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Background Acute myeloid leukemia (AML) is a challenging heterogenous hematologic malignancy characterized by suboptimal outcomes. Genetic characterization of AML enhanced the understanding of individualized patient’s risk and led to the development of new therapeutic strategies. Gene expression analysis facilitates detection of new diagnostic, prognostic, and predictive biomarkers. This necessitates the expansion of diagnostic testing with higher throughput technologies, such as targeted next-generation sequencing (NGS).Objectives To study the expression profiles of MECOM and BAALC genes in a cohort of newly diagnosed Egyptian AML patients via Oncomine Myeloid Research assay (OMA) by NGS technology in addition to studying their potential prognostic role and impact on overall survival (OS).Methods The OMA was used to evaluate the expression levels of MECOM and BAALC genes and five control genes (FBXW2, PUM1, TRIM27, PSMB2, and EIF2B1), in twenty-four newly diagnosed AML patients by NGS technology, using RNA extracted from bone marrow aspirate (BMA) specimens.Results Gene expression analysis of MECOM and BAALC genes revealed that MECOM overexpression was significantly associated with the presence of lymphadenopathy and the high MECOM median expression level was significantly associated with lower hemoglobin concentrations at presentation. BAALC overexpression showed significant associations with the presence of CD34, the presence of wild type NPM1 mutation, and the absence of FLT3-ITD mutations. However, BAALC underexpression was significantly associated with normal cytogenetics, while its overexpression was associated with adverse and favorable cytogenetics, with a statistically significant difference between them (p = 0.049)*. Statistically significant positive correlation was found between BAALC expression levels and postinduction BM blast percentages. Among these two genes, only high BAALC expression had significantly shorter OS in AML patients based on the log rank test (p = 0.037)*.Conclusion BAALC expression might be a specific molecular marker used for the assessment of prognosis and OS in AML patients and might be used in the future as targeted therapy in AML, aiming to improve patient outcomes and OS.

Obscure gastrointestinal bleeding represents about 5% of all gastrointestinal haemorrhages which is characterized by continuous or recurrent bleeding from an undetermined source after an initial bidirectional endoscopy. Meckel’s diverticulum is a rare but recognized cause of obscure gastrointestinal bleeding. A carefully selected line of investigations is paramount to localize the causative lesion in obscure gastrointestinal bleeding which is a challenge in subacute cases. We present a case of 35-year-old female with thalassemia minor and mild anaemia presented with acute gastrointestinal bleeding from the ectopic pancreatic mucosa of an Meckel’s diverticulum where only a small focus of gastric tissue was identified histologically during the follow-up. This case discusses the rarity of this histological presentation of Meckel’s diverticulum as obscure gastrointestinal bleeding and the importance of intraoperative decision-making and intraoperative enteroscopy in cases of obscure gastrointestinal bleeding when other tests are negative.

ABSTRACTBackground and Aims Liver transplantation is associated with hemodynamic instability. Systemic and Splanchnic circulations interact closely. Portal hypertension is linked to vasodilatory molecules resulting in arterial vasodilatation. Terlipressin, is a synthetic vasopressin analogue causes selective vasoconstriction of splanchnic arteriols, thus decreasing splanchnic blood flow and shifting blood from the splanchnic to the systemic circulation resulting in enhanced systemic hemodynamics.This study aimed to assess the impact of intraoperative terlipressin on systemic and hepatic hemodynamics in recipients of living donor liver transplantation (LDLT).Methods The present longitudinal observational study was carried out at Ain Shams Center for Organ Transplant on 30 cases suffering from portal hypertension and chronic liver disease undergoing LDLT. Subjects were equally categorized into two groups: Group 1(control): patients did not receive intraoperative terlipressin, Group 2 (terlipressin): patients received terlipressin (1 mg intravenously over 10 min) just after exposure of the portal vein to maintain mean arterial blood pressure over 65 mmHg.Results Systolic and diastolic blood pressure were better preserved in the terlipressin group, with reduced norepinephrine requirements as well as a substantial decline in the heart rate during the anhepatic and reperfusion phases (P

In rapidly urbanizing regions, enhancing passenger comfort in subway systems through sustainable methods is a critical challenge. This study introduces an innovative exploration of the impact of subway entrance geometry on natural ventilation and its subsequent effects on the thermal environment within Cairo’s subway system. The primary objective is to identify optimal entrance configurations that maximize natural airflow, thereby improving passenger comfort and reducing energy consumption. Focusing on the newly constructed segments of the Cairo subway, the research employs a mixed-methods approach that integrates computational fluid dynamics (CFD) simulations with a questionnaire survey to evaluate interactions between various entrance designs and urban wind flow patterns. This dual approach allows for a comprehensive assessment of how different geometrical configurations influence the capture and distribution of prevailing winds. The results indicate that specific entrance geometries can significantly enhance ventilation efficiency by optimizing wind capture and distribution. The most effective designs demonstrated substantial improvements in air quality and thermal comfort, providing practical insights for subway systems in similar hot arid climates. The novelty of this research lies in its detailed analysis of architectural elements to leverage natural environmental conditions for improving indoor air quality and thermal comfort in public transit systems. The significance of this study is its contribution to the field of sustainable urban transport, offering a valuable framework for urban planners and engineers. By demonstrating how thoughtful design can lead to energy savings and enhanced passenger experiences, this research advances the discourse on sustainable urban infrastructure. This work not only enhances theoretical understanding but also provides actionable recommendations for creating more sustainable and comfortable public transit infrastructures.

The European DEMOnstration power plant (EU DEMO) project is currently leading the research endeavours within the fusion field with the goal of developing a next generation fusion reactor. Given the challenging nature of the application, it is essential to establish methodologies that can provide convenient and reliable characterisation of the chosen materials within DEMO. In this paper, the recently developed Time-of-Flight Neutron Bragg Edge Imaging (TOF-NBEI) was used on Tungsten (W)/ Copper (Cu) dissimilar joints sample mock-ups of the cooling system design used in the critical divertor component with the goal of mapping the residual stresses across the sample. Residual strain mapping was performed on the W phase with considerable tensile residual strains identified close to the W-Cu interface. The large-grain microstructure of the Cu phase was analysed using the energy-resolved neutron radiographs. The results will be used as a basis for future TOF-NBEI experiments of tungsten monoblocks related to DEMO.

Background: Pilonidal sinus disease is a common surgical concern for 20- and 30-year-old males. Surgery is the most acceptable management. Surgical recurrence and wound infections are rare especially with Wide excision. It leaves a large midline incision that takes months to heal and may lower quality of life. The optimal therapy is debatable. Karydakis flap and Modified Bascom are two promising surgical techniques. Objectives: The aim of this study is to evaluate early postoperative outcomes and satisfaction of patients with Pilonidal Sinus (PNS) who underwent either Karydakis flap or Modified Bascom Cleft Lift Procedure at our Department. Patients and methods: From March 2022 to January 2023, Qena University Hospitals, South Valley University performed a randomized control experiment on 60 pilonidal sinus patients. Metronidazole was administered intravenously before 30 min and after 6 h of all spinal anaesthetic surgeries. Results: The Karydakis group had a greater rate of infection occurrence than the Modified Bascom group (P = 0.0237), but there was no difference in drain removal, hospital stay, post-operative discomfort, or pain. Modified Bascom group required significantly longer time for painless defecation than Karydakis group (P = 0.01773). Both research groups had good to excellent post-operative patient satisfaction. Conclusion: Both methods are effective in management of Pilonidal Sinus with no huge distinction. Modified Bascom Technique has a lower risk of infection. However, Karydakis Flap was better to achieve painless defecation in a shorter period of time.

