Ancient Greek laws of nature.

The prevailing narrative in the history of science maintains that the ancient Greeks did not have a concept of a 'law of nature'. This paper overturns that narrative and shows that some ancient Greek philosophers did have an idea of laws of nature and, moreover, they referred to them as 'laws of nature'. This paper analyzes specific examples of laws of nature in texts by Plato, Aristotle, Philo of Alexandria, Nicomachus of Gerasa, and Galen. These examples emerged out of the closely intertwined Platonic and Pythagorean traditions, and these philosophers' texts make reference to laws of nature when describing arithmetical methods, arithmological doctrines, or medical theories. Nicomachus' laws of nature are especially noteworthy, because they have features that historians look for in the search for the origin of the modern concept of laws of nature. Nicomachus' laws of nature are mathematical, universal, and necessary. This paper raises the possibility that the ancient Platonic and Pythagorean traditions influenced the subsequent development of the idea of laws of nature in medieval and early modern Europe, including the conception of laws of nature deployed by Johannes Kepler and Isaac Newton.

Effect of Adding the Antimicrobial L-Carnitine to Growing Rabbits' Drinking Water on Growth Efficiency, Hematological, Biochemical, and Carcass Aspects.

The current study was designed to assess the impact of L-carnitine (LC) supplementation in the drinking water of growing Alexandria-line rabbits on performance and physiological parameters. Two hundred eighty-eight 35-day-old rabbits were divided into four groups of twenty-four replicates each (seventy-two rabbits/treatment). The treatment groups were a control group without LC and three groups receiving 0.5, 1, and 1.5 g/L LC in the drinking water intermittently. The results showed that the group receiving 0.5 g LC/L exhibited significant improvements in final body weight, body weight gain, feed conversion ratio, and performance index compared to the other groups. The feed intake remained unaffected except for the 1.5 g LC/L group, which had significantly decreased intake. Hematological parameters improved in all supplemented groups. Compared with those in the control group, the 0.5 g LC/L group showed significant increases in serum total protein and high-density lipoprotein, along with decreased cholesterol and low-density lipoprotein. Compared to other supplemented groups, this group also demonstrated superior carcass traits (carcass, dressing, giblets, and percentage of nonedible parts). In conclusion, intermittent supplementation of LC in the drinking water, particularly at 0.5 g/L twice a week, positively influenced the productivity, hematology, serum lipid profile, and carcass traits of Alexandria-line growing rabbits at 84 days of age.

Acute Poisoning Among Children Admitted to Alexandria Poison Center, Egypt: Patterns and Predisposing Factors.

Acute poisoning in children is a major public health problem worldwide. Children poisoning ranks among the top unintentional injuries in children aged less than four years. This paper aimed to describe the pattern and characteristics of acute poisoning incidents, estimate the percentage of medication poisoning among those children and highlight the possible risk factors. All children aged below 10 years admitted to Alexandria Poison Centre (APC) with acute poisoning from the July 1, 2022, to December 31, 2022, were included in the study. A pre-designed structured interviewing questionnaire was used to collect data: socio-demographic data of the poisoned child and his/her caregiver, medical history of the poisoned child and family members, history of previous poisoning incidents in the family, details of the poisoning incident including causative agent, route of poisoning, scene of poisoning, time interval to reach APC and the first aid done.  350 children admitted to APC were included in our study, of which 59% (n=208) of poisoned children were males with mean age 3.14 ± 2.28 years. The types of poisoning found were 46.6% chemical compounds, 31.4% medication, 18% household and 4% food poisoning. Most of the children were poisoned orally. High education of caregiver, urban residence and the presence of chronic disease within a family member were significantly associated with medication poisoning while low education of caregiver, drug addiction, having chronic disease among a family member and the presence of previous poisoning accident in the family were significantly associated with poisoning with chemical compounds. The study found that acute poisoning is more common among young male children in Alexandria; the chemical compounds came first as the main source of poisoning followed by the medication poisoning.

Public awareness, attitude, and practice regarding food labeling, Alexandria, Egypt.

