Role of fetal pulmonary artery Doppler in prediction of neonatal respiratory distress in neonates of diabetic mothers

Background: Newborn respiratory complication is one of the most prevalent and life-threatening disorders. The clinical indications of early newborn respiratory distress with consistent radiologic features. The Doppler examination of the primary pulmonary artery in the foetus has been proven to be beneficial. The foetal pulmonary artery At/Et ratio is linked to foetal gestational age and amniotic fluid foetal lung maturity (FLM) tests. The aim of the study was to assess the accuracy of foetal main pulmonary artery (MPA) Doppler indices in prediction of the development of neonatal respiratory distress syndrome (RDS) in diabetic mothers.Methods: This was a prospective observational study carried out on 100 cases of diabetic mothers in obstetrics and gynecology department, Tanta University during one year from the approval of the university counsel. The physician evaluated the foetal heart in a methodical manner after a regular ultrasound assessment that included foetal biometry, anomaly scan, measured foetal weight, and amniotic fluid index. Classic chest radiological features include reticulogranular patterns, air bronchogram and ground glass look, as well as the need for surfactant.Results: PI and RI were significantly higher in newborns with RDS than those without RDS (p=0.025 and 0.036 respectively) PSV and At/Et ratio were significantly reduced in neonates with RDS compared with RDS free ones (p=0.004 and <0.001 respectively). RI was significantly higher in neonates with RDS than those without RDS (P = 0.048) PSV and At/Et ratio were significantly reduced in newborns with RDS compared to RDS free ones (p=0.008 and <0.001 respectively). The ROC curve displayed that the cut off value of ≤0.25 for At/Et ratio was associated with a sensitivity of 76.92%, a specificity of 100.0%, a PPV of 100.0% and a NPV of 96.7% for prediction of neonatal RDS with AUC of 0.925 and p≤0.001.Conclusions: development of neonatal RDS in foetus of diabetic mothers with a cut off value of ≤0.25, a sensitivity of 76.92%, a specificity of 100.0%, a PPV of 100.0%, a NPV of 96.7% and AUC of 0.925 The usage of corticosteroids improved the Doppler indices of main pulmonary artery and is accompanied by less morbimortality related to RDS

Semi-decentralized Inference in Heterogeneous Graph Neural Networks for Traffic Demand Forecasting: An Edge-Computing Approach

Prediction of taxi service demand and supply is essential for improving customer's experience and provider's profit. Recently, graph neural networks (GNNs) have been shown promising for this application. This approach models city regions as nodes in a transportation graph and their relations as edges. GNNs utilize local node features and the graph structure in the prediction. However, more efficient forecasting can still be achieved by following two main routes; enlarging the scale of the transportation graph, and simultaneously exploiting different types of nodes and edges in the graphs. However, both approaches are challenged by the scalability of GNNs. An immediate remedy to the scalability challenge is to decentralize the GNN operation. However, this creates excessive node-to-node communication. In this paper, we first characterize the excessive communication needs for the decentralized GNN approach. Then, we propose a semi-decentralized approach utilizing multiple cloudlets, moderately sized storage and computation devices, that can be integrated with the cellular base stations. This approach minimizes inter-cloudlet communication thereby alleviating the communication overhead of the decentralized approach while promoting scalability due to cloudlet-level decentralization. Also, we propose a heterogeneous GNN-LSTM algorithm for improved taxi-level demand and supply forecasting for handling dynamic taxi graphs where nodes are taxis. Extensive experiments over real data show the advantage of the semi-decentralized approach as tested over our heterogeneous GNN-LSTM algorithm. Also, the proposed semi-decentralized GNN approach is shown to reduce the overall inference time by about an order of magnitude compared to centralized and decentralized inference schemes.Comment: 13 pages, 10 figures, LaTeX; typos corrected, references added, mathematical analysis adde

Epidemiology and Outcomes of Hospitalized Burn Patients in Gaza Strip: A Descriptive Study