Abstract Background Meta-analyses are on top of the evidence-based medicine pyramid, yet many of them are not completed after they are begun. Many factors impacting the publication of meta-analysis works have been discussed, and their association with publication likelihood has been investigated. These factors include the type of systematic review, journal metrics, h-index of the corresponding author, country of the corresponding author, funding sources, and duration of publication. In our current review, we aim to investigate these various factors and their impact on the likelihood of publication. A comprehensive review of 397 registered protocols retrieved from five databases was performed to investigate the different factors that might affect the likelihood of publication. These factors include the type of systematic review, journal metrics, h-index of the corresponding author, country of the corresponding author, funding sources, and duration of publication. Results We found that corresponding authors in developed countries and English-speaking countries had higher likelihoods of publication: 206/320 (p = 0.018) and 158/236 (p = 0.006), respectively. Factors affecting publications are the countries of corresponding author (p = 0.033), whether they are from developed countries (OR: 1.9, 95% CI: 1.2–3.1, p = 0.016), from English-speaking countries (OR: 1.8, 95% CI: 1.2–2.7, p = 0.005), update status of the protocol (OR: 1.6, 95% CI: 1.0–2.6, p = 0.033), and external funding (OR: 1.7, 95% CI: 1.1–2.7, p = 0.025). Multivariable regression retains three variables as significant predictors for the publication of a systematic review: whether it is the corresponding author from developed countries (p = 0.013), update status of the protocol (p = 0.014), and external funding (p = 0.047). Conclusion Being on top of the evidence hierarchy, systematic review and meta-analysis are the keys to informed clinical decision-making. Updating protocol status and external funding are significant influences on their publications. More attentions should be paid to the methodological quality of this type of publication.

Abstract Introduction Out‐of‐hospital cardiac arrest (OHCA) is defined as the loss of functional mechanical activity of the heart in association with an absence of systemic circulation, occurring outside of a hospital. Immediate coronary angiography (CAG) with percutaneous coronary intervention is recommended for OHCA with ST‐elevation. We aimed to evaluate the effect of early CAG on mortality and neurological outcomes in OHCA patients without ST‐elevation. Methods This meta‐analysis and systemic review was conducted as per principles of Preferred Reporting Items for Systematic Reviews and Meta‐analysis (PRISMA) group. A protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO, Ref No. = CRD42022327833). A total of 674 studies were retrieved after scanning several databases (PubMed Central, EMBASE, Medline, and Cochrane Central Register of Controlled Trials). Results A total of 18 studies were selected for the final analysis, including 6 randomized control trials and 12 observational studies. Statistically, there was no significant difference in primary outcome, i.e., mortality, between early and delayed CAG. In terms of the grade of neurological recovery as a secondary outcome, early and delayed CAG groups also showed no statistically significant difference. Conclusion Early CAG has no survival benefits in patients with no ST elevations on ECG after OHCA.

Distributed generation (DG) allows the microgrid (MG) to be more active and flexible. However, MG is exposed to some power quality (PQ) issues such as harmonics and voltage sag/swell especially during unbalanced loading. To overcome these challenges, isolated areas adopting DG technology rely on ensuring an active compensation of PQ on each standalone micro-source. This paper addressed a control strategy for a specific implementation named 3P four-leg inverters (3P4LI). This implementation is based on DG connection to improve the output voltage regulation, total harmonic distortion (THD) and unbalanced load under various load types. A new control architecture named triple-loop compensation (TLC) based on PI, PR, and feedforward schemes, is proposed. Proposed TLC parameters are optimized based on a multi-objective function under the constraints to compensate for the voltage regulation, THD mitigation, system stability, and unbalanced load compensation to meet the recommended standards. The proposed strategy has proven that the system voltage has been regulated successfully for both 3P/1P loads with minimum error. The voltage unbalanced factor (VUF) has been successfully minimized during aggressive loading. The TLC performance has met the objectives ensuring 5–6 times enhanced accuracy compared to the previous work.

Egypt produces more rice straw than any other nation, and this residue is currently discarded in untreated landfills and open fields, causing environmental damage in the country. Furthermore, eggshells, a waste product used in bakeries, restaurants, and poultry farms, were typically disposed of in landfills, posing health hazards. So, grinding eggshells into nanoparticles, known as nano eggshell powder (NEP), increases its activity. In addition, to its high calcium content, NEP may be used with pozzolanic substances like rice straw ash (RSA), which have a lower calcium concentration. This study examined the characteristics of ultra-high-performance concrete (UHPC) produced using RSA and NEP eco-friendly components within partial cement substitution. The ratios of RSA to cement were 0 %, 10 %, 20 %, and 30 %, while the NEP quantities were 2 %, 4 %, and 6 % of the total binder. The results indicate that combining NEP and RSA as pozzolanic materials can improve concrete characteristics while decreasing cement content and reducing environmental contamination. Using RSA and NEP as substitutes for cement has also improved the material's mechanical characteristics, durability, and dry shrinkage.

Energy demand forecasting has been an indispensable research target for academics, which has led to creative solutions for energy utilities in terms of power system design, control, and planning. The usefulness of energy demand forecasting is confined to the power engineering industry but globally exceeds such outcomes to contribute to the environment and health sectors. Despite the large number of research projects published on this topic, the challenge of energy demand forecasting still exists, especially with the developments in modeling concepts via artificial intelligence, which motivates more attractive solutions for the variables involved in energy demand forecasting. Mathematical correlation or extrapolation-like methods cannot be effective in all situations; however, when a time series neural network is presented, most statistical, empirical, and theoretical problems can be easily handled. This paper presents a simple and easy-to-understand method for the next decade of energy demand forecasting based on a nonlinear autoregressive (NAR) neural network. From its time series past values, NAR structurally is an optimal predictor for a future variable. A publicly available data set for global energy consumption has been used to construct the network model with sufficiently accurate results. The evidence has appeared in precisely following the exponential trend of energy consumption as well as the regressions for training, testing, and validation, which ensures the model's robustness and avoids getting involved in overfitting. The proposed model concepts and results can be easily used in undergraduate engineering education, training graduates, and future research.

