Multi-attribute decision-making based on novel Fermatean fuzzy similarity measure and entropy measure.

To deal with situations involving uncertainty, Fermatean fuzzy sets are more effective than Pythagorean fuzzy sets, intuitionistic fuzzy sets, and fuzzy sets. Applications for fuzzy similarity measures can be found in a wide range of fields, including clustering analysis, classification issues, medical diagnosis, etc. The computation of the weights of the criteria in a multi-criteria decision-making problem heavily relies on fuzzy entropy measurements. In this paper, we employ t-conorms to suggest various Fermatean fuzzy similarity measures. We have also discussed all of their interesting characteristics. Using the suggested similarity measurements, we have created some new entropy measures for Fermatean fuzzy sets. By using numerical comparison and linguistic hedging, we have established the superiority of the suggested similarity metrics and entropy measures over the existing measures in the Fermatean fuzzy environment. The usefulness of the proposed Fermatean fuzzy similarity measurements is shown by pattern analysis. Last but not least, a novel multi-attribute decision-making approach is described that tackles a significant flaw in the order preference by similarity to the ideal solution, a conventional approach to decision-making, in a Fermatean fuzzy environment.

Tracking the developmental events in the duodenum of the quail embryo: Using light and electron microscope.

The present study described the full morphology of the duodenum of the Japanese quail during the embryonic stage from 3rd day of incubation till hatching using the light and electron (scanning and transmission) microscope. The specimens were collected, analyzed and described anatomically, morphometrically and microscopically. The first recognition of the prospective duodenum was at the 4th day of incubation and developed continuously by age progression. The prospective duodenum consisted of a flat pseudostratified epithelium, mesenchyme and covering mesothelium. On day 8th of incubation, the epithelium developed three evaginations lead to formation three previllous ridges protruding inside the duodenal lumen, which later at the 9th day differentiated into numbers of projections; villi. On the 9th day, the epithelium lined the villi transformed into a simple columnar type, the duodenal villi appeared as pyramidal-shaped projections, had wide base and narrow apex and by age progression, the duodenal villi went through changes in number, size and shape. On hatching day, the duodenal epithelium consisted of enterocytes interspersed with secretory goblet cells, which stained positive for both Periodic Acid Schiff (PAS) and Alcian blue AB and represented filled with metachromatic granules. The muscular wall started as mesenchymal condensation on the 6th day then differentiated into the circular smooth muscle layer on the 9th day of incubation. Giving detailed information about the morphological development of the duodenum during the incubation period of quail embryo helps in reaching a satisfactory explanation about how the duodenum plays a vital role in digestion, absorption and immunity. HIGHLIGHTS: Studying the quail duodenum can be used as a model for understanding the mammalian duodenum. Understanding the duodenal structure and its function is the best way to maximize the efficiency of the production of the livestock through giving the best type of diet. Duodenum plays a vital role in digestion through the digestible secretions, absorption of nutrients, and immunity against invaders. Duodenum is the spot where the food digestion mostly occurs.

Morphological and ultrasonographic characterization of the three zones of supratesticular region of testicular artery in Assaf rams.

To fully understand the histological, morphometrical and heamodynamic variations of different supratesticular artery regions, 20 mature and healthy Assaf rams were examined through ultrasound and morphological studies. The testicular artery images of the spermatic cord as shown by B-mode analysis indicated a tortuous pattern along its course toward the testis, although it tends to be less tortuous close to the inguinal ring. Doppler velocimetric values showed a progressive decline in flow velocity, in addition to pulsatility and vessel resistivity when entering the testis, where there were significant differences in the Doppler indices and velocities among the different regions. The peak systolic velocity, pulsatility index and resistive index were higher in the proximal supratesticular artery region, followed by middle and distal ones, while the end diastolic velocity was higher in the distal supratesticular region. The total arterial blood flow and total arterial blood flow rate reported a progressive and significant increase along the testicular cord until entering the testis. Histological examination revealed presence of vasa vasorum in the tunica adventitia, with their diameter is higher in the proximal supratesticular zone than middle and distal ones. Morphometrically, the thickness of the supratesticular artery wall showed a significant decline downward toward the testis; meanwhile, the outer arterial diameter and inner luminal diameter displayed a significant increase distally. The expression of alpha smooth muscle actin and vimentin was higher in the tunica media of the proximal supratesticular artery zone than in middle and distal ones.

