Search

Background: We evaluated the efficacy of dexmedetomidine versus magnesium sulfate as an adjuvant to intraperitoneal (IP) bupivacaine in pediatric laparoscopic inguinal herniorrhaphy. Methods: Ninety-seven male children, ASA I–II, 1–6 years old, undergoing laparoscopic inguinal herniorrhaphy, were randomized to receive before peritoneal insufflation, IP 2 mg.kg−1 bupivacaine 0.5% combined with either 1 μg.kg−1 of dexmedetomidine (Group D), 30 mg.kg−1 of magnesium sulfate (Group M), or normal saline (Group C). All tested drugs were diluted to the volume of 10 mL with normal saline. FLACC pain scores, need for rescue analgesics, time to flatus and first stool, emetic events, adverse effects, functional recovery, and parents’ satisfaction were recorded for the first 48 h postoperatively. Results: FLACC scores were significantly higher in Group C than in the other two groups at 6, 8, 12, 18, 24, and 48 hours after surgery with no differences between Groups D and M. Rescue analgesia was significantly higher in Group C with none of the children in Groups D and M requiring rescue analgesia (p = 0.001). Times to first flatus and stool, emetic events, and adverse effects did not differ among groups. Times to return to normal functional activity were comparable in all groups. Parents’ satisfaction was greater in Groups D and M than in Group C (p = 0.026). Conclusion: Dexmedetomidine and magnesium sulfate added to IP bupivacaine improved the analgesia afforded by bupivacaine in the first two postoperative days in children scheduled for laparoscopic herniorrhaphy.

Objective: Serotonin reuptake inhibitors cause weight gain, leading to drug discontinuation, relapse, and worsening of symptoms. This study aims to investigates the effect of metformin on weight loss, anthropometric indicators and laboratory assessments in patients of Rasht city. Methods: This clinical trial study with parallel-group design was organized based on 60 patients in treatment group (undergoing metformin) and 60 patients in control group (undergoing routine treatment) in Shafa hospital during July 2019 to January 2020. First, we determined the overweight patients. After that, a psychiatric assistant randomly divides them into two groups, intervention and control. Both groups of patients will be explained in terms of how they were studied and whether or not they received metformin. In order to statistical analysis of collected data, we applied the Mann-Whitney U test and repeated measures ANOVA. For conducting all analysis, the IBM SPSS Statistics 28 software was used. Results: The mean BMI and abdominal circumference decreased significantly in the intervention group. The wrist circumference in the intervention group decreased over time, but this difference was not statistically significant. There was no statistically significant difference between the average changes of the mean values of the laboratory assessment among the group. Conclusion: Weight gain can cause problems related to compliance with treatment and anxiety and depression. On the other hand, in our study, metformin was not superior to lifestyle improvements and practicing preventive methods for weight control. Further research on SSRIs and monitoring of anthropometric indices is recommended.

Objective: To identify and support correction of misspelled medication names recorded as free text, we compared the relative effectiveness of two user-friendly methods, used without reliance on clinical knowledge. Methods: Leveraging the SAS® COMPGED function, fuzzy string search programs examined 1.8 million medication records from 183,600 World Trade Center General Responder Cohort monitoring visits conducted in New York and New Jersey between 7/16/2002 and 3/31/2021, producing replicable generalized edit distance scores between the reported and correct spelling. Scores

Direct current (DC) distribution systems play a crucial role in integrating various DC systems, renewable energy sources, and power loads. Single-ended protection methods are inadequate for ensuring high-speed selective protection due to the lack of boundary elements, while current differential protection methods can be affected by line-distributed capacitance currents. Therefore, an event-based protection scheme is proposed that uses communication infrastructure and the first derivative of the transient fault current to provide a selective protection system for Medium Voltage Direct Current (MVDC) networks. The scheme utilizes Intelligent Electronic Devices (IEDs) to transmit events to the Intelligent Protection Center (IPC) via a communication network, which compares them to identify the faulty section. The proposed protection scheme is effective in detecting and isolating faults, even under challenging network conditions, as demonstrated by simulation results on a two-terminal topology MVDC distribution network using the PSCAD/EMTDC platform.

Background: Coronary artery disease remains a leading cause of death worldwide. Bone mesenchymal stem cell–derived extracellular vesicles (EVs) have shown promise in the setting of myocardial ischemia. Furthermore, the properties of the EVs can be modified via preconditioning of progenitor cells. Previous research from our lab demonstrated a significant decrease in proinflammatory signaling following treatment with EVs derived from starvation preconditioning of human bone mesenchymal stem cells (MVM EVs) in a porcine model of chronic myocardial ischemia. However, rodent models have demonstrated that the use of EVs derived from hypoxia preconditioning of bone mesenchymal stem cells (HYP EVs) may have extended benefits compared to MVM EVs. This study evaluated the effect of HYP EVs on inflammation in a swine model of chronic myocardial ischemia. We hypothesized that HYP EVs would have a greater anti-inflammatory effect than MVM EVs or saline (CON). Methods: Yorkshire swine fed a standard diet underwent placement of an ameroid constrictor to the left circumflex artery. Two weeks later, the animals received intramyocardial injection of saline (CON; n = 6), starvation-derived EVs (MVM; n = 10), or hypoxia-derived EVs (HYP; n = 7). After 5 weeks, myocardial perfusion was assessed, and left ventricular myocardial tissue was harvested. Protein expression was measured using immunoblotting. Data were analyzed via the Kruskal-Wallis test or one-way analysis of variance based on the results of a Shapiro-Wilk test. Coronary perfusion was plotted against relative cytokine concentration and analyzed with the Spearman rank-sum test. Results: HYP EV treatment was associated with decreased expression of proinflammatory markers interleukin (IL)-6 (P = .03), Pro-IL-1ß (P = .01), IL-17 (P

The Egyptian Red Sea coast, a mountainous coastal region, is periodically exposed to landslide that cause severe man and economic losses. That is due to its geological, hydrogeomorphological, and seismological nature. This research aims to map landslide susceptibility in the study area using a multi-criteria overlay analysis approach. Slopes, elevations, aspects, curvature, lineaments, faults, earthquakes, rainfall, stream network, and rock units are the factors used to derive the landslide's susceptibility map. The data were obtained from research organizations and open-source geospatial platforms. The landslide susceptibility map of the area under investigation ranges from low to high as follows: 1) low (23 %), 2) moderate (43 %), and 3) high (34 %) from total area. The used model is validated using direct field check and statistical analysis by Receiver operating characteristic (ROC) curve test 40 landslides events. Based on ROC, the multi-criteria overlay analysis approach can predict landslides by 82 % at a 95 % confidence level. The leading causes of landslides are geological, topographical, hydrogeomorphological, and seismological. For long-term development, the study's findings would assist decision-makers in lowering the risks connected with landslides in the areas. To reduce the chance of landslides, the study recommended it is important to take into account the rugged topography of zones where landslides are likely to occur and implement rockfall protection systems like barriers, embankments, or mesh.

