Validation of a modified cow’s milk-related symptom score (CoMISS) for screening of lactose intolerance in adults

Introduction: Lactose intolerance (LI) is the failure to digest foods and beverages containing the lactose present in milk. LI can present by many digestive symptoms. Objective: To validate the modified CoMiSS score for prediction of LI, that was confirmed by a stool acidity test. Patients and methods: A cross-sectional study, was conducted at Ain Shams University Hospitals/Gastrointestinal Clinics, and included one hundred adult participants during the period from December 2018 to December 2019. Enrolled patients had one or more gastrointestinal symptoms and were subjected to a stool acidity test (fecal PH test) as a reference test and modified CoMiSS as an index test. Results: The mean age of participants was 35.30 ± 10.714 years old; 55% were females, and their mean body mass index (BMI) was 23.08 ± 2.080 kg/m2, with no significant relation between LI and patients` gender or BMI. Out of the studied participants 24% had positive stool PH, LI diagnosed according to modified CoMISS was present among 19% of them. The mean value of modified CoMISS Score was significantly higher in positive cases (12.37) compared to negative LI participants (2.33) as p < .001. Area under ROC Curve was 0.998, at the selected cut-off value 8, the sensitivity was 89.5% and specificity was 100% thus, levels of questionnaire scoring of 8 or higher would indicate presence of lactose intolerance. Conclusion: Modified CoMiSS is a simple, fast, and easy-to-use tool that can predict LI, with a cut-off value of >8, the Area under the ROC Curve was 0.998, sensitivity 89.5%, and specificity was 100%

Adaptive Neuro Fuzzy Technique for Speed Control of Six-Step Brushless DC Motor

The brushless DC motors with permanent magnets (PM-BLDC) are widely used in a miscellaneous of industrial applications. In this paper, The adaptive neuro fuzzy inference system (ANFIS) controller for Six-Step Brushless DC Motor Drive is introduced. The brushless DC motor’s dynamic characteristics such as torque , current , speed, , and inverter component voltages are showed and analysed using MATLAB simulation. The  propotional-integral (PI) and fuzzy system controllers  are developed., based on designer’s test and error process and experts. The  experimential and hardware resuts for the inverter- driver circuits are presented. The simulation results using MATLAB simulink are conducted to validate the proposed (ANFIS) controller’s robustness and high performance relative to other controllers

Management of congenital esophageal stenosis associated with esophageal atresia and its impact on postoperative esophageal stricture

Aim The aim of this work was to study the incidence, management of congenital esophageal stenosis (CES) associated with esophageal atresia (EA) and tracheoesophageal fistula (TEF), and its impact on esophageal stricture (ES) after primary repair.Patients and methods From January 2006 to December 2014, 41 sequential cases of EA with distal TEF were retrospectively studied. Cases with significant ES after primary repair were included in the study. Associated CES was diagnosed in the neonatal period by taking histopathologic samples from the tips of the esophageal pouches, failure to pass a size-6 nasogastric tube distally during primary repair, and by initial esophagogram.Results Significant ES developed in 19 patients (46.3%); of them, six had CES (32%). Three patients had tracheobronchial remnants at the anastomotic site. Two of them had refractory strictures requiring resections and one had mainly major esophageal dysmotility. Patients 4 and 5 had CES distal to the anastomotic site on initial esophagogram. Patient 4 responded well to dilatations, whereas the other one had refractory stricture. Patient 6 had distal CES due to fibromuscular stenosis diagnosed by failure to pass a size-6 nasogastric tube distally. The patient responded well to dilatation, myectomy, and Thal’s fundoplication.Conclusion One-third of the patients with significant stricture had CES; half of them were refractory to dilatation. Failure to have histology specimens and a high index of suspicion will make the incidence of this association a rarity. Diagnosis and management of CES with EA/TEF in the neonatal period is possible. Esophageal dilatation is the initial management for all cases with a low threshold for gastric fundoplication and gastrostomy. Resection is reserved for refractory stenosis.Keywords: congenital esophageal stenosis, esophageal atresia, esophageal stricture, tracheoesophageal fistul

Performance and enhancement evaluation of a solar still by using spraying technology

