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Abstract Background Inflammatory bowel disease is characterized by chronic and relapsing inflammation of the gastrointestinal tract, including two prominent forms: Crohn’s disease and ulcerative colitis. Determining diagnostic biomarkers for predicting disease activity and treatment response remains a challenging aspect. Aim of the work The purpose of our research was to compare fecal CP and fecal MMP-9, two non-invasive biomarkers for inflammatory bowel disease (IBD), and to find out how fecal MMP-9 levels relate to disease activity by looking at how they relate to clinical, endoscopic, and histologic scores of disease activity. Patients and methods This study was performed on 80 subjects divided into 3 groups: group A: 30 patients with Crohn’s disease evidenced by endoscopy ileocolonoscopy, upper GI endoscopy, and tissue biopsy (15 patients with active disease and 15 patients in remission). Group B: 30 patients with ulcerative colitis disease evidenced by colonoscopy and tissue biopsy (15 patients with active disease and 15 patients in remission). Group C: 20 age-matched and sex-matched healthy controls. All participants underwent a thorough history review, comprehensive physical examination, complete laboratory tests, and C-reactive protein measurements. A quantitative enzyme-linked immunosorbent assay was used to determine the levels of fecal matrix metalloproteinase MMP 9 for both the patients and the controls. Ulcerative colitis was evaluated using the Mayo score, Montreal classification, and the Riley histological score. Additionally, Crohn’s disease was assessed with the Crohn’s Disease Activity Index, the Simple Endoscopic Score for Crohn’s Disease, and the D’Haens histological score. Results Comparing fecal MMP-9 with fecal calprotectin (FC), we found that fecal MMP-9 was superior to FC in differentiating active Crohn’s disease from inactive Crohn’s disease, although there was no significant difference between FC and MMP-9 (P-value = 0.561). However, in ulcerative colitis, FC was superior to MMP-9 in distinguishing active UC from inactive UC, but again, there was no significant difference between FC and MMP-9 (P-value = 0.0731).In both the ulcerative colitis and Crohn’s disease groups, fecal MMP-9 could discriminate between patients in remission and those with active disease. Fecal matrix metalloproteinase-9 (MMP-9) was discovered to be a significant marker for assessing the clinical activity of both Crohn’s disease (CD) and ulcerative colitis (UC), with an AUC of 0.998 for CD and 0.991 for UC. Fecal MMP-9 demonstrated great sensitivity (93.33%), specificity (100%), positive predictive value (PPV) of 100%, and negative predictive value (NPV) of 93.7% (with a P-value 0.34 ng/mL for CD and > 0.36 ng/mL for UC. There was a strong positive correlation between fecal MMP-9 and endoscopic and clinical scores of disease activity. Conclusion Fecal MMP-9 has emerged as a promising biomarker for evaluating the clinical activity of both Crohn’s disease and ulcerative colitis. It demonstrated superior diagnostic performance compared to fecal calprotectin in distinguishing active from inactive disease, especially in Crohn’s disease. Although fecal calprotectin outperformed MMP-9 in identifying active ulcerative colitis, the differences between the two markers were not statistically significant, suggesting that they may complement each other in clinical practice. Furthermore, fecal MMP-9 is capable of assessing the activity of endoscopically visible inflammatory bowel disease (IBD), which could help reduce the need for invasive endoscopic procedures.

Abstract Background The upsurge of diarrheagenic E. coli pathotypes carrying extended-spectrum beta-lactamases (ESBLs)/plasmid-mediated AmpC β-lactamase (pAmpC) among animals constitutes an emerging threat for humans and animals. This study investigated the burden of ESBL-/pAmpC-producing diarrheagenic E. coli among diarrheic foals and its potential public health implications. Rectal swabs were collected from 80 diarrheic foals. These swabs were processed to isolate and identify ESBL/pAmpC-producing E. coli using a selective culture medium, biochemical tests, phenotypic identification, and molecular identification of ESBL- and pAmpC-encoding genes. Moreover, all ESBL-/pAmpC-producing E. coli isolates were examined for different virulence genes related to diarrheagenic E. coli pathotypes. Results Out of 80 examined foals, 26 (32.5%) were confirmed as ESBL-/pAmpC-producing E. coli, of which 14 (17.5%) animals carried only ESBL-producing E. coli, whereas 12 (15%) animals possessed ESBL-pAmpC-producing E. coli. The only detected diarrheagenic pathotype was enterotoxigenic, encoded by the heat-stable enterotoxin gene (ST) with a prevalence rate of 80.8% (21/26). The ST gene was further characterized where STa, STb, and STa + STb were found in one, four, and 16 strains, respectively. Moreover, all enterotoxigenic E. coli (ETEC) isolates exhibited a multidrug-resistance pattern. The phylogenetic analysis of 3 obtained partial STb sequences revealed high genetic relatedness to ETEC isolates retrieved from humans, conferring such sequences' public health significance. Conclusions These findings highlight that diarrheic foals could serve as a potential reservoir for multidrug-resistant ESBL-/pAmpC-producing enterotoxigenic E. coli.

Background: Low-density screw constructs yield significant radiographic and clinical improvements with reduced risk of neurological complications. This study aimed to investigate the relationship between coronal Cobb angle and pelvic incidence (PI) in the correction of adolescent idiopathic scoliosis (AIS) using a low-density construct, as well as the association between PI and functional outcomes. PATIENTS AND METHODS: This prospective cohort study involved 60 posteriorly instrumented AIS patients, aged 10–16 years, with Cobb angles ranging from 45° to 90° of various Lenke types. Radiological assessments were conducted pre- and postsurgery at 1, 3, 6, 12, and 24 months. Functional evaluation utilized the Scoliosis Research Society score form (SRS-30). Results: A positive correlation was observed between screw density and operation time, blood loss, and degree of correction with SRS change (P = 0.004). No correlation was found between screw density and hospital stay, loss of correction, correction rate, SRS change, change in PI, or Cobb angle. Conclusions: Correction of AIS through a posterior approach using a low-density construct can lead to satisfactory curve correction, impacting spinopelvic parameters. However, PI alone does not directly influence patient functional outcomes assessed by SRS-30. Low-density implant constructs reduce operative time, blood loss, costs, and complication risks.

Abstract Purpose Acute decompensated heart failure (ADHF) patients with a poor renal function have a worse prognosis. The urea-to-creatinine ratio (UCR) may be a valuable tool for assessing kidney function and stratifying patients with ADHF. We evaluated the value of an admission and follow-up UCR in predicting AKI, 28-day mortality, and rehospitalization in patients with ADHF. Methods This prospective research comprised sixty patients with ADHF. Based on the mean admission UCR, patients are classified into two groups: the high UCR group (UCR ≥ 42.33) and the low UCR group (UCR 34.85 (p

Abstract Objective Cardiovascular magnetic resonance (CMR) is considered the gold standard imaging modality for assessing myocardial infarction lesions, offering precise myocardial tissue characterization. Elevated transverse relaxation time (T2) serves as a specific indicator of increased myocardial water content, thus becoming a valuable index for myocardial edema. However, conventional T2-weighted CMR sequence exhibits several limitations, primarily providing qualitative information. In contrast, recently developed quantitative T2 mapping techniques overcome these limitations, enabling a more reliable assessment of myocardial edema. These techniques offer the advantage of diagnosing and monitoring myocardial injury without the necessity of contrast agents. Our study aims to add to a growing literature demonstrating the efficacy of quantitative T2 mapping technique to detect and quantify regions of myocardial edema post-myocardial infarction. Result Native T1 and T2 mapping accurately identified myocardial edema in all patients enrolled in the study. Notably, native T1 and T2 values exhibited a significant elevation in the infarcted myocardium compared to the remote myocardium (for T1: 1295.50 ± 87.65 vs. 1074.95 ± 92.86 ms, respectively; and for T2: 74.63 ± 6.51 vs. 52.53 ± 6.26 ms, respectively; p

