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The purpose of this article is to evaluate the water company in Algeria (ADE) subscribers’ Willingness To Pay (WTP) for a better service offer. This study assessed the WTP for improved drinking water in the department of Souk-Ahras (Algeria), using contingent valuation survey data of 5,342 households, with a response rate of 10.86% (greater than 10% of each municipality's total number of subscribers). Then, Probit and Tobit models were applied to analyze the determinants of WTP. The results show that the majority of respondents (62.84%) testified that they were not satisfied with the quality of the service provided in terms of quantity and quality of the water distributed. This research revealed that the WTP for an improved water supply service was approximately 16.18 Algerian dinar (DZD)/m3 (approximately 0.11 US$/m3) instead of the current tariff (6.3 DZD/m3–0.04 US$ /m3). With this new water tariff, the average water charge for a household is around 1.37% of the average monthly income. HIGHLIGHTS The households reported an average WTP of 0.11 US$/m3.; The determinants of WTP were analyzed using the Probit and Tobit models.; 62.84% of respondents stated that they were dissatisfied with the service in terms of the quantity and quality of the water distributed.; The application of the new tariff increased the water bill from 220%.; If the ADE applies the new tariff, the annual revenue will be 1,691,056.62 US$.;

Here, we present the case of an otherwise healthy patient, without risk factors, who developed a refractory case of onychomycosis caused by Kloeckera apiculata, an uncommon human pathogen. The diagnosis was ultimately confirmed by fungal nail plate culture, histopathology, and PCR. Whereas prior treatments with topical 5 % tavaborole solution, oral terbinafine, and oral fluconazole were ineffective, complete clinical and mycological cure was achieved with a 3-month course of oral itraconazole.

This study presents a thorough evaluation of the simultaneous planar laser-induced fluorescence (PLIF) on hydroxyl (OH) radicals and nitric oxide (NO), for characterizing hydrogen detonation fronts. The study combines experimental and numerical results to evaluate the benefits and drawbacks of different visualization strategies, namely OH-PLIF alone, NO-PLIF alone, OH-PLIF + shock det. (comparable to simultaneous OH-PLIF and schlieren), and combined OH- and NO-PLIF. Main findings are: (i) For the first time, simultaneous single-shot OH- and NO-PLIF visualizations are demonstrated on detonation waves for three mixtures with varying stability levels: Mixture (a) 2H2-O2-3.76Ar, Mixture (b) 2H2-O2-3.76N2, and Mixture (c) 3H2-CH4-3.5O2-3.76Ar; (ii) the simultaneous visualization evidences the self-similarity of both techniques, with a clear interlock of OH-PLIF imaging into NO-PLIF imaging. This means that the structure of the OH-reaction zone, typically visualized from OH-PLIF, can be accurately described from NO-PLIF imaging alone, from which induction zones can also be visualized. In addition, both can clearly depict the wrinkling of the front and the presence of unburned pockets; (iii) the effectiveness of the four visualization strategies at characterizing the detonation wave of a H2-O2-3.76Ar mixture is determined using ZND and spectroscopic simulations. Interestingly, the induction zone (Δi) is more accurately predicted by NO-PLIF (3% error) than with the combined OH + shock det. (10% error). This study highlights the potential of NO-PLIF diagnostic in characterizing detonation waves with low levels of confinement (i.e., d/λ>>>1) both qualitatively (e.g., reaction zone structure) and quantitatively (e.g., Δi measurements) using a single diagnostic. Additionally, the simultaneous OH- and NO-PLIF diagnostic may offer significant advantages in characterizing the detonation waves in engine-relevant conditions (i.e., in complex geometries with unburned pockets or local quenching events), as combining both diagnostics enables to discriminate unburned pockets and local quenching events.

The goal is to take advantage of the Earth-ionosphere wave guide’s fundamentally two-dimensional wave propagation, utilizing the normalized Airy functions (NAFs) in a complex domain. It is demonstrated that the typical working formula of VLF radio-mode theory may be obtained simply from orthogonality reflections, devoid of the requirement of sophisticated argumentation in the open unit disk. The combination of the expressions is given by considering the symmetry-convex illustration of the NAFs.

This article presents an empirical analysis of the link between technological leadership and the use of information and communication technologies. This paper aims to formalize the factors that determine the country's potential for technological leadership. The methodological toolkit for analyzing the link between the development of information and communication technologies and the technological leadership of the country is the methods of panel regression analysis: the fixed effects model, the random effects model, the Hausman test for correlated random effects, the combined regression model with dummy variables, the Wald test and the model fixed effects with dummy variables. The information base of the research is World Bank data, data files of national accounts of the Organization for Economic Cooperation and Development, and Eurostat data. The object of the study is the data of ten countries of the world (Brazil, India, China, South Africa, South Korea and Turkey, France, Germany, Italy and Spain), the period of the study is 2008-2016 years. The indicator of innovative development of the country, which is evaluated by the number of issued patents, was used as a dependent variable. The influence of factor indicators is considered in terms of four components: entrepreneurship (the number of new enterprises founded in the country during the fiscal year), export of high-tech goods (the share of the export of high-tech goods in the total export of goods according to 2007 data), GDP per capita (in US dollars for according to 2010 data), startups (number of registered startups). According to the results of building a model with fixed effects, a positive relationship between the technological leadership of the country and the development of information and communication technologies has been proven. In addition, the results of empirical calculations prove that the share of export of high-tech goods in the total export of countries is insignificant during the analyzed period. The study proves the essential role of information and communication technologies in technological progress and empirically confirms the potential difference in profits between manufacturers and exporters of technological products.

