Agent Based Modelling and Simulation of Pedestrian Crowds in Panic Situations

The increasing occurrence of panic stampedes during mass events has motivated studying the impact of panic on crowd dynamics. Understanding the collective behaviors of panic stampedes is essential to reducing the risk of deadly crowd disasters. In this work, we use an agent-based formulation to model the collective human behavior in such crowd dynamics. We investigate the impact of panic behavior on crowd dynamics, as a specific form of collective behavior, by introducing a contagious panic parameter. The proposed model describes the intensity and spread of panic through the crowd. The corresponding panic parameter impacts each individual to represent a different variety of behaviors that can be associated with panic situations such as escaping danger, clustering, and pushing. Simulation results show contagious panic and pushing behavior, resulting in a more realistic crowd dynamics model

Toll-Like Receptors Gene Polymorphism and Susceptibility to Cancer Development

Toll-like receptors (TLRs) play an important role in immune-surveillance and responses towards pathogenic and non-pathogenic microorganisms. They act as innate immune sensors against endogenous and exogenous danger signals by recognizing the pattern recognition molecules (DAMPs and PAMPs) and drive an adaptive immune response through their signaling pathways, which leads to NF-κB and IRF3 transactivation and induces different inflammatory cytokine genes. TLRs polymorphisms were investigated in various cancer types studies. However, precious studies have reported that the Polymorphisms on TLR1-TLR10 cluster have been associated with increased risk of prostate cancer. However, it has known that TLRs genetic variation is associated with increased the susceptibility to gastric cancer. A same synthetically meta- analysis also confirmed the association of TLRs with increased the gastrointestinal cancer but with decreased prostate cancer risk. Our previous studies have demonstrated a strong link between TLRs polymorphisms and colon cancer and breast cancer in Saudi Arabia population. Similar studies were analyzed with Korean patients with papillary thyroid cancer and their clinic-pathologic features in age matched controls by using direct sequencing. The general objective of this chapter was to investigate the role of different TLRs (i.e., TLR2, TLR4, and TLR6) polymorphisms and their association with cancer development

Reevaluating vitamin C in sepsis and septic shock: a potential benefit in severe cases?

Vitamin C (Ascorbic acid) has evolved as an emergent co-intervention for sepsis and septic shock patients. Multiple studies discussed the pathophysiological value of vitamin C to reserve endothelial functionality and improve microcirculatory flow in these patients. Nevertheless, most randomized clinical trials failed to show the clinical impact of adding vitamin C to sepsis and septic shock. Pneumonia is the most common infection to induce sepsis and septic shock, which could be an acute respiratory distress syndrome. Preliminary in-vitro data support the role of vitamin C in mitigating the risk of acute respiratory distress syndrome (ARDS) development. This review aims to compare and contrast these trials and explore differences in their patients’ populations, methodologies, and outcomes, emphasizing pneumonia-induced sepsis and septic shock

Optimal allocation of a wind turbine and battery energy storage systems in distribution networks based on the modified BES-optimizer

Recently, incorporating renewable energy resources (RERs) like wind turbines (WTs) in a distribution network is rapidly increased to meet the load growth. However, distribution networks have been facing many challenges to withstand the intermittent output power of RERs. Battery energy storage (BES) is used with RERs to smoothly inject the output power to the grid by RERs. Therefore, this paper proposes an effective strategy for optimal allocation of WT and BES in RDS to decrease the total system losses. In addition, a modified bald eagle search (BES-optimizer) is proposed to obtain the preferable allocations of WT and BES simultaneously in the radial distribution system (RDS) considering the probabilistic distribution of the WT and load demand. IEEE 69-bus RDS is utilized as a test system. Based on the obtained results, installing WTs with BES gives better results than installing WTs alone in the RDS. However, the proposed algorithm proved its efficiency to obtain the best global results compared with other well-known techniques

Comparison of 4-factor fixed-dose versus 4-factor weight-based–dose prothrombin complex concentrate for emergent warfarin reversal: a systematic review and meta-analysis

Objective The objective of this systematic review and meta-analysis is to evaluate the efficacy, safety, time to international normalized ratio (INR) reversal, and total volume of 4-factor prothrombin complex concentrate (4-PCC) administered using fixed-dose versus weight-based dosing strategies in patients requiring urgent warfarin reversal, with specific focus on clinical outcomes of hemostatic efficacy, thromboembolic events, and mortality rates. Methods A comprehensive systematic review was conducted using the PubMed, Embase, and Cochrane databases from inception through October 2023. We searched for randomized clinical trials or observational studies that compared efficacy or safety outcomes of fixed versus variable 4-PCC dose in adult patients. Results In the 14 included studies, the overall use of fixed-dose 4-PCC was associated with a lower likelihood of reaching the INR goal (risk ratio [RR], 0.84; 95% confidence interval [CI], 0.80–0.89) compared to the variable-dose group. In addition, a significantly larger proportion of patients (169 of 651, 26%) required an additional dose of 4-PCC. The rates of mortality (RR, 0.85; 95% CI, 0.70–1.03) and thromboembolic events (RR, 1.27; 95% CI, 0.65–2.45) were similar between the two treatment groups. Conclusion This systematic review and meta-analysis showed that variable dosing of 4-PCC more successfully achieves the target INR for warfarin reversal compared to fixed dosing. However, the dosing strategies have similar mortality and thromboembolic rates. While fixed dosing offers a simpler approach, it may require additional administration. Future studies should focus on optimizing dosing strategies to balance efficacy, safety, and practicality in various clinical scenario