Objective: Limited treatments exist for nonoperative chronic coronary artery disease. Previously, our laboratory has investigated extracellular vesicle (EV) therapy as a potential treatment for chronic coronary artery disease using a swine model and demonstrated improved cardiac function in swine treated with intramyocardial EV injection. Here, we seek to investigate the potential cardiac benefits of EVs by using hypoxia-conditioned EVs (HEV). Specifically, this study aims to investigate the effect of HEV on apoptosis in chronically ischemic myocardium in swine. Methods: Fourteen Yorkshire swine underwent placement of an ameroid constrictor on the left circumflex artery. Two weeks later, swine underwent redo left thoracotomy with injection of either saline (control, n = 7) or HEVs (n = 7). After 5 weeks, swine were euthanized for tissue collection. Terminal deoxynucleotidyl transferase dUTP nick end labeling was used to quantify apoptosis. Immunoblotting was used for protein quantification. Results: Terminal deoxynucleotidyl transferase dUTP nick end labeling staining showed a decrease in apoptosis in the HEV group compared with the control (P = .049). The HEV group exhibited a significant increase in the anti-apoptotic signaling molecule phospho-BAD (P = .005), a significant decrease in B-cell lymphoma 2 (P = .006) and an increase in the phospho-B-cell lymphoma to B-cell lymphoma 2 ratio (P

Background: Although the association between acute kidney injury and heart failure has recently become understood, the patient’s recognition of this relationship is still deficient. The least impact of heart failure on kidney functioning may attributed to promoted patient perception and self-care. Aims: To identify the impact of heart failure nurse-led education on the perception and self-care behaviours of heart failure patients suffering from acute kidney injury. Methods: A pre-test-post-test intervention design was implemented. Perception of cardio-renal disease and self-care behaviours were assessed before and after conducting a brief nurse-led educational program focusing on self-care management for heart failure and its association with renal disease using the “Visual Learners” learning model. Results: A total of fifty patients completed the study. The mean age of the patients was 51.16 years, and 58.0 % were males. The pre-test assessment revealed a moderate deficit in perception and self-care behaviours. However, education improved patients’ perception (t: 3.65, df: 49, SE: 0.34, p

Introduction: Sodium-glucose cotransporter-2 inhibitors (SGLT2i) are cardioprotective, and canagliflozin (CANA), an SGLT2i, has been shown to improve perfusion, AMPK signaling, and oxidative stress in chronically ischemic myocardium. The aim of this study is to determine the effects of CANA in nonischemic myocardium on coronary collateralization, oxidative stress, and other molecular pathways determined by proteomic profiling. Methods: Yorkshire swine underwent placement of an ameroid constrictor to the left circumflex artery. Two weeks later, pigs received no drug (CON, n = 8) or 300 mg CANA daily (n = 8). Treatment continued for five weeks, followed by tissue harvest of nonischemic myocardium. Results: CANA was associated with decreased capillary density (p = 0.05) compared to CON, without changes in arteriolar density. Reduced capillary density did not correlate with reduced perfusion. Oxidative stress was reduced with CANA (22 % decrease). In the CANA group, there was a trend towards increased p-eNOS and eNOS, without a change in p-eNOS/eNOS ratio, p-Akt, Akt, and p-Akt/Akt ratio. There was no change in p-ERK1/2, but a decrease in total ERK1/2 and increase in p-ERK1/2/ERK1/2 ratio. There were no changes in expression of p-AMPK, AMPK, with a trend towards increased ratio of p-AMPK/AMPK. Proteomics analysis identified 2819 common proteins, of which 120 were upregulated and 425 were downregulated with CANA. Pathway analysis demonstrated wide regulation of metabolic proteins. Conclusions: The effects of CANA on myocardial perfusion and AMPK signaling in chronically ischemic myocardium are not found in nonischemic territory, despite attenuation of oxidative stress. Metabolic proteins are widely regulated in nonischemic myocardium with CANA.

We consider Melvin-like cosmological and static solutions for the theories of N=2, D=4 supergravity coupled to vector multiplets. We analyze the equations of motion and give some explicit solutions with one scalar and two gauge fields. Generalized Melvin solutions with four charges are also constructed for an embedding of a truncated N=8 supergravity theory. Our results are then extended to supergravity theories with the scalar manifolds SL(N,R)/SO(N,R). It is shown that solutions with N charges only exist for N=8, 6 and 5 corresponding to theories with space-time dimensions D=4, 5 and 7.

Background: Contribution of host factors in mediating susceptibility to extrapulmonary tuberculosis is not well understood. Objective: To examine the influence of patient sex on anatomical localization of extrapulmonary tuberculosis. Methods: We conducted a retrospective cross-sectional study in Mali, West Africa. Hospital records of 1,304 suspected cases of extrapulmonary tuberculosis, available in TB Registry of a tertiary tuberculosis referral center from 2019 to 2021, were examined. Results: A total of 1,012 (77.6%) were confirmed to have extrapulmonary tuberculosis with a male to female ratio of 1.59:1. Four clinical forms of EPTB predominated, namely pleural (40.4%), osteoarticular (29.8%), lymph node (12.5%), and abdominal TB (10.3%). We found sex-based differences in anatomical localization of extrapulmonary tuberculosis, with males more likely than females to have pleural TB (OR: 1.51; 95% CI [1.16 to 1.98]). Conversely, being male was associated with 43% and 41% lower odds of having lymph node and abdominal TB, respectively (OR: 0.57 and 0.59). Conclusion: Anatomical sites of extrapulmonary tuberculosis differ by sex with pleural TB being associated with male sex while lymph node and abdominal TB are predominately associated with female sex. Future studies are warranted to understand the role of sex in mediating anatomical site preference of tuberculosis.

