A General Approach Students’ Attitude towards to Virtual Reality Technology in Distance Education Environment

E-learning has become a prominent and effective role in recent years. The factor of place and time became ineffective in the educational process. So that anyone can learn anywhere in the world. The educational services that benefit the learner during the educational process as well as the factors of assistance are important elements that help in the success of the educational process in the environment of e-learning. The more these services, the greater the benefit from e-learning. But its way of reviewing electronic content is still ineffective. Therefore it was necessary to create a suitable environment for the learner is similar to the real reality. Through which the learner feels the integration and concentration in the academic content as if it were realistic. So, the trend was to take advantage of the virtual reality technology that have become effective in all fields. The use of this technology will help the learner gain mo re realism and make full use of the electronic content. This study reviews the effect of the use of virtual reality technology in the review of the learner\u27s electronic content, as well as the attitudes and opinions of the students of the Business Information Systems program at the Faculty of Commerce, Helwan University, Cairo, Egypt, about the use of this technology and to what extent will effect on change and effectiveness in the quality of educational process

Assessment of Retinal Nerve Fiber Layer Thickness Using Optical Coherence Tomography Before and After Ranibizumab Intravitreal Injection in Patients with Diabetic Macular Edema

Background: Anti-Vascular Endothelial Growth Factor (Anti-VEGF) therapy serves to decrease central retinal thickness in eyes affected with diabetic macular edema (DME). The Retinal Nerve Fiber Layer (RNFL) forms the basis of the optic nerve. Objectives: Our study is concerned with studying the effects of Anti-VEGF injections in patients with DME on RNFL thickness. Patients and methods: This was a prospective cohort interventional study conducted at South Valley University Hospital, Ophthalmology department outpatient clinic. It included 50 diabetic patients with diabetic macular edema whose RNFL thickness was measured before the anti-VEGF injections and again after the completion of the three injections treatment course using spectral domain optical coherence tomography (SD-OCT). Results: This study included 50 eyes from 50 patients. 35 (70%) of them were females and 15 (30%) of them were males. 26 patients (52%) had their right eye injected, and 24 patient (48%) had their left eye injected. The superior quadrant of the RNFL showed a mean increase of 1.2 microns (SD = 38.4, 95% Confidence Interval CI = -9.7:12.1, p value = 0.829). The inferior quadrant showed a mean increase of 7.5 microns (SD = 35.6, 95% CI = -2.6:17.6, p value = 0.144). The nasal quadrant showed a mean increase of 8.3 microns (SD = 23, 95% CI = 1.8:14.9, p value = 0.014). The temporal quadrant showed a mean increase of 4.1 microns (SD = 33.2, 95% CI = -5.3:13.6, p value = 0.386). Conclusion: There is no statistically significant correlation between intra-vitreal injections of anti-VEGF and the RNFL thickness

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Real-time PCR: A rapid and sensitive method for diagnosis of dermatophyte induced onychomycosis, a comparative study

Onychomycosis is the most common nail disorder, accounting for up to 50% of all nail problems and about 30% of cutaneous fungal infections. Treatment of onychomycosis is expensive. It requires long-term therapy with an oral antifungal medication with potential side effects. Therefore, a proper diagnosis of infection is needed. Aim of the study: This study aimed to compare real time PCR using novel primers targeting the pan-dermatophyte-specific sequence of the chitin synthase 1 gene (CHS1) with nested PCR targeting the same gene, KOH microscopy, direct microscopy in relation to culture for diagnosis of clinically suspected onychomycosis. Subjects and methods: This study was conducted during the period from April 2013 through May 2014. Eighty patients attending Outpatient Dermatology and Andrology clinic at Benha University Hospital were included in this study. They were 30 females and 50 males with suspected clinical diagnosis of onychomycosis. Their ages ranged from 22 to 77 years. Thirty eight of them were living in rural areas, while the other 42 came from urban areas. Nail scrapings were collected and examined by the following: direct KOH microscopic examination, culture, nested PCR using double sets of primers and finally real time PCR. Results: As regards direct microscopy by KOH examination, 66 (82.50%) cases were positive, while 14 (17.5%) were negative. Culture was positive only in 38 (47.5%) of nail samples revealing different fungi. Dermatophytes were isolated from 30 (37.5%) cases; most of them were Trichophyton mentagrophytes, and in 8 cases the only isolated non-dermatophytic organism was Aspergillus Niger spp. (10.00%). Nested PCR was positive in 52 (65.00%) of nail samples while real time PCR was positive in 58 (72.5%) of nail samples. Conclusion: Real-time PCR followed by melting-point analysis, gives a diagnostic tool that has a higher sensitivity (93.3%) and is faster than nested PCR (73.3%) and other conventional methods