Abstract Background The characterization of pathologically enlarged mediastinal lymph nodes is clinically essential for effective disease management and accurate prognosis. Malignancy (metastases and lymphoma) and granulomatous conditions (sarcoidosis and tuberculosis) are the most common causes. Magnetic resonance imaging (MRI) is a good modality to characterize the mediastinal pathologically enlarged lymph nodes based on the excellent soft tissue contrast. It can save high-risk patients from radiation exposure and hazards of intervention such as general anesthesia and biopsy. Aim of the work To estimate the accuracy of different advanced MRI quantitative parameters in the differentiation between benign and malignant mediastinal lymphadenopathy. This would involve the lesion-to-cord signal intensity ratio (SIR) in the T2-WI and diffusion weighted image (DWI), the lesion-to-chest wall muscle SIR in T2-WI and DWI, and the mean apparent diffusion coefficient (ADC) values. These values would be correlated with the prospective pathological data and the results of the positron emission tomography (PET-CT). Results Prospectively, the study was conducted during the period between June 2022 and September 2023 on 45 patients with indeterminate or suspicious mediastinal lymphadenopathy identified by CT. MRI examination, PET-CT, and biopsy were applied for all patients. The intra-class correlation coefficient ranged between 0.89 and 0.95. (A) The lesion-to-cord SIR in T2-WI in the malignant group (1.49 ± 0.30) was higher than that in the benign group (0.83 ± 0.24) with P 1.2) estimated 90% sensitivity, 100% specificity, with AUC = 0.989. (B) The lesion-to-chest wall muscle SIR in T2-WI in malignant nodes (3.13 ± 0.84) was significantly higher than that in the benign nodes (1.90 ± 0.80) with P 2.4) estimated 86.67% sensitivity, 86.67% specificity, with AUC = 0.88. (C) The lesion-to-cord signal SIR in b500-DWI in the malignant node (1.80 ± 0.54) was higher than that in the benign group (0.75 ± 0.29) with P 1.2) estimated 100% sensitivity and specificity with AUC = 1.00. (D) The lesion-to-chest wall SIR in b500-DWI in the malignant node (6.43 ± 1.28) was higher than that in the benign node (2.63 ± 0.94) with P 4.1) estimated 96.67% sensitivity, 100% specificity, with AUC = 0.997. € The mean ADC values in the malignant nodes (0.83 ± 0.20 × 10–3 mm2/s) were significantly lower than that in the benign nodes (1.85 ± 0.19 × 10−3 mm2/s) with P

Abstract The Late Cretaceous was a time of high eustatic sea level that enabled extensive epicontinental seaways and carbonate platforms across the Tethyan Realm, providing favorable habitats for oyster communities to flourish. This study focuses on the Campanian Tethyan oysters from the North Eastern Desert of Egypt regarding taxonomy, palaeoecology, and palaeobiogeography. Three oyster species, Nicaisolopha nicaisei (Coquand, 1862), Pycnodonte (Phygraea) vesicularis (Lamarck, 1806), and Ambigostrea bretoni (Thomas and Peron, 1891), were identified from the Campanian succession in two studied sections. The sampled specimens of the genus Nicaisolopha have undergone a systematic palaeontological revision. As a result, N. tissoti (Thomas and Peron, 1891) is considered herein a junior synonym of N. nicaisei (Coquand, 1862). Palaeobiogeographically, the likely primary migration pattern of the studied oysters suggests an east–west trend along the Southern Tethys margin. All identified oysters in this study exhibit a Tethyan affinity and are primarily abundant in two main provinces: the Southern Tethys and the Western Tethys. The macrofaunal contents are categorized into two fossil associations: the Nicaisolopha nicaisei association of the middle-late Campanian age and the Pycnodonte vesicularis association of the late Campanian age. These macrofaunal associations indicate a deepening trend during the middle-late Campanian age, suggesting a transition from shallow inner neritic to middle neritic environments. Additionally, it is observed that Pycnodonteinae tend to grow larger under eutrophic conditions, low-energy environments, and nutrient-rich waters with high carbonate contents.

Abstract Background Flexible ureteroscopy offers numerous advantages, such as increased reach, superior stone-free rate, reduced risk of bleeding, minimal surgical trauma, and faster recovery time. There are few studies discussing the effectiveness of single-use flexible ureteroscopy in children, and none so far have addressed its safety. This study aims to evaluate the effectiveness and safety of a single-use flexible ureteroscope for treating upper urinary tract stones in children. Methods This study included children with single upper urinary tract stones measuring less than 2 cm who underwent single-use flexible ureteroscopy between October 2020 and January 2023. We assessed the following patient characteristics: age, gender, stone type, size, position, pre and postoperative stent placements, use of a ureteral access sheath, stone-free rate, operation duration, and the rate of complications. A patient was considered stone-free if there were no residual stone particles larger than 3 mm after surgery. Results Flexible ureteroscopy and holmium laser lithotripsy were undertaken for 44 participants, with an average age of 8.5 years (range: 2–16 years). The typical stone size was 14 mm (range: 6–20 mm). The average operation time was 74 min (range 35–110 min). Ureteral access sheaths were used in 81.8% (36 out of 44) of procedures. After a single FURS session, 86.36% (38 out of 44) of patients achieved stone-free status. Postoperative JJ stent application was noted in 86.4% (38 out of 44) of patients. Complications were categorized using the Calvien system, revealing that 25% (11 out of 44) of patients experienced mild hematuria, colic, and low-grade fever (Calvien I). No severe side effects like mucosal avulsion or ureteral perforation were reported. Conclusion In the short-term, single-use flexible ureteroscopy is a safe and effective method for managing single renal and proximal ureteric stones, measuring 2 cm or less, in children.

Introduction: The curative effects of Solanum elaeagnifolium have aroused the interest of botanical medicine researchers. However, no research has been carried out into its potential toxicity. The aim of this study was firstly to screen the secondary metabolites contained in the leaves and fruits of S. elaeagnifolium and their mineralogical composition, and secondly to assess the acute oral toxicity of S. elaeagnifolium in Swiss albino mice. Methods: The amount of minerals in the plant powder was assessed by inductively coupled plasma atomic emission spectrometry, and phytochemical screening was performed. The hydroethanolic extracts of the leaves and fruits of this plant were prepared using the maceration method. Acute oral toxicity was assessed according to the OECD guideline 423. Mice were given leaf extracts (SEFE) and fruit extracts (SEFR) once at doses of 500 mg/kg, 1000 mg/kg and 2000 mg/kg in an acute toxicity study. The animals were then monitored for 14 days. The animals were then monitored for 14 days. To rule out any potential toxicity, the general behavior of the animals, the clinical symptoms of poisoning, body weight, biochemical and hematological markers, and liver, kidney, and spleen histology were examined. Results: The two different plant extracts comprised very important mineralogical elements such as Mg, Zn, and k, as well as secondary metabolites such as polyphenols and flavonoids, these chemical elements were shown to have very important biological activities. An oral administration of a hydroethanolic extract of S. elaeagnifolium leaves and fruits at a dose of 2000 mg/kg resulted in toxicity and death in mice. We found no significant difference in the weight of the mice. For doses less than 2000 mg/kg, biochemical markers in the liver, kidneys, and hematology did not differ significantly from those in the control group. Furthermore, there were no changes in hematological markers. Furthermore, the architecture of the liver, spleen, and kidney was normal and histopathological analysis did not reveal significant adverse effects. Conclusions: These findings indicate that the plant harbors a significant array of secondary metabolites and minerals. S. elaeagnifolium exhibited signs of toxicity and induced histological, hematological, and biochemical alterations at a dose of 2000 mg/kg body weight. These comprehensive studies will help to improve our understanding of S. elaeagnifolium safety and potential utility, laying the groundwork for its safe use in a variety of settings.

Vehicle-to-infrastructure (V2I) communication facilitates seamless interaction between vehicles and the surrounding infrastructure. Recently, there has been a notable surge in research interest in ambient backscatter communications (AmBC), primarily due to its ability to enable battery-free communication. Concurrently, reconfigurable intelligent surfaces (RISs) have garnered attention as a promising technology, particularly for the advancement of cellular systems beyond 5G. Additionally, non-orthogonal multiple access (NOMA) assumes a pivotal role in enhancing spectrum utilization. This paper proposes a new RIS-enhanced NOMA-AmBC system where all channels are characterized by Nakagami-m fading and with the main objective of assessing the performance of such system. To this end, new closed-form expressions for the outage probabilities (OPs) were derived under the practical assumption of imperfect successive interference cancellation (SIC). In addition, to gain a deep insight into the system’s performance, we derived asymptotic, upper-bound, and lower-bound expressions for the OPs. Furthermore, we proposed a power allocation optimization problem to achieve an outage-optimal performance. To validate the analytical results, we conducted extensive investigations using Monte Carlo simulations, which indicates a high degree of consistency. Moreover, our results underscore the remarkable performance improvements achieved by the RIS-assisted AmBC-NOMA system when compared to both the traditional benchmark AmBC-NOMA system and the RIS-assisted orthogonal multiple access (AmBCOMA) counterparts.

