A document by Ahmed Elagwany. Click on the document to view its contents.

Objective: Telemedicine has advanced to the forefront of healthcare delivery, including maternal-fetal medicine. Smart wearable electrocardiogram (ECG) devices can enable pregnant women to monitor their health and that of their fetuses. Such technology would be a logical extension of the telemedicine ecosystem. However, it is not known how pregnant women perceive the ability to use such technologies. Design: Observational cross-sectional study. Setting: Online survey in the United States in 2019. Population: A representative sample of 507 women aged 18-45 were polled from 45 states. Methods: Study participants were recruited using the SurveyMonkey Audience Polling system and responded virtually. Main Outcome Measures: Women were asked to identify willingness to use a wearable ECG device the size of a patch-sized large band-aid on their abdomen. Ten binary or multiple-choice questions were used to gauge population interest and related demographics towards the usage of a wearable ECG device. Results: 91% of women expecting to become pregnant in the next five years accept wearable ECG technology as a mechanism for increased frequency of monitoring of maternal and fetal health throughout the pregnancy outside the hospital. 78% of women demonstrated a willingness to wear devices day and night or at least during sleep and 42% of women would spend up to $200 on such a device. Conclusions: Even though conducted prior to the COVID-19 pandemic, this study clearly indicates a high degree of readiness of prospective pregnant women for telemedicine with continuous health monitoring of the mother-fetus dyad during the entire antepartum period.

This paper constructs a hybrid data-driven and physics-based model for temperature prediction of automotive exterior components based on insufficient natural exposure experimental data. The hybrid model consists of the physical part on heat conduction and the data-driven part on artificial intelligence algorithms. The physical part is developed by the heat balance equation, which ensures the generalization ability of the model. The data-driven part is developed based on BP neural network to calculate the unknown parameters and estimate the missing weather data, which are necessary for the physical part. At the end of the paper, the model performance is evaluated by the experiment data. The numerical results illustrate that the hybrid model not only has accurate predictive ability, but also possesses good generalization capability.

Polyhydroxyalkanoates (PHAs) are steadily getting integrated into our daily life due to their biocompatibility, biodegradability, and production from renewable sources. Different microbial species can accumulate the PHAs from verities of substrates and yield can be improved by strategic optimization of carbon flux into the biomass growth and polymer accumulation. Modelling bioprocess of PHA production is not only essential to understand the dynamics but also to trace the optimal operating conditions. A variety of models has been proposed in the literature depending on single or multi-substrate growth, involvement of substrate or product inhibition and parametric perturbation shifting from growth to PHA accumulation phase. Therefore, this communication attempts to review the scientific basis, assumption, usage, and limitations of those mathematical models at large while suggesting improvement on existing ones. Exploration of those models in different bioreactor systems, adopted strategies in model selection exercise has also been reviewed.

This report describes the effective measures in order to prevent the devastating complication of AV groove disruption following mitral valve replacement. Ethics committee approval, consent statement and clinical trial registration are not applicable for our study.

Grey seals (Halichoerus grypus) can act as sentinel species reflecting the condition of the environment they inhabit. Our previous research identified strains of pathogenic Campylobacter and Salmonella, originating from both human and agricultural animal hosts, on rectal swabs from live grey seal (Halichoerus grypus) pups and yearlings on the Isle of May, Scotland, UK. We examined rectal swabs from the same pup (n=90) and yearling (n=19) grey seals to gain further understanding into the effects of age-related changes (pup versus yearling) and three different natal terrestrial habitats on seal pup faecal microbiota. DNA was extracted from a subset of rectal swabs (pups n=23, yearlings n=9) using an optimised procedure, and the V4 region of 16S rDNA sequenced to identify each individual’s microbiota. Diversity in pup samples was lower (3.92 ± 0.19) than yearlings (4.66 ± 0.39) although not significant at the p=0.05 level (p = 0.062), but differences in composition of the microbiota were (p < 0.001). Similarly, differences between the composition of the microbiota from pups from three different terrestrial habitats (PH, RR and TS) was highly significant (p < 0.001). Pairwise tests showed significant differences between all three habitats: PH vs TS (p = 0.019), PH vs RR (p = 0.042) and TS vs RR (p = 0.020). This preliminary study suggests a general trend, that seal microbiomes are modified by both age and, in pups, different terrestrial habitats. Furthermore, knowledge of the microbiota species present has the potential to be used in determining the environmental quality index.

Low acid resistance of LTA zeolite membranes has restricted their wider application in dehydration of organics. Herein, an effective and facile route was proposed to enhance the acid stability of LTA zeolite membrane. Organosilica BTESE layer was deposited on the surface of the defective LTA zeolite membrane aiming at combining the high hydrophilicity of LTA zeolite membrane with good acid resistance and selectivity of BTESE. FT-IR, SEM, XRD and EDX showed that BTESE layer was coated on the surfaces of LTA membrane. The effects of coating circle and concentration of BTESE sol on the separation performance were investigated in detail. The obtained BTESE/LTA composite membrane maintained stable and high separation performance within 240 min for the separation of 90 wt% ethanol/water mixture at pH=3, indicating the BTESE/LTA membrane would be potential candidate for dehydration of organics in acidic condition.

We present a 5-year-old male patient who is being treated for acute lymphoblastic leukemia and is on dexamethasone as a part of a chemotherapy regimen. The patient presented to emergency department with acute history of bilateral leg pain. MRI features are suggestive of established grade 3 right femoral capital femoral avascular necrosis. Dexamethasone was omitted from the patient's future treatment and was discharged on oral pain medication. The use of systemic corticosteroids should be done under critical observation and both physician and patient should be aware of the possibility of avascular necrosis.

Robust oxidoreductases in non-aqueous system is promising to bridge the gap between research and industrial application. Malate dehydrogenases (MDHs) were select as model enzyme for redesign based on motif assembly study. Computationally inserted the robust motifs which response to salt concentration into the selected scaffold, and resulted novel MDHs. Top-scoring MDH with structure compatibility and dynamic harmony is expressed for experimental verification. Result indicated the MDH03 with enhanced thermostability, extended pH adaptation and ionic liquid tolerance. The activity of MDH03 was 1.78-fold of parent MDH in present of [EMIM]BF4. Further study of amino acid residues interaction network explain the robustness of MDH03 based on high-density salt bridges. Research also indicated the hydrophobic contacts and pi-pi contacts of interfacial interactions of motifs play key role for activity and stability of MDH03.This work promote an approach to design robust dehydrogenase with high ionic liquids tolerance and the further application in biosensors.

The extensive application of nanomaterials had caused a great environmental load in soil environment. Thus, clarifying the process of environmental migration is significant for environmental safety and human health. In this study, alfalfa was used as an experiment crop to determine the effects of different doses of ZnO NPs on the growth of alfalfa and the soil environment. Contrary to the results from exposure to high-concentration ZnO NPs, a low-concentration of ZnO NPs could promote the growth of alfalfa. The Zn concentration in the alfalfa tissue and exposure dose showed a significant positive correlation. N750 treatment significantly reduced the number of alfalfa nodules, and a noneffective nitrogen fixation area in the nodules was found. ZnO NPs caused the rupture and bending of the nodule cell wall and reduced the concentration of nitrate--nitrogen. ZnO particles could enter the tissues at root tip and nodule and aggregated into larger particles. High-dose ZnO NPs reduced the relative abundance and diversity of the soil microorganisms. Therefore, short-term and high-dose exposure to ZnO NPs would cause multiple toxic effects to the plant and soil environment.

Background To analyze the epidemic characteristics of the human rhinovirus (HRV) outbreaks in Guangzhou, China, in 2020. Method Descriptive epidemiological methods were used to analysis the HRV related outbreaks of Guangzhou, 2020. Results 17 outbreaks were reported in 2020 during the COVID-19 pandemic in Guangzhou, a total of 465 patients (290 males and 175 females) were enrolled, with a median age of 10. 223(47.96%) had been tested for HRV, 89 (39.91%) of which were positive. 344/465 (73.98%) had fever, 138/465 (29.68%) had runny nose, 139/465 (29.89%) had sore throat, 86/465 (18.49%) had cough, 41/465 (8.82%) had headache, 37/465 (7.96%) had sneeze. Patients at age of 13 to 15 had the highest rate of sore throat and runny nose, patients at the age of 11 to 12 had the highest rate of sneeze, and patients at age of 12 to 14 had the highest rate of positive rate. Patients tested positive had a higher rate of fever (2=11.271, P=0.001), cough (2=6.987, P=0.008), runny nose (2=7.980, P=0.005) and sneeze (2=4.676, P=0.031). Conclusion The HRV was restored during the fighting the COVID-19 Pandemic. The conventional COVID-19 control measures were not effective enough in preventing rhinovirus. More appropriate control measures should be used to control HRV.

