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Thrombotic disease represents a rare manifestation of leprosy. In this study, we report the case of an external jugular vein thrombosis associated with tuberculoid leprosy in a 23-year-old male patient. The patient presented with a 3-month history of painful cord-like swelling on the left side of the neck and a nearly 3-week history of skin lesions on the left cheek and right leg. Physical examination revealed cord-like, tender swelling on the left lateral aspect of the neck overlying the sternocleidomastoid muscle, and a hypopigmented, hypoaesthetic 6×7 cm lesion with an irregular margin on the left cheek. A Doppler ultrasound examination of the jugular vein showed thrombosis of the left external jugular vein. Three-dimensional reconstruction of the computed tomography scan showed the enlarged and enhanced left external jugular vein, as well as 1 of its tributaries, and the thickened skin patch. A skin punch biopsy from the left cheek lesion revealed granulomatous inflammation with occasional peri-adnexal granulomas, consistent with the clinical impression of tuberculoid leprosy. A diagnosis of leprosy with external jugular vein thrombosis was established. Anticoagulation therapy was initiated, and the patient was referred to an infectious disease clinic for treatment with anti-leprosy medications.

Dynamic wireless charging (DWC) is a promising technology to charge Electric Vehicles (EV) using on-road charging segments (CS), also known as DWC pads. In order to ensure effective utilization of this on-the-road charging service, communication and coordination need to be established between the EVs and the different network entities, thereby forming an Internet of Electric Vehicles (IoEV). In an IoEV, EVs can utilize different V2X communication modes to enable charging scheduling, load management, and reliable authentication and billing services. Yet, designing an authentication scheme for dynamic EV charging presents significant challenges given the mobility of the EVs and the short contact time between the EVs and the charging segments. Accordingly, this work proposes a fast, secure and lightweight authentication scheme that allows only authentic EVs with valid credentials to charge their batteries while ensuring secure and fair payments. The presented scheme starts with a key pre-distribution phase between the charging service company (CSC) and the charging pad owner (PO), followed by a hash chain and digital signature-based registration and authentication phase between the EV and the CSC, before the EV reaches the beginning of the charging lane. These preliminary authentication phases allow the authentication between the EVs and the charging segments to be performed using simple hash key verification operations prior to charging activation, which reduces the computational cost of the EVs and the CS. Symmetric and asymmetric key cryptography are utilized to secure the communication between the different network entities. Analysis of the computational and transmission time requirements of the proposed authentication scheme shows that, for an EV traveling at 60 km/h to start charging at the beginning of the charging lane, the authentication process must be initiated at least 1.35 m ahead of the starting point of the lane as it requires ≃81 ms to be completed.

Abstract Immunosensors are used to detect the presence of certain bio-reagents mostly targeted at the diagnosis of a condition or a disease. Here, a general purpose electrical immunosensor has been fabricated for the quantitative detection of multiple bio-reagents through the formation of an antibody-antigen pair. The sensors were fabricated using all printing approaches. 2D transition metal dichalcogenide (TMDC) MoS2 thin film was deposited using Electrohydrodynamic atomization (EHDA) on top of an interdigitated transducer (IDT) electrode fabricated by reverse offset printing. The sensors were then treated with three different types of antibodies that were immobilized by physisorption into the highly porous multi-layered structure of MoS2 active layer. BSA was used as blocking agent to prevent non-specific absorption (NSA). The sensors were then employed for the targeted detection of the specific antigens including prostate specific antigen (PSA), mouse immunoglobulin-G (IgG), and nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB). IgG was then selected to test the sensors for point of care (POC) diagnosis through a specially designed electronic readout system for sensors and interfacing it with a smartphone using Bluetooth connection. The sensors showed promising performance in terms of stability, specificity, repeatability, sensitivity, limit of detection (LoD), and range of detection (RoD).

Introduction: Most cases of chronic diseases result in physical, psychological, financial, and social burdens on the patients and the economy. The overall health-related quality of life of patients can be positively influenced by several variables including glycemic control, economic status, comorbidities, presence of complications, and the quality of medical, psychological, and social support. Studies examining the effects of fasting on diabetes during Ramadan fasting underline the biochemical changes without considering the psychosocial and financial implications. This study aimed to illuminate some of the challenges faced by both fasting and non-fasting diabetic patients during Ramadan.Further, we evaluated the quality of life of diabetes patients, explored the socio-demographic and disease-related variables, and estimated the percentage of diabetic patients who fasted during Ramadan. Methods: This was a community-based cross-sectional study conducted from August 2015 to October 2015. Diabetes 39 instrument was administered to 112 patients with diabetes in Khartoum to evaluate their health-related quality of life during Ramadan. Results: Fifty-four percent of study participants were female and 64.3% of them were aged between 40-60 years old. Sixty-two participants were able to fast (55.4%) and fasted for more than 15 days. Half of the participants had, at least, one comorbidity, among which hypertension was the most common. Approximately 59% of fasting patients had mild impairment in their health-related quality of life, whereas 60% of non-fasting participants had moderate impairment. Limited stamina, and fear of hypoglycemia were the items with the highest mean scores in both groups. The fasting group had a lower average score (2.88) compared to the non-fasting group (3.66). This difference was statistically significant (p=0.033). Conclusion: Over 53% of study patients fasted for at least 1 day during Ramadan. Interestingly, Patients who fasted had a better health-related quality of life when compared to those who did not fast. Patients with hypertension and cardiac diseases were the subjects least able to fast during Ramadan.