BACKGROUND: Food labeling is an important public health tool allowing consumers to make informed and healthy choices. Considering how important it is for consumers to be aware of food labels while choosing healthy foods, this study aims at assessing public awareness, attitude, and practice regarding food labeling in Alexandria Governorate, Egypt. METHODS: A cross sectional study using a predesigned interview questionnaire to collect data from 719 adult consumers from both sexes (28.2% males: 71.8% females), recruited from different branches of one of the largest supermarkets in Alexandria. RESULTS: More than half of the participants (55.6%) reported reading food labels. The most frequently read information was production/ expiry date (76.8%), product name (68.3%), and ingredients (38.0%) while the least frequently read was nutritional facts (29.9%). More than half of the study sample (50.9%) had low awareness about the content of food labels, nevertheless, having higher scores on awareness about food labels predicted reading practice. Nearly three-quarters of the respondents had average to good food label reading practice. Most respondents (81.8%) had a favorable attitude about food labeling in its present form, however, higher attitude scores did not seem to influence their use of food labels. Being older (ß = 0.045, CI; 0.014-0.076, p = 0.005), being female (ß = 1.162, CI; 0.541-1.784, p = 0.000), having secondary education or equivalent (ß = 1.042,CI; 0.050-2.034, p = 0.040), having university education or beyond (ß = 3.090, CI; 2.132-4.048, p = 0.000), and having higher scores on awareness about food labels (ß = 1.407, CI; 1.324-1.490, p = 0.000) were significant predictors of reading food labels. CONCLUSIONS: Most of the studied consumers had a positive attitude towards food labeling, however, more than half of them had low awareness of food labeling content. Nutritional facts were the least frequently read by consumers. Reading food labels was significantly predicted by having higher education, being older, being a female, and having better awareness.

Spatial congruency or discrepancy? Exploring the spatiotemporal dynamics of built-up expansion patterns and flood risk.

Most coastal cities have been experiencing unprecedented urbanization-induced flood risk, climatic events, and haphazard anthropogenic activities, jeopardizing residents' lives and building environments. Despite mounting flood-related studies, analyzing the correlation between the spatiotemporal dynamics of Built-up Expansion patterns (BE) and flood risk remains unknown and holds divergent perspectives. In this context, the coastal city of Alexandria, Egypt, characterized by multiple urban patterns and experiencing heavy rainfall annually, was selected as a testbed. Our method defined the spatiotemporal rates of BE from 1995 to 2023, quantified flood risk spatially, and finally investigated the correlation between BE and flood risk through spatial and statistical analysis. Our results show the built-up area occupied 30.32 % of the total city area till 2023, and the infilling pattern dominated the BE growth by 45.21 % of the total built-up area, followed by leapfrogging and edge expansion by 33.25 % and 21.55 %, respectively. The unplanned-infilling pattern is predominantly highly correlated with the flood-vulnerable peaks (correlation coefficient (rk) = 0.975, p-value < 0.05) and lowers dramatically towards planned-infilling regions with flood protections. Meanwhile, a spatial mismatch exists between high-risk peaks and leapfrogging and edge expansion (rk = 0.118 and 0.662, respectively, with a p-value < 0.01), indicating that controlling the built-up amount is inadequate for mitigating flood risk. Porosity-based urban configuration and spatial distribution of built-up patches in harmony with nature-based solutions are recommended for shaping flood-resilient and effective urban planning.

In-Ovo injection of melittin into Alexandria chicken eggs: a way for early immune acceleration.

This study intended to assess the properties of in-ovo administration of Melittin (MLT) on hatchability, chick yield, hematology, immunological indices and relative organs weight of Alexandria chickens at hatch. A total of 600 eggs with an average weight of (45.12 g), were gathered and split into five groups: a non-injected group or negative control (NC), a saline injection group or positive control (PC), and three concentrations of MLT (5, 10 and 15 µg of MLT per egg, respectively). On day 18 of incubation, eggs from the injection groups were injected into the amniotic fluid from the large end with the in-ovo injection solutions (0.2 ml per egg). Results indicated that 10 µg MLT/egg positively affected the weight and yield of chicks. In addition, our findings indicated that the in-ovo administration with 10 or 15 µg MLT/egg was superior in most of the immunological indicators (spleen and bursa relative weights, immunoglobulins IgG and IgM, T cells and B cells). In conclusion, in order to improve the immune efficiency (early immune acceleration) of Alexandria chicks, which may contribute to offering a significant boost to their future performance, this study suggests injecting eggs with 5 or 10 µg MLT/egg.

Metabolic Fingerprinting of Muscat of Alexandria Grape Musts during Industrial Alcoholic Fermentation Using HS-SPME and Liquid Injection with TMS Derivatization GC-MS Methods.

