Understanding the net primary productivity(NPP) of grassland is crucial to evaluate the terrestrial carbon cycle. In this study, we investigated the spatial distribution and the area of global grassland across the glo...Understanding the net primary productivity(NPP) of grassland is crucial to evaluate the terrestrial carbon cycle. In this study, we investigated the spatial distribution and the area of global grassland across the globe. Then, we used the Carnegie-Ames-Stanford Approach(CASA) model to estimate global grassland NPP and explore the spatio-temporal variations of grassland NPP in response to climate change from 1982 to 2008. Results showed that the largest area of grassland distribution during the study period was in Asia(1737.23 × 104 km^2), while the grassland area in Europe was relatively small(202.83 × 10~4 km^2). Temporally, the total NPP increased with fluctuations from 1982 to 2008, with an annual increase rate of 0.03 Pg C/yr. The total NPP experienced a significant increasing trend from 1982 to 1995, while a decreasing trend was observed from 1996 to 2008. Spatially, the grassland NPP in South America and Africa were higher than the other regions, largely as a result of these regions are under warm and wet climatic conditions. The highest mean NPP was recorded for savannas(560.10 g C/(m^2·yr)), whereas the lowest was observed in open shrublands with an average NPP of 162.53 g C/(m^2·yr). The relationship between grassland NPP and annual mean temperature and annual precipitation(AMT, AP, respectively) varies with changes in AP, which indicates that, grassland NPP is more sensitive to precipitation than temperature.展开更多
In the present study,the effect of aging heat treatment at 650,750,and 850？C on the impact toughness of 316L austenitic stainless steel,2205 duplex stainless steel and their weldments has been investigated.Welding pr...In the present study,the effect of aging heat treatment at 650,750,and 850？C on the impact toughness of 316L austenitic stainless steel,2205 duplex stainless steel and their weldments has been investigated.Welding process was conducted using the TIG（tungsten inert gas） welding technique.Instrumented impact testing,at room temperature,was employed to determine the effect of aging treatment on the impact properties of investigated materials.Aging treatment resulted in degradation in the impact toughness as demonstrated by the reduction in the impact fracture energy and deformation parameters（strain hardening capacity,fracture deffection,and crack initiation and propagation energy）.The degree of embrittlement was more noticeable in duplex stainless steel parent and weld-metal than in 316L stainless steel and became greater with the increase of aging temperature.The degradation in impact toughness was discussed in relation to the observed precipitation of the intermetallic sigma phase in the microstructure of the stainless steel weldments and the corresponding fracture surface morphology.展开更多
CDX2 is a nuclear homeobox transcription factor that belongs to the caudalrelated family of CDX homeobox genes. The gene encoding CDX2 is a nonclustered hexapeptide located on chromosome 13q12-13. Homeobox genes play ...CDX2 is a nuclear homeobox transcription factor that belongs to the caudalrelated family of CDX homeobox genes. The gene encoding CDX2 is a nonclustered hexapeptide located on chromosome 13q12-13. Homeobox genes play an essential role in the control of normal embryonic development. CDX2 is crucial for axial patterning of the alimentary tract during embryonic development and is involved in the processes of intestinal cell proliferation, differentiation, adhesion, and apoptosis. It is considered specif ic for enterocytes and has been used for the diagnosis of primary and metastatic colorectal adenocarcinoma. CDX2 expression has been reported to be organ specif ic and is normally expressed throughout embryonic and postnatal life within the nuclei of epithelial cells of the alimentary tract from the proximal duodenum to the distal rectum. In this review, the authors elaborate on the diagnostic utility of CDX2 in gastrointestinal tumors and other neoplasms with intestinal differentiation. Limitations with its use as the sole predictor of a gastrointestinal origin of metastatic carcinomas are also discussed.展开更多
Sodium-glucose cotransporter-2 inhibitors (SGLT-2 inhibitors) have transformed diabetes management by targeting renal glucose reabsorption. Designed initially as antidiabetic agents, their ability to lower blood gluco...Sodium-glucose cotransporter-2 inhibitors (SGLT-2 inhibitors) have transformed diabetes management by targeting renal glucose reabsorption. Designed initially as antidiabetic agents, their ability to lower blood glucose levels independently of insulin is well-documented. Beyond glycemic control, emerging research has unveiled their profound cardiorenal benefits. By inhibiting SGLT-2 protein, these drugs enhance glucose excretion in urine, reducing blood glucose levels. This mechanism has translated into significant cardiovascular and renal protection, establishing SGLT-2 inhibitors as pivotal in managing not only diabetes but also cardiovascular and renal diseases. Recent studies have illuminated the broader therapeutic potential of SGLT-2 inhibitors beyond diabetes. Evidence indicates their efficacy in managing heart failure, chronic kidney disease (CKD), and cardiovascular complications in individuals with or without diabetes. This expanded therapeutic landscape has catalyzed a paradigm shift in SGLT-2 inhibitor use, positioning them as key agents in the cardiorenal metabolic continuum. Moreover, their role in the secondary prevention of cardiovascular events and slowing CKD progression in T2DM patients has garnered considerable attention. This consensus-based review aims to offer practical guidance in an algorithmic approach to primary care healthcare professionals to optimize SGLT-2 inhibitors utilization and maximize their benefits. The review seeks to empower clinicians to effectively manage patients who may benefit from SGLT-2 inhibitor therapy by addressing common initiation barriers and optimizing treatment strategies. Additionally, it aims to raise awareness among primary care physicians regarding the multifaceted benefits of these medications and overcome clinical inertia in their adoption into routine clinical practice.展开更多
Background: Despite the conservative treatment of tibio-femoral osteoarthritis through realignment osteotomies, the rate of total knee replacements following an osteotomy is increasing. The aim of this study was to id...Background: Despite the conservative treatment of tibio-femoral osteoarthritis through realignment osteotomies, the rate of total knee replacements following an osteotomy is increasing. The aim of this study was to identify the factors associated with the progression of knee osteoarthritis after a medial closing-wedge distal femoral osteotomy. Methods: Hospital-based observational study on 20 patients who underwent a medial closing-wedge distal femoral osteotomy evaluating the progression of osteoarthritis using the Kellgren and Laurence classification. The Wilcoxon test was used to compare the variation in the progressive stage of the Kellgren and Laurence classification of knee osteoarthritis preoperatively and at the final follow up. Univariate analysis made it possible to determine the factors associated with progression. The final significance threshold for statistical tests was set at 5% (p Results: Overall, the mean follow-up of 46 months ± 6.6 months, with a mean age of 43 years (range: 27 - 69 years) and a female predominance (M: F = 3/7). The progression of tibiofemoral osteoarthritis following a medial closing-wedge distal femoral osteotomy is associated with valgus or varum malalignment been a moderate valgus (OR 6.2 [1.5 - 42.7] at 95% CI;p-value = 0.02), a correction of the mechanical deviation angle with a valgus alignment (OR 2.7 [0.9 - 8.3] at 95% CI), and loss of correction (OR 3.8 [1.3 - 11.6] at 95% CI;p -value) for the lateral compartment while varus alignment (OR 1.7 [0.9 - 8.3] 95% CI, p-value = 0.05) and with rupture of the lateral cortex (OR 2.8 [1.7 - 11.5] 95% CI, p-value = 0.02) were those of the medial compartment. Conclusion: Distal femur closing wedge osteotomy does not definitively interrupt the progression of valgus knee osteoarthritis. The factors associated with the progression of this pathology are modifiable. Taking them into account when performing this surgical technique could improve the osteotomy survival curve.展开更多
