Fuzzy Fractional Differential Equation Involving the Fuzzy Conformable Derivative and the α - Semigroups.

In this work, we discuss solutions to the abstract Cauchy problem of fuzzy conformal fractional. In addition, the method of fuzzy fractional semigroups is used to obtain analytical solutions to the fractional differential equation. We use the concept of Krasnoselskii's fixed point theorem to determine the existence and uniqueness of the solution. An application is also given to illustrate our main abstract results.

Economic burden of lung cancer in Morocco: A cost of illness study.

INTRODUCTION: Lung cancer is the most common cancer in men and the second most common cancer in women. It is associated with substantial economic impact in terms of direct and indirect costs. The main objective of this study is to estimate the direct medical cost of lung cancer management in Morocco MATERIALS AND METHODS: A cost-of-illness study was conducted among patients treated at the Mohammed VI Center of Cancer (Casablanca) in 2019. The costs were estimated from the societal perspective using a bottom-up approach. The materials and procedures used were identified and quantified retrospectively from the information system and files. Their monetary value was calculated according to official prices published by the national health insurance agency. The horizon time adopted was 12 months. RESULTS: The study included 271 patients, with an average age of 62.5 ± 9.5 years. Of these, 93.4 % were men and 92.1 % were former smokers. In terms of cancer staging, 68.3 % of patients were in stage IV while 28.8 % were in stage III. Adenocarcinoma was present in 43.5 % of cases. Patients underwent an average of 10.6 ± 5.1 radiological investigations, 56.1 ± 30.9 biological tests, and 24.1 ± 11.7 consultations. The average direct medical cost was 4455.3 USD (95 % CI: 4037.4-4873.2). Chemotherapy accounted for 19.9 % of the total cost, while radiological investigations and drugs accounted for 18.7 % and 17.6 %, respectively. Diagnostic tests and radiotherapy each accounted for 7.6 % of the total cost, while biological tests accounted for 7.5 % and hospitalizations accounted for 7.1 %. The cost was statistically higher in young patients (p = 0.017), in patients with adenocarcinoma (p < 0.0001), in patients with stage II tumor (< 0.00001), in patients who have undergone surgery (p = 0.002), chemotherapy (p < 0.0001), radiotherapy (p < 0.001) and in those without metastases (p < 0.0001). CONCLUSION: These results provide evidence to support the ratification of the Framework Convention on Tobacco Control and the full adherence of the Kingdom of Morocco to the MPOWER measures.

Calcium Carbonate.

Calcium carbonate is a chemical compound with the formula CaCO3 formed by three main elements: carbon, oxygen, and calcium. It is a common substance found in rocks in all parts of the world (most notably as limestone), and is the main component of shells of marine organisms, snails, coal balls, pearls, and eggshells. CaCO3 exists in different polymorphs, each with specific stability that depends on a diversity of variables.

Transition from intravenous or subcutaneous prostacyclin therapy to inhaled treprostinil in patients with pulmonary arterial hypertension: a retrospective case series.

WHAT IS KNOWN AND OBJECTIVE: Inhaled treprostinil represents an attractive alternative to the other available prostacyclin formulations by obviating the use of continuous infusions and its associated risks. Published evidence describing the process of transition from infusion prostacyclin therapy to inhaled treprostinil is limited. The purpose of this report is to describe an inpatient protocol for transitioning patients with pulmonary arterial hypertension (PAH) from intravenous (IV) or subcutaneous (SQ) prostacyclin therapy to inhaled treprostinil. METHODS: A retrospective case cohort study was performed evaluating medical records of three patients undergoing transition from IV/SQ continuous infusion prostacyclin therapy to inhaled treprostinil. The transition protocol and clinical data were collected prospectively. RESULTS AND DISCUSSION: Haemodynamics, six-min walk distance (6MWD), World Health Organization (WHO) functional class, modified Borg Dyspnea Score and brain natriuretic peptide prior to and after transition remained similar. All patients were receiving concomitant oral PAH medications prior to and after conversion. Adverse effects during the change were mild. No patients discontinued inhaled treprostinil following transition. At long-term follow-up, functional class remained stable at WHO functional class II or better. Patient 1 and Patient 3 demonstrated stable to modest improvement in 6MWD, whereas Patient 2 had a slight decrease in 6MWD. The transition to inhaled treprostinil from IV/SQ infusion prostacyclin therapy appears to be safe in carefully selected patients. WHAT IS NEW AND CONCLUSION: Our report describes a standard method used to transition patients from IV/SQ infusion prostacyclin to inhaled treprostinil.