Group decision-making analysis with complex spherical fuzzy N-soft sets.

This paper develops the ELiminating Et Choice Translating REality (ELECTRE) method under the generalized environment of complex spherical fuzzy $ N $-soft sets ($ CSFN\mathcal{S}_{f}Ss $) that have distinctive and empirical edge of non-binary parametrization and also indeed overcome the limitations and flaws of existing ELECTRE I methods. We propose an innovatory decision-making technique, namely, $ CSFN\mathcal{S}_{f} $-ELECTRE I method where the data and information are in modern modes. The proposed $ CSFN\mathcal{S}_{f} $-ELECTRE I method enjoys all the distinct and modern attributes of uncertain information which mainly comprises of parameterizations, neutral perspective, multi-valuation and two-dimensional representations. We support the proposed work by a flowchart along with an algorithm and then utilize it to solve the MAGDM problem under $ CSFN\mathcal{S}_{f} $ environment. This novel technique employs the principles of $ CSFN\mathcal{S}_{f} $ concordance and $ CSFN\mathcal{S}_{f} $ discordance sets which are established on score and accuracy functions and engrossed to enjoin the most superior alternative. Ultimately, the decision graph and aggregated outranking Boolean matrix are formulated by merging the outcomes of $ CSFN\mathcal{S}_{f} $ concordance and $ CSFN\mathcal{S}_{f} $ discordance indices which are evaluated through score function and distance measures, respectively. Moreover, linear-ranking order is evaluated which provides linear ordering of decision alternatives. A prime MAGDM problem of poverty alleviation is addressed from socio-economic field that approve the flexibility of the intended approach. We perform a sustaining comparison with another approach (CSF-ELECTRE I approach) to assure the productivity and potency of the proposed methodology. We also provide an allegorical line graph of this comparison that demonstrate the admissibility of the resulting outcomes.

A new MAGDM method with 2-tuple linguistic bipolar fuzzy Heronian mean operators.

In this article, we introduce the 2-tuple linguistic bipolar fuzzy set (2TLBFS), a new strategy for dealing with uncertainty that incorporates a 2-tuple linguistic term into bipolar fuzzy set. The 2TLBFS is a better way to deal with uncertain and imprecise information in the decision-making environment. We elaborate the operational rules, based on which, the 2-tuple linguistic bipolar fuzzy weighted averaging (2TLBFWA) operator and the 2-tuple linguistic bipolar fuzzy weighted geometric (2TLBFWG) operator are presented to fuse the 2TLBF numbers (2TLBFNs). The Heronian mean (HM) operator, which can reflect the internal correlation between attributes and their influence on decision results, is integrated into the 2TLBF environment to analyze the effect of the correlation between decision factors on decision results. Initially, the generalized 2-tuple linguistic bipolar fuzzy Heronian mean (G2TLBFHM) operator and generalized 2-tuple linguistic bipolar fuzzy weighted Heronian mean (G2TLBFWHM) operator are proposed and properties are explained. Further, 2-tuple linguistic bipolar fuzzy geometric Heronian mean (2TLBFGHM) operator and 2-tuple linguistic bipolar weighted geometric Heronian mean (2TLBFWGHM) operator are proposed along with some of their desirable properties. Then, an approach to multi-attribute group decision-making (MAGDM) based on the proposed aggregation operators under the 2TLBF framework is developed. At last, a numerical illustration is provided for the selection of the best photovoltaic cell to demonstrate the use of the generated technique and exhibit its adequacy.

Performance scanning electron microscopic investigations and elemental analysis of hair of the different animal species for forensic identification.

Veterinary forensics have attracted less attention compared with human forensics. Animal hair morphological examination using scanning electron microscopy (SEM) and hair mineral analysis using energy-dispersive X-ray fluorescence (ED-XRF) provide reference databases for animal hair identification used in forensic investigations. This study was performed on four different animal species: large ruminants (buffalo and cattle), small ruminants (goat and sheep), carnivores (cat and dog), and equines (donkey and horse). The hair scale pattern, scale margin type, and distance between scales were identified. The hair scale pattern was imbricate in large ruminants, goat, and horse; coronal (crown-like) in carnivores and donkey; and spinous in sheep. The morphometric measurements, including cuticle layer thickness, cuticle scale height, cortex diameter, and hair shaft width were recorded. The highest cuticle thickness was found in horse, and the highest cuticle hair scale was detected in cattle. Moreover, the largest cortex diameter was measured in buffalo, whereas the smallest one was in cat. With regard the content of hair elements, some elements were specific for the hair of certain tested animals, such as bromine in sheep and magnesium and phosphorus in buffalo. In addition, vanadium and titanium were found only in cattle and dog, and the latter element was also detected in sheep. In conclusion, this study provides two techniques for animal hair identification that can be used in forensic investigations. RESEARCH HIGHLIGHTS: Hair scale pattern was imbricate in (large ruminants, goat, and horse); coronal in (carnivores and donkey); and spinous in (sheep) with different scale margins type. Hair shaft width in all tested animal species ranged from 23.78 ± 1.24 µm to 85.51 ± 1.14 µm.

Predictive factors of successful testicular sperm extraction for non-obstructive azoospermia with a history of bilateral cryptorchidism and normal testosterone.

This study aimed to assess the predictive factors of successful sperm retrieval in non-obstructive azoospermia with a history of bilateral cryptorchidism. This retrospective study included 103 patients with azoospermia who had micro-dissection testicular sperm extraction between January 2010 and January 2020. The median (range) age of the patients and their wives in the study group was 33 (21-44) and 24 (19-33) years, respectively. The patients with low testosterone level (<3 ng/dl) were prescribed with human chorionic gonadotropin 5,000 IU injection every 3 days for 3 months. Those with persistent low testosterone even after hormonal stimulation were excluded. Sperms were retrieved from 64 (62%) patients, whilst failed in 39 (38%) patients. On univariate analysis, the median testicular volume was significantly larger in the successful group versus the failed group (p < .001), serum FSH and serum LH were significantly lower in the successful group (p = .001), serum testosterone was significantly higher in the successful group compared to the failed group (p < .001) and the age of orchidopexy was lower in the successful group versus the failed group (p = .016). On multivariate analysis, the average testicular volume and the serum testosterone levels were independent factors for successful sperm retrieval.

Morphometrical, histological, and scanning electron microscopic investigations on the hard palate of Rahmani sheep (Ovis aries).

The present study investigated the hard palate of Rahmani sheep (Ovis aries). Samples from nine healthy adult male sheep were investigated using morphometrical, histological and scanning electron microscopic examination. Morphologically, the hard palate was elongated, narrow rostrally, and wide caudally. The incisive papilla was heart-shaped, flanked on both sides by a groove on which the nasopalatine duct opened. The palatine raphe was in the form of a groove that contained a ridge caudally. On both sides of the raphe, 13-15 pairs of palatine ridges were present and mainly occupying the narrow part. The wide part had a rough part that contains few ridges rostrally and a smooth part caudally. Histologically, the incisive papilla and palatine ridges were lined by a keratinized stratified squamous epithelium resting on a dense layer of lamina propria. The incisive papilla characterized by the presence of seromucoid salivary glands and hyaline cartilage fragments in the lamina propria. The salivary glands became abundant and well-developed in the wide part till the end of hard palate. All palatine salivary glands were Alcian blue-periodic acid-Schiff positive. By scanning electron microscopy, numerous gland openings were scattered on the surface of the palatine ridges. In conclusion, the hard palate of Rahmani sheep presented characteristic features, which may be related to the species differences, feeding behavior, and possible functional adaptations. This is the first study to report the presence of cartilaginous segments and salivary glands in the incisive papilla and provide detailed descriptions of the Rahmani sheep hard palate.

