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In the field of medicine, diagnosing diseases involves various steps, procedures, and protocols. Histopathological examination remains the gold standard for a definitive and accurate diagnosis. This process relies on an initial step of tissue fixation.Formaldehyde is a traditional fixative material and is typically used as 10% or 4% buffered solutions. However, significant health risks are associated with formaldehyde exposure.Our paper aimed to evaluate and compare variable media as a preservative agent. The study included eight groups as follows: (1) normal saline 0.9%; (2) local anesthesia with epinephrine (2% Lidocaine HCl/ 1:100,000 epi); (3) local anesthesia without epinephrine (3% Mepivacaine HCl/ plain); (4) distilled water; (5) Saliva collected from healthy male participants; (6) Milk (Almarai- full-fat fresh milk); (7) Propolis; and (8) l0% formalin. Three tissue samples from each group were fixed in 10% formalin for 24 h after being preserved for 6 h at ambient temperature in their respective media. All specimens were stained with Hematoxylin and Eosin.The following histological structures were assessed: (1) superficial 1/3 of the epithelium, (2) middle 1/3 of the epithelium, (3) lower 1/3 of the epithelium, (4) basement membrane/rete ridges, (5) fibrous connective tissue, (6) blood vessels/endothelial cells, (7) skeletal muscle, (8) adipose tissue, and (9) nerve bundles. A numerical rating system was employed to assess these components, with scores ranging from 1 to 4.Our findings suggest propolis has promising potential as a tissue fixative. This study highlighted the effectiveness of propolis as a preservative and fixative solution, which warrants further investigation.

Each individual possesses a unique signature that is primarily employed to verify personal identity and authenticate legally binding documents or facilitate significant transactions, a method commonly utilized for verifying their identity. The utilization of this technology is restricted to the authentication of biometric recognition in a range of financial, legal, banking, insurance, and various other business documents. Techniques for recognizing signatures are employed to determine the specific user associated with a particular signature. In recent years, a significant number of researchers have focused on the implementation of novel approaches in this area, with a notable increase in the prevalence of deep learning techniques. To enhance the understanding of the evolution of offline handwritten signature recognition among researchers, this manuscript adopts a structured methodology to categorize this research, drawing primarily from studies found in set major databases. This study assesses methodologies for offline handwritten signature recognition by implementing predetermined inclusion and exclusion criteria. It explores various aspects, such as feature extraction and challenges in classification. In recent years, there have been noticeable advances and new developments. The paper accentuates the dominance of deep learning research directions in this specific domain. Differing from existing surveys, this paper does not confine itself to a particular research phase but meticulously outlines each stage, aspiring to guide future researchers in their investigations.

Introduction: Human papillomavirus (HPV) has been implicated in several studies pertaining to oral squamous cell carcinoma (OSCC) in the last several decades. Infection with human papillomavirus (HPV), particularly HPV16 and 18, is the leading cause of squamous cell carcinoma of the neck (SCCHN). Methodology: We selected an adequate number of subjects with the same parameters for both the case and the controls based on detailed case histories, specifically taking into account the adverse habits (tobacco in any form and alcohol) that each subject had recorded. The subjects were selected from the Outdoor Patient Department of Kothiwal Dental College and Research Centre. Before commencing the experimental procedure, all the subjects had undergone blood examinations (HB%, CT, BT, RBS, HBsAg, HIV). Group 1 consisted of 40 subjects, whereas Group 2 had 20 subjects. Result: Human papillomaviruses (HPVs) play an important role in oral cancer, and this research demonstrated a substantial link between HPV-16 and HPV-18 and the disease. Although this research does not allow us to draw any conclusions about cause and effect, our results are consistent with and even expand upon those of previous case–control studies. The presence of HPV causes molecular damage in cells, thereby resulting in cell proliferation and malignant conversions. Therefore, we can conclude that the human papillomavirus significantly contributes to carcinogenesis. Conclusion: Although the current results are based on a limited sample, they provide strong evidence that a larger study of individuals with head and neck cancer is necessary to make firm conclusions.

Pearl millet [Pennisetum glaucum (L.) R. Br.] is a subtropical grain and forage crop. It is privileged with several desirable forage attributes. Nevertheless, research on pearl millet is limited, especially as a forage crop, in developing countries. Therefore, the objectives of this study were to investigate the field performance and stability of pearl millet genotypes for forage yield across seven environments. The study was conducted in seven environments (combination of locations and seasons) during the 2016/2017–2018/2019 seasons. Twenty-five pearl millet genotypes, selected based on forage yield from a core collection of 200 accessions, were arranged in an alpha lattice design with three replications. The parameters measured were fresh forage yield, days to flowering, plant height, number of culms m−2, leaf-to-stem ratio, and stem girth. The combined analysis revealed that environments, genotypes, and their interaction had significant effects on all traits studied except the genotypic effect on stem girth. Across the seven environments, four genotypes (G14, G01, G12, and G22) outyielded the check genotype in fresh matter yield by 20.7, 16.5, 11.0 and 9.8%, respectively. The additive main effects and multiplicative interaction (AMMI) analysis showed that the genotype, environment, and their interaction were highly significant (p ≤ 0.001) for fresh matter yield. The results of AMMI stability values (ASVs) and the genotype selection index (GSI) combined with the AMMI estimate-based selection showed that genotypes G14, G22 and G01 were the most stable and adapted genotypes and were superior to the check genotype. These results indicate that forage pearl millet varieties could be developed directly through evaluating the wealth of available collections or indirectly through hybridization in crop breeding programs.

Background: Teleconsultations have gained prominence as a viable method for delivering medical services remotely. In oral radiology, the ability to interpret radiographic images accurately is crucial for diagnosing and treating various dental conditions. The use of teleconsultations in this domain holds promise for extending specialized care to patients who are geographically distant from dental healthcare facilities. Materials and Methods: A total of 50 patients' oral radiographic images were collected for analysis in this study. These images were obtained from diverse geographical locations, showcasing the applicability of teleconsultations. Two groups of dental professionals, one conducting in-person evaluations and the other performing remote interpretations through teleconsultations, participated in the study. The radiographic findings were assessed for concurrence between the two groups. Statistical analysis included the calculation of P values to determine the level of agreement between the in-person and teleconsultation interpretations. Results: The results of this study revealed a substantial level of agreement between in-person and teleconsultation interpretations of oral radiographic images. The calculated P values indicated a statistically significant concordance between the two evaluation methods (P < .05). This suggests that teleconsultations can be a reliable approach for oral radiology interpretation, offering comparable results to traditional in-person evaluations. Conclusion: In conclusion, teleconsultations have demonstrated their potential as an effective means of interpreting oral radiographic images remotely.