This review focuses on DNA vaccines, denoting the last two decades since the early substantiation of preclinical protection was published in Science in 1993 by Ulmer et al. In spite of being safely administered and ea...This review focuses on DNA vaccines, denoting the last two decades since the early substantiation of preclinical protection was published in Science in 1993 by Ulmer et al. In spite of being safely administered and easily engineered and manufactured DNA vaccine, it holds the future prospects of immunization by inducing potent cellular immune responses against infectious and non-infectious diseases. It is well documented that injection of DNA plasmid encoding a desired gene of interest can result in the subsequent expression of its products and lead to the induction of an immune response within a host. This is pertinent to prophylactic and therapeutic vaccination approach when the peculiar gene produces a protective epitope from a pathogen. The recent studies demonstrated by a number of research centers showed that these immune responses evoke protective immunity against several infectious diseases and cancers, which provides adequate support for the use of this approach. We attempt in this review to provide an informative and unbiased overview of the general principles and concept of DNA vaccines technology with a summary of a novel approach to the DNA vaccine, present investigations that describe the mechanism(s) of protective immunity provoked by DNA immunization and to highlight the advantages and disadvantages of DNA immunisation.展开更多
Introduction-Objective: COVID-19 is a highly transmissible but often mild viral infection. However, some patients can present severe COVID-19 and subsequently die. The aim of the present study was to assess the risk f...Introduction-Objective: COVID-19 is a highly transmissible but often mild viral infection. However, some patients can present severe COVID-19 and subsequently die. The aim of the present study was to assess the risk factors for COVID-19 related death during the first three waves of the disease at the Epidemic Treatment Center (ETC) of Dakar Principal Hospital (DPH). Method: We conducted a descriptive and analytical perspective survival study from April 4, 2020 to September 25, 2021, including adult patients with COVID-19, hospitalized at the ETC of DPH. Log Rank test and multivariate Cox model were performed to identify risk factors for death. Results: We included 556 COVID-19 patients with mean age of 57 ± 17 years and a male-to-female ratio of 1.26. The number of deaths during one month of follow-up was 41, representing a cumulative risk of 7.4%. The log Rank test showed that being from the third wave (p = 0.0056), advanced age (p = 0.00098), presence of at least one comorbidity (p = 0.034), High blood pressure (p = 0.024), d-dimer level ≥ 1000 IU/L (p Conclusion: Our study showed that elderly and third-wave of COVID-19 patients were more at risk to die. Knowledge of risk factors for COVID-19 related death could improve the prognosis of these patients.展开更多
Tuberculosis is a major public health problem, especially in developing countries. Neuro-meningeal involvement is rare but represents one of the most severe forms with high morbidity and mortality. We report the case ...Tuberculosis is a major public health problem, especially in developing countries. Neuro-meningeal involvement is rare but represents one of the most severe forms with high morbidity and mortality. We report the case of an ischemic stroke complicating neuromeningeal and pulmonary tuberculosis in a four-month-old infant at the National Hospital Center of children Albert Royer (Senegal). The case was a four-month-old, male infant with no history. His vaccination was up to date according to Senegal’s expanded vaccination program. There was no notion of tuberculosis contagion. He was seen for a prolonged fever for more than a month and chronic cough. He had moderate malnutrition. Neurological examination revealed coma, meningeal syndrome, generalized tonic convulsions and hypertonia. The pupils were in bilateral miosis. Osteotendinous reflexes were abolished with a bilateral Babinski sign. He also had severe respiratory distress, bilateral pulmonary condensation syndrome. Brain computed tomography was in favor of an ischemic stroke. The test GeneXpert MTB/RIF was positive on cerebrospinal fluid and gastric tubing fluid. The curative treatment was based on a quadruple therapy based on rifampicin, isoniazid, pirazinamide and ethambutol. The evolution was unfavorable with the death of the patient.展开更多
Background: Ovarian tuberculosis is a rare form of tuberculosis. Its clinical presentation mimics an ovarian tumor, leading to misdiagnosis. Proper treatment with anti-tuberculosis drugs can lead to a cure for the dis...Background: Ovarian tuberculosis is a rare form of tuberculosis. Its clinical presentation mimics an ovarian tumor, leading to misdiagnosis. Proper treatment with anti-tuberculosis drugs can lead to a cure for the disease but can sometimes cause adverse effects that compromise therapeutic management. Observation: We report a 71-year-old female Senegalese patient who presented with a chronic abdominopelvic mass with an elevated Cancer Antigen 125 (CA125) level, raising the suspicion of an ovarian tumor. She underwent an exploratory laparotomy and the anatomopathological study confirmed the diagnosis of ovarian and peritoneal tuberculosis. After starting treatment with anti-tuberculosis drugs, she developed toxidermia in the form of generalized urticaria. Discontinuation of the four-drug therapy and separate reintroduction of anti-tuberculosis drugs led to the incrimination of rifampicin. Progress was then favorable on Isoniazid (H) pyrazinamide (Z) and Ethambutol (E). Conclusion: Ovarian tuberculosis should be suspected in the presence of an abdominopelvic mass in a woman living in an endemic area. The occurrence of adverse reactions to anti-tuberculosis treatment is not uncommon, hence the importance of regular monitoring.展开更多
Aim: The objective of this research is to highlight the effectiveness of physical exercise and music therapy in older patients with Alzheimer’s disease (AD). Methods: Patients with a mild level of AD were included in...Aim: The objective of this research is to highlight the effectiveness of physical exercise and music therapy in older patients with Alzheimer’s disease (AD). Methods: Patients with a mild level of AD were included in this study, divided into the therapy group (TG;N = 30, aged 68 ± 3.2 years) and the control group (CG;N=30, aged 65 ± 2.6 years). The therapy group was enrolled in an exercise-training program (walking, resistance and balance exercises) combined with musical therapy for 10 weeks (three sessions of 60 minutes per week). The Control group was instructed to follow their daily rhythm of life (e.g., rest, reading) under the same conditions. The intervention program was enrolled under the supervision of;one psychologist;a neurologist;two music therapists, and two physiotherapists, all belonging to the same hospital unit. After 10 weeks of participation in the combined program, cognitive parameters were improved in the therapy group measured with the Behavior Pathology in Alzheimer Disease (BEHAVE-AD), (p < 0.05) for activity disturbance, diurnal rhythm disturbances, anxieties and phobias, affective disturbance. The percentage range of improvements is 1.07% to 2.96%. Results: Our results demonstrate that physical exercise combined with music therapy improves cognitive function in patients with Alzheimer’s disease. Conclusions: Physical exercise and music therapy are beneficial combined treatments for improving life quality in older patients. This approach may be useful to help patients with a mild level of Alzheimer’s disease improve their behavioral and psychological parameters.展开更多