Summary: Background: The causes for immune-mediated inflammatory diseases (IMIDs) are diverse and the incidence trends of IMIDs from specific causes are rarely studied. The study aims to investigate the pattern and trend of IMIDs from 1990 to 2019. Methods: We collected detailed information on six major causes of IMIDs, including asthma, inflammatory bowel disease, multiple sclerosis, rheumatoid arthritis, psoriasis, and atopic dermatitis, between 1990 and 2019, derived from the Global Burden of Disease study in 2019. The average annual percent change (AAPC) in number of incidents and age standardized incidence rate (ASR) on IMIDs, by sex, age, region, and causes, were calculated to quantify the temporal trends. Findings: In 2019, rheumatoid arthritis, atopic dermatitis, asthma, multiple sclerosis, psoriasis, inflammatory bowel disease accounted 1.59%, 36.17%, 54.71%, 0.09%, 6.84%, 0.60% of overall new IMIDs cases, respectively. The ASR of IMIDs showed substantial regional and global variation with the highest in High SDI region, High-income North America, and United States of America. Throughout human lifespan, the age distribution of incident cases from six IMIDs was quite different. Globally, incident cases of IMIDs increased with an AAPC of 0.68 and the ASR decreased with an AAPC of −0.34 from 1990 to 2019. The incident cases increased across six IMIDs, the ASR of rheumatoid arthritis increased (0.21, 95% CI 0.18, 0.25), while the ASR of asthma (AAPC = −0.41), inflammatory bowel disease (AAPC = −0.72), multiple sclerosis (AAPC = −0.26), psoriasis (AAPC = −0.77), and atopic dermatitis (AAPC = −0.15) decreased. The ASR of overall and six individual IMID increased with SDI at regional and global level. Countries with higher ASR in 1990 experienced a more rapid decrease in ASR. Interpretation: The incidence patterns of IMIDs varied considerably across the world. Innovative prevention and integrative management strategy are urgently needed to mitigate the increasing ASR of rheumatoid arthritis and upsurging new cases of other five IMIDs, respectively. Funding: The Global Burden of Disease Study is funded by the Bill and Melinda Gates Foundation. The project funded by Scientific Research Fund of Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital (2022QN38).

Background: Chronic kidney failure (CRF) is characterized by a progressive loss of functional status over weeks or months, which may result in one of the illness's recognized consequences, such as cardiovascular disease, chest pain, or anemia. CRF has been generally understood as a worldwide public health problem and a big factor to death and morbidity during the previous decade. Methods: Determination of zinc and copper, urea, creatinine, total protein, globulin, alanine aminotransferase (ALT), albumin, aspartate aminotransferase (AST), alkaline phosphatase (ALP), and lactate dehydrogenase (LDH) in (CRF) Iraqi patients. This study included (40) patients and (38) healthy subjects as control. Samples were collected from January to April (2022). The biochemical parameters were determined using spectrophotometrically, but zinc and copper were determined by atomic absorption spectrophotometer. Results: Copper, urea, creatinine, ALP, AST, ALT, and LDH were significantly higher in CRF patients, whereas zinc, total protein, albumin, and globulin were lower in CRF patients as compared with control. The research also concerned study the relation between sex (male and female) and biochemical parameters which showed significant differences in comparison male of patients with males of control, yet globulin showed nonsignificant differences. While patients and control females showed nonsignificant differences. Conclusions: LDH in CRF patients might be used as a biomarker to detect renal dysfunction in dialysis patients at an early point, and blood serum Zn deficit in CRF. Furthermore, a relationship among Zn and albumin amounts was discovered. As a result, Zn and copper in CRF, particularly hypoalbuminemia, must be frequently evaluated and adjusted.

Heart disease remains a global leading cause of death and disability, necessitating a comprehensive understanding of the heart’s development, repair, and dysfunction. This review surveys recent discoveries that explore the developmental transition of proliferative fetal cardiomyocytes into hypertrophic postnatal cardiomyocytes, a process yet to be well-defined. This transition is key to the heart’s growth and has promising therapeutic potential, particularly for congenital or acquired heart damage, such as myocardial infarctions. Although significant progress has been made, much work is needed to unravel the complex interplay of signaling pathways that regulate cardiomyocyte proliferation and hypertrophy. This review provides a detailed perspective for future research directions aimed at the potential therapeutic harnessing of the perinatal heart transitions.

Abstract The colony stimulating factor 2 receptor subunit beta (CSF2RB) is the common signaling subunit of the cytokine receptors for IL‐3, IL‐5, and GM‐CSF. Several studies have shown that spontaneous and random mutants of CSF2RB can lead to ligand independence in vitro. To date, no report(s) have been shown for the presence of potentially transforming and oncogenic CSF2RB mutation(s) clinically in cancer patients until the first reported case of a leukemia patient in 2016 harboring a germline‐activating mutation (R461C). We combined exome sequencing, pathway analyses, and functional assays to identify novel somatic mutations in KAIMRC1 cells and breast tumor specimen. The patient’s peripheral blood mononuclear cell (PBMC) exome served as a germline control in the identification of somatic mutations. Here, we report the discovery of a novel potentially transforming and oncogenic somatic mutation (S230I) in the CSF2RB gene of a breast cancer patient and the cell line, KAIMRC1 established from her breast tumor tissue. KAIMRC1 cells are immortalized and shown to survive and proliferate in ligand starvation condition. Immunoblot analysis showed that mutant CSF2RB signals through JAK2/STAT and PI3K/mTOR pathways in ligand starvation conditions. Screening a small molecule kinase inhibitor library revealed potent JAK2 inhibitors against KAIMRC1 cells. We, for the first time, identified a somatic, potentially transforming, and oncogenic CSF2RB mutation (S230I) in breast cancer patients that seem to be an actionable mutation leading to the development of new therapeutics for breast cancer.

Gas turbines are used in the energy sectors as propulsion and power generation technologies. Despite technological advances in power generation and the emergence of numerous energy resources, gas turbine technology remains important due to its flexibility in load demand following, dynamical behavior, and the ability to work on different fuels with minor design changes. However, there would be no ambitious progress for gas turbines without reliable modeling and simulation. This paper describes a novel approach for modeling, identifying, and controlling a running gas turbine power plant. A simplified nonlinear model structure composed of s-domain transfer functions and nonlinear blocks represented by rate limiters, saturations, and look-up tables has been proposed. The model parameters have been optimized to fit real-world data. The verified model was then used to design a multiple PI/PD control to regulate the gas turbine via the inlet guide vane and fuel vales. The aim is to raise and stabilize the compressor’s differential pressure or pressure ratio, as well as raise the set-point of the temperature exhausted from the combustion turbine; as a result, energy efficiency has been improved by an average of 237.16 MWh saving in energy (or 8.96% reduction in fuel consumption) for a load range of 120 MW to 240 MW.

