Dynamic Resource Management in Integrated NOMA Terrestrial-Satellite Networks using Multi-Agent Reinforcement Learning

This study introduces a resource allocation framework for integrated satellite-terrestrial networks to address these challenges. The framework leverages local cache pool deployments and non-orthogonal multiple access (NOMA) to reduce time delays and improve energy efficiency. Our proposed approach utilizes a multi-agent enabled deep deterministic policy gradient algorithm (MADDPG) to optimize user association, cache design, and transmission power control, resulting in enhanced energy efficiency. The approach comprises two phases: User Association and Power Control, where users are treated as agents, and Cache Optimization, where the satellite (Bs) is considered the agent. Through extensive simulations, we demonstrate that our approach surpasses conventional single-agent deep reinforcement learning algorithms in addressing cache design and resource allocation challenges in integrated terrestrial-satellite networks. Specifically, our proposed approach achieves significantly higher energy efficiency and reduced time delays compared to existing methods.Comment: 16, 1

Viral shedding and antibody response in 37 patients with MERS-coronavirus infection

Background. The Middle East respiratory syndrome (MERS) coronavirus causes isolated cases and outbreaks of severe respiratory disease. Essential features of the natural history of disease are poorly understood. Methods. We studied 37 adult patients infected with MERS coronavirus for viral load in the lower and upper respiratory tracts (LRT and URT, respectively), blood, stool, and urine. Antibodies and serum neutralizing activities were determined over the course of disease. Results. One hundred ninety-nine LRT samples collected during the 3 weeks following diagnosis yielded virus RNA in 93% of tests. Average (maximum) viral loads were 5 × 106 (6 × 1010) copies/mL. Viral loads (positive detection frequencies) in 84 URT samples were 1.9 × 104 copies/mL (47.6%). Thirty-three percent of all 108 serum samples tested yielded viral RNA. Only 14.6% of stool and 2.4% of urine samples yielded viral RNA. All seroconversions occurred during the first 2 weeks after diagnosis, which corresponds to the second and third week after symptom onset. Immunoglobulin M detection provided no advantage in sensitivity over immunoglobulin G (IgG) detection. All surviving patients, but only slightly more than half of all fatal cases, produced IgG and neutralizing antibodies. The levels of IgG and neutralizing antibodies were weakly and inversely correlated with LRT viral loads. Presence of antibodies did not lead to the elimination of virus from LRT. Conclusions. The timing and intensity of respiratory viral shedding in patients with MERS closely matches that of those with severe acute respiratory syndrome. Blood viral RNA does not seem to be infectious. Extrapulmonary loci of virus replication seem possible. Neutralizing antibodies do not suffice to clear the infection

Assessment of knowledge, attitude and practice of diabetic people in Najran, Kingdom of Saudi Arabia

Background: This cross-sectional hospital based study aimed at determining the level of knowledge, attitude and practice of diabetes among local people of Najran, Saudi Arabia.Methods: We aimed to investigate the levels of knowledge, attitude and practice among diabetic people in Najran area.Results: 10% of the participants scored >7, 28% scored >5 and 62% scored 5 and less in Knowledge questionnaire. None [0.00%] of the participants scored 7 or more out of the attitude questionnaire. 100% of the participants scored 5 and less out of 12. 100% of the participants scored >6 and 0% scored 12 or more in the practice questionnaire.Conclusions: Our study revealed that the level of knowledge, attitude and practice of diabetes in the area of Najran is very poor. We suggest that a structured educational program to be adopted by the health authorities in Saudi Arabia

Metal-organic frameworks (MOFs) based nanofiber architectures for the removal of heavy metal ions