Abstract Background Chemotherapy-associated cardiomyopathy is a well-known cardiotoxicity of contemporary cancer treatment. As cancer outcomes improve, cardiovascular disease has become a leading cause of morbidity and mortality among cancer survivors. The objective of this study was to evaluate the role of CMR in the detection of early cardiotoxic changes and in the identification of patients at risk of developing CTRCD. Patients and methods Fifty patients diagnosed breast cancer examined by echocardiography and cardiac MRI before the start of chemotherapeutic regimen followed by 2 and 4 months post-chemotherapy. Results By echocardiography, all measures were within normal range at the start and at the first follow-up. Twenty (40%) patients show decreased LVEF at second follow-up reaching up to 50% with milder affection of the other parameters. CMR examination shows decreased LVF at second and third follow-up (p = 0.005). There was significant elevation of T2 value for 10 patients at first follow-up (p value 0.04) and for 22 patients at second follow-up (p value 0.01) in correlation with baseline. The T1 mapping and ECV showed elevation at first and second follow-up as compared to baseline (p =

Abstract Breast cancer, the most prevalent cancer among women, has posed a significant challenge in identifying biomarkers for early diagnosis and prognosis. This study aimed to elucidate the gene expression profile of Estrogen Receptor-1 (ESR-1), long non-coding RNA HOTAIR, and microRNA-130a in the serum of Egyptian breast cancer patients, evaluating the potential of HOTAIR and miR-130a as biomarkers for predicting pathological parameters in BC. The study involved 45 patients with primary BC, with serum samples collected preoperatively and postoperatively twice. The expression levels of ESR-1, HOTAIR, and miR-130a were quantified using real-time PCR and analyzed for correlations with each other and with the clinical and pathological parameters of the patients. Serum HOTAIR levels exhibited a strong positive association with metastasis and demonstrated a significant increase after 6 months in all patients with locally advanced and stage IV BC. Conversely, tumors with advanced stages and metastatic lesions showed significantly lower expression levels of miR-130a. Notably, a significant positive correlation was observed between preoperative ESR-1 expression and both HOTAIR and miR-130a levels. Serum HOTAIR and miR-130a levels have emerged as promising non-invasive biomarkers with the potential to predict the pathological features of BC patients. HOTAIR, an oncogenic long non-coding RNA (lncRNA), and miR-130a, a tumor suppressor miRNA, play crucial roles in tumor progression. Further investigations are warranted to elucidate the intricate interplay between HOTAIR and miR-130a and to fully comprehend the contribution of HOTAIR to BC recurrence and its potential utility in early relapse prediction.

This study introduces an innovative method to improve the load-bearing properties of loose fine-grained soils, mitigate geodynamic stress-related risks to supported structures, and address the issue of end-of-life tire waste. This technique involves blending shredded end-of-life tires with sandy soil and compacting the mixture into sand-rubber compacted piles (SRCP), thereby enhancing both the soil's load-bearing capacity and its ability to absorb energy. As per the ASTM classification system, the sand used in this study falls into the category of fine to medium poorly graded sand, with particle sizes ranging from 4.75 mm and an average particle size (D50) of 0.2 mm. An experimental program was devised to investigate the physical and mechanical properties of this composite material. Field plate load tests (FPLT) were conducted to assess the effectiveness of the proposed technique, taking into account factors such as the initial relative density of the soil, the ratio of rubber to sand (R/S) in the mixture, and the distribution of piles in the surrounding environment. The results from the plate load tests revealed that when SRCP was applied to soil with a relative density of 40 %, the ultimate load-bearing capacity increased by 100 %.

Study Design randomized, prospective, and level I clinical study. Purpose To compare the clinical outcomes and radiological findings of revision discectomy alone versus revision discectomy with fusion as surgical treatment for recurrent lumbar disc herniation (RDH). Overview of Literature RDH is a common complication following a primary discectomy. The optimal surgical procedure for RDH is still debated. Methods Sixty patients with RDH were randomly divided into two equal groups: the first group underwent revision discectomy alone and the second underwent revision discectomy with fusion. The primary outcomes evaluated were Visual Analog Scale (VAS) for low back and limb pains, Oswestry Disability Index (ODI), disc height indexes, foraminal height index, and disc height subsidence. Secondary outcomes included operative time, blood loss, postoperative hospital stay, and complications. Results Revision discectomy with fusion showed superior pain relief and improved functional outcomes, including better VAS scores for both back and leg pain and ODI at 24-month follow-up. Additionally, it restored the stability of the spine better with lower disc height subsidence without significant complications. However, these advantages came at the cost of increased blood loss and longer operative time and hospital stays. Conclusions Revision discectomy with fusion is recommended for RDH; however, the choice of the procedure should be made case-by-case basis, considering many factors related to the patient and surgical facilities.

The functionality of magnetoelectric multiferroics depends on the formation, size, and coupling of their magnetic and electric domains. Knowing the parameters guiding these criteria is a key effort in the emerging field of magnetoelectric domain engineering. Here we show, using a combination of piezoresponse-force microscopy, nonlinear optics, and x-ray scattering, that the correlation length setting the size of the ferroelectric domains in the multiferroic hexagonal manganites can be engineered from the micron range down to a few unit cells under the substitution of Mn^{3+} ions with Al^{3+} ions. The magnetoelectric coupling mechanism between the antiferromagnetic Mn^{3+} order and the distortive-ferroelectric order remains intact even at substantial replacement of Mn^{3+} by Al^{3+}. Hence, chemical substitution proves to be an effective tool for domain-size engineering in one of the most studied classes of multiferroics.

Non-orthogonal multiple access (NOMA) has emerged as a promising technology for 5G networks and beyond. In order to fully reap the benefits of NOMA, it is essential to characterize its performance under different channel fading. In this paper, we carry out a performance analysis of the downlink NOMA-based dual-hop mixed powerline/wireless communication (PLC/WLC) system. Specifically, we investigate the system reliability and spectrum efficiency in terms of the outage probability and the ergodic capacity, respectively, where the PLC link undergoes lognormal fading while the WLC link undergoes block Rayleigh fading. The accuracy of the analytical results has been validated, the effect of different system controlling parameters is tested; and the optimal values of power allocation factors are obtained. Also, the system performance is compared to a benchmark system through representative extensive simulations.

Abstract Background Severe COVID-19 disease is typically associated with an urgent need for supplemental oxygen therapy that may be successfully delivered through conventional methods or require invasive mechanical ventilation. Early prediction of the need for invasive mechanical ventilation could significantly improve outcomes of COVID-19 patients. Plasma levels of D-dimer and a number of inflammatory markers as well as values of complete blood counts, all measured in the first two days of hospital admission of COVID-19 patients, were evaluated for their significance as predictors of the eventual need for invasive mechanical ventilation support as well as their values as predictors of post-ventilation morbidly and mortality. Methods This retrospective cohort study was conducted at a single center and included data pertaining to 200 patients with previously confirmed moderate to severe COVID-19 disease in the period between May 2021 and the end of December 2022. Data were retrieved from medical records for further analysis. Results The mean (SD) age of patients stood at 59 (14) years of age, and with a majority of patients being male (77%). About 18% of cases, all of significantly older age, had been connected to invasive mechanical ventilation (IMV). Total leucocytic count (TLC), as well as levels of urea, creatinine, D-dimer, ferritin, and CRP in IMV patients were significantly higher than non-ventilated patients (p