Lichen sclerosis-induced long segment anterior urethral stricture: The early outcome of one-stage repair using dorsolateral onlay buccal mucosa graft.

BACKGROUND: Substitution urethroplasty using buccal mucosal grafts can be performed by several approaches including ventral onlay graft, dorsal onlay graft, or ventral urethrotomy with dorsal inlay graft. Our study aims to evaluate the surgical outcome of dorsolateral buccal mucosal graft for long segment anterior urethral stricture >6 cm in patients with Lichen sclerosus (LS). METHODS: A retrospective study included patients who underwent repair for long segment anterior urethral stricture >6 cm due to LS between January 2013 and April 2019. All patients were followed-up at 3, 6, 9, and 12 months postoperatively and then yearly by clinical symptoms, uroflowmetry, and calculation of post-void residual urine volume. Retrograde urethrogram was requested for patients with voiding symptoms or decreased maximum flow rate. Stricture recurrence that required subsequent urethrotomy or urethroplasty was considered failure. The success rate and surgical complications were collected and analyzed. RESULTS: Thirty patients were identified. The median age (range) was 39 (25-61) years and a median (range) stricture length was 8 (6-14) cm. Most of postoperative complications were of minor degree. The success rate at median follow-up of 15 (12-24) months was 86.5%. The median maximum flow rate increased significantly from 6 (2-11) ml/s preoperatively to 18 (range: 6-23) ml/s at the 6th month (p value < 0.001). CONCLUSION: Dorsolateral buccal mucosal grafts urethroplasty for long anterior urethral stricture caused by LS has a high success rate and low risk of complications including stricture recurrence.

Scanning electron microscopy of the nasal skin in different animal species as a method for forensic identification.

The current study aims to provide a new method for the identification of animal species by using the scanning electron microscopic study on the nasal skin around the nostril. The reference databases for animal identification using traditional ways (i.e., hair and bone analyses) were somewhat available. This study was conducted on the nasal skin of seven different animal species: large ruminants (Saidi buffalo and frozen Angus cattle); small ruminants (Egyptian goat and Rahmani sheep); camels (one-hump dromedary camel); equines (African domestic donkey and Arabian horse); carnivores (farm domestic cat, Egyptian Baladi dog, and red fox); swine (Danish Landrace pig); and rodents (albino rat and New Zealand white rabbit). The nasal skin was divided by grooves into different shaped raised areas in some examined animals, the mean diameter of these areas and width of the grooves of each animal species were recorded. The characteristic differential features of the nasal skin of each animal species have been documented. Few openings of the nasolabial glands were demonstrated in large ruminants and swine, which were H letter-shaped in buffaloes, oval-shaped in cattle, and whirlpool-shaped with several layers of folds on their margin in pig. Moreover, the openings of the lateral nasal glands were whirlpool, ovoid, and oval shaped in goats, sheep, and camels, respectively. In conclusion, the present study proved that the skin around the nostrils plays an important role as means of identification in forensic investigations and improves the field of veterinary forensic medicine in general, which is not well-developed in comparison with human forensics.

Morphological and ultrastructural features of the laryngeal mound of Egyptian Cattle Egret (Bubulcus ibis, Linnaeus, 1758).

BACKGROUND: According to our acknowledgment this is the first full anatomical description of the studied laryngeal mound of the Egyptian Cattle Egret (Bubulcus ibis, Linnaeus, 1758). This study was obtained with the aid of scanning electron microscopy (SEM) and histological techniques. Heads of ten healthy adult male Egyptian cattle egrets were used in this study. RESULTS: The laryngeal mound (Mons laryngealis) was a pear-shaped musculoskeletal elevation. It represented 20.55 and 67.87% of the total length of the oropharyngeal floor and the pharyngeal floor, respectively. By SEM view, the lateral aspect of the caudal third of the laryngeal mound had a serrated mucosal appearance, forming of 6-7 finger-like projections. Furthermore, the terminal part of the laryngeal mound (except the middle part) was bordered a transverse row of pyramidal-shaped papillae, which demarcated from the esophagus. Histologically, laryngeal salivary glands termed (cricoarytenoid salivary glands) of the laryngeal mound were simple tubular type and were arranged in one row within the lamina propria connective tissue close to the lamina epithelialis. Those glands were surrounded by abundant aggregation of lymphocytes, extended overlying the surface lining epithelium. The glottis within the laryngeal mound was supported by hyaline cartilages; dorsally by paired arytenoid cartilages, ventrolaterally by cricoid cartilage, and caudodorsally by procricoid cartilage. Two groups of intrinsic laryngeal skeletal muscles have connected the cartilages. The glandular epithelium of the laryngeal salivary glands and chondrocytes of the laryngeal cartilages showed strongly positive alcian blue reaction. CONCLUSIONS: The laryngeal mound shows certain features that are unique as an adaptation to lifestyles and bird's habitat.