Abstract Background The development of acute kidney injury (AKI) is an important indicator of clinical outcomes after cardiac surgery. Elevated preoperative hemoglobin A1c level may be associated with acute kidney injury in patients undergoing coronary artery bypass grafting. This study will investigate the association of preoperative HbA1c levels with AKI after isolated coronary artery bypass grafting (CABG). Results Forty patients undergoing elective CABG were enrolled in this cohort study. Patients are divided into 2 equal groups who underwent isolated coronary artery bypass grafting (CABG): patients with preoperative HbA1c 5.7–6.4% (group A) (prediabetics) and patients with preoperative HbA1c > or = 6.5% (group B) (diabetics). Acute kidney injury according to the Kidney Disease: Improving Global Outcomes criteria developed in 11 patients (27.5%). There was a significant difference between the two groups as regards postoperative urinary NGAL, creatinine level on the 1st day, creatinine level on the 2nd day, urine output on the 1st day, and urine output on the 2nd day (p value was 0.001, 0.002, 0.006, 0.0002, and 0.012 respectively). Postoperative ICU stay duration was statistically significant in the diabetic group (P value 0.009). The need for renal replacement therapy was higher in the diabetic group, but it was not statistically significant between the two groups. Roc analysis shows AUC 0.922 with a significant p value (

Abstract Background One of the most common problems in parturients receiving regional anesthesia during cesarean section is shivering. It usually interferes with the readings of the oxygen plethysmography (SpO2) and electrocardiogram (ECG). It expands the needs for oxygen and increases creation of carbon dioxide about four folds. The aim of this work is to compare the efficacy of dexamethasone and dexmedetomidine in prevention of perioperative shivering when added to hyperbaric bupivacaine intrathecally in cesarean sections (CS) and their effect on the intraoperative hemodynamics, intensity of the block, sedation, and postoperative analgesic requirement. Results Study included 60 obstetric patients who fulfilled all the inclusion criteria and were randomized into 2 equal groups, each consisting of 30 patients, namely group A (dexmedetomidine group) and B (dexamethasone group). Group A patients received 5 μg dexmedetomidine with 12.5 mg hyperbaric bupivacaine 0.5% intrathecally. Group B patients received 8 mg dexamethasone then 12.5 mg hyperbaric bupivacaine 0.5% intrathecally. The comparison included assessment of intra- and postoperative hemodynamics, duration of surgery, assessment of sensory and motor block, assessment for shivering and sedation, and assessment of adverse events. This study showed that there were a small number of patients complaining of shivering (five patients in group A and seven patients in group B) with no statistical difference between both groups in the incidence and intensity of shivering. Time to two segment regression (minutes) was longer in group B compared to group A, and also, time to first analgesic rescue was longer in group B compared to group A. For sedation intensity, there was statistical difference between both groups as all patients in group A were sedated compared to six patients only in group B. There was no statistical difference between both groups as regards incidence of adverse effects. Conclusion We concluded that both drugs can be added safely to bupivacaine, and both dexmedetomidine and dexamethasone decreased the incidence and the intensity of shivering. Dexamethasone was found to prolong the duration of sensory block and delay opioid requirements post-operatively, while dexmedetomidine is more effective in sedating the patients intra- and postoperatively.

Abstract The principles of achieving an aesthetically pleasing and harmonious facial appearance are influenced by our evolving understanding of the three-dimensional topography of the face coupled with novel approaches to midface volumization and contouring. In parallel with the evolving landscape of facial aesthetic surgery, an increasing number of publications have emerged focusing on the role of intraoral buccal fat pad removal (BFPR) for the purposes of aesthetic midface contouring. The authors sought to emphasize an underreported and potentially preventable and untoward complication involving iatrogenic parotid duct injury following BFPR. The purpose of this publication is 3-fold: (1) to review the relevant anatomy and literature on intraoral BFPR, (2) to present a case example of this complication, and (3) to discuss treatment options as part of a proposed management algorithm. The authors detail the surgical indications for performing BFPR and review the relevant anatomic considerations. Complication prevention strategies are outlined, and details regarding avoidance of parotid duct injury are reviewed. The diagnostic criteria and clinical presentation of parotid duct injuries following BFPR are comprehensively outlined. The authors present a clinically actionable algorithm for managing a suspected or diagnosed parotid duct injury following BFPR. A clinical case example is discussed to highlight this complication, the diagnostic criteria, and the systematic and algorithmic approach to management. Intraoral BFPR is an incredibly valuable and powerful procedure that can improve facial contour in patients with buccal lipodystrophy or buccal fat pad pseudoherniation. The authors propose a proper diagnostic approach and treatment algorithm to manage this untoward complication. Level of Evidence: 5

Background: The femur normally has a degree of bowing that could influence the performance and outcome of some surgical procedures like intra-medullary nailing and hip replacement. This article aimed at evaluating the anterior femoral bowing angle in the Arab population, determining if age and sex are potential influencing factors, and reviewing the literature for identifying possible risk factors. Methods: Measuring the anterior bowing of 116 Arab femora was done using lateral radiographs. The relationship between age and femoral bowing was done using the Pearson correlation coefficient, while an independent t-test was used to compare the bowing angles in males and females. A literature review was done to identify similar studies using PubMed and the references included in the identified papers. Results: From the 116 femora, of which 37 (32%) belonged to male individuals and 79 (68%) to females, the mean femoral bowing angle was 8.13° with a standard deviation of 1.87°. Weak positive correlation was found between age and the bowing angle (r = 0.09, 95%CI [-0.09 to 0.27], p-value = 0.312). However, the angle of femoral bowing was greater in males than females by a mean of 0.76° (95%CI [0.04 to 1.49], p-value = 0.04) when compared using the independent t-test. Conclusion: It appears that anterior femoral bowing is more pronounced in the Arab population, compared to other ethnicities. We encourage more research to define the possible outcomes in patients with severe femoral deformity and to assess the use of computer-assisted surgery in these cases.

Abstract Background Although protocol registration of systematic reviews/meta-analysis (SR/MA) is still not mandatory, it is highly recommended that authors publish their SR/MA protocols prior to submitting their manuscripts for publication as recommended by the Cochrane guidelines for conducting SR/MAs. our aim was to assess the awareness, obstacles, and opinions of SR/MA authors about the protocol registration process. Methods A cross-sectional survey study included the authors who published SR/MAs during the period from 2010 to 2016, and they were contacted for participation in our survey study. They were identified through the literature search of SR/MAs in Scopus database. An online questionnaire was sent to each participant via e-mail after receiving their approval to join the study. We have sent 6650 emails and received 275 responses. Results A total of 270 authors responses were complete and included in the final analysis. Our results has shown that PROSPERO was the most common database used for protocol registration (71.3%). The registration-to-acceptance time interval in PROSPERO was less than 1 month (99.1%). Almost half of the authors (44.2%) did not register their protocols prior to publishing their SR/MAs and according to their opinion that the other authors lack knowledge of protocol importance and mandance to be registered, was the most commonly reported reason (44.9%). A significant percenatge of respondents (37.4%) believed that people would steal their ideas from protocol databases, while only 5.3% reported that their SR/MA had been stolen. However, the majority (72.9%) of participants have agreed that protocol registries play a role in preventing unnecessary duplication of reviews. Finally, 37.4% of participants agree that SR/MA protocol registration should be mandatory. Conclusion About half of the participants believes that the main reason for not registering protocols, is that the other authors lack knowledge concerning obligation and importance to register the SR/MA protocols in advance. Therefore, tools should be available to mandate protocol registration of any SRs beforehand and increasing awareness about the benefits of protocol registration among researchers.

