Theoretical Evaluation of Electromagnetic Emissions from GSM900 Mobile Telephony Base Stations in the West Bank and Gaza Strip-Palestine

Theoretical assessments of power density in far-field conditions were used to evaluate the levels of environmental electromagnetic frequencies from selected GSM900 macrocell base stations in the West Bank and Gaza Strip. Assessments were based on calculating the power densities using commercially available software (RF-Map from Telstra Research Laboratories—Australia). Calculations were carried out for single base stations with multiantenna systems and also for multiple base stations with multiantenna systems at 1.7m above the ground level. More than 100 power density levels were calculated at different locations around the investigated base stations. These locations include areas accessible to the general public (schools, parks, residential areas, streets and areas around kindergartens). The maximum calculated electromagnetic emission level resulted from a single site was 0.413 μWcm−2 and found at Hizma town near Jerusalem. Average maximum power density from all single sites was 0.16 μWcm−2. The results of all calculated power density levels in 100 locations distributed over the West Bank and Gaza were nearly normally distributed with a peak value of ~0.01% of the International Commission on Non-Ionizing Radiation Protection’s limit recommended for general public. Comparison between calculated and experimentally measured value of maximum power density from a base station showed that calculations overestimate the actual measured power density by ~27%

The effect of educational software based on drill and practice, and gamification in developing English language skills for third-grade students in Jiza District

The article aimed to investigate the effect of using an educational software program based on Drill and Practice, and Gamification patterns in developing English language skills for third-grade students in Jiza District. Nusaiba Al Mazenia School affiliated to the Director of Education Giza District , where peopils chosen randomly. The study tool consisted of two English language tests, a reading test consisting of (16) questions, and a writing test consisting of (17) questions. The results related to the answer of the first and second questions showed a difference in the pre and post performance of the two study groups, and in favor of the post application in reading and writing skills. The results related to the answer of the third question showed that there was no statistically significant difference at the significance level (α = 0.05) in the development of students’ reading skills due to the method used (an educational program based on the gamification pattern, an educational program based on the pattern of Drill and practice), where the values of the arithmetic means are close, while the results related to the answer of the fourth question showed that there were differences at the significance level (α = 0.05) in the arithmetic mean values of students\u27 performance on the post-writing skill test, and the difference was in favor of the exercise and practice method. Among the most important recommendations is building a strategy that combines the advantages of the modes of exercise, practice, and gamification, in order to achieve the maximum benefit for teaching reading and writing skills

أثر وحدة تعليمية مطورة في مادة العلوم وفق منحى STEAM في تنمية الدافعية العقلية والتحصيل لطلبة الصف الثالث األساسي

هدف المقال إلى تطوير وحدة دراسية من مادة العلوم الصف الثالث األساسي وفق منحى STEAM وذلك إلستقصاء أثر الوحدة المطورة في مادة العلوم وفق منحى STEAM في تنمية الدافعية العقلية والتحصيل لدى طلبة الصف الثالث االساسي في لواء الجامعة، ولتحقيق أهداف الدراسة تم اعتماد المنهج شبه التجريبي، تكونت عّينة الدراسة من )60( طالبا وطالبة تم ً توزيعها عشوائيا الى مجموعتين تجريبية وضابطة اشتملت كل ً منهما على )30( طالباً وطالبة من طلبة الصف الثالث األساسي في مدرسة الكمالية االساسية التابعة لمديرية التربية والتعليم لواء الجامعة . تكونت أداة الدراسة من مقياس للدافعية العقلية يشتمل على )35( فقرة شملت مجاالت الدافعية العقلية جميعها، واختبار تحصيلي لمادة العلوم. أظهرت النتائج المتعلقة باإلجابة عن السؤالين األول والثاني وجود فروق ذات داللة إحصائية عند مستوى الداللة )0.05 =α )في األداء البعدي لمجموعتي الدراسة، لصالح طلبة المجموعة التجريبية حيث كان هناك أثر للمنحى في تنمية الدافعية العقلية والتحصيل. وأظهرت النتائج المتعلقة باإلجابة عن السؤال الثالث وجود عالقة ارتباطية دالة احصائيا عند مستوى الداللة )0.05 =α )بين الدافعية العقلية ً تعزى إلى الطريقة المستخدمة )STEAM )لطلبة والتحصيل ُ الصف الثالث األساسي.من أهم التوصيات تبني منحى STEAM عند تطوير المناهج الدراسية المختلفة والمواقف الصفية المتعددة؛ لفعاليتها في تنمية الدافعية العقلية والتحصيل وتعليم العلوم، تنظيم وترتيب المحتوى الدراسي الذي يحقق األهداف التعليمية بحيث يكون هناك سهولة في عرض المادة التعليمية بما يتناسب مع الخصائص النمائية والعمرية لطلبة الصف الثالث األساسي

