Behçet’s disease: Spectrum of MDCT chest and pulmonary angiography findings in patients with chest complaints

AbstractObjectiveThe aim of the work was directed to evaluate the value of multi-detector computed tomography pulmonary angiography study in evaluation of known patients with Behcet’s disease.Materials and methodsThis study was done retrospectively and included eighteen known patients with Behcet’s disease and referred for MDCT pulmonary angiography.ResultsPulmonary artery aneurysm was the most common finding as it was found in 16 patients, followed by pulmonary embolism which was found in 14 patients, 12 patients with pulmonary hypertension, right ventricular strain in 6 patients, intracardiac thrombus in 4 patients, dilated bronchial arteries in 8 patients, venous occlusion in 4 patients, mosaic attenuation of the lung in 12 patients, pulmonary infarcts in 4 patients, and pleural effusion in 4 patients.ConclusionMDCT pulmonary angiography is an important diagnostic imaging tool for diagnosis of vascular complications in patients with Behcet’s disease

Forecasting wind power based on an improved al-Biruni Earth radius metaheuristic optimization algorithm

Wind power forecasting is pivotal in optimizing renewable energy generation and grid stability. This paper presents a groundbreaking optimization algorithm to enhance wind power forecasting through an improved al-Biruni Earth radius (BER) metaheuristic optimization algorithm. The BER algorithm, based on stochastic fractal search (SFS) principles, has been refined and optimized to achieve superior accuracy in wind power prediction. The proposed algorithm is denoted by BERSFS and is used in an ensemble model’s feature selection and optimization to boost prediction accuracy. In the experiments, the first scenario covers the proposed binary BERSFS algorithm’s feature selection capabilities for the dataset under test, while the second scenario demonstrates the algorithm’s regression capabilities. The BERSFS algorithm is investigated and compared to state-of-the-art algorithms of BER, SFS, particle swarm optimization, gray wolf optimizer, and whale optimization algorithm. The proposed optimizing ensemble BERSFS-based model is also compared to the basic models of long short-term memory, bidirectional long short-term memory, gated recurrent unit, and the k-nearest neighbor ensemble model. The statistical investigation utilized Wilcoxon’s rank-sum and analysis of variance tests to investigate the robustness of the created BERSFS-based model. The achieved results and analysis confirm the effectiveness and superiority of the proposed approach in wind power forecasting

A novel voting classifier for electric vehicles population at different locations using Al-Biruni earth radius optimization algorithm

The rising popularity of electric vehicles (EVs) can be attributed to their positive impact on the environment and their ability to lower operational expenses. Nevertheless, the task of determining the most suitable EV types for a specific site continues to pose difficulties, mostly due to the wide range of consumer preferences and the inherent limits of EVs. This study introduces a new voting classifier model that incorporates the Al-Biruni earth radius optimization algorithm, which is derived from the stochastic fractal search. The model aims to predict the optimal EV type for a given location by considering factors such as user preferences, availability of charging infrastructure, and distance to the destination. The proposed classification methodology entails the utilization of ensemble learning, which can be subdivided into two distinct stages: pre-classification and classification. During the initial stage of classification, the process of data preprocessing involves converting unprocessed data into a refined, systematic, and well-arranged format that is appropriate for subsequent analysis or modeling. During the classification phase, a majority vote ensemble learning method is utilized to categorize unlabeled data properly and efficiently. This method consists of three independent classifiers. The efficacy and efficiency of the suggested method are showcased through simulation experiments. The results indicate that the collaborative classification method performs very well and consistently in classifying EV populations. In comparison to similar classification approaches, the suggested method demonstrates improved performance in terms of assessment metrics such as accuracy, sensitivity, specificity, and F-score. The improvements observed in these metrics are 91.22%, 94.34%, 89.5%, and 88.5%, respectively. These results highlight the overall effectiveness of the proposed method. Hence, the suggested approach is seen more favorable for implementing the voting classifier in the context of the EV population across different geographical areas

