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The medial patellofemoral ligament (MPFL) is the main restraining force against lateral patellar displacement in the first 20° of flexion and is disrupted after patellar subluxation or dislocation. Management of acute patellar dislocations is controversial, and many clinicians opt for conservative treatment in the acute phase. However, a traumatic rupture of the MPFL warrants surgical attention. Several considerations must be made by surgeons attempting reinsertion of the MPFL, including the choice of implant and timing of surgery, to restore the anatomy and biomechanics of the patellofemoral joint. Our aim is to achieve robust reinsertion of the MPFL restoring the anatomy and biomechanics of the patellofemoral joint using a simple, reproducible, and economical technique. We present MPFL reinsertion to the medial border of the patella in an acute patellar dislocation with a braided No. 2 ultrahigh-molecular-weight polyethylene suture (No. 2 Ultrabraid; Smith & Nephew, Memphis, TN) that is passed through 3 transverse parallel tunnels and tied over a bone bridge on the lateral border of the patella. This technique is simple with no implanted hardware, does not have the risk of donor-site morbidity of MPFL reconstruction, and can be performed in skeletally immature patients without growth plate concerns. [Display omitted] [ABSTRACT FROM AUTHOR]

Breast cancer is the most prevalent cancer in the United Arab Emirates (UAE). This is the first study to provide data on predisposition of breast cancer susceptibility genes with associated clinical and pathological aspects in the UAE. A retrospective chart review for breast cancer patients undergoing genetic testing from 2016 to 2018. According to National Comprehensive Cancer Network (NCCN) guidelines genetic testing was offered. The analyzed data included; age, ethnicity, family cancer history, pathogenic variant, histopathology, stage, molecular subtype and proliferation. 309 patients underwent genetic testing with a positive result in 130 patients (11.9%) over a period of 36 months. In 34.6% pathogenic and likely pathogenic variants were identified. BRCA2 was the most common gene identified. The mean age was 42.9 years (±9.01). Positive family history was identified in 66 patients (50.7%). Majority had stage 1 or 2 disease (66.2%), invasive ductal carcinoma (81.5%) and hormone receptor positive cancer (45.3%). This is the first study in the UAE to describe the clinical and pathological characteristics of hereditary breast cancer in a mixed ethnic group with dominant Arabic population. Further genetic studies will be required in the UAE population, as the prevalence of breast cancer continues to rise. • First study about breast cancer genetics in the United Arab Emirates with a mixed ethnic population. • BRCA2 is the most common mutation detected. • Most hereditary breast cancers with a dominant Arabic ethnic group is diagnosed at a lower stage. • Most hereditary breast cancers diagnosed a decade earlier compared to western population. [ABSTRACT FROM AUTHOR]

There is strong association between meniscal lesions and anterior cruciate ligament injuries. Recently, light was shown on a new entity: ramp lesions. The incidence of these lesions and their management is still unclear. Although some believe that some lesions, when stable, can be managed conservatively, most surgeons repair ramp tears. Accessibility of these tears is challenging; they are best accessed through posterior portals, which is time-consuming and poses potential risk to vital structures. Our technique allows access to and management of ramp lesions through safe standard anterior portals. Ramp lesions are searched for as a routine step during anterior cruciate ligament reconstruction by advancing the scope through the intercondylar notch just beside the medial femoral condyle. If a lesion is found, it is repaired; only very stable small tears are treated with needling to refresh the edges and induce a healing response. A simple suture, horizontal mattress suture, or a circumferential stitch is used. [ABSTRACT FROM AUTHOR]

Forty fish samples of Amphacanthus sigan were collected from Sharm El-Naga southern Hurghada to study the parasitic infection included and present a new individual to Helicometra species using light microscope and re-describe another digenean trematode species using scanning electron microscope (SEM). Two trematode species were identified and described; Helicometra siganus n. sp. Nov belonging to Helicometra Odhner, 1902 (family Opecoelidae Ozaki, 1925) which is different from all the listed species in many features as having an elongated body, tapering anteriorly and larger sucker ratio; the vitellaria extended from the intestinal bifurcation to the posterior extremity of the hind-body and finally the cirrus sac and cirrus longer than the other species and extended to the midpoint of esophagus level. So, these criteria are specific and sufficient to consider it as a new species. The other species, Gyliauchen volubilis Nagaty, 1956 (Gyliauchenidae Fuki, 1929 and Ozaki, 1933) which was described before but some other constituent are not evident and appeared using the electron microscope. However, the present sample illustrated transverse striations on the body surface, the acetabulum evaginates outward, ovoid shaped and surrounded by lip-like structures and finally, the excretory pore is situated at some distance from the acetabulum at the posterior end extremity. [ABSTRACT FROM AUTHOR]

