Effect of physical training on lung function and respiratory muscles strength in policewomen trainees

Background: Measurement of respiratory muscles strength has not been widely investigated in the context of physical training.Methods: This cross-sectional study has assessed pulmonary function and strength of respiratory muscles in two women groups: group I includes healthy policewomen (n=28) exposed to physical training 3 hours daily for at least 2 years and group II is a matched control group (n=31) of untrained apparently healthy second year medical students. Lung function tests including forced vital capacity (FVC), forced expiratory volume in the first second (FEV1) and peak expiratory flow rate (PEF) were performed using a digital spirometer and maximum inspiratory and expiratory pressures (MIP and MEP) as indicators for respiratory muscle strength were measured using a digital respiratory pressure meter.Results: The mean FVC (L), FEV1 (L), PEF (L/min) values were significantly higher in the police-trained group (p=0.000, 0.000 and 0.003 respectively). Similarly, the mean MIP and MEP (cm/H2O) values were significantly higher among trained group (p=0.000 and 0.003 respectively).Conclusions: Long-term regular physical exercise improves lung function as well as respiratory muscle power and may delay the age-related decline in lung function.

The Constitutional Controls over Issuing Temporary Laws in the Jordanian Constitution of 1952 In Light of the Constitutional Amendments of 2011

This Study tackles a significant subject in the successive Jordanian constitutional systems, which are temporary laws issued by the council of ministers with approval of the King in accordance with Article (94) of the Constitution. This Article has been of criticism of Jurists and researchers because of the expansion of qualifying subjective and temporal circumstances for issuing them. Therefore, the competent authority of constitutional amendment opined that the constitutional amendments should include the constitutional provision, which governed issuing like this kind of legislation. Hence, the constitutional legislator restricted the Executive Authority having jurisdiction of issuing them within a period of four months following only the decree of the dissolution of the Chamber of Deputies. This temporal restriction must be coincident with one of the exceptional circumstances identified by the constitutional legislator, which are the state of war, emergencies, public disasters, and the need to pay out urgent financial expenses. These laws are subject to the censorship of the Parliament in the first session it holds, in which the Parliament might endorse these laws, then they, concerning their legal description, change from temporary to ordinary laws. The Parliament might amend or reject them. In this situation, the council of ministers must, with approval of the king, pronounce their nullification immediately without affecting the acquired rights. These laws also are subject to the judicial review represented by the Constitutional Court review on constitutionality of these laws by virtue of Article (59) of the Constitution. The study has concluded several recommendations and outcomes. Among the most substantial outcomes is that despite the constitutional amendment of Article (94) restricting the jurisdiction of the Executive Authority to issue the temporary laws, but in the more confined exceptional circumstances, the state of public disasters might be interpreted widely by the Executive Authority leading to the expansion of issuing them. The constitutional amendment has passed over clarifying the authority competent to issue this kind of laws within the time between the periods of holdings identified by six months

Post-Kala-Azar Dermal Leishmaniasis: A Paradigm of Paradoxical Immune Reconstitution Syndrome in Non-HIV/AIDS Patients

Visceral leishmaniasis (VL) is a parasitic disease characterized by immune suppression. Successful treatment is usually followed by immune reconstitution and a dermatosis called post-Kala-azar dermal leishmaniasis (PKDL). Recently, PKDL was described as one of the immune reconstitution syndromes (IRISs) in HIV/VL patients on HAART. This study aimed to present PKDL as a typical example of paradoxical IRIS in non-HIV/AIDS individuals. Published and new data on the pathogenesis and healing of PKDL was reviewed and presented. The data suggested that PKDL is a typical example of paradoxical IRIS, being a new disease entity that follows VL successful treatment and immune recovery. PKDL lesions are immune inflammatory in nature with granuloma, adequate response to immunochemotherapy, and an ensuing hypersensitivity reaction, the leishmanin skin test (LST). The data also suggested that the cytokine patterns of PKDL pathogenesis and healing are probably as follows: an active disease state dominated by IL-10 followed by spontaneous/treatment-induced IL-12 priming, IL-2 stimulation, and INF-γ production. INF-γ-activated macrophages eliminate the Leishmania parasites/antigen to be followed by LST conversion and healing. In conclusion, PKDL is a typical example of paradoxical IRIS in non-HIV/AIDS individuals with anti-inflammatory cytokine patterns that are superseded by treatment-induced proinflammatory cytokines and lesions healing

