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Understanding the development and use of musical instruments in prehistory is often hampered by poor preservation of perishable materials and the relative rarity of durable examples. Here, the authors present a pair of third-millennium BC copper cymbals, excavated at Dahwa, Oman. Although they are the only well-contextualised examples from Arabia, the Dahwa cymbals are paralleled by contemporaneous examples from the Indus Valley and images in Mesopotamian iconography. Not only do the cymbals add to the body of evidence interpreted in terms of Indus migrants in Early Bronze Age Oman, they also suggest shared musical and potentially ritual practices around the Arabian Gulf at that time.
To date, implantation is the rate-limiting step for the success of in vitro fertilization (IVF) treatment. Accumulating evidence suggests that immune cells contribute to embryo implantation, and several therapeutic approaches have been proposed for the treatment of recurrent implantation failure (RIF). Endometrial immune modulation with autologous activated peripheral blood mononuclear cells (PBMCs) is one of the most widely used protocols. However, the effect of intrauterine insemination of mixed paternal and maternal-activated PBMCs has not yet been attempted and studied. The aim of our study is to test the effect of the addition of paternal lymphocytes on the implantation rate in RIF patients. Mononuclear cells were isolated from the peripheral blood of 98 RIF patients and cultured for 72 h before insemination into the endometrial cavity 48 h before embryo transfer. Our patients were divided into 4 groups according to the type and number of PBMCs inseminations. Our study shows that activated PBMCs promoted clinical pregnancy rates (CPR) in all groups. Moreover, we found that the groups injected with more than 2 million cells showed a better clinical outcome and, more interestingly, patients inseminated with both paternal and maternal activated PBMCs showed the highest CPR, reaching 47.2%, in addition to the highest implantation rate 31. 2% and the live birth rate 41.39%. Our work demonstrates the importance of administering a large number of activated PBMCs with the addition of paternal activated PBMCs to immunomodulate the endometrium for the success of in vitro fertilization in RIF patients.
Approximately five million individuals have traumatic injuries annually. Implementing prehospital blood-component transfusion (PHBT), encompassing packed red blood cells (p-RBCs), plasma, or platelets, facilitates early hemostatic volume replacement following trauma. The lack of uniform PHBT guidelines persists, relying on diverse parameters and physician experience.
Aim:
This study aims to evaluate the efficacy of various components of PHBT, including p-RBCs and plasma, on mortality and hematologic-related outcomes in traumatic patients.
Methods:
A comprehensive search strategy was executed to identify pertinent literature comparing the transfusion of p-RBCs, plasma, or a combination of both with standard resuscitation care in traumatized patients. Eligible studies underwent independent screening, and pertinent data were systematically extracted. The analysis employed pooled risk ratios (RR) for dichotomous outcomes and mean differences (MD) for continuous variables, each accompanied by their respective 95% confidence intervals (CI).
Results:
Forty studies were included in the qualitative analysis, while 26 of them were included in the quantitative analysis. Solely P-RBCs alone or combined with plasma showed no substantial effect on 24-hour or long-term mortality (RR = 1.13; 95% CI, 0.68 - 1.88; P = .63). Conversely, plasma transfusion alone exhibited a 28% reduction in 24-hour mortality with a RR of 0.72 (95% CI, 0.53 - 0.99; P = .04). In-hospital mortality and length of hospital stay were mostly unaffected by p-RBCs or p-RBCs plus plasma, except for a notable three-day reduction in length of hospital stay with p-RBCs alone (MD = -3.00; 95% CI, -5.01 to -0.99; P = .003). Hematological parameter analysis revealed nuanced effects, including a four-unit increase in RBC requirements with p-RBCs (MD = 3.95; 95% CI, 0.69 - 7.21; P = .02) and a substantial reduction in plasma requirements with plasma transfusion (MD = -0.73; 95% CI, -1.28 to -0.17; P = .01).
Conclusion:
This study revealed that plasma transfusion alone was associated with a substantial decrease in 24-hour mortality. Meanwhile, p-RBCs alone or combined with plasma did not significantly impact 24-hour or long-term mortality. In-hospital mortality and length of hospital stay were generally unaffected by p-RBCs or p-RBCs plus plasma, except for a substantial reduction in length of hospital stay with p-RBCs alone.
