Effect of Cognitive Rehabilitation on Improving Cognitive Function and Activities of Daily Living among Elderly Patients With Stroke at Assiut University Hospital

Cognitive impairment is a frequent consequence of stroke. The study aimed to measure the effect of cognitive rehabilitation of elderly patients with stroke on their cognitive function and activities of daily living. Quasi experimental research design were used in this study. This study was conducted at neuropsychiatric, physical medicine and rehabilitation departments at Assiut University hospital, their number were 70 elderly stroke patients aged 60 years and above, (study group, 35, control group, 35) . Six tools were utilized ,tool 1: Socio- demographic characteristics and questions about stroke tool II: Mini-Mental State Examination tool III: Digit Span tool IV: Logical memory tool V: Geriatric Depression Scale. Tool VI:  Barthel Index scale. The rehabilitation program: consist of five practical session about spatial memory, attention and concentration, visual attention, fish face task and N400 task and three theoretical session about health education for diabetes mellitus, hypertension and prevention of recurrent stroke. The main result of the present study revealed that a significant statistical difference was existed between both studied groups in relation to Min Mental State Examination  (P-value = 0.000*). Conclusion: Application of training program about cognitive impairment  of stroke elderly patients have significant therapeutic effect on cognitive function, and on activities of daily living. Recommendation: Routine use of screening assessment of cognitive impairment in every stroke patient for early detection, and Health education to the elderly patients and caregivers about the possible ways of prevention of recurrent stroke and ways for controlling of diabetes and hypertension Keywords: Cognitive rehabilitation, Elderly, Stroke patient

Optimal Performance of Dynamic Particle Swarm Optimization Based Maximum Power Trackers for Stand-Alone PV System Under Partial Shading Conditions

One of the important tasks for increasing the efficiency of photovoltaic (PV) system is the development and improvement of the maximum power point tracking algorithms (MPPT). These MPPT algorithms lead to the ability to catch efficiently the global maximum power point of the partially shaded PV array. One of these trackers is the particle swarm optimization (PSO) algorithm which is one of the Soft computing techniques. The conventional PSO based trackers have many advantages such as the simplicity of hardware implementation and independence from the installed system. The actual problem of the practical application of PSO is the determination of its parameters to ensure high effectiveness of extracting the global MPP. Analysis of scientific papers devoted to the PSO algorithm has shown that there is currently no methodology for the optimal parameters' selection of PSO algorithm based maximum power trackers for the PV system. This paper aims to create a convenient and reasonable method for choosing the optimal parameters of the PSO algorithm, taking into account the topology and parameters of the DC-DC converter and the configuration of solar panels. A new method for selecting the parameters of a buck converter connected to a battery has been presented. The optimal value of the sampling time for the digital MPP controllers, providing their maximum performance; has been determined based on a new methodology. Matlab/Simulink software package is used as the main research tool. The prominent outcomes identify that the modified PSO and its designed parameters best meet the requirements of the MPPT controller for the PV system

Clinical characteristics of aggressive Non-Hodgkin lymphoma with emphasis on the role of positron emission tomography/computed tomography in assessment of treatment response: a retrospective study

Purpose: The purpose of this study was to evaluate the role of post-treatment Positron Emission Tomography/Computed Tomography (PET/CT) in aggressive non-Hodgkin’s lymphoma (NHL) with regard to the clinical and treatment characteristics and disease-free survival (DFS).Methods: We retrospectively studied charts of 30 patients with aggressive NHL who had PET/CT only after completion of treatment.Results: Thirty patients received CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) or Rituximab (R)-CHOP (22 and 8 patients respectively), followed by radiotherapy in 19/30 patients (63.3%). Following 3-4 cycles of chemotherapy, interim CT showed regressive, stationary and progressive disease in 18, 10, 2 (60%, 33.3%, 2%) patients respectively. PET/CT was performed 4-6 weeks after end of treatment. 22/30 (73.3%) patients had negative scan, of whom 13 (59.1%) patients remained in remission till the end of the study while 9 patients relapsed after a median DFS of 12 months. PET/CT was positive in 8/30 (26.7%) patients who had refractory disease. PET/ CT scan had sensitivity of 75%, specificity of 72.7%, negative predictive value (NPV) of 88.9%, and positive predictive value (PPV) of 50%.Conclusion: PET/CT has an important role in end- of- therapy response evaluation in fluorodeoxyglucose (FDG)-avid aggressive NHL. It proves high sensitivity and specificity in detection of residual disease and provides an accurate indication of overall survival and disease-free survival. CT continues to have an important role in post-treatment response assessment whether as a single modality or in combination with PET scan

Wear-resistant and stable low-friction nanodiamond composite superhard coatings against Al2O3 counter-body in dry condition.

