turkey in a study to determine SARS Co-V-2 seroprevalence after the first peak of the COVID-19 pandemic. A point of care serologic lateral flow rapid test kit for immunoglobulin (Ig)M/IgG was used. Seroprevalence and its association with demographic characteristics and possible risk factors were analyzed. Results: SARS-CoV-2 seropositivity prevalence in health care personnel tested was 6.1%. Seropositivity was more common among those who did not universally wear protective masks (10.6% vs 6.1%). Having a COVID-19-positive co-worker increased the likelihood of infection. The least and the most experienced personnel were more likely to be infected. Most of the seropositive health care personnel (68.0%) did not suspect that they had previously had COVID-19. Conclusions: Health surveillance for health care personnel involving routine point-of-care nucleic acid testing and monitoring personal protective equipment adherence are suggested as important strategies to protect health care personnel from COVID-19 and reduce nosocomial SARS-CoV-2 transmission.

The growth within the Internet and communications areas have led to a massive surge in the dimension of network and data. Consequently, several new threats are being created and have posed difficulties for security networks to correctly discover intrusions. Intrusion Detection System (IDs) is one amongst the foremost essential events for security arrangements in network environments, and it is commonly applied to spot, track, and detect malevolent threats. Detecting intruders using metaheuristics and machine learning methodologies in recent trend offers improved discovery rate. Therefore, this paper presented an intrusion detection model using an improved Binary Manta Ray Foraging (BMRF) Optimization Algorithm based on adaptive S-shape function and Random Forest (RF) classifier. The BMFR is envisioned to identify the most relevant features and remove redundant and irrelevant ones from the intrusion detection datasets. Furthermore, the RF is used for feature evaluation and to build the intrusion detection model. The proposed method was validated and compared with other methods using two IDs benchmark datasets, which include NSL-KDD and CIC-IDS2017 datasets. The result indicates that the presented model selected 38 features with 99.6% precision, 94.3% recall, 96.9% f-measure, and 99.3% accuracy for the CIC-IDS2017 dataset. Moreover, for the NSL-KDD dataset, the presented model selected 22 features with 96.8%, 96.2%, 96.5%, and 98.8% for precision, recall, F-measure, and accuracy. In addition, a statistical significance test reveals a significance difference between the presented model and the compared methods in terms of F-measure.

Background/objectives: The Internet of Things (IoT) can create disruptive innovation in healthcare. Thus, during COVID-19 Pandemic, there is a need to study different applications of IoT enabled healthcare. For this, a brief study is required for research directions. Methods: Research papers on IoT in healthcare and COVID-19 Pandemic are studied to identify this technology’s capabilities. This literature-based study may guide professionals in envisaging solutions to related problems and fighting against the COVID-19 type pandemic. Results: Briefly studied the significant achievements of IoT with the help of a process chart. Then identifies seven major technologies of IoT that seem helpful for healthcare during COVID-19 Pandemic. Finally, the study identifies sixteen basic IoT applications for the medical field during the COVID-19 Pandemic with a brief description of them. Conclusions: In the current scenario, advanced information technologies have opened a new door to innovation in our daily lives. Out of these information technologies, the Internet of Things is an emerging technology that provides enhancement and better solutions in the medical field, like proper medical record-keeping, sampling, integration of devices, and causes of diseases. IoT’s sensor-based technology provides an excellent capability to reduce the risk of surgery during complicated cases and helpful for COVID-19 type pandemic. In the medical field, IoT’s focus is to help perform the treatment of different COVID-19 cases precisely. It makes the surgeon job easier by minimising risks and increasing the overall performance. By using this technology, doctors can easily detect changes in critical parameters of the COVID-19 patient. This information-based service opens up new healthcare opportunities as it moves towards the best way of an information system to adapt world-class results as it enables improvement of treatment systems in the hospital. Medical students can now be better trained for disease detection and well guided for the future course of action. IoT’s proper usage can help correctly resolve different medical challenges like speed, price, and complexity. It can easily be customised to monitor calorific intake and treatment like asthma, diabetes, and arthritis of the COVID-19 patient. This digitally controlled health management system can improve the overall performance of healthcare during COVID-19 pandemic days.