Objective: This study aimed to explore the incidence and antimicrobial resistance (AMR) of Escherichia coli, Staphylococcus aureus, and Bacillus cereus in raw milk and some Egyptian dairy products, namely Kariesh cheese and rice with milk. Material and Methods: 112 samples (70 raw milk, 30 Kariesh cheese, and 12 rice with milk) were randomly collected from different districts in Cairo and Giza, Egypt. The samples were examined for E. coli, S. aureus, and B. cereus presence. The susceptibility of the obtained isolates was tested against 11 antimicrobials using the disk diffusion method, and further, the presence of AMR genes was examined. Results: The incidences of E. coli, S. aureus, and B. cereus were 69.64%, 12.5%, and 16.7% in the examined samples, respectively. The antibiogram indicated that E. coli isolates (n = 60) were resistant to gentamycin (73.33%), ampicillin (AM, 53.3%), and cefotaxime (CTX, 16.66%). Multidrug-resistant (MDR) E. coli strains (n = 5) were tested for β-lactams resistance genes. blaTEM was detected in all isolates, and two of them additionally carried blaCTX-M. Staphylococcus aureus isolates (n = 10) were resistant to AM (100%), followed by tetracycline (TE), CTX, and gentamycin (60% each). All MDR S. aureus strains (n = 4) carried blaZ and tetK, and three of them additionally carried aac(6')-aph (2''). Bacillus cereus isolates (n = 30) showed resistance to AM (100%), amoxi¬cillin (20%), and TE (6.66%). bla and tetA genes were detected in all MDR B. cereus isolates (n = 6). Conclusion: Our findings denote the high incidence of potential health hazards in raw milk and some of its products and the existence of AMR bacteria, including MDR strains, which can cause human illnesses that are difficult to treat. [J Adv Vet Anim Res 2023; 10(2.000): 275-283]

Herpes simplex encephalitis (HSVE) is a potentially fatal infectious central nervous system (CNS) disorder. Thus, early detection is critical in determining the case's fate. Clinical history and examination, brain computed tomography, dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI), and lumbar puncture have been used to establish a diagnosis. This report describes a case of HSVE with hypocellular cerebrospinal fluid (CSF) and an uncommon form of memory impairment. However, MRI results were consistent with HSVE, and CSF PCR tested positive for HSV-1 DNA that responded to treatment. We routinely advise patients to begin antiviral therapy as soon as possible to avoid complications.

Abstract Leishmaniasis is a protozoal infection transmitted by sandfly vector; there are three main types of leishmaniasis: cutaneous leishmaniasis (CL), mucocutaneous leishmaniasis (MCL), and visceral leishmaniasis (VL). Herein, we present a case of endonasal mucocutaneous leishmaniasis in a 34-year-old Yemeni patient who presented with disfiguring nasal swelling associated with fever, a swab from the lesion and direct microscopic examination proved to have mucocutaneous leishmaniasis; he was successfully treated with intravenous antimonial stibogluconate, 1 month after treatment biopsy from the lesion revealed cytotoxic T-cell lymphoma, the purpose is to alert the physicians and otolaryngologists to consider leishmaniasis in the differential diagnosis of nasal granulomas and also to highlight the importance of early diagnosis of cancer in survivors of cutaneous leishmaniasis, especially in areas where cutaneous leishmaniasis is still highly prevalent, as the chronic local inflammation may disfigure the face if not recognized early and adequately treated; also, early cancer diagnosis can prevent mortality

Abstract Background The multi-detector computed tomography (MDCT) and tissue biopsy are the gold standards for the evaluation of lung malignancies. However, there is a wide range of pulmonary indeterminate lesions that could mimic lung cancer. Furthermore, the diagnosis of malignancy could be challenging if the lesion is small and early presenting by a part-solid or ground-glass nodule or if surrounded by parenchymal lung reaction with consolidation and atelectasis. The previous literature focused on the role of diffusion-weighted image–magnetic resonance imaging (DWI) and the apparent diffusion coefficient (ADC) mapping in the evaluation of lung malignancy. A novel quantitative T2 assessment is provided and tested in this study. Aim of the work: To evaluate the accuracy of specific non-invasive quantitative magnetic resonance imaging (MRI) parameters in the characterization of suspicious lung lesions and the discrimination between the malignant and benign nature. They included the lesion-to-spinal cord signal intensity ratio in T2-WI and DWI as well as the mean and minimum apparent diffusion coefficient (ADC) values. This is performed using a prospective pathologic correlated study with receiver-operating characteristics (ROC) analysis and comparison with positron emission tomography (PET-CT) accuracy results. Results This study was prospectively performed during the period between June/2021 and June/2022. It was conducted on 43 suspicious lung lesions detected by MDCT. MRI and PET/CT examinations were performed for all patients, and the results were compared to the final diagnosis obtained after biopsy and pathological assessment, using the statistical tests of significance and P-value. Cutoff values were automatically calculated, and then, accuracy tests and ROC analyses were performed. Five expert radiologists and a single consulting pulmonologist participated in this study. The inter-rater reliability ranges between good and excellent with the intra-class correlation coefficient (ICC) ranging between 0.85 and 0.94. In T2-WI: The lesion-to-spinal cord signal intensity ratio was higher in the malignant group (1.35 ± 0.29) than in the benign group (0.88 ± 0.40), (P 1), the sensitivity was 96.43%, the specificity was 80.00%, and AUC = 0.86. In b500-DWI: The lesion-to-spinal cord signal intensity ratio was higher in the malignant group (0.70–1.35) than in the benign group (0.20–0.70) (P 0.7), the sensitivity was 71.43%, the specificity was 86.67%, and AUC = 0.86. The mean and minimum ADC values were lower in the malignant group (0.6–1.3 and 0.3–1.1 × 10–3 mm2/s) than the benign group (1–1.6 and 0.7–1.4 × 10–3 mm2/s), (P

Abstract Background Several clinical studies tested the efficacy of the different COVID-19 vaccinations while very few radiological researches targeted this issue before. Aim of the work To verify the additive role of lung CT-Volumetry in testing the efficacy of three widely distributed COVID-19 vaccinations; namely the "Sinopharm", "Oxford-AstraZeneca", and "Pfizer-BioNTech" vaccinations, with comparative analysis of variance (ANOVA). Results This study was retrospectively conducted on 341 COVID-19 patients during the period between June/2021 and March/2022. Based on the immunization status, they were divided into four groups; group (A) included 156/341 (46%) patients who did not receive any vaccination (control group), group (B) included 92/341 (27%) patients who received "Sinopharm" vaccine, group (C) included 55/341 (16%) patients who received "Oxford-AstraZeneca" vaccine, group (D) included 38/341 (11%) patients who received "Pfizer-BioNTech" vaccine. Every group was subdivided based on the medical history into three groups; group (1) patients without comorbidities, group (2) patients with comorbidities, and group (3) immunocompromised patients. Automated CT volumetry was calculated for the pathological lung parenchyma. Five CT-severity scores were provided (score 0 = 0%, score 1 = 1–25%, score 2 = 25–50%, score 3 = 51–75%, and score 4 = 76–100%). Analysis of variance (ANOVA) including Tukey HSD testing was utilized in comparison to the non-immunized patients. The "Phizer-Biontech" vaccine succeeded to eliminate severity in patients without and with comorbidity, and also decreased severity in immunocompromised patients (from 79 to 17%). The "Oxford-AstraZeneca" vaccine and to a lesser extent "Sinopharm" vaccine also decreased the clinical severity in patients with comorbidities and immunocompromised patients (from 15 to 9% & 10% as well as from 79 to 20% & 50% respectively). Significant variance was proved regarding the use of "Sinopharm", "Oxford-AstraZeneca", and "Phizer-Biontech" vaccines in patients without comorbidities (f-ratio averaged 4.0282, 10.8049, and 8.4404 respectively, also p-value averaged 0.04632, 0.001268, and 0.004294). Significant variance was proved regarding the use of "Oxford-AstraZeneca", and "Phizer-Biontech" vaccines in patients with comorbidities and immunocompromised patients (f-ratio averaged 4.7521, and 4.1682 as well as 11.7811, and 15.6 respectively, also p-value averaged 0.03492, and 0.04857, as well as both 0.003177, and 0.0009394 respectively, all

Purpose The aim of this study was to investigate the efficacy of in-situ transconjunctival scleral fixation of dislocated one-piece foldable intraocular lens (IOL) with flanged prolene 6/0 suture. Patients and methods The study included seven eyes of seven patients with dislocated IOL. A 6/0 prolene suture was threaded into a 30-G needle that was then passed transconjunctively. The needle was passed through the optic–haptic junction of the luxated IOL. The prolene was then retrieved through the corneal tunnel. Two central and two scleral bulbs (flanges) were created by heating the ends of the prolene suture. Results The best-corrected visual acuity was significantly improved from 0.16±0.05 preoperatively to 0.62±0.08 3 months postoperatively (P=0.006). There were nonsignificant IOP elevation and endothelial cell loss (P>0.05). All cases had well-centered IOL. No postoperative complications such as vitreous hemorrhage, macular edema, retinal detachment, or endophthalmitis were recorded. Conclusion In-situ transconjunctival scleral fixation of foldable one-piece IOLs is a safe effective technique for fixing dislocated IOLs.

