Search results for: Soraia Assad Nasbine Rabeh

Authors: Elucir Gir, Laelson Rochelle Milanês Sousa, Renata Karina Reis, Soraia Assad Nasbine Rabeh, Mayra Gonçalves Menegueti, Ana Cristina de Oliveira e Silva, Sheila Araújo Teles

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Context and significance: Nursing team professionals faced challenges in combating the COVID-19 pandemic around the world. They were subjected to exhausting workloads and prolonged use of Personal Protective Equipment. Using N95 masks for long periods of time can cause skin changes. In this context, health professionals who worked on the front lines of fighting the pandemic were more exposed to possible physical and psychological changes. Objective: The aim of the study was to analyze the factors associated with skin lesions resulting from the use of N95 masks among nursing team professionals. Method: The study was carried out in all regions of Brazil from October to December 2020, with professionals from the nursing team who worked in health care during the COVID-19 pandemic. Participants were recruited via social media, and information was collected electronically and stored on the Survey Monkey platform. Descriptive statistics were used to characterize the sample, association tests (Chi-square), with a statistical significance level of p < 0.05. Factors associated with skin lesions resulting from the use of an N95 mask were determined by Binary Logistic Regression, with a significance level of 5% (α = 0.05). Results: 8,405 nursing professionals participated in the study, 5,492 nurses (65.3%), 2,747 nursing technicians (32.7%), and 7,084 females (84.3%). Female nursing team professionals were 1.4 times more likely to develop skin lesions due to the use of N95 masks when compared to males (OR 1.4 [CI95% 1.22 – 1.59] p < 0.001). The following protective factors were identified: nursing technician (ORA 0.608 [CI95% 0.43 – 0.86] p = 0.005) and not having provided assistance in field hospitals for COVID-19 (0.73 [CI95% 0.65-0.81] p<0.000). Conclusion: It was concluded that female nursing team professionals were more likely to have skin changes related to the use of N95 masks. The need for intervention studies is emphasized in order to explore measures to prevent these types of injuries. Descritores: Nursing professionals; COVID-19; SARS-CoV-2; Brazil.

Keywords: nursing professionals, COVID-19, SARS-CoV-2, Brazil

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Authors: Haian Dukhan

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The death of Hafez al-Assad and the ascension of his son, Bashar, to rule brought an end to the state-society dynamics that his father worked on for decades. Hafez al-Assad built an authoritarian state that rests on patronage networks that connected his regime to the society. During Bashar’s reign, these patronage relationships have been affected by the policies of privatization and liberalization. Privatization and liberalisation of the economy have created new economic and social players that transformed the populist nature of the authoritarian regime into a regime that is connected mainly with bourgeoisie and the upper class neglecting the rural tribal constituency that was a vital part of Hafez al-Assad’s authoritarian state. Drawing on different data gathered through interviews as well as written literature, this paper will explore the policies that Bashar al-Assad carried out towards the Arab tribes in the period extended from 2000 until 2010. The paper starts by outlining how Bashar al-Assad narrowed the coalition of his rule to depend mainly on his family, the city merchants excluding the lower and middle strata in the periphery. It will then trace the disintegration of the social contract between the regime and the Arab tribe as a result of the latter’s failure to deliver adequate development services in their regions. Losing the support of the tribes undermined the stability of the regime resulting in different clashes between the tribes themselves, the tribes and the Kurds, the tribes and the druze (a sect of Islam situated in Southern Syria), which will be investigated in detail in this paper. In similar policies adopted by his father who used the tribes as leverage against the Islamists and the Kurds, Bashar al-Assad’s regime encouragement of Syrian tribal youth to join the Iraqi insurgency against the Americans will be explored in detail. The regime’s tolerance of Iran missionary activities in the tribal regions and its accommodation of Islamists group’s activities in those regions have erased the regime’s secular foundation. This paper will argue that Bashar al-Assad’s policies towards the Arab tribes have chipped away the regime’s ideological pillars and threatened the longer-term cohesion of its social base which paved the way for the uprising to start in the tribal regions.

Keywords: Syria, tribes, uprising, regime

Procedia PDF Downloads 351

Authors: Assad Maalouf, Lunjin Lu, James Lynott

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We design and implement a precise model of string operations using finite state machine transformers and state transformers to approximate the values string variables can take throughout the execution of the program.We use our model to analyze Android program string variables. Our experimental results show that our string analysis is very efficient at detecting the contextual effect of string operations on the string variables. Our model proved to be very useful when it came to verifying statements about the string variables of the program.

Keywords: abstract interpretation, android, static analysis, string analysis

Procedia PDF Downloads 149

Authors: Assad Maalouf, Lunjin Lu, James Lynott

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We present a taint analysis that can automatically detect when string operations result in a string that is free of taints, where all the tainted patterns have been removed. This is an improvement on the conservative behavior of previous taint analyzers, where a string operation on a tainted string always leads to a tainted string unless the operation is manually marked as a sanitizer. The taint analysis is built on top of a string analysis that uses finite state automata to approximate the sets of values that string variables can take during the execution of a program. The proposed approach has been implemented as an extension of FlowDroid and experimental results show that the resulting taint analyzer is much more precise than the original FlowDroid.

Keywords: android, static analysis, string analysis, taint analysis

Procedia PDF Downloads 146

Authors: Zaaraoui Abdelkader, Kerfah Rabeh, Noura Belkheir, Matene Elhacene

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The trapezoidal bluff body is a typical configuration of vortex shedding bodies. The aim of this work is to study flow behaviour over a trapezoidal cylinder at low Reynolds number. The geometry was constructed from a prototype device for measuring the volumetric flow-rate by counting vortices. Simulations were run for this geometry under steady and unsteady flow conditions using finite volume discretization. Laminar flow was investigated in this model with rigid walls and homogeneous incompressible Newtonian fluid. Calculations were performed for Reynolds number range 5 ≤ Re ≤ 180 and several flow parameters were documented. The present computations are in good agreement with the experimental observations and the numerical calculations by several investigators.