[Necrotizing fasciitis of the thoracoabdominal wall complicating Dujarier's bandage: a case report]. / Fasciite nécrosante compliquant un bandage de Dujarier: à propos d'une observation.

The necrotizing fasciitis (NF) means a serious infection of the subcutis, the fascia and superficial dermis secondarily. We report the case of a patient with cellulitis NF of the thoracoabdominal wall complicating Dujarier's bandage. It was monobacterial NF caused by ß hemolytic streptococcus, whose development was supported through an appropriate medical and surgical care. The situation mentioned is the occurrence of secondary infection of skin necrosis occurred in the bandage too tight opposite the support zone of the elbow on the trunk. We point out, through this case, the importance of the medicosurgical and also the importance of making any thoracoabdominal bandage, which could lead, if it is tight, a pressure sore can be a door entry for any NF plus a late diagnosis.

The incidence of hypoglycaemia in Muslim patients with type 2 diabetes treated with sitagliptin or a sulphonylurea during Ramadan: a randomised trial.

AIMS: To compare the incidence of symptomatic hypoglycaemia in fasting Muslim patients with type 2 diabetes treated with sitagliptin or a sulphonylurea during Ramadan. METHODS: Patients with type 2 diabetes (age ≥ 18 years) who were treated with a stable dose of a sulphonylurea with or without metformin for at least 3 months prior to screening, who had an HbA(1c) < 10% and who expressed their intention to daytime fast during Ramadan were eligible for this open-label study. Patients were randomised in a 1 : 1 ratio to either switch to sitagliptin 100 mg qd or to remain on their prestudy sulphonylurea. Patients completed daily diary cards to document information on hypoglycaemic symptoms and complications. The primary end-point was the overall incidence of symptomatic hypoglycaemia recorded during Ramadan. RESULTS: Of the 1066 patients randomised, 1021 (n = 507 for sitagliptin and n = 514 for sulphonylurea) returned at least one completed diary card and were included in the analysis. The proportion of patients who recorded one or more symptomatic hypoglycaemic events during Ramadan was lower in the sitagliptin group (6.7%) compared with the sulphonylurea group (13.2%). The risk of symptomatic hypoglycaemia was significantly decreased with sitagliptin relative to sulphonylurea treatment (Mantel-Haenszel relative risk ratio [95% CI] = 0.51 [0.34, 0.75]; p < 0.001). There were no reported events that required medical assistance (i.e. visits to physician or emergency room or hospitalisations) or were considered severe (i.e. events that caused loss of consciousness, seizure, coma or physical injury) during Ramadan. CONCLUSIONS: In Muslim patients with type 2 diabetes who observed the fast during Ramadan, switching to a sitagliptin-based regimen decreased the risk of hypoglycaemia compared with remaining on a sulphonylurea-based regimen. The incidence of hypoglycaemia was lower with gliclazide relative to the other sulphonylurea agents and similar to that observed with sitagliptin.

Comment on: "Photocurrent amplification at carbon nanotube-metal contacts".

Lien et al. (Adv. Mater. 2006, vol. 18, p. 98) reported on photocurrent generation in SWNT thin films suspended across metal electrodes at zero bias and the effect was attributed to the Schottky contacts formed at the nanotube-metal interfaces. By performing a set of independent experiments and tests on similarly engineered two-terminal devices and analyzing the results reported in said paper we show that the response is not associated with the contacts or temperature-induced conductance change (bolometric effect), but is instead caused by an optically induced thermovoltaic effect.

[Inferior gluteal artery perforator flap: anatomical study for its application in breast reconstruction]. / Lambeau perforant glutéal inférieur : étude anatomique en vue de son application en reconstruction mammaire.