The Effect of Ephedra Foeminea Extract as an Antimicrobial and Antifungal Agent

Drugs derived from natural sources play a significant role in the prevention and treatment of human diseases. In many developing countries, traditional medicine is an essential part of primary healthcare systems (Abdallah, 2011). Due to the emergence of drug-resistant bacteria, it is essential to investigate new drugs with lesser resistance especially ones that can be derived from natural resources like plants. Ephedra is likely one of the oldest medicinal plants that are still currently in use. Antimicrobial and antifungal activities of some ephedra species have been noticed in recent years (ZHANG Ben-Mei et al,2018). The aim of the study is to observe and understand the effects of E. foeminea extracts as antimicrobial and antifungal agents. It is an experimental study; four different types of bacteria including, Staphylococcus aureus, Pseudomonas aeruginosa, MRSA, and Escherichia coli as well as two different types of fungi including, Klebsiella pneumoniae and Candida albicans were used as test microorganisms. Maceration extraction technique (William P. Jones,2012) for the dried stem of E. foeminea will be used by methanol / water 90/10 for 2 days (Ali Parsaeimehr et el,2010). Three concentrations of the extract will be used on 30 plates for each type of microorganism in the laboratories of the University of Palestine. Antimicrobial activity will be tested by using plate methods in which a variable diameter of a growth inhibition zone in most types of bacteria will appear. The MIC values may also be evaluated using the broth serial dilution method according to standard methods (CLSI, 2012)

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

A systematic review and network meta-analysis comparing azacitidine and decitabine for the treatment of myelodysplastic syndrome

Abstract Background Hypomethylating agents (HMA), azacitidine, and decitabine are frequently used in the management of myelodysplastic syndromes (MDS). However, there are no clinical trials that have directly compared these agents. We conducted a systematic review and indirectly compared the efficacy of azacitidine to decitabine in MDS. Methods We conducted a comprehensive search of several databases (MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and Scopus) through June 28, 2018, without language or time restrictions. Studies were screened by two independent reviewers, and differences were resolved by consensus. The fixed effect model and adjusted indirect comparison methods were used to pool relative risks (RR) of major outcomes of interest (mortality, response rate, quality of life, hematologic improvement, hospitalization, leukemia transformation, transfusion independence). Results Only four trials met the eligibility criteria. Two trials compared azacitidine to the best supportive care (BSC) and included 549 patients, and the other two compared decitabine to BSC and included 403 patients. The risk of bias was unclear overall. Compared to BSC, azacitidine was significantly associated with lower mortality (RR = 0.83, 95% CI 0.74–0.94, I 2 = 89%) whereas decitabine did not significantly reduce mortality (RR = 0.88, 95% CI 0.77–1.00, I 2 = 53%). Both drugs were associated with higher partial and complete response compared to BSC. Indirect comparisons were not statistically significant for all the studied outcomes, except for complete response where azacitidine was less likely to induce complete response compared to decitabine (RR = 0.11, 95% CI = 0.01–0.86, very low-certainty evidence). Conclusions Azacitidine and decitabine are both associated with improved outcomes compared to BSC. The available indirect evidence comparing the two agents warrants very low certainty and cannot reliably confirm the superiority of either agent. Head-to-head trials are needed. In the meantime, the choice of agent should be driven by patient preferences, adverse effects, drug availability, and cost

Imaging for the diagnosis of hepatocellular carcinoma: A systematic review and meta-analysis.