Background: Cutaneous Leishmaniasis (CL) is an endemic disease in many countries and caused by different species of Leishmania parasite. It results in a deformed scar after a relatively long period. Many therapies hav...Background: Cutaneous Leishmaniasis (CL) is an endemic disease in many countries and caused by different species of Leishmania parasite. It results in a deformed scar after a relatively long period. Many therapies have been tried in treatment of this disease. Objective: To compare the effect of oral zinc sulfate and oral ketoconazole singly and in combination in the treatment of acute cutaneous leishmaniasis. Patients and Methods: This single, blinded, therapeutic, controlled study was conducted in the Department of Dermatology, Baghdad Teaching Hospital, Baghdad, Iraq, during the period, January 2015 to July 2015. Seventy-five patients with acute CL were enrolled in this study. The total numbers of lesions were 327, and the duration of lesions ranged from 4 to 12 (6.9 ± 0.7) weeks. The diagnosis was confirmed by smear and histopathology. Patients were divided into three groups: 24 patients in Group A were treated with oral zinc sulfate capsules 10 mg/kg/day for 6 weeks;24 patients in Group B were treated with ketoconazole tablets 200 mg twice daily for 6 weeks and 27 patients in Group C were treated orally with a combination of zinc sulfate and ketoconazole for 6 weeks. All patients were seen regularly every 2 weeks for 6 weeks of treatment period, then monthly for the next three months as follow up period. Healing of the lesions was assessed by using Sharquie’s modified Leishmania score to assess the objective response to the topical or systemic therapy. Results:After six weeks, 75 patients have completed the treatment, 24patients received zinc sulfate capsule, 24 patients received oral ketoconazole and 27 patients received a combination of both treatments. The cure rate was (60%) in the group receiving oral zinc sulfate capsuleand (50%) in the one receiving oral ketoconazole tablet (P = 0.146) and (96%) in the combination group (P ? 0.04). Conclusion: The combination therapy using oral zinc sulfate and oral ketoconazole gave a high cure rate. The combination therapy is a new mode of therapy as both drugs ac展开更多
Ordinary Portland Cement (OPC) is by mass the largest manufactured product on Earth, responsible for approximately 6% - 8% of global anthropogenic carbon dioxide emissions (CO<sub>2</sub>) and 35% of indus...Ordinary Portland Cement (OPC) is by mass the largest manufactured product on Earth, responsible for approximately 6% - 8% of global anthropogenic carbon dioxide emissions (CO<sub>2</sub>) and 35% of industrial CO<sub>2</sub> emissions. On average 0.8 to 0.9 ton of CO<sub>2</sub> is emitted to produce one ton of OPC. In this paper, partial substitution of clinker (30% - 35%) by the calcined clay-limestone mixture was investigated in order to produce an eco-cement (LC3). Analyzes by XRF, XRD and ATG/ATD have characterized different components, determined the calcination temperature and selected the right clay which can act as effective Supplementary Cementitious Material (SCM). Mechanical tests on mortar carried out over a period of 90 days. The WBCSD/WRI “Greenhouse Gas Protocol” methodology then allowed the calculation of CO<sub>2</sub> emissions into the atmosphere. Three types of clay are available in the Songololo Region. The kaolinite is the principal clay mineral and its content varies from 27% to 34%. The sum of kaolinite and amorphous phase which enable clay to react with cementitious material ranges from 57% to 60%. The SiO<sub>2</sub> content ranges from 33% to 76%, the Alumina content from 12% to 20% so that the ratio Al<sub>2</sub>O<sub>3</sub>/SiO<sub>2</sub> is on the higher side (0.17 - 0.53). The calcination window is between 750°C and 850°C and the best clay which can act as SCM identified. The clinker’s substitution reduced CO<sub>2</sub> emissions from 0.824 ton of CO<sub>2</sub> for one ton of OPC to 0.640 ton of CO<sub>2</sub> for one ton of LC3, means 22% less emissions. The compressive strengths developed by LC3 vary from 8.91 to 57.6 MPa (Day 1 to Day 90), exceed those of references 32.5 cement and are close to 42.5 cement. In view of the results, LC3 cement can be considered for industrial trials.展开更多
Introduction: GBS is a rare condition in children. The risk factors for GBS are present in Africa;however, the majority of studies reported are case series. The objective of our work was to evaluate the epidemiologica...Introduction: GBS is a rare condition in children. The risk factors for GBS are present in Africa;however, the majority of studies reported are case series. The objective of our work was to evaluate the epidemiological, clinical, paraclinical, therapeutic and evolutionary profile of GBS cases. Material and Method: This was a prospective longitudinal study, lasting 24 months between November 2019 and November 2021. All patients aged 2 - 18 years diagnosed with GBS according to the Brighton criteria (level 2) were included in our study. Patients with incomplete or unexploitable records were excluded. Results: Over a 24-month period, 16 cases of GBS were collected. These included 12 boys (75%) and 4 girls (25%). The demyelinating form (ADIP) was found in 9 children (43.75%) and the axonal form in 7 patients (37.5%), 5 of whom had pure motor involvement (AMAN) and 2 with sensory-motor involvement (AMSAN). Corticosteroid therapy was more effective in treating pain and in demyelinating forms. Three deaths were noted and all had AMAN. Conclusion: GBS poses a management problem in our context of a country with limited resources. Corticosteroid therapy has been shown to be effective in the treatment of pain and demyelinating forms of the disease and should be considered for use in GBS.展开更多
Common bile duct(CBD)stones are a common biliary tract disease.For asymp-tomatic CBD stones,stone removal by endoscopic retrograde cholangiopancreato-graphy(ERCP)is recommended in available guidelines.Because asymptom...Common bile duct(CBD)stones are a common biliary tract disease.For asymp-tomatic CBD stones,stone removal by endoscopic retrograde cholangiopancreato-graphy(ERCP)is recommended in available guidelines.Because asymptomatic CBD stones is a benign disease with no noticeable symptoms,the risk vs benefit strategy should be thoroughly considered before performing ERCP in these patients.Clinical care review,technical aspects of the procedure,and patient preferences should also be considered.展开更多
Background: Vitiligo is a common autoimmune inflammatory skin disease, where there are different surgical techniques for treatment of stable patches of vitiligo .Objective: To find non-costly, minimally invasive, simp...Background: Vitiligo is a common autoimmune inflammatory skin disease, where there are different surgical techniques for treatment of stable patches of vitiligo .Objective: To find non-costly, minimally invasive, simple technique by direct melanocytes transplant by spade needle technique in treatment of vitiligo. Patients and Methods: This interventional, therapeutic, comparative study was done in Department of Dermatology, Baghdad Teaching Hospital, Baghdad, Iraq from April 2014-March 2015. Twenty patients with localized, generalized and segmental vitiligo were included. Full history and examination for each patient was done with 4 (20%) males and 16 (80%) females and their ages ranged from 9 - 40 (23.15 ± 11.44) years. Forty one patches in 20 patients treated by spade grafting technique and the donor and recipient sites were demarcated and anesthesia done by xylocaine 2% with adrenalin 1:100,000. Transplantation was started by using disposable needle gauge 18 (the sharp end of needle was cut by a scissor to make it a spade like) with medical syringe 5 ml supplied with normal saline. The micro-pieces were taken from donor site and transplanted directly, easily and rapidly into dermis of recipient site and followed by pushing normal saline and the procedure was repeated to cover all recipient sites with 5 mm distance between injection points. The surface area of the lesions was calculated and the reduction rate was estimated every month till the end of the 4th month period of the treatment. Results: Including 41 patches in 20 patients with the surface area of the patches ranged from 1.5 - 90 cm<sup>2</sup> (13.78 ± 17.57) cm<sup>2</sup>. The mean ±SD of surface area of lesions was decreased from 13.78 ± 17.57 cm<sup>2</sup> at baseline visit to 13.61 ± 17.48 cm<sup>2</sup> at the second visit (after 2 weeks ) which was statistically significant (p value ≤ 0.001). The mean surface area continued to be reduced till reaching 12.20 ± 15.68 cm<sup>2</sup> at the third visit and 12.01 ± 15.55 cm<sup>2</sup> at展开更多
BACKGROUND The most common technique for treating benign and early malignant rectal lesions is transanal endoscopic microsurgery(TEM).Local excision is an acceptable technique for high-risk and elderly patients,but th...BACKGROUND The most common technique for treating benign and early malignant rectal lesions is transanal endoscopic microsurgery(TEM).Local excision is an acceptable technique for high-risk and elderly patients,but there are hardly any data regarding young patients.AIM To describe TEM outcomes in patients under 50 years of age.METHODS We collected demographic,clinical,and pathological data from all patients under the age of 50 years who underwent the TEM procedure at Hasharon Rabin Medical Center from January 2005 to December 2018.RESULTS During the study period,a total of 26 patients under the age of 50 years underwent TEM procedures.Their mean age was 43.3 years.Eleven(42.0%)were male.The mean operative time was 67 min,and the mean tumor size was 2.39 cm,with a mean anal verge distance of 8.50 cm.No major intraoperative or postoperative complications were recorded.The median length of stay was 2 d.Seven(26.9%)lesions were adenomas with low-grade dysplasia,four(15.4%)were high-grade dysplasia adenomas,two were T1 carcinomas(7.8%),and three were T2 carcinomas(11.5%).No residual disease was found following endoscopic polypectomy in two patients(7.8%),but four(15.4%)had other pathologies.Surgical margins were negative in all cases.Local recurrence was detected in one patient 33 mo following surgery.CONCLUSION Among young adult patients,TEM for benign rectal lesions has excellent outcomes.It may also offer a balance between the efficacy of complete oncologic resection and postoperative quality of life in the treatment of rectal cancer.In some cases,it may be considered an alternative to radical surgery.展开更多
Billets of A356 aluminum alloy were treated using ultrasonic vibrations during solidification.The billets were reheated to the semisolid state at different routes to optimize the procedure.Billets were,then,thixocast ...Billets of A356 aluminum alloy were treated using ultrasonic vibrations during solidification.The billets were reheated to the semisolid state at different routes to optimize the procedure.Billets were,then,thixocast using a die casting machine.The results showed that the ultrasonic-treated billets exhibited finely distributed α（Al） globules after reheating and thixocasting.The thixocast ultrasonic-treated billets showed higher ultimate tensile strength and elongation compared with the untreated billets.Moreover,the thixocast parts showed a tendency to ductile fracture under tension when made from ultrasonic-treated billets,while those made of untreated billets showed brittle fracture with obvious straight facets.These results revealed the feasibility and competence of ultrasonic melt treatment as a potential route for preparing billets for thixocasting.展开更多
Recently,fuzzy multi-sets have come to the forefront of scientists’interest and have been used in algebraic structures such asmulti-groups,multirings,anti-fuzzy multigroup and(α,γ)-anti-fuzzy subgroups.In this pape...Recently,fuzzy multi-sets have come to the forefront of scientists’interest and have been used in algebraic structures such asmulti-groups,multirings,anti-fuzzy multigroup and(α,γ)-anti-fuzzy subgroups.In this paper,we first summarize the knowledge about the algebraic structure of fuzzy multi-sets such as(α,γ)-anti-multi-fuzzy subgroups.In a way,the notion of anti-fuzzy multigroup is an application of anti-fuzzy multi sets to the theory of group.The concept of anti-fuzzy multigroup is a complement of an algebraic structure of a fuzzy multi set that generalizes both the theories of classical group and fuzzy group.The aim of this paper is to highlight the connection between fuzzy multi-sets and algebraic structures from an anti-fuzzification point of view.Therefore,in this paper,we define(α,γ)-antimulti-fuzzy subgroups,(α,γ)-anti-multi-fuzzy normal subgroups,(α,γ)-antimulti-fuzzy homomorphism on(α,γ)-anti-multi-fuzzy subgroups and these been explicated some algebraic structures.Then,we introduce the concept(α,γ)-anti-multi-fuzzy subgroups and(α,γ)-anti-multi-fuzzy normal subgroups and of their properties.This new concept of homomorphism as a bridge among set theory,fuzzy set theory,anti-fuzzy multi sets theory and group theory and also shows the effect of anti-fuzzy multi sets on a group structure.Certain results that discuss the(α,γ)cuts of anti-fuzzy multigroup are explored.展开更多
Purpose： ＂Polytrauma＂ patients are of a higher risk of complications and death than the summation of expected mortality and morbidity of their individual injuries. The ideal goal in trauma resuscitation care is to ...Purpose： ＂Polytrauma＂ patients are of a higher risk of complications and death than the summation of expected mortality and morbidity of their individual injuries. The ideal goal in trauma resuscitation care is to identify and treat all injuries. With clinical and technological advanced imaging available for diagnosis and treatment of traumatic patients, point of care-rapid ultrasound in shock and hypotension （RUSH） significantly affects modern trauma services and patient outcomes. This study aims to evaluate the accuracy of RUSH and patient outcomes by early detection of the causes of unstable polytrauma. Methods： This cross-sectional, prospective study included 100 unstable polytrauma patients admitted in Suez Canal University Hospital. Clinical exam, RUSH and pan-computed tomography （pan-CT） were conducted. The result of CT was taken as the standard. Patients were managed according to the advanced trauma life support （ATLS） guidelines and treated of life threatening conditions if present. Patients were followed up for 28 days for a short outcome. Results： The most diagnostic causes of unstability in polytrauma patients by RUSH are hypovolemic shock （64%）, followed by obstructive shock （14%）, distributive shock （12%） and cardiogenic shock （10%） respectively. RUSH had 94.2% sensitivity in the diagnosis of unstable polytrauma patients; the accuracy of RUSH in shock patients was 95.2%. Conclusion： RUSH is accurate in the diagnosis of unstable polytrauma patients; and 4% of patients were diagnosed during follow-up after admission by RUSH and pan-CT.展开更多