Background Transconjunctival intrascleral fixation using double flanged prolene suture was used for scleral fixation of intraocular lenses (IOLs), Cionni capsule tension ring, and Ahmed segment. This technique carries the risk of flange exposure with subsequent hypotony and inflammation. Aim This study aimed to evaluate the efficacy of combining the Hoffman pocket with the traditional technique of Cionni ring scleral fixation in the prevention of flange exposure. Patients and methods This is a prospective study that included nine cases in which scleral fixation of the Cionni ring was indicated to treat severe zonular dialysis due to pseudo-exfoliation syndrome. The patients were followed up on the first day, after 1 week, and monthly for 6 months. During each postoperative visit, slit lamp biomicroscopy was performed to evaluate the status of the cornea, IOL centration, and position of the prolene flanges. Uncorrected visual acuity and best-corrected visual acuity were recorded. Results The mean best-corrected visual acuity improved significantly from 0.21±0.1 preoperatively to 0.76±0.24, 6 months postoperatively (P=0.0056). In all cases, the IOLs were well-centered and stable all through the postoperative follow-up period which ranged from 6 to 8 months (mean=6.9±0.66 months). No hypotony or endophthalmitis were reported. Conclusion The use of the Hoffman pocket to bury the terminal flanged ends of prolene sutures proved to be an efficient method to decrease the risk of conjunctival erosion and flange exposure.

Abstract Population-based genomics studies have proven successful in identifying genetic variants associated with diseases. High-quality biospecimens linked with informative health data from diverse segments of the population have made such research possible. However, the success of biobank research depends on the willingness of the public to participate in this type of research. We aimed to explore the factors associated with the willingness of the public to participate in biobank research from four low- and middle-income countries in the Arab region (Egypt, Jordan, Morocco, and Sudan). We used a previously validated questionnaire to assess several constructs that included the public’s perceptions, attitudes, and willingness to participate in biobank research. We recruited 967 participants. More than half did not have prior awareness of biobanks. Participants’ willingness to donate biospecimens and health data was less than 10%. Our results also showed that participants harbored concerns with trust, privacy, and with data-sharing involving international researchers. Predictors of willingness to participate in biobank research included no previous involvement in research and positive attitudes toward biobanks. Finally, our study showed several differences between the four countries regarding several of the investigated constructs. We conclude there should be additional efforts to raise public awareness and enhance perceptions of the public in biobanking research to enhance trust. We further recommend qualitative research to explore the underlying factors that contribute to the public’s concerns with international data sharing that would enhance global health.

Abstract Background The new guidelines limited the use of lung biopsy in the evaluation of lung fibrosis because of its hazards. The differential diagnosis of interstitial pulmonary fibrosis (IPF) or usual interstitial pneumonia (UIP) is challenging because of overlapping multi-detector computed tomography (MDCT) morphologic features between interstitial and non-interstitial fibrosing lung diseases. Scar carcinoma is a serious complication that needs to be excluded in certain conditions. Aim of the work: To achieve a multi-disciplinary algorithm for the diagnosis of fibrosing lung diseases to limit the need for lung biopsy by combining the clinico-laboratory and radiological roles. Results This study included two major steps. The first step (prevalence/significance analysis of the contributing parameters for the diagnosis of fibrosing lung diseases) was retrospectively conducted on 150 patients pathologically proved with fibrosing lung disease during the period between January/2016 and April/2018. Based on a P-value

Abstract Background Recent studies suggested association between hepatitis C virus (HCV) infection and cardiovascular disorders, including carotid atherosclerosis with evidence of an effect of HCV clearance on carotid atherosclerosis. Objectives We aimed to evaluate the impact of direct-acting antiviral (DAA) therapy for chronic hepatitis C virus (HCV) infection on carotid atherosclerosis. Subjects and methods This is a prospective cohort study that was carried out in Internal Medicine and Hepatology Department, and outpatient clinics of the Ain Shams University hospitals included 80 Egyptian patients with chronic HCV infection who started treatment in the form of IFN-free DAA-based regimen and completed the course of treatment and 6-month follow-up period. All patients were subjected to detailed history taking, full physical examination, full laboratory investigations, radiological assessment by abdominal ultrasonography, and high-resolution B-mode ultrasonography of both the common carotid arteries. Results The mean age of cases was 58.13 ± 7.56 years, 49 (61.25%) males and 31 (38.75%) females. IMT was significantly decreased after treatment 1.24 versus 1.57 mm p

Abstract Objectives Pancreatic reserve could be preserved by early assessment of pancreatic iron overload among transfusion-dependent sickle cell disease (SCD) patients. This study aimed to measure pancreatic iron load and correlate its value with patients’ laboratory and radiological markers of iron overload. Materials and methods Sixty-six SCD children and young adults underwent MRI T2* relaxometry using a simple mathematical spreadsheet and laboratory assessment. Results The results indicated moderate-to-severe hepatic iron overload among 65.2% of studied cases. None had cardiac iron overload. Normal-to-mild iron overload was present in the pancreas in 86% of cases, and 50% had elevated serum ferritin > 2500 ug/L. There was no significant correlation between pancreatic R2* level, serum ferritin, and hepatic iron overload. Patients with higher levels of hemolysis markers and lower pre-transfusion hemoglobin levels showed moderate-to-severe pancreatic iron overload. Conclusion Chronically transfused patients with SCD have a high frequency of iron overload complications including pancreatic iron deposition, thereby necessitating proper monitoring of the body’s overall iron balance as well as detection of extrahepatic iron depositions.

The third-generation alloy, AA2198-T8, is highly recommended for the aerospace industry. However, it has come under scrutiny due to its high cost. This study aims to decrease the cost of manufacturing through a hybrid design that uses AA2198-T8 alloys for the crucial parts and AA2024-T3 alloys for the remaining structure. The two main techniques for joining AA2024-T3 to AA2198-T8 are reversed double-sided friction stir welding (DS-FSW) and traditional single-sided friction welding (SS-FSW). They were carried out under unaltered tool rotation speed followed by five different welding speeds. The mechanical properties of the joints were explored, and the maximum joining efficiency of the welding process was 96% for reversed DS-FSW at 102 mm/min welding speed. The hybrid joint was tested for compliance with ASTM G34 standards to examine the welding joint's exfoliation corrosion (EXCO) for eight exposure times. The findings showed that joint efficiency decreased relative to as-welded joints, and mechanical property deterioration increased with EXCO exposure duration, reaching 40% for specimens exposed for 120 h to the corroding solution. It has been noted that morphology and grain size changes significantly impact EXCO.

Despite considerable improvements in oral health, dental caries remains a public health issue. The most frequently used technique to remove caries is through rotating drills. New minimally invasive strategies were introduced into dental practice, such as the use of lasers to perform highly controlled tissue ablation while limiting pain and discomfort, as well as overcoming drill phobia. The objective was to assess and compare treatment with Er:YAG laser versus a conventional rotary treatment during cavity preparation in children with regard to bond interface quality. In a randomized trial using a split-mouth design, 40 (9–12 year-old) children with 80 carious primary molars were included. The cavity in one quadrant was treated conventionally using a bur, while the cavity in the other quadrant was prepared using an Er:YAG laser. Twenty restored teeth were extracted after one year. The SEM histological evaluation of bond interface results demonstrated no statistically significant differences between restorations placed following bur preparation and those placed following the Er:YAG laser preparation, and both treatments demonstrated promising results. Over a one-year period, no statistically significant differences in the bond interface quality were observed following class I cavity preparation in primary teeth with either Er:YAG laser or a conventional rotary bur.