Background: Influenza spreads from schools to the rest of the society. Thus, we conducted questionnaire surveys of influenza vaccination in elementary and middle schools, in a district, for 10 years, to determine immunization rates and in-fection conditions among students that were potential sources of infection at home. Methods: The questionnaire- based survey on influenza vaccine administration, influenza infection, and influenza types contracted, as well as influenza im-munization history, was conducted in 10 seasons over a period of 10 years. Results: Results indicate that, in elementary schools, vaccination was associated with lower morbidity in most years, whereas in middle schools, morbidity increased among students who were vaccinated every year. Our study did not find consistent trends among faculty and staff. In addition, we found that morbidity was significantly higher among elementary (P<.001) and middle (P<.05) school students who had been vaccinated since infancy. Conclusions: These results suggest that vaccinating infants for influenza may increase the risk of contracting influenza later, and thus, the influenza vaccination recommendation for infants should be reconsidered.

we here report the clinical case of a serious adverse reaction to booster dose COVID-19 vaccination in a 40-year-old woman, who soon ,developed severe headache, high fever, and musculoskeletal pains, with very important elevation of D-dimer levels and clear reduction of White Blood Count.

The heat transport mechanisms and stagnation point of the MHD Williamson nanofluid are investigated in the presence of Brownian motion and thermophoresis diffusion past a permeable stretching/shrinking cylinder. Both the conditions of velocity slip and heat source/sink effects are considered. The governing partial differential equations are converted into a system of coupled ordinary differential equations using suitable similarity transformation and then solved numerically via shooting scheme together with Runge-Kutta-Fehlberg method. The effect on drag coefficient, heat and mass transport rates as well as the dimensionless velocity, temperature and concentration fields of the physical boundaries objectives of the study, are graphically delineated and thoroughly discussed. As nanoparticle concentration increases at the outer surface of the boundary layer, the rising patterns of Nusselt number as well as skin friction are observed. Dual solutions with the critical value of the mass transfer parameter (0

The barycentric rational collocation method for solving semi-infinite domain problems is presented. Following the barycentric interpolation method of rational polynomial and Chebyshev polynomial. Truncation method and transformation method are presented to solve linear and nonlinear differential equation defined on the semi-infinite domain problems At last, three numerical examples are presented to test the theoretical analysis.

Background: Previous studies have shown that transcatheter aortic valve implantation (TAVI) is the best alternative therapy to surgical aortic valve replacement (SAVR) in high-risk surgical patients with aortic stenosis (AS). However, it is not clear whether TAVI can be utilised in low-risk surgical patients with AS. This study aimed to evaluate the safety and efficacy of TAVI in low-risk patients. Methods: From the outset of our initiative until June 2021, PubMed, EMBASE, and Cochrane were thoroughly searched, yielding the selection of 3 randomised controlled trials including 2633 patients with AS, to assess outcome measures at distinct follow-up time periods. Results: The mean Society of Thoracic Surgeons Predicted Risk of Mortality score of patients was 2.2. At the 30-day and 1-year follow-up, TAVI was associated with a lower incidence of all-cause mortality, cardiovascular mortality, acute kidney injury (stage 2 or 3), life-threatening or significant bleeding, and new atrial fibrillation (NAF), but an increased risk of permanent pacemaker implantation. At the 2-year follow-up, TAVI only had an advantage in NAF (RR, 0.27; 95% CI, 0.14–0.51; P＜0.0001) without any significant difference in any of the other outcome measures. Conclusions: For low-risk surgical patients with AS, the efficacy of TAVI was superior to that of SAVR by the 30-day and 1-year follow-up. This was most evident by the 2-year follow-up, except for the advantages of NAF, with no other significant differences.

We report a young female patient with a complex cardiac surgical history that underwent a redo complex aortic valve replacement. In the context of severe AR and dilated LV, we experienced that it is safer to start the LV venting after aortic cross clamping. In this setting NIRS can be, in this particular context, a useful monitoring tool to prevent potential severe neurological damage.

Osteoarticular mucormycosis is relentlessly progressive, with bone destruction that necessitates extremity amputation. This case reports a 16-year-old female with pre-B cell acute lymphoblastic leukemia (B-cell ALL) who underwent consolidative haploidentical hematopoietic stem cell transplantation (HSCT) and developed Zygomycetes spp. osteomyelitis after receiving anti-TNF therapy for presumed pulmonary GVHD. Due to progression on systemic therapy, she received the adjunct of intra-operatively placed amphotericin B cement beads changed at regular surgical debridement over 6 weeks. This case demonstrates that early diagnosis and aggressive anti-fungal therapy with surgical debridement and amphotericin cement beads can allow limb sparing and complete recovery.