Apple fruits have components of therapeutic nature.Such components,to a great extent,decline or decompose during post-harvest that negatively affect fruit shelf-life.Chitosan fruit-filming has proved useful in maintai...Apple fruits have components of therapeutic nature.Such components,to a great extent,decline or decompose during post-harvest that negatively affect fruit shelf-life.Chitosan fruit-filming has proved useful in maintaining these compounds.This study aims,therefore,at enhancing Chitosan coating-film performance by mixing with some olive wastes extracts of leaf and pomace extracts.Apple fruits were sprayed with six different coating formulas including chitosan-water wax coating,in addition to the uncoated fruits.Then,the total phenolic,flavonoids,antioxidants,pigments,weight loss,decay area,and microstructure were assayed.The bioactive substances drastically changed in uncoated rather than coated fruits.Conversely,weight loss and decay area significantly increased in uncoated fruits.Amazingly,the addition of olive leaf extract to chitosan coating films meaningfully reduced the gradual decline in total phenolic,flavonoids and antioxidants.Olive pomace extract recorded the lowest influencing on anthocyanins during storage at 4±1C for 35 d.Also,both olive leaf and pomace extracts enhanced the coating distribution,due to no pores were observed in the fruits’surfaces.Decidedly,incorporation of olive leaf extracts with 2%into chitosan coating solution was the best formula comparable with the others.Thus,olive wastes extracts,incorporated into chitosan fruit coatings;relatively improve the nutritional quality of apple fruits during post-harvest.展开更多
基金Under the auspices of Asia Pacific Network for Global Change Research(APN)Global Change Fund Project(No.ARCP2015-03CMY-Li)+2 种基金National Natural Science Foundation of China(No.41271361,41501575)National Key Research and Development Project(No.2018YFD0800201)Key Project of Chinese National Programs for Fundamental Research and Development(No.2010CB950702)
文摘Understanding the net primary productivity(NPP) of grassland is crucial to evaluate the terrestrial carbon cycle. In this study, we investigated the spatial distribution and the area of global grassland across the globe. Then, we used the Carnegie-Ames-Stanford Approach(CASA) model to estimate global grassland NPP and explore the spatio-temporal variations of grassland NPP in response to climate change from 1982 to 2008. Results showed that the largest area of grassland distribution during the study period was in Asia(1737.23 × 104 km^2), while the grassland area in Europe was relatively small(202.83 × 10~4 km^2). Temporally, the total NPP increased with fluctuations from 1982 to 2008, with an annual increase rate of 0.03 Pg C/yr. The total NPP experienced a significant increasing trend from 1982 to 1995, while a decreasing trend was observed from 1996 to 2008. Spatially, the grassland NPP in South America and Africa were higher than the other regions, largely as a result of these regions are under warm and wet climatic conditions. The highest mean NPP was recorded for savannas(560.10 g C/(m^2·yr)), whereas the lowest was observed in open shrublands with an average NPP of 162.53 g C/(m^2·yr). The relationship between grassland NPP and annual mean temperature and annual precipitation(AMT, AP, respectively) varies with changes in AP, which indicates that, grassland NPP is more sensitive to precipitation than temperature.
文摘In the present study,the effect of aging heat treatment at 650,750,and 850？C on the impact toughness of 316L austenitic stainless steel,2205 duplex stainless steel and their weldments has been investigated.Welding process was conducted using the TIG（tungsten inert gas） welding technique.Instrumented impact testing,at room temperature,was employed to determine the effect of aging treatment on the impact properties of investigated materials.Aging treatment resulted in degradation in the impact toughness as demonstrated by the reduction in the impact fracture energy and deformation parameters（strain hardening capacity,fracture deffection,and crack initiation and propagation energy）.The degree of embrittlement was more noticeable in duplex stainless steel parent and weld-metal than in 316L stainless steel and became greater with the increase of aging temperature.The degradation in impact toughness was discussed in relation to the observed precipitation of the intermetallic sigma phase in the microstructure of the stainless steel weldments and the corresponding fracture surface morphology.
文摘CDX2 is a nuclear homeobox transcription factor that belongs to the caudalrelated family of CDX homeobox genes. The gene encoding CDX2 is a nonclustered hexapeptide located on chromosome 13q12-13. Homeobox genes play an essential role in the control of normal embryonic development. CDX2 is crucial for axial patterning of the alimentary tract during embryonic development and is involved in the processes of intestinal cell proliferation, differentiation, adhesion, and apoptosis. It is considered specif ic for enterocytes and has been used for the diagnosis of primary and metastatic colorectal adenocarcinoma. CDX2 expression has been reported to be organ specif ic and is normally expressed throughout embryonic and postnatal life within the nuclei of epithelial cells of the alimentary tract from the proximal duodenum to the distal rectum. In this review, the authors elaborate on the diagnostic utility of CDX2 in gastrointestinal tumors and other neoplasms with intestinal differentiation. Limitations with its use as the sole predictor of a gastrointestinal origin of metastatic carcinomas are also discussed.
文摘Sodium-glucose cotransporter-2 inhibitors (SGLT-2 inhibitors) have transformed diabetes management by targeting renal glucose reabsorption. Designed initially as antidiabetic agents, their ability to lower blood glucose levels independently of insulin is well-documented. Beyond glycemic control, emerging research has unveiled their profound cardiorenal benefits. By inhibiting SGLT-2 protein, these drugs enhance glucose excretion in urine, reducing blood glucose levels. This mechanism has translated into significant cardiovascular and renal protection, establishing SGLT-2 inhibitors as pivotal in managing not only diabetes but also cardiovascular and renal diseases. Recent studies have illuminated the broader therapeutic potential of SGLT-2 inhibitors beyond diabetes. Evidence indicates their efficacy in managing heart failure, chronic kidney disease (CKD), and cardiovascular complications in individuals with or without diabetes. This expanded therapeutic landscape has catalyzed a paradigm shift in SGLT-2 inhibitor use, positioning them as key agents in the cardiorenal metabolic continuum. Moreover, their role in the secondary prevention of cardiovascular events and slowing CKD progression in T2DM patients has garnered considerable attention. This consensus-based review aims to offer practical guidance in an algorithmic approach to primary care healthcare professionals to optimize SGLT-2 inhibitors utilization and maximize their benefits. The review seeks to empower clinicians to effectively manage patients who may benefit from SGLT-2 inhibitor therapy by addressing common initiation barriers and optimizing treatment strategies. Additionally, it aims to raise awareness among primary care physicians regarding the multifaceted benefits of these medications and overcome clinical inertia in their adoption into routine clinical practice.