The correlation of antioxidant levels of breast cancer: A case controlled study.

ABSTRACT: Many free radicles are implicated to activate a number of oncogenic signaling, cause damage to deoxyribonucleic acid and tumor suppressor genes, or promote expression of proto-oncogenes. Reduced level of antioxidants and increases oxidative stress markers are associated with the development of various types of cancer.This prospective study included 60 women who were grouped into equal groups. Patients group included 30 breast cancer women and control group consisting of 30 apparently healthy women. Both groups were compared regarding the serum levels of antioxidants biomarkers (vitamin C, ceruloplasmin, glutathione) and oxidative stress biomarkers, malondialdehyde (MDA), peroxynitrite, and gamma-glutamyl transferase.In regard to the antioxidant biomarkers, there was a significant difference between the patients and the controls regarding the levels of serum ceruloplasmin and glutathione, (P values .000) for each while vitamin C showed no significant correlation (P value .053), while regarding oxidative stress biomarkers, the correlation was significant for both peroxynitrite and MDA (P value .000 and .001) respectively, and not significant for gamma-glutamyl transferase (P value 1.00).Reduced level both ceruloplasmin and glutathione is seen in patients with breast cancer while vitamin C is not associated. Elevated levels of both peroxynitrite and MDA is seen in patients with breast cancer which may be used as serum markers for the early detection of breast cancer.

Strengthening of Continuous Reinforced Concrete Deep Beams with Large Openings Using CFRP Strips.

To accommodate utilities in buildings, different sizes of openings are provided in the web of reinforced concrete deep beams, which cause reductions in the beam strength and stiffness. This paper aims to investigate experimentally and numerically the effectiveness of using carbon fiber reinforced polymer (CFRP) strips, as a strengthening technique, to externally strengthen reinforced concrete continuous deep beams (RCCDBs) with large openings. The experimental work included testing three RCCDBs under five-point bending. A reference specimen was prepared without openings to explore the reductions in strength and stiffness after providing large openings. Openings were created symmetrically at the center of spans of the other specimens to represent 40% of the overall beam depth. Moreover, finite elements (FE) analysis was validated using the experimental results to conduct a parametric study on RCCDBs strengthened with CFRP strips. The results confirmed reductions in the ultimate load by 21% and 7% for the un-strengthened and strengthened specimens, respectively, due to the large openings. Although the large openings caused reductions in capacities, the CFRP strips limited the deterioration by enhancing the specimen capacity by 17% relative to the un-strengthened one.

The impact of varicocelectomy on sperm DNA fragmentation and pregnancy rate in subfertile men with normal semen parameters: A pilot study.