Abstract Background Variable results have been reported regarding the clinical outcomes in Total hip arthroplasty (THA) based on the surgical approach. The aim of this study is to compare the clinical outcomes between Direct anterior (DA) and direct lateral (DL) approaches in THA when performed immediately after fellowship training. Methods During the 1st year of practice, all consecutive patients who underwent THA via DA and DL hip approaches were retrospectively investigated. Patients’demographics, diagnosis, American society of Anesthesiology (ASA) score, route of anesthesia, length of hospital stay (LOS), leg length discrepancy (LLD), radiographic parameters, operative time, number of opioids refills postoperatively, and complications were collected and compared between the two groups. The short form of Hip Disability and Osteoarthritis Outcome score, Joint Replacement (HOOS, JR) was prospectively collected pre and postoperatively. The minimum follow-up period was 2 years. Results Forty patients in DA group and 38 patients in DL group were included. No statistically significant difference was found between the two groups in terms of demographics, diagnosis, ASA scores, route of anesthesia at the time of THA, postoperative radiographic parameters, LOS, LLD, opioid refills and HOOS scores (p > 0.05). Patients in the DA group had shorter operative time (83 ± 17 min) when compared to the DL group (93 ± 24 min) (p = 0.03). No major complications were found except for one early deep infection patient in DL group. Conclusion Both DA and DL approaches resulted in satisfactory outcomes in THA when performed by a fellowship trained surgeon.

The thermal and photochemical stabilities of colloidal quantum-dot (QD) nanophosphors incorporated into a blue microLED matrix by spin-cast deposition were investigated in this study. The optical characteristics of QDs-based color-converted microLEDs were also investigated in this study. The measurements performed in this work suggest the ultimate limit of QD performance in microLED devices. The findings from the stability evaluations encourage and motivate the employment of red, green QD color converters in blue microLED matrices to create full-color microLED devices. Such studies will be helpful in the design and the fabrication of high-efficiency and high-performance micro-LED microdisplay panels

Regarding applied, facile, green chemical research, a bio-inspired approach is being reported for the sonochemical synthesis of Ag nanoparticles by Aloe vera gel extract as a natural reducing/stabilising and solid support agent without using any toxic and harmful reagent. The biosynthesized Ag NPs/A. vera gel bionanocomposite was characterised by advanced physicochemical techniques like ultraviolet-visible (UV–Vis), Scanning Electron Microscopy (SEM), Transmission Electron Microscopy (TEM), Energy Dispersive X-ray spectroscopy (EDX), X-ray photoelectron spectroscopy (XPS), X-ray Diffraction (XRD) and elemental mapping study. It has been established that Aloe vera gel-stabilized silver nanoparticles have a spherical shape with a mean diameter of around 35–40 nm. To investigate the antioxidant potentials of Ag NPs/A. vera gel, one of the common antioxidant techniques i.e. DPPH was used. The results of DPPH test proved the excellent antioxidant properties of Ag NPs/A. vera gel in comparison to the positive control used i.e. butylated hydroxytoluene. The IC50 of Ag NPs/A. vera gel was 42 µg/mL in the antioxidant test. Thereafter, on having a significant IC50 value in radical scavenging assay, we extended the bio-application of the desired nanocomposite in the anticancer study. To survey the cytotoxicity and anti-human cervical carcinoma effects of Ag NPs/A. vera gel, MTT assay was used on CC1-PI19, SiHa, HeLa and HNCF-PI52 cell lines. The IC50 of the Ag NPs/A. vera gel was 16, 13, 15 and 11 µg/mL against CC1-PI19, SiHa, HeLa and HNCF-PI52 cell lines, respectively. As mentioned, the Ag NPs/A. vera gel had significant antioxidant and anti-human cervical cancer effects. After approving the above results in the clinical trial studies, the Ag NPs/A. vera gel can be used as a chemotherapeutic drug for the treatment of several types of cervical cancers. According to the above results, the significant anti-cervical cancer effects of Ag NPs/A. vera gel are confirmed.

Tariq Siddiqui,1 Mohammad Asim,2 Khalid Ahmed,1 Saji Mathradikkal,1 Zeenat Bakhsh,1 Maarij Masood,1 Ammar Al-Hassani,1 Syed Nabir,3 Nadeem Ahmed,3 Gustav Strandvik,1 Ayman El-Menyar,2,4 Hassan Al-Thani1 1Trauma Surgery Section, Hamad General Hospital (HGH), Doha, Qatar; 2Clinical Research, Trauma & Vascular Surgery, Hamad General Hospital, Doha, Qatar; 3Radiology Department, Hamad General Hospital, Doha, Qatar; 4Clinical Medicine, Weill Cornell Medical College, Doha, QatarCorrespondence: Ayman El-Menyar, Trauma & Vascular Surgery Section, Hamad Medical Corporation & Weill Cornell Medical College, PO Box 3050, Doha, Qatar, Tel +97444396130, Email aymanco65@yahoo.comBackground: We sought to evaluate the clinical characteristics and risk factors for early versus late pulmonary embolism (PE) in trauma patients.Methods: This was a retrospective analysis of injured patients who presented with a confirmed PE between 2013 and 2019. Data were analysed and compared for patients with early PE (≤ 4 days) versus late PE (> 4 days post-trauma).Results: The study included 82 consecutive trauma patients with confirmed diagnosis of PE. The mean age of patients was 42.3 ± 16.2 years. The majority were males (79.3%) and the median time from injury to PE was 10 days. Of the PE cases, 24 (29.3%) had early PE, while 58 (70.7%) had late PE. The early PE group had higher rates of surgical intervention within 24 hours of admission than the late PE group (p = 0.001). Also, the rate of sub-segmental thrombi was significantly higher in the early PE group (p = 0.01). The late PE group sustained more moderate-to-severe injuries ie, GCS ED < 13 (p = 0.03) and the median time from injury to PE diagnosis was 15 days (p = 0.001). After adjusting for the potential covariates, surgery within 24 hours of admission [adjusted odds ratio 37.58 (95% confidence interval 3.393– 416.20), p = 0.003] was found to be significant independent predictor of early PE in trauma patients.Conclusion: One-third of post-trauma PEs occurs early after trauma and the surgical intervention within the first 24 hours of admission is a major risk factor. A prospective study is needed to develop an objective risk assessment for the prevention and detection of early and late PE post-trauma.Keywords: pulmonary embolism, trauma, timing, risk factors, outcomes