文摘Background: Despite the conservative treatment of tibio-femoral osteoarthritis through realignment osteotomies, the rate of total knee replacements following an osteotomy is increasing. The aim of this study was to identify the factors associated with the progression of knee osteoarthritis after a medial closing-wedge distal femoral osteotomy. Methods: Hospital-based observational study on 20 patients who underwent a medial closing-wedge distal femoral osteotomy evaluating the progression of osteoarthritis using the Kellgren and Laurence classification. The Wilcoxon test was used to compare the variation in the progressive stage of the Kellgren and Laurence classification of knee osteoarthritis preoperatively and at the final follow up. Univariate analysis made it possible to determine the factors associated with progression. The final significance threshold for statistical tests was set at 5% (p Results: Overall, the mean follow-up of 46 months ± 6.6 months, with a mean age of 43 years (range: 27 - 69 years) and a female predominance (M: F = 3/7). The progression of tibiofemoral osteoarthritis following a medial closing-wedge distal femoral osteotomy is associated with valgus or varum malalignment been a moderate valgus (OR 6.2 [1.5 - 42.7] at 95% CI;p-value = 0.02), a correction of the mechanical deviation angle with a valgus alignment (OR 2.7 [0.9 - 8.3] at 95% CI), and loss of correction (OR 3.8 [1.3 - 11.6] at 95% CI;p -value) for the lateral compartment while varus alignment (OR 1.7 [0.9 - 8.3] 95% CI, p-value = 0.05) and with rupture of the lateral cortex (OR 2.8 [1.7 - 11.5] 95% CI, p-value = 0.02) were those of the medial compartment. Conclusion: Distal femur closing wedge osteotomy does not definitively interrupt the progression of valgus knee osteoarthritis. The factors associated with the progression of this pathology are modifiable. Taking them into account when performing this surgical technique could improve the osteotomy survival curve.
基金Supported by the Department of Microbiology and Immunology,College of Medicine and Health Sciences,Sultan Qaboos University,Sultanate of Oman(Code Number:RP032015)
文摘This review focuses on DNA vaccines, denoting the last two decades since the early substantiation of preclinical protection was published in Science in 1993 by Ulmer et al. In spite of being safely administered and easily engineered and manufactured DNA vaccine, it holds the future prospects of immunization by inducing potent cellular immune responses against infectious and non-infectious diseases. It is well documented that injection of DNA plasmid encoding a desired gene of interest can result in the subsequent expression of its products and lead to the induction of an immune response within a host. This is pertinent to prophylactic and therapeutic vaccination approach when the peculiar gene produces a protective epitope from a pathogen. The recent studies demonstrated by a number of research centers showed that these immune responses evoke protective immunity against several infectious diseases and cancers, which provides adequate support for the use of this approach. We attempt in this review to provide an informative and unbiased overview of the general principles and concept of DNA vaccines technology with a summary of a novel approach to the DNA vaccine, present investigations that describe the mechanism(s) of protective immunity provoked by DNA immunization and to highlight the advantages and disadvantages of DNA immunisation.
文摘Introduction-Objective: COVID-19 is a highly transmissible but often mild viral infection. However, some patients can present severe COVID-19 and subsequently die. The aim of the present study was to assess the risk factors for COVID-19 related death during the first three waves of the disease at the Epidemic Treatment Center (ETC) of Dakar Principal Hospital (DPH). Method: We conducted a descriptive and analytical perspective survival study from April 4, 2020 to September 25, 2021, including adult patients with COVID-19, hospitalized at the ETC of DPH. Log Rank test and multivariate Cox model were performed to identify risk factors for death. Results: We included 556 COVID-19 patients with mean age of 57 ± 17 years and a male-to-female ratio of 1.26. The number of deaths during one month of follow-up was 41, representing a cumulative risk of 7.4%. The log Rank test showed that being from the third wave (p = 0.0056), advanced age (p = 0.00098), presence of at least one comorbidity (p = 0.034), High blood pressure (p = 0.024), d-dimer level ≥ 1000 IU/L (p Conclusion: Our study showed that elderly and third-wave of COVID-19 patients were more at risk to die. Knowledge of risk factors for COVID-19 related death could improve the prognosis of these patients.
文摘Tuberculosis is a major public health problem, especially in developing countries. Neuro-meningeal involvement is rare but represents one of the most severe forms with high morbidity and mortality. We report the case of an ischemic stroke complicating neuromeningeal and pulmonary tuberculosis in a four-month-old infant at the National Hospital Center of children Albert Royer (Senegal). The case was a four-month-old, male infant with no history. His vaccination was up to date according to Senegal’s expanded vaccination program. There was no notion of tuberculosis contagion. He was seen for a prolonged fever for more than a month and chronic cough. He had moderate malnutrition. Neurological examination revealed coma, meningeal syndrome, generalized tonic convulsions and hypertonia. The pupils were in bilateral miosis. Osteotendinous reflexes were abolished with a bilateral Babinski sign. He also had severe respiratory distress, bilateral pulmonary condensation syndrome. Brain computed tomography was in favor of an ischemic stroke. The test GeneXpert MTB/RIF was positive on cerebrospinal fluid and gastric tubing fluid. The curative treatment was based on a quadruple therapy based on rifampicin, isoniazid, pirazinamide and ethambutol. The evolution was unfavorable with the death of the patient.
文摘Background: Ovarian tuberculosis is a rare form of tuberculosis. Its clinical presentation mimics an ovarian tumor, leading to misdiagnosis. Proper treatment with anti-tuberculosis drugs can lead to a cure for the disease but can sometimes cause adverse effects that compromise therapeutic management. Observation: We report a 71-year-old female Senegalese patient who presented with a chronic abdominopelvic mass with an elevated Cancer Antigen 125 (CA125) level, raising the suspicion of an ovarian tumor. She underwent an exploratory laparotomy and the anatomopathological study confirmed the diagnosis of ovarian and peritoneal tuberculosis. After starting treatment with anti-tuberculosis drugs, she developed toxidermia in the form of generalized urticaria. Discontinuation of the four-drug therapy and separate reintroduction of anti-tuberculosis drugs led to the incrimination of rifampicin. Progress was then favorable on Isoniazid (H) pyrazinamide (Z) and Ethambutol (E). Conclusion: Ovarian tuberculosis should be suspected in the presence of an abdominopelvic mass in a woman living in an endemic area. The occurrence of adverse reactions to anti-tuberculosis treatment is not uncommon, hence the importance of regular monitoring.
文摘Aim: The objective of this research is to highlight the effectiveness of physical exercise and music therapy in older patients with Alzheimer’s disease (AD). Methods: Patients with a mild level of AD were included in this study, divided into the therapy group (TG;N = 30, aged 68 ± 3.2 years) and the control group (CG;N=30, aged 65 ± 2.6 years). The therapy group was enrolled in an exercise-training program (walking, resistance and balance exercises) combined with musical therapy for 10 weeks (three sessions of 60 minutes per week). The Control group was instructed to follow their daily rhythm of life (e.g., rest, reading) under the same conditions. The intervention program was enrolled under the supervision of;one psychologist;a neurologist;two music therapists, and two physiotherapists, all belonging to the same hospital unit. After 10 weeks of participation in the combined program, cognitive parameters were improved in the therapy group measured with the Behavior Pathology in Alzheimer Disease (BEHAVE-AD), (p < 0.05) for activity disturbance, diurnal rhythm disturbances, anxieties and phobias, affective disturbance. The percentage range of improvements is 1.07% to 2.96%. Results: Our results demonstrate that physical exercise combined with music therapy improves cognitive function in patients with Alzheimer’s disease. Conclusions: Physical exercise and music therapy are beneficial combined treatments for improving life quality in older patients. This approach may be useful to help patients with a mild level of Alzheimer’s disease improve their behavioral and psychological parameters.