Summary: Bacillus Calmette-Guérin (BCG) confers heterologous immune protection against viral infections and has been proposed as vaccine against SARS-CoV-2 (SCV2). Here, we tested intravenous BCG vaccination against COVID-19 using the golden Syrian hamster model. BCG vaccination conferred a modest reduction on lung SCV2 viral load, bronchopneumonia scores, and weight loss, accompanied by a reversal of SCV2-mediated T cell lymphopenia, and reduced lung granulocytes. BCG uniquely recruited immunoglobulin-producing plasma cells to the lung suggesting accelerated local antibody production. BCG vaccination also recruited elevated levels of Th1, Th17, Treg, CTLs, and Tmem cells, with a transcriptional shift away from exhaustion markers and toward antigen presentation and repair. Similarly, BCG enhanced recruitment of alveolar macrophages and reduced key interstitial macrophage subsets, that show reduced IFN-associated gene expression. Our observations indicate that BCG vaccination protects against SCV2 immunopathology by promoting early lung immunoglobulin production and immunotolerizing transcriptional patterns among key myeloid and lymphoid populations.

High feed prices and limited access to feed are two critical problems faced by fish producers. One approach that farmers may consider is using less expensive and locally available components. We conducted a 60-day feeding trial to investigate the consequences of the dietary addition of Hemicell® (HC) as exogenous β-mannanase and lavender flower meal (LFM) in low- protein diet (25 % CP) in Oreochromis niloticus. The investigation assessed growth, feed utilization, somatic, body composition and hemato-biochemical indices, and digestive enzyme activity. Fish (N = 180; average weight: 17.17 ± 0.72 g) were haphazardly organized into six groups in triplicates (10 fish/replicate) and stocked in 18 plastic tanks (60 L). For 60-days, fish groups were fed on six prepared experimental diets. The negative control group (NCG) and positive control group (PCG) were fed basal diets containing 30 % CP and 25 % CP, respectively. Groups (G1-G4) were fed on basal diets containing 25 % CP and supplemented with 0.25 g/kg HC, 0.5 g/kg HC, 0.25 g/kg HC+ 10 g/kg LFM, and 0.5 g/kg HC+ 10 g/kg LFM, respectively. The findings showed decreases in the growth, body composition (crude protein and lipids), and white blood cells count (WBCs) in PCG as compared with the control group (NCG); meanwhile, no significant alteration was recorded for other parameters. Dietary addition of HC alone or with LFM enhanced growth, feed utilization, digestive enzymes activity (trypsin, amylase, and lipase), serum total protein, and hematological indices (red blood cells count, WBCs, and Hb) as compared with PCG. The highest results were notable in G2. No marked impacts were observed on water quality parameters, fish survival, somatic index (hepato-somatic and visceral-somatic), and the level of cholesterol, glucose, and creatinine in fish serum by dietary HC or LFM. However, values of triglycerides, urea, hepatic enzymes (alanine and aminotransferases), and body crude lipids increased by supplementation of HC alone or with LFM. Our findings demonstrated that feeding O. niloticus a low-protein diet supplemented with HC (0.5 g/kg) could promote growth, digestive capability, and health status. This provides a platform for potential exogenous enzyme (HC) use in low-protein diets to reduce feed costs and support the aquaculture industry.

Background: Bilateral tumors in double organs like bilateral adrenal neuroblastoma are highly rare. Few cases have been reported in the literature. Case reports: A full-term male infant, 11 months old, had an abdominal mass diagnosed by triphasic abdominal CT as bilateral adrenal neuroblastoma. The case was stage 1, and the management was bilateral adrenalectomy. Discussion: When the neuroblastoma mass measures less than 5 cm in diameter, the infant can likely be safely supervised without cytoreduction surgery or histological confirmation of the tumor, but if the tumour progressively increases in size or the size is greater than 5 cm, then surgery is essential. Conclusion: Surgery is the best option when an infant has bilateral large localized adrenal neuroblastoma.

Background: Subacute endocarditis usually presents over a period of weeks or months. Symptoms usually include low grade fever, and generalized symptoms of malaise, anorexia, weight loss. Here we present a case of subacute endocarditis presenting solely as acute left hypochondrial pain, which was found to be splenic infarct. Typical symptoms of subacute endocarditis were absent in our patient. Case report: A 48-year-old Yemeni gentleman presented to the emergency department with acute and severe left hypochondrial abdominal pain for a few hours. Blood investigations revealed normal blood count differential, renal, liver function, and electrolyte levels. CT abdomen with contrast showed large focal wedge-shaped splenic lesion representing splenic infarct. Initial workup was negative for an underlying etiology. TEE showed a spherical mobile mass attached to the aortic valve with moderate to severe aortic regurgitation. Subsequently, 3 sets of blood cultures were sent and revealed growth of streptococcus viridians in all bottles. The patient received IV antibiotics as a treatment of endocarditis. Conclusion: This case highlights how subacute endocarditis presented as splenic infarction, with the absence of the typical infectious symptoms. In case of splenic infarction with unclear source or etiology, it is reasonable to investigate thoroughly for infective endocarditis preferably with TEE.

Summary: Background: Bacterial vaginosis (BV), a condition in which vaginal Lactobacillus spp. are in low abundance, is associated with vulvovaginal symptoms, obstetric outcomes and urogenital infections. Recurrent BV is difficult to manage, and emerging data indicate a reduced risk of BV with the use of hormonal contraception (HC). Despite widespread use, little longitudinal data is available on whether, and in what timeframe, combined oral contraceptive pills (COCs) may act to affect vaginal microbiota stability and Lactobacillus dominance. Methods: We compared the vaginal microbiota of reproductive-age cisgender women during intervals on combined estrogen and progestin COCs with non-use intervals in a 2-year observational study. Vaginal microbiota were characterized by 16S rRNA gene amplicon sequencing. Findings: COC users were more likely to have Lactobacillus-dominated microbiota and more stable microbiota over time. Stability increased and then plateaued four weeks after COC initiation. The associations between COCs and Lactobacillus spp. dominance, and microbiota stability, were statistically significant for White, but not African American women; however sample size was limited for African American participants. Findings were similar for other forms of HC and when excluding samples collected during menses. Interpretation: Our study provides a methodologic framework to evaluate observational longitudinal microbiota data with exposure crossovers. We found COCs are associated with vaginal microbiota stability and a Lactobacillus-dominated state. COCs appear to impact stability within a month of initiation. Our findings have clinical implications for how soon benefits can be expected in (at least White) patients initiating COCs, and support the need for larger prospective trials to verify our results in ethnically diverse populations. Funding: R01-AI089878.