Abstract Background Infection with the hepatitis C virus (HCV) is a worldwide health problem. HCV infection is linked to a variety of metabolic abnormalities as it interferes with lipid metabolism, causing steatosis and a wide range of adipocytokine alterations, as well as impairing glucose metabolism, resulting in a rising prevalence of insulin resistance (IR) and type 2 diabetes. Over the last few years, numerous oral anti-HCV medicines (direct-acting antivirals; DAAs) have been introduced. With DAA therapy, HCV can now be eradicated from the infected host within 12 weeks. There is a need for more research because there is minimal information on the effects of DAA therapy on metabolic profiles, lipid profiles, and adiponectin levels. Thus, the purpose of this study was to see how direct-acting antivirals (DAAs) affected metabolic profiles and serum adiponectin levels in 2 different categories of Egyptian patients with chronic hepatitis C infection. This study included 100 patients with chronic HCV who were separated into two groups. Group I consisted of 50 patients who were treated for 12 weeks with sofosbuvir, daclatasvir, and ribavirin). Group II consisted of 50 patients who were treated for 12 weeks with ombitasvir, paritaprevir, and ritonavir/ribavirin. This regimen was chosen because these patients had an eGFR of 30 ml/min. Fasting lipid profiles (total cholesterol, triglyceride, HDL, and LDL), metabolic profiles (fasting blood sugar, fasting insulin, HOMA-IR, and HbA1C), and serum adiponectin levels were measured before and after the end of treatment. Results Statistical analysis of the data showed a significant difference in the lipid profile in group I before and after treatment, as we found a significant reduction in serum triglycerides after treatment (113.2 ± 22.9 mg/dL vs 105.6 ± 23.2 mg/dL, P < 0.001) and a significant elevation of serum total cholesterol, LDL, and HDL after treatment (TC: 153.2 ± 20.1 mg/dL vs 174.1 ± 19 mg/dL, P < 0.001; LDL: 74.7 ± 9.9 mg/dL vs 93.3 ± 12 mg/dL, P < 0.001; HDL: 54.6 ± 10.1 mg/dL vs 57.2 ± 10.3 mg/dL, P 0.010). But in group II, there was no significant difference in the lipid profile before and after treatment. We also found a significant reduction in fasting insulin, HOMA-IR, and HBA1C after treatment in group I (fasting insulin: 11.4 ± 3.3 (µU/L)/ml vs 9.7 ± 2.2 (µU/L)/ml, P < 0.001; HOMA-IR: 2.7 ± 0.9 vs 2.2 ± 0.6, P < 0.001; HBA1C: 5.6 ± 0.4 vs 5.4 ± 0.3, P 0.003). But in group II, there was no significant difference in fasting insulin, HOMA-IR, and HBA1C before and after treatment. Also, we found that there were no significant changes in the serum adiponectin level in either group before or after treatment. Conclusion HCV clearance with DAAs had an impact on the lipid and metabolic profiles of the patients at the end of treatment. This could depend on the type of DAAs used in the treatment, the stage of the liver disease, and the associated conditions of patients. However, serum adiponectin levels are unaffected.

Abstract Background Biobanks have recently been established in several low- and middle-income countries (LMICs) in the Arab region of the Middle East. We aimed to explore the views of biobank managers regarding the challenges, ethical issues, and governance arrangements of their biobanks. Methods In-depth semi-structured qualitative interviews were conducted with a purposive sample of eight biobank managers from Egypt (6), Jordan (1), and Sudan (1). Interviews were performed either face-to-face, by phone, or via Zoom and lasted approximately 45–75 min. After verbal consent, interviews were recorded and then transcribed. The authors performed a thematic analysis of the transcripts independently and then integrated the themes via a consensus process. Results Biobank managers discussed the main challenges in establishing their biobanks. These included the staff’s lack of experience and training, limited funds, deficit awareness of biobanks, obtaining funding from different sources. Only four reported they were active in distributing biospecimens and health data to researchers. Six biobanks used a broad consent model, one used tiered consent, and another allowed participants to opt-out of being recontacted. Five managers avoided partnerships with pharmaceutical companies due to concerns with unfavorable reactions from the community. Five managers did not have clear policies for returning research results to the donors. Five expressed challenges with sample and data sharing with international collaborators; all five used material transfer agreements. The biobank managers revealed variable governance arrangements and activities with community involving awareness and educational efforts rather than active engagement. Several expressed the importance of transparency with the operations of their biobanks and gaining the trust of their stakeholders. Conclusion Managers of biobanks in LMICs in the Arab Middle East encounter financial, operational, and social challenges toward their sustainability efforts. Discussions with key stakeholders are warranted to manage ethical issues involving informed consent, privacy, data sharing, and the return of results. We recommend that biobank managers in the Arab Middle East form collaborative networks within the region and internationally, develop trusting governance relationships with their stakeholders, and pursue engagement activities with their communities to enhance trust.

Abstract Background COVID-19 vasculopathy is a critical condition that impacts the disease prognosis including vasculitis and thromboembolic complications. This study aimed to provide the Egyptian experience about the COVID-19 vasculopathy during the past two years of the pandemic and to collectively include the different modalities and imaging techniques for the diagnosis of cerebrovascular, pulmonary, gastrointestinal, and peripheral arterial vascular complications. Results This is a multi-center retrospective analysis of 3500 PCR-proved COVID-19 infection between March 2020 and December 2021. A cohort of 282 consecutive patients with COVID-19 vasculopathy was considered for inclusion. They included 204 males and 78 females (72:28%). The mean age was 68 years, and age ranged from 48 to 90 years. Five radiologists evaluated the different imaging examinations in consensus including computed tomography (CT), CT-angiography (CTA), CT-perfusion (CTP), magnetic resonance imaging (MRI), MR-arteriography (MRA), and MR-venography (MRV). 244/282 (86.5%) patients suffered from non-hemorrhagic cerebral ischemic infarctions. 13/282 (4.6%) patients suffered from hemorrhagic cerebral infarctions. 5/282 (1.8%) patients suffered from cerebral vasculitis. Pulmonary vascular angiopathy was detected in 10/282 (3.5%) patients, including pulmonary embolism in 10/10 patients, pulmonary infarctions in 8/10 patients, pulmonary vascular enlargement in 5/10 patients, and vascular "tree-in-bud" sign in 2/10 patients. Intestinal ischemia and small bowel obstruction were detected in 3/282 patients (1%) while GIT bleeding was encountered in 4/282 patients (1.4%). Lower limb arterial ischemia was found in 3/282 patients (1%). Additionally; 39/282 (13.8%) patients developed peripheral deep venous thrombosis (DVT) due to prolonged ICU recumbence while 28/282 (10%) patients developed jugular vein thrombosis sequel to prolonged catheterization. A p value (0.002) and (r) = 0.8 statistically proved strong significant relation between COVID-19 vasculopathy and D-dimer levels. Conclusions Multi-system vasculopathy was a serious complication of COVID-19 which impacted the patients' morbidity and mortality. An Egyptian experience about the COVID-19 vasculopathy during the past two years of the pandemic was provided. It encountered the different modalities and imaging techniques for the diagnosis of cerebrovascular, pulmonary, gastrointestinal, and peripheral arterial COVID-19 vascular complications.