Muscat of Alexandria is one of the most aromatic grape cultivars, with a characteristic floral and fruity aroma, producing popular appellation of origin wines. The winemaking process is a critical factor contributing to the quality of the final product, so the aim of this work was to study metabolomic changes during the fermentation of grape musts at the industrial level from 11 tanks, 2 vintages, and 3 wineries of Limnos Island. A Headspace Solid-Phase Microextraction (HS-SPME) and a liquid injection with Trimethylsilyl (TMS) derivatization Gas Chromatography-Mass Spectrometry (GC-MS) methods were applied for the profiling of the main volatile and non-volatile polar metabolites originating from grapes or produced during winemaking, resulting in the identification of 109 and 69 metabolites, respectively. Multivariate statistical analysis models revealed the differentiation between the four examined time points during fermentation, and the most statistically significant metabolites were investigated by biomarker assessment, while their trends were presented with boxplots. Whilst the majority of compounds (ethyl esters, alcohols, acids, aldehydes, sugar alcohols) showed an upward trend, fermentable sugars, amino acids, and C6-compounds were decreased. Terpenes presented stable behavior, with the exception of terpenols, which were increased at the beginning and were then decreased after the 5th day of fermentation.

Assessing the effectiveness of nature-based solutions-strengthened urban planning mechanisms in forming flood-resilient cities.

Cities have experienced rapid urbanization-induced harsh climatic events, especially flooding, inevitably resulting in negative and irreversible consequences for urban resilience and endangering residents' lives. Numerous studies have analyzed the effects of anthropogenic practices (land use changes and urbanization) on flood forecasting. However, non-structural mitigation's effectiveness, like Nature-Based Solutions (NBS), has yet to receive adequate attention, particularly in the Middle East and North Africa (MENA) region, which have become increasingly significant and indispensable for operationalizing cities efficiently. Therefore, our study investigated the predictive influence of incorporating one of the most common NBS strategies called low-impact development tools (LID) (such as rain gardens, bio-retention cells, green roofs, infiltration trenches, permeable pavement, and vegetative swale) during the urban planning of Alexandria, Egypt, which experiences the harshest rainfall annually and includes various urban patterns. City characteristics-dependent 14 LID scenarios were simulated with recurrence intervals ranging from 2 to 100 years using the LID Treatment Train Tool (LID TTT), depending on calibrated data from 2015 to 2020, by the Nash-Sutcliffe efficiency index and deterministic coefficient, and root-mean-square error with values of 0.97, 0.91, and 0.31, respectively. Our findings confirmed the significant effectiveness of combined LID tools on total flood runoff volume reduction by 73.7%, revealing that different urban patterns can be used in flood-prone cities, provided LID tools are considered in city planning besides grey infrastructure to achieve optimal mitigation. These results, which combined multiple disciplines and were not explicitly mentioned in similar studies in developing countries, may assist municipalities' policymakers in planning flood-resistant, sustainable cities.

Are Coastal Hotels Ready for Climate Change? The Case of Alexandria, Egypt.

Climate change casts a shadow on the tourism industry in Egypt in general, and on coastal hotels in particular, as the coastal areas of Egypt have been classified as the most vulnerable to climate change in the Middle East. As such, mitigating the negative impacts and threats of climate change requires an assessment of the vulnerability of coastal hotels and the extent to which adaptation measures are applied. Accordingly, this study applied a hybrid methodology to achieve three main objectives. First, to evaluate Alexandria's vulnerability to future climate change (at the destination level) by analyzing the recent climatic trends and expected scenarios. Second, to assess the vulnerability of Alexandria's coastal hotels to climate change (sector level) using satellite images, aerial mapping, remote sensing, and geographic information systems (GIS). Third, to explore how coastal hotels are adapting to the risks of climate change using the four business-focused adaptation measures (i.e., technical, managerial, policies, and awareness-raising). The findings of the study revealed and confirmed that the hotel sector in Alexandria is threatened by sea level rise (SLR). Four hotels are at risk of inundation, and the extent of hotels at risk will increase with future scenarios of SLR. On the other hand, the results of examining the adaptation measures of 36 hotels indicated that the scope of the adaptation measures differed significantly between hotels due to factors such as hotel category, size, duration of operation, and EMS status, but overall, the scope of application was more comprehensive and varied than expected. Technical adaptation measures were the most common and applied by the majority of hotels in Alexandria. The results of this study should help figure out what adaptation measures coastal hotels should take and show policymakers where they should focus their adaptation efforts.

