Performance modelling for advanced envelope systems.

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Reinforced concrete bridge damage detection using arithmetic optimization algorithm with deep feature fusion

Inspection of Reinforced Concrete (RC) bridges is critical in order to ensure its safety and conduct essential maintenance works. Earlier defect detection is vital to maintain the stability of the concrete bridges. The current bridge maintenance protocols rely mainly upon manual visual inspection, which is subjective, unreliable and labour-intensive one. On the contrary, computer vision technique, based on deep learning methods, is regarded as the latest technique for structural damage detection due to its end-to-end training without the need for feature engineering. The classification process assists the authorities and engineers in understanding the safety level of the bridge, thus making informed decisions regarding rehabilitation or replacement, and prioritising the repair and maintenance efforts. In this background, the current study develops an RC Bridge Damage Detection using an Arithmetic Optimization Algorithm with a Deep Feature Fusion (RCBDD-AOADFF) method. The purpose of the proposed RCBDD-AOADFF technique is to identify and classify different kinds of defects in RC bridges. In the presented RCBDD-AOADFF technique, the feature fusion process is performed using the Darknet-19 and Nasnet-Mobile models. For damage classification process, the attention-based Long Short-Term Memory (ALSTM) model is used. To enhance the classification results of the ALSTM model, the AOA is applied for the hyperparameter selection process. The performance of the RCBDD-AOADFF method was validated using the RC bridge damage dataset. The extensive analysis outcomes revealed the potentials of the RCBDD-AOADFF technique on RC bridge damage detection process

Primary resistance to clarithromycin, metronidazole and amoxicillin of Helicobacter pylori isolated from Tunisian patients with peptic ulcers and gastritis: a prospective multicentre study

<p>Abstract</p> <p>Background</p> <p>The frequency of primary resistance to antibiotics in H. pylori isolates is increasing worldwide. In Tunisia, there are limited data regarding the pattern of H. pylori antibiotic primary resistance.</p> <p>Aim</p> <p>To evaluate the primary resistance of H. pylori to clarithromycin, metronidazole and amoxicillin and to detect the mutations involved in clarithromycin resistance.</p> <p>Materials and methods</p> <p>273 strains isolated from adults and children were enrolled. The primary resistance to clarithromycin, metronidazole and amoxicillin was evaluated by means of E-test minimal inhibitory concentration (MIC). The real-time PCR using Scorpion primers was performed in all cases to assess clarithromycin primary resistance and point mutations involved.</p> <p>Results</p> <p>No resistance to amoxicillin was detected. For adults, resistance to clarithromycin and metronidazole was found respectively in 14.6% and 56.8%, and respectively in 18.8% and 25% in children. Overall, the rates of global primary resistance to clarithromycin and metronidazole in Tunisia were respectively determined in 15.4% and 51.3%.</p> <p>By the use of Scorpion PCR, the A2143G was the most frequent point mutation observed (88.1%), followed by the A2142G (11.9%); the A2142C was not found and 18 of 42 patients (42.8%) were infected by both the resistant and the susceptible genotype.</p> <p>The association of clarithromycin resistance with gender was not statistically significant, but metronidazole resistant strains were isolated more frequently in females (67.8%) than in males (32.2%) and the difference was significant. As for gastroduodenal diseases, the difference between strains isolated from patients with peptic ulceration and those with non peptic ulceration was not statistically significant. When about the distribution of resistant strains to clarithromycin and metronidazole between the three Tunisian cities (Tunis, Menzel Bourguiba and Mahdia), the difference was not statistically significant.</p> <p>Conclusion</p> <p>Local data regarding the primary resistance of H. pylori to clarithromycin, metronidazole and amoxicillin and the main genetic mutation involved in clarithromycin resistance in vivo (A2143G) are necessary to prove a clear need for a periodic evaluation of antibiotic consumption and new therapeutic strategies in Tunisia in order to avoid the emergence of resistant strains.</p

Characterization of greater middle eastern genetic variation for enhanced disease gene discovery

The Greater Middle East (GME) has been a central hub of human migration and population admixture. The tradition of consanguinity, variably practiced in the Persian Gulf region, North Africa, and Central Asia1-3, has resulted in an elevated burden of recessive disease4. Here we generated a whole-exome GME variome from 1,111 unrelated subjects. We detected substantial diversity and admixture in continental and subregional populations, corresponding to several ancient founder populations with little evidence of bottlenecks. Measured consanguinity rates were an order of magnitude above those in other sampled populations, and the GME population exhibited an increased burden of runs of homozygosity (ROHs) but showed no evidence for reduced burden of deleterious variation due to classically theorized ‘genetic purging’. Applying this database to unsolved recessive conditions in the GME population reduced the number of potential disease-causing variants by four- to sevenfold. These results show variegated genetic architecture in GME populations and support future human genetic discoveries in Mendelian and population genetics

Contrasting cardiovascular mortality trends in Eastern Mediterranean populations: contributions from risk factor changes and treatments

Background Middle income countries are facing an epidemic of non-communicable diseases, especially coronary heart disease (CHD). We used a validated CHD mortality model (IMPACT) to explain recent trends in Tunisia, Syria, the occupied Palestinian territory (oPt) and Turkey. Methods Data on populations, mortality, patient numbers, treatments and risk factor trends from national and local surveys in each country were collated over two time points (1995–97; 2006–09); integrated and analysed using the IMPACT model. Results Risk factor trends: Smoking prevalence was high in men, persisting in Syria but decreasing in Tunisia, oPt and Turkey. BMI rose by 1–2 kg/m2 and diabetes prevalence increased by 40%–50%. Mean systolic blood pressure and cholesterol levels increased in Tunisia and Syria. Mortality trends: Age-standardised CHD mortality rates rose by 20% in Tunisia and 62% in Syria. Much of this increase (79% and 72% respectively) was attributed to adverse trends in major risk factors, occurring despite some improvements in treatment uptake. CHD mortality rates fell by 17% in oPt and by 25% in Turkey, with risk factor changes accounting for around 46% and 30% of this reduction respectively. Increased uptake of community treatments (drug treatments for chronic angina, heart failure, hypertension and secondary prevention after a cardiac event) accounted for most of the remainder. Discussion CHD death rates are rising in Tunisia and Syria, whilst oPt and Turkey demonstrate clear falls, reflecting improvements in major risk factors with contributions from medical treatments. However, smoking prevalence remains very high in men; obesity and diabetes levels are rising dramatically

Hematological alterations and parasitological studies among infected patients with Plasmodium vivax and Plasmodium falciparum in Hail, Kingdom of Saudi Arabia

Objective: To investigate hematological alterations and parasitological studies among infected patients with Plasmodium vivax and Plasmodium falciparum. Methods: The present study was conducted from 1st September 2014 to 30th November 2015. A complete blood count, blood smears and malaria rapid diagnostic test were done for each patient. Results: There were 30 infected patients. These patients were infected Plasmodium vivax (20%) and Plasmodium falciparum (5%). Their age ranged between 20–60 years. The patients had severe malaria. There was a significant reduction in hemoglobin, platelet count, leucocyte and erythrocyte levels in infected patients caused by malaria compared with those of healthy control subjects. The percentage of neutrophil cells in the infected subjects was significantly higher than in the healthy group. The percentage of lymphocytes in the infected patients was significantly lower than in the healthy group. Conclusions: This study showed that results of complete blood count can provide a diagnostic predictor for increasing the prospect of malaria and enhancing quick treatment

Comparative study of clonidine

Background: Laparoscopic surgical procedures have various benefits to the patient in terms of decreased tissue damage, early ambulation, decreased hospital stay and reduced analgesic needs. Pneumoperitoneum with carbon dioxide (CO2) leads to stimulation of the sympathetic nervous system which can be a risk factor in patients with cardiovascular diseases. Moreover, reverse Trendelenburg position affects homeostasis in laparoscopic surgeries. In this study, we compared the efficacy of clonidine (which is α2 adrenergic agonist) versus esmolol (which is ultra short acting cardio-selective β1-receptor antagonist) on the hemodynamic response during laparoscopic cholecystectomy. Materials and methods: A total of 60 patients scheduled to undergo laparoscopic cholecystectomy were randomly assigned into two groups: Group C: received 2 μg/kg of clonidine diluted in 20 ml normal saline, given with slow intravenous infusion over 10 min just before induction of GA and Group E: received 1.5 mg/kg of esmolol as a loading dose over a period of 5 min just before induction of GA followed by 10 μg/kg/min as a maintenance dose throughout the procedure. No hypnotic medication was given on the evening before surgery. Systolic, diastolic, mean arterial blood pressures and heart rate were recorded at (1) baseline, (2) three minutes after endotracheal intubation, (3) before pneumoperitoneum, (4) fifteen minutes after pneumoperitoneum, (5) thirty minutes after pneumoperitoneum, (6) five minutes after release of CO2 and (7) five minutes after extubation. Degree of sedation according to Ramsay sedation score was assessed 15 min after reaching PACU. Results: Both groups were similar with respect to demographic data. Clonidine group showed more stability in hemodynamic responses than esmolol group in all hemodynamic variables but with more postoperative sedation. Conclusion: This study concluded that clonidine and esmolol provide hemodynamic stability in laparoscopic cholecystectomy but clonidine provides more stability with postoperative sedation

Determination of cytocompatibility and osteogenesis properties of in situ forming collagen-based scaffolds loaded with bone synthesizing drug for bone tissue engineering

Bone tissue engineering using in situ forming 3D scaffolds can be an alternative to surgically treated scaffolds. This work aimed to develop in situ forming scaffolds using poly (lactic-co-glycolic acid) and a bone synthesizing drug (risedronate) with or without the porogenic agent (collagen). Hybrid scaffolds were formed through solvent-induced phase inversion technique and were morphologically evaluated using scanning electron microscopy (SEM). The effect of scaffolds on Saos-2 cell line viability using 3-(4,5- dimethyl-2-thiazolyl)-2,5-diphenyl-2H-tetrazolium bromide test besides their effect on cell growth using fluorescence microscope was assessed. Furthermore, alkaline phosphatase (ALP) activity as well as Ca2þ deposition on the scaffolds was evaluated. SEM images revealed the porous structure for collagen-based scaffolds. Saos-2 cell proliferation was significantly enhanced with risedronate-loaded scaffolds compared to those lacking the drug. Porous collagen-based scaffolds were more favorable for both the cell growth and the promotion of ALP activity. Furthermore, collagen-based scaffolds promoted the Ca2þ deposition compared to their counterparts without collagen. Such results suggest that collagen-based scaffolds offer excellent biocompatibility for bone regeneration, where this biocompatible nature of scaffold leads to the proliferation of cells that lead to the deposition of mineral on the scaffold. Such in situ forming 3D scaffolds provide a promising noninvasive approach for bone tissue engineering

Lumbar plexus block as a method of postoperative analgesia after hip surgery

AbstractBackgroundPosterior lumbar plexus block provides unilateral blockade and great hemodynamic stability. In this trial, the efficacy of addition of clonidine to bupivacaine used in lumbar plexus block (LPB) was evaluated.Patients and methodsSixty ASA I or II adult patients undergoing hip surgery, receiving general anesthesia, were randomly allocated to three equal sized groups, according to the technique of postoperative analgesia. In group A patients extubated when they met the standard extubation criteria. In group B, a mixed solution of 15mL bupivacaine 0.5% and 15mL normal saline 0.9% was injected through lumbar plexus block technique before extubation. In group C, 2.5μg/ml clonidine was added to bupivacaine. Postoperative pain, sedation, hemodynamics, analgesic consumption, local anesthetic side effects and serum cortisol level were compared.ResultsThere was a highly significant statistical difference between the three groups as regards the postoperative VAS scores (P<0.001). In contrast to group A patients, VAS remained <50mm till the 6th hour postoperatively in group B patients and till the 12th hour in group C with high significant difference in postoperative morphine consumption (P<0.001). Hemodynamics and respiratory rate were in normal range 2h postoperatively in the three groups. After the 6th hour postoperatively; SBP, DBP, HR and RR were significantly higher in group A patients in comparison to groups B and C (P<0.05). In group C patients; SBP, DBP, HR and RR were in normal range for the first 12h postoperatively. Blood cortisol level was higher then normal in group A patients since 2h postoperatively (P, 0.05), while started to rise from the 6th hour in group B patients and the 12th hour in group C patients.ConclusionThe study showed that posterior lumbar plexus block was an effective postoperative analgesic technique in patients undergoing hip surgeries and that adding clonidine in a concentration of 2.5μg/ml to bupivacaine 0.25% has resulted in decreasing the postoperative analgesic requirements