Middle East respiratory syndrome coronavirus (MERS-CoV) causes severe human infections and dromedary camels are considered an intermediary host. The dynamics of natural infection in camels are not well understood. Through systematic surveillance in Egypt, nasal, rectal, milk, urine and serum samples were collected from camels between June 2014 and February 2016. Locations included quarantines, markets, abattoirs, free-roaming herds and farmed breeding herds. The overall seroprevalence was 71% and RNA detection rate was 15%. Imported camels had higher seroprevalence (90% vs 61%) and higher RT-PCR detection rates (21% vs 12%) than locally raised camels. Juveniles had lower seroprevalence than adults (37% vs 82%) but similar RT-PCR detection rates (16% vs 15%). An outbreak in a breeding herd, showed that antibodies rapidly wane, that camels become re-infected, and that outbreaks in a herd are sustained for an extended time. Maternal antibodies titers were very low in calves regardless of the antibody titers of the mothers. Our results support the hypothesis that camels are a reservoir for MERS-CoV and that camel trade is an important route of introducing the virus into importing countries. Findings related to waning antibodies and re-infection have implications for camel vaccine development, disease management and zoonotic threat.Emerging Microbes & Infections (2017) 6, e1; doi:10.1038/emi.2016.130; published online 4 January 2017

In order to design a high efficiency Wireless Electric Vehicle Charging (WEVC) system, the design of the different system components needs to be optimized, particularly the design of a high-coupling, misalignment-tolerant inductive link (IL), comprising primary and secondary charging coils. Different coil geometries can be utilized for the primary and the secondary sides, each with a set of advantages and drawbacks in terms of weight, cost, coupling at perfect alignment and coupling at lateral misalignments. In this work, a Finite Element Method (FEM)-based systematic approach for the design of double-D (DD) charging coils is presented in detail. In particular, this paper studies the effect of different coil parameters, namely the number of turns and the turn-to-turn spacing, on the coupling performance of the IL at perfect alignment and at ±200 mm lateral misalignment, given a set of space constraints. The proposed design is verified by an experimental prototype to validate the accuracy of the FEM model and the simulation results. Accordingly, FEM simulations are utilized to compare the performance of rectangular, DD and DDQ coils. The FEM results prove the importance of utilizing an additional quadrature coil on the secondary side, despite the added weight and cost, to further improve the misalignment tolerance of the proposed inductive link design.

Recently, electric vehicles (EVs) have been introduced as an alternative method of transportation to help mitigate environmental issues, such as carbon emissions and fuel consumption, caused by conventional transportation systems. The implementation of effective EV charging systems is essential to motivate mass adoption of EVs. Accordingly, fast and reliable communications between the charging systems and the EVs are vital for efficient management of the charging process. Different radio access technologies (RATs) are discussed in the literature to enable communication between the highly mobile EVs and the charging subsystems, to collect and exchange information such as state of charge (SoC), users’ locations, and charging decisions between the different network entities. This information can be used to coordinate charging plans and select the optimal routes for moving vehicles. This paper presents a survey of existing literature on vehicular communications for EV charging coordination and management. The communication requirements and feasible communication technologies for vehicular communication are first discussed in details. A review of the physical layer security strategies is then presented and the role of the different RATs in EV charging coordination and management is described and studied.

Acoustic emission (AE) is a phenomenon where transient waves of stress are generated during deformed material, which is applied to detect and monitor the cracks and cracks propagation. The majority of related literature studied simulated wave sources, which were utilized for a single point of a pipe and have been strictly controlled by temporal characteristics. Therefore, the realistic wave sources which do not have known temporal characteristics are studied in the present work. The realistic source is quasi-static crack propagation under three-point bending. The distortions of AE signals are experimentally evaluated by testing the AE signals of crack propagation using simulated sources. A variety of stress intensities are applied on a steel pipe to determine the effect of stress type and intensity on the characteristics of the source using time and frequency domains. Machines are mounted on the steel pipe to locate and reconstitute the features of time and frequency domain of the AE sources. It is concluded that the AE energy was sensitive to the crack size which was concerning to the transition of plane-stress to plane-strain. The potential of AE technique for identifying the nature, intensity and location of crack propagation is demonstrated.

Dynamic wireless power transfer (DWPT) systems are becoming increasingly important for on-the-move electric vehicle (EV) charging solutions, to overcome range anxiety and compensate for the consumed energy while the EV is in motion. In this work, a DWPT EV charging system is proposed to be implemented on a straight road stretch such that it provides the moving EV with energy at a rate of 308 Wh/km. This rate is expected to compensate for the vehicle’s average energy consumption and allow for additional energy storage in the EV battery. The proposed charging system operates at an average power transfer efficiency that is higher than 90% and provides good lateral misalignment tolerance up to ±200 mm. Details of the proposed system’s design are presented in this paper, including EV specifications, inductive link and compensation network design and power electronic circuitry.

Background: Retinitis pigmentosa (RP) is a clinically and genetically heterogeneous group of inherited retinal degenerations that is estimated to affect more than 1.5 million people worldwide. RP is characterized by retinal pigment deposits visible on fundus examination, abnormal electroretinogram and progressive retinal dysfunction. Aim: The present work aimed to identify the possible mutations in the rhodopsin gene (RHO) among Egyptian RP patients as well as identifying the different inheritance patterns of those patients. Subjects and methods: Thirty diagnosed retinitis pigmentosa patients were enrolled in the study. Inheritance forms of RP were identified by recording full family history, the coding regions of the rhodopsin gene were sequenced using blood-derived genomic DNA samples donated by patients and fifteen healthy controls. Results: A high percentage of autosomal recessive cases was reported. Also a high parental consanguinity rates were evident. Sequencing of rhodopsin gene revealed no mutations among the study population. Conclusion: Rhodopsin mutations are scarcely associated with the autosomal recessive RP, suggesting that wide scale studies are needed to determine the genetic variations involved in RP and particularly in the autosomal recessive inheritance.

The introduction of cellphones with poor receiver sensitivity, known as dirty devices, to the Code Division Multiple Access (CDMA) cellular network results in a reduction in cell edge coverage, degraded capacity, and higher drop-call rates. This poor network performance has a negative impact on customer experience and satisfaction, which may result in increased churn for CDMA wireless carriers. Previous research on the impact of dirty devices has used computer-based simulations. This paper demonstrates the influence of dirty devices on a live commercial CDMA network using two distinct approaches. The first approach deploys dirty and non-dirty devices in a live commercial cell, and measures the impact on forward base transceiver station (BTS) power and forward link Ec/Io (Ec is the received pilot chip energy and Io is the spectral density of the total power seen by the device). A series of tests on a live CDMA network with known dirty devices shows an increase in BTS transmit power resources compared with non-dirty devices, leading to the degradation of forward link Ec/Io. The second approach uses a statistical study of the aggregated pilot strength measurement messages reported by the mobile to ascertain the impact of known dirty devices on the overall network Ec/Io of non-dirty devices.

Objective: To present the molecular characterization of Cysticercus tenuicollis (C. tenuicollis) of Taenia hydatigena (T. hydatigena) from livestock isolates in Egypt, and to introduce a detailed image of C. tenuicollis infection in ruminant animals in Upper Egypt. Methods: The prevalence rates of C. tenuicollis infections among the slaughtered animals from different organs were determined using the amplification of sequencing of the MT-CO1 gene. Results: In the present study the infection rates of C. tenuicollis were found to be 16% and 19% in sheep and goat samples respectively. Firstly we report one larval stage of T. hydatigena detected in the camel liver in Egypt. C. tenuicollis infection manifested a higher prevalence in females than in males. Those above two years of age manifested a higher infection rate than younger animals. The preferred site for the infection was the omentum: a 70% preference in sheep and a 68% preference in goats. The molecular characterization using the MT-CO1 gene of isolates from sheep, goats and camels corresponded to T. hydatigena. For this study, molecular characterizations of T. hydatigena were done for the first time in Egypt. Molecular tools are of great assistance in characterizing the C. tenuicollis parasite especially when the morphological character cannot be detected, because the metacestodes are frequently confused with infection by the hydatid cyst, especially when these occur in the visceral organs. In the present study, C. tenuicollis manifested high identity in the goat and sheep samples, while differences were found more frequently in the camel samples (10 base pair). Conclusions: Clearly molecular diagnosis for C. tenuicollis infection significantly helps to differentiate it from such other metacestodes as hydatidosis, which manifests a completely different pathogenicity and requires different control programs.