Conventional machining lubricants pose environmental hazards and increase production costs. This study addresses this challenge by investigating nanodiamond composite (NDC) coatings deposited on WC–Co substrates as a lubricant-free alternative for sustainable machining. The NDC films show superior hardness (65 GPa) compared to the substrate (22 GPa) and enhanced adhesion (HF2). The NDC's unique self-lubrication results in a low and stable friction coefficient (COF ≤ 0.095) and exceptional wear resistance (7.45 x 10−8 mm3/N·m) in dry tesing against Al2O3 counter-body. Compared to CVD diamond, NDC coatings show a 47.8 % reduction in COF and a 31.65 % enhancement in wear resistance, promoting environmentally friendly machining practices

Evaluating the Impact of a Collaborative Care Model in Diabetes Management in a Primary Healthcare Setting in Qatar Using Real-World Data

Objectives: To evaluate the impact of Collaborative Care Model (CCM) on diabetes-related outcomes among patients with diabetes attending a primary care setting. Methods: A multiple-time series, retrospective, observational study with a control group among patients with diabetes followed-up at Qatar Petroleum Diabetes Clinic. The impact of CCM on glycemic control, blood pressure, lipid profile, and anthropometrics was evaluated at baseline and up to 17 months of follow-up. Quantitative data were analyzed descriptively and inferentially using SPSS. Results: CCM significantly improved (p<0.05) the mean values (baseline vs. 17 months) of glycated hemoglobin A1c (6.9% vs. 6.5%), random blood glucose (194.38 mg/dL vs. 141.23 mg/dL), low-density lipoprotein cholesterol (3.7 mmol/L vs. 2.8 mmol/L), total cholesterol (5.43 mmol/L vs. 4.34 mmol/L), weight (78.52 Kg vs. 77.85 Kg), and body mass index (30.41 Kg/m2 vs. 30.17 Kg/m2) over 17-months within the intervention group; whereas, no significant changes occurred within the control group. Similarly, the between group comparisons demonstrated the superiority of CCM over usual care in improving several clinical outcomes. Conclusion: Inefficiencies in delivering diabetes care can be circumvented by the integration of CCM. The implementation of CCM in a primary healthcare setting improved several diabetes-related outcomes over 17-months

Comprehensive validation of transient stability calculations in electric power systems and hardware-software tool for its implementation

Reliability and survivability of electric power systems (EPS) depend on transient stability assessment (TSA). One of the most effective way to TSA is time-domain simulation. However, large-scale EPS mathematical model contains a stiff nonlinear system of high-order differential equations. Such system cannot be solved analytically. At the same time, numerical methods are imperfectly applied for such system due to limitation conditions. To make it appropriate, the EPS mathematical model is simplified and additional limitations are used. These simplifications and limitations reduce reliability of simulation results. Consequently, their validation is needed. The most reliable approach to provide it is to compare the simulation results with the field data. However, in practice, there are not enough data for such validation. This paper proposes an alternative approach for validation - the application of a reference model instead of field data. A hardware-software system HRTSim was used as a reference model. This power system simulator has all the necessary properties and capabilities to obtain reliable information required for comprehensive validation of transient stability calculations in EPSs. Main disturbances leading to instability in EPSs are investigated to conduct the validation (processes in cases of faults, single-phase auto-reclosing operation and power system interconnection). Fragments of corresponding experimental studies illustrate the efficiency of the proposed approach. Obtained results confirmed the possibility of the developed approach to identify the causes of numerical calculation errors and to determine disturbances calculated with the significant error. In addition, experimental studies have revealed that numerical calculations error depends on disturbances intensity