Abstract Background Vocal cords signify an imperative lane for air flow in and out of the respiratory tract along with a phonetic role. So, the aim of this work is to assess the impact of habitual versus occasional utilization of inhalation therapy of patients with bronchial asthma on their vocal cords regarding visual endoscopic pathological changes in addition to phonetic dysfunction. This study was conducted on 112 diagnosed bronchial asthma patients (66 male and 46 females). They were classified into the following: group A (habitual user), 65 patients with severe persistent asthma with regular frequent intake of inhalation therapy, and group B (occasional user), 47 patients with intermittent asthma with alternating intake of inhalation therapy. They were submitted to clinical, vocal assessment plus laryngoscopic examination. Results The habitual users group demonstrated that laryngeal edema and hyperemia attained the higher percentage in the adult than children age group (60%, 40–67.3%, 50%) respectively together after 6 and 9 months of study followed by laryngeal nodules (5.4%, 0–9%, 10%). Occasional users presented the same findings comparable to the habitual group (27%, 10–32.4%, 20%). Cord paresis, cord dysfunction, and fungal plaques were in the second frequencies in both age groups with the same percentage (3.6%) at the end of the study; however, in occasional users, fungal plaques illustrated low percentage (2.7%, 5.4–0, 10%, respectively). Conclusion Inhalation therapy as a form of asthma medication correlated with major counter effects on vocal cords with well-recorded laryngeal hyperemia, edema, and vocal nodules in addition to fungal plaques moreover phonetic dysfunction.

Abstract The virulence and proteolytic activity of some entomopathogenic fungi isolates, viz., Metarhizium anisopliae, Beauveria bassiana, Verticillium lecanii, and Trichoderma harzianum , against the two-spotted spider mite, Tetranychus urticae Koch (Acari: Tetranychidae), were evaluated. Common maize plants (Zea mays L.) infested with females of T. urticae were treated in vivo by spraying with suspensions of 1 × 108 conidia ml−1 concentration of selected isolates. Lethal effects of fungal isolates were assessed as percentages of daily mortalities of mites, compared to the mortality in control. Virulence of the fungi isolates was estimated based on the LC50 values calculated by probit analysis for the individuals treated by 1 × 105 conidia ml−1 concentration. Proteolytic activity of isolates was assayed on casein substrate to reflect their virulence towards T. urticae. The mite mortality rates increased with increasing conidial concentrations as well as days after treatment. The mortality rate caused by M. anisopliae isolate varied from 18.75 to 85%, with LC50 value of 4.6 × 105 conidia/ml and LC90 value of 2.4 × 108 conidia/ml during 7 days, respectively. The isolate of B. bassiana caused 15 to 70% mortality, and its LC50 and LC90 values estimated 3.3 × 106 and 7.8 × 109 conidia/ml, respectively. However, V. lecanii isolate caused 11.25 to 72.50% mortality with LC50 of 5.2 × 106 conidia/ml, while T. harzianum was potentially less virulent than other isolates causing 8.75 to 63.75% mortality rate to T. urticae with LC50 of 9.4 × 106 conidia/ml. M. anisopliae showed the highest proteolytic activity at all concentrations, followed by B. bassiana in 3rd, 5th, and 7th day post treatment. These findings recommend the selection of virulent fungal isolates for use as natural and environmentally safe agents in biological control programs to combat mite pests.

Workplace environment is defined as the current conditions of the surroundings of a workplace. More than 80% of performance problems are influenced by the workplace environment where efficiency of workplace environment represents the total amount of work done by one employee in a single day. There are different types and traits of employees in Architectural Design firms , where only 5 types are being analyzed in this research paper which encounters; creative, innovative ,Talented , Technical & Analytical Architects that should be considered to achieve an efficient workplace environment. Hence , The Problem of this paper the inefficient management creating inefficient management for architects results in the dissatisfaction of employees while boosting the rate of turnovers impacting the productivity negatively. One approach that has been introduced to tackle such problem is creativity management which could embrace the 5 types of employees in Architectural design firms. Thus, the main purpose of this study is introducing how creativity management approach can effect the workplace environment and increase its efficiency in Architectural design firms . To achieve the aim of this paper , a comprehensive literature review analysis has been done on recently published Research papers from 2000 to 2018. This includes discussing the contribution of authors on the approaches for efficient workplace environment , and introducing creativity management approach in workplace environment in Architectural Design firms. Hence, Findings of this paper took the form of impact analysis , where the effect of creativity management approach on achieving efficient workplace has been identified.

Objectives: The study aimed at assessing the stressors among hemodialysis (HD) patients and finding out whether there is any relation between these stressors and patients' characteristics in the North of the West Bank. Methods: A quantitative, cross-sectional, descriptive–analytical study was carried out. Data collection took place at three governmental hospitals and one private hospital where 120 HD patients responded to the HD stress scale. Results: Hemodialysis patients were mildly to moderately stressed, the greatest perceived sources of stress appeared to be “physiological stressors” (mean = 2.655), but the item with the highest percentage was 'limitation on time and place for vacation' (84.2%) which belong to psychosocial stress subscale, and the item stress with the least percentage was “dependency on nurses and technicians”(45%). Conclusions: There was significant difference between the psychosocial stressors and duration of treatment. The study concluded that HD patients are in need for continuous support, and it is recommended different contributions to improve the quality of their life.

Background: Double J ureteral stents have been widely used in urological practice. They are liable to biofilm formation on their outer or inner surfaces. Objectives: To assess the effect of oral co-trimoxazole on decreasing bacterial adherence and biofilm formation on double J ureteral stent surfaces and subsequent post-operative urinary tract infection. Patients and methods: 109 patients undergoing double J ureteral stent insertion in our department randomized into two groups group A (55 patients) not taking any antibiotics during the indwelling time “control group” and group B (54 patients) on oral co-trimoxazole (2 TMP mg/kg/day) during the indwelling time. Two weeks post double J stent insertion, urine analysis was done for all patients and urine culture was done for patients with significant pyuria (WBCs => 20 by high power field). One-month post-operative, double J stent was removed anda segment of about 3-5 cm is sent for culture. All results recorded and analyzed with Statistical Package for Social Science® (SPSS) and Microsoft Excel 2010. Results: 63.6% of group A (35 patients) were positive stent culture, while 37% of group B (20 patients) were positive stent culture. Escherichia coli was the organism most commonly isolated from the stent culture in both groups. Conclusion: This study shows that oral co-trimoxazole has a role on decreasing bacterial adherence and biofilm formation on double J ureteral stent surfaces.

