Assessment of lacrimal glands in thyroid eye disease with diffusion-weighted magnetic resonance imaging

Purpose: To assess the lacrimal glands in patients with thyroid eye disease with diffusion-weighted magnetic resonance (MR) imaging. Material and methods: This study was carried out on 44 consecutive patients (17 males, 27 females, with mean age 36 years) with thyroid eye disease and 20 age- and sex-matched volunteers. They underwent diffusion-weighted MR imaging of the orbit. The apparent diffusion coefficient (ADC) values of the lacrimal glands were calculated and correlated with the clinical activity score (CAS). Results: The mean ADC of lacrimal glands in thyroid eye disease (1.73 × 10-3 mm2/s) was significantly higher (p = 0.001) than that of volunteers (1.52 × 10-3 mm2/s). The cutoff ADC value of lacrimal gland used for differentiation of thyroid eye disease from volunteers was 1.62 × 10–3 mm2/s with an area under the curve value of 0.95 and an accuracy of 96%. There was significant difference (p = 0.03) in the ADC of the lacrimal glands in patients with active (n = 24) and inactive (n = 20) disease. The cutoff ADC value of the lacrimal gland used to suspect active disease was 1.76 × 10-3 mm2/s with an area under the curve value of 0.80 and an accuracy of 82%. There was positive correlation between the ADC value of the lacrimal glands and CAS (r = 0.73, p = 0.001). Conclusions: The ADC of the lacrimal glands is a non-invasive imaging parameter that can be used for diagnosis of thyroid eye disease and to predict the active form of the disease

Role of diffusion-weighted magnetic resonance (MR) imaging in differentiation between graves' disease and painless thyroiditis

Background: To assess the role of diffusion-weighted MR imaging in differentiation between Graves' disease and painless thyroiditis. Material/Methods: A prospective study was conducted among 37 consecutive patients with untreated thyrotoxicosis (25 female and 12 male; mean age of 44 years) and 15 age- and sex-matched controls. Diffusion-weighted MR imaging of the thyroid gland was performed in patients and controls. The apparent diffusion coefficient (ADC) value of the thyroid gland was calculated and correlated with Tc-99m uptake and thyroid function tests of the patients. Results: There was a significant difference in the ADC value of the thyroid gland between patients and the control group (P=0.001). The mean ADC value of the thyroid gland in Graves' disease was 2.03±0.28×10-3 mm2/sec, and in patients with painless thyroiditis 1.46±0.22×10-3 mm2/sec, respectively. There was a significant difference in the ADC values between Graves' disease and painless thyroiditis (P=0.001). When the ADC value of 1.45×10-3 mm2/sec was used as a threshold value for differentiating Graves' disease from painless thyroiditis, the best result was obtained with area under the curve of 0.934, accuracy of 83.8%, sensitivity of 95.8%, and specificity of 61.5%. The mean ADC value of the thyroid gland in patients positively correlated with serum TRAb and Tc-99m uptake (r=0.57, P=0.001 and r=0.74, P=0.001, respectively). Conclusions: We concluded that ADC values of the thyroid gland can be used to differentiate Graves' disease from painless thyroiditis in patients with untreated thyrotoxicosis

Long jump training emphasizing plyometric exercises is more effective than traditional long jump training: A randomized controlled trial

The aim of the study was to evaluate the impact of an 8-weeksplyometric training program on the sprint and jump performance. The intervention study employed a controlled experimental design with two parallel groups of male long jumpers. While the experimental group (n = 18) trained with plyometric exercises, the control group (n=10) performed classical long jump training. Both groups were examined for athletic performance (30m sprint, standing long jump, vertical jump) and biomechanical parameters of a long-jump movement (max vertical height, horizontal and vertical velocity at take-off, flight time, take-off duration) prior and following the intervention. The experimental group demonstrated significantly better developments than the control group in most of the physical and biomechanical parameters respectively and improved their long jump records. Combining an 8-weeksplyometricprogram with athletics training significantly develops long jump and general athletic performance as well as biomechanical parameters. Therefore, plyometric training can be recommended to athletics coaches as an additional training alternative to improve sprint and long jump abilities in athletes

Application of machine learning algorithms to evaluate the influence of various parameters on the flexural strength of ultra-high-performance concrete