Cure of post Kala-azar dermal leishmaniasis with paromomycin/sodium stibogluconate combination: a proof of concept

Background: Post kala-azar dermal leishmaniasis (PKDL) is  a  recognized  dermatologic  complication  of  successfully  treated  visceral  leishmaniasis  (VL). PKDL lesions are suspected to be important reservoirs for VL transmission in Sudan. Prolonged treatment schedules, feeling of general well-being and the social stigmata of PKDL prevent most patients seeking treatment. The mainstay of treatment is cardiotoxic sodium stibogluconate (SSG) for 60-120 days. Recently, liposomal amphotericin B (Ambisome®) and immunochemotherapy gave promising results. Ambisome® is expensive and difficult to prepare under field conditions. Paromomycin/SSG combination has been shown to be safe, efficacious and can save time in VL treatment. This study aims to prove that Paromomycin/SSG combination can cure and reduce PKDL treatment duration.Methods:We are reporting nine cases of patients with PKDL lesions of ≥6 months duration who were diagnosed by clinical signs, histopathological/immunohistochemical and PCR.Results: Patients’ mean age was 11.7 ± 4.3 years. A third of the patients (3/9; 33.3%) who failed previous SSG treatment of 2-3 months duration responded completely to 40 days of paromomycin/SSG combination. The majority of patients (5/9; 55.6%) responded completely to 30 days of the combination. One patient (1/9; 11.1%) relapsed following 30 days paromomycin/SSG combination.Conclusion:It was concluded that paromomycin/SSG combination for 30 days is time-saving, safe and efficacious for PKDL treatment.

Stakeholder identification overview and challenges in requirements engineering prospective

Stakeholder identification (SI) illustrates a critical part of the requirements elicitation activity. It helps software analysts gather accurate system requirements to ensure high quality and avoid system failure. Stakeholder identification considered one of the earliest stages of project development. The main problem related to project success and failure is identifying the real stakeholders and selecting the right one. The lack of stakeholder identification methodologies and the shortage of previous research in identifying the stakeholders for different systems, encourage the research to propose a guideline framework, assist analysts in building the convenient methodology for identifying real stakeholders. Stakeholders are defined based on different projects and the various services they provide. This difference leads to the fact that a particular and systematic technique must be used to identify stakeholders based on the project's types. The exploration of stakeholder identification matters and the guideline framework is a baseline for future research in requirements engineering

Relationship between obesity, physical activity, sleeping hours and red blood cell parameters in adult Sudanese population: Effect of exercise and sleep hours on RBC parameters

Ideal body weight with proper physical activity and good sleep are essential parameters for good quality of life. This study is concerned with assessing the association of general obesity, physical activity and sleeping hours with hemoglobin (Hb) concentration and red blood cell (RBC) parameters in healthy adults in Sudan. In this cross sectional study, 1086 healthy adults between 20 and 60 years were included out of which 275 were males and 811 were females. A complete blood count (CBC) was performed for Hb, RBC count, PCV, MCH and MCHC using Sysmex KX-21 automated hematology analyzer. The median and 95 percentile (2.5th to 97.5th) range values for Hb and RBC count in underweight were 13.0 (Range: 9.6-16.7) g/dl and 4.6 (Range: 3.6-5.8) ×103/µL respectively, while Hb and RBC count in obese were 13.1 (Range: 10.4-17.0) g/dl and 4.6 (Range: 3.7-5.9) ×103/µL respectively, with no significant difference. The RBC count (p=0.004) and Hb (p?0.001) were significantly high in physically active compared to physically inactive participants; whereas the hemoglobin concentration (p=0.047), red blood cells (p=0.007) and hematocrit (p?0.001) values were significantly low in long-term sleep compared to normal sleeping hours. In conclusion, there were no significant differences in hemoglobin concentration, RBC count, PCV, MCH and MCHC between unde weight, normal weight, overweight and obese persons. Increased physical activity was associated with higher Hb levels and RBC counts, while long-term sleep showed lower Hb and RBCs

Darcy flow and heat transfer of nanoliquid within a porous annulus with incorporating magnetic terms