Keywords: bluff body, confined flow, numerical calculations, steady and unsteady flow, vortex shedding flow meter

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Authors: Bendjaballah Malek; Makhlouf Mohammed Rabeh; Boukerche Imane; Benhamza Mohammed El Hocine

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In this study, chitosan was derived from Parapenaeus longirostris shrimp shells sourced from a local market in Annaba, eastern Algeria. The extraction process entailed four chemical stages: demineralization, deproteinization, decolorization, and deacetylation. The degree of deacetylation was calculated to be 80.86 %. The extracted chitosan was physically altered to synthesize chitosan beads and characterized via FTIR and XRD analysis. These beads were employed to eliminate cadmium ions from synthetic water. The batch adsorption process was optimized by analyzing the impact of contact time, pH, adsorbent dose, and temperature. The adsorption capacity of and Cd+2 on chitosan beads was found to be 6.83 mg/g and 7.94 mg/g, respectively. The kinetic adsorption of Cd+2 conformed to the pseudo-first-order model, while the isotherm study indicated that the Langmuir Isotherm model well described the adsorption of cadmium . A thermodynamic analysis demonstrated that the adsorption of Cd+2 on chitosan beads is spontaneous and exothermic.

Keywords: Cd, chitosan, chitosanbeds, bioadsorbent

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Authors: Chadi Azoury, Assad Kallassy, Pierre Rahme

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In this paper, we consider the modal analysis of small frames. Firstly, we construct the 3D model using H8 elements and find the natural frequencies of the frame focusing our attention on the modes in the XY plane. Secondly, we construct the 2D model (plane stress model) using Q4 elements. We concluded that the results of both models are very close to each other’s. Then we formulate the stiffness matrix and the mass matrix of the 3-noded Timoshenko beam that is well suited for thick and short beams like in our case. Finally, we model the corners where the horizontal and vertical bar meet with a special matrix. The results of our new model (3-noded Timoshenko beam for the horizontal and vertical bars and a special element for the corners based on the Q4 elements) are very satisfying when performing the modal analysis.

Keywords: corner element, high-order Timoshenko beam, Guyan reduction, modal analysis of frames, rigid link, shear locking, and short beams

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Authors: Badr M. Alshammari, A. Rabeh, A. K. Mohamed

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This paper presents the modeling and the control of a grid-connected photovoltaic system (PVS). Firstly, the MPPT control of the PVS and its associated DC/DC converter has been analyzed in order to extract the maximum of available power. Secondly, the control system of the grid side converter (GSC) which is a three-phase voltage source inverter (VSI) has been presented. A special attention has been paid to the control algorithms of the GSC converter during grid voltages imbalances. Especially, three different control objectives are to achieve; the mitigation of the grid imbalance adverse effects, at the point of common coupling (PCC), on the injected currents, the elimination of double frequency oscillations in active power flow, and the elimination of double frequency oscillations in reactive power flow. Simulation results of two control strategies have been performed via MATLAB software in order to demonstrate the particularities of each control strategy according to power quality standards.

Keywords: renewable energies, photovoltaic systems, dc link, voltage source inverter, space vector SVPWM, unbalanced voltage dips, symmetrical components

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Authors: Brahim Brahmi, Mohammed Hamza Laraki, Mohammad Habibur Rahman, Islam M. Rasedul, M. Assad Uz-Zaman

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The humanoid robot, specifically the NAO robot must be able to provide a highly dynamic performance on the soccer field. Maintaining the balance of the humanoid robot during the required motion is considered as one of a challenging problems especially when the robot is subject to external disturbances, as contact with other robots. In this paper, a dynamic controller is proposed in order to ensure a robust walking (stabilization) and to improve the dynamic balance of the robot during its contact with the environment (external disturbances). The generation of the trajectory of the center of mass (CoM) is done by a model predictive controller (MPC) conjoined with zero moment point (ZMP) technique. Taking into account the properties of the rotational dynamics of the whole-body system, a modified previous control mixed with feedback control is employed to manage the angular momentum and the CoM’s acceleration, respectively. This latter is dedicated to provide a robust gait of the robot in the presence of the external disturbances. Simulation results are presented to show the feasibility of the proposed strategy.

Keywords: preview control, Nao robot, model predictive control

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Authors: Amira Ben Rabeh, Faouzi Benzarti, Hamid Amiri, Mouna Bouaziz

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Alzheimer is a disease that affects the brain. It causes degeneration of nerve cells (neurons) and in particular cells involved in memory and intellectual functions. Early diagnosis of Alzheimer Diseases (AD) raises ethical questions, since there is, at present, no cure to offer to patients and medicines from therapeutic trials appear to slow the progression of the disease as moderate, accompanying side effects sometimes severe. In this context, analysis of medical images became, for clinical applications, an essential tool because it provides effective assistance both at diagnosis therapeutic follow-up. Computer Assisted Diagnostic systems (CAD) is one of the possible solutions to efficiently manage these images. In our work; we proposed an application to detect Alzheimer’s diseases. For detecting the disease in early stage we used the three sections: frontal to extract the Hippocampus (H), Sagittal to analysis the Corpus Callosum (CC) and axial to work with the variation features of the Cortex(C). Our method of classification is based on Support Vector Machine (SVM). The proposed system yields a 90.66% accuracy in the early diagnosis of the AD.