The effect of various parameters on the flexural strength (FS) of ultra-high-performance concrete (UHPC) is an intricate mechanism due to the involvement of several inter-dependent raw ingredients. In this digital era, novel artificial intelligence (AI) approaches, especially machine learning (ML) techniques, are gaining popularity for predicting the properties of concrete composites due to their better precision than typical regression models. In addition, the developed ML models in the literature for FS of UHPC are minimal, with limited input parameters. Hence, this research aims to predict the FS of UHPC considering extensive input parameters (21) and evaluate each their effect on its strength by applying advanced ML approaches. Consequently, this paper involves the application of ML approaches, i.e., Support Vector Machine (SVM), Multi-Layer Perceptron (MLP), and Gradient Boosting (GB), to predict the FS of UHPC. The GB approach is more effective in predicting the FS of UHPC precisely than the SVM and MLP algorithms, as evident from the outcomes of the current study. The ensembled GB model determination coefficient (R2) is 0.91, higher than individual SVM with 0.75 and individual MLP with 0.71. Moreover, the precision of applied models is validated by employing the k-fold cross-validation technique. The validity of algorithms is ensured by statistical means, i.e., mean absolute error and root mean square errors. The exploration of input parameters (raw materials) impact on FS of UHPC is also made with the help of SHAP analysis. It is revealed from the SHAP analysis that the steel fiber content feature has the highest influence on the FS of UHPC

Crack sliding model for non-shear FRP-reinforced slender concrete elements under shear

Fiber-reinforced polymer (FRP)-reinforced concrete (RC) elements fail under one-way shear in a devastating and complicated manner with no adequate warning. In recent decades, there has been pioneering research in this area; however, there is no agreement among researchers regarding mechanically-based models. Thus, in this current study, a plasticity-based model is developed for FRP-RC elements under shear. A selected model was firstly assessed for its accuracy, consistency, and safety against an extensive experimental database. Secondly, a plasticity-based model (i.e., crack shear sliding model) was adapted, refined, and proposed for FRP-RC elements under one-way shear. The two proposed models were found to be reliable and more accurate with respect to selected existing methods. Modeling of FRP’s axial rigidity is more consistent only under Young’s modulus with respect to the experimental database. Several concluding remarks on the selected existing models are outlined and discussed to assist the future development of these models and design codes

Viral etiology, seasonality and severity of hospitalized patients with severe acute respiratory infections in the Eastern Mediterranean Region, 2007-2014.

INTRODUCTION: Little is known about the role of viral respiratory pathogens in the etiology, seasonality or severity of severe acute respiratory infections (SARI) in the Eastern Mediterranean Region. METHODS: Sentinel surveillance for SARI was conducted from December 2007 through February 2014 at 20 hospitals in Egypt, Jordan, Oman, Qatar and Yemen. Nasopharyngeal and oropharyngeal swabs were collected from hospitalized patients meeting SARI case definitions and were analyzed for infection with influenza, respiratory syncytial virus (RSV), adenovirus (AdV), human metapneumovirus (hMPV) and human parainfluenza virus types 1-3 (hPIV1-3). We analyzed surveillance data to calculate positivity rates for viral respiratory pathogens, describe the seasonality of those pathogens and determine which pathogens were responsible for more severe outcomes requiring ventilation and/or intensive care and/or resulting in death. RESULTS: At least one viral respiratory pathogen was detected in 8,753/28,508 (30.7%) samples tested for at least one pathogen and 3,497/9,315 (37.5%) of samples tested for all pathogens-influenza in 3,345/28,438 (11.8%), RSV in 3,942/24,503 (16.1%), AdV in 923/9,402 (9.8%), hMPV in 617/9,384 (6.6%), hPIV1 in 159/9,402 (1.7%), hPIV2 in 85/9,402 (0.9%) and hPIV3 in 365/9,402 (3.9%). Multiple pathogens were identified in 501/9,316 (5.4%) participants tested for all pathogens. Monthly variation, indicating seasonal differences in levels of infection, was observed for all pathogens. Participants with hMPV infections and participants less than five years of age were significantly less likely than participants not infected with hMPV and those older than five years of age, respectively, to experience a severe outcome, while participants with a pre-existing chronic disease were at increased risk of a severe outcome, compared to those with no reported pre-existing chronic disease. CONCLUSIONS: Viral respiratory pathogens are common among SARI patients in the Eastern Mediterranean Region. Ongoing surveillance is important to monitor changes in the etiology, seasonality and severity of pathogens of interest

Cubically cage-shaped mesoporous ordered silica for simultaneous visual detection and removal of uranium ions from contaminated seawater