Assessment and Management of Atopic Dermatitis in Primary Care Settings

An increasingly common chronic inflammatory skin condition is atopic dermatitis (AD). It exhibits severe itching as well as recurring eczematous lesions. New difficulties for treatment selection and approach occur with the expansion of available therapy alternatives for healthcare professionals and patients.  The article highlights recent developments in scientific research on atopic dermatitis diagnosis and assessment that have led to the identification of novel therapeutic targets and the development of targeted therapies, both of which have the potential to completely change the way AD is treated, particularly in a primary care setting

Exploring factors that influence the knowledge and awareness of breastfeeding among Saudi mothers: a qualitative study

PurposeBreastfeeding provides short- and long-term benefits for mothers and babies. Despite these advantages, the prevalence of breastfeeding among Saudi mothers is low. We explored factors affecting the knowledge and awareness of breastfeeding among Saudi mothers in Riyadh.MethodsThis qualitative study included 17 mothers. The inclusion criteria were Saudi mothers aged 18–50 years, with at least one child, living in Riyadh. Semi-structured interviews of approximately 20–40 min were conducted online or in person between March and April 2024. Data were analyzed using the constant comparative method with NVivo 11. Ethical approval was obtained from an academic institutional review board prior to data collection.ResultsTwo key themes emerged from the data. Theme 1 concerned factors facilitating knowledge and awareness of breastfeeding; subthemes included positive experience with breastfeeding, knowledge of breastfeeding, family support, and financial considerations. Theme 2 concerned factors limiting knowledge and awareness of breastfeeding; subthemes included negative experiences of breastfeeding, work situations, misconceptions, and mental health issues.ConclusionDespite the low prevalence of breastfeeding in Saudi Arabia, mothers were aware of its benefits. Physicians and midwives should provide ongoing education and support for mothers during ante- and post-natal periods to minimize misconceptions regarding breastfeeding and promote its use

Association between rhesus and ABO blood group types and their impact on clinical outcomes in critically ill patients with COVID-19: A multi-center investigation

Background: There is increasing evidence suggesting that ABO blood type may play a role in the immunopathogenesis of COVID-19 infection. In addition to ABO blood type, the Rhesus (Rh) factor has also been implicated in various disease processes. Therefore, our study aimed to assess the association between both ABO and Rh blood types in critically ill patients with COVID-19 and their clinical outcomes. Methods: A multicenter retrospective cohort study conducted in Saudi Arabia between March 1, 2020, and July 31, 2021, involving adult COVID-19 patients admitted to Intensive Care Units, aimed to explore potential associations between rhesus blood group types (Positive versus Negative) and clinical outcomes. The primary endpoint assessed was the hospital length of stay (LOS). Other endpoints were considered secondary. Results: After propensity score matching (3:1 ratio), 212 patients were included in the final analysis. The hospital length of stay was longer in a negative Rh blood group compared with patients in the Rh-positive group (beta coefficient 0.26 (0.02, 0.51), p = 0.03). However, neither 30-day mortality (HR 0.28; 95% CI 0.47, 1.25, p = 0.28) nor in-hospital mortality (HR 0.74; 95% CI 0.48, 1.14, p = 0.17) reached statistical significance. Additionally, among the different ABO types, the A+ blood group exhibited a higher proportion of thrombosis/infarction and in-hospital mortality (28.1% and 31.2%, respectively). Conclusion: This study highlights the potential impact of blood group type on the prognosis of critically ill patients with COVID-19. It has been observed that patients with a negative Rh blood group type tend to have a longer hospital stay, while their mortality rates and complications during ICU stay are similar to the patients with a Rh-positive group

SARS-CoV-2 susceptibility and COVID-19 disease severity are associated with genetic variants affecting gene expression in a variety of tissues

Variability in SARS-CoV-2 susceptibility and COVID-19 disease severity between individuals is partly due to genetic factors. Here, we identify 4 genomic loci with suggestive associations for SARS-CoV-2 susceptibility and 19 for COVID-19 disease severity. Four of these 23 loci likely have an ethnicity-specific component. Genome-wide association study (GWAS) signals in 11 loci colocalize with expression quantitative trait loci (eQTLs) associated with the expression of 20 genes in 62 tissues/cell types (range: 1:43 tissues/gene), including lung, brain, heart, muscle, and skin as well as the digestive system and immune system. We perform genetic fine mapping to compute 99% credible SNP sets, which identify 10 GWAS loci that have eight or fewer SNPs in the credible set, including three loci with one single likely causal SNP. Our study suggests that the diverse symptoms and disease severity of COVID-19 observed between individuals is associated with variants across the genome, affecting gene expression levels in a wide variety of tissue types