Keywords: Alzheimer Diseases (AD), Computer Assisted Diagnostic(CAD), hippocampus, Corpus Callosum (CC), cortex, Support Vector Machine (SVM)

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Authors: Atitallah Sofien, Bouyahia Olfa, Hadj Salah Ibrahim, Ben Saleh Foued, Missaoui Nada, Ben Rabeh Rania, Yahyaoui Salem, Mazigh Sonia, Boukthir Samir

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Introduction: Carbon monoxide (CO) poisoning is a common pathology responsible for high morbidity and mortality worldwide. Aim: The purpose of this study was to determine the epidemiological profile of CO poisoning as well as its clinical, paraclinical, therapeutic, and evolutionary aspects. Methods: Our study included observations of CO poisoning in children hospitalized in the pediatric department C of the Children's Hospital in Tunis over a period of 3 years. Results: We have collected 199 cases of CO poisoning in children. The average age was 5.43 years, with a sex ratio of 0.98. The source of CO was inside the home in 73.2% of cases, and it was the gas bath heater in 68.8% of cases. The intoxication was collective in 93.5% of the cases, and it occurred during the month of January in 35.8% of the cases. The clinical manifestations were headaches in 69.5% of cases. The rate of carboxyhemoglobin was pathological in 73.9% of cases. All patients received normobaric oxygen therapy, and only 3.6% of patients had a hyperbaric oxygen therapy session. We did not deplore any case of death in our study. Conclusion: CO poisoning remains a public health problem in Tunisia with high morbidity. The risk of secondary complications, particularly neuropsychiatric, requires clinical and possibly neuroradiological monitoring of these victims.

Keywords: poisoning, carbon monoxide, children, hyperbaric oxygenation

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Authors: Mir Hussain Nawaz, Lyudmila Nedyalkova, Haizhong Zhu, Wael M. Rabeh

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In this study, we aim to biochemically and structurally characterize the interactions of human HK2 with the mitochondria in addition to the role of its N-terminal domain in catalysis and stability of the full-length enzyme. Here, we solved the crystal structure of human HK2 in complex with glucose and glucose-6-phosphate (PDB code: 2NZT), where it is a homodimer with catalytically active N- and C-terminal domains linked by a seven-turn α-helix. Different from the inactive N-terminal domains of isozymes 1 and 3, the N- domain of HK2 not only capable to catalyze a reaction but it is responsible for the thermodynamic stabilizes of the full-length enzyme. Deletion of first α-helix of the N-domain that binds to the mitochondria altered the stability and catalytic activity of the full-length HK2. In addition, we found the linker helix between the N- and C-terminal domains to play an important role in controlling the catalytic activity of the N-terminal domain. HK2 is a major step in the regulation of glucose metabolism in cancer making it an ideal target for the development of new anticancer therapeutics. Characterizing the structural and molecular mechanisms of human HK2 and its role in cancer metabolism will accelerate the design and development of new cancer therapeutics that are safe and cancer specific.

Keywords: cancer metabolism, enzymology, drug discovery, protein stability

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Authors: Assad Rashid, Umair Ahmed, Zafar Baig

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A new trend in construction is widely influenced by the use of Steel-Concrete Composite Columns. The rapid growth in Steel-Concrete Composite construction has widely decreased the conventional R.C.C structures. Steel Concrete composite construction has obtained extensive receiving around the globe. It is considering the fact that R.C.C structures construction is most suitable and economical for low-rise construction, so it is used in farming systems in most of the buildings. However, increased dead load, span restriction, less stiffness and risky formwork make R.C.C construction uneconomical and not suitable when it comes to intermediate to high-rise buildings. A Base + Ground +11 storey commercial building was designed on ETABS 2017 and made a comparison between conventional R.C.C and encased composite column structure. After performing Equivalent Static non-linear analysis, it has been found that construction cost is 13.01% more than R.C.C structure but encased composite column building has 7.7% more floor area. This study will help in understanding the behavior of conventional R.C.C structure and Encased Composite column structure.

Keywords: composite columns structure, equivalent static non-linear analysis, comparison between R.C.C and encased composite column structures, cost-effective structure

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Authors: Atitallah Sofien, Missaoui Nada, Ben Rabeh Rania, Yahyaoui Salem, Mazigh Sonia, Bouyahia Olfa, Boukthir Samir

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Introduction: Acute bronchiolitis (AB) is a real public health problem on a global and national scale. Its treatment is most often outpatient. The use of audio-visual supports, such as educational videos, is an innovation in therapeutic education in outpatient treatment. The aim of our study was to evaluate the impact of an educational video on the knowledge, attitudes, and practices of mothers of infants with AB. Methodology: This was a descriptive, analytical, and cross-sectional study with prospective data collection, including mothers of infants with AB. We assessed mothers' knowledge, attitudes, and practices regarding AB, and we created an educational video. We used a questionnaire written in Tunisian Arabic concerning sociodemographic data, mothers' knowledge and attitudes regarding AB, and their opinions on the video, as well as an observation grid to evaluate their practices on the nasopharyngeal unblocking technique. We compared the different parameters before and after watching the video. Results: We noted a statistically significant improvement in mothers' knowledge scores on AB (7.46 in the pre-test versus 14.08 in the post-test; p≤0.05), practices (12.42 in the pre-test versus 18 in the post-test; p≤0.05) and attitudes (5.86 in pre-test versus 9.02 in post-test; p≤0.05). Conclusion: The use of an educational video has a positive impact on the knowledge, practices, and attitudes of mothers towards AB.