PURPOSE: The inferior gluteal artery perforator flap, which is vascularised by perforator branches of the inferior gluteal artery (formerly ischiatic artery) is harvested in the gluteal crease. The purpose of this anatomical study was to clarify the anatomical features of this flap and locate the perforators of the inferior gluteal artery destined to the flap, in view to facilitate its surgical removal, as free flap for breast reconstruction. MATERIALS AND METHOD: We performed 12 dissections on fresh cadavers, after selective injection of the inferior gluteal artery with a gelified solution. During harvesting, we located the perforators which arise from the inferior gluteal artery and perfuse the flap. RESULTS: We distinguished four zones, defined relatively to anatomical landmarks of the region, according to the frequency of perforators. CONCLUSION: This anatomical study makes possible an improvement of the technique to raise this flap in its free shape with view to use it for breast autologus reconstruction especially given its numerous advantages: a constant volume of fat even in thin patients and minimal donor site morbidity.

Effect of pulmonary hypertension in patients with end-stage lung disease on posttransplantation outcomes.

A subgroup of patients with end-stage lung disease develop secondary pulmonary hypertension (PH). PH results in worse prognosis in these patients. However, it is unclear if this effect prevails in the immediate- and long-term outcomes of these patients after lung transplantation (LT). The objective of this study was to evaluate the effect of pretransplantation PH on immediate- or long-term posttransplantation outcomes. A retrospective chart review of post-LT patients at Henry Ford Hospital from January 1995 through January 2008 was done. Patients were grouped by presence or absence of PH and were compared using chi-square or Fisher exact tests for categorical variables and t tests or Wilcoxon rank sum tests for continuous variables. Kaplan-Meier estimation was used to evaluate primary and secondary outcomes. Among the patients included in the study, 25 had PH. This group consisted mostly of females (68%). There was no difference in the indication or type of LT in the 2 groups. There was no statistically significant difference in freedom from bronchiolitis obliterans syndrome (BOS; P = .42), time to onset of BOS (P = .82), grade of BOS (P = .21), or cummulative acute rejection (CAR) score (P = .66). There was no difference in overall mortality at 3 and 5 years (P = .57) or time to death (P = .25). Number of A1 rejection episodes was the only significant predictor for BOS (P = .001). In conclusion, PH due to end-stage lung disease does not have any effect on early or late posttransplantation outcomes. There is predisposition for females with end-stage lung disease to develop secondary PH more so than males. The number of A1 rejections increases the likelihood of development of BOS. A larger multicenter study is needed to confirm the results of this pilot study.

The association between periodontal disease, physical activity and healthy diet among adults in Jordan.

BACKGROUND AND OBJECTIVE: Physical inactivity and an unhealthy diet have been implicated as risk factors for several chronic diseases that are known to be associated with periodontitis, such as cardiovascular diseases, obesity and diabetes. Studies investigating the relationship between periodontitis and physical activity and diet are limited. Therefore, this study was conducted to determine the relationship between physical activity, healthy eating habits and periodontal health status. MATERIAL AND METHODS: A systematic random sample of 340 persons, 18-70 years of age, was selected from persons accompanying their relative patients who attended the outpatient clinics in the medical center of Jordan University of Science and Technology in north of Jordan. Data collected included socio-demographic and clinical characteristics, anthropometric measurements, physical activity level and dietary assessment. RESULTS: Individuals who were highly physically active had a significantly lower average plaque index, average gingival index, average clinical attachment loss (CAL) and percentage of sites with CAL ≥ 3 mm compared to individuals with a low level of physical activity and individuals with a moderate level of physical activity. Those who had a poor diet had a significantly higher average number of missing teeth and an average CAL compared with those who had a good diet. In the multivariate analysis, a low level of physical activity and a poor diet (diets with a healthy eating index score of < 50 points) were significantly associated with increased odds of periodontitis. CONCLUSIONS: A low physical activity level and a poor diet were significantly associated with increased odds of periodontal disease. Further studies are needed to understand this relationship in greater detail.

Plasma C-terminal pro-endothelin-1 is associated with left ventricular mass index and aortic root diameter in African-American adults with hypertension.