Abstract Epstein-Barr virus (EBV) infection may present with fulminant constitutional symptoms, cytopenia(s), and systemic lymphadenopathy, raising clinical suspicion for lymphoma and prompting lymph node and bone marrow biopsies. At the microscopic level, the histopathologic findings in cases of acute EBV lymphadenitis may mimic certain lymphoid neoplasms, creating a range of differential diagnoses and diagnostic pitfalls. We present a case of fulminant EBV infection in an adolescent whose clinical and radiographic findings led to lymph node and bone marrow biopsies to rule out lymphoma. One week after being diagnosed with acute EBV infection (infectious mononucleosis), a 17-year-old Caucasian male presented with worsening symptoms including persistent fever, progressive, painful lymphadenopathy, and splenomegaly. A peripheral blood smear showed lymphocytosis with many reactive lymphocytes, anemia, and thrombocytopenia. Laboratory studies showed elevated ferritin, triglycerides, and soluble IL-2/CD25. A cervical lymph node biopsy demonstrated an EBV-positive, reactive B-immunoblast proliferation with large atypical lymphoid cells mimicking Reed-Sternberg cells of Hodgkin lymphoma, in addition to patchy vasculitis, coagulative necrosis, and prominent hemophagocytic activity. Bilateral bone marrow biopsies showed a hypercellular marrow with patchy infiltrates of similar EBV-positive, large atypical lymphoid cells, as well as prominent hemophagocytic activity. The diagnosis of acute EBV associated lymphoproliferation with concurrent hemophagocytic lymphohistiocytosis (HLH) was rendered. Recognition of common and uncommon clinical presentations of acute EBV infection is essential, particularly when histopathologic findings raise suspicion for a possible hematolymphoid neoplasm. Both the lymph node architectural and viral cytopathic changes observed in EBV lymphadenitis exhibit significant morphologic overlap with classic Hodgkin lymphoma (cHL) and several other lymphomas, including anaplastic large cell lymphoma, diffuse large B cell lymphoma, and angioimmunoblastic T cell lymphoma. Recognition of immunohistochemical staining patterns in EBV lymphadenitis is critical to avoid misdiagnosis. Conversely, bona fide lymphoma, particularly cHL, can masquerade as EBV infection. We provide a concise discussion and tables of the histopathologic differential diagnosis of EBV lymphadenitis, including cHL and other lymphomas. Pathologists should include acute EBV infection within the differential diagnosis when confronted with clinical and pathologic findings concerning for lymphoma, particularly in adolescents and young adults.

This study is searching for some crucial physicochemical properties of groundwater samples collected from eleven outlets in Dakhla Oasis, Egypt, including the pH-value, electrical conductivity (EC), total dissolved solids (TDS), in addition to the concentrations of heavy metals and trace elements. In total 21 elements were analyzed using inductively coupled plasma spectrometry (ICP-OES). To categorize the water class: Chronic daily intakes (CDI), water quality index (WQI) and hazard risk (HR) were computed for the 21 elements in the water samples. Some biological parameters such as levels of urea, creatinine, and the tumor marker CEA were measured. The obtained results showed that the pH-values (6.12 to 6.56) for water samples are within the acceptable limits of the WHO. Results showed, also, that EC (274 to 532 μS/cm), TDS (175 to 340 ppm) besides, the level of measured 21 elements were lower than the values allowed by World Health Organization (WHO) and US Environmental Protection Agency (USEPA). Additionally, the reached data were comparable to other internationally published figures. It is emphasized that the data obtained for WQI confirmed that water from all the sampling points was of expedient quality. Based on the obtained data and the evaluated parameters, it can be concluded that the groundwater samples of the studied areas are of excellent quality; they do not pose any health risks to the local citizens, and are safe for their domestic consumption. Moreover, the results of urea, creatinine, and CEA analyses showed very few abnormal cases, which confirmed, again, that the groundwater in the studied areasdid not pose a risk to human health.

Objective This study aims to explore the user archetypes of health apps based on average usage and psychometrics. Methods The study utilized a dataset collected through a dedicated smartphone application and contained usage data, i.e. the timestamps of each app session from October 2020 to April 2021. The dataset had 129 participants for mental health apps usage and 224 participants for physical health apps usage. Average daily launches, extraversion, neuroticism, and satisfaction with life were the determinants of the mental health apps clusters, whereas average daily launches, conscientiousness, neuroticism, and satisfaction with life were for physical health apps. Results Two clusters of mental health apps users were identified using k-prototypes clustering: help-seeking and maintenance users and three clusters of physical health apps users were identified: happy conscious occasional , happy neurotic occasional , and unhappy neurotic frequent users. Conclusion The findings from this study helped to understand the users of health apps based on the frequency of usage, personality, and satisfaction with life. Further, with these findings, apps can be tailored to optimize user experience and satisfaction which may help to increase user retention. Policymakers may also benefit from these findings since understanding the populations’ needs may help to better invest in effective health technology.