A Closed-Loop Clinical Audit of Surgical Documentation of Inpatient Records at a Tertiary Level Hospital in Egypt.

BACKGROUND: Optimal record keeping is a very essential component in health care provision especially in the surgical setting. This study aimed to evaluate the quality of surgical records in wards of a surgical department at Alexandria Main University Hospital, Egypt. METHODS: We created a systematically designed checklist using standard hospital protocol and universal guidelines presented in the previously validated STAR and CRABEL auditing tools as a basis for Yes/No questions. This checklist was then used to prospectively evaluate the quality of surgical records of patients who underwent surgery in the surgical oncology department from July 2023 to October 2023. Total STAR and section-specific STAR scores were then calculated and compared statistically. RESULTS: A total of 80 records were randomly selected and evaluated using the STAR questionnaire. All domains showed improvement compared to the baseline except for the discharge summary which did not change from an already relatively high baseline of 96±0.0. The highest improvements were observed in the anesthetic record and operative record domains which increased from 90.65±4.3 and 86.15±5.347 to 100±0.0 and 95.6±3.365, respectively. CONCLUSION: Our study demonstrates that significant improvements in the quality of surgical records can be achieved by simply using preprepared templates, personnel education, and systematic auditing.

Assessment of patient safety culture among the staff of the University Hospital for Gynecology and Obstetrics in Alexandria, Egypt.

BACKGROUND: Patient safety (PS) is a fundamental component of healthcare quality. Patient Safety Culture (PSC) assessment provides an organization with insight of perceptions and attitudes of its staff related to patient safety. In addition, it is meant to improve performance rather than blaming individuals. This study aimed to assess patient safety culture from the health care staff perspective in El-Shatby University Hospital for Gynecology and Obstetrics. METHODS: A descriptive cross-sectional study was conducted. The study was conducted at El-Shatby University Hospital for Gynecology and Obstetrics from November 2020 to January 2021. The target participants were assistant lecturers, residents, and head nurses in charge during the field study period. The number of potential participants who fulfilled the inclusion criteria (in charge during the period of data collection and working in the hospital for more than 3 months) was 83; the twelve participants who participated in the pilot study were excluded. The total number of participants who agreed to participate in the study was 66 participants (38 residents, 18 assistant lecturers, and 10 head nurses) out of 71 potential participants representing a 92.9% response rate. A structured self-administered questionnaire format adapted from Hospital Survey on Patient Safety Culture (HSOPSC) questionnaire was distributed anonymously to the participants. The questionnaire has 42 items measuring twelve patient safety culture dimensions: teamwork within the unit, supervisors' expectations and actions to promote patient safety, feedback and communication about error, organizational learning, communication openness, overall perception of patient safety, hands-off and transitions, teamwork across units, frequency of events reported, management support for patient safety, staffing, and management support for patient safety. Except for two items that are responded on a five-point frequency scale (never, rarely, sometimes, most of the time, and always) the majority of patient safety culture questions are answered on a five-point agreement scale (strongly disagree, disagree, neutral, agree, and strongly agree), with a higher score indicating a more favorable attitude toward patient safety. RESULTS: The overall average positive percent score was 45.4%. Average positive response percentages to individual items ranged from 28.8 to 81.8%. No domain had an average positive percent score of more than 75%. Out of the twelve dimensions of patient safety culture included in the HSOPSC questionnaire, "the teamwork within unit" domain had the highest average positive percent score (62.1%) among all participants. On the other hand, the "Non-punitive response to error" domain had the lowest score (18.9%). More than half (57.6%) of the participants rated patient's safety at the hospital as acceptable. CONCLUSION: Investing in practices that strengthen patient safety is crucial if the hospital is to improve overall performance and quality of services. The present study displays a frail patient safety culture (PSC) in the majority of the domains. All the domains should be considered of high priority focused areas for remark and reformative tasks. Continuous training programs of the staff on patient safety to improve their perception of safety culture are necessary. All PSC composites need improvement starting with regular assessment of PSC along with continuous monitoring and increasing the healthcare providers' awareness of demanded PSC.

Water quality and trophic status of Lake Mariut in Egypt and its drainage water after 8-year diversion.