Abstract Background Improvement of functional capacity and mortality reduction in post-MI patients were found to be associated with regular exercise training. The cardiac magnetic resonance (CMR) is considered the most accurate non-invasive modality in quantitative assessment of left ventricular (LV) volumes and systolic functions. Our main objective was to investigate the impact of exercise training on LV systolic functions in patients post anterior MI using CMR. 32 patients on recommended medical treatment 4 week after having a successful primary PCI for an anterior MI were recruited, between May 2018 and May 2019. They were divided into two groups, training group (TG): 16 assigned to a 12 week exercise training program and control group (CG): 16 who received medical treatment without participating in the exercise training program. Treadmill exercise using modified Bruce protocol was done to TG before and after the training program in order to record the resting and maximum HR, metabolic equivalent (MET), and calculate HR reserve. CMR was performed for all patients 4 weeks after PCI and was repeated after completion of the study period to calculate ejection fraction (EF), left ventricular end-systolic volume (LVESV), left ventricular end-diastolic volume (LVEDV), and wall motion score index (WMSI). Results 100% were males. 6 patients from CG dropped during follow-up, no statistically significant difference between the two groups regarding age, BMI, smoking status, hypertension, diabetes mellitus and dyslipidemia. Using the CMR, the TG showed significant improvement in EF (36.6 ± 14.2% to 43.1 ± 12.4%; P

In this work, a highly sensitive sensor based on silicon nitride (SiN) waveguide is proposed that can be used for gas sensing using visible light. The whole sensor waveguide uses a silicon dioxide (SiO2) cladding while the sensing arm uses a fluidic cladding such as water. The proposed device is based on loop-mirror terminated (LMT) Mach-Zehnder interferometer (MZI), where the reference arm is exposed to the reference SiO2 medium, while the sensing arm is exposed to the sensing medium leading to a change in the refractive index of the waveguide cladding. The sensor performance is overall optimized by optimizing the design performance of all the components of the structure one by one. The waveguide sensitivity of both strip and slot types is analyzed for gaseous medium in order to compare their sensitivities and select the dimensions of the waveguide that results in the highest device sensitivity. Transverse-electric (TE) polarization is considered in this study for strip waveguide, where a higher sensitivity is founded with respect to the transverse-magnetic (TM) polarization. The field confinement in the slot waveguide in the sensing region is investigated and verified with a mode solver, where the optimum dimensions are obtained using finite difference eigenmode and finite difference time domain solvers. With a sensing arm length of 150 μm only, the proposed sensor achieves a device sensitivity of about 1,320 nm/RIU and a figure-of-merit (FOM) as high as 641 RIU−1 at the wavelength of 650 nm, which is the highest reported FOM up to the author’s knowledge. Higher values of the FOM are possible by employing a longer sensing arm.

The main disadvantage of photovoltaic (PV) systems is the mismatch between load and generation profiles. To overcome this disadvantage, it is either connected to battery bank or connected to the utility grid via inverters. While the battery choice is expensive and produces contaminating elements, the grid-connected mode is the most common choice. However, the inverters represent high percentage of the system cost that affect its potential to be a competitive economic replacement for other conventional energy sources. In addition, interfacing different users to the grid using inverters increase the total harmonics distortion (THD) and reduce the power quality of the grid. Moreover, exporting surplus energy generated from PV during off-peak periods with lower tariff reduces the economic effectiveness of PV systems. This paper proposes a segmented structure of the electric thermal loads with control algorithm that can achieve the MPPT objectives with no need for inverters. Moreover, with the right selection of PV size, it is possible to be locally consumed each generated kWh of energy without the need to export any to the main grid with low tariff. The segments of the electric thermal load that satisfy the MPP condition are connected to the PV while the rest segments are connected to main grid via set of electromagnetic relays. A simulation of the proposed structure and control algorithm was performed. The results shows that accurate MPPT was achieved according to the number of load segments. To increase the accuracy, the number of load segments should be increased.

Abstract Background Due to the paucity of scientific evidence, it is unclear among pulmonologists and physicians in critical care units if and when splenomegaly in novel coronavirus disease (2019) (COVID-19) patients is worrisome. This study aims to evaluate the significance of splenic volume during COVID-19 infection with or without cytokine storm and correlates splenic volume to the volume of pathological lung changes through linear regression analysis. Results A retrospective study collected 509 polymerase chain reaction proved COVID-19 patients (399 males, 110 females; mean age 48 years, age range 24–78 years) between June and November 2021, without a history of splenic pathology. A control group of age and sex-matched 509 healthy subjects was used and analyzed according to the splenic volume. Five consulting radiologists evaluated initial and follow-up computed tomography (CT) examinations using lung CT volumetry and splenic volume calculation in consensus. Three consulting pulmonologists correlated the severity of clinical and laboratory findings, including oxygen requirements and interleukin-6 (IL-6) levels. The T test results for comparison between the COVID-19 patients and the healthy subjects control group regarding the splenic volume were significant (T value was − 4.731452 and p value was 0.00002). There was no significant correlation between the severity of the disease and normal-sized spleen (26% of patients, p = 0.916) or splenomegaly (24% of patients, p = 0.579). On the other hand, all patients with a small spleen or progressive splenomegaly during serial follow-up imaging had clinically severe disease with a statistically significant correlation (p = 0.017 and 0.003, respectively). Ninety-seven percent of patients with clinically mild disease and splenomegaly had 0–20% lung involvement (CT-severity score 1) while all patients with clinically severe disease and splenomegaly had 27–73% lung involvement (CT-severity score 2 and 3) (r = 0.305, p = 0.030). Conclusions Splenomegaly is a non-specific sign that may be found during mild and severe COVID-19 infection, it was not statistically correlated with the clinical severity and a weak positive relationship was found between the splenic size and the CT-severity score of the pathological lung volume. On the other hand, the presence of splenic atrophy or progressive splenomegaly was correlated with severe COVID-19 presentation and “cytokine storm”. Therefore, the splenic volume changes should not be overlooked in COVID-19 serial CT examinations, particularly in severe or critically ill patients with cytokine storms.

Abstract Background The importance of thymic CT-grading and presence of thymic rebound hyperplasia during COVID-19 infection were only investigated in a few studies. This multivariate study aims to evaluate the relation between thymus CT-grading and rebound during COVID-19 infection and the following: (1) the patients' age, (2) the patients' blood lymphocytic count, (3) the CT-volumetry of the diseased lung parenchyma, (4) the patient's clinical course and prognosis, and finally (5) the final radiological diagnosis. Results Multicenter retrospective analyses were conducted between March and June 2021 on 325 adult COVID-19 patients with positive PCR results and negative history of malignant or autoimmune diseases. They included 186 males and 139 females (57.2%:42.8%). Their mean age was 40.42 years ± 14.531 SD. Three consulting radiologists performed CT-grading of the thymus gland (grade 0–3) and CT-severity scoring (CT-SS) of the pathological lung changes in consensus. Two consulting pulmonologists correlated the clinical severity and blood lymphocytic count. Pearson correlation coefficient (r) and linear regression analyses were statistically utilized. Sub-involuted thymus (with CT-grade 0:2) was detected in 42/325 patients (12.9%); all of them had a mild clinical course and low CT-SS (0–1). Thymic rebound hyperplasia was the only positive CT-finding in 15/325 patients (4.6%) without pathological lung changes. A weak positive significant correlation was proved between thymic grade and patient's age, clinical course, and CT-SS (r = 0.217, 0.163, and 0.352 with p ≤ 0.0001,

Abstract Background Abnormalities of the cardiovascular system are the most common congenital diseases in the fetus and the first cause of infant mortality. Echocardiography is still the method of choice to visualize the fetal cardiac cardiovascular abnormalities, yet cardiovascular magnetic resonance (CMR) is relatively unaffected by maternal and fetal conditions such as maternal obesity, uterine myoma, twins, oligohydramnios, fetal position and rib calcification, which particularly impair sonographic visualization of the fetal heart. Fetal cardiac MR imaging is a novel MRI technique which can provide valuable information that could add to the prenatal diagnosis and evaluation of cardiac and most of extra-cardiac anomalies. In this work, we aimed to highlight the advantage of FCMRI over fetal echocardiography in assessment of fetal congenital cardiac anomalies. Results Fifty-Two fetuses with suspected or diagnosed congenital cardiac anomalies. All cases underwent detailed history taking, underwent fetal echocardiography using suitable curvilinear probe and performed according to standard protocol, then fetal cardiac MR was done with Balanced fast field echo, Black blood single shot, white blood Cine, Real-time 3D dynamic sequences, images were acquired in the transverse, four-chamber, short-axis, coronal and oblique sagittal views. Findings of fetal echocardiography were compared with that of cardiac MRI and with standard post-natal echocardiography. Prenatal Echo and fetal cardiac MRI showed significant moderate agreement between the two modalities in the detection of different congenital cardiac anomalies, Kappa test: 0.500; p value 0.021. Fetal MRI had a significant role in detection of extra cardiac anomalies in most cases. Comparing to gold standard post-natal echo. Accuracy of fetal CMRI is 95.5% and of fetal Echo is 86.4% regarding overall cardiac anomalies: Conclusion Fetal cardiac MR imaging as an adjunct to fetal echocardiography may provide valuable information that could add to the prenatal diagnosis and evaluation of cardiac and most of extra cardiac anomalies.