Reducing the seismic risk for societies requires a bridge between scientific knowledge and societal actions. In recent years, three subjects that facilitate this connection gained growing importance: open science, transdisciplinarity, and ethics. We outline their relevance in general and specifically at the example of `'dynamic seismic risk' as explored in a dedicated workshop. We argue that these reflections can be transferred to other research fields for improving their practical and societal relevance. We provide recommendations for scientists at all levels to make science more open, transdisciplinary, and ethical. Only with a transition can we, as scientists, address current societal challenges and increase societies' resilience to disasters.

The field of image processing has been revolutionized by Convolutional Neural Networks (CNNs), which exhibit exceptional capability in feature extraction and accurate image classification. However, training CNNs requires large volumes of annotated data and significant computational resources. Considering these challenges, transfer learning has emerged as a promising approach to reducing the dependence on labeled data and computational resources. Transfer learning involves utilizing knowledge gained from a source task to improve the training process for a target task. This technique has demonstrated considerable benefits; however, it also possesses certain limitations. Consequently, this survey explores the advantages and constraints of transfer learning and the various factors that influence its effectiveness in optimizing image processing using CNNs. Additionally, the survey investigates the most recent advancements and research in the field of transfer learning specifically for image processing with CNNs. In summary, this comprehensive analysis highlights the significance of transfer learning in the context of optimizing image processing with CNNs, providing unique insights into this rapidly evolving domain.

Muhammad Asim,1 Mohammed Akhtar2 1Division of Nephrology, Department of Medicine, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar; 2Department of Laboratory Medicine and Pathology, Hamad General Hospital, Hamad Medical Corporation, Doha, QatarCorrespondence: Muhammad Asim, Division of Nephrology, Department of Medicine, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar, Tel +97455838342, Email masim@hamad.qaAbstract: Anti-glomerular basement membrane (anti-GBM) disease is a rare but serious autoimmune disease, which is characterized by the development of pathogenic antibodies to type IV collagen antigens in the glomerular and alveolar basement membranes. This results in rapidly progressive glomerulonephritis (GN), alveolar hemorrhage, or both. A variety of environmental factors can trigger the disease in genetically predisposed patients. Temporal associations with influenza, SARS-CoV-2 infection, and COVID-19 vaccination have been described although there is insufficient evidence to suggest causality. Anti-GBM disease accounts for approximately 20% of the cases of rapidly progressive GN cases secondary to crescentic GN, but is an uncommon cause of end-stage kidney disease. Early diagnosis by detection of circulating antibodies, increased awareness of atypical as well as complex clinical variants of the disease, and combined therapy with immunosuppression and plasma exchange has improved the prognosis of patients with this potentially fatal disease. Progress has been hampered by the rarity of anti-GBM disease, but new agents and therapeutic regimens are emerging.Keywords: antibody, glomerulonephritis, rapidly progressive glomerulonephritis, plasma exchange, IdeS, rituximab

Objectives: Alopecia areata (AA) is a multifactorial autoimmune disease with a strong genetic predisposition. A variety of genes involved in immunity and inflammatory responses, such as cytokines, are suspected to increase the risk of developing AA. In which, different interleukin (IL) genes that associated with several autoimmune diseases and AA in varied populations. The objective of this study was to investigate the possible genetic association of AA with ten variants of single nucleotide polymorphism (SNP) in IL12B, IL13, IL16, IL17A, and IL18 genes among Jordanian patients. Methods: In this case-control study, peripheral blood samples of 152 Jordanian AA patients and 150 controls (total of 302 subjects) were collected, genomic DNA extracted and genotyped, based on which their allele and genotype frequencies were assessed. Results:In the rs11073001 SNP located in the exon region of the IL16 gene, the A allele was distributed more frequently in AA patients (p = 0.01). A difference was found between the patients and the controls for the rs17875491 SNP in the promoter region of the IL16 gene (p = 0.04). The mean age of onset was 27.3±12.6 with male predominance. Most patients (68.4%) were asymptomatic but some reported experiencing associated sensations before the hair loss episodes. The patchy patterns of alopecia were the most common (90.3%). Nail changes were found in 7.3% of the patients. Conclusions: The findings support the hypothesis of the involvement of IL16 gene in the etiology of AA. Moreover, it emphasizes the variations in the genetic component of AA, as well as the clinical phenotypes among different ethnic groups.

Abstract Background While pre-existing cardiovascular disease (CVD) appears to be associated with poor outcomes in patients with Coronavirus Disease 2019 (COVID-19), data on patients with CVD and concomitant cancer is limited. The purpose of this study is to evaluate the effect of underlying CVD and CVD risk factors with cancer history on in-hospital mortality in those with COVID-19. Methods Data from symptomatic adults hospitalized with COVID-19 at 86 hospitals in the US enrolled in the American Heart Association’s COVID-19 CVD Registry was analyzed. The primary exposure was cancer history. The primary outcome was in-hospital death. Multivariable logistic regression models were adjusted for demographics, CVD risk factors, and CVD. Interaction between history of cancer with concomitant CVD and CVD risk factors were tested. Results Among 8222 patients, 892 (10.8%) had a history of cancer and 1501 (18.3%) died. Cancer history had significant interaction with CVD risk factors of age, body mass index (BMI), and smoking history, but not underlying CVD itself. History of cancer was significantly associated with increased in-hospital death (among average age and BMI patients, adjusted odds ratio [aOR] = 3.60, 95% confidence interval [CI]: 2.07–6.24; p