Using a Fuzzy Genetic Algorithm for Solving Transportation Logistics Problems

Recently, Science defined transportation as the most potent component of logistics. In addition, it has an interdependent relationship with business logistics. Also, AI is intervened in transportation logistics to solve transportation issues. Also, it is used for optimizing and obtaining possible solutions for critical and complex problems. This paper aims to optimize costs and profit to get satisfaction for individuals and organizations using AI techniques. A proposed methodology consisted of two phases. The first phase discusses data collection, and the second involves applying FGA Artificial Intelligence techniques. A proposed Transportation Logistics model was used to determine boundary profit for each Product, and a Fuzzy Genetic Algorithm FGA for transportation logistics was done to solve transportation issues. According to that, outcomes were detected by optimizing the transportation cost by detecting the parent's and the child's chromosomes, and it took the number of iterations =2000. Also, between 100 loops, the best of 5 loops took 1.53 Millie seconds per loop Using GA. Similarly, GA was used for optimizing the minimum total cost of the Product also by determining parents and child chromosomes, which took the Number of iterations= 2000, and among 100 loops, the best five loops took 1.40 ms per loop. Moreover, determining the profit boundary of each predicted Product using triangular fuzzy logic shows that the minimum profit is considered between (20 million and 23.9 million), while the moderate profit is (24 million), and the maximum profit is more than (24.1 million)

Nano-scaled polyacrylonitrile for industrialization of nanofibers with photoluminescence and microbicide performance

Abstract Nanofibers are investigated to be superiorly applicable in different purposes such as drug delivery systems, air filters, wound dressing, water filters, and tissue engineering. Herein, polyacrylonitrile (PAN) is thermally treated for autocatalytic cyclization, to give optically active PAN-nanopolymer, which is subsequently applicable for preparation of nanofibers through solution blow spinning. Whereas, solution blow spinning is identified as a process for production of nanofibers characterized with high porosity and large surface area from a minimum amounts of polymer solution. The as-prepared nanofibers were shown with excellent photoluminescence and microbicide performance. According to rheological properties, to obtain spinnable PAN-nanopolymer, PAN (12.5–15% wt/vol, honey like solution, 678–834 mPa s), thermal treatment for 2–4 h must be performed, whereas, time prolongation resulted in PAN-nanopolymer gelling or rubbering. Size distribution of PAN-nanopolymer (12.5% wt/vol) is estimated (68.8 ± 22.2 nm), to reflect its compatibility for the production of carbon nanofibers with size distribution of 300–400 nm. Spectral mapping data for the photoluminescent emission showed that, PAN-nanopolymer were exhibited with two intense peaks at 498 nm and 545 nm, to affirm their superiority for production of fluorescent nanofibers. The microbial reduction % was estimated for carbon nanofibers prepared from PAN-nanopolymer (12.5% wt/vol) to be 61.5%, 71.4% and 81.9%, against S. aureus, E. coli and C. albicans, respectively. So, the prepared florescent carbon nanofibers can be potentially applicable in anti-infective therapy

An authentication protocol based on Kerberos 5

We introduce some modifications to the widely deployed Kerberos authentication protocol. The principle’s secretkey will be independent of the user password to overcome the weak passwords chosen by the network principal that are susceptible to password guessing attacks, the main drawback of the Kerberos protocol. Instead, the Kerberos Distribution Center saves a profile for every instance in its realm to generate the principle’s secret-key by hashing the profile, and encrypting the output digest. Besides, the lifetime of the secret-key is controlled using the system clock. Triple-Des is used for encryption, SHA-256 for hashing, and Blum Blum Shub for random number generation

Solving Fully Rough Interval Multi-level Multi-objective linear Fractional Programming Problems via FGP

This paper introduces an algorithm for solving fully rough intervalmulti-level multi-objective linear fractional programming problems where all of its coefficients in objective functionsand in constraints are rough intervals. At the first phases of the solution approach and to avoid the complexity of the problem, the shifting method proposed by Osman and El-sherbiny [20] will be used to split the rough problem into four crisp problems which will be solved simultaneously. At the second phase, for each problem, a membership function was constructed to develop a fuzzy goal programming model for obtaining the satisfactory solution of the multilevel multi-objective fractional programming problem. The linearization process introduced by Pal et. al [1] will be applied to linearize the membership functions. Finally, an illustrative numerical example is given to demonstrate the algorithm