A Dual-Band Compact Integrated Rectenna for Implantable Medical Devices

This work describes a dual band compact fully integrated rectenna circuit for implantable medical devices. The implantable rectenna circuit consists of tunnel diode 10×10µm2 QW-ASPAT (Quantum Well Asymmetric Spacer Tunnel Layer diode) was used as the rectifier due to its temperature insensitivity and non-linearity compared with conventional SBD diodes. A miniaturized dual band implantable folded dipole antenna with multiple L-shaped conducting sections for operation in the WMTS band is 1.5GHz and ISM band of 5.8GHz. High dielectric constant material Gallium Arsenide (εr=12.94) and folded geometry helps to design compact antennas with a small footprint of 2.84mm3 (4.5×1×0.63) mm3. Four-layer human tissue model was used, where the antenna was implanted in the skin model at depth of 2mm. The 10-dB impedance bandwidths of the proposed compact antenna at 1.5GHz and 5.8GHz are 227MHz (1.4-1.63GHz) with S11 is -22.6dB and 540MHz (5.47-6.02GHz) with S11 is -23.1dB, whereas gains are -36.9dBi, and -24.3dBi, respectively. The output DC voltage and power of the rectenna using two stage rectifiers are twice that produced by the single stage at input RF power of 10dBm

Performance improvement of fractional N-PLL synthesizers for digital communication applications

Loop filter with two order was designed to improve the performance of the fractional N-phase locked loop (PLL) circuit (reference spurs noise and switching time), decreasing these two factors give good characteristic to fractional N-PLL circuit, the second order and third order loop filters are widely used in frequency synthesizer because they give good stability tolerance and for their simple architecture. They are designed at bandwidth B=125 KHz and its multipoles, at two values of the phase margin (pm)= 35°, 57°. MATLAB program was used to find the lock time, the component values for each element in the loop filter, also the filter impedance T(s), the bode plot of frequency response for close loop (CL) and open loop gain (OL). It is found by comparing the result of the frequency response for the 2nd order loop filter and 3rd order loop filter, that increasing the order of the filter will reduce the spurs noise that destroy the received signal at receiving side

Forensic Analysis of Microsoft Teams: Investigating Memory, Disk and Network

Videoconferencing applications have seen a jump in their userbase owing to the COVID-19 pandemic. The security of these applications has certainly been a hot topic since millions of VoIP users’ data is involved. However, research pertaining to VoIP forensics is still limited to Skype and Zoom. This paper presents a detailed forensic analysis of Microsoft Teams, one of the top 3 videoconferencing applications, in the areas of memory, disk-space and network forensics. Extracted artifacts include critical user data, such as emails, user account information, profile photos, exchanged (including deleted) messages, exchanged text/media files, timestamps and Advanced Encryption Standard encryption keys. The encrypted network traffic is investigated to reconstruct client-server connections involved in a Microsoft Teams meeting with IP addresses, timestamps and digital certificates. The conducted analysis demonstrates that, with strong security mechanisms in place, user data can still be extracted from a client’s desktop. The artifacts also serve as digital evidence in the court of Law, in addition to providing forensic analysts a reference for cases involving Microsoft Teams

Multidisciplinary Approach for the Management of Brain Arteriovenous Malformations

Objective: The main Objective of this study was to evaluate the significance of multimodality treatment of AVMs.Material and Methods: The data for this study was collected from the four years audit of surgical management of Arterio-venous Malformation in King Faisal Specialist Hospital and research center Jeddah, from year 2014 to 2017 which include 24 patients with brain AVMs.Results: In our study equal no. of male and female patients were recorded i.e. 12 patients in each group (50.00%). Seventeen (70.83%) patients were found in the first three decades of life indicating that the disease affects the younger age group. Main presenting complaint was seizures that was noted in 16 patient (66.66%) while headache was present in 15 patients (62.50%) followed by other signs and symptoms. Treatment of the patient was tailored according to the type of AVM its grade and the best possible way to take the complex disease. It included combination of pre-surgical or post-operative embolization, Complete of partial surgical resection of the lesion and stereotactic radiosurgery. The combination of these modalities were employed according to the situation of the patient to keep the plan of treatment safe, affective and ending finally in exclusion of the disease from the brain circulation. Pre-surgical embolization was successfully done in 7(29.16%) patients wile surgical resection was done in all patients at different stages of treatment. With use of multidisplanary approach in this series; Improvement was seen in 16 (66.66%) of the patient, 6 (25.00%) revealed no improvement while one patient (04.16%) was deteriorated.Conclusion: It was concluded that tailoring the treatment plan and use of multidisciplinary Approach for the management of Brain AVM depending upon their initial grades according to Spetrelz Martin grading system results in maximum favorable results

