The effect of blended learning of the maternity course on academic student's achievements and satisfaction

Background: Blended learning is an advanced model that encompasses the advantages of both traditional teaching in the classroom, Information and Communication Technology supported learning. Blended learning requires rigorous efforts, right attitude, handsome budget and highly motivated teachers and students for its successful implementation. Aim: To assess the nursing students' achievements and satisfaction toward blended learning. Design: A descriptive study design. Setting: Faculty of nursing, Fayoum University. Sample: Convenience sample of 170 nursing student at third level maternity department. Tools: three tools were used to collect study data, structured interviewing questionnaire, Academic achievement form and Student Satisfaction questionnaire. Results: More than half of studied students were female, more than three quarter of them uses smart phones, more than half of students have high achievement score is excellent, majority of students were satisfied with blended learning. There were highly statistically significant between total satisfaction, total achievement and statistically significant between demographic characteristics, achievement and satisfaction. Conclusion: more than half of students with high total achievement score are excellent, about sixty percent were satisfied toward blended learning, and also, there is highly statistically significant between total satisfaction and total achievement. Recommendation: Involve blended learning as alternative plan at the time of crisis.&nbsp

Do anti-carbamylated protein antibodies in rheumatoid arthritis reflect local and systemic osteoporosis? A study of osteoprotegrin and receptor activator for nuclear factor kappa B ligand and radiological assessment

Abstract Background One of the most important and dangerous complications of rheumatoid arthritis (RA) is bone loss, which manifested by erosions and juxta-articular or systemic bone loss. Anti-carbamylated protein (anti-CarP) antibodies which are also called anti-homocitrulline antibodies have recently been found in RA. Increase anti-CarP antibody titres may lead to severe disease and increase the progression of bone loss. Osteoprotegrin and receptor activator for nuclear factor kappa B and its ligand (RANKL) are the main players in the pathogenesis of osteoporosis. Thus, we aimed to investigate and detect the presence and prevalence of anti-CarP in rheumatoid arthritis and their association with disease severity and osteoporosis, as well as with OPG/RANKL in 80 Egyptian RA patients to highlight this relationship which could be useful in managing RA patients with osteoporosis. Results Serum anti-CarP levels were significantly increased in the RA group compared with the control group (P< 0.001). We found a negative association between anti-CarP and anti-CCP and disease activity (r=−0.878, −0.534, respectively, P<0.001). We also found a positive correlation between anti-CarP and the Larsen score, DEXA score, RF, HAQ, and RANKL (r=0.646, 0.287, 0.243, 0.892, 0.671, 0.869 [respectively], P<0.001) and there was negative correlation between anti-CarP and OPG (r=−0.553, P<0.001). Conclusion Anti-CarP antibodies are associated with disease severity and disability in RA patients. They could play an important and significant role in the pathogenesis of osteoporosis in these patients

Effect of Using a Plastic Stent with Apically Repositioned Flap in Peri-Implant Soft Tissue Augmentation: A Randomized Controlled Clinical Trial

Objectives. This study aimed to clinically assess and compare the width of peri-implant keratinized mucosa following the use of a readymade plastic stent with apically repositioned flap versus conventional apically repositioned flap with papillary sparing incisions during single-stage implant placement protocol. Materials and Methods. A total of 20 patients were enrolled in this study. In the test group, a prefabricated implant-retained stent was clipped on the healing abutment after implant surgery to reposition the keratinized tissue buccoapically. In the control group, simple interrupted sutures were applied instead of using a stent. After the surgical procedure, the width of the buccal keratinized mucosa was measured at the mesial, middle, and distal aspects of the healing abutment. The change in the width of the buccal keratinized mucosa was assessed at 3 months and 6 months. Results. No statistically significant difference was found between the stent group and control group in 6 months’ interval where p=0.840, where both groups showed the same mean value of 4.70 ± 0.35 and 4.70 ± 0.63, respectively. The percent of change in the width of KM was found to be higher in the stent group than in the control group with no statistical significance. Conclusion. The use of a readymade plastic stent in combined full/partial-thickness apically repositioned flap shows to be effective in increasing the width of KM compared to the conventional technique. This trial is registered with NCT03754894

