Efficacy of vitamin B6 plus magnesium in enhancing cognitive and language functions in preschool children with autism spectrum disorder and well-controlled epilepsy: a double-blind placebo-controlled study

Background: Autism spectrum disorder (ASD) in children often involves deficits in communication, social interaction, and behavioral regulation. Emerging evidence suggests that vitamin B6 and magnesium supplementation may aid in alleviating these symptoms. This study aims to assess the effectiveness of vitamin B6 plus magnesium in improving social, nonverbal communication, speech, and language skills in preschool children with ASD and well-controlled epilepsy.  Methods: A double-blind placebo-controlled trial was conducted involving 50 children under 14 years diagnosed with ASD based on CARS-2 criteria. Participants were randomly assigned to either receive vitamin B6 plus magnesium (n=25) or a placebo (n=25) for 120 days. Clinical outcomes were evaluated weekly and analyzed using SPSS v19. Results: The intervention group showed significant improvement in social skills (Mean = 11.10, SD = 0.47, p = 0.0103), nonverbal communication (Mean = 10.67, SD = 0.59, p = 0.0024), and speech and language skills (Mean = 10.87, SD = 0.47, p = 0.0030) compared to the placebo group. Conclusion: Vitamin B6 plus magnesium significantly improves cognitive and language functions in children with ASD and well-controlled epilepsy

Applications of new thermoplastic CFRP rebars and mechanically anchored carbon fibre sheets in reinforcing and strenghening concrete beams

Thermoset fibre-reinforced polymer composite (FRP) rebars and laminates are widely used in reinforcing and strengthening concrete structures due to their advantages such as: corrosion free material, high strength to weight ratio, and electromagnetic resistance. However, thermoset composites have some limitations due to the fact that they cannot be bent once the resin solidifies when used as internal reinforcement (FRP rebars). On the other hand, externally bonded FRP sheets used in strengthening concrete structures is subject to non-ductile failure due to debonding. This emphasizes the need of exploring new methods for reinforcing and strengthening concrete structures. This thesis evaluates the performance of a new thermoplastic CFRP rebar that can be bent after the resin set and also examines the behaviour of using unbonded mechanically anchored dry carbon fibre (CF) sheets in shear strengthening of concrete T-beams to avoid debonding mode of failure. Three sets of tests were conducted on the developed CFRP rebars in order to evaluate their mechanical characteristics, minimum development length of the straight rebars, and the tail length of bent rebars. Based on the test results and the modes of failure of the tested specimens, recommendations were proposed to improve the behaviour of the new thermoplastic CFRP rebars. The properties of the newly developed CFRP rebars were compared to similar thermoset and thermoplastic FRP rebars available in the literature and market. Three reinforced concrete (RC) T-beams were tested up to failure in four point bending test. One was reserved as control beam, while two beams were strengthened in shear using mechanically anchored dry CF sheets. The tested beams were instrumented with the conventional measuring devices that were connected to a data acquisition system. Moreover, the beam was monitored using acoustic sensors which monitored the acoustic energy activity of the tested beam

Developing a framework to enhance the operation of quality assurance in Saudi Arabia’s higher education: educational management and e-management perspectives

