Magnetohydrodynamic double-diffusive peristaltic flow of radiating fourth-grade nanofluid through a porous medium with viscous dissipation and heat generation/absorption

This article focuses on determining how to double diffusion affects the non-Newtonian fourth-grade nanofluids peristaltic motion within a symmetrical vertical elastic channel supported by a suitable porous medium as well as, concentrating on the impact of a few significant actual peculiarities on the development of the peristaltic liquid, such as rotation, initial pressure, non-linear thermal radiation, heat generation/absorption in the presence of viscous dissipation and joule heating with noting that the fluid inside the channel is subject to an externally induced magnetic field, giving it electromagnetic properties. Moreover, the constraints of the long-wavelength approximation and neglecting the wave number along with the low Reynolds number have been used to transform the nonlinear partial differential equations in two dimensions into a system of nonlinear ordinary differential equations in one dimension, which serve as the basic governing equations for fluid motion. The suitable numerical method for solving the new system of ordinary differential equations is the Runge-Kutta fourth-order numerical method with the shooting technique using the code MATLAB program. Using this code, a 2D and 3D graphical analysis was done to show how each physical parameter affected the distributions of axial velocity, temperature, nanoparticle volume fraction, solutal concentration, pressure gradients, induced magnetic field, magnetic forces, and finally the trapping phenomenon. Under the influence of rotation [Formula: see text], heat Grashof number [Formula: see text], solutal Grashof number [Formula: see text], and initial stress [Formula: see text], the axial velocity distribution [Formula: see text] changes from increasing to decreasing, according to some of the study's findings. On the other hand, increasing values of nonlinear thermal radiation [Formula: see text] and temperature ratio [Formula: see text] have a negative impact on the temperature distribution [Formula: see text] but a positive impact on the distributions of nanoparticle volume fraction [Formula: see text] and solutal concentration [Formula: see text]. Darcy number [Formula: see text] and mean fluid rate [Formula: see text] also had a positive effect on the distribution of pressure gradients, making it an increasing function.

Can prediabetes diagnosed using HemoglobinA1c or oral glucose tolerance test predict presence and severity of coronary artery disease in symptomatic patients?

We investigated whether prediabetes diagnosed by hemoglobinA1c (HbA1c) or oral glucose tolerance test (OGTT) could predict presence and severity of coronary artery disease (CAD) in symptomatic patients. The presence of plaque, stenosis, plaque characteristics, and coronary artery calcium (CAC) were evaluated by coronary CT angiography in 702 patients with suspicion of CAD. Patients were classified by glycemic status using the American Diabetes Association criteria for HbA1c and OGTT, and compared to their respective normal ranges. Prediabetes was observed in 24% by HbA1c and 72% by OGTT. Both prediabetes classifications were associated with increased presence of plaque, stenosis, calcified plaques, CAC >400, and a lower frequency of zero CAC compared to their respective normal range (all, p < 0.05). After adjusting for potential confounders, patients with HbA1c-prediabetes had an odds ratio of 2.1 (95% CI: 1.3-3.5) for CAC >400 and 1.5 (95% CI: 1.0-2.4) for plaque presence, while none of the associations for OGTT-prediabetes were significant. The receiver operating characteristic-curve for HbA1c-prediabetes showed an area under the curve of 0.81 for CAC >400 and 0.77 for plaque presence. Prediabetes defined by HbA1c predicts presence and severity of CAD. Although OGTT identified more patients with prediabetes, their risk of CAD were not explained by prediabetes using these diagnostic-criteria.

Does a normal electrocardiogram exclude heart failure with reduced left ventricular ejection fraction?

Background

In the ESC guidelines for chronic heart failure an electrocardiogram (ECG) is part of the diagnostic set-up (1).

A normal ECG makes the diagnosis unlikely. But can a normal ECG exclude heart failure with reduced left ventricular ejection fraction (HFrEF) and be a gatekeeper to echocardiography?

Methods

Patients referred from primary care to the cardiac outpatient clinic with suspicion of heart failure were consecutively included in the study, during a period of one year. With the referral from primary care was included an ECG which was assessed by a senior cardiologist and divided into two groups: 1) Patients with normal ECG; 2) Patients with pathologically ECG.

Subsequently, an echocardiographic examination was performed in a blinded fashion and left ventricular ejection fraction (LVEF) was measured.