Qatar is a peninsular country with predominantly hot and humid weather, with 88% of the total population being immigrants. As such, it leaves the country liable to the introduction and dissemination of vector-borne diseases, in part due to the presence of native arthropod vectors. Qatar's weather is expected to become warmer with the changing climatic conditions across the globe. Environmental factors such as humidity and temperature contribute to the breeding and distribution of different types of mosquito species in a given region. If proper and timely precautions are not taken, a high rate of particular mosquito species can result in the transmission of various vector-borne diseases. In this study, we analyzed the environmental impact on the probability of occurrence of different mosquito species collected from several different sites in Qatar. The Naive Bayes model was used to calculate the posterior probability for various mosquito species. Further, the resulting Naive Bayes predictions were used to define the favorable environmental circumstances for identified mosquito species. The findings of this study will help in the planning and implementation of an active surveillance system and preventive measures to curb the spread of mosquitoes in Qatar.

Abstract There are different approaches that indicate the dynamic of the growth of microbe. In this research, we simulate the growth by utilizing the concept of fractional calculus. We investigate a fractional system of integro-differential equations, which covers the subtleties of the diffusion between infected and asymptomatic cases. The suggested system is applicable to distinguish the presentation of growth level of the infection and to approve if its mechanism is positively active. An optimal solution under simulation mapping assets is considered. The estimated numerical solution is indicated by employing the fractional Tutte polynomials. Our methodology is based on the Atangana–Baleanu calculus (ABC). We assess the recommended system by utilizing real data.

Abstract Lately, many studies were offered to introduce the population dynamics of COVID-19. In this investigation, we extend different physical conditions of the growth by employing fractional calculus. We study a system of coupled differential equations, which describes the dynamics of the infection spreading between infected and asymptomatic styles. The healthy population properties are measured due to the social meeting. The result is associated with a macroscopic law for the population. This dynamic system is appropriate to describe the performance of growth rate of the infection and to verify if its control is appropriately employed. A unique solution, under self-mapping possessions, is investigated. Approximate solutions are presented by utilizing fractional integral of Chebyshev polynomials. Our methodology is based on the Atangana–Baleanu calculus, which provides various activity results in the simulation. We tested the suggested system by using live data. We found positive action in the graphs.

It is well known that there is a deep connection between the symmetric and traveling wave solutions. It has been shown that all symmetric waves are traveling waves. In this paper, we establish new analytic solution collections of nonlinear conformable time-fractional water wave dynamical equation in a complex domain. For this purpose, we construct a new definition of a symmetric conformable differential operator (SCDO). The operator has a symmetric representation in the open unit disk. By using SCDO, we generalize a class of water wave dynamical equation type time-space fractional complex Ginzburg–Landau equation. The results show that the obtainable approaches are powerful, dependable and prepared to apply to all classes of complex differential equations.

In a complex domain, the investigation of the quantum differential subordinations for starlike functions is newly considered by few research studies. In this note, we arrange a set of necessary conditions utilizing the concept of the quantum differential subordinations for starlike functions related to the set of parametric Julia functions. Our method is based on the usage of quantum Jack lemma, where this lemma is generalized recently by the quantum derivative (Jackson calculus). We illustrate a starlike formula dominated by different types of Julia functions. The sufficient conditions are computed in the quantum and the Julia fractional parameters. We indicate a relationship between these two parameters.

The symmetric Schur process has many different types of formals, such as the functional differential, functional integral, and special functional processes based on special functions. In this effort, the normalized symmetric Schur process (NSSP) is defined and then used to determine the geometric and symmetric interpretations of mathematical expressions in a complex symmetric domain (the open unit disk). To obtain more symmetric properties involving NSSP, we consider a symmetric differential operator. The outcome is a symmetric convoluted operator. Geometrically, studies are presented for the suggested operator. Our method is based on the theory of differential subordination.

Although covered stents have been available for percutaneous treatment of coronary aneurysms, patients with longer aneurysmal segments have been difficult to treat with covered stents. We describe a case of a right coronary artery aneurysm with an angiographically estimated length exceeding 30 mm treated percutaneously using covered stents and conventionally available hardware. (Level of Difficulty: Advanced.)

Cement-polymer composites were developed to enhance the mechanical durability and reduce the porosity of cement, and to acquire a value-added end product useful for many applications in the construction sector. The novel product should be stable during exposure to various challenging environments, e.g., water of different quality, origin, and dissolved ions. The present work evaluated the impact of immersing the new cement-polymer composites (CPs), containing different fractions of recycled waste polystyrene foam, in plain, ground and sea water on the composites’ properties. After 420 days of immersion in all studied types of water, the obtained CPs showed acceptable compressive strength values (more than 30 MPa); in addition, corrosion resistance coefficients (K) were increased more than unity in comparison to non-immersed samples. Moreover, this study also determined alterations of internal architecture of composite specimens cured for 28 days after immersion for up to 420 days in water of different composition. X-ray diffraction (XRD) and scanning electron microscopy (SEM) were used for these studies.

Background: Association of history of coronary artery bypass graft surgery (CABG) with clinical outcomes in patients presenting with ST-segment elevation myocardial infarction (STEMI) is unclear from current data. Methods: Using Nationwide Inpatient Sample (NIS) data from 2003 to 2014, adult patients hospitalized with principal diagnosis of STEMI were extracted. The cohort was divided into patients with a history of CABG and those without a history of CABG. The primary outcome measure was in-hospital mortality (IHM). Results: 2,710,375 STEMI patients were included in final analysis of which 110,066 had history of CABG. Patients with history of CABG had higher unadjusted (12.2% vs. 8.8%, P

The notion of k-symbol special functions has recently been introduced. This new concept offers many interesting geometric properties for these special functions including logarithmic convexity. The aim of the present paper is to exploit essentially two-dimensional wave propagation in the earth-ionosphere wave path using k-symbol Airy functions (KAFs) in the open unit disk. It is shown that the standard wave-mode working formula may be determined by orthogonality considerations without the use of intricate justifications of the complex plane. By taking into account the symmetry-convex depiction of the KAFs, the formula combination is derived.