Endothelin-1 (ET-1), a circulating vasoactive peptide with potent vasoconstricting and mitogenic properties, may contribute to target-organ damage in hypertension. We investigated whether plasma levels of C-terminal pro-endothelin-1 (CT-pro-ET-1) are associated with left ventricular (LV) mass and aortic root diameter in African-American adults with hypertension. Plasma CT-pro-ET-1 was measured by an immunoluminometric assay in 1041 African Americans (65±9 years, 72% women) with hypertension. LV mass and aortic root diameter were measured according to the American Society of Echocardiography guidelines, and LV mass was indexed by height to the power 2.7 (LVMi). Multivariable regression analyses were used to assess whether plasma CT-pro-ET-1 was associated with LVMi and aortic root diameter, independent of potential confounding variables. Plasma CT-pro-ET-1 was modestly correlated with LVMi (r=0.21, P<0.0001) and aortic root diameter (r=0.09, P=0.004). In separate multivariable regression models that adjusted for age, sex, body mass index, total and high-density lipoprotein cholesterol, smoking history, diabetes, history of myocardial infarction or stroke, and blood pressure-lowering medication and statin use, log CT-pro-ET-1 was significantly associated with greater LVMi (P=0.001) and larger aortic root diameter (P=0.006). CT-pro-ET-1 is independently associated with LVMi and aortic root diameter and may be a marker of target-organ damage in African-Americans adults with hypertension.

Shaping canals with ProFiles and K3 instruments: does operator experience matter?

OBJECTIVE: The aim of this study was to determine the influence of operator experience on the shaping ability of ProFile and K3 nickel-titanium rotary instruments in simulated root canals. STUDY DESIGN: One hundred sixty simulated canals consisting of 4 different shapes in terms of angle and position of curvature were prepared by experienced and inexperienced operators. One experienced operator prepared 80 canals and 2 inexperienced operators prepared 80 canals with a crown-down technique using either ProFile or K3 .06 taper instruments. Images of the canals were taken, using a camera attached to a computer with image analysis software, before surgery and after preparation to sizes 20, 25, and 30 to working length. Postoperative images were combined with the preoperative image to highlight the amount and position of material removed during preparation as well as the shape of the prepared canal. RESULTS: Overall, there was a highly statistically significant difference (P<.001) between the instruments for the time taken to prepare the canals, with K3 instruments taking a mean of 4.9 minutes and ProFile 6.0 minutes. Six instruments fractured (3 in each operator category); 4 were ProFile instruments. Four instruments deformed, all with the inexperienced operators; 3 were K3. No perforations or zips were observed; however, 1 danger zone (created by the experienced operator using K3 instruments) and 1 ledge (created by an inexperienced operator using K3 instruments) were created. Twelve outer widenings were created with a highly significant difference (P<.001) between the operator and instrument used. There was a highly significant difference by instrument (P<.001), and experience (P=.008) regarding absolute transportation at the beginning of the curve and a statistically significant difference (P=.031) for the instrument used regarding absolute transportation half way to the orifice. CONCLUSION: The experienced operator prepared canals more quickly and safely than the inexperienced operators when using K3 instruments; both used ProFile instruments quickly and safely. Inexperienced operators would be advised to train using less aggressive instruments and when confident could progress to other instrument designs.

Internal jugular vein morphology and hemodynamics in patients with multiple sclerosis.

AIM: The aim of this study is to compare the hemodynamics and the morphology of the internal jugular veins using colour-Doppler and B-mode sonongraphy in multiple sclerosis patients (MS) and in controls. METHODS: The internal jugular veins of 25 MS patients and 25 controls were examined using colour Doppler and B-mode ultrasound in sitting and supine positions, recording the changes in hemodynamics and the presence or absence of morphological changes. The presence of at least two of the extracranial Zamboni criteria in the same individual was considered positive for evidence of chronic cerebrospinal venous insufficiency (CCSVI). RESULTS: According to the described criteria, 92% of the MS patients showed abnormal findings and 84% of them showed evidence of CCSVI, however; only 24% of controls showed abnormal findings, but none of them showed evidence of CCSVI (OR=7.25, 95% CI 2.92-18.01, P<0.0001). CONCLUSION: Hemodynamic abnormalities and morphological changes involving the internal jugular vein are strongly associated with MS. These findings can be demonstrated by a non-invasive, cost effective Doppler ultrasound criteria.