Hassan Al-Thani,1 Husham Abdelrahman,2 Ali Barah,3 Mohammad Asim,4 Ayman El-Menyar4,5 1Department of Surgery, Trauma&Vascular Surgery, Hamad General Hospital, Doha, Qatar; 2Department of Surgery, Trauma Surgery, Hamad General Hospital, Doha, Qatar; 3Department of Radiology, Hamad General Hospital, Doha, Qatar; 4Department of Surgery, Clinical Research, Trauma & Vascular Surgery, Hamad General Hospital, Doha, Qatar; 5Department of Clinical Medicine, Weill Cornell Medical School, Doha, QatarCorrespondence: Ayman El-MenyarClinical Research, Trauma &vascular Surgery, Hamad General Hospital, Doha, QatarTel +974 44394029Email aymanco65@yahoo.comBackground: Massive bleeding is a major preventable cause of early death in trauma. It often requires surgical and/or endovascular intervention. We aimed to describe the utilization of angioembolization in patients with abdominal and pelvic traumatic bleeding at a level 1 trauma center.Methods: We conducted a retrospective analysis for all trauma patients who underwent angioembolization post-traumatic bleeding between January 2012 and April 2018. Patients’ data and details of injuries, angiography procedures and outcomes were extracted from the Qatar national trauma registry.Results: A total of 175 trauma patients underwent angioembolization during the study period (103 for solid organ injury, 51 for pelvic injury and 21 for other injuries). The majority were young males. The main cause of injury was blunt trauma in 95.4% of the patients. The most common indication of angioembolization was evident active bleeding on the initial CT scan (contrast pool or blushes). Blood transfusion was needed in two-third of patients. The hepatic injury cases had higher ISS, higher shock index and more blood transfusion. Absorbable particles (Gelfoam) were the most commonly used embolic material. The overall technical and clinical success rate was 93.7% and 95%, respectively, with low rebleeding and complication rates. The hospital and ICU length of stay were 13 and 6 days, respectively. The median injury to intervention time was 320 min while hospital arrival to intervention time was 274 min. The median follow-up time was 215 days. The overall cohort mortality was 15%.Conclusion: Angioembolization is an effective intervention to stop bleeding and support nonoperative management for both solid organ injuries and pelvic trauma. It has a high success rate with a careful selection and proper implementation.Keywords: angioembolization, trauma, injury, bleeding, pelvic, solid organ

Munzir Obaid,1 Ayman El-Menyar,2,3 Mohammad Asim,2 Hassan Al-Thani1 1Department of Surgery, Hamad General Hospital (HGH), Doha, Qatar; 2Department of Surgery, Clinical Research, Trauma and Vascular Surgery Section, HGH, Doha, Qatar; 3Department of Clinical Medicine, Weill Cornell Medical School, Doha, QatarCorrespondence: Ayman El-MenyarWeill Cornell Medical College, Consultant Clinical Research, Trauma Surgery, Hamad General Hospital, Doha, QatarTel +974 44394029Fax +974 44394031Email aymanco65@yahoo.comBackground: We aimed to study the prevalence and outcomes of thrombophilia in acute pulmonary embolism.Methods: A retrospective observational study was conducted to include patients with a radiologically confirmed diagnosis of PE screened for thrombophilia from May 2011 to February 2015. Data included patients’ demographics; clinical presentation, risk factors, laboratory investigations, management, and outcome were analyzed and compared in patients with and without thrombophilia.Results: A total of 227 cases of PE were included in the study, of which 108 (47.6%) had thrombophilia. The most frequent coagulopathic abnormality included deficiency of protein S, protein C, and antithrombin III and hyperhomocysteinemia. Only seven out of 79 patients were found to have factor V Leiden. PE patients diagnosed with thrombophilia were 10 years younger in age and peaked in the age range 30– 39 years. Prior history of DVT (p=0.001) and PE (p=0.001) were the main significant risk factors in the thrombophilia group. The frequency of different risk categories of clinical probability scores did not differ significantly among those with and without thrombophilia. Pulmonary hypertension was a common complication in the thrombophilia group (P=0.009). Medications used included warfarin (74.7%), enoxaparin (73.9%), and heparin (55.4%). The overall mortality rate was 8.4%, and was non-significantly higher in the non-thrombophilia group.Conclusion: Deficiencies of protein S, protein C, and antithrombin III are the leading causes of thrombophilic defects. Patients with hereditary thrombophilia are at increased risk of acute PE, particularly among young individuals. Therefore, early detection of thrombophilic defects together with other unprovoked risk factors could reduce the risk of recurrent VTE.Keywords: pulmonary embolism, thrombophilia, risk factors, thromboembolism, outcome

Introduction: Attitude, Ethics and Communication modules (AETCOM) for undergraduate medical students have been suggested by the Indian Medical Council (2015) in the new curriculum based on competencies. There is a need to assess the attitude of students towards communication skills training modules. Communication Skills Assessment Scale (CSAS) is an accepted tool for it. Aim: To assess the attitude of first year medical undergraduate students towards communication skills learning programme. Materials and Methods: The present cross-sectional study was conducted in Department of Physiology at Government Medical College, Aurangabad, Maharashtra, India, in the third week of November 2016. Total 60 students from first year undergraduate (MBBS) course were included in the study. The CSAS questionnaire has 26 items using five-point Likert scale with 13 positive and 13 negative statements about communication skills training labelled as Positive Assessment Scale (PAS) and Negative Assessment Scale (NAS). The scores were compared for gender groups and English medium and vernacular medium group by Independent two-tailed student’s t-test. Results: Sixty students (34 females and 26 males) were present with mean age of 18.4±0.8 years. Overall, PAS was 53.5±7.8, and NAS was 32.2±6.1. Among 26 males, PAS was 52±10.7, and among 34 females it was 54.7±4.4 (p-value=0.18). NAS in males was 34.2±6.3, whereas, in females, it was 30.7±5.6 (p-value=0.026). Conclusion: The findings indicate the acceptability of communication skills training among first year MBBS students. There is a need to utilise these positive perception among students and train them to become competent doctors with the desired communication skills.

Alopecia areata (AA) is a common non-scarring hair loss disease of defined patterns with varied patches size and body sites. The etiology of AA has a complex basis of autoimmunity, environment, and genetic variations. The latter factor is found to play a crucial role in AA risk. Thus, this study aimed to investigate the potential impact of specific immune-related gene polymorphisms among a cohort of Jordanian patients, which was previously reported in other populations. Blood samples of AA patients and control subjects were collected for genomic DNA (gDNA) extraction. Targeted single nucleotide polymorphisms (SNPs) of MASP2, TLR1, CTLA4, and C11orf30 were genotyped in duplicate using the Sequenom MassARRAY® system (iPLEX GOLD). Genotype and allele analysis reveals statistical differences in TLR1 rs4833095 (allele C, P = 0.044), MASP2 rs2273346 (genotype AA, P = 0.0026), and C11orf30 rs2155219 (genotype GG, P = 0.0069) distribution. These findings present the significant contribution of genetic variations in AA susceptibility in the Jordanian population, which is infrequently studied.