With increased interests in affordable energy resources, a cleaner environment, and sustainability, more objectives and operational obligations have been introduced to recent power plant control systems. This paper presents a verified load frequency model predictive control (MPC) that aims to satisfy the load demand of three practical generation technologies, which are wind energy systems, clean coal supercritical (SC) power plants, and dual-fuel gas turbines (GTs). Simplified state-space models for the two thermal units were constructed by concepts of subspace identification, whereas the individual wind turbine integration was implicated by the Hammerstein–Wiener (HW) model and then augmented from the output to simulate the effect of a wind farm, assuming similar power harvesting from all turbines in the farm. A practical strategy of control was then suggested, which was as follows: with a changing load demand, the available harvested wind energy must be fully admitted to the network to cover part of the load demand with the free energy, and the resultant load signal will then be instructed to the MPCs designed for the coal and gas units for the coordination of generation. The load signal, after being penetrated by wind, has more transients and faster changes, and needs a more sophisticated control in order to follow the load demand of the flexible coal and gas units. Furthermore, as the level of wind penetration increases, the power system frequency excursions are higher. The simulation results show an acceptable performance for linear MPCs embedded to the GT and coal units, with around a 90 MW share of wind without exceeding the safe restrictions of the plants and allowable reasonable frequency excursions. The complete simulation framework can be used to facilitate wind energy penetration in such power systems and train the operators and future engineers with subsequent power system frequency simulation studies.

Background Global surgery has recently gained prominence as an academic discipline within global health. Authorship inequity has been a consistent feature of global health publications, with over-representation of authors from high-income countries (HICs), and disenfranchisement of researchers from low-income and middle-income countries (LMICs). In this study, we investigated authorship demographics within recently published global surgery literature.Methods We performed a systematic analysis of author characteristics, including gender, seniority and institutional affiliation, for global surgery studies published between 2016 and 2020 and indexed in the PubMed database. We compared the distribution of author gender and seniority across studies related to different topics; between authors affiliated with HICs and LMICs; and across studies with different authorship networks.Results 1240 articles were included for analysis. Most authors were male (60%), affiliated only with HICs (51%) and of high seniority (55% were fully qualified specialist or generalist clinicians, Principal Investigators, or in senior leadership or management roles). The proportion of male authors increased with increasing seniority for last and middle authors. Studies related to Obstetrics and Gynaecology had similar numbers of male and female authors, whereas there were more male authors in studies related to surgery (69% male) and Anaesthesia and Critical care (65% male). Compared with HIC authors, LMIC authors had a lower proportion of female authors at every seniority grade. This gender gap among LMIC middle authors was reduced in studies where all authors were affiliated only with LMICs.Conclusion Authorship disparities are evident within global surgery academia. Remedial actions to address the lack of authorship opportunities for LMIC authors and female authors are required.

Background/purpose of the study Chronic hepatitis C virus (HCV) infection is considered one of the major health problems. About 170 million patients were infected with HCV worldwide. Till few years, Egypt was considered the highest HCV prevalent country worldwide, with predominant genotype number 4. The host immunity plays a major role in HCV infection with evolving data confirming the role of T-helper 17 cells in the formation of chronic HCV infection. The aim of our work was to determine the role of interleukins 17A (IL17A), 17F (IL17F) in the formation of chronic hepatitis C infection. Patients and methods We classify the patients into two groups: the first group included 51 chronic HCV patients who did not take antiviral therapy (the study group) and the second group included 51 healthy blood donors (as a control group). The levels of IL17A and IL17F in the serum of both groups were measured using the sandwich enzyme-linked immunosorbent assay method. Results The serum values of IL17A were higher in patients with chronic HCV than the other group with the mean values being 52.9±32.6 pg/ml in the patient group and 17.1±10.4 pg/ml in the control group. IL17F was slightly higher in the HCV patient group than the control group, but it was statistically insignificant. Moreover, there were significant positive correlations between IL17A and alanine aminotransferase, viral load, and degree of liver fibrosis. Conclusion Patients with chronic HCV infections had a higher serum level of IL17A than the normal persons and it is positively correlated with alanine aminotransferase, viral load, and degree of liver fibrosis. This suggests its pivotal role in the formation of chronic HCV infection; so, it can be used as a new marker for disease progression due to its positive correlation with the severity of liver injury.

Abstract Background There is limited evidence regarding the ways in which displacement disrupts social norms, expectations and trajectories for adolescent girls and young women and the resulting impacts on their risks of violence. This knowledge gap is especially marked with regards to Syrian adolescent girls and young women seeking refuge in Turkey. We explored risks of gender-based violence against Syrian adolescent girls and young women in Turkey and examined how these risks were shaped by their displacement. Methods Data were collected in August 2016 in Izmir, Turkey through five sex-specific focus group discussions with Syrian adolescents and young people (aged 15–25 years) and two mixed gender focus group discussions with Syrian adults (18 years and older). Group discussions covered the issues facing Syrian adolescents and young women in Turkey, and how these were influenced by their displacement. Discussions in Arabic were audio-recorded, transcribed and translated into English. Data were coded inductively, and analysed thematically. Results Syrian adolescent girls and young women expressed an increased sense of vulnerability to violence since their displacement. Due to financial strains and limited educational opportunities, they were often encouraged by parents to work or marry, both of which they perceived to increase the risks of violence. In contrast, some adults suggested that marriage could protect adolescent girls and young women from risks of violence associated with working. Being alone outside the home was viewed as risky by all participants due to pervasive sexual, verbal and physical harassment, aggression, and even kidnapping attempts. To limit these risks, many parents reported keeping adolescent girls and young women at home, or ensuring that they were accompanied by male relatives when in public. Conclusions Syrian adolescent girls and young women face multiple risks of violence following displacement related to altered social trajectories. Some family-based strategies to protect young women from violence could reinforce restrictive gender norms and increase risks of violence. Interventions to address violence should include providing safe spaces, access to education and safe transport for young women, and financial support for families as well as community-based interventions to address the daily risks of sexual harassment in public spaces.