The current experimental investigation uses the water spraying approach to increase the productivity and efficiency of pyramid solar still. The design, construction, and testing of a traditional and modified small-scale pyramid solar still were conducted under identical meteorological conditions as in Tanta City, Egypt (30° 47\u27 N, 31°E). One of the modifications is that heated sheet metal will occasionally be sprayed with salted water. We looked into how the modified solar still\u27s (MPSS) performance characteristics were affected by solar radiation, water depth, and sheet metal-specified temperature. Measurements were made of the saline water temperature, glass temperature, spraying flow rate, and daily productivity. The performance of MPSS and traditional pyramid solar stills (CPSS) was contrasted. Because the results indicated that water depth had a detrimental impact on productivity, we chose the lowest level that could be achieved—roughly 15 mm for MPSS and 8 to 22 mm for CPSS. For MPSS and CPSS, the daily productivity was approximately 5000 ml/m2 and 2830 ml/m2, respectively. MPSS outperformed CPSS in productivity by almost 44 %. Furthermore, the modified pyramid solar daily efficiency ranges from 57 to 69%, while the regular pyramid solar still ranges from 26 to 41%

Effect of Microalloying Elements on the Heat Treatment Response and Tensile Properties of Al-Si-Mg Alloys

This study was carried out on a series of heat-treatable Al-Si-Mg alloys to determine the effects of Fe, Mg, Sr and Be addition on their microstructural characteristics and tensile properties. The results showed that the eutectic temperature was reduced by 10°C with 0.8 wt% Mg addition. The solidification curves and first derivatives of Sr-free alloys with high Fe and Mg contents revealed a peak at 611°C consequent to the formation of a script-like Be-Fe (Al8Fe2BeSi) phase, which was very close to the peak for α-Al. The morphology of the β-iron platelets underwent changes due to their dissolution, thinning, necking, and fragmentation with increase in solutionizing time. Increased Mg contents are beneficial to the tensile properties unlike the detrimental effect of increasing Fe contents. Additions of Be and Sr noticeably improved the properties at the same Fe and/or Mg contents, the enhancements being markedly observed at higher Mg contents and reduced Fe levels. At high Fe levels, addition of Be is preferable as it neutralizes the deleterious effects of Fe in these alloys; however, addition of 500 ppm Be is inadequate for interacting with other alloying elements

Detection and tracking of discrete phenomena in sensor-network databases

This paper introduces a framework for Phenomena Detection and Tracking (PDT, for short) in sensor network databases. Examples of detectable phenomena include the propagation over time of a pollution cloud or an oil spill region. We provide a crisp definition of a phenomenon that takes into consideration both the strength and the time span of the phenomenon.We focus on discrete phenomena where sensor readings are drawn from a discrete set of values, e.g., item numbers or pollutant IDs, and we point out how our work can be extended to handle continuous phenomena. The challenge for the proposed PDT framework is to detect as much phenomena as possible, given the large number of sensors, the overall high arrival rates of sensor data, and the limited system resources. Our proposed PDT framework uses continuous SQL queries to detect and track phenomena. Execution of these continuous queries is performed in three phases; the joining phase, the candidate selection phase, and the grouping/output phase. The joining phase employs an in-memory multi-way join algorithm that produces a set of sensor pairs with similar readings. The candidate selection phase filters the output of the joining phase to select candidate join pairs, with enough strength and time span, as specified by the phenomenon definition. The grouping/ output phase constructs the overall phenomenon from the candidate join pairs. We introduce two optimizations to increase the likelihood of phenomena detection while using less system resources. Experimental studies illustrate the performance gains of both the proposed PDT framework and the proposed optimizations