Current investigation was carried out to analyze the treatment of nanomaterial within a domain which experienced magnetic force. Outer rhombus wall is cold and the inner circle has uniform heat flux and due to these conditions, carrier fluid rotates counterclockwise. Darcy law was used for simulation and Joule heating was neglected in equations. Influences of parameters were discussed in plots and contours and CVFEM has been employed to reach such outputs. Rotational core becomes stronger with the rise of Ra while opposite results have been accomplished with the soar of Ha. In cases with higher values of shape factor, Nu has higher values and a similar trend is reported for Rd. Moreover, Nu experiences 30% reduction when Ha augments. This negative impact becomes more sensible when radiation terms are added in equations. Inclusion of nano powders has a favorable impact on Nu although it has a negative impact on temperature gradient

Smart healthcare system for severity prediction and critical tasks management of COVID-19 patients in IoT-fog computing environments

COVID-19 has depleted healthcare systems around the world. Extreme conditions must be defined as soon as possible so that services and treatment can be deployed and intensified. Many biomarkers are being investigated in order to track the patient's condition. Unfortunately, this may interfere with the symptoms of other diseases, making it more difficult for a specialist to diagnose or predict the severity level of the case. This research develops a Smart Healthcare System for Severity Prediction and Critical Tasks Management (SHSSP-CTM) for COVID-19 patients. On the one hand, a machine learning (ML) model is projected to predict the severity of COVID-19 disease. On the other hand, a multi-agent system is proposed to prioritize patients according to the seriousness of the COVID-19 condition and then provide complete network management from the edge to the cloud. Clinical data, including Internet of Medical Things (IoMT) sensors and Electronic Health Record (EHR) data of 78 patients from one hospital in the Wasit Governorate, Iraq, were used in this study. Different data sources are fused to generate new feature pattern. Also, data mining techniques such as normalization and feature selection are applied. Two models, specifically logistic regression (LR) and random forest (RF), are used as baseline severity predictive models. A multi-agent algorithm (MAA), consisting of a personal agent (PA) and fog node agent (FNA), is used to control the prioritization process of COVID-19 patients. The highest prediction result is achieved based on data fusion and selected features, where all examined classifiers observe a significant increase in accuracy. Furthermore, compared with state-of-the-art methods, the RF model showed a high and balanced prediction performance with 86% accuracy, 85.7% F-score, 87.2% precision, and 86% recall. In addition, as compared to the cloud, the MAA showed very significant performance where the resource usage was 66% in the proposed model and 34% in the traditional cloud, the delay was 19% in the proposed model and 81% in the cloud, and the consumed energy was 31% in proposed model and 69% in the cloud. The findings of this study will allow for the early detection of three severity cases, lowering mortality rates.Web of Science2022art. no. 501296

Efficacy and Safety of AmBisome in Combination with Sodium Stibogluconate or Miltefosine and Miltefosine Monotherapy for African Visceral Leishmaniasis: Phase II Randomized Trial.

BACKGROUND: SSG&PM over 17 days is recommended as first line treatment for visceral leishmaniasis in eastern Africa, but is painful and requires hospitalization. Combination regimens including AmBisome and miltefosine are safe and effective in India, but there are no published data from trials of combination therapies including these drugs from Africa. METHODS: A phase II open-label, non-comparative randomized trial was conducted in Sudan and Kenya to evaluate the efficacy and safety of three treatment regimens: 10 mg/kg single dose AmBisome plus 10 days of SSG (20 mg/kg/day), 10 mg/kg single dose AmBisome plus 10 days of miltefosine (2.5mg/kg/day) and miltefosine alone (2.5 mg/kg/day for 28 days). The primary endpoint was initial parasitological cure at Day 28, and secondary endpoints included definitive cure at Day 210, and pharmacokinetic (miltefosine) and pharmacodynamic assessments. RESULTS: In sequential analyses with 49-51 patients per arm, initial cure was 85% (95% CI: 73-92) in all arms. At D210, definitive cure was 87% (95% CI: 77-97) for AmBisome + SSG, 77% (95% CI 64-90) for AmBisome + miltefosine and 72% (95% CI 60-85) for miltefosine alone, with lower efficacy in younger patients, who weigh less. Miltefosine pharmacokinetic data indicated under-exposure in children compared to adults. CONCLUSION: No major safety concerns were identified, but point estimates of definitive cure were less than 90% for each regimen so none will be evaluated in Phase III trials in their current form. Allometric dosing of miltefosine in children needs to be evaluated. TRIAL REGISTRATION: The study was registered with ClinicalTrials.gov, number NCT01067443

African Linguistics in Central and Eastern Europe, and in the Nordic Countries

Non peer reviewe