BACKGROUNG: Burns are serious health problems and leading causes of mortality and morbidity in the Eastern Mediterranean Region. This study aimed to overview the epidemiological profile and to present outcomes among hospitalized burn patients in AL Alamy burn center in Gaza.METHODS: This was a cross-sectional retrospective study of medical records of hospitalized patients from July 2013 to June 2014. Descriptive analysis for studied variables was applied and P . 0.05 considered statistically significant.RESULTS: One humdred eighty nime admissions, 60.8% were males and 63% were under 10 years old. Burn patients in the age range between 19-40 years represented 25.9%. Most common burn injuries were accidental (86.2%), located at home (88.9%), caused by scald (66.1%) and by fire flame (23.8%). On admission, the majority of cases presented with second degree burn (45.5%) or mixed burn (38.6%). The mean TBSA was 11.86 (SD } 10.78) ranging from 1% to 75% whereas, the mean hospital length of stay was 11.45 (SD } 12.60) ranging from 1 to 115 days. Total in hospital mortality rate was 2.1% and length of stay was significantly associated with TBSA (P &lt; 0.001).CONCLUSION: Young children below 10 years seem to be at a higher risk for burn injuries. A significant improvement in burn patients care is observed and practiced and in hospital mortality rate is better compared to neighbouring countries. Preventive programs focusing on safety measures, especially for mothers working in the home, should be implemented urgently to save our children.KEYWORDS: Burns, Hospitalized patients, Length of stay, Mortalit

Parámetros sedimentarios y texturales de continuidad y características mineralógicas del río Jajrood, Irán

In this research, we try to study the sedimentary characteristics and the trend of textural changes in the sediments of the Jajrood River from upstream to downstream at the point of junction to Latiyan dam. Based on the textural changes of sediments along the path from the upstream in the Garmabdar area to the downstream to the Latiyan Dam, the Jajrood River is divided into four A, B, C and D basins. Twenty sediment samples were collected and all sieved by dry and wet method also the specimens were morphoscopically studied. Data from field and laboratory phases were combined and interpreted using reliable scientific sources and finally a detailed summary was obtained regarding sedimentology of the study area. Mineralogically, the sediment type of the river is a clastic carbonate sedimentary type with fragments ranging from 30 to 58 percent and rock fragments between 25 to 50 percent abundance. Other minerals, such as feldspar minerals, account for about 1 to 4 percent, quartz 5 to 10 percent, and opauqe minerals from 1 to 5 percent. Examination of the average particle size in the A to D basins shows that decreasing trend of sediment size from the A to C basin occurs and reverses in the D basin. In the first three basins, the sorting grade of the river sediments is very bad and in the last basin it has become extremely bad. The amount of kurtosis of the particle distribution curve from upstream to downstream of the river is generally increasing trend. Textural changes along the river do not follow natural conditions due to the influence of various natural factors such as the entry of distributary into the main River, and phenomena such as landslide and rock collapses and debris flows, especially during floods along the riverbank.En esta investigación, tratamos de estudiar las características sedimentarias y la tendencia de los cambios de textura en los sedimentos del río Jajrood desde aguas arriba hacia aguas abajo en el punto de unión con la presa de Latiyan. Basado en los cambios de textura de los sedimentos a lo largo del camino desde el río arriba en el área de Garmabdar hasta la presa de Latiyan, el río Jajrood se divide en cuatro cuencas A, B, C y D. Se recogieron veinte muestras de sedimentos y todas se tamizaron por método seco y húmedo, y las muestras se estudiaron morfoscópicamente. Los datos de las fases de campo y laboratorio se combinaron e interpretaron utilizando fuentes científicas confiables y finalmente se obtuvo un resumen detallado sobre la sedimentología del área de estudio. Desde el punto de vista mineralógico, el tipo de sedimento del río es un tipo sedimentario de carbonato clástico con fragmentos que van del 30 al 58 por ciento y fragmentos de roca entre el 25 y el 50 por ciento de abundancia. Otros minerales, como los minerales de feldespato, representan alrededor del 1 al 4 por ciento, los cuarzos del 5 al 10 por ciento y los minerales opacos del 1 al 5 por ciento. El examen del tamaño promedio de partícula en las cuencas A a D muestra que se produce una tendencia decreciente del tamaño del sedimento de la cuenca A a C y se invierte en la cuenca D. En las primeras tres cuencas, el grado de clasificación de los sedimentos del río es muy malo y en la última cuenca se ha vuelto extremadamente malo. La cantidad de curtosis de la curva de distribución de partículas de río arriba a río abajo es generalmente una tendencia creciente. Los cambios de textura a lo largo del río no siguen las condiciones naturales debido a la influencia de varios factores naturales, como la entrada de distribución en el río principal, y fenómenos como derrumbes y derrumbes de rocas y flujos de escombros, especialmente durante las inundaciones a lo largo de la orilla del río

Parámetros sedimentarios y texturales de continuidad y características mineralógicas del río Jajrood, Irán