Background: Intussusception of the appendix is a relatively rare condition with an estimated incidence of 0.01%. It can mimic several clinical conditions including acute appendicitis or be mistaken as a cecal polypoid lesion on radiological imaging making the diagnosis before or during surgery is very difficult. Case presentation: A 6-year-old female presented to our unit with complaining of colicky abdominal pain and repeated vomiting for 3 days with no history of constipation. Abdominal examination revealed mild right iliac fossa tenderness and mild abdominal distension. Abdominal ultrasound revealed subhepatic intussusception mass measuring about 3 × 4 cm suggesting underlying Meckel's diverticulum. Three trials of hydrostatic reduction under ultrasound guidance were failed. Abdominal exploration revealed appendiceal intussusception mimicking cecal mass with failed trial of reduction. Ileocecectomy done with primary ileocolic anastomosis. We discharged our patient on the seventh day postoperatively. Conclusions: We report a rare case of appendiceal intussusception that required ileocecectomy in young female child. appendiceal intussusception is very rare condition but it must be considered in children.

Background: In most cases, ingested foreign bodies pass in alimentary tract silently. Rarely, ingested foreign bodies enter vermiform appendix. However, when it happened, they cannot reenter alimentary tract and may result in an inflammatory process. We report a case of iliopsoas abscess secondary to ingested metallic foreign body penetrating appendix. Case presentation: A 2-year-old child presented to our unit with her mother complaining that her child developed fever, repeated vomiting, and abdominal distension after one week of accidently ingestion of a rusty veil pin. Abdominal examination revealed right iliac tenderness and rebound tenderness. Abdominal ultrasound and multi-slice computer topography (MSCT) with intravenous contrast and gastrograffin enema revealed right iliopsoas abscess and metallic foreign body piercing appendicular wall with its tip seen in the iliopsoas abscess. We do appendectomy via transabdominal approach with good drainage of the abscess cavity. We discharged our patient on the fifth day postoperatively. Conclusions: The ingestion of inedible and indigestible objects is frequent in children. In most cases, ingested foreign bodies (FB) pass in alimentary tract silently. Rarely, ingested foreign bodies enter vermiform appendix and if it happened it may result in devastating complications as iliopsoas abscess. The is necessary to increase awareness of potential complications of ingested foreign bodies, especially in children.

In light of the increased use of communication technologies, the harm caused by continuous exposure to emitted radiation on pregnancy and developing newborns is among the public concerns. Using Sprague-Dawley rats, our study investigates the effects of 24 h/day prenatal and postnatal 900 MHz radiofrequency electromagnetic radiation (RF-EMR) exposure of female rats on liver oxidative stress (OS) and other hepatic parameters at postnatal days (PND) 1, 9, and 21. Our results showed that RF-EMR exposure led to an increase in oxidative stress status as indicated by a significant elevation in MDA level at PND9 and PND21, a decrease in catalase (CAT) activity at all ages, a reduction (PND1 and PND9) in catalase amounts and mRNA expression, in addition to a decrease in GPx activity at PND21 in the exposed group. Current findings also showed a significant increase in cytoSOD at PND9 and 21 and a reduction in mitoSOD at PND21 in the exposed groups compared to the control groups. However, significant increases in glutathione peroxidase (GPx) level and mitoSOD activity were observed at all studied ages. Furthermore, cytoSOD activity showed a significant reduction in PND1, whereas in PND9 the value of this parameter increased compared to the non-exposed group. Moreover, while SOD1 mRNA expression increased at PND1, it decreased at PND9 and 21. However, GPx1 expression was shown to be always decreased in the exposed group. In addition, at PND1 and 9, exposed rats showed a similar response on Akt1, nuclear factor erythroïd 2-related factor 2 (Nrf-2), and intercellular adhesion molecule-1 (ICAM-1) expression. Therefore, an increased oxidative stress status produced from a continuous (24 h/day) GSM-modulated 900 MHz radiofrequency electromagnetic radiation (RF-EMR) exposure during the prenatal and postnatal periods may result in adverse health effects during future life stages.

Background: The coronavirus disease-2019 (COVID-19) pandemic significantly affected management of cardiovascular disease around the world. The effect of the pandemic on volume of cardiovascular diagnostic procedures is not known. Objectives: This study sought to evaluate the effects of the early phase of the COVID-19 pandemic on cardiovascular diagnostic procedures and safety practices in Asia. Methods: The International Atomic Energy Agency conducted a worldwide survey to assess changes in cardiovascular procedure volume and safety practices caused by COVID-19. Testing volumes were reported for March 2020 and April 2020 and were compared to those from March 2019. Data from 180 centers across 33 Asian countries were grouped into 4 subregions for comparison. Results: Procedure volumes decreased by 47% from March 2019 to March 2020, showing recovery from March 2020 to April 2020 in Eastern Asia, particularly in China. The majority of centers cancelled outpatient activities and increased time per study. Practice changes included implementing physical distancing and restricting visitors. Although COVID testing was not commonly performed, it was conducted in one-third of facilities in Eastern Asia. The most severe reductions in procedure volumes were observed in lower-income countries, where volumes decreased 81% from March 2019 to April 2020. Conclusions: The COVID-19 pandemic in Asia caused significant reductions in cardiovascular diagnostic procedures, particularly in low-income countries. Further studies on effects of COVID-19 on cardiovascular outcomes and changes in care delivery are warranted.

We consider general charged Kasner-like solutions for the theory of five-dimensional supergravity coupled to Abelian vector multiplets in arbitrary space-time signature. These solutions, depending on the choice of coordinates, can be thought of as generalisations of Melvin/Rosen cosmologies, flux-branes and domain walls.

We discuss general bosonic configurations of four-dimensional N=2 supergravity coupled to vector multiplets in (t,s) space-time. The supergravity theories with Euclidean and neutral signature are described by the so-called para-special Kähler geometry. For extremal solutions, we derive in a unified fashion, using the equations of motion, the flow equations for all space-time signatures. Demanding that the solutions with neutral and Euclidean signatures admit unbroken supersymmetry, we derive the constraints, known as the stabilisation equations, on the para-covariantly holomorphic sections expressed in terms of the adapted coordinates. The stabilisation equations expressed in terms of the para-complex sections imply generalised flow equations in terms of para-complex central charge. For Euclidean and neutral signature, it is demonstrated that solutions for either signs of gauge kinetic terms are mapped into each other via field redefinitions.