We show that the conceptual distance between any two theories of first-order logic is the same as the generator distance between their Lindenbaum–Tarski algebras of concepts. As a consequence of this, we show that, for any two arbitrary mathematical structures, the generator distance between their meaning algebras (also known as cylindric set algebras) is the same as the conceptual distance between their first-order logic theories. As applications, we give a complete description for the distances between meaning algebras corresponding to structures having at most three elements and show that this small network represents all the possible conceptual distances between complete theories. As a corollary of this, we will see that there are only two non-trivial structures definable on three-element sets up to conceptual equivalence (i.e., up to elementary plus definitional equivalence).
The intercalation of kaolinite through the insertion of ions or molecules amongst the structural aluminosilicate layers is a vital process in numerous clay-based applications and products. Layer neutrality and hydrogen bonding limits direct intercalation into kaolinite, other than for small molecules. Synthesizing zirconia-intercalated kaolinite is not a straightforward matter. To overcome this barrier, raw Egyptian kaolin (UnK) or its acid-activated product (HK) was sonicated and impregnated in aqueous ZrOCl2·8H2O solution followed by thermal treatment at various temperatures (100, 200, 300, and 500°C). The intercalation process was confirmed using various spectroscopic and analytical techniques. The direct intercalation of ZrO2 into the kaolinite layers was observed even through a mild thermal treatment (100, 200, and 300°C). The mechanism of intercalation was suggested to occur by binding ZrO2 to the Si/AlO groups with a preference for the acid-activated HK, causing variable enlargements of the basal spacing and producing very perturbed layers. Interestingly, the surface area increased by 250% as a result of zirconia intercalation. Scanning electron microscopy (SEM) images showed a remarkable improvement in the stacking order of the kaolinite particles. The impact of ZrO2 intercalation into kaolinite also enhanced its adsorption efficiency for Pb2+, Cu2+, and Cd2+ ions. Preliminary investigations showed that the zirconia-intercalated HK demonstrated a removal efficiency, which is three times greater than that of pristine HK. The adsorption tendency toward Pb2+ ions was greater than those of Cu2+ and Cd2+ and followed the order: Pb2+ >> Cu2+ > Cd2+. The study suggests that the chemical modification of kaolin by zirconia via a direct intercalation technique, which greatly improves its functionality as demonstrated by the selective sorption of heavy metal ions, is worthy of further study.
Ziziphus lotus is an underappreciated natural genetic resource widespread in Algeria. This study aimed to compare the fruit phytochemical composition of nine populations of Z. lotus from different areas to highlight its diversity. Fruits were harvested from the semiarid, dry steppe and Saharan stages. Primary and secondary metabolites and minerals contents were determined. Significant variations in the fruit phytochemical composition between populations of Z. lotus and between pulp and seeds were recorded. Z. lotus is dry fruit with 8.768 ± 0.449 to 13.468 ± 1.303% water in pulp and 6.7 to 12.12% in seeds. Significantly higher values were recorded in the fruit pulp for sugar (35.25 to 48.87%), phosphorus (63.114 to 155.269 mg 100−1g), sodium (34.8 to 56.91 ppm), calcium (91.78 to 382.69 ppm), β-carotene (36.4 to 46 μg g−1), lycopene (59.15 to 100.25 μg g−1) and chlorophyll a (3.6 to 7.2 μg g−1) contents. Seeds had much higher protein (8.37 to 27.75%), lipid (35.39 to 48.01%), potassium (125.874 to 325.408 mg. 100−1 g), polyphenol (439.465 to 1349.46 mg.GAE.100 g−1), flavonoid (83.908 to 98.259 mg.QE.100 g−1), tannins (55.268 to 277.94 mg.GAE.100 g−1) and chlorophyll b (11.2 to 30.4 μg g−1) contents. Bougtob, Boghar and Mougheul populations had higher primary metabolites and mineral values. Oued Nougued, Maarif and Mougheul populations were the richest in phenolic compounds. Oued Nougued, Maarif and Mougheul populations had more liposoluble pigments. This research is the beginning of investigating the variety of Z. lotus as phylogenetic sources. Further comparative investigations over a larger distribution region and further study of variations in the composition in fruit composition using GC-MS are needed.
Due to the increasing demand for antibiotic-free livestock products from the consumer side and the ban on the use of antibiotic growth promoters, the poultry feed industry is increasingly interested in developing more alternatives to cope with this problem. Organic acids (butyric acid) have many beneficial effects on poultry health, performance, and egg quality when used in their diet, thus they can be considered for the replacement of antibiotics in livestock production systems. Butyric acid is most efficacious against pathogenic bacteria such as Salmonella spp. and Escherichia coli, and stimulates the population of beneficial gut bacteria. It is a primary energy source for colonocytes and augments the differentiation and maturation of the intestinal cells. Collectively, butyric acid should be considered as an alternative to antibiotic growth promoters, because it reduces pathogenic bacteria and their toxins, enhancing gut health thereby increasing nutrient digestibility, thus leading to improved growth performance and immunity among birds. The possible pathways and mechanisms through which butyric acid enhances gut health and production performance are discussed in this review. Detailed information about the use of butyric acid in poultry and its possible benefits under different conditions are also provided, and the impacts of butyric acid on egg quality and osteoporosis are noted.