Problem By 31 December 2021, only 5.5% (861 879/15 670 530) of the Somali population had been fully vaccinated against coronavirus disease 2019 (COVID-19). Approach To rapidly increase COVID-19 vaccine coverage in 2022, the health ministry and its partners (World Health Organization and United Nations Children&apos;s Fund) adopted a more responsive strategy. This strategy included careful microplanning, better targeting of populations and providing people-centred vaccination services close to their homes. These services were combined with childhood vaccination and basic health-care provision using the existing polio network and community health workers. Additionally, a digital tool for recording COVID-19 vaccination data and a mobile phone-based electronic registration system were introduced. Local setting Somalia, a fragile and conflict-affected state, faced challenges when implementing COVID-19 vaccination, including inexperience in managing mass adult vaccination, inadequate infrastructure and health workforce. Furthermore, insecurity in some areas and severe drought resulted in large-scale displacement of people. Relevant changes The implementation of a more context-specific strategy helped Somalia reach substantially more people with COVID-19 vaccination and 42.1% coverage by 31 December 2022. Additionally, 84 600 zero- dose children received their first childhood vaccine during the integrated campaigns. The increased coverage has led to public health benefits that outweigh the investment in the COVID-19 vaccination campaigns. Lessons learnt Successful roll-out of adult vaccination is achievable even in a fragile and conflict-affected setting through implementation of a tailored contextualized approach. Key factors include good microplanning, use of digital tools, better population-targeting, bundling vaccines together and delivering vaccination services close to people&apos;s homes. Probleme Au 31 decembre 2021, seulement 5,5% (861 879/15 670 530) des Somaliens etaient totalement vaccines contre la maladie a coronavirus 2019 (COVID-19). Approche Afin d&apos;accroitre rapidement la couverture vaccinale contre la COVID-19 en 2022, le Ministere de la Sante et ses partenaires (l&apos;Organisation mondiale de la Sante et le Fonds des Nations Unies pour l&apos;enfance) ont adopte une strategie plus reactive. Celle-ci comprenait une microplanification minutieuse, un meilleur ciblage des populations et la fourniture de services de vaccination centres sur les personnes, a proximite de leur domicile. Ces services etaient combines a une vaccination des enfants et a des soins de base, grace au reseau actuel de lutte contre la polio et des agents de sante communautaires. En outre, un outil numerique d&apos;acquisition des donnees relatives a la vaccination contre la COVID-19 ainsi qu&apos;un systeme d&apos;enregistrement electronique via telephone mobile ont ete deployes. Environnement local La Somalie, un Etat fragile et en conflit, a ete confrontee a des difficultes de mise en reuvre de la vaccination contre la COVID-19, notamment en raison de son manque d&apos;experience dans la gestion de campagnes de vaccination massive des adultes, de ses infrastructures inadaptees et d&apos;une penurie de soignants. De plus, l&apos;insecurite qui regne dans certaines regions et la secheresse extreme ont entraine des deplacements a grande echelle. Changements significatifs L&apos;instauration d&apos;une strategie mieux adaptee au contexte a aide la Somalie a vacciner nettement plus de gens contre la COVID-19, et a atteindre 42,1% de couverture vaccinale au 31 decembre 2022. Par ailleurs, 84 600 enfants <> ont recu leur premier vaccin pediatrique durant les campagnes combinees. L&apos;amelioration de la couverture vaccinale a engendre de nombreux benefices pour la sante publique, depassant l&apos;investissement dans les campagnes de vaccination contre la COVID-19. Lecons tirees En definissant une approche contextualisee et sur mesure, il est possible de proceder a la vaccination des adultes, meme dans une region fragile et en conflit. Parmi les facteurs cles figurent une bonne microplanification, le recours aux outils numeriques, un meilleur ciblage des populations, le regroupement des vaccins et la mise a disposition de services de vaccination non loin des habitations. Situacion A 31 de diciembre de 2021, solo el 5,5% (861 879/15 670 530) de la poblacion somali habia sido completamente vacunada contra la enfermedad por coronavirus de 2019 (COVID-19). Enfoque Para aumentar rapidamente la cobertura de la vacuna contra la COVID-19 en 2022, el Ministerio de Sanidad y sus asociados (la Organizacion Mundial de la Salud y el Fondo de las Naciones Unidas para la Infancia) adoptaron una estrategia mas receptiva. Esta estrategia incluia una cuidadosa microplanificacion, una mejor seleccion de las poblaciones y la prestacion de servicios de vacunacion centrados en las personas y cercanos a sus hogares. Los servicios se combinaron con la vacunacion infantil y la prestacion de atencion sanitaria basica mediante la red antipoliomielitica existente y los agentes de salud comunitarios. Ademas, se introdujeron una herramienta digital para registrar los datos de vacunacion contra la COVID-19 y un sistema de registro electronico por telefono movil. Marco regional Somalia, un estado fragil y afectado por conflictos, atraveso dificultades a la hora de implementar la vacunacion contra la COVID-19, como la inexperiencia en la gestion de la vacunacion masiva de adultos, la falta de infraestructuras y de personal sanitario. Asimismo, la inseguridad en algunas regiones y la grave sequia provocaron desplazamientos de poblacion a gran escala. Cambios importantes La implementacion de una estrategia mas adaptada al contexto ayudo a Somalia a llegar a un numero mucho mayor de personas con la vacunacion contra la COVID-19 y a una cobertura del 42,1% a 31 de diciembre de 2022. Ademas, 84 600 ninos con dosis cero recibieron su primera vacuna infantil durante las campanas integradas. El aumento de la cobertura ha propiciado beneficios para la salud publica que superan la inversion en las campanas de vacunacion contra la COVID-19. Lecciones aprendidas El despliegue exitoso de la vacunacion de adultos es posible incluso en un entorno fragil y afectado por conflictos mediante la implementacion de un enfoque contextualizado y adaptado. Los factores clave consisten en una buena microplanificacion, el uso de herramientas digitales, una mejor orientacion de la poblacion, la agrupacion de vacunas y la prestacion de servicios de vacunacion cerca de los hogares., Introduction Somalia received its first 300 000 doses of coronavirus disease 2019 (COVID-19) vaccines from the COVID-19 Vaccines Global Access (COVAX) initiative on 15 March 2021, (1) and the first [...]

Regeneration and reconstruction of segmental bone defects (SBD) is a clinical challenge in maxillofacial surgery and orthopedics. The present study evaluated efficacy of guided bone-regeneration (GBR) of rat femoral SBD using osteoconductive equine-bone (EB) and beta-tricalcium phosphate (beta-TCP) grafts, either with or without platelet-derived growth-factor (PDGF). Following ethical-approval, 50 male Wistar-Albino rats (aged ~12–15 months and weighing ~450–500 g) were included. A 5 mm femoral critical-size SBD was created and animals were divided into five groups depending on the graft material used for GBR (EB, EB + PDGF, Autograft, beta-TCP, beta-TCP + PDGF; n = 10/group). Following 12-weeks of healing, animals were sacrificed and femur specimens were analyzed through qualitative histology and quantitative histomorphometry. There was new bone bridging femoral SBD in all groups and qualitatively, better bone formation was seen in autograft and EB + PDGF groups. Histomorphometric bone-area (BA %) was significantly high in autograft group, followed by EB + PDGF, beta-TCP + PDGF, EB, and beta-TCP groups. Addition of PDGF to EB and beta-TCP during GBR resulted in significantly higher BA%. After 12-weeks of healing, EB + PDGF for GBR of rat femoral segmental defects resulted in new bone formation similar to that of autograft. Based on this study, GBR with EB and adjunct PDGF could be a potential clinical alternative for reconstruction and regeneration of segmental bone defects.

