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Mohamed Laban,1 Eman A Ibrahim,2 Alaa S Hassanin,3 Magda A Nasreldin,4 Amal Mansour,5 Waleed M Khalaf,3 Ahmed M Bahaa Eldin,3 Sherif H Hussain,3 Mohammed S Elsafty,1 Ahmad S Hasanien6 1Gynecologic Oncology Unit, Obstetrics and Gynecology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt; 2Pathology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt; 3Obstetrics and Gynecology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt; 4Pathology Department, Early Cancer Detection Unit of Ain Shams Maternity Hospital, Faculty of Medicine, Ain Shams University, Cairo, Egypt; 5Biochemistry and Molecular Biology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt; 6Family Medicine Department, Royal Australian College of General Practitioners, Sydney, Australia Background: The aim of this study was to evaluate the association of Chlamydia trachomatis (CT) infection with primary tubal and high-grade serous ovarian cancers. Methods: This is a cross-sectional, retrospective study conducted at Ain Shams University Maternity Hospital, Egypt, from February 2008 to October 2017. Sixty-seven paraffin archival blocks specimens were retrieved from cases who underwent staging laparotomy due to high-grade serous ovarian cancer (30 cases), primary tubal serous cancer (25 cases), and control specimens of (12) tubal specimens from cases of benign gynecological conditions. All samples were examined for CT DNA using semiquantitative qRT-PCR. Results: CT DNA was detected in 84% of high-grade tubal serous cancer, 16.7% of high-grade serous ovarian cancer, and 13.3% in controls (P

OBJECTIVE: The use of scoring systems contributes to the faster identification of septic patients, especially those at a high risk of a fatal outcome. The best scoring system does not exist, so the search for the optimal one is always current. The aim of this study is to estimate the prognostic value of the six scoring systems in predicting 24-hour mortality among septic patients presented at the emergency department. PATIENTS AND METHODS: An observational retrospective study was conducted in the Emergency Triage Room (ETR) of the Emergency Center (EC) at the University Clinical Center of Serbia (UCCS) in Belgrade. Consecutive septic patients, according to the Sepsis-3 definition, with or without shock, presented to the ETR and then hospitalized in Intensive Care Units were included in the study. Mortality data within 24 h and on the 28th day were extracted from the Hospital information system or the National mortality database. Scoring systems including sequential organ failure assessment (SOFA), quick sequential organ failure assessment (qSOFA), systemic inflammatory response syndrome (SIRS), National early warning score (NEWS), sepsis patient evaluation in the emergency department (SPEED), and mortality in emergency department sepsis (MEDS) were analyzed for all patients utilizing the available data. The primary outcome of this study was death within 24 hours of triage. Receiver operating characteristic (ROC) analysis was used to determine the most effective scoring system. Lactate was then added to this system to enhance its predictive accuracy. RESULTS: Nineteen out of 120 patients included in the study (15.8%) experienced death within 24 hours of triage. The twenty-eight-day mortality rate was 55%. SOFA score demonstrated the highest predictive value for 24-hour mortality but was only moderately predictive overall, with an area under the receiver operating curve (AUC) of 0.755 (95% CI 0.625-0.885). SPEED, MEDS, and NEVS exhibited modest discriminatory power [0.673 (95% CI 0.543-0.803), 0.665 (95% CI 0.536-0.794), 0.630 (95% CI 0.528- 0.724)], while SIRS and qSOFA remained insignificant in predicting 24-hour mortality. The predictive value of the SOFA score was increased by the addition of lactate (AUC 0.865, 95% CI 0.736-0.995; p=0.0081). All scores demonstrated better and satisfactory predictive power for 28-day mortality. CONCLUSIONS: SOFA, with the addition of lactate, is a complex but reliable tool for the early stratification of septic patients who are presenting at an emergency department. [ABSTRACT FROM AUTHOR]