Introduction: Structural and electrophysiological changes play a critical role in the development of atrial fibrillation (AF). Although the pathophysiology of paroxysmal AF (PAF) has not been fully elucidated, oxidative stress (OS) and DNA damage appear to be important triggers. Thus far, no studies have investigated the relationships among total oxidant status (TOS), DNA damage, and PAF. The goal of this study was to assess TOS and DNA damage in patients with PAF. Methods: This cross-sectional study included 56 patients with PAF and 31 healthy controls. OS was assessed based on TOS, total antioxidant capacity (TAC), and oxidative stress index (OSI). The level of DNA damage was assessed using 8-hydroxy-2′-deoxyguanosine (8-OHdG). Results: There were no significant differences between the groups in terms of baseline characteristics. However, patients with PAF had significantly higher high-sensitivity C-reactive protein (p=0.018), TOS (p=0.001), OSI (p=0.001), and 8-OHdG (p=0.019) levels, compared with the control group. Multivariate logistic regression analysis showed that serum TOS level (odds ratio: 1.608; 95% confidence interval [CI]: 1.188-2.176, p=0.002) was the only independent predictor of PAF. TOS ≥12.2 predicted PAF with a sensitivity of 82% and specificity of 76% (AUC: 0.785, 95% CI: 0.687-0.883, p

Purpose: To investigate the clinical and pathological predictive factors affecting biochemical recurrence (BCR) after radical prostatectomy (RP) in patients with positive and negative surgical margin (SM). Methods: Patients who underwent RP were retrospectively reviewed for the study. Demographic, clinical, pathological and oncological data were evaluated. All data were compared between patients with positive SM and negative SM to detect factors associated with SM status. Later, patients were divided into two groups as BCR-negative and BCR-positive groups. Data were separately compared between BCR groups for all patients, SM-negative and SM-positive patients, respectively. Results: A total of 254 patients with a mean age of 63.5 years and the mean prostate-specific antigen of 10.9 ng/ml were evaluated in the study. SM positivity was found to be an independent prognostic factor for BCR (p = 0.013, Odds Ratio (OR): 0.267, 95% Confidence Interval (CI): 0.094-0.755). In SM-positive patients, biopsy Gleason Score and International Society of Urological Pathology grade were found to be independent predictive factors for BCR (p 75 μm TSMD were recurrence free, 5 of 31 patients with

The recent advancements in science, engineering, and technology have facilitated huge generation of datasets. These huge datasets contain noisy, redundant, and irrelevant features which negatively affects the performance of classification techniques in machine learning and data mining process. Feature selection is a pre-processing stage for reducing the dimensionality of datasets by selecting the most important attributes while increasing the accuracy of classification at the same time. In this paper, we present a novel hybrid binary version of enhanced chaotic crow search and particle swarm optimization algorithm (ECCSPSOA) to solve feature selection problems. In the proposed ECCSPSOA, in order to navigate the feature space, we hybridized the enhanced version of the CSA algorithm which has a better search strategy and particle swarm optimization (PSO) which is capable of converging into the best global solution in the search field. We further embed opposition-based learning technique in the local search of the hybrid algorithm. The ECCSPSOA was compared using 15 datasets from the UCI repository with four well-known optimization algorithms, such as particle swarm optimization (PSO), binary particle swarm optimization (BPSO), crow search algorithm (CSA), and chaotic crow search algorithm (CCSA). In the experiments with k-Nearest Neighbour (KNN) as a classifier, six different performance metrics were used. To tackle the over-fitting problem, each dataset is divided into training and testing data using K-fold cross-validation. The computational findings demonstrate that the proposed algorithm obtains an average accuracy rate of 89.67 % over 15 datasets, indicating that our technique exceeds state-of-the-art findings in 12 of the 15 datasets studied. Furthermore, the suggested approach outperforms state-of-the-art methods in terms of fitness value and standard deviation, obtaining the lowest value in 13 and 8 of the datasets studied respectively.