Keywords: acute bronchiolitis, therapeutic education, mothers, educational video

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Authors: Khalid Kaddoura, Ahmed Assad, Tarek Zayed

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Sewer pipelines are prone to deterioration over-time. In fact, their deterioration does not follow a fixed downward pattern. This is in fact due to the defects that propagate through their service life. Sewer pipeline defects are categorized into distinct groups. However, the main two groups are the structural and operational defects. By definition, the structural defects influence the structural integrity of the sewer pipelines such as deformation, cracks, fractures, holes, etc. However, the operational defects are the ones that affect the flow of the sewer medium in the pipelines such as: roots, debris, attached deposits, infiltration, etc. Yet, the process for each defect to emerge follows a cause and effect relationship. Deformation, which is the change of the sewer pipeline geometry, is one type of an influencing defect that could be found in many sewer pipelines due to many surrounding factors. This defect could lead to collapse if the percentage exceeds 15%. Therefore, it is essential to predict the deformation percentage before confronting such a situation. Accordingly, this study will predict the percentage of the deformation defect in sewer pipelines adopting the multiple regression analysis. Several factors will be considered in establishing the model, which are expected to influence the defamation defect severity. Besides, this study will construct a time-based curve to understand how the defect would evolve overtime. Thus, this study is expected to be an asset for decision-makers as it will provide informative conclusions about the deformation defect severity. As a result, inspections will be minimized and so the budgets.

Keywords: deformation, prediction, regression analysis, sewer pipelines

Procedia PDF Downloads 155

Authors: Christopher Leung, Assad Zahid

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Mesenteric vasculitis can often mimic abdominal sepsis in a postoperative setting leading to a predicament where steroids could improve mesenteric vasculitis whilst worsening abdominal sepsis. Here this study presents a unique and rare case of perforated sigmoid diverticulitis secondary to systemic vasculitis. A 68-year-old gentleman presented with perforated sigmoid diverticulitis requiring an emergency Hartmann’s procedure. Early in his postoperative course, he had painful and asymmetrical neuropathy that, after a careful history and examination, revealed a patient with mono neuritis multiplex on a background history of longstanding rheumatoid arthritis. On day seven of his postoperative course, he had rising inflammatory markers and a CT abdomen and pelvis showing fluid around the mesentery. Whilst contamination from sigmoid perforation was somewhat congruent with these signs, a diagnosis of polyarteritis nodosa, a common cause of mononeuritis multiplex, is also possible, although involvement of the large bowel in polyarteritis nodosa is extremely rare. The histopathology from the initial Hartmann’s procedure was re-examined, showing medium vessel disease vasculitis. Given his lack of fevers, absence of abdominal pain, and worsening neurology, he was given a provisional diagnosis of polyarteritis nodosa and was treated successfully, not on IV antibiotics but on steroids. Large bowel involvement of polyarteritis nodosa is extremely rare and this is the first case of polyarteritis nodosa causing perforated diverticulitis. The learning point here is to obtain a good clinical picture of a patient to identify mesenteric vasculitis as compared to abdominal sepsis as the treatment of one worsens the other.

Keywords: abdominal sepsis, diverticulitis, mesenteric vasculitis, polyarteritis nodosa

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Authors: Ebru Nergiz

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The world is facing one of the biggest refugee crisis’ in history as hundred thousands of refugees who run away from the battle and genocide in the Middle East are travelling illegally to reach Europe over the Mediterranean and Aegean Sea. The number of refugees has reached huge numbers due to the civil war that was caused by the Arab Spring. The number of asylum applications to the European Union has also increased in parallel with the increase in the number of refugees. The conflict in Syria between the government of Bashar Al-Assad and various other forces, which started in the spring of 2011, continues to cause displacement within the country and across the region. The refugee situation caused by the Syrian conflict has placed enormous strain on neighboring countries Lebanon, Jordan, Iraq, Egypt, and especially Turkey. Turkey hosts massive numbers of Syrian refugees, almost 3 million and Syrians have been seeking protection in increasing numbers. The refugee crisis has affected the relationships between Turkey and the European Union deeply. President of the European Council Donald Tusk chaired a meeting of EU heads of state or government with Turkey on 29 November 2015. The meeting opened a new era in the relationships between Turkey and the European Union in terms of the migration crisis. The EU and Turkey agreed to negotiate Turkey's accession process to the European Union and to hold regular summits on Turkey-EU relations and discuss these issues. This paper looks at the reasons and consequences of the European refugee crisis and its effects on Turkey- European Union relationships. This paper also argues that the European Union has not sufficiently contributed toward alleviating the burden caused by the refugee influx, in terms of both financial assistance and refugee resettlement. The European Union’s priority is to guarantee that the lowest possible number of refugees reach Europe rather than to ensure the security of the refugees.

Keywords: European Union, human rights, refugee crisis, Turkey-European union relationships

Procedia PDF Downloads 267

Authors: Atitallah Sofien, Bouyahia Olfa, Krifi Farah, Missaoui Nada, Ben Rabeh Rania, Yahyaoui Salem, Mazigh Sonia, Boukthir Samir

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Introduction: Cutis marmorata telangiectatica congenita (CMTC) is a rare cutaneous vascular malformation. It most often appears at birth or during the first days of life. Its origin is still unknown. It associates a livedo with telangiectasias of diffuse or segmental topography. In rare cases, it can be associated with neurological disorders such as macrocephaly and, less frequently, with epilepsy. Methodology: We report a case of an infant with Macrocephaly- Cutis marmorata telangiectatica congenita syndrome associated with epilepsy. Results: This is the case of a one month and 15 days old female infant from a non-consanguineous marriage, admitted for a status epilepticus in the context of apyrexia. Infectious and metabolic causes had been eliminated. Physical examination had shown non-infiltrated and reticular livedoid erythematous patches affecting the left upper limb and atrophic on the back of the left hand. Cerebral magnetic resonance imaging (MRI) showed thin layers of bifrontal, temporal, and left parietal hygromas associated with the widening of the bifrontal subarachnoid spaces. The electroencephalogram showed a well-organized sleep tracing with a single right occipital paroxysmal abnormality. Antiepileptic treatment has been administered with good clinical evolution and regression of the skin lesion and a control electroencephalogram without abnormality. Conclusion: This observation illustrates an association of CMTC with both macrocephaly and epilepsy. This pathology, which is relatively benign and has a good prognosis, generally does not require treatment. However, a detailed examination must be carried out, and a follow-up plan must be put in place for each patient presenting with CMTC, given the risk of association with other abnormalities, which can be potentially serious.