BackgroundUtilization of diabetic care services remains a challenge among adult patients in low- and middle-income countries. Optimal utilization of diabetic care services could reduce morbidity and mortality and delay the development of long-term complications. This study assessed the utilization of basic diabetic care services and associated factors among diabetes mellitus patients at Mbarara Regional Referral Hospital in Western Uganda.MethodsWe enrolled 208 patients with either type 1 or 2 diabetes mellitus in a cross-sectional study between June and August 2022 at Mbarara Regional Referral Hospital, Uganda. Consecutive sampling was used to select patients with diabetes mellitus who attended the diabetes clinic based on their scheduled date of appointment. Optimal utilization of basic diabetic services was defined as receiving at least three of the four core services: health education, assessment of vital signs (blood sugar, blood pressure, and body mass index), assessment of diabetic complications, and diabetic drug refills. Modified Poisson regression analysis was used to assess the determinants of utilization of basic diabetic services in STATA version 14.0.ResultsThree-quarters of the study participants were female patients (75.0%), and the median (inter-quartile range, IQR) age was 52 (43, 56). Moreover, 62.0% [95% confidence interval (CI): 55.3–68.7] self-reported to have utilized basic diabetic care services. In the adjusted analysis, waiting longer than 120 min to receive any service [adjusted prevalence ratio (aPR) 0.46, 95% CI 0.27–0.80), being 45–54 years old (aPR 1.48, 95% CI:1.11–1.98), and being 55–60 years old (aPR, 1.38, 95% CI: 1.02 1.86)] were significantly associated with the utilization of basic diabetic care services.ConclusionUtilization of basic diabetic care services among adult patients remains sub-optimal. Age and waiting time were significantly associated with the utilization of diabetic care services. Interventions should be directed toward shortening the waiting time in service delivery at diabetes clinics.

The meetings industry is one of the fastest developing segments of the tourism market and inevitable component of performances achieved on the destination level. The Covid-19 crisis has transformed the way this industry operates, leading to new ways of holding meetings. The aim of the paper is to analyze the effect of the Covid-19 pandemic on meetings' industry performances of the Republic of Serbia, as well as its post-covid recovery in this country. The results of the analysis showed a decrease in the meetings held in pandemic years, but also a recovery in 2022. Results also showed that holding virtual meetings became the new normal. Moreover, online meetings were the foundation for developing novel approaches for the new future of the meetings industry and special event management.

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.paerosci.2004.08.001 Byline: N. Qin (a), A. Vavalle (b), A. Le Moigne (a), M. Laban (c), K. Hackett (b), P. Weinerfelt (d) Abstract: In this paper, we present a progressive aerodynamic study of a blended wing body (BWB) configuration within a European project, MOB (A computational design engine incorporating multi-disciplinary design and optimisation for blended wing body configuration). The paper starts with an overview of various blended wing body aircraft design projects in relation to their aerodynamic behaviour. After a theoretical assessment of the ideal aerodynamic performance for the baseline configuration, viscous flow simulations were carried out to investigate the aerodynamic performance of the baseline design. The effects of spanwise distribution on the BWB aircraft aerodynamic efficiency were studied through an inverse twist design approach, combining both a low-fidelity panel method and a high-fidelity Reynolds-averaged Navier-Stokes solution method. Following the inverse design studies, the BWB wing was mapped to an aerofoil optimisation problem and the optimised aerofoil was projected back to the BWB wing to investigate further performance improvement. Finally, three-dimensional aerodynamic surface optimisation of the BWB is carried out based on both continuous and discrete adjoint approaches. A progressive improvement of the aerodynamic performance is demonstrated for the given BWB planform and the design cruise condition. Author Affiliation: (a) Department of Mechanical Engineering, University of Sheffield, Sheffield S1 3JD, UK (b) Future Systems Technology, QinetiQ Ltd., Bedford MK44 2FQ, UK (c) National Aerospace Laboratory, NLR, The Netherlands (d) Future Products, SAAB Aerospace, SE-581 88 Linkoping, Sweden

