Prototyping Design and Optimization of Smart Electric Vehicles/Stations System using ANN

This paper demonstrates an experimental attempt to prototype electric vehicle charging station’s (EVCS) decision-making unit, using artificial neural network (ANN) algorithm. The algorithm acts to minimize the queuing delay in the station, with respect to the vehicle state of charge (SOC), and the expected arrival time. A simplified circuit model has been used to prototype the proposed algorithm, to minimize the overall queuing delay. Herein, the worst-case scenario is considered by having number of electric vehicles arriving to the station at the same time greater than the charging points available in the station side. Accordingly, the optimization technique was applied to reduce the mean charging time of the vehicles and minimize queuing delay. Results showed that this model can help in reducing the queuing delay by around 20% of the mean charging time of the station, while referring to a bare model without ANN algorithm as a reference

Concurrent pelvic radiation with weekly low-dose cisplatin and gemcitabine as primary treatment of locally advanced cervical cancer: A phase II study

Purpose: This study was done to evaluate response, compliance and survival of weekly low dose cisplatin (20 mg/m2) and gemcitabine (125 mg/m2) concurrently with pelvic radiation as primary treatment of stage IIB-IIIB cervical cancer.Methods: External radiation consisted of 50 Gy/25 fractions using 6-10 MV photon followed by 600 cGy boost to parametrium if it was still felt thickened. Then, intracavitary radiotherapy to deliver 60 Gy at point A. Chemotherapy consisted of gemcitabine at a dose of 125 mg/ m2 was given by i.v infusion over 30 minutes immediately after cisplatin 20 mg/ m2 weekly for 5 weeks during EBRT. Forty–five eligible patients received the treatment protocol. Results: Toxicity was tolerable and manageable. No grade 4 toxicity while grade 3 was recorded in hematologic one only. In order of frequency; diarrhea, nausea and vomiting, and anemia (50%, 40%, 35.5%) were most common adverse events. Overall clinical response rate was 93.4% with pathological complete response of 62.2%. After median follow-up of 20 months, 2-year survival and progression-free survival rates were 90.5% and 81% respectively. Conclusion: Weekly combination of low- dose cisplatin and gemcitabine given concurrently with pelvic radiotherapy in primary treatment of locally advanced cervical cancer resulted in a high response rate with a good compliance. Further exploration is needed for the use of this approach prior to incorporating it into routine clinical care through phase III clinical trial

Flow Cytometry of Breast Cancer Resistant Protein and microRNA in Breast Cancer Patients Post Metformin Effect

The goal of the present study is to investigate the role of metformin (MF) as a target of miRNAs in breast cancer resistant protein (BCRP) inhibition in an attempt to develop treatment strategies that may improve the response of breast cancer (BC) patients to chemotherapy (CT). In order to fulfill this target, non-diabetic female subjects were categorized into three groups: control group (group 1) (n=5), CT group of BC patients (group 2) (n=25) and CT plus MF group of BC patients (group 3) (n=25). All patients were subjected to full history taking, laboratory studies including mammogram, chest X-ray, pelvic-abdominal ultrasound and isotopic bone scan, in addition to ER and PR states. CT group was treated with neoadjuvent CT in the form of 5-FU (500 mg/m2), Adriamycin (50 mg/m2) and cyclophosphamide (500 mg/m2). Flow cytometry (FC) of BCRP and MiRNA was carried out on blood samples at every cycle of treatment for all partners. The results showed the presence of miRNA was higher than the presence of BCRP in the normal healthy control group. In most cases of CT and CT plus MF groups (group 2, 3) it was well noticed that the amount of BCRP in the blood samples exceeded that of miRNA illustrated the dysregulation of miRNA in BC patients and also to prove the basic role of BCRP as a multidrug resistance (MDR) for chemotherapeutic agents in patients with BC. It is concluded that the role of MF was well proved in targeting of miRNA to reinforce BC medication, so oncologists can be advised to use MF equivalent to CT in the recommended doses

Lignocellulosic Biomasses from Agricultural Wastes Improved the Quality and Physicochemical Properties of Frying Oils

In this work, the effects of using natural lignocellulosic-based adsorbents from sugarcane bagasse (SC), cornstalk piths (CP), and corn cob (CC) on the physicochemical properties and quality of fried oils were studied. The properties of lignocellulosic biomasses were examined using X-ray diffraction (XRD), scanning electron microscope (SEM), and Fourier transform infrared spectroscopy (FTIR). Moreover, the changes in the physicochemical properties of fresh, fried oils (for 4, 8, 12, 16 and 20 h) and adsorbents-treated oils were examined. The XRD results revealed that SC and CP biomasses have more amorphous regions than CC biomass, which had the highest crystallinity percentage. The results also showed that lignocellulosic biomasses enhanced the quality of the used oils. SC was the most effective biomass to enhance the properties of the used sunflower oil. For instance, the acid value of oil samples fried for 20 h reduced from 0.63 ± 0.02 to 0.51 ± 0.02 mg KOH/g oil after SC biomass treatment. For the peroxide value, the SC biomass treatment reduced it from 9.45 ± 0.56 (fried oil for 20 h) to 6.91 ± 0.12 meq O2/kg. Similarly, SC biomass adsorbent reduced the p-Anisidine Value (p-AV) of the used oil (20 h) from 98.45 ± 6.31 to 77.92 ± 3.65. Moreover, SC adsorbents slightly improved the lightness of the used oils (20 h). In conclusion, natural lignocellulosic biomasses, particularly SC, could be utilized as natural adsorbents to improve the oil quality. The results obtained from this study could help in developing sustainable methods to regenerate used oils using natural and cheap adsorbents

Prevalence of Sexual Long COVID (SLC) in Egypt: A Single Institute Study

Objectives: we conducted a cross section study to assess the prevalence and severity of ED among COVID-19 survivors presenting to andrology outpatients’ clinics, Kasr AlAiny hospital, faculty of medicine, Cairo university. Materials and Methods: a total of 1000 COVID-19 survivors were screened for ED using validated Arabic version of the international index of erectile function (ArIIEF-5) during the period between Jan 2022 till Jan 2023. All patients were previously diagnosed with positive PCR for COVID-19 infection at least 3 months before the time of data collection.   Result: we found that the prevalence of ED among COVID-19 survivors were 11.4%, mild ED in 7%, moderate in 3.2% and severe ED in 1.2%, severity of ED was not associated with demographic, clinical, laboratory and penile duplex characteristics. Conclusion: severity of ED among COVID-19 survivors showed no statistically significant association with demographics, depression, anxiety, penile duplex findings and hormonal disturbances

A multi-class deep learning model for early lung cancer and chronic kidney disease detection using computed tomography images

Lung cancer is a fatal disease caused by an abnormal proliferation of cells in the lungs. Similarly, chronic kidney disorders affect people worldwide and can lead to renal failure and impaired kidney function. Cyst development, kidney stones, and tumors are frequent diseases impairing kidney function. Since these conditions are generally asymptomatic, early, and accurate identification of lung cancer and renal conditions is necessary to prevent serious complications. Artificial Intelligence plays a vital role in the early detection of lethal diseases. In this paper, we proposed a modified Xception deep neural network-based computer-aided diagnosis model, consisting of transfer learning based image net weights of Xception model and a fine-tuned network for automatic lung and kidney computed tomography multi-class image classification. The proposed model obtained 99.39% accuracy, 99.33% precision, 98% recall, and 98.67% F1-score for lung cancer multi-class classification. Whereas, it attained 100% accuracy, F1 score, recall and precision for kidney disease multi-class classification. Also, the proposed modified Xception model outperformed the original Xception model and the existing methods. Hence, it can serve as a support tool to the radiologists and nephrologists for early detection of lung cancer and chronic kidney disease, respectively

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

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

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