Methane hydrate applications in gas storage and desalination have attracted increasing attention in recent years. In the present work, the effect of isopentane (IP), sodium dodecyl sulfate (SDS), and IP/SDS blends as promoters on methane hydrate formation kinetics, in terms of the pressure–temperature (P-T) profile, gas uptake, hydrate induction time (HIT), and water-to-hydrate conversion ratio (WHCR), were studied for distilled water and seawater samples with an IP/water sample ratio of 3:10 (by volume) and an SDS/water sample ratio of 1:1000 (by mass). Each solution was tested in a stirred tank at 600 rpm at a temperature and pressure of 2 °C and 5.2–5.3 MPa. In the case of methane hydrate formation in distilled water, the highest WHCR attained was 9.97% without additives, and 45.71% and 72.28% for SDS and isopentane additives, respectively. However, when using seawater at a salinity of 3.9%, the highest WHCR attained was 2.26% without additives and 9.89% and 18.03% for SDS and IP promoters, respectively, indicating the inhibiting effect of salinity on hydrate formation. However, the HIT was longer for seawater hydrate formation, with an average of 13.1 min compared to 9.90 min for methane hydrate formation. Isopentane enhances the HIT for methane hydrate formation in seawater by 2.23 times compared to SDS. For methane hydrate formation in seawater, the presence of IP shortened the HIT by 15.6 min compared to the seawater sample without promoters. Additionally, a synergistic effect was observed when IP and SDS were combined and used in methane hydrate formation in distilled water and seawater systems. The positive effect of IP on methane hydrate formation is possibly due to the binary hydrate formation mechanism, which improves the hydrate formation thermodynamic and kinetic parameters.

Background Critical limb ischemia (CLI) is considered the most severe stage of peripheral artery disease. Patients with CLI typically have the disease affecting multiple levels (i.e. aortoiliac, femoropopliteal, and infrapopliteal). CLI due to isolated infrapopliteal arterial disease is commonly seen in patients with long-standing diabetes mellitus, chronic kidney disease, or the elderly. Endovascular treatment of infrapopliteal arteries has been considered a primary approach for revascularization in CLI. Objective The aim of this study was to evaluate the efficacy of percutaneous transluminal angioplasty (PTA) for isolated infrapopliteal arterial occlusive disease in diabetic patients with CLI. Patients and methods This prospective study included 20 diabetic patients with CLI in 28 limbs due to isolated infrapopliteal arterial occlusive disease who underwent infrapopliteal PTA between January 2017 and January 2019 in Mataria Teaching Hospital, Cairo, Egypt. Results The study was conducted on 20 diabetic patients, 12 (60%) men and eight (40%) women. Their age ranged between 54 and 76 years with a mean age of 65 years. Successful recanalization was achieved in 23 (82.1%) limbs. Reintervention was needed in five (17.9%) limbs and it was successful in four limbs. The follow-up period ranged from 6 to 18 months with the mean overall follow-up being 12.5 months. The primary patency rate and secondary patency rate were, respectively, 78.3 and 80% at 1 year. The limb salvage rates after 1 year were 75%. Mortality rate after 1 year was 10%. Conclusion PTA is effective and the preferred procedure for revascularization and limb salvage in diabetic patients with CLI due to isolated infrapopliteal arterial occlusive disease.

Fungiform papillae are raised lingual structures which contain taste buds and thus play an important role in taste perception. These structures vary in number due to their relative sensitivity to a range of systemic and local factors which affect the dorsum of the tongue. Taste sensation can be measured using both chemical and electrical methods; however, the number of fungiform papillae has a direct effect on chemogustometric and electrogustometric values during evaluation. This review provides a general overview of fungiform papillae, their quantification methods and the various factors which may affect these structures. In addition, numerous methods of recording taste sensation and their clinical applications are highlighted. Keywords: Sensation; Taste; Taste Perception; Tongue; Taste Buds; Investigative Techniques.

Background: Fixation of biopsy specimens is a critical step before processing and staining them for histological tissue examination. Formalin is considered the gold standard fixative solution for its attributes. However, it has concerning side effects, such as carcinogenic and potential irritational properties. Owing to its various harmful effects, a safer natural substitute should be explored. In this study, we compared the effectiveness of propolis to 10% formalin and determined its ability as a natural fixative solution. Materials and Methods: Sixty tissue specimens were collected from goats’ tongues and immediately placed in (1) 6.6% propolis, (2) 10% natural buffered formalin (positive control), (3) 6.6% propolis followed by 10% formalin, and (4) 0.9% saline (negative control). Tissue samples were fixed at different time points (12, 24, 48, and 72 h) at room temperature, followed by processing and staining. The quality of the microscopic parameters was blindly assessed by two oral and maxillofacial pathologists using a numerical scoring scale. Scores were statistically analyzed. Results: The fixation of tissue samples placed in 6.6% propolis was statistically significantly better than that of samples placed in 10% formalin and 0.9% saline at different time points. Conclusion: Propolis showed promising fixation properties and can be considered a natural alternative to 10% formalin.

Background Public health emergencies may significantly impact emergency medical services responses to cardiovascular emergencies. We compared emergency medical services responses to out‐of‐hospital cardiac arrest (OHCA) and ST‐segment‒elevation myocardial infarction (STEMI) during the 2020 COVID‐19 pandemic to 2018 to 2019 and evaluated the impact of California's March 19, 2020 stay‐at‐home order. Methods and Results We conducted a population‐based cross‐sectional study using Los Angeles County emergency medical services registry data for adult patients with paramedic provider impression (PI) of OHCA or STEMI from February through May in 2018 to 2020. After March 19, 2020, weekly counts for PI‐OHCA were higher (173 versus 135; incidence rate ratios, 1.28; 95% CI, 1.19‒1.37; P

Ion implantation-fabrication of gap-free III-nitride micro-light emitting diode (μLED) arrays has been analyzed along with its impacts on micro-LED electrical and optical characteristics. The implanted ions were designed to block the current between the adjacent pixels in the micro-LED array for gap-free isolation. Electrical simulation suggests that the crosstalk current among the pixels depends on three key parameters, i.e., ion energy, ion dose, and the width of the isolation barrier. The ion implantation parameters used in the simulation were chosen from previous published reports to provide some insights of the follow up experimental study of this work. The electrical crosstalk can be reduced by the increase in the impurity concentration in the isolation barriers, which introduces more deep level traps that impede the lateral current low between the pixels in the array. The optical simulation results show that the gap-free configuration of the pixelated micro-LEDs also suppresses the light crosstalk caused by the wave-guide effect substantially. Studying the electrical and optical crosstalk performance of gap-free micro-LED arrays could pave the way for developing LED-based microdisplay panels with ultra-small pitch dimensions and low crosstalk noises, both of which are essential for high display resolutions.