This study discusses the potentials and challenges of Zoom theatre performances during the lockdown caused by the Covid-19 pandemic. It examines the utilization and applicability of videoconferencing software Zoom, and other streaming software compatible with it, in creating a viable performance option for theatre practitioners and audiences during mandatory social distancing. Such software can be a strategy for social inclusion, alleviating the adverse effects of extended quarantine. The article also discusses the technical and performative aspects of Zoom theatre, pointing out its pros and cons. It uses a critical and analytical approach to performances of two Zoom plays, Pandemic Therapy and Corona Chicken (Part Two), revealing how the playwright, dramaturg, and actors manage to present a live theatrical experience capable of engaging audiences and promoting social interaction. Khaled Mostafa Karam is an Assistant Professor of English Literature at the Suez University in Egypt and a Postdoctoral Fellow in the Department of Cognitive Science, Case Western Reserve University, USA. He has published eleven articles on the interdisciplinary field of cognitive science and drama. Galal Mohamed Naguib is an Assistant Professor of Sociology at Suez University and author of several articles in the fields of demographic analysis and the sociology of art.
Family medicine practitioners (FMP) take care of a varied range of patients with undifferentiated conditions over a lifetime. Although it was incepted in Saudi Arabia in 1980, limited data exists on FMP. This paper explores what family physicians deem relevant.
Methods:
A cross-sectional survey was conducted among FMP in Saudi Arabia in 2018–2019 who responded to an online questionnaire that listed 20 activities usually done by FMP asking them to rate their meaningfulness on a 5-point Likert Scale, and select the top 3 they would like to spend the most and the least time on. Chi-square statistics were used to compare preference for time spent on these six activities by participant characteristics
Results:
Of the 415 survey participants, the majority were male (246) and had a Bachelor’s degree (176). The management of risk conditions, follow-up of chronic illnesses and running preventive health clinics were listed as most meaningful. The majority wished to spend more time on managing health risks, handling daily common complaints and follow-up of chronic illnesses and less time on terminal care activities (46.8%), emergency care (32.3%) and addiction medicine (23.4%). Bachelor’s degree holders wished to spend more time on emergency care compared to Diploma, Board-certified and Fellowship holders (63%, 21%, 10% and 5%, respectively; P = 0.01).
Conclusions:
The activities preferred by FMP align with prevailing disease epidemiology. Variations in preferences of ‘managing emergencies’ reflect the varied format of training. Training of FMP should be standardized and further studies investigate reasons for specific preferences.
This study aims to assess the knowledge and awareness, and to identify the practice reflection of knowledge concerning Middle East Respiratory Syndrome (MERS) on hospital visitor’s daily life.
Methods:
A cross-sectional study, conducted in 2 tertiary referral hospitals in Riyadh Saudi Arabia, from February 2015 to February 2016. A total random sample of 305 hospital visitors consented to participate. Data were collected through a self-administered questionnaire consisting of questions regarding awareness and practice of measures to prevent the spread of infection.
Results:
Study showed that participants have a fair knowledge regarding the cause of MERS (N = 228; 74.8%). Nearly half of them (47%) stated that camels are the source of the spread of MERS. Approximately 70% of the participants preferred both sanitization and wearing facemasks as preventive measures for MERS. However, only 3.95% practiced not eating camel products, such as milk and meat.
Conclusions:
Although hospital visitors showed some knowledge and positive awareness in several aspects of MERS awareness, there are weak areas where knowledge and awareness were not up to recommended guidelines. Continued educational programs are needed to improve awareness and knowledge of all the public toward MERS-coronavirus infection. This study may assist in the development of future strategies on preventive measures of the disease.
Port-a-Cath or chemoport provides prolonged central venous access for cancer patients requiring prolonged chemotherapy. Prolonged use of chemoport is associated with many complications. Dislodgement and migration of chemoport catheter is a rare and reportable complication with potentially serious consequences.
Methods:
The medical charts of 1222 paediatric cancer patients admitted to the Children’s Cancer Center in Lebanon who had chemoports inserted for long-term chemotherapy were retrospectively reviewed. Descriptive analysis of data was conducted.