Water resource management and lake rehabilitation are global interest, to overcome the acute water scarcity facing most urban areas, especially in developing countries. Lake Mariut (LM) is an Egyptian lake that lies south of the Mediterranean Sea, and its management had a great interest in Alexandria's future development and as a part of the environmental sustainability of the Mediterranean basin. LM consists of 4 major basins, namely, main (MB), northwest (NWB), southwest (SWB), and fishery (FB). The MB has deteriorated as it consistently received (sewage and industrial) wastewaters till 2010. This was the date of diversion of the polluting sources as a rehabilitation step. The present work is made after elapsing 8 years from the diversion and aims at monitoring and assessing the status of the water quality not only of MB but also for the other 3 basins too. This was carried out twice, one in cold winter and the other in warm summer. The parameters studied were physico-chemical including water temperature, pH, dissolved oxygen/hydrogen sulfide (DO/H2S), salinity, and chlorophyll a besides nutrient salts (nitrogen, N and phosphorus, P compounds). The results revealed that the waters of both MB and SWB basins were depleted in DO to a level difficult to sustain fish life and showed elevated levels of most nutrient salts. Trophically, all the studied basins were in eutrophic-hypereutrophic condition. As a result of pollution source diversion away from MB to be discharged in the downstream part of Umum Drain (UD), the levels of TN and TP entering Mex Bay through UD were slightly higher than the permissible limit and lower than dangerous loading. The applying of principle component analysis (PCA)-based classification approach, for obtaining the WQI on the current study, revealed that the FB, NWB, and SWB2000 showed a relatively good water quality when compared with MB. The depletion in the vital DO is catastrophic and needs urgent solution/s. One of the proposed solutions is the dredging of bottom spoiled organic-rich sediments. This and other suggested solutions are, however, discussed, evaluated, and presented.

Self-practice among patients with psoriasis: University hospital experience.

OBJECTIVES: This study aimed to assess the self-care practices of patients with psoriasis and factors affecting them. METHODS: A cross-sectional study was conducted on 110 adult patients with confirmed diagnosis of psoriasis. Each patient underwent a personal structured interview with the physician using two predetermined questionnaires, one for assessing self-care practices and another for evaluating patients' knowledge of their disease and sociodemographic and clinical features. RESULTS: Most studied patients had poor level of self-care practices and knowledge. Patients' level of self-care was positively associated with the level of the knowledge of their disease. Poor level of self-care practice was significantly associated with low level of education, disease severity, and Psoriasis Area and Severity Index score. CONCLUSION: Patients with low level of education or disease knowledge will mostly have poor self-care behavior.

Very High Fascioliasis Intensities in Schoolchildren from Nile Delta Governorates, Egypt: The Old World Highest Burdens Found in Lowlands.

Quantitative coprological analyses of children were performed in Alexandria and Behera governorates, Egypt, to ascertain whether individual intensities in the Nile Delta lowlands reach high levels as those known in hyperendemic highland areas of Latin America. Analyses focused on subjects presenting intensities higher than 400 eggs per gram of faeces (epg), the high burden cut-off according to WHO classification. A total of 96 children were found to shed between 408 and 2304 epg, with arithmetic and geometric means of 699.5 and 629.07 epg, respectively. Intensities found are the highest hitherto recorded in Egypt, and also in the whole Old World. A total of 38 (39.6%) were males and 58 (60.4%) were females, with high intensities according to gender following a negative binomial distribution. The high burden distribution shows a peak in the 7-10 year-old children group, more precocious in females than males. Results showed high burdens in winter to be remarkably higher than those known in summer. The fascioliasis scenario in Egyptian lowlands shows similarities to highlands of Bolivia and Peru. Diagnostic methods, pathogenicity and morbidity in high burdens should be considered. The need for an appropriate quantitative assessment of heavy infected children to avoid post-treatment colic episodes is highlighted.

Pattern of Urban Flora in Intra-City Railway Habitats (Alexandria, Egypt): A Conservation Perspective.