Background In the initial treatment of deep venous thrombosis (DVT), enoxaparin is administered twice daily. A once-daily treatment regimen is more convenient for the patients and may optimize home treatment. However, it is not clear whether a once-daily treatment regimen is as safe and effective as a twice-daily treatment regimen. Purpose Our objective is to assess and compare the efficacy (in terms of recurrent venous thromboembolism) and safety (i.e. major hemorrhagic events) of once-daily versus twice-daily administration of enoxaparin for the initial treatment of DVT. Patients and methods A case–control study was conducted. We studied the efficacy and safety of an enoxaparin regimen, 1.5 mg/kg once daily, as a bridge to warfarin for the treatment of acute DVT. We undertook a case–control design. We enrolled 40 acute DVT cases prospectively and matched them by age, sex, and location of venous thromboembolism to 40 previously treated controls. Only hospitalized patients were enrolled; no outpatients were studied. All controls had received enoxaparin 1 mg/kg twice daily. We followed the cases for 30 days. We discontinued enoxaparin after we achieved the target international normalized ratio between 2.0 and 3.0. Results One (2.5%) case and two (5%) controls had recurrent venous thromboembolic events. There were no major bleeding complications in the case group, compared with one (2.5%) in the control group. Conclusion Once-daily enoxaparin, 1.5 mg/kg, as a bridge to warfarin is as effective with a similar safety profile as twice-daily enoxaparin, 1 mg/kg, for initial treatment of acute DVT. Results showed no statistically significant differences between the two treatment regimens.

Hassan Al-Thani,1 Moamena El-Matbouly,1 Maryam Al-Sulaiti,1 Mohammad Asim,2 Ahmad Majzoub,1 Abdelhakem Tabeb,1 Ayman El-Menyar2,3 1Department of Surgery, Hamad General Hospital, Doha, Qatar; 2Clinical Research, Trauma & Vascular Surgery, Hamad General Hospital, Doha, Qatar; 3Clinical Medicine, Weill Cornell Medical College, Doha, Qatar Background: Hyperparathyroidism is a frequent endocrine disorder with variable clinical manifestations and outcomes. We aimed to evaluate clinical presentations, management and outcomes of hyperparathyroidism.Methods: A retrospective study was conducted to include all patients presented with hyperparathyroidism between 1995 and 2014 at a single tertiary hospital with an average follow-up period of 46 months. Data were reviewed for clinical presentations, diagnostic work-up, intraoperative findings, management, and outcomes.Result: We identified 161 patients with hyperparathyroidism; 69% were females and the mean age was 49.4±15 years. Patients presented mainly with musculoskeletal (65.8%), renal (37.3%), gastrointestinal tract (53.8%) and neuropsychiatric (8.8%) manifestations. At presentation, mean serum calcium and parathyroid hormone levels were elevated while mean vitamin D level was lower. Sestamibi-99mTc (MIBI) scintigraphy was done for 134 patients (83.2%) and was positive in 94 (70%). Primary hyperparathyroidism (67.7%) was the most frequent diagnosis followed by secondary (29.8%) and tertiary hyperparathyroidism (2.5%). The frequent indication for surgery was hypercalcemia (67.3%), bone disease (35.6%) and renal calculi (28.9%). The main postoperative pathology was parathyroid adenoma (63.1%) followed by hyperplasia (37.3%). Fourteen (8.9%) and 18 (11.4%) patients had persistent and recurrent hyperparathyroidism, respectively. Autotransplantation of parathyroid tissue was done in 36 cases.Conclusion: Primary hyperparathyroidism is the most frequent cause of the parathyroid disease. Parathyroidectomy is the effective surgical approach in symptomatic patients. Further studies are needed to establish the association between vitamin D levels, renal disorders and persistent or recurrent hyperparathyroidism. Keywords: hyperparathyroidism, parathyroidectomy, renal disorders, Qatar

This paper studies the global existence and uniqueness of classicalsolutions for a generalized quasilinear parabolic equation withappropriate initial and mixed boundary conditions. Under somepracticable regularity criteria on diffusion item and nonlinearity, weestablish the local existence and uniqueness of classical solutionsbased on a contraction mapping. This local solution can be continuedfor all positive time by employing the methods of energy estimates, $ L^{p} $-theory, and Schauder estimate of linear parabolic equations. Astraightforward application of global existence result of classical solutions to a density-dependent diffusion model of in vitroglioblastoma growth is also presented.

This study was designed to investigate the effect of prenatal exposure to synthetic sex steroid on sperm quantity and quality, relative testicular and epididymal weights, and reproductive hormones level in adult Wistar rats. Forty male Wistar rats were divided into two groups: a test group (n = 20) that included mature rats that were born to dams exposed to gestational treatment with hydroxyprogesterone and a control group (n = 20) that included mature rats born to untreated dams. Compared to the control group, the test group showed a significant reduction in the sperm count, viability and motility, relative testicular and epididymal weights together with increased abnormal spermatozoa (p

Objective: The aim of this study was to assess the oral dryness in postmenopausal women and to correlate the salivary flow rate determined by sialometry with the clinical oral dryness score (CODS) obtained from Challacombe Scale. To correlate between subjective and objective oral dryness and relationship of salivary flow rate with that of the duration of menopause. Materials and Methods: Sixty postmenopausal women were questioned regarding their oral dryness status and the duration of menopause. Patients complaining of xerostomia formed the case group and rest formed the control group. CODS was assessed based on the 10 features of oral dryness. Unstimulated whole salivary (UWS) flow rate was assessed by sialometry for 5 min. Results: Highly significant negative correlation was observed between UWS and CODS (r = −0.651), low negative correlation was noted between the duration of menopause and UWS flow rates (r = −0.159), and no significant correlation was found between subjective oral dryness with that of UWS flow rates (P = 0.0964). There was no statistically significant difference between case and control group with regard to CODS (P = 0.525). Conclusion: A good correlation of CODS with sialometry scores indicates that CODS can be utilized for semiquantitative assessment of oral dryness. It appears that UWS has poor correlation with duration of menopause. Xerostomia and UWS were not significantly related.