Impact of Anisakis pegreffi Infection on Gonadal Health and Gonadosomatic Index of European Hake (Merluccius merluccius)

Parameters belonging to the physical status and gonadal size of certain fish provide crucial information for assessing both the productivity and fecundity of declining fish populations. These parameters are vulnerable to the negative impacts of disease agents such as internal or systemic parasites. Although parasitic diseases might influence these parameters, the literature investigating these pathophysiological alterations is scanty. Therefore, the current study represents one of the scarcest studies that document the possible link between parasitism, gonadal health, and the growth of European hake (Merluccius merluccius). Screening of imported European halves indicated a relatively high prevalence of Anisakis pegreffi Larvae 3 infestation, with an 80% prevalence rate, a mean intensity of 24.4, and a mean abundance of 19.5. However, the prevalence of Anisakid larvae infection in native fish was 36% with a mean intensity of 7.36 and mean abundance of 2.65.The current research revealed remarkable ovarian pathology that involved several forms of degenerative changes in ovarian tissues. Such gonadal pathologies were attributed to the damaging effect of the retrieved Anisakis pegreffi Larvae 3. Gonadosomatic index of both heavily infected imported / native hakes was relatively impacted by the progressive gonadal pathology resulting from Anisakis pegreffi L3 infection. Morphometric measurements of the gonads and body have revealed that, gonadosomatic index of both heavily infected imported / native hakes was relatively impacted by the progressive gonadal pathology resulting from Anisakis pegreffi L3 infection

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

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

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&nbsp;years; 78.2% included were male with a median age of 37&nbsp;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

Designing for inseparable Conjoined twins: Interaction Design Approach (Craniopagus Case Study)

Conjoined twins are two babies who are born physically connected to each other. For some of these conjoined twins the separation process is possible, but for some others is not. Therefore, it is important to design special products to support them in their daily activities and mental and physical development without health and psychological problems. As well as helping parents to care for their children in their work as parents of children with problems in dealing with their needs and dealing with those around them.Research Importance:The research presents a case study "Menna and Mai". They are two identical twin girls of the type attached to the head (Craniopagus). And the focus to solve the problem of walking and mobility as one of the problems faced by each of the twins and deal with each other with parents and deal with this problem in the case of the pre-separation or non-separation. The researchers explored and discussed the related needs, the limitations and conditions in order to suggest a suitable design for this specific case, applying interaction design technics to decrease the complexity of the using process for both parents and kids, and in the same time ensure kids ability to develop their own identity, skills as normal as possible.Research ObjectivesFocusing on one need, which is walking, as a basic need to develop the rest of child’s skills easily and naturally, that moving kid is a learning kid. Helping the two girls to walk freely and response for each of them to give the opportunity to walk and help each other

Egyptian Surrealism in The Printable Design of Ladies Clothes appurtenances

The Origins of Surrealist thought in Egypt back to the discovery and establishment of a new world of perceptions unrealism vital forms, rich, and the conversion of continuous change and power through the vital forces. Egyptian surrealists aim to use a means to force the contents of the subconscious; some of them use the world of symbols and signs and forms so represented the language, could detect the importance of using the texture techniques close analogy of photography, whether in the natural elements or fairy tales. • The research problem:      The research problem can be formulated in the following question How to take advantage of the structural foundations of constructivist movement Egyptian Movement surrealists characters through the work of some of its artists (Abdul Hadi al-Jazzar, Hamed Nada, Samir Rafie) to achieve innovative entrances to develop systems and new directions Printing designs for ladies modern typographical manner. • The goal of the search:      Research aims to adapt the methods the touch and tonal and formal fine for some Egyptian surrealistic artists To innovating and originality typographic designs for integrant of clothes sovereign and do Presentation of study analytic for some composition and the relative to its directions To achieve new dimensions in the pilot thought of using some computer programs specialized in this area • Procedural steps of the searching: - The analytic study the technician for selected from works of some Egyptian surrealist artists. -  Manners of the printing design for women integrant sovereign clothes. - The Applied means. - The Printing designs (The self-study experience)