文摘Background: Cutaneous Leishmaniasis (CL) is an endemic disease in many countries and caused by different species of Leishmania parasite. It results in a deformed scar after a relatively long period. Many therapies have been tried in treatment of this disease. Objective: To compare the effect of oral zinc sulfate and oral ketoconazole singly and in combination in the treatment of acute cutaneous leishmaniasis. Patients and Methods: This single, blinded, therapeutic, controlled study was conducted in the Department of Dermatology, Baghdad Teaching Hospital, Baghdad, Iraq, during the period, January 2015 to July 2015. Seventy-five patients with acute CL were enrolled in this study. The total numbers of lesions were 327, and the duration of lesions ranged from 4 to 12 (6.9 ± 0.7) weeks. The diagnosis was confirmed by smear and histopathology. Patients were divided into three groups: 24 patients in Group A were treated with oral zinc sulfate capsules 10 mg/kg/day for 6 weeks;24 patients in Group B were treated with ketoconazole tablets 200 mg twice daily for 6 weeks and 27 patients in Group C were treated orally with a combination of zinc sulfate and ketoconazole for 6 weeks. All patients were seen regularly every 2 weeks for 6 weeks of treatment period, then monthly for the next three months as follow up period. Healing of the lesions was assessed by using Sharquie’s modified Leishmania score to assess the objective response to the topical or systemic therapy. Results:After six weeks, 75 patients have completed the treatment, 24patients received zinc sulfate capsule, 24 patients received oral ketoconazole and 27 patients received a combination of both treatments. The cure rate was (60%) in the group receiving oral zinc sulfate capsuleand (50%) in the one receiving oral ketoconazole tablet (P = 0.146) and (96%) in the combination group (P ? 0.04). Conclusion: The combination therapy using oral zinc sulfate and oral ketoconazole gave a high cure rate. The combination therapy is a new mode of therapy as both drugs ac
文摘Ordinary Portland Cement (OPC) is by mass the largest manufactured product on Earth, responsible for approximately 6% - 8% of global anthropogenic carbon dioxide emissions (CO<sub>2</sub>) and 35% of industrial CO<sub>2</sub> emissions. On average 0.8 to 0.9 ton of CO<sub>2</sub> is emitted to produce one ton of OPC. In this paper, partial substitution of clinker (30% - 35%) by the calcined clay-limestone mixture was investigated in order to produce an eco-cement (LC3). Analyzes by XRF, XRD and ATG/ATD have characterized different components, determined the calcination temperature and selected the right clay which can act as effective Supplementary Cementitious Material (SCM). Mechanical tests on mortar carried out over a period of 90 days. The WBCSD/WRI “Greenhouse Gas Protocol” methodology then allowed the calculation of CO<sub>2</sub> emissions into the atmosphere. Three types of clay are available in the Songololo Region. The kaolinite is the principal clay mineral and its content varies from 27% to 34%. The sum of kaolinite and amorphous phase which enable clay to react with cementitious material ranges from 57% to 60%. The SiO<sub>2</sub> content ranges from 33% to 76%, the Alumina content from 12% to 20% so that the ratio Al<sub>2</sub>O<sub>3</sub>/SiO<sub>2</sub> is on the higher side (0.17 - 0.53). The calcination window is between 750°C and 850°C and the best clay which can act as SCM identified. The clinker’s substitution reduced CO<sub>2</sub> emissions from 0.824 ton of CO<sub>2</sub> for one ton of OPC to 0.640 ton of CO<sub>2</sub> for one ton of LC3, means 22% less emissions. The compressive strengths developed by LC3 vary from 8.91 to 57.6 MPa (Day 1 to Day 90), exceed those of references 32.5 cement and are close to 42.5 cement. In view of the results, LC3 cement can be considered for industrial trials.
文摘Introduction: GBS is a rare condition in children. The risk factors for GBS are present in Africa;however, the majority of studies reported are case series. The objective of our work was to evaluate the epidemiological, clinical, paraclinical, therapeutic and evolutionary profile of GBS cases. Material and Method: This was a prospective longitudinal study, lasting 24 months between November 2019 and November 2021. All patients aged 2 - 18 years diagnosed with GBS according to the Brighton criteria (level 2) were included in our study. Patients with incomplete or unexploitable records were excluded. Results: Over a 24-month period, 16 cases of GBS were collected. These included 12 boys (75%) and 4 girls (25%). The demyelinating form (ADIP) was found in 9 children (43.75%) and the axonal form in 7 patients (37.5%), 5 of whom had pure motor involvement (AMAN) and 2 with sensory-motor involvement (AMSAN). Corticosteroid therapy was more effective in treating pain and in demyelinating forms. Three deaths were noted and all had AMAN. Conclusion: GBS poses a management problem in our context of a country with limited resources. Corticosteroid therapy has been shown to be effective in the treatment of pain and demyelinating forms of the disease and should be considered for use in GBS.
文摘Common bile duct(CBD)stones are a common biliary tract disease.For asymp-tomatic CBD stones,stone removal by endoscopic retrograde cholangiopancreato-graphy(ERCP)is recommended in available guidelines.Because asymptomatic CBD stones is a benign disease with no noticeable symptoms,the risk vs benefit strategy should be thoroughly considered before performing ERCP in these patients.Clinical care review,technical aspects of the procedure,and patient preferences should also be considered.
文摘Background: Vitiligo is a common autoimmune inflammatory skin disease, where there are different surgical techniques for treatment of stable patches of vitiligo .Objective: To find non-costly, minimally invasive, simple technique by direct melanocytes transplant by spade needle technique in treatment of vitiligo. Patients and Methods: This interventional, therapeutic, comparative study was done in Department of Dermatology, Baghdad Teaching Hospital, Baghdad, Iraq from April 2014-March 2015. Twenty patients with localized, generalized and segmental vitiligo were included. Full history and examination for each patient was done with 4 (20%) males and 16 (80%) females and their ages ranged from 9 - 40 (23.15 ± 11.44) years. Forty one patches in 20 patients treated by spade grafting technique and the donor and recipient sites were demarcated and anesthesia done by xylocaine 2% with adrenalin 1:100,000. Transplantation was started by using disposable needle gauge 18 (the sharp end of needle was cut by a scissor to make it a spade like) with medical syringe 5 ml supplied with normal saline. The micro-pieces were taken from donor site and transplanted directly, easily and rapidly into dermis of recipient site and followed by pushing normal saline and the procedure was repeated to cover all recipient sites with 5 mm distance between injection points. The surface area of the lesions was calculated and the reduction rate was estimated every month till the end of the 4th month period of the treatment. Results: Including 41 patches in 20 patients with the surface area of the patches ranged from 1.5 - 90 cm<sup>2</sup> (13.78 ± 17.57) cm<sup>2</sup>. The mean ±SD of surface area of lesions was decreased from 13.78 ± 17.57 cm<sup>2</sup> at baseline visit to 13.61 ± 17.48 cm<sup>2</sup> at the second visit (after 2 weeks ) which was statistically significant (p value ≤ 0.001). The mean surface area continued to be reduced till reaching 12.20 ± 15.68 cm<sup>2</sup> at the third visit and 12.01 ± 15.55 cm<sup>2</sup> at
文摘BACKGROUND The most common technique for treating benign and early malignant rectal lesions is transanal endoscopic microsurgery(TEM).Local excision is an acceptable technique for high-risk and elderly patients,but there are hardly any data regarding young patients.AIM To describe TEM outcomes in patients under 50 years of age.METHODS We collected demographic,clinical,and pathological data from all patients under the age of 50 years who underwent the TEM procedure at Hasharon Rabin Medical Center from January 2005 to December 2018.RESULTS During the study period,a total of 26 patients under the age of 50 years underwent TEM procedures.Their mean age was 43.3 years.Eleven(42.0%)were male.The mean operative time was 67 min,and the mean tumor size was 2.39 cm,with a mean anal verge distance of 8.50 cm.No major intraoperative or postoperative complications were recorded.The median length of stay was 2 d.Seven(26.9%)lesions were adenomas with low-grade dysplasia,four(15.4%)were high-grade dysplasia adenomas,two were T1 carcinomas(7.8%),and three were T2 carcinomas(11.5%).No residual disease was found following endoscopic polypectomy in two patients(7.8%),but four(15.4%)had other pathologies.Surgical margins were negative in all cases.Local recurrence was detected in one patient 33 mo following surgery.CONCLUSION Among young adult patients,TEM for benign rectal lesions has excellent outcomes.It may also offer a balance between the efficacy of complete oncologic resection and postoperative quality of life in the treatment of rectal cancer.In some cases,it may be considered an alternative to radical surgery.