The sharp rise in network attacks has been a major source of concern in cyber security, particularly that now internet usage and connectivity are in high demand. As a complement to cloud computing, fog computing can offer low-latency services among users of mobile and the cloud. Because of the closeness of the end users to the fog nodes and having inadequate computing resources, fog devices may get into security issues. Conventional network threats may demolish the fog computing system. The use of Intrusion Detection Systems (IDS) in conventional networks has been extensively researched, applying them directly in to the fog computing platform might become unsuitable. Nodes of the fog generate enormous quantities of data most of the time, so implementing an Intrusion detection system model over large datasets in the fog computing setting is critical. To combat some of these network attacks, an intrusion detection system (IDS), a strategic intrusion prevention innovation that can be applied in the fog computing platform utilizing machine learning techniques for network anomaly detection and network event classification threat, has proven efficient and effective. This paper presented a Genetic Algorithm Wrapper-Based feature selection and Nave Bayes for Anomaly Detection Model (GANBADM) in a Fog Environment which removes extraneous attributes to reduce time complexity while also developing an enhanced model that can predict results with greater accuracy using the Security Laboratory Knowledge Discovery Dataset (NSL-KDD). Based on the analysis, the developed system has a higher overall performance of 99.73% accuracy, with a false positive rate as low as 0.6%. This results show that the proposed GANBADM approach performs better than similar approaches in the literature.

Objective: Autoimmune cytopenia is observed in many hematological malignancies, whereas immune thrombocytopenia is rarely observed in plasma cell dyscrasias, such as multiple myeloma. On the other hand, cytopenias secondary to myelosuppression due to lenalidomide use are frequently observed, whereas immune thrombocytopenia is a rarer complication. Case report: A 63-year-old female patient without any known disease was performed bone marrow biopsy in January 2019 due to anemia and high sedimentation rate. She was diagnosed with IgG-kappa type multiple myeloma and administered four cycles of bortezomib-cyclophosphamide-dexamethasone treatment. She went into remission after this treament and was then performed autologous stem cell transplantation followed by a consolidation therapy comprising 2 cycles of bortezomib-lenalidomide-dexamethasone treatment. Subsequently, she was administered lenalidomide maintenance therapy with regular follow-up visits. Isolated thrombocytopenia was observed in the patient in her last follow-up visit and was therefore hospitalized for further examination. No schistocyte was observed in the peripheral smear as well as no rouleaux formation. It was determined that her LDH (lactate dehydrogenase) levels were normal and that she did not have organomegaly. The results of the Coombs test, in addition to the results of hepatitis B, hepatitis C, HIV (Human Immunodeficiency Virus), EBV (Ebstein-Barr Virus), and ANA (antinuclear antibody) tests, which were run in order to determine whether she had any viral diseases, came out as negative. Post-transfusion purpura was ruled out in the patient as she had no history of transfusion in the last three months. She was then performed bone marrow biopsy, since her platelet count did not increase after discontinuation of lenalidomide treatment despite the fact that she was given platelet suspension transfusion. Subsequently, it was was determined that her megakaryocyte count increased, whereas her plasma cell ratio was less than 5%. In view of the foregoing, she was pre-diagnosed with lenalidomide-related immune thrombocytopenia, and was thus given 1 gr of methylprednisolone for 3 days followed by the administration of methylprednisolone at a daily dose of 1 mg/kg for 5 days. However, a sufficient increase in her platelet count could not be achieved with the said treatment. Therefore, she was administered eltrombopag therapy instead, since she was refractory to other treatments that could have been administered as a replacement treatment, such as IVIG (Intravenous Immunoglobulin), rituximab or cyclophosphamide. The patient, whose platelet count increased after the administration of eltrombopag therapy, was then discharged with full recovery. Conclusion: The aim of this case report is to demonstrate that lenalidomide-associated immune thrombocytopenia should also be considered when there is isolated thrombocytopenia in patients with multiple myeloma without a decrease in other cell lines.