Results:
Chemoport fracture and migration were found in seven cases with an incidence of 0.57%. The duration of chemoport use before the event of dislodgement varied from 2 months to 102 months. Non-functioning chemoport was the most common presentation. Totally, six cases were managed successfully by loop snaring, three cases by paediatric cardiology team, and three cases by interventional radiology team. One case was managed surgically during chemoport removal.
Conclusion:
Fracture and migration of chemoport catheter is a rare complication of uncertain aetiology and with potentially serious consequences. Percutaneous retrieval, done by experienced cardiologist or interventional radiologist, is the first choice for management of this complication as it is considered as a safe and effective approach.
Basal ganglia (BG) lesions are rarely reported in patients with uremia and may manifest by movement disorders. However, their exact incidence and pathogenesis have not been extensively studied. This study aimed to determine the frequency, types, risk variables (clinical, laboratory, and imaging), and manifestations of BG lesions with uremia and patients’ neurologic outcomes.
Methods:
This observational study included 70 adults (mean age: 45.87 ± 3.36 years; duration of uremia: 5.5 ± 1.5 years). They underwent extensive evaluations (clinical, laboratory, and neuroimaging) and had prospectively evaluated clinically every 3 months for 2 years. Repeated magnetic resonance imaging (MRI) brains were done to patients with movement disorders and correlated with their neurologic outcomes.
Results:
BG lesions were found in 15 patients (21.4%) and 6 (8.6%) had movement disorders [Parkinsonism (n = 4), choreo-dystonia (n = 1) and dystonia (n = 1)] after the onset of uremia (mean = 10 months). There were no characteristic risk variables that distinguished patients with movement disorders from those without. Five developed movement disorders prior to the period of the study and one was de novo. The majority was females and had diabetes and higher frequencies of abnormal renal dysfunction, metabolic derangements, and white matter hyperintensities in MRIs. Movement disorders persisted in all patients despite the resolution of neuroimaging in three patients.
Conclusions:
There is no clear threshold for renal failure to result in movement disorders due to BG lesions. The clinical outcome is variables depending on each patient’s comorbidities and complications. Persistent neuronal damage (due to uremic toxins/metabolic/nutritional and ischemic/microvascular factors) has been suggested as the cause of poor neurologic outcomes.
In the literature, there have been several methods and definitions for working out whether two theories are “equivalent” (essentially the same) or not. In this article, we do something subtler. We provide a means to measure distances (and explore connections) between formal theories. We introduce two natural notions for such distances. The first one is that of axiomatic distance, but we argue that it might be of limited interest. The more interesting and widely applicable notion is that of conceptual distance which measures the minimum number of concepts that distinguish two theories. For instance, we use conceptual distance to show that relativistic and classical kinematics are distinguished by one concept only.
Artificial Neural Networks (ANNs)-based techniques have dominated state-of-the-art results in most problems related to computer vision, audio recognition, and natural language processing in the past few years, resulting in strong industrial adoption from all leading technology companies worldwide. One of the major obstacles that have historically delayed large-scale adoption of ANNs is the huge computational and power costs associated with training and testing (deploying) them. In the mean-time, Neuromorphic Computing platforms have recently achieved remarkable performance running the bio-realistic Spiking Neural Networks at high throughput and very low power consumption making them a natural alternative to ANNs. Here, we propose using the Random Neural Network, a spiking neural network with both theoretical and practical appealing properties, as a general purpose classifier that can match the classification power of ANNs on a number of tasks while enjoying all the features of being a spiking neural network. This is demonstrated on a number of real-world classification datasets.
When patients feel spiritually supported by staff, we find increased use of hospice and reduced use of aggressive treatments at end of life, yet substantial barriers to staff spiritual care provision still exist. We aimed to study these barriers in a new cultural context and analyzed a new subgroup with “unrealized potential” for improved spiritual care provision: those who are positively inclined toward spiritual care yet do not themselves provide it.
Method
We distributed the Religion and Spirituality in Cancer Care Study via the Middle East Cancer Consortium to physicians and nurses caring for advanced cancer patients. Survey items included how often spiritual care should be provided, how often respondents themselves provide it, and perceived barriers to spiritual care provision.
Result
We had 770 respondents (40% physicians, 60% nurses) from 14 Middle Eastern countries. The results showed that 82% of respondents think staff should provide spiritual care at least occasionally, but 44% provide spiritual care less often than they think they should. In multivariable analysis of respondents who valued spiritual care yet did not themselves provide it to their most recent patients, predictors included low personal sense of being spiritual (p < 0.001) and not having received training (p = 0.02; only 22% received training). How “developed” a country is negatively predicted spiritual care provision (p < 0.001). Self-perceived barriers were quite similar across cultures.