Vaccination is the most functional medical intervention to prophylactically control severe diseases caused by human-to-human or animal-to-human transmissible viral pathogens. Annually, seasonal influenza epidemics attack human populations leading to 290−650 thousand deaths/year worldwide. Recently, a novel Middle East Respiratory Syndrome Coronavirus emerged. Together, those two viruses present a significant public health burden in areas where they circulate. Herein, we generated a bacterial outer membrane vesicles (OMVs)-based vaccine presenting the antigenic stable chimeric fusion protein of the H1-type haemagglutinin (HA) of the pandemic influenza A virus (H1N1) strain from 2009 (H1N1pdm09) and the receptor binding domain (RBD) of the Middle East Respiratory Syndrome Coronavirus (MERS-CoV) (OMVs-H1/RBD). Our results showed that the chimeric antigen could induce specific neutralizing antibodies against both strains leading to protection of immunized mice against H1N1pdm09 and efficient neutralization of MERS-CoV. This study demonstrate that OMVs-based vaccines presenting viral antigens provide a safe and reliable approach to protect against two different viral infections.

INTRODUCTION: despite the Treatment pulmonary TB patients, defaulting from treatment may remain the major challenge to control TB. In addition, it increases the risk of drug resistance, relapse, and death and may prolong infectiousness. Our objective was to identify determinants of treatment defaulting among TB patients in Khartoum State, Sudan. METHODS: we conducted a case-control study where the patients defaulting from treatment were considered as ''cases'' and those completing treatment as ''controls''. Between may 2010 to may 2011. RESULTS: there were 2727 TB patients who attended TB treatment clinics during study period. Out of these 2399 patients (86%) had continued their treatment while 328 patients (14%) had interrupted it. 105 cases were traced and interviewed. In addition 210 patients who had continued their treatment were included (controls). In the multivariate analysis the variables that remained in the model were: residential locality (rural area) (OR 2.58; 95% CI 1.4 -4.67), patients moving or changing address(OR 5.47; 95% CI 2,90- 10-35), absence of family support (OR 2.14; 95% CI 1.12 - 4.11),and occupation (blue collar work) (OR 2.38; 95% CI 1.39 -4.10). CONCLUSION: the results of this study conclude some socio-demographic factors influence defaulting of TB treatment. We believe that the findings are applicable to current situation of TB management and control in Sudan and other developing countries

BackgroundThe epidemiology of Alkhurma hemorrhagic fever disease is yet to be fully understood since the virus was isolated in 1994 in the Kingdom of Saudi Arabia.SettingPreventive Medicine department, Ministry of Health, Kingdom of Saudi Arabia.DesignRetrospective analysis of all laboratory confirmed cases of Alkhurma hemorrhagic fever disease collected through active and passive surveillance from 1(st)-January 2009 to December, 31, 2011.ResultsAlkhurma hemorrhagic fever (AHFV) disease increased from 59 cases in 2009 to 93 cases in 2011. Cases are being discovered outside of the region where it was initially diagnosed in Saudi Arabia. About a third of cases had no direct contact with animals or its products. Almost all cases had gastro-intestinal symptoms. Case fatality rate was less than 1%.ConclusionsFindings in this study showed the mode of transmission of AHFV virus may not be limited to direct contact with animals or its products. Gastro-intestinal symptoms were not previously documented. Observed low case fatality rate contradicted earlier reports. Close monitoring of the epidemiology of AHFV is recommended to aid appropriate diagnosis. Housewives are advised to wear gloves when handling animals and animal products as a preventive measure.

BACKGROUND: Hepatitis C Virus (HCV) infection is a global health burden particularly in Egypt, where HCV genotype 4a (GT-4a) predominates. The prevention and control of HCV infection will remain a challenge until the development of an effective vaccine that protects against different genotypes. Several HCV GT-1-based vaccines are in different stages of clinical trials, but antigenic differences could make protection against other genotypes problematic. In this regard, data comparing the cell-mediated immune (CMI) response to different HCV genotypes are limited. We aimed to ex vivo investigate whether GT-1-based vaccine may protect against HCV GT-4 infections. This was carried out on samples collected from genotype 4 infected/exposed subjects. METHODS/PRINCIPAL FINDINGS: The CMI responses of 35 subjects; infected with HCV GT-4/or who had spontaneously-resolved the infection and 10 healthy control subjects; to two sets of seven HCV overlapping 15-mer peptide pools derived from both genotypes; and covering most of the viral proteins; were evaluated. This was carried out using an interferon gamma (IFNγ) enzyme-linked immunospot (ELISpot) assay. Peripheral blood mononuclear cells (PBMC) from 17 subjects (48%) responded to at least one peptide pool derived from GT-1b/GT-4a with 13 subjects responding to peptide pools from both genotypes. A strong correlation was found in the responses to both genotypes (r = 0.82, p