Design and Modeling of Ultra-Compact Wideband Implantable Antenna for Wireless ISM Band

This paper proposes a wideband ultra-compact implantable antenna for a wireless body area network (WBAN). The proposed patch antenna works in the industrial, scientific, and medical (ISM) bands. The proposed patch antenna with an ultra-compact size (5 × 5 × 0.26 mm3) was designed with 29% wide bandwidth (about 670 MHz). This wide bandwidth makes the antenna unaffected by implantation in different human body parts. The miniaturization process passed many steps by adding many slots with different shapes in the radiating element as well as in the ground plane. A 50 Ω coaxial feeding excites the antenna to maintain matching and low power loss. The specific absorption rate (SAR) was calculated for health considerations. The result was within the standard limits of IEEE organizations and the International Commission on Non-Ionizing Radiation Protection (ICNRP). The antenna was tested in tissues with multiple layers (up to seven layers) and at various depths (up to 29 mm). The link margin was calculated, and the proposed antenna enables 100 Kbps of data to be transferred over a distance of 20 m and approximately 1 Mbps over a distance of 7 m. The proposed antenna was fabricated and tested. The measured S11 parameters and the simulated results using the Computer Simulation Technology (CST Studio) simulator were in good agreement

Impacts of poultry by-product meal substituting fishmeal on growth efficiency, body composition, liver, and intestine morphology of European sea bass, Dicentrarchus labrax

A twelve week feeding experiment was conducted to evaluate the replacement of fishmeal (FM) with poultry by-product meal (PBM) in practical diets for European sea bass, Dicentrarchus labrax with an average initial weight of 0.89 g. Five isocaloric (5.1 kcal lipid g−1) and isonitrogenous (451 g protein kg−1) diets were formulated with PBM replacing FM at levels of 0% (control), 25%, 50%, 75%, and 100%. The experiment was carried out in 30-in. nylon mesh net cages (hapas). At the termination of the trial, growth performance including final body weight, weight gain, specific growth rate, and protein growth rate of diets containing up to 75% PBM were comparable to those of the control group, whereas the diet with 100% PBM resulted in a significantly lower values (p < 0.05). Feed utilization exhibited variation among the treatments (p < 0.05). Whole body composition also showed significant differences across the dietary treatments. Essential amino acid (EAA) contents specifically arginine (Arg), histidine (His), methionine (Met), and threonine (Thr) in the whole body of fish fed diets with up to 50% PBM replacement were not significantly different from those in the control group. Furthermore, the intestinal microvilli length, width and absorption area increased significantly (p < 0.05) with PBM replacement levels up to 50%. Histological analysis of the liver revealed mild vacuolation of hepatocytes in fish fed up to 50% PBM,while pre-pancreatic fatty degeneration of hepatocytes was observed in fish fed diets with 75% and 100% PBM. Therefore, this study demonstrates that PBM can replace up to 50% of FM in the diets of European sea bass without adverse effects on growth performance, body composition, or liver and intestine morphology

Neuronal autoantibodies in a sample of Egyptian patients with drug-resistant epilepsy

Abstract Background Epilepsy is one of the most common and chronic neurological diseases. About one-third of epilepsy patients do not achieve seizure freedom despite adequate therapy with antiseizure medications (ASMs) and develop drug-resistant epilepsy (DRE). Autoimmunity is increasingly being recognized as a cause of epilepsy in those patients. Some cases are associated with antibodies against several target antigens, including neuronal extracellular proteins as well as intracellular structures. In such patients, immunotherapy may be highly effective. This study aimed to investigate the presence of NMDA-R, AMPA1-R, AMPA2-R, CASPR2, LGI1, GABAB-R, and GAD65 autoantibodies in a sample of Egyptian patients with new-onset DRE; also, to assess the clinical, cerebrospinal fluid (CSF), electroencephalogram (EEG), and radiological characteristics of those patients. Twenty-five patients with recent onset DRE were recruited from the department of Neurology at Ain Shams University (ASU) hospitals. All patients underwent serum and CSF antibody testing using cell-based assay (CBA) at the Immunology unit of the Clinical pathology laboratory at ASU hospitals. This is beside routine CSF analysis, EEG and MRI brain with contrast. Results Out of 25 patients with recent onset DRE, one (4%) patient tested positive to anti-NMDA-R antibodies and another one (4%) tested positive to anti-GAD 65 in both serum and CSF. Although the remaining 23 patients tested negative for the 7 autoantibodies, yet 92% of them achieved either seizure freedom or more than 50% reduction in the frequency of seizure and 84% had marked improvement in seizure-associated symptoms after receiving immunotherapy trial. Also, evidence of neuroinflammation was detected in the CSF and MRI brain of the majority of those patients. Conclusions Autoimmunity should be considered as a possible etiology of new-onset DRE. It is essential to provide insight into the clinical phenotypes and other associated features of those patients, as there are probably numerous patients who are not positive for one of the available antibodies via clinical laboratory testing. In addition to early diagnosis, early treatment and empirical immunotherapy trial based on the clinical judgment is crucial and is likely to improve outcomes with near-complete seizure freedom

Consensus Guideline on the Management of Epilepsy in Egypt: A National Delphi Consensus Study

Abstract Objective In epilepsy, early diagnosis, accurate determination of epilepsy type, proper selection of antiseizure medication, and monitoring are all essential. However, despite recent therapeutic advances and conceptual reconsiderations in the classification and management of epilepsy, serious gaps are still encountered in day‐to‐day practice in Egypt as well as several other resource‐limited countries. Premature mortality, poor quality of life, socio‐economic burden, cognitive problems, poor treatment outcomes, and comorbidities are major challenges that require urgent actions to be implemented at all levels. In recognition of this, a group of Egyptian epilepsy experts met through a series of consecutive meetings to specify the main concepts concerning the diagnosis and management of epilepsy, with the ultimate goal of establishing a nationwide Egyptian consensus. Methods The consensus was developed through a modified Delphi methodology. A thorough review of the most recent relevant literature and international guidelines was performed to evaluate their applicability to the Egyptian situation. Afterward, several remote and live rounds were scheduled to reach a final agreement for all listed statements. Results Of 278 statements reviewed in the first round, 256 achieved ≥80% agreement. Live discussion and refinement of the 22 statements that did not reach consensus during the first round took place, followed by final live voting then consensus was achieved for all remaining statements. Significance With the implementation of these unified recommendations, we believe this will bring about substantial improvements in both the quality of care and treatment outcomes for persons with epilepsy in Egypt. Plain Language Summary This work represents the efforts of a group of medical experts to reach an agreement on the best medical practice related to people with epilepsy based on previously published recommendations while taking into consideration applicable options in resource‐limited countries. The publication of this document is expected to minimize many malpractice issues and pave the way for better healthcare services on both individual and governmental levels

Accuracy of the Traditional COVID-19 Phone Triaging System and Phone Triage-Driven Deep Learning Model

Objectives: During the COVID-19 pandemic, a quick and reliable phone-triage system is critical for early care and efficient distribution of hospital resources. The study aimed to assess the accuracy of the traditional phone-triage system and phone triage-driven deep learning model in the prediction of positive COVID-19 patients. Setting: This is a retrospective study conducted at the family medicine department, Cairo University. Methods: The study included a dataset of 943 suspected COVID-19 patients from the phone triage during the first wave of the pandemic. The accuracy of the phone triaging system was assessed. PCR-dependent and phone triage-driven deep learning model for automated classifications of natural human responses was conducted. Results: Based on the RT-PCR results, we found that myalgia, fever, and contact with a case with respiratory symptoms had the highest sensitivity among the symptoms/ risk factors that were asked during the phone calls (86.3%, 77.5%, and 75.1%, respectively). While immunodeficiency, smoking, and loss of smell or taste had the highest specificity (96.9%, 83.6%, and 74.0%, respectively). The positive predictive value (PPV) of phone triage was 48.4%. The classification accuracy achieved by the deep learning model was 66%, while the PPV was 70.5%. Conclusion: Phone triage and deep learning models are feasible and convenient tools for screening COVID-19 patients. Using the deep learning models for symptoms screening will help to provide the proper medical care as early as possible for those at a higher risk of developing severe illness paving the way for a more efficient allocation of the scanty health resources