Objective: To evaluate the outcome of microscopic subinguinal varicocelectomy on sperm DNA fragmentation (SDF) and pregnancy rate in men with normal semen parameters. Patients and methods: A pilot study that included male patients with a minimum of a 1-year history of male subfertility, normal semen parameters, a high percentage of SDF, and clinically palpable varicoceles. Microscopic subinguinal varicocelectomy was carried out for 45 patients (study group), while 40 patients had no intervention (control group). Semen analysis and SDF were measured before and at 6 months after the varicocelectomy. The pregnancy rate was assessed at the 6- and 12-month follow-ups. Results: Between July 2014 and January 2019, 85 subfertile men were included in the study and completed 12 months of follow-up. The two groups were comparable in terms of their age, body mass index, infertility duration, infertility type, varicoceles laterality, and varicoceles grade (P values = 0.84, 0.34. 0.35, 1, 0.39, and 0.46, respectively). At 6 months after varicocelectomy, the mean SDF was reduced in both groups, and this reduction was statistically higher in the varicocelectomy group (P < 0.001). After 1-year, spontaneous pregnancy was achieved in 62% of the patients in the varicocelectomy group compared to 30% in the control group (P = 0.009). Conclusion: Varicocelectomy has a positive impact on SDF and spontaneous pregnancy in infertile men with clinically palpable varicoceles and normal semen parameters. Abbreviations: BMI: body mass index; DFI: DNA fragmentation Index; SDF: sperm DNA fragmentation.

Effect of low-intensity extracorporeal shock wave therapy on diabetic erectile dysfunction: Randomised control trial.

This study aimed to assess the effectiveness of low-intensity extracorporeal shockwave therapy (Li-ESWT) in the management of erectile dysfunction in diabetic patients with mixed vasculogenic and neurogenic causes as confirmed by nerve conduction and Doppler studies. This randomised controlled trial included 42 patients 41-55 years of age with a confirmed diagnosis of erectile dysfunction and diabetic polyneuropathy. They were randomly allocated to one of two groups: shock wave group (n = 21) treated with Li-ESWT plus pelvic floor muscle training and control Group (n = 21) treated with pelvic floor muscle exercise and sham therapy by a shock wave. The erectile function was scored according to the five-item version of the International Index of Erectile Function (IIEF-5). Colour-coded duplex sonography was used for the evaluation of penile perfusion of the two cavernous arteries. The assessment was done before and three months after treatment. IIEF-EF increased significantly in the study group (p < .001), but not in the control group (p = .194). Peak systolic velocity increased significantly in the two groups; however, the post-treatment peak systolic velocity was significantly higher in the study group compared to the control group (p < .001, for both arteries).

Varicocelectomy versus antioxidants in infertile men with isolated teratozoospermia: A retrospective analysis.

OBJECTIVE: To compare the outcome of microscopic subinguinal varicocelectomy versus oral antioxidants for the management of male infertility due to isolated teratozoospermia. MATERIAL AND METHODS: Clinical patients' database of a tertiary infertility referral center was retrospectively reviewed to collect data on male infertility due to isolated teratozoospermia from July 2014 to January 2019. Seventy-two patients who underwentmicroscopic subinguinal varicocelectomy for their clinically palpable varicoceles were considered as a study group, while 60 patients who were treated with antioxidants (L-carnitine, vitamin C, and vitamin E) were included as controls. The improvement in the sperm morphology, sperm DNA fragmentation (SDF), and the achievement of natural pregnancy were compared between the two groups. RESULTS: In the varicocelectomy group, all sperm parameters and SDF statistically improved 6months after the operation (P-value <.001). In the control group, the percentage of sperm morphology and SDF statistically improved 6months after the treatment (P-value <.05). The improvement in sperm parameters, SDF, and the pregnancy rate was statistically higher in the varicocelectomy group compared to the control group. Within the range of follow-up (12-18 months), 30.5% of patients' partners achieved natural pregnancy in the varicocelectomy groups compared to 16.7% in the control group. CONCLUSION: We believe that varicocelectomy has a positive effect on the sperm morphology, SDF, and pregnancy rate in male infertility caused by isolated teratozoospermia.

The Knowledge, Attitude and Practices of the Caregivers about Oral Health Care, at Centers for Intellectually Disabled, in Southern Region of Saudi Arabia.