The congestion problem has driven many researchers to address it, among other networking issues. In a packet-switched network, congestion is essential; it leads to a high response time to deliver packets due to heavy traffic, which eventually causes packet loss. Hence, congestion control mechanisms are utilized to prevent such cases. Several interesting algorithms are proposed to focus on this dilemma, such as the Self-Clocked Rate Adaptation for Multimedia (SCReAM) designed for interactive real-time video streaming applications. One of the main issues of SCReAM is the high design complexity due to the large size of its documentation and coding. Furthermore, there is a considerable number of parameters that can be adjusted to accomplish the desired performance. This study proposes a guided parameters’ tuning approach to assess and optimize the SCReAM algorithm in an emulated 5G environment through a detailed exploration of its parameters. The proposed approach consists of three phases, namely, the initialization phase, the standalone experimentation phase, and the hybrid experimentation phase. In the first phase, we illustrate the method of initializing and implementing the environment, followed by specifying the investigated parameters’ settings, testing, and validation. The second phase aims to investigate SCReAM parameters in isolation to identify the effect on the performance in relation to network queue delay, smoothed Round Trip Time (sRTT), and throughput. The final phase discusses the possibility of achieving the optimum performance by combining various sets to provide researchers with clear and explicit guidelines to establish an adequate SCReAM behavior for the desired application. To the best of our knowledge, this is the first study that proposes a preliminary and comprehensive analysis of the SCReAM algorithm. Based on the proposed approach, when L4S/ECN is disabled, we reduced the network queue delay by 63.36% and increased the network throughput by 48.6% as compared to the results generated by the original design. In L4S/ECN-enabled mode, the network queue delay is reduced by 16.17% while the network throughput increased by 93%.

In the present investigation, the phenolic compounds of Solanum elaeagnifolium were identified, and the plant’s anti-lipase and anti-glycation effects on hemoglobin were discovered through in vitro experiments, as well as its short-term antihyperglycemic and anti-inflammatory effects. The chemical compound composition was detected using HPLC-DAD, the anti-lipase activity was tested in vitro using 4-nitrophenyl butyrate as a substrate, and the antiglycation activity of the plant extracts was also tested in vitro using a haemoglobin model. The antihyperglycemic effect was determined by inhibiting pancreatic α-amylase and α-glycosidase activity and performing an in vivo glucose tolerance test on normal rats, and the anti-inflammatory activity was determined by inducing paw inflammation with carrageenan. In both the SEFR (fruit) and SEFE (leaf) extracts, chromatographic analysis revealed the presence of quercetin 3-O-β-D-glucoside, rutin, and quercetin. SEFR inhibited the pancreatic lipase enzyme more effectively, with an IC50 of 0.106 ± 0.00 mg/mL. S. elaeagnifolium extracts demonstrated significant antiglycation activity, with 3.990 ± 0.23 mg/mL of SEFE and 3.997 ± 0.14 mg/mL of SEFR. When compared to positive and negative controls, plant extracts had very significant anti-diabetic and anti-inflammatory effects. The findings in this study and previous research on this plant encourage us to investigate other pharmacological activities of this plant besides its duiretic, cictrisant, and anti-ulcer activity.

The combination of radio-frequency (RF) communication and underwater optical wireless communication (UOWC) plays a vital role in the underwater Internet of Things (UIoT). This correspondence proposes a dual-hop hybrid satellite underwater system that exploits non-orthogonal multiple access (NOMA) as a spectrum-efficient access technique. The RF link from the satellite to the relay on an oil platform is presumptively subject to a Shadowed-Rician (SR) fading, while the UOWC channels from the relay to the underwater destinations are suggested to follow Exponential-Generalized Gamma (EGG) distributions. The reliability of the system is characterized in terms of both underwater destinations and system outage probabilities (OPs). We derive new closed-form expressions for the OPs under imperfect successive interference cancellation (SIC) conditions. Furthermore, the asymptotic OP and the diversity order (DO) are obtained to learn more about the system’s performance. The results are verified through an extensive representative Monte-Carlo simulation. Also, we investigate the performance against the turbulence of the salty water, air bubbles level (BL), temperature gradients (TG), shadowing parameters, and satellite pointing errors due to satellite motion, even if the beam is pointed at the center of the directive antenna relay, the beam will randomly oscillate. Finally, we contrast our approach with the conventional orthogonal multiple access (OMA) scheme to demonstrate its superiority.

Background: Multisystem inflammatory syndrome in children (MIS-C) is a post-viral complication that has been described among children after 2–6 weeks of exposure to the COVID-19 virus from various parts of the world. However, published literature regarding MIS-C from the United Arab Emirates (UAE) is limited. The aim of this study was to investigate the demographic details, clinical, radiological and laboratory findings, disease management, and clinical outcomes of a larger group of patients from UAE presenting with features of MIS-C. Subjects and Methods: This hospital-based retrospective observational study was conducted among children between the age of 1 month and 12 years, hospitalized in the pediatric intensive care unit of a tertiary care hospital in Sharjah, from September 2020 to October 2021. Results: Our study population belonged to various nationalities from the Middle East, South Asia, and Africa. The median interquartile range age of our patient population was 7.5 (4–10) years. All the study participants presented with fever lasting for a mean duration of 5.17 days. About 93.33% and 83.33% of the patients presented with gastrointestinal and cardiovascular symptoms, respectively. MIS-C overlapping with Kawasaki disease was the most common phenotype. All the patients received intravenous immunoglobulin and steroids. There was only one death in our study cohort. Conclusions: Although our patient population belonged to mixed ethnicity most characteristics of our MIS-C patients were very similar to that of other cohorts in terms of clinical, laboratory features, and response to treatment.

Abstract Background Corticosteroids are usually prescribed for severe cases with SARS-CoV-2 (COVID-19). Despite their importance to decrease patients’ mortality, they can cause serious side effects like fulminant fungal infection that can damage lungs or invade the sinuses then rapidly spread to the orbit and even intra-cranially. Unless early diagnosed and properly managed, patients can lose their vision or die from cavernous sinus thrombosis or other intracranial complications. Case presentation A 71-year-old diabetic male patient presented with dry cough, fever, and dyspnea for 6 days. PCR test for COVID-19 was ordered and declared positive. The oxygen saturation on day 7 started to decline to reach 90%. Eight ampules of intra-muscular dexamethasone were prescribed. The patient’s dyspnea improved, and the oxygen saturation reached 94% by day 13. Oral prednisone was prescribed in a withdrawal protocol. Unfortunately, on day 15, the patient complained of mild left-sided cheek swelling and noticeably dropped left angle of mouth. Neurological consultation suspected facial palsy and asked for brain MRI examination. Limited lower cuts of the MRI study that covered the left maxillary antrum revealed mild fullness of the pre-maxillary fat planes with mucosal thickening. Complimentary dedicated MRI and CT cuts over the left maxillary sinus showed localized signs of invasive fungal sinusitis without orbital or intracranial complications. The patient received antifungal therapy even before evident endoscopic findings appeared. He underwent endoscopic debridement few days after and he had an excellent outcome without any progression or significant morbidities. Conclusion Early CT/MRI radiological signs of invasive fungal sinusitis that complicated COVID-19 infection aid in the diagnosis and proper timely management of this fatal disease.

Background: Ovarian masses are late symptomatic so early detection and characterization of the ovarian neoplasm is very important for adequate therapeutic procedure, this starts from the physical examination to the imaging technique and laboratory investigations. MRI show high contrast resolution so MRI gives proper detection and differentiation of benign and malignant ovarian masses by the utility of different sequences like conventional MRI imaging, To obtain anatomical data and study the different signal intensities of the ovarian lesions T1 and T2 sequences are needed, T1 SPIR to assess the hemorrhagic and fatty areas, MRI with Gadolinium enhance the MRI ability to differentiate between benign and malignant ovarian masses, tumor staging and follow up.Diffusion-weighted imaging and proton MRI spectroscopy are a functional MRI sequences increase MRI sensitivity and specificity in diagnosis of ovarian lesions. Conclusion: MRI is considered solving problem imaging modality in early determine the site and characterize the ovarian masses, also it is helpful at ovarian tumor staging.