The role of Rezum in the management of refractory urinary retention due to benign prostate hyperplasia: A literature review

Background: Benign prostatic hyperplasia is the most common cause of urinary retention in men (BPH). The gold standard surgical treatment is transurethral resection of the prostate (TURP). However, due to the morbidity and mortality associated with TURP, more minimally invasive treatments, such as vaporizing the prostate with the Rezum system, have been introduced. We investigated the efficacy of Rezum in the treatment of refractory urinary retention due to BPH in this review. Methodology and materials: To conduct this review, the Cochrane methodology for systematic reviews was used. All studies that used Rezum to treat catheter-dependent patients with enlarged prostates were included. The literature search showed 111 studies, 84 of which were excluded due to non-relevance based on titles and 18 due to lack of relevance based on abstract review. Full manuscripts were reviewed in nine studies, three of which were excluded because they did not meet the inclusion criteria. Results: This review included 301 patients in total. The rate of a successful trial of voiding post Rezum therapy was 85%. The complication rated between 3.8 and 4.3% all of which were mild and self-limited. As there was no major complication of Rezum (clavien dindo >2), the procedure-related morbidity is negligible. Conclusion: In this review, Rezum was found to be an efficacious and safe alternative in the treatment of refractory retention with mild complications and minimal morbidity.The author(s) reported there is no funding associated with the work featured in this article. We would like to thank The Arab Urology Association for providing Open Access funding for this article.Scopu

Medical students' perceptions of complementary and alternative medicine therapies: A pre- and post-exposure survey in Majmaah University, Saudi Arabia

Background: Evidently, Complementary and Alternative Medicine (CAM) is increasingly a recognized medical practice that efficiently uses multiple treatment therapies and techniques in promoting the health  and wellbeing of people as well as preventing and managing a variety of human disorders. Research in CAM, which courses exposure to diverse healthcare professionals, is important from many perspectives including improvement in teaching skills of faculty, enhancing capacity building, and  innovative curriculum development. This pre- and post-design crosssectional study aimed to assess perceptions, training needs, personal usage, use in office practice, and knowledge of two batches of medical students toward CAM therapies in Majmaah University, Saudi Arabia.Materials and Methods: The second year medical students of the first (year 2012-13) and second (year 2013-2014) batch [n=26 & 39, respectively] were selected for this study. A reliable 16-item  self-administered questionnaire was distributed among all students for answering before and after the 48-hour specific 19 CAM therapies course, in terms of CAM therapies are clearly conventional or  alternative, training needs, effectiveness, personal use, use in practice, management of two clinical cases by CAM or conventional therapies, and views about which evidence based approach strongly support individual CAM modalities.Results: Medical students' knowledge and perceptions of CAM therapies significantly improved across some sub-items of CAM questionnaire with a positive trend in the rest of its items including their views about CAM therapies, need for further training, personal use of therapies and advising patients regarding CAM practices strongly supported by randomized clinical controlled trials and published case studies.Conclusion: CAM course tends to have positive impact on the knowledge and perceptions of medical students, in addition to need for further training, and personal use and use of CAM therapies in practice in line with strong evidence-based data regarding therapeutic efficacy. The preliminary results of this study call for further research in specific CAM modalities with a larger sample in academic settings across the nation. Key words: Medical students; Complementary and Alternative Medicine; CAM course; CAM therapies; pre-post design study; Saudi Arabia

MEDICAL STUDENTS' PERCEPTIONS OF COMPLEMENTARY AND ALTERNATIVE MEDICINE THERAPIES: A PRE- AND POST-EXPOSURE SURVEY IN MAJMAAH UNIVERSITY, SAUDI ARABIA