Oral health is perhaps the most neglected aspect of healthcare for persons living in rehabilitation centers, compared to the general population. The caregivers play a vital role in administering daily oral care to residents in rehabilitation centers: The aim of the present questionnaire-based study was to evaluate the caregivers' knowledge, attitude and practices towards oral healthcare at centers for the intellectually disabled in the Southern region of Saudi Arabia (SA). The present study was designed as a cross-sectional one-point time survey. The samples were selected by using a non-probability convenience sampling method. The self-administered closed-ended questionnaire comprised of 22 items divided into four sections, which was designed to elicit the demographic information, awareness of oral care, attitude towards oral health and practice of the oral healthcare regime among the participants. Of the164 participants, 53.0% and 47.0% were male and female, respectively. Most of the participants-54.9%-were between 30-39 years of age. Participants were almost equally distributed between educational groups, and about 87% had more than 2 years of experience. A brief overview showed a fair level of knowledge and attitude among 61.6% and 58.5% of respondents, respectively. Participants with an education level above that of high school showed good knowledge and attitude scores (p < 0.05), whereas females showed better attitude scores compared to the males (p < 0.05). Respondents mentioned the difficulties they faced while treating the subjects. The special healthcare workers generally had acceptable oral health knowledge and practices. Caregivers who had lower education levels should be advised for training programs that addressed the importance of oral health services.

Correction to: Implementation of machine learning algorithms to create diabetic patient re-admission profiles.

An amendment to this paper has been published and can be accessed via the original article.

Prediction of pelvic adhesions at repeat cesarean delivery through assessment of striae gravidarum score: A cross-sectional study.

OBJECTIVE: To investigate the predictive value of the Davey Score for striae gravidarum (SG) on the presence of pelvic adhesions at repeat cesarean delivery (CD). MATERIALS AND METHODS: The current study was a cross-sectional study conducted in a tertiary university hospital between November 2016 and March 2018. All women scheduled for elective CD were included if they had at least previous one CD with pregnancy in term fetus (37-40 weeks gestation. Preoperative evaluation of SG severity using Davey score, which is a validated scoring system, was done on the examination bed. Patients with no/mild striae (score 0-2) were classified as group (I) and women with severe striae (score 3-8) were classified as group (II). During surgery, pelvic adhesions were evaluated and classified according to the Nair's scoring system. The primary outcome was the difference in the rate of pelvic adhesions between both groups. RESULTS: The study included 300 women; group I included 114 women and group II included 186 women. About 90% of women with severe striae versus 82.5% of women with no/mild striae were found to have adhesions (p = 0.035). Dense adhesions were significantly present in severe striae group (57.4%) versus (41.5%) in no/mild striae group (p = 0.022). The mean Davey score in women in group (II) was significantly higher than group (I) (4.25 ± 3.36 vs. 3.09 ± 2.95, p = 0.03). Nair's score had a significant positive moderate correlation with Davey score (r = 0.541, p = 0.016). According to the results of multivariate regression analysis, Davey score >2 was the only variable associated with increased risk of pelvic adhesions (p = 0.010). CONCLUSION: Assessment of SG score in women with previous CD using Davey score might help to predict pelvic adhesions status before planning a new surgery.

Implementation of machine learning algorithms to create diabetic patient re-admission profiles.

BACKGROUND: Machine learning is a branch of Artificial Intelligence that is concerned with the design and development of algorithms, and it enables today's computers to have the property of learning. Machine learning is gradually growing and becoming a critical approach in many domains such as health, education, and business. METHODS: In this paper, we applied machine learning to the diabetes dataset with the aim of recognizing patterns and combinations of factors that characterizes or explain re-admission among diabetes patients. The classifiers used include Linear Discriminant Analysis, Random Forest, k-Nearest Neighbor, Naïve Bayes, J48 and Support vector machine. RESULTS: Of the 100,000 cases, 78,363 were diabetic and over 47% were readmitted.Based on the classes that models produced, diabetic patients who are more likely to be readmitted are either women, or Caucasians, or outpatients, or those who undergo less rigorous lab procedures, treatment procedures, or those who receive less medication, and are thus discharged without proper improvements or administration of insulin despite having been tested positive for HbA1c. CONCLUSION: Diabetic patients who do not undergo vigorous lab assessments, diagnosis, medications are more likely to be readmitted when discharged without improvements and without receiving insulin administration, especially if they are women, Caucasians, or both.