This research aimed to develop a framework to enhance the operation of quality assurance in Saudi Arabia’s higher education institutions, through exploring stakeholders' perspectives, considering educational management and the potential of e-management. In looking to generate an insight into the reality of QA practice towards developing a heuristic enhancement framework, a case study methodology consisting of both qualitative and quantitative data collection methods was employed. In the initial stage, a scoping study was employed to explore the main issues surrounding the operation of QA by conducting 10 interviews with elite stockholders. For the main study, interviews, focus groups and a questionnaire were employed to gather data simultaneously. There were 23 participants in interviews, 9 in focus groups and 301 responders to a questionnaire. Qualitative data were analysed based on thematic analysis, descriptive statistics were applied to the quantitative data making use of the SPSS statistical package. Data were analysed separately and then integrated and compared in the process of interpretation of the overall results. This case study found that participants from all levels of the institution agreed that QA requirements are a primary part of academic commitments. The results showed that stakeholders are willing to engage in the QA operations at an individual level. However, not all faculty members accepted the changes resulting from a systematic QA approach. There are those who support and engage effectively and those who reject the idea because of uncertainty or lack of a clear understanding of QA. This study has identified that the largest group of stakeholders actively participating in QA operations is made up of QA staff, followed by administrative and faculty staff. In addition, the study found that stakeholders with experience in QA participate significantly more than others. The study noticed a disparity between the engagement of stakeholders at older long established colleges and new ones. Several factors driving this trend emerged, such as the work environment, availability of support from senior management, availability of human and financial support, and the extent of understanding of QAP. The study discovered a wide range of evidence indicating significant difficulties in relation to the participation of stakeholders in the QA operations, due to a number of common challenges; such as management issues, individual attitudes, staff development, incentives and external factors. The study indicated that the relationship between QA operation and e-management in the university is limited or unclear. In terms of the positive perception of participants toward the potential of e-management in the operation of QA, the results indicated that e-management could provide essential solutions to a number of challenges confronting stakeholders in QA operations. Five potential areas in which e-management could help in QA operations were outlined: administration, operation, information management, control and evaluation and support. However, the study revealed several potential challenges that could confront higher education institutions in taking full advantage of e-management in the operation of QA, namely, management aspects, stakeholders, and technical issues. The study has proposed a heuristic framework to enhance the operation of QA and to tackle the issues that arose over the course of the research. The framework’s development is grounded in the literature across three disciplines (Change, QA and e-management), and in the perspectives of stakeholders involved in the actual operation of QA. This framework considers seven main areas: leadership, stakeholders, QAP, staff development, rewards and incentives, e-management and external factors. The study proposes a framework with the intention of providing guidance and insight for higher education policy and decision makers, academic leaders in Saudi HEIs, and for HEIs throughout the region

Evaluating the quality of insurance services from the client's perspective: case study of the Algerian insurance company, El Oued agency

This study aims to assess and evaluate the quality of insurance services by addressing the following research problem: How can the quality of insurance services be evaluated from the perspective of clients of the Algerian Insurance Company (CAAT), El Oued Agency? The study focused on evaluating the quality of services provided by the company under study from the viewpoint of its clients. To achieve the study's objectives, a questionnaire was distributed to a sample of 170 clients, of which 150 responses were valid. Various statistical methods were employed and analyzed using the SPSS 22.0 software to test the proposed hypotheses and derive results. The findings revealed that clients' evaluation of insurance service quality varies across different dimensions and that there is a positive correlation between service quality and customer satisfaction. Additionally, service quality significantly impacts customer satisfaction

Choledochoduodenal fistula due to peptic duodenal ulcer diagnosed by X-barium meal study: interest of medical treatment

Peptic ulcer complication has decreased over le last years. Spontaneous bilio-digestive fistulas, in the absence of primary biliary disease, remain a very unusual complication of the upper digestive tract. The choledochoduodenal fistula is an extremely rare entity which can be caused by a duodenal peptic ulcer. It appears with the symptoms of peptic ulcer disease. They are diagnosed incidentally on radiological exams. It was suspected after finding pneumobilia on abdominal ultrasound and confirmed by X-barium meals study. The purpose of this observation is to report the case of a patient presenting a choledochoduodenal fistula diagnosed by X-barium meal to underline the importance of this radiological exam to diagnose this disease and to insist on the conservative treatment for choledochoduodenal fistula caused by a duodenal peptic ulcer. The prognosis of patients treated medically is good, although the fistula can remain asymptomatic. Angiocholitis and biliary sequelae remain rare and do not warrant prophylactic surgical treatment

Exploring the Efficiency of Algerian Kaolinite Clay in the Adsorption of Cr(III) from Aqueous Solutions: Experimental and Computational Insights