الملخص: أهداف البحث: يلعب هرمون الاستروجين دورا رئيسا في تطور أورام الثدي. وفقا لذلك، تُستخدم مثبطات الأروماتاز (مثل الليتروزول) على نطاق واسع في علاج سرطان الثدي عن طريق تثبيط إنزيم الأروماتاز الذي يحول الأندروجين إلى هرمون الاستروجين مما يؤدي إلى إنخفاض مستوى هرمون الاستروجين. وكذلك فإن هرمون الاستروجين له دور كبير في سلامة كتلة العظام، ويمنع هشاشه العظام لدى النساء. لذلك استخدام البايفوسفونيت (مثل حمض الزوليدرونيك) مع الليتروزول من أجل أن يقلل من هشاشة العظام لدى المرضي الذين يعالجون بمثبطات الأروماتاز. في هذه الدراسة، تم فحص التأثير المضاد للسرطان لكلا من الليتروزول وحمض الزوليدرونيك لعلاج سرطان الثدي البشري وتقليل حدوث هشاشة العظام. طرق البحث: تم استخدام كيمياء الخلايا المناعية والتقنيات المناعية لقياس مستوي البروتين في هذه الدراسة. النتائج: وجد أن الليتروزول ثبط النمو الخلوي بتركيز ٥٠٪ من الخلايا لـكل من الخلايا المدروسة عند تركيز ٧٠± ٠.٠٠١ و١٤٠±٠.٠٠١ نانومولار، على التوالي، في حين ثبط حمض الزوليدرونيك النمو الخلوي عند ٥٠± ٠.٠٠٥ و١٥٠ ± ٠.٠٠٤ ميكرومولار لخطوط الخلايا المدروسة، على التوالي. ومن المثير للاهتمام أن استخدام الليتروزول مع حمض الزوليدرونيك سويا قد خفف من التعبير البروتيني لبروتين تحويل الإشارة وتنشيط النسخ، بينما لوحظ زيادة ملحوظة في مستوي التعبير البروتيني للبروتين المسئول عن تنظيم انقسامات الخلايا المدروسة. بالإضافة إلى ذلك، لقد كان هناك زيادة ملحوظة في التواجد النووي لبروتين المسئول عن تنظيم انقسامات الخلايا بعد علاج الخلايا لمدة ٢٤ ساعة بالليتروزول مقارنة بالخلايا الضابطة. وعلى الجانب الاخر، كان هناك انخفاض في التواجد النووي لبروتين تحويل الإشارة وتنشيط النسخ الذي يمكن أن يكون هدفا جذابا يمكن استخدامه للعلاج وتثبيط انتشار وتطور سرطان الثدي. الاستنتاجات: يمكن استنتاج أن العلاج باستخدام كلا من الليتروزول وحمض الزوليدرونيك قد عزز من الموت المبرمج للخلايا السرطانية المستخدمة بجانب تثبيط نموها. بالإضافة إلى ذلك، قد يكون هذا المزيج مفيدا في علاج سرطان الثدي بجانب الحفاظ على سلامة العظام في حالة جيدة لدى النساء المصابات بسرطان الثدي. Abstract: Objectives: Oestrogen plays a key role in the development of breast malignancies. Therefore, aromatase inhibitors (e.g. letrozole [LTZ]) are widely used in the treatment of breast cancer. On the other hand, oestrogen is important to the integrity of bone mass. Research has shown that zoledronic acid (ZLA) may prevent osteoporosis. Therefore, the present research aims to investigate the effect of a combination of LTZ and ZLA in the treatment of breast cancer and in reducing osteoporosis in patients with breast cancer. Methods: We used immunocytochemistry and Western immunoblotting techniques in this study. Results: We observed that LTZ inhibited cellular growth of Michigan Cancer Foundation-7 (MCF-7) and T-47D at IC50 (70 ± 0.001) and (140 ± 0.004) nM, respectively, whereas ZLA inhibited cellular growth at IC50 (50 ± 0.005) μM and (150 ± 0.004) μM for MCF-7 and T-47D cell lines, respectively. Interestingly, the LTZ and ZLA combination down-regulated the protein expression of signal transducer and activator of transcription 3 (STAT3) and up-regulated BRCA1 protein expression in both cell lines. Moreover, a notable enhancement in the nuclear localisation of the BRCA1 protein was obtained after treatment of T-47D cells with LTZ for 24 h compared to the control cells. In contrast, there was a reduction in the nuclear localisation of STAT3 protein, which could be an attractive target for inhibition of breast cancer proliferation and progression. Conclusion: Our study has shown that a combination of LTZ and ZLA enhanced apoptosis and inhibited growth of both breast cancer cell lines. This combination can be used to maintain bone integrity in women with breast cancer.

Background: Infants with recurrent vomiting and respiratory tract infection since birth constitute a challenging diagnosis for pediatric surgeons. The surgeon must put in mind a congenital microgastria (CM) as a differential diagnosis. Case reports: A five-month-old male infant complained of non-bilious vomiting since birth. A gastrografin swallow had referred to the dilated esophagus, small capacity stomach, and the contrast flows easily distally to the duodenum. A gastric augmentation was created through a Hunt-Lawrence (HL) pouch with a good outcome. Discussion: Diagnosis of CM can be discovered during the intrauterine life through the absence of visualization of the gastric gas. CM may be associated with other anomalies or may be isolated. The isolated anomaly should operate early, as soon as possible because the stomach will not spontaneously enlarge with the conservative management. Conclusions: HL pouch is a suitable gastric augmentation for the infant with isolated CM. The dilated esophagus returns to its normal size after increasing the stomach reservoir.

Background: The Kingdom of Saudi Arabia (KSA) provides free healthcare, including medications, for the over 2 million Muslim pilgrims who attend Hajj every year. Information on drug utilization patterns at the Hajj is important to strengthen the supply chain for medicines, avert stock-outs, identify inappropriate use, and support public health planning for the event. Method: We investigated drug utilization pattern among outpatients in eight seasonal Holy sites hospitals in Makkah, KSA, during the 2018 Hajj. Data on medication prescribed and dispensed were retrieved from the hospitals' electronic records. Data were also used to calculate six of the WHO indicators for drug use at these facilities. Results: A total of 99,117 medications were prescribed for 37,367 outpatients during 37,933 encounters. Outpatients were mainly older males and originated from 134 countries. Twenty medications accounted for 72.8% of the 323 different medications prescribed. These were mainly nonsteroidal anti-inflammatory drugs, analgesics and antipyretics, and antibacterial medicines for systemic use. Outpatients were prescribed an average of 2.6 (SD = 1.2) drugs per consultation and polypharmacy (≥5 medications) was observed in 4.8% of the encounters. Antibiotics and an injection were prescribed in 46.9% and 6.5% of encounters, respectively. Nearly 90% of the prescribed drugs were actually dispensed. On average, medications were dispensed 16.4 (SD = 119.8) minutes from the time they were prescribed for the patient. All hospitals had a copy of the essential drugs list available and all of the prescribed drugs appeared on that list. Conclusion: Nonsteroidal anti-inflammatory drugs, analgesics and antibiotics are the most common medications prescribed to outpatient during Hajj. Our results, including the calculated WHO drug use indicators, can form a basis for further investigations into appropriate drug use at the Hajj and for planning purposes. These results could also guide the development of reference values for medications prescribing and use indicators at mass gatherings.