Environmental heavy metal ions (HMIs) accumulate in living organisms and cause various diseases. Metal-organic frameworks (MOFs) have proven to be promising and effective materials for removing heavy metal ions from contaminated water because of their high porosity, remarkable physical and chemical properties, and high specific surface area. MOFs are self-assembling metal ions or clusters with organic linkers. Metals are used as dowel pins to build two-dimensional or three-dimensional frameworks, and organic linkers serve as carriers. Modern research has mainly focused on designing MOFs-based materials with improved adsorption and separation properties. In this review, for the first time, an in-depth look at the use of MOFs nanofiber materials for HMIs removal applications is provided. This review will focus on the synthesis, properties, and recent advances and provide an understanding of the opportunities and challenges that will arise in the synthesis of future MOFs-nanofiber composites in this area. MOFs decorated on nanofibers possess rapid adsorption kinetics, a high adsorption capacity, excellent selectivity, and good reusability. In addition, the substantial adsorption capacities are mainly due to interactions between the target ions and functional binding groups on the MOFs-nanofiber composites and the highly ordered porous structure

Taguchi L25 (54) approach for methylene blue removal by polyethylene terephthalate nanofiber‐multi‐walled carbon nanotube composite

A membrane composed of polyethylene terephthalate nanofiber and multi‐walled carbon nanotubes (PET NF‐MWCNTs) composite is used to adsorb methylene blue (MB) dye from an aqueous solution. Scanning electron microscopy, Fourier transform infrared spectroscopy, and X‐ ray diffraction techniques are employed to study the surface properties of the adsorbent. Several parameters affecting dye adsorption (pH, MB dye initial concentration, PET NF‐MWCNTs dose, and contact time) are optimized for optimal removal efficiency (R, %) by using the Taguchi L25 (54) Orthogonal Array approach. According to the ANOVA results, pH has the highest contributing percentage at 71.01%, suggesting it has the most significant impact on removal efficiency. The adsorbent dose is the second most affected (12.08%), followed by the MB dye initial concentration of 5.91%, and the least affected is the contact time (1.81%). In addition, experimental findings confirm that the Langmuir isotherm is well‐fitted, suggesting a monolayer capping of MB dye on the PET‐NF‐MWCNT surface with a maximum adsorption capacity of 7.047 mg g−1. Also, the kinetic results are well‐suited to the pseudo‐second‐order model. There is a good agreement between the calculated (qe) and experimental values for the pseudo‐second‐order kinetic model

The Effect of Hepatitis B on Humans

The aim of the study is to know the effect of the hepatitis B virus on humans, how the virus is transmitted, what is the method of preventing it, and what treatment is used to alleviate the severity of the disease. The questionnaire was designed via the Google Drive application and distributed via the social networking application (WhatsApp), with complete transparency to the population targeted by the research. The city of Mecca, from the age of (25-55 years), where 550 questionnaires were distributed via social media application groups (WhatsApp) according to available conditions (distancing), and answers to 525 questionnaires were obtained

The Saudi Critical Care Society practice guidelines on the management of COVID-19 in the ICU: Therapy section

BACKGROUND: The rapid increase in coronavirus disease 2019 (COVID-19) cases during the subsequent waves in Saudi Arabia and other countries prompted the Saudi Critical Care Society (SCCS) to put together a panel of experts to issue evidence-based recommendations for the management of COVID-19 in the intensive care unit (ICU). METHODS: The SCCS COVID-19 panel included 51 experts with expertise in critical care, respirology, infectious disease, epidemiology, emergency medicine, clinical pharmacy, nursing, respiratory therapy, methodology, and health policy. All members completed an electronic conflict of interest disclosure form. The panel addressed 9 questions that are related to the therapy of COVID-19 in the ICU. We identified relevant systematic reviews and clinical trials, then used the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach as well as the evidence-to-decision framework (EtD) to assess the quality of evidence and generate recommendations. RESULTS: The SCCS COVID-19 panel issued 12 recommendations on pharmacotherapeutic interventions (immunomodulators, antiviral agents, and anticoagulants) for severe and critical COVID-19, of which 3 were strong recommendations and 9 were weak recommendations. CONCLUSION: The SCCS COVID-19 panel used the GRADE approach to formulate recommendations on therapy for COVID-19 in the ICU. The EtD framework allows adaptation of these recommendations in different contexts. The SCCS guideline committee will update recommendations as new evidence becomes available

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat