Improving the prognostic value of blunt abdominal trauma scoring systems in children

Purpose Blunt abdominal trauma (BAT) is a frequent reason for hospital admission and a significant cause of death in children older than 2 years of age. Mechanisms causing abdominal injuries are predominantly motorvehicle accidents, falls, and intentional injuries. Blunt trauma accounts for 90% of pediatric injuries. There are many scoring systems that are designed to monitor victims of BAT and to predict victims who may require conservative management and those who may require surgical intervention. None of these scoring systems is perfect and fulfill the data for accurate prediction of the prognosis of these victims. We assessed three  different clinical scoring systems and their prognostic properties alone and after their modification by adding a plain, erect, abdominal radiographic film to improve their prognostic values.Patients and methods We included all patients presenting with BAT older than 2 years and younger than 18 years. All children were subjected to three different trauma scoring systems. We evaluated all children usingPediatric Trauma Score, Clinical Abdominal Score System, and Blunt Abdominal Trauma in Children. We then added plain, erect, abdominal radiographic films to these systems.Results A total of 250 children with BAT were subjected to three different scoring systems. Among them, 58% were boys and 42% were girls. The cause for BAT in two hundred and two cases was car accidents, falling from heights in seven, and kicks and abuse in 41 cases. The mean time until hospital arrival was 2 h. The mean age was 15 years. The mean time for every scoring system was 5 min. Radiographic imaging showed positive signs of trauma (air under diaphragm, elevated copula of diaphragm) in 45 patients.Conclusion Adding a simple radiographic film in the erect position of the abdomen and lower chest markedly improved the prognostic value of the different scoring systems included. Keywords: children, scoring systems, traum

Efficient multiscale modeling of heterogeneous materials using deep neural networks

Material modeling using modern numerical methods accelerates the design process and reduces the costs of developing new products. However, for multiscale modeling of heterogeneous materials, the well-established homogenization techniques remain computationally expensive for high accuracy levels. In this contribution, a machine learning approach, convolutional neural networks (CNNs), is proposed as a computationally efficient solution method that is capable of providing a high level of accuracy. In this work, the data-set used for the training process, as well as the numerical tests, consists of artificial/real microstructural images (“input”). Whereas, the output is the homogenized stress of a given representative volume element RVE . The model performance is demonstrated by means of examples and compared with traditional homogenization methods. As the examples illustrate, high accuracy in predicting the homogenized stresses, along with a significant reduction in the computation time, were achieved using the developed CNN model

Mastitogenic Bacteria Isolated from Clinical Mastitis Cases Associated with Teat Lesions and their Antimicrobial Sensitivity

Mastitis is the most common and most expensive disease that impacts dairy farms in Egypt. In this study, we investigated bacterial mastitis cases that did not respond to antimicrobial treatment from buffaloes and cows. Milk samples (11) were collected from diseased animals (5 buffaloes and 6 cows). The samples were tested microbiologically to isolate and identify the causative bacteria and antimicrobial susceptibility. The antimicrobial sensitivity of the isolated bacteria was tested by using minimum inhibitory concentration technique according to the clinical national laboratory standards.  The total number of bacterial isolates from the cases was 15 isolates. Staphylococcus aureus (S. aureus) was isolated alone in two cases (13.33% of the isolates), and S. aureus isolated in combination with Arcanobacterium pyogenes (A. pyogenes) in one case (6.67%), and S. aureus isolated in combination with both A. pyogenes and Streptococcus agalactiae (S. agalactiae) in two cases (13.33%), and Coagulase negative staphylococci (CNS) isolated alone in one case (6.67%), and CNS isolated in combination with Klebsiella pneumoniae in one case (6.67%), and A. pyogenes isolated alone in two cases (13.33%). In two cases were not able to isolate any bacterial pathogen. In terms of susceptibility to antibiotics, the isolated strains were sensitive to clindamycin with MICs ranging from 0.125 to <0.03125 µM. The same isolates exhibited medium sensitivity to gentamicin and ciprofloxacin with MICs ranging from 0.5 to 8 µM. Most S. aureus isolates were resistant to oxytetracycline with a MIC of 128 µM. Most of the isolated bacteria were resistant to polymyxin B with a MIC > 128 µM. With the exception of the A. pyogenes isolates, all the isolated bacteria were sensitive to enrofloxacin with a MIC <1 µM.       &nbsp

Improving the physicochemical and antioxidative properties of fermented goat milk using carob molasses and some probiotic strains

Fermented goat milk samples, processed by adding 0, 2, and 4% carob molasses, and Bifidobacterium bifidum DSMZ or Lactobacillus helveticus CH5, were evaluated for their physicochemical, antioxidative, and sensory properties along with probiotic viability during storage. pH and viscosity gradually decreased over the storage period whereas their values increased with the increased amount of carob molasses. Bifidobacterium bifidum DSMZ or Lactobacillus helveticus CH5 kept higher viable numbers. Lactobacillus helveticus CH5 strain recorded higher viability. Increasing the added amount of carob molasses increased the total phenolic content, which in turn is reflected in the increase in antioxidant activity. Adding carob molasses participated in the partial masking of the goaty flavor and had no significant effect on the product’s acceptability, which was strongly influenced by the progress of cold storage. Therefore, fermented goat milk described by its enhanced physicochemical and antioxidative properties could be obtained by adding carob molasses and probiotics.<br/

Patient satisfaction with cataract surgery

<p>Abstract</p> <p>Introduction</p> <p>Measuring the patient satisfaction is a very important issue that will help very much in improving the service provided to patients and improve the level of satisfaction.</p> <p>Aim</p> <p>To evaluate patient satisfaction with the cataract surgery service and identify any areas for improvement, determination of patient satisfaction with referral, out-patient consultation, pre-assessment clinic, surgery and post-operative care, also to report patients' comments relating to improvement in service provision.</p> <p>Methodology</p> <p>A retrospective study was undertaken for 150 patients underwent cataract surgery at Barrow General Hospital, UK, the survey sample was by postal questionnaires. We collected our data from the theatre lists for a period of 4 month.</p> <p>Results</p> <p>This study included 150 patients; the response rate was (72%) 108 patients, Most patients were referred from their general practitioner 86.1%, 93 (86.1%) patients were happy with the time interval from seeing their GP to eye clinic. In the eye out patient department many factors significantly affected the level of patient satisfaction, in general the more information provided for the patient the more the satisfaction.</p> <p>Conclusion</p> <p>Patient satisfaction is on important health outcome old understanding both the domains of satisfaction as well as their relative importance to patients is necessary to improve the overall quality of patient care. Meeting the doctor, presenting all relevant information and giving printed information are very important factors in improving the patient's satisfaction with cataract surgery.</p

STABILITY-INDICATING LIQUID CHROMATOGRAPHY METHOD FOR THE DETERMINATION OF PENTOXYVERINE CITRATE AND ITS DEGRADANT

Objectives: The objectives of this research were to develop and validate a HPLC method for determination of Pentoxyverine citrate (PNX) and its degradant (DG). Methods: Forced degradation studies were performed on bulk sample using alkaline (0.1M sodium hydroxide) and acid (1M hydrochloric acid. The proposed method was based on using a 150 x 4.6 mm (i. d.) (Luna, Phenomenex, Torrance, CA, USA) (5 µm particle size) reversed phase C18 column with mobile phase consisting of a mixture of methanol-10 mM sodium dihydrogen phosphate pH 4 in ratio of (60:40, v/v) and UV detection at 230 nm with flow rate of 1 mL min-1. Results: The linear calibration range was between 10-40 mg ml-1and 10-40 mg ml-1for PNX and DG respectively. The method was found to be accurate with 100.23% and 100.07% recovery for PNX and DG respectively. The limit of detection (LOD) was found to be 3.79 x10-2μg ml-1 and 4.24 x10-2μg ml-1 for PNX and DG respectively, while the limit of quantification (LOQ) was found to be 12.62 x10-2μg ml-1 and 14.12 x10-2μg ml-1 for PNX and DG respectively. PNX was found to be most stable at a pH of 5.7. Conclusion: The validation study of the proposed method was successfully carried out and the method was found to be suitable and economic for routine determination of PNX in pharmaceutical syrup, without any interference from the excipients, and in the presence of its acidic and alkaline degradation products