The output of fuzzification process, a fuzzy data, is unsuitable for real time applications and needs to be converted into a crisp value. The process of defuzzification is very important and has a significant impact on the overall performance of a fuzzy inference system. This paper proposesa VLSI architectureof a mean max membership (MMM) defuzzification method.The MMM of defuzzification is simple and is being generally used in comparison to more complex centre of gravity defuzzification method. The proposed architectureis modeled in very high speed hardware description language (VHDL) and implemented in Vertex-4 field programmable gate array (FPGA).The functional analysis has revealed that the proposed architecture is implementing MMM based defuzzifier accurately.

The simple abstract we can talk about in this project is about the idea of information security has became very important thing in our life, so we can not depend only on data or information encryption but hiding it too which is called (Steganography).So it is a method in which we hide an information inside an other so the real information or data can not be seen. The information we want to hide in this project is a text message to be hidden in a picture which is a BMP (Bit Map) format which is simple. We will use the programming language (Visual Basic) to do this job, Hiding a text message in a picture needs on the other hand getting the image back from the picture so the program will contain this operation too.The data of the BMP picture will be replaced by the hidden text message so it may cause distortion in that place therefore the message must be distributed all over the picture so the distortion would be reduced. In the future we can hide another type of data inside another type of carrier (out world data) such as hiding text inside a voice file.

The distraction osteogenesis (DO) technique has been used worldwide to treat many orthopaedic conditions. Although successful, absent or delayed callus formation in the distraction gap can lead to significant morbidities. An alternate cycle of distraction-compression (accordion maneuver) is one approach to accelerate bone regeneration. The primary aim of our study is to report our experience with the accordion maneuver during DO and to provide a detailed description of this technique, as performed in our center. The secondary aim is to present a review of the literature regarding the use of accordion maneuver. We reviewed the database of all patients undergoing limb lengthening from the year of 1997 to 2012. Four patients (6.15%) out of 65 showed poor bone regenerate in their tibiae and therefore accordion maneuver was applied for a mean of 6.75 weeks. Of these, three patients have had successful outcome with this technique. The literature showed that this technique is successful approach to trigger bone healing. However, details of how and when to apply this combination of distraction-compression forces were lacking. In conclusion, the accordion technique is safe noninvasive approach to promote bone formation, thus avoiding more invasive surgical procedures in cases of poor callus formation in limb lengthening.

Distraction osteogenesis (DO) is a surgical technique where gradual and controlled separation of two bony fragments following an osteotomy leads to the induction of new bone formation in the distracted gap. DO is used for limb lengthening, correction of bony deformities and the replacement of bone loss secondary to infection, trauma and tumors. Although DO gives satisfactory results in most cases, one major drawback of this technique is the prolonged period of time the external fixator has to be kept on until the newly formed bone consolidates thus leading to numerous complications. Numerous attempts at accelerating bone formation during DO have been reported. One specific approach is manipulation of the mechanical environment during DO by applying changes in the standard protocol of distraction. Attempts at changing this mechanical environment led to mixed results. Increasing the rate or applying acute distraction, led to poor bone formation in the distracted zone. On the other hand, the addition of compressive forces (such as weight bearing, alternating distraction with compression or by over-lengthening and then shortening) has been reported to increase bone formation. It still remains unclear why these alterations may lead to changes in bone formation. While the cellular and molecular changes occurring during the standard DO protocol, specifically increased expression of transforming growth factor-β1, platelet derived growth factor, insulin-like growth factor, basic fibroblast growth factor, vascular endothelial growth factor, and bone morphogenic proteins have been extensively investigated, the literature is sparse on the changes occurring when this protocol is altered. It is the purpose of this article to review the pertinent literature on the changes in the expression of various proteins and molecules as a result of changes in the mechanical loading technique in DO and try to define potential future research directions.

The aim of this study is to systematically review the literature with regards to surgical treatment of patients with hip joint osteochondromas, and to report our surgical management of three paediatric patients who had femoral neck or acetabular osteochondromas in association with acetabular dysplasia. We performed a systematic review using PubMed and Embase databases for all studies that reported surgical treatments for patients with peritrochanteric or acetabular osteochondroma with or without acetabular dysplasia. We also retrospectively reviewed three patients who were diagnosed with a hip osteochondroma in association with actetabular dysplasia. These patients were known to have hereditary multiple exostoses (HME). The systematic review revealed 21 studies that met our inclusion criteria. All studies were case reports and retrospective in nature and failed to conclude a uniform treatment plan. The three reported cases illustrate successful excision of hip osteochondromas and treatment of acetabular dysplasia. Early excision of hip osteochondromas might prevent acetabular dysplasia in HME patients. Routine radiographic pelvic survey at the time of diagnosis of HME is recommended for early detection of hip osteochondromas and acetabular dysplasia in these children.

Deep venous thrombosis (DVT) is a significant source of morbidity in orthopaedic surgery. It can progress to a pulmonary embolism, a significant source of mortality. Up to date, patients with Achilles tendon rupture routinely do not receive DVT chemical prophylaxis. We are presenting a case of fatal pulmonary embolism after a surgically treated Achilles tendon rupture in a forty-two-year-old male healthy patient. In the current body of the literature, the reported incidence of DVT after Achilles tendon rupture is highly variable ranging from less than 1% to 34%, and there is a disagreement in the international guidelines regarding the need of chemical DVT prophylaxis with this type of injury. Further research needs to be conducted to investigate the risks and benefits of chemical DVT prophylaxis following Achilles tendon rupture. For low-risk patients, the use of milder forms of prophylaxis such as aspirin should also be explored.