Introduction: Submandibular glands are exposed to many effects due to diseases and therapeutic interventions. A study evaluating the effect of submandibular gland dysfunction on the parotid gland has not been presented in the literature. Objective: The aim of this study was to evaluate the histopathological changes in the parotid gland following submandibular gland failure. Methods: Three groups of seven randomly selected female New Zealand rabbits weighing 2500–3000 g were studied. Unilateral and bilateral submandibular glands were removed in Groups 1 and 2, respectively. No procedure was performed in Group III, the control group. The parotid glands were removed 30 days later. Histological parameters were evaluated and graded between 0 (none) and 3 (severe). Differences between groups were compared using the Mann–Whitney U test. Results: Mean mucus accumulation in acinar cells was 2.57 ± 0.53 and 1.71 ± 0.75 in Groups 1 and 2, respectively (p 0.05). This value was 0.28 ± 0.48 in Group 3, which was significantly lower than in Groups 1 and 2 (p 0,05). Esse valor foi de 0,28 ± 0,48 no Grupo 3, significativamente menor do que nos Grupos 1 e 2 (p

Summary: Objectives: To evaluates the management and outcome of non-iatrogenic pediatric and adolescence extremity arterial injuries in a resource-challenged setting. Methods: A retrospective study of the surgical management for non-iatrogenic extremity arterial trauma in pediatric and adolescence during the period from January 2008 to December 2015. This study was performed in two different countries at tertiary referral university and teaching hospitals having a specialized emergency and trauma centers. A thorough study of each patient record was collected from these centers including, the original demographic data and their clinical presentations. Operative data of each patient was also reported. Results: During the 8-year period of the study, 149 pediatric and adolescent extremity arterial trauma patients were treated. They were 93.3% male, and 6.7% female, respectively. The age ranged from 2 to 18 years with a mean of 10.25 ± 4.05 years. Lower extremity arterial trauma was recorded in 51%, while 49% were having upper extremity injuries. Primary repair with end-to-end vascular anastomosis was performed in 51.7%, while an interposition reversed saphenous vein graft was performed in 48.3%. The operative procedures were performed by an experienced vascular surgeon and well-trained pediatric surgeons and general surgeons. Pseudoaneurysms was recorded in 9% of cases. Fasciotomy was performed in 15% of cases. Conclusion: Treatment of pediatric and adolescent extremity arterial injuries with primary end-to-end vascular anastomoses or with the use of an interposition reversed saphenous vein graft is a reliable, feasible, and more cost-effectiveness technique with good results. Moreover, it should be adopted for all vascular trauma patients, whenever possible. Keywords: Non-iatrogenic, Pediatric and adolescence, Peripheral arterial trauma, Vascular anastomosis, Interposition reversed saphenous vein graft, Prophylactic fasciotomy