Results

Overall, 403 patients were included in the study. A normal ECG was present in 155 (38%) patients and a pathological ECG was present in 248 (62%) patients. In total, an echocardiographic examination identified 55 (14%) patients with an LVEF below 60% and 33 patients (8%) with LVEF below 50%. In patients with a normal ECG, only two patients had heart failure with a mildly reduced ejection fraction (41–49%), Figure 1.

Thus, the ECG had a sensitivity of 94% and a negative predictive value of 99%, Figure 2.

Conclusion

A normal electrocardiogram has a high diagnostic sensitivity and negative predictive value for excluding heart failure with reduced LVEF and could be a gatekeeping tool in the prioritization of patients referred to echocardiography examination from primary care.

Funding Acknowledgement

Type of funding sources: Private hospital(s). Main funding source(s): Department of Cardiovascular research, OUH, Svendborg Hospital

Efficacy of neuromuscular electrical stimulation of calf muscles on nocturnal symptoms and quality of life in asthmatic children

OBJECTIVE

To determine whether neuromuscular electrical stimulation of calf muscles could improve nocturnal symptoms and quality of life in asthmatic children.

PATIENTS AND METHODS

Sixty children (8-12 years) with moderate asthma were randomly allocated to three groups (A, B, and C). The three groups completed 12 weeks of supervised breathing exercises for 30 min. In addition, group A completed neuromuscular electrical stimulation of the calf muscles and group B completed aerobic exercise in the same period. The intervention was conducted five days a week for 12 consecutive weeks. Pre-and post-treatment evaluations involved pulmonary function tests, the Children's Asthma Control Questionnaire, calf muscle isometric muscle force, six-minute walk test, and Pediatric Asthma Quality of Life Questionnaire.

RESULTS

A significant increase in all measured variables was recorded in all groups in favor of group A (p < 0.001). However, calf muscle isometric muscle strength, and nocturnal symptoms were non-significant in group C (p > 0.05). There was a significant difference between groups A and C in all measured variables (p < 0.001) in favor of group A. Significant differences between groups B and C in all measured variables (p < 0.001) in favor of group B were also noted. No significant differences were seen between groups A and B (p > 0.05).

CONCLUSIONS

Neuromuscular electrical stimulation of calf muscles is an excellent adjunct to breathing exercise programs in improving nocturnal symptoms and quality of life in asthmatic children. Moreover, it can serve as a considerable alternative to traditional physical training in periods of disease exacerbation.

Impact of Schroth three-dimensional vs. proprioceptive neuromuscular facilitation techniques in adolescent idiopathic scoliosis: a randomized controlled study

OBJECTIVE

The aim of the study was to investigate the effect of proprioceptive neuromuscular facilitation (PNF) and compare its effect to the Schroth exercises on scoliosis angle, static plantar pressure distribution, and functional capacity in adolescent idiopathic scoliosis.

PATIENTS AND METHODS

Thirty-four girls (aged 14-16 years) with thoracolumbar curves were randomly distributed into two study groups of equal numbers. The Schroth group underwent Schroth exercises, whereas the PNF group underwent treatment using proprioceptive neuromuscular facilitation. Patients in both groups received treatment for one hour, three times per week for six successive months. Measurements of Cobb's angle, angle trunk rotation, total static plantar pressure on both lower limbs, and functional capacity using the six-minute walk test were performed just before and after six months of treatment.

RESULTS

A significant decrease in Cobb's angle and right total static plantar pressure with a significant increase in left total static plantar pressure post-treatment was noted in both groups, with a higher effect in the Schroth group. A significant increase was recorded in the six-minute walk test with a decrease in angle trunk rotation in the Schroth group, while no significant changes were recorded in the PNF group.

CONCLUSIONS

Based on the results obtained in this study, this program of PNF patterns did not show a significant improvement in angle trunk rotation, which is a critical aspect in correction of the curve in comparison to the Schroth exercises. These proprioceptive neuromuscular facilitation patterns are not recommended for the correction of adolescent idiopathic scoliosis.

Efficacy of different approaches on quality of upper extremity function, dexterity and grip strength in hemiplegic children: a randomized controlled study

OBJECTIVE

To investigate the effect of mirror therapy (MT) together with taping compared to modified constraint-induced movement therapy (mCIMT) and MT alone on the quality of upper extremity (UE) function, dexterity, and grip strength in children with hemiplegic cerebral palsy (CP).