Keywords: cutis marmorata telangiectatica congenita, macrocephaly, epilepsy, children

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Authors: Gilda Santos, Rita Marques, Francisca Marques, João Ribeiro, André Fonseca, João M. Miranda, João B. L. M. Campos, Soraia F. Neves

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Every year, an unacceptable number of firefighters are seriously burned during firefighting operations, with some of them eventually losing their life. Although thermal protective clothing research and development has been searching solutions to minimize firefighters heat load and skin burns, currently commercially available solutions focus in solving isolated problems, for example, radiant heat or water-vapor resistance. Therefore, episodes of severe burns and heat strokes are still frequent. Taking this into account, a consortium composed by Portuguese entities has joined synergies to develop an innovative protective clothing system by following a procedure based on the application of numerical models to optimize the design and using a combinationof protective clothing components disposed in different layers. Recently, it has been shown that Phase Change Materials (PCMs) can contribute to the reduction of potential heat hazards in fire extinguish operations, and consequently, their incorporation into firefighting protective clothing has advantages. The greatest challenge is to integrate these materials without compromising garments ergonomics and, at the same time, accomplishing the International Standard of protective clothing for firefighters – laboratory test methods and performance requirements for wildland firefighting clothing. The incorporation of PCMs into the firefighter's protective jacket will result in the absorption of heat from the fire and consequently increase the time that the firefighter can be exposed to it. According to the project studies and developments, to favor a higher use of the PCM storage capacityand to take advantage of its high thermal inertia more efficiently, the PCM layer should be closer to the external heat source. Therefore, in this stage, to integrate PCMs in firefighting clothing, a mock-up of a vest specially designed to protect the torso (back, chest and abdomen) and to be worn over a fire-resistant jacketwas envisaged. Different configurations of PCMs, as well as multilayer approaches, were studied using suitable joining technologies such as bonding, ultrasound, and radiofrequency. Concerning firefighter’s protective clothing, it is important to balance heat protection and flame resistance with comfort parameters, namely, thermaland water-vapor resistances. The impact of the most promising solutions regarding thermal comfort was evaluated to refine the performance of the global solutions. Results obtained with experimental bench scale model and numerical simulation regarding the integration of PCMs in a vest designed as protective clothing for firefighters will be presented.

Keywords: firefighters, multilayer system, phase change material, thermal protective clothing

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Authors: Atitallah Sofien, Bouyahia Olfa, Krifi farah, Missaoui Nada, Ben Rabeh Rania, Yahyaoui Salem, Mazigh Sonia, Boukthir Samir

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Introduction: Subcutaneous fat necrosis of the newborn (SCFN) is a rare acute hypodermatitis characterized by skin lesions in the form of infiltrated, hard plaques and subcutaneous nodules, with a purplish-red color, occurring between the first and sixth week of life. SCFN is generally a benign condition that spontaneously regresses without sequelae, but it can be complicated by severe hypercalcemia. Methodology: This is a retrospective case report of neonatal subcutaneous fat necrosis complicated with severe hypercalcemia and nephrocalcinosis. Results: This is a case of a female newborn with a family history of a hypothyroid mother on Levothyrox, born to non-consanguineous parents and from a well-monitored pregnancy. The newborn was delivered by cesarean section at 39 weeks gestation due to severe preeclampsia. She was admitted to the Neonatal Intensive Care Unit at 1 hour of life for the management of grade 1 perinatal asphyxia and immediate neonatal respiratory distress related to transient respiratory distress. Hospitalization was complicated by a healthcare-associated infection, requiring intravenous antibiotics for ten days, with a good clinical and biological response. On the 20th day of life, she developed skin lesions in the form of indurated purplish-red nodules on the back and on both arms. A SCFN was suspected. A calcium level test was conducted, which returned a result of 3 mmol/L. The rest of the phosphocalcic assessment was normal, with early signs of nephrocalcinosis observed on renal ultrasound. The diagnosis of SCFN complicated by nephrocalcinosis associated with severe hypercalcemia was made, and the condition improved with intravenous hydration and corticosteroid therapy. Conclusion: SCFN is a rare and generally benign hypodermatitis in newborns with an etiology that is still poorly understood. Despite its benign nature, SCFN can be complicated by hypercalcemia, which can sometimes be life-threatening. Therefore, it is important to conduct a thorough skin examination of newborns, especially those with risk factors, to detect and correct any potential hypercalcemia.

Keywords: subcutaneous fat necrosis, newborn, hypercalcemia, nephrocalcinosis

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Authors: Atitallah Sofien, Bouyahia Olfa, Attar Souleima, Missaoui Nada, Ben Rabeh Rania, Yahyaoui Salem, Mazigh Sonia, Boukthir Samir

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Introduction: Ciliopathies are a spectrum of diseases that have in common a defect in the synthesis of ciliary proteins. It is a rare cause of neonatal cholestasis. Clinical presentation varies extremely, and the main affected organs are the kidneys, liver, and pancreas. Methodology: This is a descriptive case report of a newborn who was admitted for exploration of neonatal cholestasis in the Paediatric Department C at the Children’s Hospital of Tunis, where the investigations concluded with a rare genetic mutation. Results: This is the case of a newborn male with no family history of hepatic and renal diseases, born to consanguineous parents, and from a well-monitored uneventful pregnancy. He developed jaundice on the second day of life, for which he received conventional phototherapy in the neonatal intensive care unit. He was admitted at 15 days for mild bronchiolitis. On clinical examination, intense jaundice was noted with normal stool and urine colour. Initial blood work showed an elevation in conjugated bilirubin and a high gamma-glutamyl transferase level. Transaminases and prothrombin time were normal. Abdominal sonography revealed hepatomegaly, splenomegaly, and undifferentiated renal cortex with bilateral medullar micro-cysts. Kidney function tests were normal. The infant received ursodeoxycholic acid and vitamin therapy. Genetic testing showed a homozygous mutation in the DCDC2 gene that hadn’t been documented before confirming the diagnosis of renal-hepatic ciliopathy. The patient has regular follow-ups, and his conjugated bilirubin and gamma-glutamyl transferase levels have been decreasing. Conclusion: Genetic testing has revolutionized the approach to etiological diagnosis in pediatric cholestasis. It enables personalised treatment strategies to better enhance the quality of life of patients and prevent potential complications following adequate long-term monitoring.