Background: Robotic-assisted percutaneous coronary intervention (R-PCI) has been successfully employed in the United States since 2011. Performing R-PCI from a remote location has never been reported but if feasible would extend availability of treatment to many patients with coronary artery disease (CAD) who would otherwise go without. Objective: To assess the feasibility of remote tele-R-PCI with the operator 20 miles away from the patients. Methods: Five patients with single, type A coronary artery lesions treatable by PCI consented to participate. The primary endpoint was procedural success with no major adverse cardiac events (MACE) before discharge. Procedural success was defined as achieving

Abstract The economic order quantity (EOQ) model describes the quantity that minimizes the aggregate sum of all cost functions. We propose an assembly for EOQ, nonlinear local fractional differential models with costs functions with respect to time in a cyclic period. For this system, using fractional entropy, we study the related optimization problem and improve a relaxed method for calculating a bounded interval containing the optimal cycle length. Also, for a special class of transportation functions, we study these consequences and introduce processes to compute the optimal size and the matching optimal order stage.

We used the concept of quantum calculus (Jackson’s calculus) in a recent note to develop an extended class of multivalent functions on the open unit disk. Convexity and star-likeness properties are obtained by establishing conditions for this class. The most common inequalities of the proposed functions are geometrically investigated. Our approach was influenced by the theory of differential subordination. As a result, we called attention to a few well-known corollaries of our main conclusions.

Newly, numerous investigations are considered utilizing the idea of parametric operators (integral and differential). The objective of this effort is to formulate a new 2D-parameter differential operator (PDO) of a class of multivalent functions in the open unit disk. Consequently, we formulate the suggested operator in some interesting classes of analytic functions to study its geometric properties. The recognized class contains some recent works.

Recently, microalgal biotechnology has received increasing interests in producing valuable, sustainable and environmentally friendly bioproducts. The development of economically viable production processes entails resolving certain limitations of microalgal biotechnology, and fast evolving genetic engineering technologies have emerged as new tools to overcome these limitations. This review provides a synopsis of recent progress, current trends and emerging approaches of genetic engineering of microalgae for commercial applications, including production of pharmaceutical protein, lipid, carotenoids and biohydrogen, etc. Photochemistry improvement in microalgae and CO2 sequestration by microalgae via genetic engineering were also discussed since these subjects are closely entangled with commercial production of the above mentioned products. Although genetic engineering of microalgae is proved to be very effective in boosting performance of production in laboratory conditions, only limited success was achieved to be applicable to industry so far. With genetic engineering technologies advancing rapidly and intensive investigations going on, more bioproducts are expected to be produced by genetically modified microalgae and even much more to be prospected.

Summary: Histone methyltransferase KMT2D harbors frequent loss-of-function somatic point mutations in several tumor types, including melanoma. Here, we identify KMT2D as a potent tumor suppressor in melanoma through an in vivo epigenome-focused pooled RNAi screen and confirm the finding by using a genetically engineered mouse model (GEMM) based on conditional and melanocyte-specific deletion of KMT2D. KMT2D-deficient tumors show substantial reprogramming of key metabolic pathways, including glycolysis. KMT2D deficiency aberrantly upregulates glycolysis enzymes, intermediate metabolites, and glucose consumption rates. Mechanistically, KMT2D loss causes genome-wide reduction of H3K4me1-marked active enhancer chromatin states. Enhancer loss and subsequent repression of IGFBP5 activates IGF1R-AKT to increase glycolysis in KMT2D-deficient cells. Pharmacological inhibition of glycolysis and insulin growth factor (IGF) signaling reduce proliferation and tumorigenesis preferentially in KMT2D-deficient cells. We conclude that KMT2D loss promotes tumorigenesis by facilitating an increased use of the glycolysis pathway for enhanced biomass needs via enhancer reprogramming, thus presenting an opportunity for therapeutic intervention through glycolysis or IGF pathway inhibitors.

Abstract: Assay of cell-free DNA in blood offers an approach to assessment of tumor DNA. We sought to determine whether Epstein-Barr virus (EBV) DNA in cell-free blood is also a good surrogate for the presence of tumor DNA in children with Hodgkin lymphoma, as it is in adults, and whether it correlates with pediatric outcomes. Pediatric patients enrolled in a Children's Oncology Group trial (AHOD0031) were studied at baseline and at 8 days after the initiation of treatment. At baseline, EBV DNA in cell-free blood correlated with the presence of EBV in tumor, and EBV DNA 8 days after the initiation of therapy predicted inferior event-free survival. EBV DNA in cell-free blood warrants further investigation as a marker of inadequate tumor response in Hodgkin lymphoma. This trial was registered at www.clinicaltrials.gov as #NCT00025259.

Pediatric soft tissue sarcomas of the oral/maxillofacial region are rare neoplasms that present significant difficulty with respect to treatment and local control measures. We report four cases of pediatric oral/maxillofacial soft tissue sarcomas from our tertiary care pediatric hospital and emphasize the rarity of these malignancies and the challenges encountered in treating these lesions, and suggest areas for further research. We conclude that multimodal therapy and interdisciplinary cooperation are paramount to successful management of these lesions.