Background: Measuring knowledge, attitude, and practice towards COVID-19 helps policymakers observe knowledge gaps and provide key messages to people to act better against the pandemic. This study aims to assess the knowledge, attitude, and practice towards COVID-19 among Syrian people resident in Turkey. Methods: A cross-sectional study designed to assess the knowledge, attitude, and practice towards COVID-19 among the Syrian people resident in Turkey. The data were collected via a web-based and self-administered questionnaire of 313 participants from 17-31 July 2020. SPSS version 16.0 was recruited to analyze the data using univariate and multivariable regression data analyses. Results: Our finding as the first study among Syrian people resident in Turkey found a high rate of good knowledge, attitude, and practice towards COVID-19 accordingly with 83.0%, 72.0%, 84.0%. Regression analysis showed that age-group of 45 years and more years, marital status of being married, female gender, living in urban area were significantly associated with upper knowledge score. Age-group of 45 years and more significantly associated with positive attitude score but inversely being married and unemployed statues significantly associated with a negative attitude. Regarding practice score, married and female people had better practice, but poor-rated health status was significantly associated with the weak practice. Conclusion: Although our finding showed a good rate for knowledge, attitude, and practice towards COVID-19, but it needs to improve cause of many barriers on Syrian people resident in Turkey, such as living in a crowded place, distant from health care services, losing whole or part of their income due to COVID-19 as an economic crisis, different language barriers. Some groups like men, people living in a rural area, and those unemployed or lost their job should be exposed by timely and accurate knowledge.

Creating deepfake multimedia, and especially deepfake videos, has become much easier these days due to the availability of deepfake tools and the virtually unlimited numbers of face images found online. Research and industry communities have dedicated time and resources to develop detection methods to expose these fake videos. Although these detection methods have been developed over the past few years, synthesis methods have also made progress, allowing for the production of deepfake videos that are harder and harder to differentiate from real videos. This research paper proposes an improved optical flow estimation-based method to detect and expose the discrepancies between video frames. Augmentation and modification are experimented upon to try to improve the system’s overall accuracy. Furthermore, the system is trained on graphics processing units (GPUs) and tensor processing units (TPUs) to explore the effects and benefits of each type of hardware in deepfake detection. TPUs were found to have shorter training times compared to GPUs. VGG-16 is the best performing model when used as a backbone for the system, as it achieved around 82.0% detection accuracy when trained on GPUs and 71.34% accuracy on TPUs.

Over the past 20 years there has been growing awareness of community-acquired primary liver abscess caused by strains of Klebsiella pneumoniaeK. pneumoniae) especially in patients of Asian descent, a minority of which are characterized by metastatic spread. A common and frequent destructive complication is endophthalmitis as well as the involvement of the central nervous system (CNS), causing suppurative meningitis or brain abscess. Here we report a case of invasive liver abscess caused by K. Pneumoniae in an Asian patient who presented to our hospital in Tanzania with bilateral lower limb swelling for 6 weeks with acute onset of difficulty in breathing.

Background: The present work aimed to investigate the expression of CD160/ CD200 in CLL and other mature B-cell neoplasms (MBN) and their use as an additional diagnostic tool for differentiating CLL from other MBN. Materials and Methods: Using flowcytometry, we detected the expression of CD160 &CD200 on B-cells from 30 CLL patients, 30 other MBN patients in addition to 20 controls. CDs160/200 measurements were determined as a percentage expression (≥20% was considered positive) and as a ratio of the mean fluorescence intensities (MFIR) of leukemic cells/controls and were considered positive when the ratios were ≥2 and 20, respectively. Results: 90% and 100% of the CLL group expressed CDs160/200 in comparison to 60% and 63.3% of other MBN (p=0.007, p

Abstract As diagnostic and therapeutic modalities for Hodgkin's Lymphoma (HL) continue to improve, patient‐related factors affecting survival become more difficult to identify. Very little is known about the relationship between the primary site of lymph node (LN) involvement and survival of HL patients. We retrospectively analyzed the United States Surveillance, Epidemiology and End Results (SEER) database for 12,658 HL patients reported between 1973 and 2010 using survival analysis and time‐interval multiple logistic regression (MLR) to disclose that relationship. The effect of all primary LN sites on the survival of HL patients was supported. The intra‐abdominal (IAB) primary LN site was significantly associated with the worst survival. The pelvic (P) LN sites were significantly and independently associated with nearly 2 times and 2.5 times the probability of having 1‐year overall mortality (OM) and 1‐year cancer‐specific mortality (CSM), respectively. Head, face and neck (HFN) primary LN sites were significant and independent predictors of better overall and HL‐specific survival. A worse survival with the intra‐abdominal primary LN site was probably related to their association with higher age, or advanced stages of HL. The biological basis behind the aggressiveness of intra‐abdominal and pelvic LN sites is yet to be investigated.

In 2008, an outbreak of isoniazid-resistant tuberculosis was identified among residents of homeless shelters in Atlanta, Georgia, USA. When initial control efforts involving standard targeted testing failed, a comprehensive approach that involved all providers of services for the homeless successfully interrupted the outbreak.

There are few studies describing the occurrence of injuries in ultimate—commonly known as Ultimate Frisbee. We present the case of an elite ultimate player who suffered a proximal hamstring avulsion injury. A 26-year-old male athlete was evaluated in our office 2 weeks after being involved in a collision during an ultimate game. Magnetic resonance imaging of the hamstrings showed an extensive, high-grade right-sided tear with a 5–6 cm of tendon retraction and moderate signal in the muscle extending to the thigh. Delayed open repair of the avulsed tendon was performed through a posterior approach under general anaesthesia. Twelve months after surgery, the patient had no complaints, and his range of motion and strength had recovered to preinjury levels. The patient has since competed at the national club level and the professional level. This case reports on the success of the primary repair even after a delay in treatment of several weeks and significant tendon retraction.

This paper presents a critical review of the research conducted for modeling and controlling supercritical power plants. Thermal power plants are classified according to the boiler pressure to supercritical and subcritical. The modeling concepts and control strategies of supercritical generation units are far more complex than those of subcritical. On the other hand, supercritical generation technologies are more efficient and much cleaner than subcritical generation units. From a deep technical analysis of the literature, there is no review that is dedicated to models-based control of supercritical power plants and most previous reviews are found to be too general to modeling-based control of fossil fuelled energy sources. This review reports the advancements on modeling and control of supercritical and ultra-supercritical plants as cleaner generation technologies. The various published achievements for modeling supercritical and ultra-supercritical units have been reviewed. The control strategies that fulfill the practical load demand requirements while keeping optimum efficiencies are also reviewed. Finally, expected future directions are reported as recommendations to overcome future challenges. The paper can be used as a brief educational directory to the postgraduate students or future researchers in the field.

This paper reviews the modeling techniques and control strategies applied to gas turbine power generation plants. Recent modeling philosophies are discussed and the state-of-the-art feasible strategies for control are shown. Research conducted in the field of modeling, simulation, and control of gas turbine power plants has led to notable advancements in gas turbines’ operation and energy efficiency. Tracking recent achievements and trends that have been made is essential for further development and future research. A comprehensive survey is presented here that covers the outdated attempts toward the up-to-date techniques with emphasis on different issues and turbines’ characteristics. Critical review of the various published methodologies is very useful in showing the importance of this research area in practical and technical terms. The different modeling approaches are classified and each category is individually investigated by reviewing a considerable number of research articles. Then, the main features of each category or approach is reported. The modern multi-variable control strategies that have been published for gas turbines are also reviewed. Moreover, future trends are proposed as recommendations for planned research.