A dual-function organic-inorganic mesoporous structure is reported for naked-eye detection and removal of uranyl ions from an aqueous environment. The mesoporous sensor/adsorbent is fabricated via direct template synthesis of highly ordered silica monolith (HOM) starting from a quaternary microemulsion liquid crystalline phase. The produced HOM is subjected to further modifications through growing an organic probe, omega chrome black blue G (OCBBG), in the cavities and on the outer surface of the silica structure. The spectral response for [HOM-OCBBG → U(VI)] complex shows a maximum reflectance at λmax = 548 nm within 1 min response time (tR); the LOD is close to 9.1 μg/L while the LOQ approaches 30.4 μg/L, and this corresponds to the range of concentration where the signal is linear against U(VI) concentration (i.e., 5-1000 μg/L) at pH 3.4 with standard deviation (SD) of 0.079 (RSD% = 11.7 at n = 10). Experiments and DFT calculations indicate the existence of strong binding energy between the organic probe and uranyl ions forming a complex with blue color that can be detected by naked eyes even at low uranium concentrations. With regard to the radioactive remediation, the new mesoporous sensor/captor is able to reach a maximum capacity of 95 mg/g within a few minutes of the sorption process. The synthesized material can be regenerated using simple leaching and re-used several times without a significant decrease in capacity. Graphical abstract: [Figure not available: see fulltext.

Cobalt doped titania-carbon nanosheets with induced oxygen vacancies for photocatalytic degradation of uranium complexes in radioactive wastes

The photocatalytic degradation of uranium complexes is considered among the most efficient techniques for the efficient removal of uranium ions/complexes from radioactive wastewater. Described here is a nanostructured photocatalyst based on a cobalt-doped TiO2 composite with induced oxygen vacancies (Co@TiO2-C) for the photocatalytic removal of uranium complexes from contaminated water. The synergy between oxygen vacancies and Co-doping produced a material with a 1.7 eV bandgap, while the carbon network facilitates electron movement and hinders the e-h recombination. As a result, the new photocatalyst enables the decomposition of uranium-arsenazo iii complexes (U-ARZ3), followed by photocatalytic reduction of hexavalent uranium to insoluble tetravalent uranium. Combined with the nanosheet structure's high surface area, the photocatalytic decomposition, reduction efficiency, and kinetics were significantly enhanced, achieving almost complete U(vi) removal in less than 20 minutes from solution with a concentration as high as 1000 mL g−1. Moreover, the designed photocatalyst exhibits excellent stability and reusability without decreasing the photocatalytic performance after 5 cycles

Assessment of the competence in electrocardiographic interpretation among Arabic resident doctors at the emergency medicine and internal medicine departments: A multi-center online cross-sectional study

BackgroundThis study aims to assess the electrocardiographic interpretation abilities of resident doctors at internal medicine and emergency medicine departments in eight Arabic countries.MethodsAn online cross-sectional study was conducted between October 7, 2022 and October 21, 2022 in eight Arabic countries. The questionnaire consisted of two main sections: the first section included sociodemographic information, while the second section contained 12 clinical case questions of the most severe cardiac abnormalities with their electrocardiography (ECG) recordings.ResultsOut of 2,509 responses, 630 were eligible for the data analysis. More than half of the participants were males (52.4%). Internal medicine residents were (n = 530, 84.1%), whereas emergency medicine residents were (n = 100, 15.9%). Almost participants were in their first or second years of residency (79.8%). Only 36.2% of the inquired resident doctors had attended an ECG course. Most participants, 85.6%, recognized the ECG wave order correctly, and 50.5% of the participants scored above 7.5/10 on the ECG interpretation scale. The proportions of participants who were properly diagnosed with atrial fibrillation, third-degree heart block, and atrial tachycardia were 71.1, 76.7, and 56.6%, respectively. No statistically significant difference was defined between the internal and emergency medicine residents regarding their knowledge of ECG interpretation (p value = 0.42). However, there was a significant correlation between ECG interpretation and medical residency year (p value < 0.001); the fourth-year resident doctors had the highest scores (mean = 9.24, SD = 1.6). As well, participants in the third and second years of postgraduate medical residency have a probability of adequate knowledge of ECG interpretation more than participants in the first year of residency (OR = 2.1, p value = 0.001) and (OR = 1.88, p value = 0.002), respectively.ConclusionAccording to our research findings, resident doctors in departments of internal medicine and emergency medicine in Arabic nations have adequate ECG interpretation abilities; nevertheless, additional development is required to avoid misconceptions about critical cardiac conditions

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London