This investigation deals with a discrete dynamic system of susceptible-infected-susceptible epidemic (SISE) using the Tsallis entropy. We investigate the positive and maximal solutions of the system. Stability and equilibrium are studied. Moreover, based on the Tsallis entropy, we shall formulate a new design for the basic reproductive ratio. Finally, we apply the results on live data regarding COVID-19.

The RAM immunophenotype has been recently described as a subtype of acute myelogenous leukemia (AML) that is characterized clinically by extremely poor prognosis. We present a case of AML with RAM immunophenotype in a 5-year-old patient that resulted in poor outcome despite early hematopoietic cell transplant. We describe the unusual morphologic features that, along with the distinct immunophenotype, may provide initial diagnostic clues and further justify the classification of this AML variant as a rather distinct subtype.

OBJETIVO: Identificar fatores de risco para mortalidade neonatal, com especial atenção aos fatores assistenciais relacionados com os cuidados durante o período pré-natal, parto e história reprodutiva materna. MÉTODOS: Trata-se de um estudo caso-controle realizado em Maceió, Nordeste do Brasil. A amostra consistiu de 136 casos e 272 controles selecionados em bancos de dados oficiais brasileiros. Os casos foram todos os recém-nascidos que morreram antes de completar 28 dias de vida, selecionados no Sistema de Informações sobre Mortalidade, e os controles foram os sobreviventes neste período, selecionados no Sistema de Informações sobre Nascidos Vivos, por sorteio aleatório entre as crianças nascidas na mesma data do caso. Entrevistas domiciliares foram realizadas com as mães. RESULTADOS: A análise de regressão logística identificou como fatores determinantes para a morte no período neonatal mães com história de filhos anteriores que morreram no primeiro ano de vida (OR = 3,08), o internamento durante a gestação (OR = 2,48), o pré-natal inadequado (OR = 2,49), a não realização de ecografia durante o pré-natal (OR = 3,89), a transferência de recém-nascidos para outra unidade após o nascimento (OR = 5,06), os recém-nascidos internados em UTI (OR = 5,00) e o baixo peso ao nascer (OR = 2,57). Entre as condições socioeconômicas, observou-se uma maior chance para mortalidade neonatal em residências com menor número de moradores (OR = 1,73) e com ausência de filhos menores de cinco anos (OR = 10,10). CONCLUSÕES: Vários fatores que se mostraram associados à mortalidade neonatal neste estudo podem ser decorrentes de assistência inadequada ao pré-natal, ao parto e ao recém-nascido, sendo, portanto, passíveis de serem modificados.

Objective: To identify risk factors for neonatal mortality, focusing on factors related to assistance care during the prenatal period, childbirth, and maternal reproductive history. Methods: This was a case-control study conducted in Maceió, Northeastern Brazil. The sample consisted of 136 cases and 272 controls selected from official Brazilian databases. The cases consisted of all infants who died before 28 days of life, selected from the Mortality Information System, and the controls were survivors during this period, selected from the Information System on Live Births, by random drawing among children born on the same date of the case. Household interviews were conducted with mothers. Results: The logistic regression analysis identified the following as determining factors for death in the neonatal period: mothers with a history of previous children who died in the first year of life (OR = 3.08), hospitalization during pregnancy (OR = 2.48), inadequate prenatal care (OR = 2.49), lack of ultrasound examination during prenatal care (OR = 3.89), transfer of the newborn to another unit after birth (OR = 5.06), admittance of the newborn at the ICU (OR = 5.00), and low birth weight (OR = 2.57). Among the socioeconomic conditions, there was a greater chance for neonatal mortality in homes with fewer residents (OR = 1.73) and with no children younger than five years (OR = 10.10). Conclusion: Several factors that were associated with neonatal mortality in this study may be due to inadequate care during the prenatal period and childbirth, and inadequate newborn care, all of which can be modified.

OBJETIVOS: Identificar as características da assistência à saúde de lactentes com muito baixo peso ao nascer no primeiro ano de vida e os fatores associados a esta atenção. MÉTODOS: Estudo descritivo com componente analítico foi realizado na cidade de Maceió, Nordeste do Brasil, com uma amostra de 53 crianças com idade mediana de cinco meses na época da entrevista, e suas respectivas mães. As mães foram entrevistadas no domicílio,quanto às condições socioeconômicas, demográficas e de assistência à saúde da criança. A atenção à saúde foi avaliada com a elaboração de um índice utilizando 16 variáveis relacionadas às ações preconizadas para esta assistência. RESULTADOS: A análise de regressão linear multivariada mostrou que a escolaridade materna e a renda familiar foram as variáveis que, juntas, melhor explicaram a variação do Índice de Atenção à Saúde (18,9%), seguidas da paridade (6,6%) e da prática do aleitamento materno na época da entrevista (6,9%). CONCLUSÕES: Considerando que as famílias com piores condições socioeconômicas e as mulheres com maior número de filhos e que não amamentaram foram os fatores associados a uma assistência inadequada à saúde de crianças nascidas com muito baixo peso, os mesmos deveriam ser contemplados nas ações de planejamento da saúde pública.OBJECTIVES: To identify the characteristics of health care in infants with very low birth weight during the first year of life and the factors associated with this care. METHODS: This was a descriptive study with an analytical component conducted in the city of Maceió, Northeastern Brazil, with a sample of 53 children with a median age of five months at the time of the interview, and their mothers. The mothers were interviewed at home regarding socioeconomic and demographic data and health care provided for the child. Health care was assessed through an index using 16 variables related to the recommended actions for this type of care. RESULTS: Multivariate linear regression analysis showed that maternal education and family income were the variables that best explained the health care index variation (18.9%), followed by parity (6.6%), and breastfeeding at the time of the interview (6.9%). CONCLUSIONS: Considering that families with lower socioeconomic status, women with a higher number of children, and women who did not breastfeed were factors associated with poor health care of children born with very low birth weight, these variables should be included in measures of public health planning.

