Waterjet cutting up to 900 MPa

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The Role of CD 34 Hematopoietic Progenitor Cells, Macrophages, and Smooth Muscle Cells in Human Coronary Artery Atherogenesis

BACKGROUND: Atherosclerosis is a widespread and devastating disease and one of the leading causes of death worldwide. So much is there to understand about atherosclerosis. And although a lot is already discovered, yet most of the studies are performed in cell cultures and animal models. Recent technologies for genetic engineering and imaging are mainly performed on animal models, with few studies in human tissues. A better understanding of their role is required. AIM: We aim to study the expression of CD 34 hematopoietic progenitor stem cell, CD 68 macrophages, and smooth muscle actin (SMA)-positive smooth muscle cells (SMCs) in the human coronary arteries and correlate their differential expression with the atherosclerosis progression. RESULTS: CD 68 and CD 34 expression increase as the atherosclerotic process proceeds from early atheroma to advanced atheroma and start to decrease as the process proceeds to fibroatheroma with a significant p < 0.001. Conversely, SMA expression decreases as the atherosclerotic process progresses with a significant p < 0.001. CONCLUSION: CD34 progenitor cells in conjunction with CD 68 macrophages have a major role in the development of atherosclerosis, whereas the SMCs are minimal in the early stages and reach their maximal levels during the stage of fibroatheroma

Spontaneous ovulation and pregnancy in women with polycystic ovarian disease; a cross sectional study

Background: Polycystic ovary disease (PCOD) is the most common endocrine disorder in women of reproductive age, with a prevalence of approximately 5-10%. This study aims to assess the rate of spontaneous ovulation and pregnancy in patients. The present study was a cross sectional study conducted at Woman's Health Hospital, Assiut University, Assiut, Egypt.Methods: The current study was a cross sectional study carried out in Assiut Women's Health Hospital between the 1st October 2016 and 31st July 2017. The patients were selected as infertile patients with PCOD. The patient ages range between 20 and 35 years. The BMI is between 18 and 30 Kg/m2. The main outcome measure was the rate of spontaneous ovulation and spontaneous pregnancy in the 3 cycles.Results: The mean age of the study participants was 26.64±4.59 years and the mean BMI was 24.46±2.62Kg/m2. The sonographic ovarian volume was 12.47±0.69 mm3 for the right ovary and 12.74±0.73 mm3 for the left ovary. No difference in the serum FSH, LH, FSH/LH ratio and prolactin over the 3 consecutive cycles. The rate of spontaneous ovulation in the 3 cycles was 6 women (8.6%) and 2 cases (2.8%) became pregnant spontaneously during the study period. There is no statistical significant difference between ovulating and non-ovulating women according to the BMI and ovarian volume.Conclusions: The present study concluded that the rate of spontaneous ovulation was 8.6% in women with PCOD within 3 cycles with no adverse effects of drugs or surgical interference

ISOLATION AND IDENTIFICATION OF ANTIBIOTIC PRODUCING PSEUDOMONAS FLUORESCENS NBRC-14160 FROM DELTA SOIL IN EGYPT

Pseudomonas fluorescens is one of plant Growth Promoting Rhizobacteria (PGPR) members which has a major role in the biological control of bacterial and fungal pathogens. A research was conducted at the Laboratory of Microbiology, Faculty of Agriculture, Ain Shams University, Qalubyia governorate intended for isolating Pseudomonas fluorescens isolate, efficient in antibiotic production. For isolation, soil samples, collected from Faculty of agriculture farm soil at depth of 10 cm, were screened for Ps. fluorescens isolates by cultivating the samples on King’s medium. Out of 30 isolates obtained, one was selected based on its high lipid content, because of the lipid’s correlation to antibiotic production and inhibitory activity. The selected isolate was characterized by morphological, physiological, biochemical tests then confirmed its identity by 16S rRNA gene sequence analysis and named Pseudomonas fluorescens NBRC-14160 16srRNA. Morphological features showed that Ps. fluorescens NBRC-14160 has large colonies, with irregular surface, opaque, producing green fluorescent pigments. Cells are short rods, Gram negative. Physiological features indicated that Ps. fluorescens NBRC-14160 is capable of producing several exoenzymes including lipase, phospholipase, protease and chitinase and incapable of producing amylase and cellulase. Carbohydrate fermentation tests were positive for fructose, glucose, D-glucose, and galactose, forming acids after 24 hrs. of incubation at 30˚C. However, it loses the ability to ferment inositol, mannose, xylose, mannitol, raffinose and rhamnose sugars. It’s lipid content was 607 mg/g. Inhibitory activity was studied by the method of disc diffusion test against nine pathogenic bacterial and fungal strains. Staphylococcus aureus was the most sensitive bacterial pathogen towards P. fluorescens NBRC-14160 with a 4.5 cm zone of inhibition, while Serratia marscens had 0.95 cm zone. Aspergillus niger and Alternaria solani were the most sensitive fungal pathogens towards P. fluorescens NBRC-14160 with 2.55 and 2.5 cm of inhibition zone, respectively. However, the most resistant fungus was Fusarium oxysporum with 1.3 cm inhibition zone