In this research, we try to study the sedimentary characteristics and the trend of textural changes in the sediments of the Jajrood River from upstream to downstream at the point of junction to Latiyan dam. Based on the textural changes of sediments along the path from the upstream in the Garmabdar area to the downstream to the Latiyan Dam, the Jajrood River is divided into four A, B, C and D basins. Twenty sediment samples were collected and all sieved by dry and wet method also the specimens were morphoscopically studied. Data from field and laboratory phases were combined and interpreted using reliable scientific sources and finally a detailed summary was obtained regarding sedimentology of the study area. Mineralogically, the sediment type of the river is a clastic carbonate sedimentary type with fragments ranging from 30 to 58 percent and rock fragments between 25 to 50 percent abundance. Other minerals, such as feldspar minerals, account for about 1 to 4 percent, quartz 5 to 10 percent, and opauqe minerals from 1 to 5 percent. Examination of the average particle size in the A to D basins shows that decreasing trend of sediment size from the A to C basin occurs and reverses in the D basin. In the first three basins, the sorting grade of the river sediments is very bad and in the last basin it has become extremely bad. The amount of kurtosis of the particle distribution curve from upstream to downstream of the river is generally increasing trend. Textural changes along the river do not follow natural conditions due to the influence of various natural factors such as the entry of distributary into the main River, and phenomena such as landslide and rock collapses and debris flows, especially during floods along the riverbank.En esta investigación, tratamos de estudiar las características sedimentarias y la tendencia de los cambios de textura en los sedimentos del río Jajrood desde aguas arriba hacia aguas abajo en el punto de unión con la presa de Latiyan. Basado en los cambios de textura de los sedimentos a lo largo del camino desde el río arriba en el área de Garmabdar hasta la presa de Latiyan, el río Jajrood se divide en cuatro cuencas A, B, C y D. Se recogieron veinte muestras de sedimentos y todas se tamizaron por método seco y húmedo, y las muestras se estudiaron morfoscópicamente. Los datos de las fases de campo y laboratorio se combinaron e interpretaron utilizando fuentes científicas confiables y finalmente se obtuvo un resumen detallado sobre la sedimentología del área de estudio. Desde el punto de vista mineralógico, el tipo de sedimento del río es un tipo sedimentario de carbonato clástico con fragmentos que van del 30 al 58 por ciento y fragmentos de roca entre el 25 y el 50 por ciento de abundancia. Otros minerales, como los minerales de feldespato, representan alrededor del 1 al 4 por ciento, los cuarzos del 5 al 10 por ciento y los minerales opacos del 1 al 5 por ciento. El examen del tamaño promedio de partícula en las cuencas A a D muestra que se produce una tendencia decreciente del tamaño del sedimento de la cuenca A a C y se invierte en la cuenca D. En las primeras tres cuencas, el grado de clasificación de los sedimentos del río es muy malo y en la última cuenca se ha vuelto extremadamente malo. La cantidad de curtosis de la curva de distribución de partículas de río arriba a río abajo es generalmente una tendencia creciente. Los cambios de textura a lo largo del río no siguen las condiciones naturales debido a la influencia de varios factores naturales, como la entrada de distribución en el río principal, y fenómenos como derrumbes y derrumbes de rocas y flujos de escombros, especialmente durante las inundaciones a lo largo de la orilla del río

Oral Delivery of Psoralidin by Mucoadhesive Surface-Modified Bilosomes Showed Boosted Apoptotic and Necrotic Effects against Breast and Lung Cancer Cells

© 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).This study aims to design and optimize chitosan-coated bilosomal formulations loaded with psoralidin (Ps-CS/BLs) with improved physicochemical properties, oral bioavailability, and boosted apoptotic and necrotic effects. In this regard, uncoated bilosomes loaded with Ps (Ps/BLs) were nanoformulated using the thin-film hydration technique using different molar ratios of phosphatidylcholine (PC), cholesterol (Ch), Span 60 (S60), and sodium deoxycholate (SDC) (1:0.4:0.2:0.125, 1:0.4:0.2:0.25, and 1:0.4:0.2:0.5, respectively). The best-optimized formulation with respect to size, PDI, zeta potential, and EE% was selected and then coated with chitosan at two different concentrations (0.125 and 0.25 w/v%), forming Ps-CS/BLs. The optimized Ps/BLs and Ps-CS/BLs showed a spherical shape and relatively homogenous size with negligible apparent agglomerations. Additionally, it was demonstrated that coating Ps/BLs with chitosan has significantly increased the particle size from 123.16 ± 6.90 in the case of Ps/BLs to 183.90 ± 15.93 nm in the case of Ps-CS/BLs. In addition, Ps-CS/BLs exhibited higher zeta potential (+30.78 ± 1.44 mV) as compared to Ps/BLs (−18.59 ± 2.13 mV). Furthermore, Ps-CS/BL showed enhanced entrapment efficiency (EE%) of 92.15 ± 7.20% as compared to Ps/BLs (68.90 ± 5.95%). Moreover, Ps-CS/BLs exhibited a more sustained release behavior of Ps compared to Ps/BLs over 48 h, and both formulations were best obeying the Higuchi diffusion model. More importantly, Ps-CS/BLs displayed the highest mucoadhesive efficiency% (74.89 ± 3.5%) as compared to Ps/BLs (26.78 ± 2.9%), indicating the ability of the designed nanoformulation to improve oral bioavailability and extend the residence time inside the gastrointestinal tract upon oral administration. Moreover, upon evaluating the apoptotic and necrotic effects of free Ps and Ps-CS/BLs on human breast cancer cell lines (MCF-7) and human lung adenocarcinoma cell lines (A549), there was a dramatic increase in the percentages of the apoptotic and necrotic cell compared to the control and free Ps. Our findings suggest the possible oral use of Ps-CS/BLs in hampering breast and lung cancers.Peer reviewe

