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In this work, we modify the dynamics of 3-D four-wing Li chaotic system (Li et al. 2015) by introducing a feedback controller and obtain a new 4-D hyperchaotic four-wing system with complex properties. We show that the new hyperchaotic four-wing system have three saddle-foci balance points, which are unstable. We carry out a detailed bifurcation analysis for the new hyperchaotic four-wing system and show that the hyperchaotic four-wing system has multistability and coexisting attractors. Using integral sliding mode control, we derive new results for the master-slave synchronization of hyperchaotic four-wing systems. Finally, we design an electronic circuit using MultiSim for real implementation of the new hyperchaotic four-wing system.

Purpose: We aimed to assess the 30-day morbidity in patients undergoing combined insertion of penile prosthesis (PP) and artificial urinary sphincter (AUS) vs. PP and male sling (MS). Materials and Methods: The National Surgical Quality Improvement Program database was queried to identify patients who underwent placement of AUS or MS combined with PP. Patient demographics, postoperative morbidity including complications, readmission and reoperation rates were recorded. Student t-test and chi-square or Fischer’s exact test were used as appropriate. Results: Forty-one patients met selection criteria between 2010 and 2016. Overall, 26 patients received PP and AUS vs. 15 that received PP and MS. Average age was similar in both groups (64.8±6.6 years vs. 62.3±6.3 years, p=0.254). Diabetes mellitus was more prevalent in PP+MS group compared to AUS+PP group (46.7% vs. 11.5%, p=0.022). Average length of stay was higher in PP+AUS group compared to PP+MS group (2.2±0.6 days vs. 1.8±0.4 days, p=0.017). Postoperative morbidity was reported in four patients in PP+AUS group. No reported complications in PP+MS group. In PP+AUS group, complications included one patient who developed urinary tract infection, one developed surgical site infection, readmission in two for postoperative infection, and one return to the operating room. No reported prosthesis explantation or revision in either groups. Conclusions: Our results showed that 30-day morbidity was recorded in the PP+AUS group and none in the PP+MS group. The complication and readmission rates remain comparable to the previous reports in both groups.

With the swift advancement of chaos theory, the modeling, chaotic oscillations, and engineering applications of chaotic and hyperchaotic systems are important topics in research. In this research paper, we elucidate our findings of a new four-dimensional two-scroll hyperchaotic system having only two quadratic nonlinearities and carry out a detailed bifurcation study of the proposed dynamical model. Also, an electronic circuit has been constructed for the new system using MultiSim (Version 14). The implementation of the new 4-D hyperchaotic system in a field-programmable gate array (FPGA) is performed herein by applying two numerical methods, viz. Forward Euler Method and Trapezoidal Method. The experimental results show a good match with the simulated hyperchaotic attractors. We also provide details of the hardware resources used for an FPGA Basys 3 Xilinx Artix-7 XC7A35T-ICPG236C.

The rising antimicrobial resistance is particularly alarming for Acinetobacter baumannii, calling for the discovery and evaluation of alternatives to treat A. baumannii infections. Some bacteriophages produce a structural protein that depolymerizes capsular exopolysaccharide. Such purified depolymerases are considered as novel antivirulence compounds. We identified and characterized a depolymerase (DpoMK34) from Acinetobacter phage vB_AbaP_PMK34 active against the clinical isolate A. baumannii MK34. In silico analysis reveals a modular protein displaying a conserved N-terminal domain for anchoring to the phage tail, and variable central and C-terminal domains for enzymatic activity and specificity. AlphaFold-Multimer predicts a trimeric protein adopting an elongated structure due to a long α-helix, an enzymatic β-helix domain and a hypervariable 4 amino acid hotspot in the most ultimate loop of the C-terminal domain. In contrast to the tail fiber of phage T3, this hypervariable hotspot appears unrelated with the primary receptor. The functional characterization of DpoMK34 revealed a mesophilic enzyme active up to 50 °C across a wide pH range (4 to 11) and specific for the capsule of A. baumannii MK34. Enzymatic degradation of the A. baumannii MK34 capsule causes a significant drop in phage adsorption from 95% to 9% after 5 min. Although lacking intrinsic antibacterial activity, DpoMK34 renders A. baumannii MK34 fully susceptible to serum killing in a serum concentration dependent manner. Unlike phage PMK34, DpoMK34 does not easily select for resistant mutants either against PMK34 or itself. In sum, DpoMK34 is a potential antivirulence compound that can be included in a depolymerase cocktail to control difficult to treat A. baumannii infections.

Venous malformations represent a major sector of vascular anomalies. Most cases are asymptomatic or subclinical; however, large extensive lesions can cause severe disability and sometimes mortality. In this report, we present a successful case of sirolimus treatment in managing an extensive venous malformation in the pelvis of a 21-month-old boy who presented with life-threatening complications. With a history dating since the day 2 of life, the patient suffered from chronic bleeding due to scrotal skin ulcerations, in addition to recurrent attacks of severe bleeding per rectum necessitating hospital admission and blood transfusion (three attacks since the age of 7 months). Pelvic magnetic resonance image showed the typical findings of extensive venous malformation involving the pelvis, perineum, scrotum, and extending to the gluteal region. The lesion was seen totally encasing the anorectum with marked thickening of their walls almost occluding their lumen. Oral sirolimus (2 mg/m2) was started with a target blood trough level of 5 to 10 ng/mL. Over a follow-up period of 5 months, there was obvious clinical improvement that included healing of skin lesions (scrotal ulcer) with complete re-epithelialization, absence of bleeding per rectum with improvement of constipation, and rise of hemoglobin level from 7.5 to 11.5 g/dL.