Value of biochemical markers in predicting outcome of COVID-19 infection in University Hospital, Alexandria, Egypt

This paper aims to examine the value of different biochemical markers in predicting the outcome of COVID-19 infection. A total of 140 patients with confirmed COVID-19 infection by polymerase chain reaction (PCR), different biochemical markers were tested, their relation to the outcome of the disease was monitored, and the most reliable tests were determined. The study found a significant correlation between all evaluated biochemical markers and severity of the disease, including C-reactive protein (CRP), D-dimer, alanine aminotransferase (ALT), Aspartate aminotransferase (AST), prothrombin time (PT), activated partial thromboplastin time (aPTT). In addition, ferritin, lactate dehydrogenase (LDH), procalcitonin (PCT) and Pro- Brain natriuretic peptide (proBNP) demonstrated highly sensitivity and specificity as well as significant prognostic performance. These markers were also independently significant in predicting mortality. Early assessment of biochemical markers in patients with COVID-19 can help clinicians in tailoring treatment and providing more intensive care to those with greater mortality risk. In particular, the assessment of ferritin, LDH, procalcitonin and proBNP can independently predict mortality

Adaptive Fuzzy Supplementary Controller for SSR Damping in a Series-Compensated DFIG-Based Wind Farm

Although using a series compensation technique in a long transmission line effectively increases the transmittable power; it may cause a sub-synchronous resonance (SSR) phenomenon. Gate-controlled series capacitor (GCSC) is an effective method for SSR damping by controlling the turn-off angle. In the previous studies, a constant supplementary damping controller (SDC) was used for controlling the turn-off angle, which can mitigate the SSR phenomenon. However, these methods can not capture the maximum transmittable power at different operating points. In this paper, a fuzzy logic controller (FLC) is proposed to compute the gain of SDC based on the wind speed and the error between the measured and reference line currents for transferring as much power as possible and damping the SSR phenomenon simultaneously. Using the MATLAB/SIMULINK program, the proposed method is tested at different operating points to validate its effectiveness and robustness. Compared to the traditional method (constant SDC), the maximum transmittable power, as well as SSR damping, is achieved in all studied cases by the proposed method (variable SDC)

cardiotoxicity with immune system targeting drugs a meta analysis of anti pd pd l1 immunotherapy randomized clinical trials

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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

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Repositioning of the global epicentre of non-optimal cholesterol

High blood cholesterol is typically considered a feature of wealthy western countries(1,2). However, dietary and behavioural determinants of blood cholesterol are changing rapidly throughout the world(3) and countries are using lipid-lowering medications at varying rates. These changes can have distinct effects on the levels of high-density lipoprotein (HDL) cholesterol and non-HDL cholesterol, which have different effects on human health(4,5). However, the trends of HDL and non-HDL cholesterol levels over time have not been previously reported in a global analysis. Here we pooled 1,127 population-based studies that measured blood lipids in 102.6 million individuals aged 18 years and older to estimate trends from 1980 to 2018 in mean total, non-HDL and HDL cholesterol levels for 200 countries. Globally, there was little change in total or non-HDL cholesterol from 1980 to 2018. This was a net effect of increases in low- and middle-income countries, especially in east and southeast Asia, and decreases in high-income western countries, especially those in northwestern Europe, and in central and eastern Europe. As a result, countries with the highest level of non-HDL cholesterol-which is a marker of cardiovascular riskchanged from those in western Europe such as Belgium, Finland, Greenland, Iceland, Norway, Sweden, Switzerland and Malta in 1980 to those in Asia and the Pacific, such as Tokelau, Malaysia, The Philippines and Thailand. In 2017, high non-HDL cholesterol was responsible for an estimated 3.9 million (95% credible interval 3.7 million-4.2 million) worldwide deaths, half of which occurred in east, southeast and south Asia. The global repositioning of lipid-related risk, with non-optimal cholesterol shifting from a distinct feature of high-income countries in northwestern Europe, north America and Australasia to one that affects countries in east and southeast Asia and Oceania should motivate the use of population-based policies and personal interventions to improve nutrition and enhance access to treatment throughout the world.Peer reviewe