A flexible paper based and dual-band antenna is designed for UMTS service (1.9 GHz) and WiMAX services (5.8 GHz). Flexible paper is used as a substrate for the printed antenna. Expanded graphite ink is used to enable printing the antenna on the substrate. The antenna has been designed, simulated, fabricated, and measured. Steps of preparing the conductive printed ink and fabrication of the antenna have been discussed. The conductivity of the printed antenna is measured to be 1 × 104 S/square and the thickness is also measured with an average of 30 µm. Through the whole paper, good agreement between simulated and measured results is satisfied. In addition to the achieved flexibility, the antenna has demonstrated good measurement results. First, the antenna has a bandwidth of 300 MHz at 1.9 GHz and 400 MHz at 5.8 GHz with fractional bandwidth of 15.7% and 6.8% at the both bands, respectively. Second, the measured antenna radiation pattern has indicated that it is omnidirectional at 1.9 GHz and approximately omnidirectional at 5.8 GHz. Third, The antenna gain is 1.266 dB and 0.512 dB at the two bands, respectively. Finally, the antenna's efficiency at the both bands is 35% and 55%. [ABSTRACT FROM AUTHOR]

This paper presents a novel electrostatic micro-tweezers to manipulate particles with diameters up to 14 μ m. The tweezers consist of two grip-arms mounted to an electrostatically actuated initially curved micro-beam. It exploits bistable equilibria, resulting from a snap-through instability, to close the separation distance between the two arms allowing them to grasp a large range of objects. The tweezers offer further control beyond the snap-through point, via electrostatic actuation, to increase pressure on larger objects or grasp smaller objects. The tweezers are fabricated in a p-type Silicon on Insulator (SOI) wafer. Euler-Bernoulli beam theory is utilized to derive the governing equation of motion taking into account the arms' rotary inertia and the electrostatic fringing field. A reduced-order model (ROM) is developed utilizing two, three and five symmetric modes in a Galerkin expansion. A finite element model (FEM) is also developed to validate the ROM and to study the arm tips' separation as a function of actuation voltage. The five-mode ROM is found to be convergent and accurate except in the vicinity of the snap-through saddle-node bifurcation. Our analysis shows that the tweezers can manipulate micro-particles with diameters ranging from 5 to 12 μ m with an operating voltage range limited by the snap-back voltage 100. 2 V and the pull-in voltage 153. 2 V. [ABSTRACT FROM AUTHOR]

The timing of initiation of Norepinephrine (NEP) in septic shock is controversial. We evaluated the impact of early NEP simultaneously with fluids in those patients. We randomized 101 patients admitted to the emergency department with septic shock to early NEP simultaneously with IV fluids (early group) or after failed fluids trial (late group). The primary outcome was the in-hospital survival while the secondary outcomes were the time to target mean arterial pressure (MAP) of 65 mmHg, lactate clearance and resuscitation volumes. There was no significant difference between the two groups regarding the baseline characteristics. NEP infusion started after 25 (20–30) and 120 (120–180) min in the early and late groups (p = 0.000). MAP of 65 mmHg was achieved faster in the early group (2 [1–3.5] h vs. 3 [2–4.75] h, p = 0.003). Serum lactate was decreased by 37.8 (24–49%) and 22.2 (3.3–38%) in both groups respectively (p = 0.005). Patients with early NEP were resuscitated by significantly lower volume of fluids (25 [18.8–28.7] mL/kg vs. 32.5 [24.4–34.6] mL/kg) in the early and late groups (p = 0.000). The early group had survival rate of 71.9% compared to 45.5% in the late group (p = 0.007). NEP started after 30 (20–120 min) in survivors vs. 120 (30–165 min) in non-survivors (p = 0.013). We concluded that early Norepinephrine in septic shock might cause earlier restoration of blood pressure, better lactate clearance and improve in-hospital survival. [ABSTRACT FROM AUTHOR]