Comparative Study of Wound Healing After Treatment With Crude Date Extract and Silver Sulphadiazine

Crude date extract in comparison with silver sulphadiazine was tested to evaluate their effects on wound healing and their antimicrobial activities against the growth of Staphylococcus aureus. Crude date extract 5% (w/v) and silver sulphadiazine 20% (w/v) inhibited the growth of Staphylococcus aureus by 67% and 87% respectively. However,10% and 20% (w/v) date extract showed 100% inhibition. Date extract was fractionated using different solvents with different polarities; all fractions were tested for their antimicrobial activities. Ethyl acetate fraction was found to have inhibitory activity against the growth of Staphylococcus aureus. Preparative TLC was done for ethyl acetate fraction which was further identified to be terpenoidal compound. The histological changes in healing wounds have also been investigated after treatment with 20% and 40% crude date extract ,and silver sulphadiazine and amoxicillin by light microscopy.  The results obtained from 20% CDE treatment as compared to untreated control indicated that, this treatment promotes the process of wound healing and stimulates fibroblast, collagen and epithelialization significantly. This effect was comparable with the effect of silver sulphadiazine treatment

Comparison of Operative vs Non-operative Management of Ankle Fractures in Diabetic Patients: Prospective Randomized Trial

This study investigates the outcomes and complications associated with the management of ankle fractures in diabetic patients. A total of 44 diabetic patients with ankle fractures were enrolled, and they were randomly assigned to either conservative or operative treatment groups. The study evaluated demographic characteristics, diagnosis, complications, functional outcomes, and correlation with HbA1c and ankle brachial index. The results revealed a 29.5% complication rate among the patients, including superficial infections, Charcot neuroarthropathy, arthritic changes, loss of reduction leading to ankle fusion, and stiffness. Functional outcome scores (AOFAS and SF36) did not significantly differ between the conservative and operative groups. Correlation analysis showed a significant negative relationship between HbA1c levels and functional scores in the conservative group. Ankle brachial index demonstrated a negative correlation with the SF36 score in the conservative treatment group. The study emphasizes the importance of diabetic control and vascular assessment in guiding treatment decisions for diabetic ankle fractures

Antimicrobial Susceptibility of Klebsiella pneumoniae and Escherichia coli with Extended-Spectrum β-lactamase associated Genes in Hospital Tengku Ampuan Afzan,Kuantan, Pahang

Background: To assess antimicrobial susceptibility of extended-spectrum β-lactamase- (ESBL-) producing Klebsiella pneumoniae and Escherichia coli isolates from Hospital Tengku Ampuan Afzan (HTAA), as well as to identify ESBL genes. Methods: Non-duplicate K. pneumoniae and E. coli isolates were recovered from various clinical samples. Isolates were screened for antimicrobial resistance by disc diffusion method. Isolates resistant to oxyimino-cephalosporins were subjected to phenotypic ESBL production. Detection of resistance genes was then performed using primers specific for ESBL genes(bla CTX-M,bla SHV and bla TEM). Results: Piperacillin/tazobactam and carbapenems remained the active β-lactam antibioti against K. pneumoniae and E. coli. ESBLs were detected among 35.5%(39/110)of K. pneumoniae and 18.8%(28/149)of E. coli isolates. CTX-M β-lactamase was detected in 90% of all ESBL-positive isolates, whereas bla SHV and bla TEM genes were found among 56% and 52% of them, respectively. Twenty-eight percent(28%)of the total ESBL-positive isolates harboured the three ESBL genes, while 50% carried two of the tested ESBL genes. Conclusion ESBLs encoded by at least one ESBL genes are frequently isolated among K. pneumoniae and E. coli in HTAA. The significant proportion rate of the resistant determinants is alarming, thus monitoring their transmission and dissemination is essential to control it at an early phase