Research, Development and Application of Hybrid Model of Back-to-Back HVDC Link

Recent hybrid simulators (or co-simulators) of the electric power system are focused on scientific and research features to propose and develop novel and more accurate simulators. The present paper demonstrates one more hybrid modelling approach based on application and combination of three modeling approaches all together: physical, analog and digital. The primary focus of the proposed approach is to develop the simulation tool ensuring such vital characteristics as three-phase simulation and modeling of a single spectrum of processes in electric power system, without separation of the electromagnetic and electromechanical transient stages. Moreover, unlimited scalability of the electric power system model and real-time simulation to ensure the opportunity of data exchange with external devices have been considered. The description of the development of the hybrid model of back-to-back HVDC link based on the proposed approach is discussed and analyzed. To confirm properties of the mentioned hybrid simulation approach and hybrid model of back-to-back HVDC link, the simulation results of the interconnection of non-synchronously operating parts of the electric power system; power flow regulation; dynamic response to external fault and damping of power oscillation in electric power system are presented and examined. Moreover, to confirm the adequacy of the obtained results, the comparison with a detailed voltage source converter HVDC model (Simulink Matlab) and Eurostag software are introduced

Laparoscopy in management of appendicitis in high-, middle-, and low-income countries: a multicenter, prospective, cohort study.

BACKGROUND: Appendicitis is the most common abdominal surgical emergency worldwide. Differences between high- and low-income settings in the availability of laparoscopic appendectomy, alternative management choices, and outcomes are poorly described. The aim was to identify variation in surgical management and outcomes of appendicitis within low-, middle-, and high-Human Development Index (HDI) countries worldwide. METHODS: This is a multicenter, international prospective cohort study. Consecutive sampling of patients undergoing emergency appendectomy over 6 months was conducted. Follow-up lasted 30 days. RESULTS: 4546 patients from 52 countries underwent appendectomy (2499 high-, 1540 middle-, and 507 low-HDI groups). Surgical site infection (SSI) rates were higher in low-HDI (OR 2.57, 95% CI 1.33-4.99, p = 0.005) but not middle-HDI countries (OR 1.38, 95% CI 0.76-2.52, p = 0.291), compared with high-HDI countries after adjustment. A laparoscopic approach was common in high-HDI countries (1693/2499, 67.7%), but infrequent in low-HDI (41/507, 8.1%) and middle-HDI (132/1540, 8.6%) groups. After accounting for case-mix, laparoscopy was still associated with fewer overall complications (OR 0.55, 95% CI 0.42-0.71, p < 0.001) and SSIs (OR 0.22, 95% CI 0.14-0.33, p < 0.001). In propensity-score matched groups within low-/middle-HDI countries, laparoscopy was still associated with fewer overall complications (OR 0.23 95% CI 0.11-0.44) and SSI (OR 0.21 95% CI 0.09-0.45). CONCLUSION: A laparoscopic approach is associated with better outcomes and availability appears to differ by country HDI. Despite the profound clinical, operational, and financial barriers to its widespread introduction, laparoscopy could significantly improve outcomes for patients in low-resource environments. TRIAL REGISTRATION: NCT02179112

Genomic characterization of SARS-CoV-2 in Egypt: insights into spike protein thermodynamic stability

The overall pattern of the SARS-CoV-2 pandemic so far has been a series of waves; surges in new cases followed by declines. The appearance of novel mutations and variants underlie the rises in infections, making surveillance of SARS-CoV-2 mutations and prediction of variant evolution of utmost importance. In this study, we sequenced 320 SARS-CoV-2 viral genomes isolated from patients from the outpatient COVID-19 clinic in the Children’s Cancer Hospital Egypt 57357 (CCHE 57357) and the Egypt Center for Research and Regenerative Medicine (ECRRM). The samples were collected between March and December 2021, covering the third and fourth waves of the pandemic. The third wave was found to be dominated by Nextclade 20D in our samples, with a small number of alpha variants. The delta variant was found to dominate the fourth wave samples, with the appearance of omicron variants late in 2021. Phylogenetic analysis reveals that the omicron variants are closest genetically to early pandemic variants. Mutation analysis shows SNPs, stop codon mutation gain, and deletion/insertion mutations, with distinct patterns of mutations governed by Nextclade or WHO variant. Finally, we observed a large number of highly correlated mutations, and some negatively correlated mutations, and identified a general inclination toward mutations that lead to enhanced thermodynamic stability of the spike protein. Overall, this study contributes genetic and phylogenetic data, as well as provides insights into SARS-CoV-2 viral evolution that may eventually help in the prediction of evolving mutations for better vaccine development and drug targets