PATIENTS AND METHODS

Sixty children with hemiplegic CP ranging in age from 6 to 8 years were enrolled. The participants were randomly distributed into three groups. The three groups underwent the same suggested upper limb (UL) exercise programme for 1h/5 days/week for 12 successive weeks. Group A performed the programme with MT and taping. Group B performed the same programme using mCIMT alone, while group C performed this programme with MT alone. In addition, the three groups underwent a routine physical therapy programme for 1 h. The quality of UE function, dexterity, and grip strength was measured using the Quality of Upper Extremity Skills Test (QUEST), Box and Block Test (BBT), and hand-held dynamometer before and after 12 successive weeks of treatment.

RESULTS

After treatment, the measurement of all variables in the three groups showed significant improvements with superior effects seen in group A.

CONCLUSIONS

Based on the results obtained in this study, MT with taping, mCIMT alone, and MT alone are good supplements to traditional physical therapy programmes in improving the quality of UE function, dexterity, and grip strength in children with hemiplegic CP with more superior effects seen after using MT together with taping.

Urinary TNF-like weak inducer of apoptosis (TWEAK) as a biomarker of lupus nephritis

BACKGROUND

Renal involvement in systemic lupus erythematosus (SLE), known as lupus nephritis (LN), is a common and severe complication and a major predictor of poor outcome. Long-term survival in SLE can be improved with early diagnosis and prompt treatment of LN. A number of biochemical markers are currently used to clinically assess disease activity in patients; however, they lack sensitivity and specificity for differentiating renal activity and damage in LN. A reliable clinical biomarker that can forecast LN flare and which could be sequentially followed would help to optimize initiation and escalation of therapy at the time of active or relapsing disease.

OBJECTIVE

This study was carried out to investigate the value of urinary tumor necrosis factor (TNF)-like weak inducer of apoptosis (uTWEAK) as a biomarker for active lupus nephritis.

PATIENTS AND METHODS

A total of 44 patients with SLE fulfilling the 1997 revised criteria for the classification of SLE as well as 11 age and sex-matched healthy controls were included in this study and subjected to full medical history taking, clinical examination, routine laboratory investigations, measurement of uTWEAK level as well as renal biopsy for patients with active LN.

RESULTS

The uTWEAK levels were significantly higher in SLE patients with active LN compared to those without or with inactive renal disease and normal healthy subjects.

Effects of blindfolding and tail bending of Egyptian water buffaloes on their behavioural reactivity and physiological responses to pain induction

This experiment was carried out to determine the effect of blindfold and tail bend during restraint of Egyptian buffaloes on behavioural reactivity and physiological responses to stressful handling procedures. Twenty-four buffalo bulls, naïve to the testing situation, were arbitrarily assigned to either blindfold (visual restriction) (BF), tail bending (physical control) (TB) or control (CT) (no visual restriction or physical control) treatment during restraint. For three minutes each, during veterinary procedures animals entered the squeeze chute and were subjected to testing trials. Heart rate (HR), respiratory rate (RR) and various behaviours of reactivity were recorded. Average HR and RR decreased in both TB and BF bulls but the reduction was greater in BF bulls. Use of the blindfold and tail bend decreased behavioural indicators of reactivity including: chest chute forcing, head move, kicking and struggling. The reduction was greater in BF bulls in the case of use of the chest chute and struggling. Both tail bend and blindfolded buffaloes decreased behavioural and physiological indicators of stress but BF appeared more beneficial, and may therefore be recommended to reduce stress accompanying routine veterinary examination of buffaloes.

Lack of pain relief during labor is blamable for the increase in the women demands towards cesarean delivery: a cross-sectional study

BACKGROUND

This study aims to assess knowledge, attitude and acceptance of antenatal women for pain relief methods during labor and to know the effect of presumed availability of pain relief methods during labor on the attitude of women towards the mode of delivery.

MATERIALS AND METHODS

A cross sectional study was conducted at a tertiary hospital between January and December 2016. A structured interview questionnaire had been administered including data related to current pregnancy, knowledge, attitude and previous experience of pain, labor analgesia, women's attitude toward the mode of delivery and its relation to the availability of adequate analgesia during labor. Visual analog scale (VAS) was used to assess pregnant women's attitude towards pain in general and that related to the process of labor (past and expected experience).