Introduction: Stent restenosis remains a clinical challenge for patients with ischemic heart disease, since it is associated with repeated coronary interventions as well as higher hospitalization rates and medical costs. Inflammation plays a significant role. Although an association between stent restenosis, increased C-reactive protein (CRP) and decreased albumin levels has been previously reported, no studies have investigated the ability of the CRP/albumin ratio to predict stent restenosis. Methods: This retrospective study included 448 patients who had previously undergone primary percutaneous coronary intervention and who were referred for subsequent reintervention due to recurrence of anginal symptoms. The study population was divided into two groups based on whether the patient had developed stent restenosis. They were then stratified into three groups according to their CRP/albumin ratio. Results: Out of 448 patients, stent restenosis was observed in 24.5% (n=110), as determined by coronary angiography. Patients with stent restenosis had a higher CRP/albumin ratio, greater platelet distribution width (PDW), higher CRP levels, and lower levels of both high-density lipoprotein (HDL) cholesterol and serum albumin. The CRP/albumin ratio (OR: 2.289, 95% CI: 1.056-4.959; p=0.036), stent diameter, PDW and HDL cholesterol levels were found to be independent predictors of stent restenosis. A ROC curve comparison demonstrated that the CRP/albumin ratio was a better predictor of restenosis than either albumin and CRP individually, but it was not better than PDW and HDL cholesterol. Conclusion: As a novel inflammation-based risk score, the CRP/albumin ratio may be an easily accessible marker for assessment of stent restenosis risk. Resumo: Objetivo: A reestenose de stent permanece como um desafio clínico em doentes com cardiopatia isquémica. A reestenose de stent está associada a intervenções coronárias recorrentes bem como a aumento de internamentos e de custos médicos. A inflamação tem um papel significativo. Embora a associação entre reestenose de stent e o aumento dos níveis de proteína C-reativa (PCR) e a diminuição dos níveis de albumina tenham sido previamente registados, nenhum estudo pesquisou a possibilidade da PCR/albumina prever um diagnóstico de reestenose de stent. Métodos: Este estudo retrospetivo incluiu 448 doentes que tinham sido previamente submetidos a intervenção coronária percutânea primária e que foram referidos para reintervenção posterior devido a ressurgimento dos sintomas de angina. A população do estudo foi dividida em dois grupos com base no facto do doente ter desenvolvido reestenose de stent. Posteriormente, foram estratificados em três grupos de acordo com as relações PCR/albumina. Resultados: De um grupo de 448 doentes, a reestenose de stent foi observada em 24,5% (n = 110), conforme determinado por avaliação através de angiografia coronária. Os doentes com reestenose de stent apresentaram uma relação PCR/albumina mais elevada, variação maior do diâmetro das plaquetas (DP), níveis mais elevados de PCR e níveis mais baixos de colesterol de lipoproteínas de alta densidade (HDL) e de albumina sérica. Os níveis da relação PCR/albumina (OR: 2,289, IC 95%:1,056 – 4,959; p = 0,036), o diâmetro do stent, a variação maior do DP e o colesterol HDL foram considerados fatores preditores independentes da restenose de stent. A comparação das curvas ROC demonstrou que a relação PCR/albumina constituiu um fator preditor melhor do que a albumina e a PCR, isoladamente, não sendo, no entanto, melhor do que o DP e o colesterol HDL. Conclusão: Como novo score de risco baseado em inflamação, a relação PCR/albumina pode ser um marcador facilmente acessível para a avaliação do risco de reestenose de stent. Keywords: Stent restenosis, C-reactive protein/albumin ratio, ST-segment elevation myocardial infarction, Inflammation, Palavras chave: Reestenose de stent, Proteína C reativa/albumina, Enfarte do miocárdio com elevação do segmento ST, Inflamação

Complete avulsion of hip abductor muscles may cause severe gait dysfunction and pain. An open surgical procedure to transfer tendons of the gluteus maximus and the tensor fasciae latae to the greater trochanter to make up for the deficient hip abductor has been proposed. The purpose of this study was to describe an endoscopic procedure to transfer gluteus maximus and the tensor fasciae latae to the greater trochanter for hip abductor deficiency.

The Sweet's syndrome is a rare dermatosis which can be related to underlying malignancies. In this case we presented a case, who applied to our clinic with severe dermatosis and hematuria. We diagnosed high grade non-muscle invasive bladder tumor, which was treated with transurethral resection of bladder-tumor and six cycle of Bacillus Calmette-Guérin therapy. After the treatment the dermatosis was regressed almost completely. However, recurrent bladder tumor was detected at the first control cystoscopy.

In this study, the chemical profile, antioxidative, cytotoxic and apoptotic effects of essential oil of Paracaryum bingoelianum Behçet &İlçim (Boraginaceae) were investigated in vitro. The chemical composition of P. bingoelianum essential oil (EO) was determined by HS-SPME/GC–MS method. DPPH free radical scavenging activity, ferric thiocyanate (FTC), and ferric reducing antioxidant potential (FRAP) methods were performed for revealing the antioxidant capacity of EO. The cytotoxic effect of EO was determined by MTT (3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyl tetrazolium bromide) cell viability assay on MCF-7 breast cancer and HT-29 colorectal adenocarcinoma cells. Apoptosis inducing effect of EO was evaluated by cell death detection Elisa (CDDE) assay and acridine orange/ethidium bromide staining method. Totally thirty-four compounds, representing 93.38% of the essential oil were identified. The DPPH scavenging activity of EO at 205 μg/mL concentration, was found as close to vit. C. Besides, it was observed that EO had significant reducing power and total antioxidant capacity. The EO inhibited the proliferation of MCF-7 and HT-29 cells, and induced apoptosis. When compared with untreated cells, the viability of MCF-7 and HT-29 cells, which treated with 800 μg/mL EO, decreased to 48.9% and 36.2%, respectively. In treated MCF-7 and HT-29 cells with EO at IC50 doses, the apoptosis was significantly induced, compared to untreated cells (p