Background: Bladder cancer (BC) is one of the most common genitourinary cancers worldwide, the pathophysiology and etiology of BC are complicated, including both internal genetic and environmental factors. Currently, some studies suggest that the abnormal function of intercellular adhesion molecules is highly correlated with the invasion of surrounding tissues and distant organ metastasis of BC. Objective: To develop a correlation between these markers and NMIBC and to help predict the recurrence and/or progression. Patients and Methods: It is a retrospective cohort (observational) study assessing a correlation regarding the alternation in the expression of E-cadherin, b-catenin and SOX4 in determining the recurrence and/or progression and their prognostic value in NMIBC TCC. Patients Diagnosed with NMIBC TCC and their follow ups data were evaluated at the urology department in Theodor Bilharz Research Institute (TBRI) and Ain Shams University from January 2019 - till July 2022. Results: Loss of normal expression of E-cadherin and b-catenin, upregulation of SOX4 is significantly correlated with BC and tumorigenesis, yet no clear relation between E-cadherin, b-catenin and SOX4 in progression or recurrence of NMIBC, regarding It's staining intensity, percentage of positive cells and immunoreactive score (IRS). Conclusion: bases on our current study, E-cadherin, b-catenin and SOX4 showed highly significance difference between normal urothelium and TCC NMIBC indicating it may have a role in diagnosis, although its value changes with follow up of the patients but of non-significant difference to predict prognosis, recurrence and/or progression among TCC NMIBC. [ABSTRACT FROM AUTHOR]

Mandibular osteomyelitis (OM) is a challenging disease. Our objective was to assess a new OM model in rabbits induced by arsenic trioxide and to assess the efficacy of local treatment of OM using injectable gentamicin‐collagen hydrogels (GNT‐COLL). OM was induced unilaterally by controlled confinement of arsenic trioxide paste to the root canal of lower incisors of rabbits, while OM progression was characterized for 16 weeks. On the other hand, two injectable COLL hydrogels functionalized with GNT were prepared and characterized for physicochemical properties; a simple GNT‐COLL and a nanohydroxyapatite (nHA)‐ loaded hydrogel (GNT‐COLL/nHA). The two hydrogels were evaluated to treat OM model, while a multidose intramuscular GNT solution served as positive control. Outcomes were assessed by standard methods at 4 and 12 weeks post‐surgery. The clinical, radiographical, and histopathological findings provided evidence for the validity of the arsenic‐induced OM. The results demonstrated that a single intra‐lesional injection of the two hydrogels was more suppressive to OM compared to multidose systemic GNT. The composite GNT‐COLL/nHA hydrogel proved to induce early preservation of alveolar bone (ridge) length and higher amount of bone area\total area at 4 weeks (40.53% ± 2.34) followed by GNT‐COLL (32.21% ± 0.72). On the other hand, the positive control group revealed the least ridge length and bone area\total area (26.22% ± 1.32) at 4 weeks. Both hydrogels successfully arrested OM with no signs of recurrence for up to 12 weeks. Therefore, results support the greater advantages of the composite hydrogel as an osteogenic/antibiotic delivery system in OM treatment. [ABSTRACT FROM AUTHOR]

Background and objectives Management of complex vascular malformations is really challenging. They usually present at birth and have different complications, including bleeding, pain, cosmetic disfigurement, and functional impairment. This study was to done to determine symptomatic relief and quality-of-life improvement after sirolimus. Patients and methods The intervention phase included sirolimus administered orally on a continuous dosing schedule at a starting dose of 0.8 mg/m2, and its level was maintained between 4 and 12 ng/ml. Dose was rounded to the nearest 1-mg tablet form. Assessment of response to sirolimus was done (usually 2 weeks after start of sirolimus) clinically by assessment of clinical improvement of the main complaints of the patients, for example, bleeding, pain, and cosmetic disfigurement. Improvement of patients' laboratory investigations was assessed after the start of sirolimus, for example, elevation of hemoglobin and mean cell volume. The administration of Arabic translation of pediatric quality-of-life PedsQL 4.0 was done again 6 months after the start of sirolimus. Results A total of 18 patients were enrolled. The age of the patients during the start of sirolimus ranged from 5 months to 13 years, with a median age of 3 years. Bleeding stopped in eight (100%) patients, cosmetic disfigurement improved in 10 (76.9%) patients, and perception of pain improved in two (66.6%) patients. Moreover, quality of life of the study patients improved significantly, as the mean of the score of the patients before sirolimus was 65.18 and improved after sirolimus to be 78. Conclusions Symptomatic relief in patients after sirolimus administration is evident, with better quality of life. [ABSTRACT FROM AUTHOR]

In this work, we modify the dynamics of 3-D four-wing Li chaotic system (Li et al. 2015) by introducing a feedback controller and obtain a new 4-D hyperchaotic four-wing system with complex properties. We show that the new hyperchaotic four-wing system have three saddle-foci balance points, which are unstable. We carry out a detailed bifurcation analysis for the new hyperchaotic four-wing system and show that the hyperchaotic four-wing system has multistability and coexisting attractors. Using integral sliding mode control, we derive new results for the master-slave synchronization of hyperchaotic four-wing systems. Finally, we design an electronic circuit using MultiSim for real implementation of the new hyperchaotic four-wing system. [ABSTRACT FROM AUTHOR]