Keywords: cholestasis, newborn, ciliopathy, DCDC2, genetic

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Authors: Soraia V. M. de Sá, Miguel A. Faria, José O. Fernandes, Sara C. Cunha

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Cereals play a vital role in fulfilling the nutritional needs of children, supplying essential nutrients crucial for their growth and development. However, concerns arise due to children's heightened vulnerability due to their unique physiology, specific dietary requirements, and relatively higher intake in relation to their body weight. This vulnerability exposes them to harmful food contaminants, particularly mycotoxins, prevalent in cereals. Because of the thermal stability of mycotoxins, conventional industrial food processing often falls short of eliminating them. Children, especially those aged 4 months to 12 years, frequently encounter mycotoxins through the consumption of specialized food products, such as instant foods, breakfast cereals, bars, cookie snacks, fruit puree, and various dairy items. A close monitoring of this demographic group's exposure to mycotoxins is essential, as toxins ingestion may weaken children’s immune systems, reduce their resistance to infectious diseases, and potentially lead to cognitive impairments. The severe toxicity of mycotoxins, some of which are classified as carcinogenic, has spurred the establishment and ongoing revision of legislative limits on mycotoxin levels in food and feed globally. While EU Commission Regulation 1881/2006 addresses well-known mycotoxins in processed cereal-based foods and infant foods, the absence of regulations specifically addressing emerging mycotoxins underscores a glaring gap in the regulatory framework, necessitating immediate attention. Emerging mycotoxins have gained mounting scrutiny in recent years due to their pervasive presence in various foodstuffs, notably cereals and cereal-based products. Alarmingly, exposure to multiple mycotoxins is hypothesized to exhibit higher toxicity than isolated effects, raising particular concerns for products primarily aimed at children. This study scrutinizes the presence of 22 mycotoxins of the diverse range of chemical classes in 148 processed cereal-based foods, including 39 breakfast cereals, 25 infant formulas, 27 snacks, 25 cereal bars, and 32 cookies commercially available in Portugal. The analytical approach employed a modified QuEChERS procedure followed by ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) analysis. Given the paucity of information on the risk assessment of children to multiple mycotoxins in cereal and cereal-based products consumed by children of Portugal pioneers the evaluation of this critical aspect. Overall, aflatoxin B1 (AFB1) and aflatoxin G2 (AFG2) emerged as the most prevalent regulated mycotoxins, while enniatin B (ENNB) and sterigmatocystin (STG) were the most frequently detected emerging mycotoxins.

Keywords: cereal-based products, children´s nutrition, food safety, UPLC-MS/MS analysis

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Authors: A. Assad, T. Zayed

Abstract:

Water networks (WNs) are responsible of providing adequate amounts of safe, high quality, water to the public. As other critical infrastructure systems, WNs are subjected to deterioration which increases the number of breaks and leaks and lower water quality. In Canada, 35% of water assets require critical attention and there is a significant gap between the needed and the implemented investments. Thus, the need for efficient rehabilitation programs is becoming more urgent given the paradigm of aging infrastructure and tight budget. The first step towards developing such programs is to formulate a Performance Index that reflects the current condition of water assets along with its criticality. While numerous studies in the literature have focused on various aspects of condition assessment and reliability, limited efforts have investigated the criticality of such components. Critical water mains are those whose failure cause significant economic, environmental or social impacts on a community. Inclusion of criticality in computing the performance index will serve as a prioritizing tool for the optimum allocating of the available resources and budget. In this study, several social, economic, and environmental factors that dictate the criticality of a water pipelines have been elicited from analyzing the literature. Expert opinions were sought to provide pairwise comparisons of the importance of such factors. Subsequently, Fuzzy Logic along with Analytical Network Process (ANP) was utilized to calculate the weights of several criteria factors. Multi Attribute Utility Theories (MAUT) was then employed to integrate the aforementioned weights with the attribute values of several pipelines in Montreal WN. The result is a criticality index, 0-1, that quantifies the severity of the consequence of failure of each pipeline. A novel contribution of this approach is that it accounts for both the interdependency between criteria factors as well as the inherited uncertainties in calculating the criticality. The practical value of the current study is represented by the automated tool, Excel-MATLAB, which can be used by the utility managers and decision makers in planning for future maintenance and rehabilitation activities where high-level efficiency in use of materials and time resources is required.