Objectives: To identify the characteristics of health care in infants with very low birth weight during the first year of life and the factors associated with this care. Methods: This was a descriptive study with an analytical component conducted in the city of Maceió, Northeastern Brazil, with a sample of 53 children with a median age of five months at the time of the interview, and their mothers. The mothers were interviewed at home regarding socioeconomic and demographic data and health care provided for the child. Health care was assessed through an index using 16 variables related to the recommended actions for this type of care. Results: Multivariate linear regression analysis showed that maternal education and family income were the variables that best explained the health care index variation (18.9%), followed by parity (6.6%), and breastfeeding at the time of the interview (6.9%). Conclusions: Considering that families with lower socioeconomic status, women with a higher number of children, and women who did not breastfeed were factors associated with poor health care of children born with very low birth weight, these variables should be included in measures of public health planning.

Objective: To evaluate the importance of combination of biochemical markers in patients with Acute Coronary Syndrome (ACS) and to determine the optimal biochemical strategy for highly sensitive, early diagnosis of myocardial injury. Patients and methods: This study was carried out in coronary care unit in Ibn- Sena Teaching Hospital in Mosul city from January to November, 2008. Two hundred and forty nine patients with (ACS) presented with chest pain and one hundred and eleven apparently healthy subjects. Four cardiac markers Creatine Kinase (CK) and Creatine Kinase-MB (CK-MB) activities (markers of necrosis), myoglobin (marker of muscle injury), and troponin I (marker of necrosis) were estimated in addition to CK-MB index. The collected data were analyzed by chi square, unpaired t-test and analysis of variance (ANOVA). Receiver Operating Characteristics (ROC) analysis was used to assess the role of selected parameters in the diagnosis of ACS and to determine optimal cut-off values for all biochemical markers. Results: The optimal cut-off value of each of 5 parameters with reasonable validity were used to define single test criteria. The serum troponin I was with highest validity among other parameters. The serum troponin I was used in combination with each of the remaining 4 criteria and the test performance was assessed. All combinations were associated with higher specificity than that of serum troponin I alone. However, the accuracy of serum troponin I alone 94.0% was higher than the accuracy of all other combinations. Conclusion: The study has suggested that combining troponin I, myoglobin and CK-MB index yields satisfactory diagnostic sensitivity and thus provide valuable information for clinicians in managing Acute Coronary Syndrome (ACS).

Platelet clumping is a common laboratory phenomenon that complicates or precludes reporting of platelet count. It is often, but not always, a phenomenon commonly caused by the anticoagulant EDTA. Herein, we discuss a case of a 14-year-old girl who was found to have platelet clumping and discuss the work-up she underwent to investigate her pseudothrombocytopenia.

A composite of copper powder reinforced with SiCp (0-10 wt%) in which aluminum powder of ( 2 wt%) was added for improving wettability of the ceramie phase. . The composite mixture was prepared by mixing with a ball mill for one hour to ensure a homogenous distribution on the composite .Gteen compacts pressed at (350MPa) a steel mold of (12mm)diameter were then sintered at (900 °C) for two hours in an electric furnace, in argon atmosphere . Optical microscopy, Density, porosity content and Vicker's hardness test were then conducted for the sintered samples. Obviously, it was concluded that there was enhancement of the physical and mechanical (hardness) properties of the sintered compacts with increasing the SiC content.

Objectives: To compare between the qualitative estimation of biochemical markers Point-of-Care testing) with the quantitative estimation of the same markers in the diagnosis of acute coronary syndrome (ACS). Design: Case-series study. Setting: This study was carried out in coronary care unit in Ibn- Sena Teaching Hospital in Mosul city from January to November, 2008. Participant: Sixty five patients with acute coronary syndrome (ACS) presented with chest pain. Main outcome measures: Three cardiac markers (Creatine kinase (CK-MB) activities (marker of necrosis), myoglobin (marker of muscle injury), and troponin I (marker of necrosis), were estimated qualitatively (near the patient= Point-of-Care testing), and quantitatively, and the results were compared. Kappa test was used for the association between the quantitative and qualitative test results. Results: The case-series study showed correlation of attributes between qualitative estimation results of troponin I, myoglobin and CK-MB and quantitative estimation results of the same parameters in (88.9%) tests. Conclusion: The early diagnosis of ACS might be facilitated by the use of qualitative point-of-care testing based on CK-MB, troponin I and myoglobin tests.

Angiography use has become increasingly common worldwide. Coronary artery aneurysm may be an incidental finding during angiography. Occasionally it might be symptomatic or may become symptomatic over the course of time. Rupture of aneurysm may lead to disastrous complications. Here we present a case in which aneurysm was asymptomatic but surgical intervention was done because of rapid increase in the size of aneurysm. This is to drive home the point that timely surgical intervention is instrumental in preventing complications associated with possible rupture of the aneurysm.