Aircraft parameter identification techniques have become accepted as indispensable tools in the evaluation of prototype- and derivative aircraft in flight. Applications include estimation of stability- and control derivatives in the linearized equations of motion, synthesis of nonlinear aerodynamic and propulsion models in the context of performance certification and incorporation of information from dynamic flight test manoeuvres in a priori nonlinear flight simulation models. A variety of techniques in the time- as well as the frequency domain have been applied in the past. One of the successful techniques is the so-called two-step method (TSM) in which the original state-parameter estimation problem is decomposed into a nonlinear state/parameter estimation or reconstruction problem and a subsequent linear parameter identification problem. In the literature, the first step of the TSM is often referred to as 'flight path reconstruction'. The present paper focuses on the first step of the TSM. After a derivation of the system models describing the flight path relative to a flat earth as well as a spherical and rotating earth, and observation models for air data and GPS, the flight path reconstruction problem is introduced. Requirements with respect to type and quality of flight test transducers are discussed. Next follows an overview of different approaches to the solution of the flight path reconstruction problem with emphasis on Kalman filter/smoother and Maximum Likelihood methods. A new adaptive algorithm is presented, the Modified Recursive Maximum Likelihood Adaptive Filter (MRML) which is shown to be significantly more robust with respect to initialisation errors than earlier methods. A reconstructibility analysis is presented for different transducer combinations. Numerical examples are presented based on simulated as well as actual flight test data. Flight results are given of the flight path reconstruction part of an on-line pseudo real-time application of the TSM. The paper ends with concluding remarks.

Abstract Poor and unreliable knowledge of the status of freshwater fisheries limits their inclusion in governance processes, thereby impeding effective management measures. This threatens the livelihoods of people, particularly in developing countries. Improved knowledge is required to draw the attention of policymakers and stimulate effective management measures to accelerate the sustainability of the freshwater fisheries. In line with this requirement, this paper provides the state of knowledge of the aquatic ecosystem and fisheries of the Lake Edward system, East Africa, focusing on lakes Edward, George and the Kazinga channel. The state of knowledge was accomplished by reviewing existing data and information on aspects of primary productivity and water quality, invertebrates, fish fauna, fish life history and ecology, and fisheries. The waterbodies have been monitored since the 1930s, albeit sporadically, providing data on all the above aspects but with substantial temporal gaps. Adequate and updated data and information exist on the water quality status of the water bodies, extant aquatic taxa (including fishes) and fish catches but with uncertainties in the latter. Data and information gaps exist on the abundance of biotic communities, fish life history, quantitative trophic ecology and fisheries management reference points. The aggregated data and information can directly support decisions for fisheries management. We recommend regular monitoring to fill the data and information gaps, more comprehensive stock assessments and the development of aquatic ecosystem models.

During the COVID-19 pandemic, many patients were completely recovered, and about 30% of patients had prolonged symptoms, independent from the severity of their clinical picture of the COVID-19. There is no correlation between severe acute COVID and severe post-COVID syndrome. According to the NICE 2020 recommendations, the term long COVID includes symptomatic COVID-19 (period 4-12 weeks after acute disease) and post-COVID-19 syndrome. According to the WHO post-COVID-19 syndrome is a condition in persons with a history of probable or confirmed COVID infection, usually 3 months from the onset of COVID-19, with symptoms lasting at least 2 months, that cannot be explained by an alternative diagnosis. Intolerance to physical exertion, experiencing breathing difficulty and neuropsychiatric disorders are the most common and the longest lasting difficulties. Most common respiratory post-COVID manifestation is persistent dyspnea, while persistent pulmonary fibrosis was extremely rare. In almost half of patients who have had severe COVID pneumonias, there was no absolute correlation between pulmonary function disorders and thoracic CT images, and disorders kept persisting after complete radiographic regression. Dominant manifestation of these disorders is reduced lung diffusion capacity for CO (TLCOc, KCOc), while spirometry values are mostly normal. Pulmonary thromboembolism, myocarditis, anxiety-depressive disorder, forgetfulness and hair loss are some of the serious post-COVID complications. A significant number of patients need physical rehabilitation.