Genetic evidence has supported a protective effect of cerebral angiotensin converting enzyme (ACE) against Alzheimer’s disease (AD). However, it is unclear whether this is mediated through blood pressure and extends to other neurodegenerative diseases. We performed genetic colocalization investigating an effect of cortical ACE expression on AD risk. We further investigated whether any effect of ACE expression is mediated through changes in blood pressure, and whether effects extend to Parkinson’s disease, small vessel disease or cognitive function. There was genetic evidence supporting a protective effect of cortical ACE expression on AD risk. Although higher cortical ACE expression was associated with higher blood pressure, there was no strong evidence to support that its association with AD was mediated through blood pressure, nor that ACE expression affected risk of other neurodegenerative traits. Genetic evidence supports protective effects of cerebral ACE expression on AD, but not other neurodegenerative outcomes.

This paper discusses on the multiple soliton solutions of the space-time fractional Zakharov-Kuznetsov (ZK) equation derived for describing weakly nonlinear ion-acoustic waves in the plasma investigated with multiple exp-function method. Also, results show that the multiple soliton solutions are precisely obtained from this method. In this paper, for the first time, we obtained a new and non-trivial one-wave solution of the fractional ZK equation. Note that this method is reliable for solving evolutionary equations of nonlinear fractions that are applicable in various fields of applied sciences, especially physics. In the end, we provide one-wave, two-wave, and three-wave solutions, which include one-soliton, two-soliton, and three-soliton type solutions.

Iron refractory iron deficiency anemia (IRIDA) is an autosomal recessive disorder caused by mutations in the TMPRSS6 gene, which impairs iron homeostasis. We report a 4-year-old girl presented with a one-year history of IDA. Hemoglobin, transferrin saturation, and hepcidin levels were 6.5 g/dL, 1.6%, and 112.17 ng/mL, respectively. High-dose oral iron therapy partially corrected hemoglobin levels, and they declined after decreasing or stopping iron therapy. Genetic analysis of the TMPRSS6 gene identified compound heterozygotes of two novel pathogenic variants of c.811C>T in exon 7 (p.R271X) and c.1254C>G in exon 11 (p.Y418X). Her parents carried a heterozygous mutation of each variant.

This paper presents a review of literature about the topic of Integrating New Network Topologies with Appropriated Bandwidth Management as Professional Resources to Support the Quality of Research and Higher Education to Initiate the Covid-19 Effects in Mali. The consensus admitted by all is the indispensability of Internet data services in the sector of education and research especially in this period of a breakout due to the coronavirus pandemic. The current paper reviewed literature about the scope to support insights that will contribute to raising the quality of research and higher education through the integration of new network topologies and the appropriated Internet data as professional resources to initiate the Covid-19 effects in Mali. This research contributes to providing both teachers and students with access to the internet with a personal user account, to facilitate the adoption of blended learning through virtual learning platforms and other relevant materials to complement their degrees programs. Thanks to the integration of these technologies, Malian higher education staff will get facilities to multiply their cooperation with highly technology-integrated countries like Indonesia, Malesia, Australia, and Korea.

A document by Kam-lun Ellis Hon. Click on the document to view its contents.

Rationale, aims and objectives: The purpose of this study is to describe the symptoms and clusters characteristics of COVID-19 patients in Taiwan. Method: The Central Epidemic Command Center (CECC) from Taiwan CDC daily press release publications were extracted for patient demographic information (age, gender, case type and cluster) and the symptoms exhibited by the patients before diagnosis were collected. Results: A total of 1030 COVID-19 cases were reported in Taiwan up until the end of March 2021, of which 1009 patients had symptoms available. Of available patient data, 633 patients (62.74%) were symptomatic and 376 patients (37.26%) were asymptomatic, as classified in our study based on the published list of potential symptoms of COVID-19 by WHO. The most prevalent symptoms of our patients were coughing (29.33%), fever (26.56%) and nasal symptoms (20.22%). Our regression analysis found when the first detected patient of the cluster had a subjective sensation of feeling feverish, the number of infected cases in the cluster increased by 4.59 cases. Similarly, patients who experienced a slightly elevated body temperature or fever were associated with an increase of 2.37 and 0.35 cases in each cluster, respectively. Furthermore, increasing one new COVID-19 test per thousand population reduces 7.22 cases per cluster. Conclusions: The majority of reported cases in Taiwan were symptomatic. Symptoms which had the greatest number of patients overall were cough, fever, and nasal symptoms. It is our hope to help physicians to better diagnose current Taiwan COVID-19 patients, while aiding the government in stopping the spread of new cases.