Background: Evidently, Complementary and Alternative Medicine (CAM) is increasingly a recognized medical practice that efficiently uses multiple treatment therapies and techniques in promoting the health and wellbeing of people as well as preventing and managing a variety of human disorders. Research in CAM, which courses exposure to diverse healthcare professionals, is important from many perspectives including improvement in teaching skills of faculty, enhancing capacity building, and innovative curriculum development. This pre- and post-design crosssectional study aimed to assess perceptions, training needs, personal usage, use in office practice, and knowledge of two batches of medical students toward CAM therapies in Majmaah University, Saudi Arabia. Materials and Methods: The second year medical students of the first (year 2012-13) and second (year 2013-2014) batch [n=26 & 39, respectively] were selected for this study. A reliable 16-item self-administered questionnaire was distributed among all students for answering before and after the 48-hour specific 19 CAM therapies course, in terms of CAM therapies are clearly conventional or alternative, training needs, effectiveness, personal use, use in practice, management of two clinical cases by CAM or conventional therapies, and views about which evidence based approach strongly support individual CAM modalities. Results: Medical students' knowledge and perceptions of CAM therapies significantly improved across some sub-items of CAM questionnaire with a positive trend in the rest of its items including their views about CAM therapies, need for further training, personal use of therapies and advising patients regarding CAM practices strongly supported by randomized clinical controlled trials and published case studies. Conclusion: CAM course tends to have positive impact on the knowledge and perceptions of medical students, in addition to need for further training, and personal use and use of CAM therapies in practice in line with strong evidence-based data regarding therapeutic efficacy. The preliminary results of this study call for further research in specific CAM modalities with a larger sample in academic settings across the nation

Histopathologic predictors of survival and recurrence in resected ampullary adenocarcinoma

Objective: The aim of the study was to define histopathologic characteristics that independently predict overall survival (OS) and disease-free survival (DFS), in patients who underwent resection of an ampullary adenocarcinoma with curative intent. Summary Background Data: A broad range of survival rates have been described for adenocarcinoma of the ampulla of Vater, presumably due to morphological heterogeneity which is a result of the different epitheliums ampullary adenocarcinoma can arise from (intestinal or pancreaticobiliary). Large series with homogenous patient selection are scarce. Methods: A retrospective multicenter cohort analysis of patients who underwent pancreatoduodenectomy for ampullary adenocarcinoma in 9 European tertiary referral centers between February 2006 and December 2017 was performed. Collected data included demographics, histopathologic details, survival, and recurrence. OS and DFS analyses were performed using Kaplan–Meier curves and Cox proportional hazard models. Results: Overall, 887 patients were included, with a mean age of 66 ± 10 years. The median OS was 64 months with 1-, 3-, 5-, and 10-year OS rates of 89%, 63%, 52%, and 37%, respectively. Histopathologic subtype, differentiation grade, lymphovascular invasion, perineural invasion, T-stage, N-stage, resection margin, and adjuvant chemotherapy were correlated with OS and DFS. N-stage (HR = 3.30 [2.09–5.21]), perineural invasion (HR = 1.50 [1.01–2.23]), and adjuvant chemotherapy (HR = 0.69 [0.48–0.97]) were independent predictors of OS in multivariable analysis, whereas DFS was only adversely predicted by N-stage (HR = 2.65 [1.65–4.27]). Conclusions: Independent predictors of OS in resected ampullary cancer were N-stage, perineural invasion, and adjuvant chemotherapy. N-stage was the only predictor of DFS. These findings improve predicting survival and recurrence after resection of ampullary adenocarcinoma

Public Knowledge, Attitudes, and Practice towards COVID-19 Pandemic in Saudi Arabia: A Web-Based Cross-Sectional Survey

(1) Background: COVID-19 has become a worldwide public health problem. No previous study has investigated factors associated with COVID-19 knowledge, attitude, and practice (KAP) after completely lifting the curfew in all Saudi Arabia regions and cities. Therefore, adequate knowledge, a positive attitude, and correct control of COVID-19 are essential to eradicate the disease. Hence, this study aims to assess factors associated with KAP of COVID-19; (2) Methods: This cross-sectional web-based survey was performed with the participation of 4305 individuals aged over 15 years living in Saudi Arabia from 11 to 19 August 2020. They were included using the snowball sampling method; (3) Results: Of the 4305 participants, 94.9% were Saudis, 60% females, and 45.4% were in the age group of 20–34 years, 61.7% married, and 49.3% from the Eastern Province of Saudi Arabia. Most of the participants demonstrated good KAP levels (89.6%, 87.2%, and 87.2%) towards the COVID-19 pandemic, respectively. In addition, most of the participants (85.8%) used the internet and social media as a source for COVID-19 information (4) Conclusions: The finding showed that most of the participants demonstrated good knowledge of COVID-19, positive attitudes, and demonstrated good practices for preventing the spread of disease infection

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London