Transcatheter aortic valve replacement (TAVR) is increasingly offered for aortic stenosis (AS) treatment in patients with a history of cancer. The impact of frailty on outcomes in this specific patient population is not well described.Frailty is associated with mortality and poorer quality of life (QOL) outcomes in patients undergoing TAVR with a history of cancer.This retrospective single center cohort study included AS patients who underwent TAVR from August 1, 2012 to May 15, 2020. Frailty was measured using serum albumin, hemoglobin, gait speed, functional dependence, and cognitive impairment. The primary outcome was a composite of all-cause mortality and QOL at 1 year. A poor primary outcome was defined as either all-cause mortality, Kansas City Cardiomyopathy Questionnaire overall summary (KCCQ-OS) score

Vascular cell adhesion molecule-1 (VCAM-1) is upregulated in ischemia reperfusion injury (IRI), persisting after restoration of blood flow. We hypothesized that microparticles of iron oxide targeting VCAM-1 (VCAM-MPIO) would depict "ischemic memory" and enable in vivo assessment of VCAM-1 expression.Mice subject to unilateral, transient (30 minutes) renal ischemia and subsequent reperfusion received intravenous VCAM-MPIO (4.5 mg iron/kg body weight). Contrast agent bound rapidly (

While pre-existing cardiovascular disease (CVD) appears to be associated with poor outcomes in patients with Coronavirus Disease 2019 (COVID-19), data on patients with CVD and concomitant cancer is limited. The purpose of this study is to evaluate the effect of underlying CVD and CVD risk factors with cancer history on in-hospital mortality in those with COVID-19.Data from symptomatic adults hospitalized with COVID-19 at 86 hospitals in the US enrolled in the American Heart Association's COVID-19 CVD Registry was analyzed. The primary exposure was cancer history. The primary outcome was in-hospital death. Multivariable logistic regression models were adjusted for demographics, CVD risk factors, and CVD. Interaction between history of cancer with concomitant CVD and CVD risk factors were tested.Among 8222 patients, 892 (10.8%) had a history of cancer and 1501 (18.3%) died. Cancer history had significant interaction with CVD risk factors of age, body mass index (BMI), and smoking history, but not underlying CVD itself. History of cancer was significantly associated with increased in-hospital death (among average age and BMI patients, adjusted odds ratio [aOR] = 3.60, 95% confidence interval [CI]: 2.07-6.24; p

BackgroundWe sought to investigate the trajectory of cardiac catheterizations for acute coronary syndrome (ACS) and out-of-hospital cardiac arrest (OHCA) during the pre-isolation (PI), strict-isolation (SI), and relaxed-isolation (RI) periods of the coronavirus disease 2019 (COVID-19) pandemic at three hospitals in Los Angeles, CA, USA.MethodsA retrospective analysis was conducted on adult patients undergoing urgent or emergent cardiac catheterization for suspected ACS or OHCA between January 1, 2020 and June 2, 2020 at three hospitals in Los Angeles, CA, USA. We designated January 1, 2020 to March 17, 2020 as the PI COVID-19 period, March 18, 2020 to May 5, 2020 as the SI COVID-19 period, and May 6, 2020 to June 2, 2020 as the RI COVID-19 period.ResultsFrom PI to SI, there was a significant reduction in mean weekly cases of catheterizations for non-ST elevation myocardial infarction/unstable angina (NSTEMI/UA) (8.29 vs. 12.5, P = 0.019), with all other clinical categories trending downwards. From SI to RI, mean weekly cases of catheterizations for total ACS increased by 17%, NSTEMI/UA increased by 27%, and OHCA increased by 32%, demonstrating a "rebound effect".ConclusionsCardiac catheterizations for ACS and NSTEMI/UA exhibited a "rebound effect" once social isolation was relaxed.

With increasing use of prosthetic valves to treat degenerative valvular heart disease (VHD) in an aging population, the incidence and adverse consequences of paravalvular leaks (PVL) are better recognized. The present work aims to provide a cohesive review of the available literature in order to better guide the evaluation and management of PVL.Despite gains in operator experience and design innovation, significant PVL remains a significant complication that may present with congestive heart failure and/or hemolytic anemia. To date, clear consensus or guidelines on the evaluation and management of PVL remain lacking. Although the evolution of transcatheter valve therapies has had a tremendous impact on the management of patients with VHD, the limitations and complications of such techniques, including PVL, present further challenges. Incidence of PVL, graded as moderate or greater, ranges from 4 to 7.4% in surgical and transcatheter valve replacements, respectively. Improved imaging modalities and the advent of novel surgical and percutaneous therapies have undoubtedly yielded a better understanding of PVL including its anatomical location, mechanism, severity, and treatment options. Echocardiography, used in conjunction with cardiac computed tomography and cardiac magnetic resonance, provides essential details for diagnosis and management of PVL. Transcatheter intervention has become a favored approach in lieu of surgical intervention in select patients after previous surgical or percutaneous valve replacement. PVL treatment with vascular plugs, balloon post-dilation, and the valve-in-valve methods have shown technical success with promising clinical outcomes in appropriately selected patients.

Coronavirus disease 2019 (COVID-19) is a viral pandemic precipitated by the severe acute respiratory syndrome coronavirus 2. Since previous reports suggested that viral entry into cells may involve angiotensin converting enzyme 2, there has been growing concern that angiotensin converting enzyme inhibitor (ACEI) and angiotensin II receptor blocker (ARB) use may exacerbate the disease severity. In this retrospective, single-center US study of adult patients diagnosed with COVID-19, we evaluated the association of ACEI/ARB use with hospital admission. Secondary outcomes included: ICU admission, mechanical ventilation, length of hospital stay, use of inotropes, and all-cause mortality. Propensity score matching was performed to account for potential confounders. Among 590 unmatched patients diagnosed with COVID-19, 78 patients were receiving ACEI/ARB (median age 63 years and 59.7% male) and 512 patients were non-users (median age 42 years and 47.1% male). In the propensity matched population, multivariate logistic regression analysis adjusting for age, gender and comorbidities demonstrated that ACEI/ARB use was not associated with hospital admission (OR 1.2, 95%CI 0.5 to 2.7, p = 0.652). CAD and CKD/end stage renal disease [ESRD] remained independently associated with admission to hospital. All-cause mortality, ICU stay, need for ventilation, and inotrope use was not significantly different between the 2 study groups. In conclusion, among patients who were diagnosed with COVID-19, ACEI/ARB use was not associated with increased risk of hospital admission.