Multiphasic computed tomography (CT) and magnetic resonance imaging (MRI) are both used for noninvasive diagnosis of hepatocellular carcinoma (HCC) in patients with cirrhosis. To determine if there is a relative diagnostic benefit of one over the other, we synthesized evidence regarding the relative performance of CT, extracellular contrast-enhanced MRI, and gadoxetate-enhanced MRI for diagnosis of HCC in patients with cirrhosis. We also assessed whether liver biopsy versus follow-up with the same versus alternative imaging is best for CT-indeterminate or MRI-indeterminate liver nodules in patients with cirrhosis. We searched multiple databases from inception to April 27, 2016, for studies comparing CT with extracellular contrast-enhanced MRI or gadoxetate-enhanced MRI in adults with cirrhosis and suspected HCC. Two reviewers independently selected studies and extracted data. Of 33 included studies, 19 were comprehensive, while 14 reported sensitivity only. For all tumor sizes, the 19 comprehensive comparisons showed significantly higher sensitivity (0.82 versus 0.66) and lower negative likelihood ratio (0.20 versus 0.37) for MRI over CT. The specificities of MRI versus CT (0.91 versus 0.92) and the positive likelihood ratios (8.8 versus 8.1) were not different. All three modalities performed better for HCCs ≥2 cm. Performance was poor for HCCs &lt;1 cm. No studies examined whether adults with cirrhosis and an indeterminate nodule are best evaluated using biopsy, repeated imaging, or alternative imaging. Concerns about publication bias, inconsistent study results, increased risk of bias, and clinical factors precluded support for exclusive use of either gadoxetate-enhanced or extracellular contrast-enhanced MRI over CT.ConclusionCT, extracellular contrast-enhanced MRI, or gadoxetate-enhanced MRI could not be definitively preferred for HCC diagnosis in patients with cirrhosis; in patients with cirrhosis and an indeterminate mass, there were insufficient data comparing biopsy to repeat cross-sectional imaging or alternative imaging. (Hepatology 2018;67:401-421)

Imaging for the diagnosis of hepatocellular carcinoma: A systematic review and meta-analysis.

Multiphasic computed tomography (CT) and magnetic resonance imaging (MRI) are both used for noninvasive diagnosis of hepatocellular carcinoma (HCC) in patients with cirrhosis. To determine if there is a relative diagnostic benefit of one over the other, we synthesized evidence regarding the relative performance of CT, extracellular contrast-enhanced MRI, and gadoxetate-enhanced MRI for diagnosis of HCC in patients with cirrhosis. We also assessed whether liver biopsy versus follow-up with the same versus alternative imaging is best for CT-indeterminate or MRI-indeterminate liver nodules in patients with cirrhosis. We searched multiple databases from inception to April 27, 2016, for studies comparing CT with extracellular contrast-enhanced MRI or gadoxetate-enhanced MRI in adults with cirrhosis and suspected HCC. Two reviewers independently selected studies and extracted data. Of 33 included studies, 19 were comprehensive, while 14 reported sensitivity only. For all tumor sizes, the 19 comprehensive comparisons showed significantly higher sensitivity (0.82 versus 0.66) and lower negative likelihood ratio (0.20 versus 0.37) for MRI over CT. The specificities of MRI versus CT (0.91 versus 0.92) and the positive likelihood ratios (8.8 versus 8.1) were not different. All three modalities performed better for HCCs ≥2 cm. Performance was poor for HCCs &lt;1 cm. No studies examined whether adults with cirrhosis and an indeterminate nodule are best evaluated using biopsy, repeated imaging, or alternative imaging. Concerns about publication bias, inconsistent study results, increased risk of bias, and clinical factors precluded support for exclusive use of either gadoxetate-enhanced or extracellular contrast-enhanced MRI over CT.ConclusionCT, extracellular contrast-enhanced MRI, or gadoxetate-enhanced MRI could not be definitively preferred for HCC diagnosis in patients with cirrhosis; in patients with cirrhosis and an indeterminate mass, there were insufficient data comparing biopsy to repeat cross-sectional imaging or alternative imaging. (Hepatology 2018;67:401-421)