Reinforced composites are prepared from a Copper as a matrix with SiCpowder in different percentage ( i.e 5-25 vol.%) .For each prepared reinforcedcomposite with respect to SiC addition , they divided into two parts , one undergo toaddition of Ni in fixed percentage (2 wt%) and the other part leave without addition.After drying , mixing and milling process, disc samples were prepared . thesesamples were heat treated at (900°C) using furnace at argon atmosphere. Density,porosity, Vicker microhardness , compressive strength were performed. Dry slidingwear tests of Cu–SiCp composites were carried out using pin on disc apparatus with atypical experimental plan of simultaneous variation of loads (5,10)N . The resultsshow that the density was decreased while porosity increased with SiC content , andthis was less remarkable with nickel presence. Vicker microhardness, compressstrength were improved by the nickel wettability on the reinforcement. Moreoverdecreasing in wear rate comparing with the absence one. The nickel presence modifiesthe interface structural model and is effective in passing load between the matrix andthe reinforcement, by lessening the extent of interfacial debonding.

A case of acute promyelocytic leukemia (APL) with RUNX1T1 insertion to 7q is described and compared to reported cases of APL with negative retinoic acid receptor alpha (RARA) abnormality. In this report, we describe the case of a 2-year-old boy who presented with bone pain and was found to have pancytopenia. Bone marrow examination showed morphologic and immunophenotypic findings typical of APL, but conventional cytogenetics, fluorescence in situ hybridization (FISH), and real-time polymerase chain reaction (RT-PCR) showed no evidence of RARA rearrangements. The only cytogenetic abnormality found was a small insertion in 7q, and three copies of RUNX1T1. Gene sequencing results became available after initiating therapy but were not informative. We describe the rarity of such cases and discuss how the typical morphologic and immunophenotypic findings of APL, coupled with the definite absence of RARA rearrangement (by FISH and RT-PCR), present a diagnostic and classification dilemma, raising the possibility of an unknown alternative mechanism for the leukemogenesis and maturation arrest seen in other APL variants. The diagnostic challenges and urgent management issues this unusual case raises may justify including it, along with similar cases, in a separate subtype of acute myeloid leukemia (AML) in future classifications.

We discuss the significance of neutrophils with increased, aberrant nuclear projections mimicking “barbed-wire” in a newborn child with trisomy 18 (T18). Increased, aberrant nuclear projections have been previously reported in trisomy of the D group of chromosomes (chromosomes 13, 14, and 15), and we report similar findings in a patient with T18. The peripheral blood smear showed relative neutrophilia with the majority (37%) of neutrophils showing two or more thin, rod-shaped or spike-shaped, and often pedunculated aberrant nuclear projections. The number of projections ranged from 2 to 6 per cell, averaged 2 per affected neutrophil, and ranged in length from 0.22 μm to 0.83 μm. This case confirms that the morphologic finding described is not restricted to trisomy of one of the chromosomes in group D, as implied in the literature.

Objectives: (a) To compare serum lipid profile in smokers with nonsmokers. (b) To determine the magnitude of dyslipidaemia in the smoker subjects. Methods: This descriptive study was conducted in Al-Zahrawi Private Hospital in Mosul, from January to December 2004. Fasting blood samples were collected from 179 apparently healthy smokers who attended the Outpatient Department and 205 apparently healthy nonsmokers matched age and sex. Serum lipid profile was compared between smokers and nonsmokers. In smokers, Comparison was also done according to the duration of smoking and the number of cigarettes smoked per day. The collected data were analyzed by Chi-square, Z, ANOVA and Duncan tests. Results: Body mass indexes (BMIs) were significantly lower in smokers than in nonsmokers (P

Se evaluó el cultivo de dorada (Brycon sinuensis) en jaulas flotantes durante 180 días. Se determinó el crecimiento mediante la ganancia en longitud, ganancia en peso, tasa de crecimiento específico, sobrevivencia final, biomasa total, factor de condición y factor de conversión alimenticia. Se sembraron 816 juveniles con talla promedio de 17.8 cm de longitud total y peso promedio de 78.7 g, en cuatro tratamientos con densidad de siembra de 25 peces/m3 y tres réplicas cada uno. Las dietas balanceadas (proteína bruta) suministradas fueron: tratamiento 1: 20%; tratamiento 2: 32%; tratamiento 3: 28%; y tratamiento 4: 24%, con diseño experimental completamente aleatorio. Se puede afirmar que la dorada consumió las dietas de origen vegetal de igual manera que las de origen animal, sin embargo la dieta del 28% de proteína bruta (tratamiento 3) muestra los mejores resultados, sin diferencias significativas entre tratamientos (p>0.05). En todos los trabajos anteriores, la ganancia en peso diaria fue baja, pero mejor que las obtenidas en esta investigación. Mientras que el rendimiento en biomasa fue mayor que los reportados para cultivos en estanques, para todos los tratamientos en este estudio fue muy bajo.Dorada´s culture (Brycon sinuensis) in floating cages during 180 days was evaluated. The increment in length, increment in weight, specify growth rate, final survival, total biomass, condition factor and nutritional conversion factor were determinated. 816 fishes with mean length of 17.8 cm total length and mean weight of 78.9 g were stocked in four treatments with stocking densities of 25 fishes/m3 and three replica each one. The balanced diets (gross protein) supplied were: treatment 1: 20%, treatment 2: 32%, treatment 3: 28%, and treatment 4: 24%, with experimental design random completely. Can be affirmed that the dorada fed the diets of vegetable origin as equal way than those of animal origin, although the diet of 28% gross protein (treatment 3) shows best perfomance, without significant differences between treatments (p>0.05). In other works with this species, the daily gain in weight was low, but better than the one obtained in this work; whereas the biomass yield was greater than the biomass yield reported for ponds cultures, the results of this study were very low