Keywords: water networks, criticality assessment, asset management, fuzzy analytical network process

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Authors: Atitallah Sofien, Bouyahia Olfa, Romdhani Meriam, Missaoui Nada, Ben Rabeh Rania, Yahyaoui Salem, Mazigh Sonia, Boukthir Samir

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Introduction: Spondylothoracic dysostosis, also known as Jarcho-Levin syndrome, is defined by a shortened neck and thorax, a protruding abdomen, inguinal and umbilical hernias, atypical spinal structure and rib fusion, leading to restricted chest movement or difficulty in breathing, along with urinary tract abnormalities and, potentially severe scoliosis. Aim: This is the case of a patient diagnosed with Jarcho-Levin syndrome, aiming to detail the range of abnormalities observed in this syndrome, the observed complications, and the therapeutic approaches employed. Results: A three-month-old male infant, born of a consanguineous marriage, delivered at full term by cesarean section, was admitted to the pediatric department for severe acute bronchiolitis. In his prenatal history, morphological ultrasound revealed macrosomia, a shortened spine, irregular vertebrae with thickened skin, normal fetal cardiac ultrasound, and the absence of the right kidney. His perinatal history included respiratory distress, requiring ventilatory support for five days. Upon physical examination, he had stunted growth, scoliosis, a short neck and trunk, longer upper limbs compared to lower limbs, varus equinus in the right foot, a neural tube defect, a low hairline, and low-set ears. Spondylothoracic dysostosis was suspected, leading to further investigations, including a normal transfontaneous ultrasound, a spinal cord ultrasound revealing a lipomyelocele-type closed dysraphism with a low-attached cord, an abdominal ultrasound indicating a single left kidney, and a cardiac ultrasound identifying Kommerell syndrome. Due to a lack of resources, genetic testing could not be performed, and the diagnosis was based on clinical criteria. Conclusion: Jarcho-Levin syndrome can result in a mortality rate of about 50%, primarily due to respiratory complications associated with thoracic insufficiency syndrome. Other complications, like heart and neural tube defects, can also lead to premature mortality. Therefore, early diagnosis and comprehensive treatment involving various specialists are essential.

Keywords: Jarcho-Levin syndrome, congenital disorder, scoliosis, spondylothoracic dysostosis, neural tube defect

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Authors: Wael M. Rabeh, Cesar Carrasco-Lopez, Juliana C. Ferreira, Pance Naumov

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Bioluminescence, the emission of light from a biological process, is found in various living organisms including bacteria, fireflies, beetles, fungus and different marine organisms. Luciferase is an enzyme that catalyzes a two steps oxidation of luciferin in the presence of Mg2+ and ATP to produce oxyluciferin and releases energy in the form of light. The luciferase assay is used in biological research and clinical applications for in vivo imaging, cell proliferation, and protein folding and secretion analysis. The luciferase enzyme consists of two domains, a large N-terminal domain (1-436 residues) that is connected to a small C-terminal domain (440-544) by a flexible loop that functions as a hinge for opening and closing the active site. The two domains are separated by a large cleft housing the active site that closes after binding the substrates, luciferin and ATP. Even though all insect luciferases catalyze the same chemical reaction and share 50% to 90% sequence homology and high structural similarity, they emit light of different colors from green at 560nm to red at 640 nm. Currently, the majority of the structural and biochemical studies have been conducted on green-emitting firefly luciferases. To address the color emission mechanism, we expressed and purified two luciferase enzymes with blue-shifted green and red emission from indigenous Brazilian species Amydetes fanestratus and Phrixothrix, respectively. The two enzymes naturally emit light of different colors and they are an excellent system to study the color-emission mechanism of luciferases, as the current proposed mechanisms are based on mutagenesis studies. Using a vapor-diffusion method and a high-throughput approach, we crystallized and solved the crystal structure of both enzymes, at 1.7 Å and 3.1 Å resolution respectively, using X-ray crystallography. The free enzyme adopted two open conformations in the crystallographic unit cell that are different from the previously characterized firefly luciferase. The blue-shifted green luciferase crystalized as a monomer similar to other luciferases reported in literature, while the red luciferases crystalized as an octamer and was also purified as an octomer in solution. The octomer conformation is the first of its kind for any insect’s luciferase, which might be relate to the red color emission. Structurally designed mutations confirmed the importance of the transition between the open and close conformations in the fine-tuning of the color and the characterization of other interesting mutants is underway.

Keywords: bioluminescence, enzymology, structural biology, x-ray crystallography

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Authors: Atitallah Sofien, Bouyahia Olfa, Romdhani Meriam, Missaoui Nada, Ben Rabeh Rania, Yahyaoui Salem, Mazigh Sonia, Boukthir Samir

Abstract:

Introduction: Traditional medicine refers to a diverse range of therapeutic practices and knowledge systems that have been employed by different cultures over an extended period to uphold and rejuvenate health. These practices can involve herbal remedies, acupuncture, massage, and alternative healing methods that deviate from conventional medical approaches. In Tunisia, we often use unidentified utensils to scratch the oral cavity internally in infants in order to widen the oral cavity for better breathing and swallowing. However, these practices can be risky and may jeopardize the patients' prognosis or even their lives. Aim: This is the case of a nine-month-old infant, admitted to the pediatric department and subsequently to the intensive care unit due to a peritonsillar abscess following the utilization of an unidentifiable tool to scrape the interior of the oral cavity. Case Report: This is a 9-month-old infant with no particular medical history, admitted for high respiratory distress and a fever persisting for 4 days. On clinical examination, he had a respiratory rate of 70 cycles per minute with an oxygen saturation of 97% and subcostal retractions, along with a heart rate of 175 beats per minute. His white blood cell count was 40,960/mm³, and his C-reactive protein was 250 mg/L. Given the severity of the clinical presentation, the infant was transferred to the intensive care unit, intubated, and mechanically ventilated. A cervical-thoracic CT scan was performed, revealing a ruptured 18 mm left peritonsillar abscess in the oropharynx associated with cellulitis of the retropharyngeal space. The oto-rhino-laryngoscopic examination revealed an asymmetry involving the left lateral wall of the oropharynx with the presence of a fistula behind the posterior pillar. Dissection of the collection cavity was performed, allowing the drainage of 2 ml of pus. The culture was negative. The patient received cefotaxime in combination with metronidazole and gentamicin for a duration of 10 days, followed by a switch to amoxicillin-clavulanic acid for 7 days. The patient was extubated after 4 days of treatment, and the clinical and radiological progress was favorable. Conclusions: Traditional medicine remains risky due to the lack of scientific evidence and the potential for injuries and transmission of infectious diseases, especially in children, who constitute a vulnerable population. Therefore, parents should consult healthcare professionals and rely on evidence-based care.