RESULTS

Eight hundred and fourteen women were included in the study. The majority of our participants (82.9%) were unaware about the availability of labor analgesia. Sixty of the study participants preferred cesarean section (CS) to avoid labor pain. Availability of adequate pain relief during labor could decrease the women decision of CS by more than 50% in women expecting moderate and severe pain during labor compared to non-availability of pain relief (9.6% vs. 22.7% and 8.2% vs. 28.1% respectively).

CONCLUSION

There is a great lack of knowledge regarding the availability of pain relief during labor. Lack of pain relief during labor can be responsible for more than half of women's intention to prefer CS as a mode of delivery.

Adrenal medulla of AS/AGU rats: a histological and immunohistochemical study

BACKGROUND

The outcome of the autograft therapy for Parkinson's disease including autologous cells from adrenal medulla was disappointing. This could be attributed to the pathological process in Parkinson's disease affecting cells of the adrenal medulla. This study was performed to investigate the histopathological changes in the adrenal medulla of AS/AGU rat, a model of Parkinson's disease, in comparison with Albino Swiss (AS) rats.

MATERIALS AND METHODS

A total of 24 male AS rats were divided into four groups, each of 6 animals: AS W1 - AS rats aged 1 week; AS adult - AS adult rats; AS/ /AGU W1 - AS/AGU rats aged 1 week; and AS/AGU adult - AS/AGU adult rats. The rats were sacrificed and the adrenal glands were dissected and processed for histological staining with haematoxylin and eosin and periodic acid Schiff and for immunohistochemical staining for S100 protein, ubiquitin and tyrosine hydroxylase.

RESULTS

The histological investigation of the adrenal medulla of AS/AGU rats showed vascular congestion, inflammatory cellular infiltration, pyknotic nuclei, necrotic chromaffin cells and medullary inclusion bodies. The immunohistochemical investigation of AS/AGU rats showed a statistically significant decrease in the expression of S100 protein, ubiquitin and tyrosine hydroxylase compared to AS rats.

CONCLUSIONS

The histological and immunohistological changes in the adrenal medulla could explain the failure of outcome of adrenal autograft therapy in Parkinson's disease.

Assessment of variable drinking water sources used in Egypt on broiler health and welfare

AIM

This study assessed the impact of four water sources used as drinking water in Egypt for broiler chickens on its performance, carcass characteristic, hematological, and immunological responses.

MATERIALS AND METHODS

A total of 204 unsexed 1-day old Indian River broiler chickens were used in this study. They were randomly allocated into four treatment groups of 51 birds in each, with three replicates, 17 birds per replicate. Groups were classified according to water source they had been received into (T1) received farm tap water; (T2) received filtered tap water (T3) received farm stored water at rooftop tanks, (T4) received underground (well) water.

RESULTS

All water sources showed no significant differences among treated groups at (p>0.05) for most of the performance parameters and carcass characteristics. However (T2) group showed higher records for body weight (BWT), BWT gain (BWG), feed conversion ratio, bursa weight, serum total protein, globulin (G), albumin (A) and A/G ratio, Ab titer against New castle disease virus vaccine. On the other hand, it showed lower records for water intake (WI), WI/Feed intake ratio, total leukocytes count %, heterophil %, lymphocyte %, H/L ratio, liver weight, glutamic oxaloacetic transaminase, glutamic pyruvic transaminase, serum uric acid and creatinine. Where filtered water reverse osmosis showed lowest records for bacterial load, the absence of coliform bacteria, total dissolved solids (TDS), electrical conductivity (EC) and salinity. On the other hand stored water showed higher numerical values for TDS, EC, alkalinity, salinity, pH, bacterial count, and coliform count.

CONCLUSION

Base on the results of this study, it is concluded that different water sources could safely be used as drinking water for poultry; as long as it is present within the acceptable range of drinking water quality for chickens. Suggesting the benefits of treatment of water sources on improving chickens' health and welfare. Draw attention to the importance of maintaining the hygienic quality of stored water.