Se evaluó el cultivo de la dorada (Brycon sinuensis) a diferentes densidades de siembra. La longitud y peso de siembra fueron de 4.6±0.1 cm de longitud horquilla (LH) y 1.6±0.2 gramos (g), y 14.2±0.4 cm LH y 42.5±7.2 g en levante y preceba, respectivamente. Se alimentó con dieta comercial de 24% de proteína bruta y 2600 Kcal/Kg y el tiempo de cultivo fue de 129 días. Los parámetros físico-químicos fueron: oxígeno disuelto, 3.1±0.5 mg/L; temperatura 30.4±0.1 °C; y pH 5.8±0.2; sólidos totales disueltos 73.7±1.1 mg/L y conductividad, 148.0±2.3 µS/cm. Los mejores valores para crecimiento en longitud y peso fueron 14.7±1.3 cm LH (T1) y 45.4±10.2 g (T1) y 20.2±1.2 cm LH (T2) y 116.8±18.8 (T2) g en levante y preceba, respectivamente, sin diferencias significativas entre tratamientos (p>0.05). Las tasas de crecimiento fueron similares y bajas; la sobrevivencia fue muy baja durante el levante (20.6%±18.8), mejorando en preceba (98.1%±0.4); y el mejor rendimiento en biomasa fue de 3842.3 g (T3) y 6253.2 g (T3) en levante y preceba, respectivamente. En general, se infiere que el tratamiento 3 alcanzó los mejores resultados, que el oxígeno, la temperatura y el pH del agua de los estanques afectaron el crecimiento y desarrollo de los peces, y que la dorada no asimiló eficientemente la dieta suministrada durante el cultivo, debido a que el alimento consumido fue utilizado para el mantenimiento o sobrevivencia y no para el crecimiento.The dorada´s culture (Brycon sinuensis) to different stocking densities was evaluated. The length and stocking weight were: 4.6±0.1 cm fork length (FL) and 1.6±0.2 gram (g), and 14.2±0.4 cm FL and 42.5±7.2 g at growing and finishing phases, respectively. Commercial concentrated with 24% of gross protein and 2600 Kcal/Kg was offered and the time´s culture were 129 days. The physical- physical-chemical parameters were: dissolved oxygen, 3.1±0.5 mg/L; temperature, 30.4±0.1 °C; pH, 5.8±0.2; dissolved total solids, 73.7±1.1 mg/L and conductivity, 148.0±2.3 µS/cm. The best values for growth in length and weight were: 14.7±1.3 cm FL (T1) and 45.4±10.2 g (T1) and 20.2±1.2 cm FL (T2) and 116.8±18.8 (T2) g at growing and finishing phases, respectively, without significant differences between treatments (p>0.05). The growth´s rates were similar and very low; the survival was very low at growing phase (20.6%±18.8), increasing at finishing phase, (98.1%±0.4); and the best yield in biomass were of 3842.3 g (T3) and 6253.2 g (T3) at growing and finishing phases, respectively. In general, it is inferred that the treatment 3 reached the best results, that the dissolved oxygen, the temperature and the pH of the ponds´s water affected the growth and development of fishes, and that the dorada didn’t assimilate efficiently the diet offered during the culture, because the consumed food was used for the maintenance or survival and it doesn’t for the growth.

OBJETIVOS: descrever e comparar fatores socio-econômicos, assistência pré-natal, exposições ao fumo e álcool e fatores reprodutivos entre mães adolescentes e adultas jovens em três maternidades públicas de Maceió, Alagoas, Nordeste do Brasil. MÉTODOS: foram entrevistadas 250 puérperas adolescentes (< 20 anos) e 250 puérperas adultas jovens (20 a 30 anos). Estudo de corte transversal realizado de julho a outubro de 1996. Foi utilizado o qui-quadrado para testar hipóteses de homogeneidade de proporções. RESULTADOS: verificou-se entre as puérperas adolescentes um percentual significantemente maior (p < 0,05) de primiparidade, baixa renda familiar, baixa escolaridade e pouca assistência no pré-natal, em relação às adultas jovens. CONCLUSÕES: mães adolescentes dos hospitais públicos estudados estão associadas às piores condições socioeconômicas e reprodutivas quando comparadas às adultas jovens, merecendo, portanto, maior atenção diferenciada e estruturada na saúde perinatal.OBJECTIVES: describe and compare social and economic conditions, prenatal care, exposure to tobacco and alcohol and reproductive factors among adolescent and young adult mothers in three public maternity hospitals located in Maceió, Alagoas, Northeast Brazil. METHODS: 250 puerperal adolescents (< 20 years old) and 250 puerperal young adult mothers (between 20 and 30 years old) were interviewed. A cross sectional study performed from July to October 1996 was performed. The Chi-Square test was used to test proportion homogeneity hypothesis. RESULTS: among adolescents a significantly higher percentage (p < 0,05) of primiparity, low family income, deficient schooling and insufficient prenatal care as compared to young adults was determined. CONCLUSIONS: adolescent mothers in the public maternity hospitals studied have worse social, economic and reproductive conditions when compared to young adult mothers; therefore they deserve more attention and perinatal care focus.