Smoking and caries experience in subjects with various form of periodontal diseases from a teaching hospital clinic.

OBJECTIVE: The aim of this study was to assess the relationships between aggressive periodontitis (AgP), caries and smoking. METHOD AND MATERIALS: A cross-sectional study was conducted among patients who were specifically referred to the Dental Teaching Clinic in Irbid, Jordan for periodontal treatment. Self-administered questionnaire related to socio-demographic data and smoking habits was completed. The oral hygiene, gingival status, periodontal health and dental status of the participants was determined by using the plaque index of Silness and Loe [Acta Odontol Scand, 22 (1964), 121], the gingival index of Loe and Silness [Acta Odontol Scand, 21 (1963), 233], clinical attachment level (CAL) and decayed, missing and filled teeth (DMFT) index respectively. RESULT: The prevalence of smoking was greater in chronic periodontitis (CP) group (44.2%) than in either chronic gingivitis (CG) (27.4%) or AgP (29.9%) group. Self-reported perio-diseases in the close family was more prevalent (77%) among subjects diagnosed with AgP. The mean plaque scores were significantly higher for smoker than non-smoker in AgP group only (P = 0.04), with significantly greater plaque and gingival scores in CG and CP groups than AgP group (P = 0.012, 0.004). A significantly greater mean gingival scores were noted among CG and CP groups than AgP group (P = 0.004). The mean CAL was higher in smokers than in non-smokers in the three groups, with statistically significant differences in CP and AgP groups (P = 0.04, 0.01 respectively).The mean number of DMFT was significantly higher in smoker than in non-smoker of all age groups (P = 0.016, 0.043 and 0.01). However, mean DMFT was significantly greater in CP and CG than AgP groups. CONCLUSION: It was concluded that (i) higher plaque and gingival index among smokers in all groups; (ii) significant difference in the CAL between smoker and non-smoke in CP and AgP groups; (iii) significant increase in caries risk among smokers in all groups; (iv) smokers and non-smokers of AgP group had significantly lower mean DMFT scores than those of CG or CP groups.

The West End Revitalization Association (WERA)'s right to basic amenities movement: voice and language of ownership and management of public health solutions in Mebane, North Carolina.

The West End Revitalization Association (WERA) cultivated strategies for assessing environmental hazards, managing stakeholder participation, and implementing corrective actions in three low-income African American communities in Mebane, North Carolina. The community voices evolved into language to drive WERA's "Right to Basic Amenities Movement" as a way to address health, legal, and quality-of-life disparities. The sustainability of this movement depends on communicating a solutions process with funding equity. Disparities are a way of life for impacted residents: dusty dead-end streets, contaminated drinking water, failed backyard septic tanks, and putrid odors. WERA organized on "common knowledge" for effective use of public health statutes and Title VI of the Civil Rights Act of 1964. WERA's board, staff, and volunteers exercised their voices in the language of government, public health, university research, and legal agencies. WERA's best practices and lessons learned may influence public policy in comparable communities in North Carolina and throughout the nation.

Fabrication of Cd(3)As(2) nanowires by direct vapor-solid growth, and their infrared absorption properties.

In this work the authors introduce and provide details of the synthesis and spectral characterization of single-crystal nanowires in less common, high performance, group II-V semiconductors such as Cd(3)As(2). The growth mechanism critically deviates from a known vapor-liquid-solid one by being completely non-catalytic and involving only two states: vapor and solid. The resultant nanowires range from ∼50 to 200 nm in diameter and reach lengths up to tens of micrometers, with their fast growth direction being normal to the (112) crystal planes. According to infrared (IR) optical absorption measurements, the nanowires have several IR active direct type light absorption transitions at 0.11, 0.28 and 0.54 eV, suggestive of their possible utility in low cost optoelectronic devices and photodetectors operating in the long wavelength range of the electromagnetic spectrum.