Intra-city railway areas are deemed large greenspaces and are believed to be key in enhancing the diversity and dynamics of urban flora. In the current study, the floristic composition and diversity along intra-city railway and tram tracks in Alexandria were surveyed. The floristic composition of the plant communities in relation to environmental factors, ecological indicators, and level of human impact was analyzed using multivariate analysis (two-way indicator species analysis (TWINSPAN) for classification and detrended correspondence analysis (DECORANA) for ordination. The multivariate ordination techniques (CCA) revealed differences in the environmental factors and climatic factors influencing the floristic composition of the railway and tram track habitats. Tram tracks suffered higher human impact while maintaining higher vitality and cover compared to train tracks. Species recorded were mainly therophytes, followed by phanerophytes and hemicryptophytes dominated by native species; however, invasive species' contribution was higher compared to surrounding regions. The number of invasive species was greater in railway areas compared to tram track areas (19 and 15, respectively). The occurrence of two endemic species (Sinapis allionii and Sonchus macrocarpus) with limited national distribution highlights the importance of these habitats as valuable refuge areas for rare and endangered species worthy of conservation action.

Using ESN-Smartphone Application to Maximize AIS Reperfusion Therapy in Alexandria Stroke Network: A Stroke Chain of Survival Organizational Model.

Background: In developing countries like Egypt, the clinical workflow of stroke management is poorly established due to the lack of awareness of the stroke patients concerning their need of therapeutic intervention and the poor identification of facilities equipped to treat stroke. Hence, establishing a stroke system of care in developing countries that can efficiently and rapidly triage patients to the appropriate reperfusion therapy center is imperative to improving stroke management and outcomes. Aims: To evaluate a pilot experience in stroke hospital identification and expediting decision-making in AIS treatment through the Alexandria stroke network and Egyptian Stroke Network (ESN)-app. Methods: Between 2017 and 2019, seven hospitals registered themselves on the AS-Network as pilot hospitals. The ESN-application was used to detect stroke type, tele-connect stroke teams and hospitals, track triage of patients to equipped facility in real time, and streamline stroke workflow. The quality of and time required for stroke management were compared between 84 patients with acute ischemic stroke (AIS) whose treatment involved the ESN-app and 276 patients whose treatment did not. Results: During this pilot study, 360 AIS cases received reperfusion therapy, 84 of which were indicated by the ESN-app. The use of the application was associated with the significant drop in time metrics for the reperfusion AIS-patients (door-in-door-out time; 56 ± 34 min vs. 96 ± 45 min, door-to-groin puncture time; 50 ± 7 min vs. 120 ± 25 min, door-to-needle time; 55 ± 12 min vs. 78 ± 16 min with p < 0.0001). Its use was also associated with higher rates of excellent outcomes at the 90-day follow-up (without ESN-app vs. with ESN-app, 67.9 vs. 47.1%, p = 0.001) but no difference in 90-day mortality or symptomatic intracerebral hemorrhage (without ESN-app vs. with ESN-app, 9.5 vs. 11.2% and 4.8 vs. 5.1%, p > 0.05). Conclusion: Our pilot experience demonstrated that the use of the ESN-app expedited the stroke treatment workflow and facilitated tele-connection between registered stroke facilities. Additionally, its use might be associated with achieving higher rates of excellent outcomes at 90 days, where a larger scale study is needed for more confirmation.

Thermal comfort optimization through bioclimatic design in Mediterranean cities.

Background: Bioclimatic design is an approach based on local climate which improves thermal qualities and indoor comfort. Buildings follow this process to minimize negative effects on the environment. However, this approach is still not suitable in developed countries. This study aims to investigate Mediterranean local bioclimatic strategies' impact on thermal comfort efficiency in housing, by examining architectural elements and treatments. Methods: We adopted a descriptive, analytical, and comparative methodology, complemented with a software simulation, within a qualitative and quantitative approach. Investigation and methodological tools were based on technical information including plans, elevations, photos, and documentation. The approach consisted of multiple stages: a literature review interpreting the concept of bioclimatic design, as well as thermal comfort variables and common Mediterranean building features. Moreover, the paper showcases three examples of successful Mediterranean passive houses. Furthermore, the paper presents a case- studyhouse in Alex West, Alexandria, designed in the Mediterranean Revival style. Results: The results showed that the most influencing building features on thermal comfort were the low-pitched roofs and the top chimney, which achieved 12.6% and 5% improvement in the summer and 13% and 6.8% in winter, respectively. The pergola and porch elements barely had an effect when placed on the northern façade. However, on the southern façade, a positive contribution in the summer by 1.4% and 3.4% respectively were reported, but a slight negative impact in winter by 0.5% and 2% respectively. Conclusions :  We examined the impact of common Mediterranean building features , and compared thermal comfort results between case-study houses. Features focusing on passive design for cooling rather than heating, allowing wind flow for maximized natural ventilation, using ventilated pitched roof spaces, using sun shading elements in the proper facades and angles, help passive thermal regulation. The study proposes recommendations for optimizing thermal comfort in residential buildings in Alexandria, Egypt.