文摘Billets of A356 aluminum alloy were treated using ultrasonic vibrations during solidification.The billets were reheated to the semisolid state at different routes to optimize the procedure.Billets were,then,thixocast using a die casting machine.The results showed that the ultrasonic-treated billets exhibited finely distributed α（Al） globules after reheating and thixocasting.The thixocast ultrasonic-treated billets showed higher ultimate tensile strength and elongation compared with the untreated billets.Moreover,the thixocast parts showed a tendency to ductile fracture under tension when made from ultrasonic-treated billets,while those made of untreated billets showed brittle fracture with obvious straight facets.These results revealed the feasibility and competence of ultrasonic melt treatment as a potential route for preparing billets for thixocasting.
基金Yibin University Pre-research Project,Research on the coupling and coordinated development ofmanufacturing and logistics industry under the background of intelligentmanufacturing,(2022YY001)Sichuan ProvincialDepartment of EducationWater Transport EconomicResearch Center,Research on the Development Path and Countermeasures of the Advanced Manufacturing Industry in the Sanjiang New District of Yibin under a“dual circulation”development pattern(SYJJ2020A06).
文摘Recently,fuzzy multi-sets have come to the forefront of scientists’interest and have been used in algebraic structures such asmulti-groups,multirings,anti-fuzzy multigroup and(α,γ)-anti-fuzzy subgroups.In this paper,we first summarize the knowledge about the algebraic structure of fuzzy multi-sets such as(α,γ)-anti-multi-fuzzy subgroups.In a way,the notion of anti-fuzzy multigroup is an application of anti-fuzzy multi sets to the theory of group.The concept of anti-fuzzy multigroup is a complement of an algebraic structure of a fuzzy multi set that generalizes both the theories of classical group and fuzzy group.The aim of this paper is to highlight the connection between fuzzy multi-sets and algebraic structures from an anti-fuzzification point of view.Therefore,in this paper,we define(α,γ)-antimulti-fuzzy subgroups,(α,γ)-anti-multi-fuzzy normal subgroups,(α,γ)-antimulti-fuzzy homomorphism on(α,γ)-anti-multi-fuzzy subgroups and these been explicated some algebraic structures.Then,we introduce the concept(α,γ)-anti-multi-fuzzy subgroups and(α,γ)-anti-multi-fuzzy normal subgroups and of their properties.This new concept of homomorphism as a bridge among set theory,fuzzy set theory,anti-fuzzy multi sets theory and group theory and also shows the effect of anti-fuzzy multi sets on a group structure.Certain results that discuss the(α,γ)cuts of anti-fuzzy multigroup are explored.
文摘Purpose： ＂Polytrauma＂ patients are of a higher risk of complications and death than the summation of expected mortality and morbidity of their individual injuries. The ideal goal in trauma resuscitation care is to identify and treat all injuries. With clinical and technological advanced imaging available for diagnosis and treatment of traumatic patients, point of care-rapid ultrasound in shock and hypotension （RUSH） significantly affects modern trauma services and patient outcomes. This study aims to evaluate the accuracy of RUSH and patient outcomes by early detection of the causes of unstable polytrauma. Methods： This cross-sectional, prospective study included 100 unstable polytrauma patients admitted in Suez Canal University Hospital. Clinical exam, RUSH and pan-computed tomography （pan-CT） were conducted. The result of CT was taken as the standard. Patients were managed according to the advanced trauma life support （ATLS） guidelines and treated of life threatening conditions if present. Patients were followed up for 28 days for a short outcome. Results： The most diagnostic causes of unstability in polytrauma patients by RUSH are hypovolemic shock （64%）, followed by obstructive shock （14%）, distributive shock （12%） and cardiogenic shock （10%） respectively. RUSH had 94.2% sensitivity in the diagnosis of unstable polytrauma patients; the accuracy of RUSH in shock patients was 95.2%. Conclusion： RUSH is accurate in the diagnosis of unstable polytrauma patients; and 4% of patients were diagnosed during follow-up after admission by RUSH and pan-CT.
基金The authors gratefully acknowledge the financial support from the Benha University project[Utilization of some agricultural wastes in food and feed processing–A/1/2]2013-2015.
文摘Apple fruits have components of therapeutic nature.Such components,to a great extent,decline or decompose during post-harvest that negatively affect fruit shelf-life.Chitosan fruit-filming has proved useful in maintaining these compounds.This study aims,therefore,at enhancing Chitosan coating-film performance by mixing with some olive wastes extracts of leaf and pomace extracts.Apple fruits were sprayed with six different coating formulas including chitosan-water wax coating,in addition to the uncoated fruits.Then,the total phenolic,flavonoids,antioxidants,pigments,weight loss,decay area,and microstructure were assayed.The bioactive substances drastically changed in uncoated rather than coated fruits.Conversely,weight loss and decay area significantly increased in uncoated fruits.Amazingly,the addition of olive leaf extract to chitosan coating films meaningfully reduced the gradual decline in total phenolic,flavonoids and antioxidants.Olive pomace extract recorded the lowest influencing on anthocyanins during storage at 4±1C for 35 d.Also,both olive leaf and pomace extracts enhanced the coating distribution,due to no pores were observed in the fruits’surfaces.Decidedly,incorporation of olive leaf extracts with 2%into chitosan coating solution was the best formula comparable with the others.Thus,olive wastes extracts,incorporated into chitosan fruit coatings;relatively improve the nutritional quality of apple fruits during post-harvest.