[Not Available]. / Les Brulures Electriques par Haut Voltage - A Propos de 10 Cas.

Les accidents électriques par haute tension (AEHT) provoquent des brûlures profondes par effet Joule le long des axes vasculo-nerveux entre les points d'entrée et de sortie, qui sont le siège de lésions délabrantes. Les Auteurs rapportent une série de dix cas d'AEHT admis au service de chirurgie réparatrice et de brûlés de l'Hôpital Ibn Sina de Rabat à travers laquelle ils étudient les caractéristiques épidémiologiques, cliniques et thérapeutiques. Tous les patients étaient des adultes de sexe masculin dont l'âge moyen était de 31 ans. Dans 70% des cas, ces brûlures étaient secondaires à un contact avec les distributeurs d'électricité avec une surface brûlée inférieure à 20%. Le traitement des lésions électrothermiques a nécessité des interventions itératives avec amputation des segments de membres nécrosés dans 70% des cas, dont les suites étaient marquées par des séquelles fonctionnelles invalidantes. La prévention des AEHT, en particulier pour les accidents du travail au sein des professions exposées, reste fondamentale.

Dental arch morphological and dimensional characteristics in Jordanian children and young adults with beta-thalassaemia major.

OBJECTIVE: The aim of this study was to examine the arch dimensions of Jordanian patients with beta-thalassaemia major in comparison with an unaffected control group. METHODS: The sample consisted of 24 patients who suffered from beta-thalassaemia major (mean age = 13.9 +/- 3.1 years) and an unaffected control group (mean age = 13.5 +/- 2.9 years) matched for dental age, sex, and incisor and molar relationships. The unaffected control group was randomly selected from four public schools in the Governate of Irbid-Jordan. Alginate impressions were taken of the maxillary and mandibular dental arches of all participants. All measurements of the arch dimensions were made on the casts using an electronic digital sliding calliper. RESULTS: In the mandibular arch, when compared with the patients with thalassaemia, the unaffected control group subjects showed a (statistically) significantly larger incisor width, larger arch depth, and larger left and right anterior arch lengths (1.18, 2.58, and 1.85 and 1.12 mm, respectively). In the maxillary arch, there was a statistically significant difference in the mean incisor width (+/- 2.16 mm), arch depth (+/- 3.14 mm), inter-molar width (+/- 1.21 mm) and in the left anterior arch length (+/- 1.97 mm). The canine widths, premolar widths, left and right posterior arch length, and curve of Spee of both arches showed no statistically significant differences between the two groups. CONCLUSION: When compared to unaffected subjects, patients with beta-thalassaemia major exhibited: a narrower maxilla; a shorter maxilla and mandible; and smaller incisor widths for the maxillary and mandibular arches.

Determination of cetirizine dihydrochloride, related impurities and preservatives in oral solution and tablet dosage forms using HPLC.

An HPLC method was developed and validated for the determination of cetirizine dihydrochloride (CZ) as well as its related impurities in commercial oral solution and tablet formulations. Furthermore, two preservatives associated with the drug formulations, namely, propyl (PP) and butylparabens (BP) were successfully determined by this method. The chromatographic system used was equipped with a Hypersil BDS C18, 5 microm column (4.6 x 250 mm) and a detector set at 230 nm in conjunction with a mobile phase of 0.05 M dihydrogen phosphate:acetonitrile:methanol:tetrahydrofuran (12:5:2:1, v/v/v/v) at a pH of 5.5 and a flow rate of 1 ml min(-1). The calibration curves were linear within the target concentration ranges studied, namely, 2 x 10(2) - 8 x 10(2) microg ml(-1) and 1-4 microg ml(-1) for CZ, 20-100 microg ml(-1) for preservatives and 1-4 microg ml(-1) for CZ related impurities. The limits of detection (LOD) and quantitation (LOQ) for CZ were, respectively, 0.10 and 0.34 microg ml(-1) and for CZ related impurities were in the ranges of 0.08-0.26 microg ml(-1) and 0.28-0.86 microg ml(-1), respectively. The method proved to be specific, stability indicating, accurate, precise, robust and could be used as an alternative to the European pharmacopoeial method set for CZ and its related impurities.