Role of adenosine A2A receptor in cerebral ischemia reperfusion injury: Signaling to phosphorylated extracellular signal-regulated protein kinase (pERK1/2)

Following brain ischemia reperfusion (IR), the dramatic increase in adenosine activates A2AR to induce further neuronal damage. Noteworthy, A2A antagonists have proven efficacious in halting IR injury, however, the detailed downstream signaling remains elusive. To this end, the present study aimed to investigate the possible involvement of phospho-extracellular signal-regulated kinase (pERK1/2) pathway in mediating protection afforded by the central A2A blockade. Male Wistar rats (250-270 g) subjected to bilateral carotid occlusion for 45 min followed by a 24-h reperfusion period showed increased infarct size corroborating histopathological damage, memory impairment and motor incoordination as well as increased locomotor activity. Those events were mitigated by the unilateral intrahippocampal administration of the selective A2A antagonist SCH58261 via a decrease in pERK1/2 downstream from diacyl glycerol (DAG) signaling. Consequent to pERK1/2 inhibition, reduced hippocampal microglial activation, glial tumor necrosis factor-alpha (TNF-α) and brain-derived neurotropic factor (BDNF) expression, glutamate (Glu), inducible nitric oxide synthase (iNOS) and thiobarbituric acid reactive substances (TBARS) were evident in animals receiving SCH58261. Additionally, the anti-inflammatory cytokine interleukin-10 (IL-10) increased following nuclear factor (erythroid-derived 2)-like 2 (Nrf-2). Taken all together, these events suppressed apoptotic pathways via a reduction in cytochrome c (Cyt. c) as well as caspase-3 supporting a crucial role for pERK1/2 inhibition in consequent reduction of inflammatory and excitotoxic cascades as well as correction of the redox imbalance.

SCH58261 the selective adenosine A(2A) receptor blocker modulates ischemia reperfusion injury following bilateral carotid occlusion: role of inflammatory mediators

In the present study, the effects of SCH58261, a selective adenosine A(2A) receptor antagonist that crosses the blood brain barrier (BBB) and 8-(4-sulfophenyl) theophylline (8-SPT), a non-selective adenosine receptor antagonist that acts peripherally, were investigated on cerebral ischemia reperfusion injury (IR). Male Wistar rats (200-250 g) were divided into four groups: (1) sham-operated (SO), IR pretreated with either (2) vehicle (DMSO); (3) SCH58261 (0.01 mg/kg); (4) 8-SPT (2.5 mg/kg). Animals were anesthetized and submitted to occlusion of both carotid arteries for 45 min. All treatments were administered intraperitoneally (i.p.) post carotid occlusion prior to exposure to a 24 h reperfusion period. Ischemic rats showed increased infarct size compared to their control counterparts that corroborated with histopathological changes as well as increased lactate dehydrogenase (LDH) activity in the hippocampus. Moreover, ischemic animals showed habituation deficit, increased anxiety and locomotor activity. IR increased hippocampal glutamate (Glu), GABA, glycine (Gly) and aspartate (ASP). SCH58261 significantly reversed these effects while 8-SPT elicited minimal change. IR raised myeloperoxidase (MPO), tumor necrosis factor-alpha (TNF-α), nitric oxide (NO), prostaglandin E₂ (PGE₂) accompanied by a decrease in interleukin-10 (IL-10), effects that were again reversed by SCH58261, but 8-SPT elicited less changes. Results from the present study point towards the importance of central blockade of adenosine A(2A) receptor in ameliorating hippocampal damage following IR injury by halting inflammatory cascades as well as modulating excitotoxicity.

Experience of laparoscopic management in 100 patients with acute abdomen

BACKGROUND/AIMS

The decision to operate on a patient with acute abdominal pain comes to the mind of the surgeon if routine investigations fail to identify the cause. A negative laparotomy may have complications, while laparoscopy appears to be a valuable way to improve the accuracy of diagnosis of acute abdominal pain and offers a promising modality of treatment.

METHODOLOGY

The study included 100 patients with provisional diagnosis of acute abdomen after clinical examination and conventional diagnostic aids. All the patients have been subjected to diagnostic laparoscopy.

RESULTS

Eight cases (8%) were managed by laparotomy following diagnosis by laparoscope (disturbed ectopic pregnancy), while 92 cases (92%) were managed laparoscopically which resulted in 81 cases (81%) of successful laparoscopic procedure (31 appendectomies, 19 cholecystectomies, 12 ovarian cyst accident, and others) and 11 cases (11%) were converted to open surgery (4 gallbladder empyema, 2 appendicular mass, 2 intestinal obstruction, and others). Postoperative complications were two cases of wound infection managed conservatively (perforated appendix). The postoperative follow-up for six months was uneventful.

CONCLUSIONS

Laparoscopic management of acute abdomen is a safe and effective method with the advantages of small scar, short hospital stay and early recovery.