An Enhanced Adaptive Learning System based on Microservice Architecture

This study aims to enhance Adaptive Learning Systems (ALS) in Petroleum Sector in Egypt by using the Microservice Architecture and measure the impact of enhancing ALS by participating ALS users through a statistical study and questionnaire directed to them if they accept to apply the Cloud Computing Service “Microservices” to enhance the ALS performance, quality and cost value or not. The study also aims to confirm that there is a statistically significant relationship between ALS and Cloud Computing Service “Microservices” and prove the impact of enhancing the ALS by using Microservices in the cloud in Adaptive Learning in the Egyptian Petroleum Sector. After developing and strengthening the ALS using the cloud computing with the benefits of using Function as a Services “FaaS”, the functions are start rapidly in order to allow handling of individual requests by using the Microservice Architecture. This study includes a description of the statistic field study approach (The study’s community and its sample. As well as used tools, methodologies, and their validity and reliability. It also includes used procedures for tools codification and their application. Finally, statistical processes that were relied upon in study analysis)

Pathogenicity, host specificity and genetic diversity in Norwegian isolates of Microdochium nivale and Microdochium majus

Microdochium majus and Microdochium nivale cause serious disease problems in grasses and cereal crops in the temperate regions. Both fungi can infect the plants during winter (causing pink snow mould) as well as under cool humid conditions during spring and fall. We conducted a pathogenicity test of 15 M. nivale isolates and two M. majus isolates from Norway at low temperature on four different grass cultivars of Lolium perenne and Festulolium hybrids. Significant differences between M. nivale isolates in the ability to cause pink snow mould were detected. The M. nivale strains originally isolated from grasses were more pathogenic than isolates from cereals. The genetic diversity of M. nivale and M. majus isolates was studied by sequencing four genetic regions; Elongation factor-1 alpha (EF-1α), β-tubulin, RNA polymerase II (RPB2) and the Internal Transcribed Spacer (ITS). Phylogenetic trees based on the sequences of these four genetic regions resolved M. nivale and M. majus isolates into separate clades. Higher genetic diversity was found among M. nivale isolates than among M. majus isolates. M. nivale isolates revealed genetic differences related to different host plants (grasses vs. cereals) and different geographic regions (Norway and UK vs. North America). Sequence results from the RPB2 and β-tubulin genes were more informative than those from ITS and EF-1α. The genetic and phenotypic differences detected between Norwegian M. nivale isolates from cereals and grasses support the assumption that host specialization exist within M. nivale isolates.publishedVersio

Helicobacter pylori Immunoglobulin-M Antibodies among Urticaria and Non-urticaria Patients Attending Khartoum Dermatology Hospital, Sudan

Abstract Background: Helicobacter pylori is the commonest bacterium that infects human

Memorex in the Neonatal Resuscitation Program (NRP). hottest recommendations from NRP 8th edition 2021

Background: Optimal neonatal resuscitation in the first few minutes of life (the Golden minutes) can save critically ill neonates. Presentation: additional new steps include the Resuscitation Quality Improvement Program (RQI) focusing on the skill of positive pressure ventilation. The four pre-birth questions are Gestational age, clear Amniotic fluid, Additional risk factors, and Umbilical cord management plan. Initial steps fulfil Warm, dry, stimulate, position airway and, suction if needed. When an alternative airway becomes necessary, a cardiac monitor is essential. The initial IV or IO dose of epinephrine is 0.02 mg/kg (equal to 0.2 mL/kg). The endotracheal epinephrine dose equal to 0.1 mg/kg (1 mL/kg). Flush IV/IO epinephrine with 3 mL normal saline for all babies. Support skin-to-skin care for bonding, breastfeeding and normothermia. If the confirmed absence of HR after all appropriate steps are performed, consider cessation of resuscitation efforts around 20 minutes after birth (Initiate discussion with the family). Unchanging steps, a qualified person or resuscitation team should attend every delivery. Establish briefing, delegate workload, and check equipment. Key behavioural skills, including the call for help. Upon delivery, a rapid assessment is the baby term, muscle tone and breathing or crying, then commencing the initial steps. Use plastic wrap for less than 32 weeks. Lung Ventilation and Ventilation Corrective Steps (MRSOPA) is the critical steps. Adjust suction pressure from 60-100 and the flowmeter to 10 L/min, oxygen with 21%, increased judiciously guided by preductal saturation. If the heart rate is less than 60 despite adequate 30-second ventilation intubate, start chest compression for 60 seconds by two thumbs technique. If still bradycardic, give the medications. Delayed cord clamping of stable babies and avoid cord milking in preterm. Conclusion: NRP regulations changed according to evidence-based medicine. The latest NRP edition will help all institution

Effect of Intravenous Ketamine Infusion on Hemodynamics of Patients Undergoing Cesarean Delivery after Spinal Anaesthesia: A Randomized, Double-Blind, Controlled Trial