The current study comprehensively investigates the adsorption behavior of chromium (Cr(III)) in wastewater using Algerian kaolinite clay. The structural and textural properties of the kaolinite clay are extensively characterized through a range of analytical methods, including XRD, FTIR, SEM-EDS, XPS, laser granulometry, N2 adsorption isotherm, and TGA-DTA. The point of zero charge and zeta potential are also assessed. Chromium adsorption reached equilibrium within five minutes, achieving a maximum removal rate of 99% at pH 5. Adsorption equilibrium is modeled using the Langmuir, Freundlich, Temkin, Elovich, and Dubinin-Radushkevitch equations, with the Langmuir isotherm accurately describing the adsorption process and yielding a maximum adsorption capacity of 8.422 mg/g for Cr(III). Thermodynamic parameters suggest the spontaneous and endothermic nature of Cr(III) sorption, with an activation energy of 26.665 kJ/mol, indicating the importance of diffusion in the sorption process. Furthermore, advanced DFT computations, including COSMO-RS, molecular orbitals, IGM, RDG, and QTAIM analyses, are conducted to elucidate the nature of adsorption, revealing strong binding interactions between Cr(III) ions and the kaolinite surface. The integration of theoretical and experimental data not only enhances the understanding of Cr(III) removal using kaolinite but also demonstrates the effectiveness of this clay adsorbent for wastewater treatment. Furthermore, this study highlights the synergistic application of empirical research and computational modeling in elucidating complex adsorption processes

Robotic right ventricle is a biohybrid platform that simulates right ventricular function in (patho)physiological conditions and intervention

The increasing recognition of the right ventricle (RV) necessitates the development of RV-focused interventions, devices and testbeds. In this study, we developed a soft robotic model of the right heart that accurately mimics RV biomechanics and hemodynamics, including free wall, septal and valve motion. This model uses a biohybrid approach, combining a chemically treated endocardial scaffold with a soft robotic synthetic myocardium. When connected to a circulatory flow loop, the robotic right ventricle (RRV) replicates real-time hemodynamic changes in healthy and pathological conditions, including volume overload, RV systolic failure and pressure overload. The RRV also mimics clinical markers of RV dysfunction and is validated using an in vivo porcine model. Additionally, the RRV recreates chordae tension, simulating papillary muscle motion, and shows the potential for tricuspid valve repair and replacement in vitro. This work aims to provide a platform for developing tools for research and treatment for RV pathophysiology.</p

Late Gadolinium Enhancement Magnetic Resonance Imaging Evaluation of Post-Atrial Fibrillation Ablation Esophageal Thermal Injury Across the Spectrum of Severity

Background Esophageal thermal injury (ETI) is a byproduct of atrial fibrillation (AF) ablation using thermal sources. The most severe form of ETI is represented by atrioesophageal fistula, which has a high mortality rate. Late gadolinium enhancement (LGE) magnetic resonance imaging (MRI) allows identification of ETI. Hence, we sought to evaluate the utility of LGE-MRI as a method to identify ETI across the entire spectrum of severity. Methods and Results All AF radiofrequency ablations performed at the University of Utah between January 2009 and December 2017 were reviewed. Patients with LGE-MRI within 24 hours following AF ablation as well as patients who had esophagogastroduodenoscopy in addition to LGE-MRI were identified. An additional patient with atrioesophageal fistula who had AF ablation at a different institution and had MRI and esophagogastroduodenoscopy at the University of Utah was identified. A total of 1269 AF radiofrequency ablations were identified. ETI severity was classified on the basis of esophageal LGE pattern (none, 60.9%; mild, 27.5%; moderate, 9.9%; severe, 1.7%). ETI resolved in most patients who underwent repeat LGE-MRI at 3 months. All patients with esophagogastroduodenoscopy-confirmed ETI had moderate-to-severe LGE 24 hours after ablation MRI. Moderate-to-severe LGE had 100% sensitivity and 58.1% specificity in detecting ETI, and a negative predictive value of 100%. Atrioesophageal fistula was visualized by both computed tomography and LGE-MRI in one patient. Conclusions LGE-MRI is useful in detecting and characterizing ETI across the entire severity spectrum. LGE-MRI exhibits an extremely high sensitivity and negative predictive value in screening for ETI after AF ablation