Asthma diagnosis and treatment - 1012. The efficacy of budesonide in the treatmetn of acute asthma in children: a double-blind, randomized, controlled trial.

Background Current evidence suggests that inhaled glucocorticoids (IGC) have a more profound topical none genomic effect on bronchial airways as compared to systemic glucocorticoids. The value of adding IGC to current therapy of acute asthma is not well established. Methods We conducted a double-blind, randomized, two-arm, parallel groups, controlled clinical trial to compare the addition of budesonide 1500 mcg or placebo (normal saline) to standard acute asthma treatment (albuterol and ipratropium bromide) administered in 3 divided mixed doses within 1 hour in the emergency department (ED). Children 2-12 years of age with moderate or severe acute asthma, scoring 8-15/15 on a well-validated scoring system were included. Both groups received a single dose of prednisone 2 mg/kg/day (max. 60 mg) at the beginning of therapy. The primary outcome was admission rate within 2-4 hours from starting therapy. Results A total of 723 children were enrolled in the study over 17 months duration, of whom 139 were allowed to re-enroll and be randomized to constitute 906 randomization assignments (458 on the treatment group and 448 on the control group); with baseline mean + SD asthma score of 10.63 + 1.73; age 5.52 + 2.76 years; 35% girls; 30.8% (16.5%) with baseline severe asthma score of ≥12 (≥ 13). Statistical Analysis plan allowed for the potential dependency in response due to reenrollments of a subset of children, using Generalized Linear Mixed Modeling (GLMM) techniques. Baseline demographic and clinical characteristics were not significantly different between the two randomized groups. Seventy-five out of 458 (16.4%) of the treatment group vs. 82/448 (18.3%) of the control group were admitted, (OR 0.85, CI: 0.59-1.23, p-value=0.39). Among the severe asthmatics with baseline score ≥13, treatment vs. placebo group, GLMM adjusted admission rate was 30% vs. 47%, indicating a 17% difference in admission rate in favor of the treatment group (adjusted OR of 0.49, CI: 0.25-0.95; p-value= 0.035) that indicated a 51% reduction in the risk of admission for the treatment vs. control group. Conclusions Children with baseline severe asthma score ≥13 who were treated with budesonide had a significant reduction in their admission rate

Synthesis and Characterization of New Polyimide Contain Heterocyclic

Novel heterocyclic polyimide 5(a,b) have been synthesized based on polyacrylic backbone. The synthetic route start with nucleophilic substitution of 2-amino, or 4-amino, pyridine 1(a,b) to the polyacryloyl chloride afforded poly substituted amide 2(a,b). Another nucleophilic substitution were carried with adipoyl chloride to form polyimide chloride 3(a,b). Treatment of 3(a,b) with hydrazine hydrate afforded acid hydrazide polyimide 4(a,b), which upon cyclocondensation with carbon disulfide gave the target heterocyclic polyimide. The synthesized compounds were identified by spectroscopic methods: FT-IR, 1H-NMR and 13C-NMR

Synthesis, Characterization and Antibacterial Activity of Cefalexin Dervatives

New series of Schiff bases 2(a-j) and corresponding beta-lactam derivatives 3(a-j) were synthesized from cefalexin (1) as starting material. The compound (1) was reacted with different aldehydes and ketones to give Schiff bases derivatives 2(a-j). The synthesized Schiff bases were cyclized by chloroacetyl chloride in the presence of triethylamine to form beta-lactam derivatives 3(a-j). The compounds were characterized by deremination melting point, FT-IR and 1H NMR. The beta-lactam derivatives were screened in vitro antibacterial against some bacterial specie

Comparison and Evaluation of Deadlock Prevention Methods for Different Size Automated Manufacturing Systems