Femtosecond Laser Induced Structural Dynamics and Melting of Cu (111) Single Crystal. An Ultrafast Time-Resolved X-Ray Diffraction Study

Femtosecond, 8.04 keV x-ray pulses are used to probe the lattice dynamics of a 150 nm Cu (111) single crystal on a mica substrate irradiated with 400 nm, 100 fs laser pulses. For pump fluences below the damage and melting thresholds, we observed lattice contraction due to the formation of a blast force and coherent acoustic phonons with a period of ∼69 ps. At larger pump fluence, solid to liquid phase transition, annealing, and recrystallization were measured in real time by monitoring the intensity evolution of the probing fs x-ray rocking curves, which agreed well with theoretical simulation results. The experimental data suggest that the melting process is a purely thermal phase transition. This study provides, in real time, an ultrafast time-resolved detailed description of the significant processes that occur as a result of the interaction of a femtosecond light-pulse with the Cu (111) crystal surface. Published by AIP Publishing. [http://dx.doi.org/10.1063/1.4975198

Scalable Decentralized Cooperative Platoon using Multi-Agent Deep Reinforcement Learning

Cooperative autonomous driving plays a pivotal role in improving road capacity and safety within intelligent transportation systems, particularly through the deployment of autonomous vehicles on urban streets. By enabling vehicle-to-vehicle communication, these systems expand the vehicles environmental awareness, allowing them to detect hidden obstacles and thereby enhancing safety and reducing crash rates compared to human drivers who rely solely on visual perception. A key application of this technology is vehicle platooning, where connected vehicles drive in a coordinated formation. This paper introduces a vehicle platooning approach designed to enhance traffic flow and safety. Developed using deep reinforcement learning in the Unity 3D game engine, known for its advanced physics, this approach aims for a high-fidelity physical simulation that closely mirrors real-world conditions. The proposed platooning model focuses on scalability, decentralization, and fostering positive cooperation through the introduced predecessor-follower "sharing and caring" communication framework. The study demonstrates how these elements collectively enhance autonomous driving performance and robustness, both for individual vehicles and for the platoon as a whole, in an urban setting. This results in improved road safety and reduced traffic congestion

The Nile Water-Food-Energy Nexus under Uncertainty: Impacts of the Grand Ethiopian Renaissance Dam

This is the author accepted manuscript. The final version is available from ASCE via the DOI in this recordData Availability Statement: All data, models, code that support the findings of this study are available from the corresponding author upon request.Achieving a water, food, and energy (WFE) nexus balance through policy interventions is challenging in a transboundary river basin because of the dynamic nature and intersectoral complexity that may cross borders. The Nile basin is shared by a number of riparian countries and is currently experiencing rapid population and economic growth. This has sparked new developments to meet the growing water, food, and energy demands, alleviate poverty, and improve the livelihood in the basin. Such developments could result in basinwide cooperation or trigger conflicts among the riparian countries. A system dynamics model was developed for the entire Nile basin and integrated with the food and energy sectors in Egypt to investigate the future of the WFE nexus with and without the Grand Ethiopian Renaissance Dam (GERD) during filling and subsequent operation using basinwide stochastically generated flows. Different filling rates from 10% to 100% of the average monthly flow are considered during the filling process. Results suggest that the GERD filling and operation would affect the WFE nexus in Egypt, with the impact likely to be significant if the filling process occurred during a dry period. Food production from irrigated agriculture would be reduced by 9%–19% during filling and by about 4% during GERD operation compared with the case without it. The irrigation water supply and hydropower generation in Sudan will be reduced during the filling phase of the GERD, but this is expected to be improved during the dam operation phase as a result of the regulation afforded by the GERD. Ethiopian hydropower generation is expected to be boosted by the GERD during the filling and operation of the dam, adding an average of 15,000  GWh/year once GERD comes online. Lastly, the results reveal the urgency of cooperation and coordination among the riparian countries to minimize the regional risks and maximize the regional rewards associated with the GERD.Ministry of Higher Education (MoHE), EgyptUniversity of Exete