K shell X-ray fluorescence cross-sections (σKα, σKβ and σK), and K shell fluorescence yields (ωK) of Ti, Ni both in pure metals and in different alloy compositions (TixNi1-x; x = 0.3, 0.4, 0.5, 0.6, 0.7) were measured by using energy dispersive X-ray fluorescence (EDXRF) technique. The samples were excited by 22.69 keV X-rays from a 10 mCi Cd-109 radioactive point source and K X rays emitted by samples were counted by a high resolution Si(Li) solid-state detector coupled to a 4 K multichannel analyzer (MCA). The alloying effects on the X-ray fluorescence (XRF) parameters of Ti-Ni shape memory alloys (SMAs) were investigated. It is clearly observed that alloying effect causes to change in K shell XRF parameter values in Ti-Ni based SMAs for different compositions of x. Also, the present investigation makes it possible to perform reliable interpretation of experimental σKα, σKβ and ωK values for Ti and Ni in SMAs and can also provide quantitative information about the changes of K shell X-ray fluorescence cross sections and fluorescence yields of these metals with alloy composition. Keywords: Alloying effect, XRF, K X-ray fluorescence cross-section, K shell fluorescence yield, Shape memory alloy

The alloying effects on X-ray fluorescence (XRF) parameters such as K shell fluorescence cross-sections (σKα, σKβ and σK), K shell average fluorescence yields (ωK) and K to L shell vacancy transfer probabilities (ηKL) of V, Ti, Fe, Co and Ni 3d transition metals in Permendur49 (Fe49Co49V2), Kovar (Fe54Ni29Co17) and Ti50Co50 alloys have been carried out by X-ray fluorescence studies. K X-ray intensity ratios of these 3d transition metals in both pure form and present alloys have been measured following excitation by 22.69 keV X-rays from a 10 mCi 109Cd radioactive point source. The characteristic K-X-ray spectra from samples were detected by a high-resolution Si(Li) solid-state detector. The investigated fluorescence parameters of present 3d transition elements in alloys indicate significant differences with respect to the pure metals. Consequently, the observed change of the investigated fluorescence parameters can be attributed to the delocalization and charge transfer phenomena between the 3d elements in alloys. Keywords: Permendur49, Kovar, Ti50Co50, X-ray fluorescence parameters, Fluorescence yields, Fluorescence cross-section, Vacancy transfer probabilities

Aim: Syntax score II (SSII) is a highly predictive scoring system, which is used to improve individualized assessment of patients with complex coronary artery disease and facilitates clinical decision making. Surrogate markers [carotid intima-media thickness (CIMT), epicardial fat tissue (EFT)] are also used for risk assessment, but their relation with SSII is not well established. Method: We enrolled 543 consecutive patients, who underwent coronary angiography for stable angina pectoris and acute coronary syndrome, in the study. SSII was calculated for each patient and the patients were divided into two groups as low SSII group and high SSII group according to their median SSII. Results: The average age of the patients was 61.4 years and 75% of the patients were male. The multivariate analysis indicated that only EFT (p: 0,035), CIMT (p:0,04) and Hypertension (HT) (p: 0,014) were independently associated with high SSII. Discussion: EFT and CIMT, the surrogate markers which can be simply and non-invasively determined, are of the independent predictors of high SSII. The inclusion of these parameters in the risk classification may provide additional clinical benefit.

Acquired or congenital disruption in enteric nervous system (ENS) development or function can lead to significant mechanical dysmotility. ENS restoration through cellular transplantation may provide a cure for enteric neuropathies. We have previously generated human pluripotent stem cell (hPSC)-derived tissue-engineered small intestine (TESI) from human intestinal organoids (HIOs). However, HIO-TESI fails to develop an ENS. The purpose of our study is to restore ENS components derived exclusively from hPSCs in HIO-TESI. hPSC-derived enteric neural crest cell (ENCC) supplementation of HIO-TESI establishes submucosal and myenteric ganglia, repopulates various subclasses of neurons, and restores neuroepithelial connections and neuron-dependent contractility and relaxation in ENCC-HIO-TESI. RNA sequencing identified differentially expressed genes involved in neurogenesis, gliogenesis, gastrointestinal tract development, and differentiated epithelial cell types when ENS elements are restored during in vivo development of HIO-TESI. Our findings validate an effective approach to restoring hPSC-derived ENS components in HIO-TESI and may implicate their potential for the treatment of enteric neuropathies.