Significance of results
Despite relatively high levels of spiritual care provision, we see a gap between desirability and actual provision. Seeing oneself as not spiritual or only slightly spiritual is a key factor demonstrably associated with not providing spiritual care. Efforts to increase spiritual care provision should target those in favor of spiritual care provision, promoting training that helps participants consider their own spirituality and the role that it plays in their personal and professional lives.
Two administrations of the Coloured Progressive
Matrices in Egypt were compared. The first was
administered to a large, representative national
sample between 2011 and 2013. The second was
administered to primary school pupils in villages in
Menoufia in northern Egypt in 2017. Adjusting for
the Flynn Effect, the IQ of the rural northern
Egyptians was shown to be statistically
significantly higher than the national average. It
is demonstrated that this is consistent with
regional socioeconomic differences in Egypt, which
strongly imply that northern Egypt has a higher
average IQ than southern Egypt.
This study was based on data for a sample of 1756 Egyptian primary school children (863 boys and 893 girls) aged 5–11 years assessed for intelligence with Raven’s Coloured Progressive Matrices (CPM). The results showed that boys obtained a slightly higher IQ than girls and had greater variance.
Health Technology Assessment (HTA) reports adaptation process is an important tool for emerging HTA agencies. INASanté (National Instance for Accreditation in Healthcare) has chosen to rely on this approach, to develop its first health intervention assessment report: comparative study of computed tomographic colonography versus standard colonoscopy for colorectal cancer screening.
METHODS:
Following consultations with healthcare professionals, the PICO question related to the colorectal cancer screening issue in Tunisia was determined. A literature search strategy covering 10 years (2006-2016) was carried out. Several databases including HTA on the net were explored. Then two independent reviewers conducted literature screening and realized a PRISMA flow diagram. Full text selected reports were submitted to three critical appraisal tools: PRISMA checklist, INAHTA checklist and Critical Appraisal Tools (FLC 2.0). The EUnetHTA adaptation toolkit was used to determine reports adaptability by assessing relevance, reliability and transferability. A structured study of the Tunisian context based on a qualitative data analysis was elaborated. The data synthesis and reporting were finalized with the contribution of a working group. Then an external peer review was conducted before the report dissemination.
RESULTS:
Eighty reports were screened to finally retain four eligible. After a critical appraisal performed by two independent reviewers, two reports from the Canadian Agency for Drug and Technolgies in Healthcare and AETSA were selected to be assessed using the EUnetHTA adaptation toolkit. Regarding transferability criteria, the second report was retained. The context study has consisted in a qualitative analysis of seventeen individual interviews with healthcare professionals involved in colorectal cancer screening issues and an up to date Tunisian literature review. The final adapted report was a combination between relevant extracted data from AETSA report and synthesis of the Tunisian context analysis.
CONCLUSIONS:
This HTA report represents a tool for policy makers to establish the appropriate colorectal cancer screening program for the Tunisian context. HTA reports adaptation process is the best way to give evidence on emerging technologies without wasting time and resources.
Glasses doped with rare earth elements (lanthanide series) are the most popular materials used in upconversion devices. The main aspect to develop these devices is to find suitable host materials for rare earth ions. The host material should have a high transmission of the upconverted photons, high thermal stability, good mechanical properties, low price, and easy to manufacture and shaping. Present work is concerned with studying the mechanical and structural properties for the oxide glass system doped with rare earth metal (erbium oxide, Er2O3). Ultrasonic pulse-echo technique is used to measure the sound velocities in the glass system (30%B2O3·30%Bi2O3·20%Li2O·10%BaO·10%Pb3O4·xEr2O3), (x = 0, 0.5, 1, 2, 3, 4) mol%. Ultrasound velocities (longitudinal and shear) are measured as a function of the Er2O3 content at a frequency of 4 MHz for longitudinal wave and 2 MHz for the shear wave at a temperature of 300 K. The elastic moduli and some physical parameters, such as Debye temperature, coordination number, and compressibility, were evaluated. Furthermore, the dimensionality of the glass network has been calculated in terms of the d ratio which equals G/B ratio. These parameters beside the x-ray diffraction, differential scanning calorimetry, and Fourier Transform Infrared (FTIR) measurements throw more light on the structure of the glass system. The measurements in this study exhibit remarkable anomalous changes in the network structure of the investigated glass doped with Er2O3.