Ischemic VSD

Background: Ischemic VSD or ventricular septal rupture (VSR) is a rare but lethal complication of myocardial infarction (MI). Multi-system coronary disease is present in more than 50% of these patients. The event occurs 2-8 days after an infarction and often precipitates cardiogenic shock. The differential diagnosis of postinfarction cardiogenic shock should exclude free ventricular wall rupture and rupture of the papillary muscles. To avoid the high morbidity and mortality associated with the disorder, patients should undergo emergent surgery. Concomitant coronary artery bypass may be required. Objective: This study stressed on a very serious complication of a common pathology (myocardial infarction), despite it,s lethal complication but still it is treatable and still surgery is the only salvageable option. Patients & methods: Retrospective study of 7 consecutive cases with ischemic VSR encountered from (1st Jan. 2008-30 of September 2011). All of the cases were carefully assessed & fully investigated preoperatively (by echocardiography study, catheterization ...etc) & for all of them emergency open heart surgery was done with heart lung machine to close a post infract VSD using synthetic patch and ventriculotomy closed with reinforced Teflon felts , all of them(except the last case which died immediately post operatively) stayed for 2-3 days in the CICU under follow up . Results: Seven patients have been operated upon, 4 males (57%) and 3 female (43%), and their ages ranged between 50-63 years (75% in the 6th decade). Three of them (43%) were diabetic only but all of them were hypertensive. All of them were haemodynamically unstable so operation carried on emergently within 12-18 days post infarction (one operation done within 27 hours of infarction) and in none of them the clinical status helped to postpone them until more than 3 weeks post infarct. Five Out of the seven patients survived the operation, one died immediately post operatively &another one died 7 days post operatively due to renal failure (due to pre operative impaired renal function). Operative & early post operative mortality is (28%). Conclusion: We need to be more aware about this fatal complication of acute MI taking in consideration its late presentation (2-8) days. We have to work hardly to improve early revascularization to decrease the incidence of VSR. Improvement in surgical technique using double patch and glue improve mortality & morbidity rates. More cases need to have a better understanding & management of these cases

Ultrasonographic evaluation of fetal lung histogram versus lamellar body count in the prediction of fetal lung maturity

Objective: The current study aims to compare the ultrasonographic evaluation of fetal lung Gray-level histogram width (GLHW) ratio with an amniotic fluid lamellar body count (LBC) in the prediction of fetal lung maturity. Methods: A prospective cohort study was conducted at a tertiary University Hospital in the period between May 1, 2017 and March 31, 2018. The study included pregnant women with a single fetus at ≥37 weeks of gestation scheduled for delivery by elective cesarean section (CS). Ultrasound evaluation was performed for assessment of the fetal lung to liver GLHW ratio to predict lung maturity. Lamellar body count was determined from an amniotic fluid sample obtained via amniotomy during CS. The lamellar body count for this sample was measured using a hematology analyzer. These data were further compared to Apgar scores at 1 and 5 minutes after delivery to assess the condition of the newborn immediately after birth, the degree of respiratory distress syndrome (RDS) and the need for resuscitation. Results: One hundred twenty women and their neonates were included in the study. There was a statistically significant decrease in the levels of both GLHW and LBC among those neonates that showed distressed respiration after Apgar testing as compared with those who did not show similar distress, with p-value <0.001. The Receiver Operating Characteristic Curve (ROC) for LBC levels in the prediction of respiratory distress shows the best cutoff point for LBC was found at ≤20214/μL with a sensitivity of 100.0%, specificity of 75.47% and area under the curve (AUC) of 88.4%. The ROC curve for GLWH levels in the prediction of respiratory distress shows the best cutoff point for GLWH was found at ≤0.93 with sensitivity of 100.0%, specificity of 84.91% and AUC of 97.1%. Conclusions: Ultrasonographic evaluation of GLHW of the fetal lung and liver is a non-invasive, inexpensive and time-efficient test for prediction of fetal lung maturity that has higher sensitivity and specificity

QoS Categories Activeness-Aware Adaptive EDCA Algorithm for Dense IoT Networks

IEEE 802.11 networks have a great role to play in supporting and deploying of the Internet of Things (IoT). The realization of IoT depends on the ability of the network to handle a massive number of stations and transmissions, and to support Quality of Service (QoS). IEEE 802.11 networks enable the QoS by applying the Enhanced Distributed Channel Access (EDCA) with static parameters regardless of existing network capacity or which Access Category (AC) of QoS is already active. Our objective in this paper is to improve the efficiency of the uplink access in 802.11 networks; therefore we proposed an algorithm called QoS Categories Activeness-Aware Adaptive EDCA Algorithm (QCAAAE) which adapts Contention Window (CW) size, and Arbitration Inter-Frame Space Number (AIFSN) values depending on the number of associated Stations (STAs) and considering the presence of each AC. For different traffic scenarios, the simulation results confirm the outperformance of the proposed algorithm in terms of throughput (increased on average 23%) and retransmission attempts rate (decreased on average 47%) considering acceptable delay for sensitive delay services.Comment: 17 pages, 10 figure