Abstract Inland fisheries support the livelihoods of millions of people in riparian communities worldwide but are influenced by increasing climate variability and change. Freshwater fishing societies are among the most vulnerable to climate change given their dependence on highly threatened aquatic resources. As climate change intensifies, building adaptive capacity within communities and understanding the efficacy of adaptive strategies for maintaining household stability is essential for coping with ongoing social and environmental change. In this study, we examined household perceptions of climate change, livelihood impacts and responses to socio‐ecological changes in fishing‐dependent households in the Lake Victoria basin in Uganda, East Africa. Through a series of household surveys and focus group discussions in five fish landing sites, we assessed social adaptive capacity (SAC) based on 207 households and identified adaptive strategies that are effective for coping with climatic change. We found that people in fishing households are aware of environmental change but that most households do not have adaptive strategies that are efficacious for securing long‐term income and food security. We also investigated household demographics that contribute to SAC, examined links between SAC and adaptive efficacy and established potential routes towards developing effective adaptive approaches in small‐scale fisheries. This work contributes to a growing foundation of documented community‐based knowledge for building adaptive capacity in inland fisheries and the communities around the world that depend on them. Read the free Plain Language Summary for this article on the Journal blog.

Due to the increasing use of immunosuppressants, particularly biological therapy, as well as HIV epidemics, latent tuberculosis (LTBI) is being activated, and this disease, which had been rather forgotten in the Western world, is becoming a topical issue in the recent years. Numerous categories of patients should be tested for latent tuberculosis, using PPD or IGRA tests. Interpreting test results is a very touchy issue, since it is the way to determine therapy of latent TB, that is, to decide on chemoprophylaxis. For the last two years, during the Covid-19 pandemics, large percentage of patients received high doses of corticosteroid and other types of immunosuppressant therapies, and it is therefore necessary to consider the potential risks for these patients, in terms of contracting tuberculosis and perhaps testing them for LTBI.

Effective conservation requires reliable data and information on the status of biodiversity. The conservation of freshwater biodiversity lags behind terrestrial and marine biodiversity because data and information limitations are greatest in freshwater ecosystems. Given that freshwater ecosystems are inhabited by disproportionately more species than other ecosystems, paucity of data and information threatens many species and dependent ecosystem services. Data and information on freshwater biodiversity is limited mainly because few freshwater ecosystems are considered for regular monitoring. However, even existing data is scattered and in non-user-friendly formats, limiting accessibility and use. It is desirable to make freshwater biodiversity data and information accessible everywhere so that it attains its full potential in guiding conservation. To increase accessibility to freshwater biodiversity data in Uganda, we present 34 datasets covering three major freshwater taxa: zooplankton, macroinvertebrates, and fish within freshwater ecosystems in the country. The datasets provide occurrence records and corresponding abundance data where applicable for the three major groups. The datasets which are available through the Global Biodiversity Information Facility (GBIF) cover a long period from 1971-2021 and have a total of 56,104 occurrence records. Of these records, 8,674 records were published in 2022. The data were mobilized from primary biodiversity surveys conducted by scientists at the National Fisheries Resources Research Institute (NaFIRRI) in Uganda. The surveys covered most of the water bodies in the country. The datasets are envisaged to increase accessibility to data for freshwater conservation research, decision making and capacity building. The data has already found use in development of conservation tools and conservation status assessments.

Rural tourism in Serbia and its development has positive effects on all aspects of rural development, both economic and social. The aim of this paperwork is to investigate the importance that touristic cooperatives in rural areas of Serbia, although relatively new in this area, have and can have on the overall development of rural areas. For the purpose of the research, an interview was conducted with the directors of the existing tourist cooperatives in Serbia. Based on the obtained data, it was determined that this form of cooperative association is necessary, not only because of the development of tourism in the countryside, but above all because of the survival of the Serbian village. The obtained data on the problems and limiting factors that cooperative members face in business can be a further basis for future research on the topic of rural development through the establishment and strengthening of tourist cooperatives.