Objective:Hypotension is the most frequent side effect of intrathecal anaesthesia, with an incidence of more than 80%. Following neuraxial anaesthesia, perioperative shivering is a serious complication affecting 40-60% of patients undergoing surgery. This study aimed to determine the effectiveness of low-dose ketamine on blood pressure in patients undergoing cesarean delivery after spinal anaesthesia.Methods:We included 126 female patients undergoing cesarean deliveries, American Society of Anesthesiologists (ASA)-(II and III), and aged 21-40 selected from the outpatient clinics of the anaesthesia department. Patients were randomized to two groups; Group K (63 patients), who received 0.3 mg kg-1 of ketamine IV diluted to 10 mL, followed by an infusion of 0.1 mg kg-1 h-1. Group C (Controlled) (63 patients) received 10 mL of normal saline, followed by an infusion of 0.1 mL kg-1 h-1, which started before spinal anaesthesia.Results:Compared with the saline group, the average heart rate, blood pressure, and level of sedation were significantly higher in the ketamine group (P 0.05).Conclusion:Ketamine decreases the incidence of hypotension and shivering in patients undergoing spinal anaesthesia during cesarean delivery. In addition, it resulted in improved sedation for the mother and prolonged postoperative analgesia without neonatal illness

Cardioprotective effects of gallic acid on an isoprenaline-induced myocardial infarction rat model

The use of antioxidants to protect against a wide range of human disease, including ischemic heart disease, has moved to the forefront in cardiovascular research. Gallic acid has shown promising effects against oxidative stress-induced disease; however, its effect in ischemic heart disease has not been well-studied. We designed the current work to investigate the potential protective effect of gallic acid against isoprenaline (ISO)-induced myocardial infarction (MI). Rats were injected subcutaneously with ISO, 100 mg/ kg for 2 days, to induce MI. Gallic acid treated rats received 15 mg/ kg gallic acid orally for 10 days prior to ISO injection. The histopathological examination of the Haematoxylin and Eosin-stained heart sections from the ISO treated rats shows karyopyknosis, hypereosinophilia, loss of striation, infiltration of macrophage in the interstitium, and thrombosis of the blood vessels, all of which indicate the induction of MI. In addition, ISO treatment significantly increased the plasma level of malondialdehyde and troponin-I, as well as the activity of alanine aminotransferase, lactate dehydrogenase, and creatine kinase, compared to untreated controls. Pre-treatment with gallic acid significantly attenuated the ISO-induced biochemical and histopathological changes, compared to untreated controls. Our results show that ISO induced oxidative stress-mediated MI, and that gallic acid protects the rat heart from MI, at least in part, through antioxidant mechanisms

The effect of high-dose vitamin D supplementation and an exercise program to lose weight on some biochemical variables of overweight women

Background and Study Aim. In recent years, there has been a technological revolution and development in all fields, particularly the sports field. This has imposed on man a lifestyle characterized by comfort at the expense of a significant portion of his movement and activities. The problem of obesity has expanded beyond the inconsistency of the body to include its direct effect of increasing the proportion of fat and the negative impact on the work of vital organs. This disruption alters the body's internal environment and causes numerous diseases. The purpose of this study is to determine the effect of a sports program on taking vitamin D to lose weight and on some biochemical variables in young adults aged 30 to 35 years old. Materials and Methods. The study involved 10 overweight women aged 30-35 years, selected through intentional sampling. Inclusion criteria required consent, good health, and no ongoing vitamin D or exercise programs. The research employed a Randomized Controlled Trial (RCT) design. Primary outcome measures encompassed body weight, body composition, lipid profile, and vitamin D status. Anthropometric measurements included age, height, weight, and training age. Biochemical measurements involved blood tests for cholesterol, triglycerides, and vitamin D levels. The experimental group received vitamin D tablets and a proposed aerobic exercise program for 12 weeks. Results. The proposed aerobic sports program with vitamin D intake improved biochemical variables, such as total fat, total cholesterol, triglyceride, high-density cholesterol, low-density cholesterol, OH, and Vitamin D-025 for the sample under investigation. The application of the aerobic program with vitamin D led to weight loss among the study's female participants. The aerobic program with vitamin D intake has a positive effect on the general health status of the sample. Conclusions. Based on the study's findings, it is recommended to consider the positive effects of Vitamin D on the overall functional state of the body, making it essential to incorporate an aerobic sports program across various age groups. Regular medical tests are crucial for monitoring and maintaining overall health. Emphasizing the importance of regular exercise is vital in preventing weight gain and reducing the risk of certain chronic diseases. By implementing these recommendations, individuals can enhance their overall well-being and lead a healthier lifestyle. To further validate these outcomes, similar studies should be conducted on different age groups and diverse samples

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely