Drone Base Station Trajectory Management for Optimal Scheduling in LTE-Based Sparse Delay-Sensitive M2M Networks

Providing connectivity in areas out of reach of the cellular infrastructure is a very active area of research. This connectivity is particularly needed in case of the deployment of machine type communication devices (MTCDs) for critical purposes such as homeland security. In such applications, MTCDs are deployed in areas that are hard to reach using regular communications infrastructure while the collected data is timely critical. Drone-supported communications constitute a new trend in complementing the reach of the terrestrial communication infrastructure. In this study, drones are used as base stations to provide real-time communication services to gather critical data out of a group of MTCDs that are sparsely deployed in a marine environment. Studying different communication technologies as LTE, WiFi, LPWAN and Free-Space Optical communication (FSOC) incorporated with the drone communications was important in the first phase of this research to identify the best candidate for addressing this need. We have determined the cellular technology, and particularly LTE, to be the most suitable candidate to support such applications. In this case, an LTE base station would be mounted on the drone which will help communicate with the different MTCDs to transmit their data to the network backhaul. We then formulate the problem model mathematically and devise the trajectory planning and scheduling algorithm that decides the drone path and the resulting scheduling. Based on this formulation, we decided to compare between an Ant Colony Optimization (ACO) based technique that optimizes the drone movement among the sparsely-deployed MTCDs and a Genetic Algorithm (GA) based solution that achieves the same purpose. This optimization is based on minimizing the energy cost of the drone movement while ensuring the data transmission deadline missing is minimized. We present the results of several simulation experiments that validate the different performance aspects of the technique

Effect of Expressive Arts Therapy Interventions on Comfort of Children Undergoing Surgery

Context: Children undergoing surgery may experience pain and discomfort. Unfortunately, it is not always possible to completely prevent postoperative pain and discomfort with analgesics. Therefore, there is an increasing interest in non-pharmacological interventions through expressive arts therapy.Aim: This study aimed to evaluate the effect of expressive arts therapy interventions on the comfort of children undergoing surgery. Methods: A quasi-experimental design was utilized in this study. This study was conducted at the Pediatric Surgical Department in Children's Hospital affiliated to Ain Shams University, Cairo, Egypt, on a purposive sample of 84 children undergoing surgery. Children were randomly assigned to two equal groups (control group 42 and study group 42). A child's assessment record was used to gather data related to the characteristics of the studied children and surgery data. Pain assessment record to assess the child's physiological and physical parameters of pain. A Numeric Pain Rating Scale to assess a child's pain intensity. State-Trait-Anxiety Inventory for Children to measure anxiety levels. Besides, A Comfort Assessment Scale to assess children's numerical pain intensity and discomfort. Results: There are statistically significant differences in mean pain intensity scores were observed between the control and study groups on the second day after surgery and before discharge (p > 0.05). The mean anxiety scores were significantly lower in the study group compared to the control group on the day after surgery and before discharge (p < 0.05). Also, there were observed improvements in mean comfort scores between the study and the control group on the day after surgery scores and on the day of discharge with a statistically significant difference (p < 0.05). There were statistically significant differences at (p-value=0.000) between children in the control and study group regarding children's postoperative pain intensity, anxiety levels, and comfort scores. Conclusion: The application of expressive arts therapy interventions was positively improving comfort and reducing pain intensity and anxiety levels among children undergoing surgery in the study group compared to the controls, emphasizing the importance of using expressive arts therapy interventions for improving children's postoperative comfort

Nursing Intervention for Mothers Having Children Suffering from Acute Bronchitis

Context: Acute bronchitis is one of the most common causes of chronic respiratory diseases in childhood with a significant impact on children.Aim: The study aimed to evaluate the effect of nursing intervention on mothers’ knowledge and practices regarding caring for their children suffering from acute bronchitis. Methods: A quasi-experimental design (one group pre/post-test). The study was conducted at the Pediatric Emergency Department and Outpatient clinic in a children's hospital affiliated to Ain Shams University Hospitals. A convenient sample of 52 children newly diagnosed with acute bronchitis accompanied their mothers who were recruited for this study. Two tools were used to collect data: a structured interview questionnaire, and a mothers’ observation checklist. Results: The study shows that there was a highly statistically significant improvement found in the post-test compared to their pre-test, regarding the mothers' knowledge and practices related to the care of their children suffering from acute bronchitis.Conclusion: The implementation of a nursing intervention program improves the mothers' knowledge and practices related to their children with acute bronchitis. These study findings were supporting the study hypotheses. Continuous mothers’ evaluation and monitoring for their knowledge and practices toward children with acute bronchitis are recommended in the pediatric emergency and outpatient clinics. Periodic health education for children and their mothers leads to improving their knowledge and practice regarding acute bronchitis

IL-13 R130Q single nucleotide polymorphism in asthmatic Egyptian children

Background: Asthma and its associated phenotypes are under a substantial degree of genetic control. The common variant IL-13 gene polymorphism R130Q is reported to be associated with the risk of development of asthma in some populations. Objective: We sought to study the association of IL-13 genetic variant R130Q with bronchial asthma in Egyptian children and its relation to various clinical and laboratory phenotypes of the disease. Methods: IL13 gene polymorphism (R130Q) was detected by PCR amplification followed by sequencing using pure script total DNA in 20 asthmatic patients in acute exacerbation. The results were compared to 20 healthy age and sex matched children. Results: Asthmatic children had significantly higher frequency of distribution of R130Q genotype (50%) than controls (15%). The serum total IgE as percent of high normal for age was significantly higher in asthmatic patients as compared to controls with a mean of 208.77 ±237.06% and 14.21 ± 8.08% respectively. No significant difference was observed in the mean AEC(as a percent of high normal for age) of both groups (80.85 ± 116.4% and 82.50 ± 81.4% respectively). No significant differences were observed between patients with IL-13 polymorphism R130Q and those without such polymorphism as regards family history, relation of exacerbations to upper respiratory tract infections, history of food allergy or asthma grading. Serum total IgE was significantly higher in asthmatics with GA genotype as compared to those with GG genotype with a mean of 373.25 ± 238.11% and 44.28 ± 42.65% respectively. A similar finding was also observed among the control group with a mean of 28.03 ± 9.12% and 11.77 ± 5.00% respectively. Finally a significantly higher AEC was observed in controls with GA as compared to GG genotype with a mean of 250.00 ± 51.96% versus 52.94 ± 36.87% respectively. Conclusion: The common variant IL-13 gene polymorphism R130Q is frequently associated with pediatric asthma. This variant is more active than the wild type in inducing allergic inflammation as reflected by the higher serum total IgE and AEC. Hence, IL-13R130Q may be candidate for future gene therapy targeted at reducing the ill-effects of this polymorphism.Keywords: IL-13R130Q – bronchial asthma - pediatricsEgypt J Pediatr Allergy Immunol 2010;8(1):9-1

Allergy-immunology glossary

No Abstrac

Allergen-specific immunotherapy in children

Egypt J Pediatr Allergy Immunol 2012;10(2):55-6

Real-Time PCR in the early detection of invasive fungal infection in immunodeficient infants and children

Background: Crucial to the diagnosis and effective therapy of invasive fungal infection (IFI) in the immunodeficient is the early identification of the causative agent especially in patients who lack clinical evidence of the disease. The standard methods for the detection of fungi in clinical specimens are direct microscopy and mycological culture. Microscopy often lacks a satisfactory sensitivity, whereas diagnosis by mycological culture often requires a long growth period. Studies have demonstrated the feasibility of detecting molds and yeast in a single reaction using the universal fungal primer. Objective: Evaluation of the role of real-time PCR in the early detection of fungal infection in immunodeficient patients with suspected IFI, who lack clinical evidence of the disease. Methods: This study included 30 immunodeficiency patients suspected of having IFI; 9 with primary and 21 with secondary immunodeficiency. All patients had at least one host factor, but no clinical criteria according to the EORTC-MSG definition of IFI. Twenty seven had fever and 3 had bronchopneumonia, both not responding to broad spectrum antibiotics for 96 hrs. or more. Blood samples were cultured for fungi and were analyzed with real-time PCR using universal fungal primers. For positive samples of fungal infection, aspergillus-specific primers were used for detection of aspergillus. Results: Seventeen patients (56.7%) proved to have IFI. Blood culture detected Candida in 2 patients only, while PCR detected Candida in another 9 and Aspergillus in 6, thus 15/17 patients with IFI (88%) were missed by blood culture. Blood culture for IFI diagnosis had a very low sensitivity (12%) but had a 100% specificity and positive predictive value. The results PCR did not vary with gender, degree of fever, immunodeficiency type, clinical presentation or current intake of antifungal treatment. Patients with proven IFI showed significantly increased CRP levels as compared to those without infection. Conclusion: Real-time PCR proved superior to culture in early diagnosis of IFI in patients with immunodeficiency before the appearance of the characteristic clinical and imaging signs. Reliance on blood culture alone at that stage would result in missing most of the positive cases with consequent delay in the initiation of specific treatment. Keywords: Invasive fungal infection, immunodeficiency, blood culture, real-time PCR, candida, aspergillusEgypt J Pediatr Allergy Immunol 2012;10(2):67-7

Wheat allergy

Food allergy is a growing health problem which emerged as the “second wave” of the allergy epidemic, lagging decades behind the ‘first wave’ of asthma, allergic rhinitis and inhalant sensitization.1 Data on challenge-diagnosed FA in some countries (e.g. China and Africa) show rising rates that became similar to those in Western countries.2 A report from US Centers for Disease Control and Prevention (CDC) indicated that among children aged 0–17 years, the prevalence of food allergies increased from 3.4% in 1997–1999 to 5.1% in 2009–2011, a 50% rise.3 About 6% of children experience food allergic reactions in the first three years of life, including approximately 2.5% with cow’s milk allergy, 1.5% with egg allergy, and 1% with peanut allergy.4 Wheat is one of the five most common foods that trigger allergic reactions in children.

Preoperative Fasting Time and Selected Postoperative Outcomes among Patients Undergoing Abdominal Surgeries: Correlation Study

Background: Prolonged preoperative fasting time had a negative impact on the recovery of the patient in the postoperative period. Aim of the study: was to determine the relationship between the preoperative fasting time and selected postoperative outcomes among patients undergoing abdominal surgeries at one of the University Hospitals Cairo-Egypt. Research question: What is the relationship between the preoperative fasting time and the selected postoperative outcomes (patients' blood glucose levels, blood pressure and vomiting frequency) among patients undergoing abdominal surgeries? Design: Descriptive-correlation design was utilized. Setting: The study was conducted on waiting areas of general surgery operating room at 2nd and 3rd floor in addition to the general surgical wards at one of the University Hospitals. Subjects: A convenience sample of 60 female & male adult patients with the following inclusion criteria: 1- undergoing abdominal surgeries, 2- have no diabetes or hypertension were recruited in the current study Tools: Two tools were utilized to collect data pertinent to the study; I- A semi-structured interview questionnaire, it contained two parts: 1: Demographic data 2: Surgical patient’s clinical data.  II - Postoperative outcomes data sheet: It included measurement of the three selected postoperative outcomes. Results: The current study findings revealed that nearly three quarters of the study sample fasted for longer than required time with a mean+ SD= 11.1 + 2.5 and more than two third of the study sample had waiting time between 3->6 hrs. There was a significance difference between pre-operative & post-operative, post-operative & baseline readings regarding the systolic blood pressure and between the baseline and the pre-operative diastolic blood pressure. There was a positive moderate correlation between the pre-operative fasting time and the post-operative blood glucose results r=0.41. Also, there was a strong correlation between baseline and preoperative blood glucose results r=0.77, while, There was no correlation  between frequency of vomiting post operatively and age, preoperative fasting time, waiting time, blood glucose, and blood pressure.  Conclusion: There was a correlation between preoperative fasting time and blood glucose level followed by blood pressure while no correlation with vomiting frequency postoperatively. Recommendations: Awareness of heath care team regarding updating evidence-based preoperative fasting guidelines, nurse should measure blood glucose level and blood pressure for the non-diabetic as well as the diabetic patients before the surgical procedure and further studies are needed to determine the optimal fasting time and its effect on postoperative outcomes. Keywords: Preoperative fasting time, waiting time, abdominal surgery, blood glucose level, blood pressure, postoperative vomiting

Validity and Reliability of Checklists Used for Objective Structured Clinical Examination: Piloting Modified Tools.

Background: Developing tools for evaluating students' performance is one of the important tasks required from faculties. The validity and reliability of tools increase its significance and the objectivity of using these tools in the field of research, as well strengthen the results. Aim: Was to test validity and reliability of the selected checklists of the objective structured clinical examination which assess the Medical-Surgical Nursing competencies. Design: Test-retest, Six Sigma was utilized to answer the research questions. Research questions: 1-Are the ten selected checklists valid? 2-Are the ten selected checklists reliable? Sample: Ten checklists were selected out of the required competencies of Medical-Surgical Nursing course during the academic year of (2010-2011 & 2011-2012). Results: The results of the tested checklists revealed that the selected checklists are valid while the reliable checklists were fluid balance, (intramuscular, intravenous) injections, surgical scrub, gloving, wound dressing and wound drain. However subcutaneous injection and withdrawal of drugs from a vial were not reliable. While the surgical gown checklist was questionable. Conclusion: Seven out of the tested ten checklists were reliable while all the checklists were valid. Recommendation: Revise and modify the unreliable checklists and retest its reliability. Go through studying validity and reliability of other competencies in the Medical-Surgical Nursing field.  OSCE checklists are strongly suggested as reliable and valid assessment of the growing number of nursing students. Key words: OSCE, validity, reliability, clinical assessment