We report the first case of a patient with a durable left ventricular assist device admitted with cardiogenic shock and managed with biventricular Impella support as a successful bridge to heart transplantation. (Level of Difficulty: Advanced.)

We report a case of a woman with arrhythmogenic right ventricular cardiomyopathy (ARVC) who presented with severe right-sided heart failure and cardiac cirrhosis that mandated heart-liver transplantation. This case highlights an emerging sex-based difference in ARVC where female sex is associated with a higher risk of heart failure than in male patients with ARVC. (Level of Difficulty: Advanced.)

Background: COVID–19 infection has spread so fast in both low– and high–income countries. In December 2019, an outbreak of a respiratory disease occurred in China, and later, it involved different countries. Acute neurological insults are more likely to occur in severely infected patients. Methods: We tried to evaluate patients with selective criteria including, the age of participants 18 and older with a confirmed diagnosis of SARS-CoV-2, and developed neurological complications post COVID-19 infection. An overall data of 1500 patients were collected from neurological and primary health care departments. About 970 of them had neurological problems. Patients-related data were gathered and assembled from the patients’ records at participating hospitals from the Ministry of Health and university hospitals. Results: We presented the results according to several variables including, regional distribution, reasons of presentation, neurological complications, follow-ups, and survival outcome. Conclusions: To our knowledge, we conducted the first retrospective analysis for neurological problems related to COVID-19 infection in Egypt. COVID-19 patients present with a variety of central and peripheral neurological symptoms, the pathogenic mechanisms of which have not been explained. Robust investigations of the neurological presentations of COVID-19 infection should be recruited for better understanding of the possible association. Moreover, further explaining the pathophysiologic mechanisms will help in designing proper treatment plans.

Background: Since the emergence of the first COVID-19 case in Wuhan, the virus affected several health care systems. Globally, the COVID-19 has a transforming effect on health care provision. Substantial evidence was clear that the global surgical services were impacted. The field of neurosurgery was primarily affected, and most elective surgeries were suspended. There are no current reports from Egypt that describe the mortality outcome of neurosurgical procedures in the context of the pandemic. Methods: We performed that study at a large tertiary center in Egypt (Cairo University Hospital). It is a single-center matched cohort study. Results: Our results examined about 346 patients earlier during the COVID-19 pandemic. About 46 (13.29%) were unmatched, so we excluded them from the final analysis of the data. About 300 patients' were matched to 304 patients' before the pandemic in 2019. The mortality outcome of neurosurgical interventions was higher during the pandemic. Conclusions: Amid the COVID-19 pandemic, the mortality outcome of neurosurgical procedures was higher than on regular days at our center. The anesthesia time was prolonged while the operation time was shortened. We strongly suggest further multicenter studies to assess the effect of COVID-19 on neurosurgical mortality and functional outcome.

Summary: Background: Antimicrobial resistance (AMR) is a serious threat to global public health. WHO emphasises the need for countries to monitor antibiotic consumption to combat AMR. Many low-income and middle-income countries (LMICs) lack surveillance capacity; we aimed to use multiple data sources and statistical models to estimate global antibiotic consumption. Methods: In this spatial modelling study, we used individual-level data from household surveys to inform a Bayesian geostatistical model of antibiotic usage in children (aged

Summary: Advances in chimeric antigen receptor (CAR) T cell therapies have led to the modality dominating translational cancer research; however, a standardized protocol for evaluating such therapies in vitro is needed. This protocol details the in vitro preclinical evaluation of CAR-T cell therapies for glioblastoma (GBM), including target cell cytotoxicity and T cell proliferation, activation, and cytokine release assays.For complete details on the use and execution of this protocol, please refer to Vora et al. (2020).

Grapes are a rich source of bioactive molecules including phenolic acids, flavonoids, anthocyanins, stilbenes, and lipids. These are the compounds which contribute to the health benefits of grape and grape-derived products. They possess antioxidant, antimicrobial, anti-inflammatory, and anti-carcinogenic activities and have wide applications in food and nutraceutical industries. Use of grape extracts rich in these bioactive compounds are linked to reduced incidence of cardiovascular disease and its major risk factors including hypertension (high blood pressure); a clinical condition associated with high mortality worldwide. Therefore, considerable attention has been given to grape-based products to alleviate and treat hypertension. The aim of this review is to summarize the bioactive compounds of grapes, composition changes in different grape extracts and the potential benefits in reducing hypertension.

Objectives: Acute Carotid Blowout Syndrome (ACBS) is an uncommon but feared complication of head and neck cancers. We present a rare Case of ACBS secondary to a pharyngo-carotid fistula post “salvage” total laryngectomy. Case report: A 45-year-old man with a history of glottic squamous cell carcinoma presented with massive transoral bleeding following total salvage laryngectomy. Imaging revealed ACBS of the ipsilateral common carotid artery, the patient underwent emergent coil embolization, and hemostasis was achieved without any neurological deficits. Further management required coil extraction and flap reconstruction due to coil extrusion. Conclusion: ACBS is a life-threatening complication of head and neck cancers which requires preventive measures as well as prompt identification and intervention to prevent fatal hemorrhaging or grave neurological morbidity.

Background: Seasonal epidemics of influenza are characterized through national or international surveillance efforts to determine vaccine efficacy and vaccine strain selection, but they do not provide detailed information about local variations in factors that can influence influenza cases and disease severity. Methods: Surveillance for influenza like illness was performed in Emergency Medicine Departments in Taipei, Taiwan and Baltimore, Maryland during the winter of 2015–16. Detailed demographic and clinical data were obtained. Nasal swabs or washes were collected for influenza virus diagnosis, sequencing and isolation. Serum was collected to determine neutralizing antibody levels. Results: H1N1 viruses dominated both sites, but more influenza cases occurred in Taipei compared to Baltimore. H1 HA clade diversity was greater in Taipei. Vaccination rates were lower in Taipei than Baltimore, but vaccination was associated with an increase in serum neutralizing antibodies to recent H1N1 strains in Taipei, but not Baltimore. There was a higher level of preexisting immunity to circulating H1N1 strains in Baltimore. Conclusions: Regional differences in preexisting immunity and H1N1 strain circulation may have contributed to the vastly different 2015-16 influenza seasons in Taipei and Baltimore and suggest immune responses to vaccination can be affected by the degree of preexisting immunity in the population.