The durability of concrete infrastructure is related to the properties of the applied concrete and the effects of the aggressive external environment on it. When concrete is directly exposed to soft water, the leaching of calcium ions from hardened cement or cement-based pastes occurs, causing reduction in strength and further deterioration of the concrete structure. This paper presents the experimental results of soft water attack effects on phase composition and compressive strength of blended cement pastes, when cement is replaced with 0, 10, 20 and 30% of natural zeolite. In order to simulate soft water attack in laboratory conditions, paste specimens were exposed to leaching in deionised water up to 180 days. The evaluation of the changes in phase composition (ettringite, portlandite, calcium silicate hydrate gel) due to calcium ion leaching was made based on X-ray diffraction analysis, Fourier-transform infrared spectroscopy and paste compressive strength tests. The presence of portlandite and ettringite after 180 days of exposure to deionised water indicates that leaching did not influence the stability of the hydration products in blended cement pastes. Moreover, blended cement paste with 10% of natural zeolite had a higher compressive strength than the reference one.

This paper aims at reviewing the basic properties of fresh-state extrusion-based three-dimensional (3D) printed concrete in order to explain the specific properties of this construction technology. The review was conducted using the bottom-up approach. The most recent literature in the field of extrusion-based concrete printing was used as a starting point, while additional papers were included through screening the references of relevant papers. Based on the inclusion criteria, review and experimental papers containing data on fresh-state 3D printed concrete properties were included, as well as materials used for 3D printing, since their properties directly affect the fresh-state properties of concrete mixture. Papers concerning data only on hardened properties were excluded. Reviewed properties are: technological properties (pump ability and flow ability) and printability properties(extrudability, print quality and buildability).

Since the beginning of the COVID-19 pandemic, many articles have been published on the subject of organising surgical activity in such conditions. The object of this article is to present the published literature in order to provide key suggestions for dealing with acute surgical problems during the pandemic. A systematic overview is presented of the most relevant articles dealing with COVID-19 and surgery, published between December 30th 2019 and April 30th 2020. The operating room is reserved solely for emergency and oncological procedures. The use of laparoscopy in COVID-19 positive patients should be assessed very carefully and critically because the virus is present in the pneumoperitoneum and its release through aerosol into the operating room can present a risk of contamination for the staff and the immediate environment. The possibility of delaying surgical procedures during the COVID-19 pandemic should be considered, until such time when the patient is no longer considered contagious or is no longer at risk of perioperative complications. If the surgery cannot be delayed, the surgeon in charge must minimize the risk of infection by including the smallest possible number of medical staff into the procedure and shortening the route the patient has to take through the hospital as much as possible. During the pandemic, open procedures take precedence. The purpose of this article is to provide surgeons with advice, so they can make decisions in the best possible interest of the patient and the surgical team, based on risk assessment for the patient (clinical presentation, comorbidity, hospital resources availability). For COVID-19 positive patients, as well as for those who are clinically highly suspected to be COVID-19 positive, nonoperative treatment is preferred if it is available and safe for the patient. If surgical procedures are necessary, personal protective equipment and all safety measures should be applied to protect the patient and the medical team.

Abstract The need to address wildlife conservation outside of protected areas has become more urgent than ever before to meet environmental and socio‐economic goals. However, there is limited knowledge about how woody plants respond to herbivory within landscapes shared by wildlife and domestic herbivores in African savanna, thus management decisions might be based on inaccurate information and ultimately be ineffective. We compared woody vegetation dynamics between two adjacent ranches with different management objectives and subjected to varying levels of herbivory by both wildlife and domesticated mammals using 421 square plots of 400 m2 nested on three transects, each 3 km long and purposively selected to minimize bio‐physical differences. Both species and structural diversity were significantly higher (p