Neutrosophic Digraph with Generalized Modus Tollens

In this paper, we generalize modus tollens method for neutrosophic digraph by using neutrosophic ruleand define degree of a vertex in neutrosophic digraph, Indegree of a vertex in neutrosophic digraph, out degree ofa vertex in neutrosophic digraph and generalized modus tollens are discussed

Recent Modalities in Treatment of Atopic Dermatitis: Review Article

Background: Inflammation of the skin marked by itchy, pigmented, dry areas is known as Atopic Dermatitis (AD), also known as Atopic Eczema (AE) or Eczema. Symptoms include red, itchy pimples that leak fluid and crust, scaly or raw skin, or raw or scaly skin. Dermatitis can come in many different forms, such as atopic, contact, or seborrheic. In children, atopic dermatitis is the most prevalent kind of eczema and often occurs in association with other allergic or asthmatic conditions. Eczema is most commonly found on the face, neck, elbows, knees, and toes, among other places. In terms of phototherapy, ultraviolet B phototherapy (280–320 nm) is the "oldest" method that is used in treatment of atopic dermatitis. Platelet rich plasma (PRP) injection utilizes the body's own regenerative mechanisms to help treat disease in the patient. Objective: Determination of the updated treatment modalities in Atopic Dermatitis management. Conclusion: Clearly there remains a need to find more potent topical agents with fewer side effects. The most gratifying advances in AD therapy have come from better understanding of immune and inflammatory mechanisms

Effect of tramadol addiction alone and its co-abuse with cannabis on urinary excretion of Copper, Zinc, and Calcium among Egyptian addicts

Background: The use of illicit drugs has become a worldwide health problem. Substances with the potential to be abused may have direct or indirect effects on physiologic mechanisms that lead to organ system dysfunction and diseases.Objective: The present study aims to investigate the structural and reabsorption integrity of the nephron among Egyptian addicts of tramadol alone and coabused with cannabis.Methods: Sixty-five males were included in the study, they were classified into control group (G1=19), tramadol addicts group (G2=18), and tramadol coabused with cannabis addicts group (G3=28). Parameters investigated for structural integrity were urinary levels ofleucineaminopeptidase and N-acetyl-β-D-glucosaminidase, and urinary parameters for reabsorption integrity were levels of copper and zinc as well as calcium, also urinary creatinine was measured. In addition, urinary levels of tramadol and tetrahydrocannabinol were estimated.Results: Among the two addicted groups, all measured parameters were not significantly different in comparison with the control group except for urinary calcium excretion which was found to be significantly increased among the two addicted groups.Conclusion: Both tramadol addiction alone or coabused with cannabis causes increased urinary excretion of calcium, indicating reabsorption dysfunction of calcium without affecting structural integrity along the nephron.Keywords: Enzymuria, copper, zinc, calcium, reabsorption impairment, tubular structural integrity

Post Covid-19 Tourism: Promoting the Holy Family Trail as a Niche Religious Tourism Destination/ الترويج ل مسار العائلة :COVID- السياحة بعد 19 المقدسة كوجهة للسياحة الدينية

The tourism sector constitutes significant importance for the Egyptian economy, with a contribution of 11.9% to the GDP and total employment of 2.49 million in 2018. The sector has different segments including both mass and niche tourism, where Egypt is heavily dependent on the former. Over the past 10 years, the sector was hammered by several internal and external intermittent hits, resulting in instability in the sector and fluctuations in its revenues that have consequently pulled down the foreign currency reserves. The current challenge of COVID-19 has introduced a new global norm that hurdled the mobility of mass tourist groups and the regular functionality of the sector in light of the imposed global travel restrictions.Despite Egypt’s tourism product portfolio diversification, Egypt relies heavily on both segments of mass tourism: recreational and cultural tourism. Given the increasing competition that characterizes the marketplace of the world’s mass tourism sector, in addition to the new normal dictated by COVID-19, there is a need to shift towards the niche tourism segments. By virtue of their nature, niche segments are less damaging, more sustainable, and more inclusive. Moreover, it generates higher revenues and expands the life cycle of tourism destinations

Video Assisted Laryngoscope versus Conventional Macintosh for Pediatric Intubation by Beginner Anesthesiologists

Background: Tracheal intubation is most usually facilitated by the use of a conventional Macintosh laryngoscope. Video and indirect laryngoscopes are becoming more significant tools in the management of the airways in children.Objective: To compare the time of intubation, the number of tries, and the success rate of pediatric intubation by beginner anesthesiologists using a video laryngoscope versus conventional Macintosh laryngoscope.Patients and Methods: This prospective randomized, single-blind clinical was conducted at Zagazig University Hospitals on 52 children aged from 2-6 years who were undergoing elective surgeries. VL Group: (n; 26 patients) intubation using video assisted laryngoscopy (Hugemed type). ML Group: (n; 26 patients) intubation using conventional Macintosh laryngoscope. Duration of intubation, number of trial, hemodynamic response as well as oxygen saturation were recorded at different intervals (base line, after induction, during intubation, after intubation) with assessment of complications.Results: As regard the efficacy and the safety of intubation those patients in ML group had lower intubation time than VL group. There was statistical difference as regard complications of endotracheal intubation as trauma,which was higher in ML group.Conclusion: With the use of a video-aided laryngoscope, it is possible to safely and under supervision to insert an airway into a patient with a difficult airway

Fetal Neuroprotective Strategies: Therapeutic Agents and Their Underlying Synaptic Pathways

Synaptic signaling is integral for proper brain function. During fetal development, exposure to inflammation or mild hypoxic-ischemic insult may lead to synaptic changes and neurological damage that impairs future brain function. Preterm neonates are most susceptible to these deleterious outcomes. Evaluating clinically used and novel fetal neuroprotective measures is essential for expanding treatment options to mitigate the short and long-term consequences of fetal brain injury. Magnesium sulfate is a clinical fetal neuroprotective agent utilized in cases of imminent preterm birth. By blocking N-methyl-D-aspartate receptors, magnesium sulfate reduces glutamatergic signaling, which alters calcium influx, leading to a decrease in excitotoxicity. Emerging evidence suggests that melatonin and N-acetyl-L-cysteine (NAC) may also serve as novel putative fetal neuroprotective candidates. Melatonin has important anti-inflammatory and antioxidant properties and is a known mediator of synaptic plasticity and neuronal generation. While NAC acts as an antioxidant and a precursor to glutathione, it also modulates the glutamate system. Glutamate excitotoxicity and dysregulation can induce perinatal preterm brain injury through damage to maturing oligodendrocytes and neurons. The improved drug efficacy and delivery of the dendrimer-bound NAC conjugate provides an opportunity for enhanced pharmacological intervention. Here, we review recent literature on the synaptic pathways underlying these therapeutic strategies, discuss the current gaps in knowledge, and propose future directions for the field of fetal neuroprotective agents

Effect of tramadol addiction alone and its co-abuse with cannabis on urinary excretion of Copper, Zinc, and Calcium among Egyptian addicts

Background: The use of illicit drugs has become a worldwide health problem. Substances with the potential to be abused may have direct or indirect effects on physiologic mechanisms that lead to organ system dysfunction and diseases. Objective: The present study aims to investigate the structural and reabsorption integrity of the nephron among Egyptian addicts of tramadol alone and coabused with cannabis. Methods: Sixty-five males were included in the study, they were classified into control group (G1=19), tramadol addicts group (G2=18), and tramadol coabused with cannabis addicts group (G3=28). Parameters investigated for structural integrity were urinary levels ofleucineaminopeptidase and N-acetyl-\u3b2-D-glucosaminidase, and urinary parameters for reabsorption integrity were levels of copper and zinc as well as calcium, also urinary creatinine was measured. In addition, urinary levels of tramadol and tetrahydrocannabinol were estimated. Results: Among the two addicted groups, all measured parameters were not significantly different in comparison with the control group except for urinary calcium excretion which was found to be significantly increased among the two addicted groups. Conclusion: Both tramadol addiction alone or coabused with cannabis causes increased urinary excretion of calcium, indicating reabsorption dysfunction of calcium without affecting structural integrity along the nephron

Evaluation Capability of Wheat (Triticum aestivum L.) Genotypes under Salinity (NaCl) Stress as a Systematic Tolerance Assessment at Seed Germination and Early Growth Stage under Laboratory Conditions

Healthy seed germination is critical for the growth cycle of plants, and determines the establishment of seedlings and subsequent crop production. High salinity conditions can result in difficulty for seed germination and delays the germination period. Development of salinity tolerant genotypes through screening and selection is one important strategy to overcome this case. In the present study, the effects of salinity (0 mM NaCl (control= distilled water)), (50 mM NaCl (slight salt stress)) and (100, 150 and 200 mM NaCl (high salt stress)) had gradual and negative effects on seed water uptake and germination attributes. The results verified a remarkable variation for genetic materials ability under salinity conditions. Overall, among 14 wheat genotypes (Sids-12, Nielien and Weiber) genotypes were seemed to be relatively salt tolerance and (Gimeza-12, Diebera, Misr-1, Katela) genotypes were seemed to be moderately tolerant genotypes to salt stress, which were attributed to higher germination percentage, seedling length, seedling fresh and dry weight, tissue water content, vigor index and tolerance index. On the other hand, the genotypes (Shandaweil-1, Giza-168, Misr-2, Sids-1, Sanora, Gimez-7 and Sakha-94) were found to be moderately to strongly sensitive toward salt stress conditions. This systematic method is able to identify genetic variation in salinity tolerance in studies breeding material or in a large number of genotypes of wheat, and help to make account of differences with respect to salinity conditions

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Wall panel structure design optimization of a hexagonal satellite

Considering that it satisfies high strength and stiffness at a low weight, the grid structure is the ideal option for meeting the requirements for developing the wall panel structure for the satellite. The most attractive grid structures for the satellite wall panel industry are isogrid and honeycomb structures. The first part of this work involves studying the mechanical and dynamic performance of five designs for the satellite wall panel made of 7075-T0 Al-alloy. These designs include two isogrid structures with different rib widths, two honeycomb structures with different cell wall thicknesses, and a solid structure for comparison. The performance of these designs was evaluated through compression, bending, and vibration testing using both finite element analysis (FEA) with the Ansys workbench and experimental testing. The FEA results are consistent with the experimental ones. The results show that the isogrid structure with a lower rib thickness of 2 mm is the best candidate for manufacturing the satellite wall panel, as this design reveals the best mechanical and dynamic performance. The second part of this work involves studying the influence of the length of the sides of the best isogrid structure in the range of 12 mm–24 mm on its mechanical and dynamic performance to achieve the lowest possible mass while maintaining the structure's integrity. Then, a modified design of skinned wall panels was introduced and dynamically tested using FEA. Finally, a CAD model of a hexagonal satellite prototype using the best-attained design of the wall panel, i.e., the isogrid structure with a 2 mm rib width and 24 mm-long sides, was built and dynamically tested to ensure its safe design against vibration. Then, the satellite prototype was manufactured, assembled, and successfully assessed