Clayey soils in Syria cover a total area of more than 20,000 km2 of the country, most of which are located in the southwestern region. In many places of the country, the clayey soils caused severe damage to infrastructures. Extensive studies have been carried out on the stabilization of clayey soils using lime. Syria is rich in both lime and natural pozzolana. However, few works have been conducted to investigate the influence of adding natural pozzolana on the geotechnical properties of lime-treated clayey soils. The aim of this paper is to understand the effect of adding natural pozzolana on some geotechnical properties of lime-stabilized clayey soils. Natural pozzolana and lime are added to soil within the range of 0%–20% and 0%–8%, respectively. Consistency, compaction, California bearing ratio (CBR) and linear shrinkage properties are particularly investigated. The test results show that the investigated properties of lime-treated clayey soils can be considerably enhanced when the natural pozzolana is added as a stabilizing agent. Analysis results of scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDX) show significant changes in the microstructure of the treated clayey soil. A better flocculation of clayey particles and further formation of cementing materials in the natural pozzolana-lime-treated clayey soil are clearly observed.

Objective: The high risk of nonunion represents a challenge in vertebral surgery, thus stimulating new strategies to improve fusion rates. We investigated the effect of 2 different bone grafts and amniotic fluid application on radiologically and histologically evaluated vertebral fusion in an experimental rat model. Materials and methods: Forty-eight 24-week-old Sprague Dawley rats were included and assigned into 1 of 4 groups: allograft group, allograft plus human amniotic fluid group, demineralized bone matrix (DBM) group, or DBM plus human amniotic fluid group. After decortication and L4–L6 spinal fusion, study treatments were applied. Fusion in each rat was examined radiologically and histologically 8 weeks after the intervention. Results: The group that received only allograft had better radiologic scores (median = 3.5; range = 3–4) when compared with the group that received only DBM (median = 2; range = 1–4) (P = 0.002); however, histologic scores did not differ. When amniotic fluid was added to the grafting, allograft-based treatments performed better than DBM-based treatments both on radiologic (median = 4; range = 3–4 vs median = 3; range = 3–4; P = 0.003) and histologic (median = 7; range = 6–7 vs median = 5; range = 3–6; P < 0.001) evaluation. Addition of amniotic fluid did not result in better outcomes in the rats that received DBM-based treatments but based on histologic evaluation, rats that received allograft-based treatments benefited from this application. Conclusions: Amniotic fluid seems to have an enhancing effect on posterior spinal fusion, particularly when combined with allograft.

Benzyl alcohol is an aromatic hydrocarbon used as a solvent and an intermediate chemical in the pharmaceutical, cosmetics, and flavor/fragrance industries. The de novo biosynthesis of benzyl alcohol directly from renewable glucose was herein explored using a non-natural pathway engineered in Escherichia coli. Benzaldehyde was first produced from endogenous phenylpyruvate via three heterologous steps, including hydroxymandelate synthase (encoded by hmaS) from Amycolatopsis orientalis, followed by (S)-mandelate dehydrogenase (encoded by mdlB) and phenylglyoxylate decarboxylase (encoded by mdlC) from Pseudomonas putida ATCC 12633. The subsequent rapid and efficient reduction of benzaldehyde to benzyl alcohol occurred by the combined activity and native regulation of multiple endogenous alcohol dehydrogenases and/or aldo-keto reductases. Through systematic deletion of competing aromatic amino acid biosynthesis pathways to promote endogenous phenylpyruvate availability, final benzyl alcohol titers as high as 114±1 mg/L were realized, representing a yield of 7.6±0.1 mg/g on glucose and a ~5-fold improvement over initial strains. Keywords: Benzyl alcohol, Benzaldehyde, Aromatic chemicals