In automated manufacturing systems (AMSs), deadlocks problems can arise due to limited shared resources. Petri nets are an effective tool to prevent deadlocks in AMSs. In this paper, a simulation based on existing deadlock prevention policies and different Petri net models are considered to explore whether a permissive liveness-enforcing Petri net supervisor can provide better time performance. The work of simulation is implemented as follows. (1) Assign the time to the controlled Petri net models, which leads to timed Petri nets. (2) Build the Petri net model using MATLAB software. (3) Run and simulate the model, and simulation results are analyzed to determine which existing policies are suitable for different systems. Siphons and iterative methods are used for deadlocks prevention. Finally, the computational results show that the selected deadlock policies may not imply high resource utilization and plant productivity, which have been shown theoretically in previous publications. However, for all selected AMSs, the iterative methods always lead to structurally and computationally complex liveness-enforcing net supervisors compared to the siphons methods. Moreover, they can provide better behavioral permissiveness than siphons methods for small systems. For large systems, a strict minimal siphon method leads to better behavioral permissiveness than the other methods

Very low prevalence of epidermal growth factor receptor (EGFR) protein expression and gene amplification in Saudi breast cancer patients

<p>Abstract</p> <p>Background</p> <p>Breast cancers which demonstrate EGFR protein expression, gene amplification and/or gene mutations may benefit therapeutically from tyrosine kinase inhibitors. In Western studies, EGFR protein expression has been demonstrated in 7-36% of breast cancer patients, while gene amplification has been found in around 6% of cases and mutations were either absent or extremely rare. Studies addressing EGFR protein expression and gene amplification in Saudi breast cancer patients are extremely scanty and the results reported have been mostly non-conclusive. Herein we report the prevalence of EGFR protein expression and gene amplification in a cohort of Saudi breast cancer patients.</p> <p>Findings</p> <p>We noticed a remarkably low incidence of EGFR protein expression (1.3%) while analyzing the spectrum of molecular subtypes of breast cancer in a Saudi population by immunohistochemistry. Also, <it>EGFR </it>gene amplification could not be demonstrated in any of 231 cases studied using silver enhanced <it>in situ </it>hybridization.</p> <p>Conclusions</p> <p>The extremely low incidence of EGFR protein expression and gene amplification in Saudi breast cancer patients as compared to Western populations is most probably ethnically related as supported by our previous finding in the same cohort of a spectrum of molecular breast cancer types that is unique to the Saudi population and in stark contrast with Western and other regionally based studies. Further support to this view is provided by earlier studies from Saudi Arabia that have similarly shown variability in molecular breast cancer subtype distribution between Saudi and Caucasian populations as well as a predominance of the high-grade pathway in breast cancer development in Middle East women. More studies on EGFR in breast cancer are needed from different regions of Saudi Arabia before our assumption can be confirmed, however.</p

Impact of Globalization on the Architecture of Mosques in Jordan

Благодарности: научному руководителю Панкиной М. В., профессору кафедры культурологии и дизайна УрФУ.Acknowledgments: Pankina M. V., Professor of the Department of Cultural Studies and Design, Ural Federal University.В исследовании проведено сравнение археологических и современных мечетей Иордании. Проанализированы планировочные решения, методы строительства и структура фасадов. Сделан вывод о сохранении традиций и новых чертах культовых сооружений, что обусловлено процессами глобализации и международным сотрудничеством архитекторов.The study compared the archaeological and modern mosques in Jordan. Planning solutions, construction methods and facade structure are analyzed. The conclusion is made about the preservation of traditions and new features of religious buildings. This is due to the processes of globalization and international cooperation of architects

Confusion Control in Generalized Petri Nets Using Synchronized Events

The loss of conflicting information in a Petri net (PN), usually called confusions, leads to incomplete and faulty system behavior. Confusions, as an unfortunate phenomenon in discrete event systems modeled with Petri nets, are caused by the frequent interlacement of conflicting and concurrent transitions. In this paper, confusions are defined and investigated in bounded generalized PNs. A reasonable control strategy for conflicts and confusions in a PN is formulated by proposing elementary conflict resolution sequences (ECRSs) and a class of local synchronized Petri nets (LSPNs). Two control algorithms are reported to control the appeared confusions by generating a series of external events. Finally, an example of confusion analysis and control in an automated manufacturing system is presented