Summary: Reactive oxygen species (ROS) are implicated in endothelial dysfunction and cardiovascular disease. Endothelial cells (ECs) produce most ATP through glycolysis rather than oxidative phosphorylation; thus mitochondrial ROS production is lower than in other cell types. This makes quantification of changes in EC mitochondrial oxidative status challenging. Here, we present an optimized protocol using mitochondrial-targeted adenovirus-based redox sensor for ratiometric quantification of specific changes in mitochondrial ROS in live human coronary artery EC.For complete details on the use and execution of this protocol, please refer to Waypa et al. (2010); Liao et al. (2020); Gao et al. (2021).

We report the evaluation of 265 compounds from a PDE-focused library for their antischistosomal activity, assessed in vitro using Schistosoma mansoni. Of the tested compounds, 171 (64%) displayed selective in vitro activity, with 16 causing worm hypermotility/spastic contractions and 41 inducing various degrees of worm killing at 100 μM, with the surviving worms displaying sluggish movement, worm unpairing and complete absence of eggs. The compounds that did not affect worm viability (n = 72) induced a complete cessation of ovipositing. 82% of the compounds had an impact on male worms whereas female worms were barely affected. In vivo evaluation in S. mansoni-infected mice with the in vitro ‘hit’ NPD-0274 at 20 mg/kg/day orally for 5 days resulted in worm burden reductions of 29% and intestinal tissue egg load reduction of 35% at 10 days post-treatment. Combination of praziquantel (PZQ) at 10 mg/kg/day for 5 days with NPD-0274 or NPD-0298 resulted in significantly higher worm killing than PZQ alone, as well as a reduction in intestinal tissue egg load, disappearance of immature eggs and an increase in the number of dead eggs. Keywords: Phosphodiesterase, In vitro drug screening, Worm killing, Schistosoma mansoni, Mouse model, Praziquantel, Schistosomiasis

Summary: Despite a surge in the preclinical development of immunotherapies, current models are unable to predict putative toxicity, particularly the “on-target, off-tumor” effects of these therapeutics. To address this gap, we used a humanized mouse model of hematopoiesis to examine the toxicity profile of CAR-Ts targeting brain tumor-antigens also expressed in the hematopoietic system. In assessing the safety of cell-based therapies, we aim to develop and integrate a preclinical evaluation protocol as a necessary step in the clinical development pathway.For complete details on the use and execution of this protocol, please refer to Vora et al. (2020).

Summary: Glioblastoma (GBM) is the most common malignant adult brain tumor that is resistant to the standard care therapy. Advances in chimeric antigen receptor (CAR) T cell therapies have spurred renewed interest in developing CAR T cell therapies to target chemoradiotherapy-resistant brain tumor-initiating cells. This protocol shows how to isolate peripheral blood mononuclear cells from healthy donors and generate CAR T cells for the antigens of interest, and how to intracranially inject the CAR T cells into a patient-derived xenograft mouse model of GBM.For complete details on the use and execution of this protocol, please refer to Vora et al. (2020).

We present static and time-dependent solutions for the theory of gravity with a dilaton field and an arbitrary rank antisymmetric tensor. The solutions constructed are valid for arbitrary space-time dimensions and signatures.

Background: There is an increased attention to stroke following SARS-CoV-2. The goal of this study was to better depict the short-term risk of stroke and its associated factors among SARS-CoV-2 hospitalized patients. Methods: This multicentre, multinational observational study includes hospitalized SARS-CoV-2 patients from North and South America (United States, Canada, and Brazil), Europe (Greece, Italy, Finland, and Turkey), Asia (Lebanon, Iran, and India), and Oceania (New Zealand). The outcome was the risk of subsequent stroke. Centres were included by non-probability sampling. The counts and clinical characteristics including laboratory findings and imaging of the patients with and without a subsequent stroke were recorded according to a predefined protocol. Quality, risk of bias, and heterogeneity assessments were conducted according to ROBINS-E and Cochrane Q-test. The risk of subsequent stroke was estimated through meta-analyses with random effect models. Bivariate logistic regression was used to determine the parameters with predictive outcome value. The study was reported according to the STROBE, MOOSE, and EQUATOR guidelines. Findings: We received data from 26,175 hospitalized SARS-CoV-2 patients from 99 tertiary centres in 65 regions of 11 countries until May 1st, 2020. A total of 17,799 patients were included in meta-analyses. Among them, 156(0.9%) patients had a stroke—123(79%) ischaemic stroke, 27(17%) intracerebral/subarachnoid hemorrhage, and 6(4%) cerebral sinus thrombosis. Subsequent stroke risks calculated with meta-analyses, under low to moderate heterogeneity, were 0.5% among all centres in all countries, and 0.7% among countries with higher health expenditures. The need for mechanical ventilation (OR: 1.9, 95% CI:1.1–3.5, p = 0.03) and the presence of ischaemic heart disease (OR: 2.5, 95% CI:1.4–4.7, p = 0.006) were predictive of stroke. Interpretation: The results of this multi-national study on hospitalized patients with SARS-CoV-2 infection indicated an overall stroke risk of 0.5%(pooled risk: 0.9%). The need for mechanical ventilation and the history of ischaemic heart disease are the independent predictors of stroke among SARS-CoV-2 patients. Funding: None.

Background: Pasteurella multocida is a gram-negative coccobacillus that is primarily found in oropharynx of dogs, cats and other animals. It causes infections in human beings through contact with animal saliva in the form of licks, bites and scratches of animals colonized by the bacteria. Meningitis due to Pasteurella multocida is rare in immunocompetent individuals. We report a case of meningitis due to Pasteurella multocida in an immunocompetent patient. Case report: A 30-year-old gentleman presented with 2-day history of fever and neck stiffness. 6 weeks earlier, he was treated as a case of bacterial meningitis. During that hospital stay, he was diagnosed to have bony defect in the sellar floor based on MRI head performed to evaluate for a prolonged history of CSF rhinorrhea. He was discharged and scheduled for an elective endoscopic endonasal/open repair of the skull base defect after resolution of meningitis. CSF findings during current admission also showed features of bacterial meningitis. CSF culture showed Pasteurella multocida sensitive to penicillin, ampicillin and ceftriaxone. Retrospective history revealed patient’s contact with stray cats as he used to feed them but there was no history of licks, bites. He was treated with intravenous ceftriaxone 2 g twice a day for 14 days with complete resolution of his symptoms. Conclusion: Pasteurella multocida is an important cause of bacterial meningitis in patients with skull defect. Patients with traumatic or non-traumatic bony defect of skull should avoid contact with dogs and cats to prevent the spread of infection the central nervous system.

We construct N=2 four and five-dimensional supergravity theories coupled to vector multiplets in various space–time signatures (t,s), where t and s refer, respectively, to the number of time and spatial dimensions. The five-dimensional supergravity theories, t+s=5, are constructed by investigating the integrability conditions arising from Killing spinor equations. The five-dimensional supergravity theories can also be obtained by reducing Hull's eleven-dimensional supergravities on a Calabi–Yau threefold. The dimensional reductions of the five-dimensional supergravities on space and time-like circles produce N=2 four-dimensional supergravity theories with signatures (t−1,s) and (t,s−1) exhibiting projective special (para)-Kähler geometry.

Purpose: Ephedra alata (E. alata) is perennial tough shrub plant that grows in Palestine and other regions. It is used often in folk's medicine for the treatment of various diseases. In this project, E. alata extract was tested for its ability to improve wound and burn healing. Methods: An aqueous extract of E. alata was prepared and underwent several phytochemical analyses for the presence of the major classes of phytochemical compounds. After that, a polyethylene glycol-based ointment containing the extract of E. alata was prepared and its wound and burn healing activities were tested in-vivo using an animal model for deep wound and full thickness skin burn. The effect was compared against a placebo ointment. Skin biopsies were evaluated by a blinded clinical histopathologist, in addition to digital analysis. Results: Phytochemical analysis demonstrated the presence of the major classes of phytochemical compounds in the prepared extract including flavonoids, alkaloids, phytosteroids, phenolic compounds, volatile oils and tannins. As compared to placebo ointment, E. alata ointment significantly improved the healing of the wound ulcers, whereas it showed no advantage on the quality of the healing of burn ulcers. Conclusion: E. alata extract is rich in phytochemical compounds and can improve wound healing when applied topically.

In ungauged supergravity theories, the no-force condition for BPS states implies the existence of stable static multi-centered solutions. The first solutions to Einstein–Maxwell theory with a positive cosmological constant describing an arbitrary number of charged black holes were found by Kastor and Traschen. Generalisations to five and higher dimensional theories were obtained by London. Multi-centered solutions in gauged supergravity, even with time-dependence allowed, have yet to be constructed. In this letter we construct supersymmetry-preserving multi-centered solutions for the case of D=5, N=2 Euclidean gauged supergravity coupled to an arbitrary number of vector multiplets. Higher dimensional Einstein–Maxwell multi-centered solutions are also presented.

We construct a new class of solutions to the dispersionless hyper-CR equation, and show how any solution to this equation gives rise to a supersymmetric Einstein–Maxwell cosmological space–time in (3+1)-dimensions.

We construct a 5D, N=2 Euclidean theory of supergravity coupled to vector multiplets. Upon reducing this theory over a circle we recover the action of 4D, N=2 Euclidean supergravity coupled to vector multiplets.

We discuss phantom metrics admitting Killing spinors in fake N=2, D=4 supergravity coupled to vector multiplets. The Abelian U(1) gauge fields in the fake theory have kinetic terms with the wrong sign. We solve the Killing spinor equations for the standard and fake theories in a unified fashion by introducing a parameter which distinguishes between the two theories. The solutions found are fully determined in terms of algebraic conditions, the so-called stabilisation equations, in which the symplectic sections are related to a set of functions. These functions are harmonic in the case of the standard supergravity theory and satisfy the wave-equation in flat (2+1)-space–time in the fake theory. Explicit examples are given for the minimal models with quadratic prepotentials.

Objective: The objective of this study was to investigate the effect of mechanical strain by mapping physicochemical properties at periodontal ligament (PDL)–bone and PDL–cementum attachment sites and within the tissues per se. Design: Accentuated mechanical strain was induced by applying a unidirectional force of 0.06 N for 14 days on molars in a rat model. The associated changes in functional space between the tooth and bone, mineral forming and resorbing events at the PDL–bone and PDL–cementum attachment sites were identified by using micro-X-ray computed tomography (micro-XCT), atomic force microscopy (AFM), dynamic histomorphometry, Raman microspectroscopy, and AFM-based nanoindentation technique. Results from these analytical techniques were correlated with histochemical strains specific to low and high molecular weight GAGs, including biglycan, and osteoclast distribution through tartrate resistant acid phosphatase (TRAP) staining. Results: Unique chemical and mechanical qualities including heterogeneous bony fingers with hygroscopic Sharpey's fibers contributing to a higher organic (amide III — 1240 cm−1) to inorganic (phosphate — 960 cm−1) ratio, with lower average elastic modulus of 8 GPa versus 12 GPa in unadapted regions were identified. Furthermore, an increased presence of elemental Zn in cement lines and mineralizing fronts of PDL–bone was observed. Adapted regions containing bony fingers exhibited woven bone-like architecture and these regions rich in biglycan (BGN) and bone sialoprotein (BSP) also contained high-molecular weight polysaccharides predominantly at the site of polarized bone growth. Conclusions: From a fundamental science perspective the shift in local properties due to strain amplification at the soft–hard tissue attachment sites is governed by semiautonomous cellular events at the PDL–bone and PDL–cementum sites. Over time, these strain-mediated events can alter the physicochemical properties of tissues per se, and consequently the overall biomechanics of the bone–PDL–tooth complex. From a clinical perspective, the shifts in magnitude and duration of forces on the periodontal ligament can prompt a shift in physiologic mineral apposition in cementum and alveolar bone albeit of an adapted quality owing to the rapid mechanical translation of the tooth.

We study metric solutions of Einstein–anti-Maxwell theory admitting Killing spinors. The analogue of the IWP metric which admits a space-like Killing vector is found and is expressed in terms of a complex function satisfying the wave equation in flat (2+1)-dimensional space–time. As examples, electric and magnetic Kasner spaces are constructed by allowing the solution to depend only on the time coordinate. Euclidean solutions are also presented.