This paper aimed at developing advanced Logit discrete choice models with several individual and mode attributes affecting the prediction of individual choice. The models have been applied to Port-Said (PS) city and have been used to investigate innovative transport systems such as Bus Rapid Transit (BRT) as a hypothetical mode situation beside the regular modes of transport (car and taxi). The methodology provides data collection of PS transportation mode system and develops Multinomial Logit Model (MNL), Nested Logit Model (NL), and Mixed Logit Model (MXL) using Visual-tm Software. The survey was formed by the Stated Preference (SP) technique conducted for individuals from all PS zones and the predictable travel mode choice behavior was analyzed. The findings showed that in PS, income is the most important attribute affecting the mode choice behavior model. The high values and positive signs of income parameters indicate that the higher income earners are more likely to use private car than taxi or bus. Contrary to most cases in developed countries, out-of-vehicle time that represents the accessibility shows higher impacts than the in-vehicle time as a result of poor access facilities in developing countries.

Traffic turning movement counts at roundabouts is one of the key inputs required for roundabout assessment, control and management. Traditionally, a direct counting is conducted to track a vehicle from entering through circulation until exiting. This counting may be difficult and costly due to the size of roundabout, the vision obstacles, and the continuous traffic flow. Many researchers tried to avoid the tracking problem by counting only at entries and exits, then estimating the movements based on historical data which unfortunately affect the results. Other researchers reduced the tracking problem by counting some turning movements in addition to at entries and exits, then calculating mathematically the remaining movements. This approach is practical and accurate; however, it was applied on limited cases. In this paper, a generalized mathematical model was developed to calculate the most difficult movements based on the easiest movements determined based on the size of monitoring area. The developed model can be used to calculate the turning movements, including the u-turns, for roundabouts with any number of legs. The developed model was presented in O–D matrix forms to be practical and user-friendly. The model was validated against reference count data and the results were found to be satisfactory.

A previously fit and well man developed acute respiratory failure due to environmental mould exposure from living in damp rental accommodation. Despite aggressive intensive care management he rapidly deteriorated and required respiratory and cardiac Extracorporeal Membrane Oxygenation. We hypothesize that poor domiciliary conditions may make an underestimated contribution to community respiratory disease. These conditions may present as acute and severe illness with non-typical pathogens identified.

This paper presents an empirical evaluation of the relationship between operational performance and platooning phenomenon in rural two-lane roads in Egypt. Seven performance measures and three platooning variables were defined and calculated for eight study sites using traffic data from roads in Minoufiya governorate, Egypt. Using graphical and statistical analyses, the associations between the performance measures and the platooning variables were examined. The results showed that the follower density performance measure was found to have the strongest correlations to platooning variables. Among the platooning variables investigated, traffic flow in the direction of travel has the highest correlations with performance measures. The study demonstrated that the relationship between follower density and traffic flow is better described by a quadratic form. Finally, threshold values for different levels-of-service were proposed. This might help traffic engineers, in Egypt, to evaluate operational performance using criteria that reflect the local conditions of the area under study.

Background: Non-alcoholic fatty liver disease (NAFLD) is a prevalent condition associated with obesity and insulin resistance (IR). Leptin plays a key role in the control of energy balance, and insulin sensitivity. In this study, we aimed to examine whether serum leptin levels correlate with insulin resistance, oxidative stress parameters and the severity of histological changes in NAFLD. Methods: Fifty-two patients (M/F: 28/24) with no alcohol intake and biopsy-proven diagnosis of NAFLD were studied. Serum leptin levels were measured by radioimmunoassay. HOMA (homeostasis model assessment) IR index was calculated. Comparisons between the patients with NAFLD and non-alcoholic steatohepatitis (NASH) were performed using the Student’s t test. Multivariate regression analysis and the area under the receiver operating characteristic (ROC) curve were used to identify the independent predictors for NASH. Results: We found no association between serum leptin, fasting insulin levels, and oxidative stress parameters. ROC curve and multiple regression analysis revealed no association between the severity of histological changes and serum leptin levels. During six months followed-up period only NASH group with elevated leptin levels had significant reductions of ALT and AST values (p = 0.03, and 0.005, respectively). Conclusion: Our findings show a preventive effect of leptin against progressive liver injury in NAFLD.