Human Health Implication of Major and Trace Elements Present in Commercial Crustaceans of a Traditional Seafood Marketing Region, Egypt.

The present study focused on the distribution of some major and trace elements (S (as SO42-), Na, K, B, Ca, Mg, F, Li, Al, Fe, Zn, Cu, Mn, Ni, Co, Cd, and Pb) in both flesh (Fl) and total cephalon/exoskeleton (C/E) tissues of selected crustacean species obtained from an Egyptian traditional seafood marketing region. The sequence of studied elements in (Fl) and (C/E) tissues in descending orders was S (as SO42-) > Na > K > B > Mg > Ca > Li > F > Al > Zn > Fe > Cu > Pb > Ni > Mn > Co > Cd, and S (as SO42-) > Na > B > K > Mg > Ca > F > Li > Al > Fe > Cu > Zn > Mn > Pb > Ni > Co > Cd, respectively. Both length-weight relationship and Fulton's condition factor showed the physical and biological statuses of the crustaceans. Ion quotient calculations of the studied tissues pointed to their importance in decreasing hypertension, preeclampsia, and heart disease. Human health risk due to the consumption of the crustacean species was determined using some guideline limits, metal pollution index (MPI), estimated daily intake (EDI), health comparison values (CVs), dietary intake (DRI-ULs), target hazard quotient (THQ), total target hazard quotient (TTHQ), and provisional tolerable weekly intake (%PTWI). MPI values of cephalon/exoskeleton tissues were greater than those of the flesh with ranges between 11.4-24.0 and 4.6-14.3, respectively. Interestingly, the calculations of TTHQ of toddler and adult were lesser than one and not expected to pose any risk concern to human from crustaceans' consumption.

Pattern of Uveitis Associated with Behçet's Disease in an Egyptian Cohort.

PURPOSE: To report the clinical experience of uveitis associated with Behçet's disease in a cohort of Egyptian patients. METHODS: The present study is a retrospective analysis of the medical charts of patients with Behçet's disease, who were referred to a tertiary eye care center in Egypt between June 2010 and June 2018. RESULTS: The current study included 1301 eyes of 681 patients with Behçet's disease. The mean age of the patients at the time of referral was 27.2 ± 3.9 years. Panuveitis was the most common presentation. About 28% of all involved eyes had a final visual acuity <20/200, by the last follow-up visit. CONCLUSION: Behçet's disease is an important cause of uveitis in Egypt, and despite the fact that the prognosis of Behçet's uveitis has globally improved in recent years, the visual outcome in Egypt is still not favorable especially in case of delayed referral to tertiary centers.

Knowledge and health beliefs of reproductive-age women in Alexandria about tetanus toxoid immunization.

BACKGROUND: Maternal neonatal tetanus is a substantial public health problem in many developing countries. In 2017, nearly, 30,848 newborns died of neonatal tetanus; thus, high immunization coverage remains a necessity. This study aims to assess knowledge and health beliefs of reproductive-age women in Alexandria about tetanus toxoid immunization. METHODS: A cross-section survey of 700 females attending health offices in Alexandria was done using an interview questionnaire to collect data regarding women's knowledge and beliefs about tetanus toxoid vaccine (TTV) and maternal and neonatal tetanus (MNT). Nine health offices were selected using multi-stage random sampling. RESULTS: Most of studied women (83.6%) had poor knowledge of MNT and TTV. The highest percentage of women had low perception of susceptibility to MNT (48.0%), moderate perception of severity of MNT (57.4%) and barriers to TTV (58.9%), high perception of benefits of TTV (86.6%), and high self-efficacy in taking the vaccine (76.2%). Less than one-third of the sampled women (27.7%) were immune by (TT2+). Logistic regression models showed that the place of antenatal care, level of knowledge, perceived barriers, and socio-economic level were significant predictors of immunity status (p = 0.008, p = 0.032, p = 0.011, and p = 0.001, respectively). CONCLUSION: Women lacked information about MNT/TTV and may even have been discouraged by their private obstetricians from taking the vaccine. Perceived barriers to receiving tetanus toxoid vaccination were shown to be an important predictor of immunization behavior.