Keywords: children, peritonsillar abscess, traditional medicine, respiratory distress

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Authors: Omair Anas

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The Persian Gulf has been in turmoil for a long time since the colonial administration has handed over the role to the small and weak kings and emirs who were assured of protection in return of many economic and security promises to them. The regional order, Saudi Arabia evolved was a rentier regional order secured by an expansion of rentier economy and taking responsibility for much of the expenses of the regional order on behalf of relatively poor countries. The two oil booms helped the Saudi state to expand the 'rentier order' driven stability and bring the countries like Egypt, Jordan, Syria, and Palestine under its tutelage. The disruptive misadventure, however, came with Iran's proclamation of the Islamic Revolution in 1979 which it wanted to be exported to its 'un-Islamic and American puppet' Arab neighbours. For Saudi Arabia, even the challenge presented by the socialist-nationalist Arab dictators like Gamal Abdul Nasser and Hafez Al-Assad was not that much threatening to the Saudi Arabia’s then-defensive realism. In the Arab uprisings, the Gulf monarchies saw a wave of insecurity and Iran found it an opportune time to complete the revolutionary process it could not complete after 1979. An alliance of convenience and ideology between Iran and Islamist groups had the real potential to challenge both Saudi Arabia’s own security and its leadership in the region. The disruptive threat appeared at a time when the Saudi state had already sensed an impending crisis originating from the shifts in the energy markets. Low energy prices, declining global demands, and huge investments in alternative energy resources required Saudi Arabia to rationalize its economy according to changing the global political economy. The domestic Saudi reforms remained gradual until the death of King Abdullah in 2015. What is happening now in the region, the Qatar crisis, the Lebanon crisis and the Saudi-Iranian proxy war in Iraq, Syria, and Yemen has combined three immediate objectives, rationalising Saudi economy and most importantly, the resetting the Saudi royal power for Saudi Arabia’s longest-serving future King Mohammad bin Salman. The Saudi King perhaps has no time to wait and watch the power vacuum appearing because of Iran’s expansionist foreign policy. The Saudis appear to be employing an offensive realism by advancing a pro-active regional policy to counter Iran’s threatening influence amid disappearing Western security from the region. As the Syrian civil war is coming to a compromised end with ceding much ground to Iran-controlled militias, Hezbollah and Al-Hashad, the Saudi state has lost much ground in these years and the threat from Iranian proxies is more than a reality, more clearly in Bahrain, Iraq, Syria, and Yemen. This paper attempts to analyse the changing Saudi behaviour in the region, which, the author understands, is shaped by an offensive-realist approach towards finding a favourable security environment for the Saudi-led regional order, a post-rentier order perhaps.

Keywords: terrorism, Saudi Arabia, Rentier State, gulf crisis

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Authors: Joseph M. Rich, Vinay A. Duddalwar, Assad A. Oberai

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Prostate adenocarcinoma is the most common cancer in males, with osseous metastases as the commonest site of metastatic prostate carcinoma (mPC). Treatment monitoring is based on the evaluation and characterization of lesions on multiple imaging studies, including Computed Tomography (CT). Monitoring of the osseous disease burden, including follow-up of lesions and identification and characterization of new lesions, is a laborious task for radiologists. Deep learning algorithms are increasingly used to perform tasks such as identification and segmentation for osseous metastatic disease and provide accurate information regarding metastatic burden. Here, nnUNet was used to produce a model which can segment CT scan images of prostate adenocarcinoma vertebral bone metastatic lesions. nnUNet is an open-source Python package that adds optimizations to deep learning-based UNet architecture but has not been extensively combined with transfer learning techniques due to the absence of a readily available functionality of this method. The IRB-approved study data set includes imaging studies from patients with mPC who were enrolled in clinical trials at the University of Southern California (USC) Health Science Campus and Los Angeles County (LAC)/USC medical center. Manual segmentation of metastatic lesions was completed by an expert radiologist Dr. Vinay Duddalwar (20+ years in radiology and oncologic imaging), to serve as ground truths for the automated segmentation. Despite nnUNet’s success on some medical segmentation tasks, it only produced an average Dice Similarity Coefficient (DSC) of 0.31 on the USC dataset. DSC results fell in a bimodal distribution, with most scores falling either over 0.66 (reasonably accurate) or at 0 (no lesion detected). Applying more aggressive data augmentation techniques dropped the DSC to 0.15, and reducing the number of epochs reduced the DSC to below 0.1. Datasets have been identified for transfer learning, which involve balancing between size and similarity of the dataset. Identified datasets include the Pancreas data from the Medical Segmentation Decathlon, Pelvic Reference Data, and CT volumes with multiple organ segmentations (CT-ORG). Some of the challenges of producing an accurate model from the USC dataset include small dataset size (115 images), 2D data (as nnUNet generally performs better on 3D data), and the limited amount of public data capturing annotated CT images of bone lesions. Optimizations and improvements will be made by applying transfer learning and generative methods, including incorporating generative adversarial networks and diffusion models in order to augment the dataset. Performance with different libraries, including MONAI and custom architectures with Pytorch, will be compared. In the future, molecular correlations will be tracked with radiologic features for the purpose of multimodal composite biomarker identification. Once validated, these models will be incorporated into evaluation workflows to optimize radiologist evaluation. Our work demonstrates the challenges of applying automated image segmentation to small medical datasets and lays a foundation for techniques to improve performance. As machine learning models become increasingly incorporated into the workflow of radiologists, these findings will help improve the speed and accuracy of vertebral metastatic lesions detection.

Keywords: deep learning, image segmentation, medicine, nnUNet, prostate carcinoma, radiomics

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