No correlation exists between coracoid tunnel widening and loss of reduction after arthroscopic acromioclavicular fixation using tightrope system.

PURPOSE: To detect the widening of the tunnel of the coracoid process after arthroscopic fixation of acute acromioclavicular joint (ACJ) dislocation using the TightRope system and its correlation with loss of reduction and functional scores. METHODS: From 2016 to 2018, a prospective study was performed on twenty-three patients with acute grade III-V ACJ dislocation. Arthroscopic TightRope repair of the ACJ was performed. Coracoid tunnel widening was measured by CT, and the coracoclavicular distance was measured on the radiographs immediately postoperatively and at 12 months. The Constant Shoulder Score, Oxford Shoulder Score, Nottingham Clavicle Score and Visual analog scale were used as outcome measures at 12 months. RESULTS: The coracoid tunnel diameter to horizontal coracoid diameter ratio increased from 22.8 ± 3.7% immediately postoperatively to 38.5 ± 5.5% at 12 months (p < 0.001). The coracoclavicular (CC) distance showed an increase from a mean of 10.8 ± 1.7 mm to a mean of 11.8 ± 2.5 at 12 months (p < 0.001). There was no correlation between the increase in the coracoclavicular distance and the patients' functional clinical scores or coracoid tunnel widening. CONCLUSION: Coracoid tunnel widening and radiological loss of reduction occur after arthroscopic fixation of acute ACJ dislocation with the TightRope system. However, they do not correlate with each other or with the functional scores of the patient. LEVEL OF EVIDENCE: Level IV.

Sound-Based Localization Using LSTM Networks for Visually Impaired Navigation.

In this work, we developed a prototype that adopted sound-based systems for localization of visually impaired individuals. The system was implemented based on a wireless ultrasound network, which helped the blind and visually impaired to navigate and maneuver autonomously. Ultrasonic-based systems use high-frequency sound waves to detect obstacles in the environment and provide location information to the user. Voice recognition and long short-term memory (LSTM) techniques were used to design the algorithms. The Dijkstra algorithm was also used to determine the shortest distance between two places. Assistive hardware tools, which included an ultrasonic sensor network, a global positioning system (GPS), and a digital compass, were utilized to implement this method. For indoor evaluation, three nodes were localized on the doors of different rooms inside the house, including the kitchen, bathroom, and bedroom. The coordinates (interactive latitude and longitude points) of four outdoor areas (mosque, laundry, supermarket, and home) were identified and stored in a microcomputer's memory to evaluate the outdoor settings. The results showed that the root mean square error for indoor settings after 45 trials is about 0.192. In addition, the Dijkstra algorithm determined that the shortest distance between two places was within an accuracy of 97%.

Anti-parallel triplexes: Synthesis of 8-aza-7-deazaadenine nucleosides with a 3-aminopropynyl side-chain and its corresponding LNA analog.

The phosphoramidites of DNA monomers of 7-(3-aminopropyn-1-yl)-8-aza-7-deazaadenine (Y) and 7-(3-aminopropyn-1-yl)-8-aza-7-deazaadenine LNA (Z) are synthesized, and the thermal stability at pH 7.2 and 8.2 of anti-parallel triplexes modified with these two monomers is determined. When, the anti-parallel TFO strand was modified with Y with one or two insertions at the end of the TFO strand, the thermal stability was increased 1.2°C and 3°C at pH 7.2, respectively, whereas one insertion in the middle of the TFO strand decreased the thermal stability 1.4°C compared to the wild type oligonucleotide. In order to be sure that the 3-aminopropyn-1-yl chain was contributing to the stability of the triplex, the nucleobase X without the aminopropynyl group was inserted in the same positions. In all cases the thermal stability was lower than the corresponding oligonucleotides carrying the 3-aminopropyn-1-yl chain, especially at the end of the TFO strand. On the other hand, the thermal stability of the anti-parallel triplex was dramatically decreased when the TFO strand was modified with the LNA monomer analog Z in the middle of the TFO strand (ΔTm=-9.1°C). Also the thermal stability decreased about 6.1°C when the TFO strand was modified with Z and the Watson-Crick strand with adenine-LNA (A(L)). The molecular modeling results showed that, in case of nucleobases Y and Z a hydrogen bond (1.69 and 1.72Ǻ, respectively) was formed between the protonated 3-aminopropyn-1-yl chain and one of the phosphate groups in Watson-Crick strand. Also, it was shown that the nucleobase Y made a good stacking and binding with the other nucleobases in the TFO and Watson-Crick duplex, respectively. In contrast, the nucleobase Z with LNA moiety was forced to twist out of plane of Watson-Crick base pair which is weakening the stacking interactions with the TFO nucleobases and the binding with the duplex part.

A multiband SSr diode RF rectifier with an improved frequency ratio for biomedical wireless applications.

This paper described a four-band implantable RF rectifier with simplified circuit complexity. Each RF-rectifier cell is sequentially matched to the four operational frequencies to accomplish the proposed design. The proposed RF rectifier can harvest RF signals at 1.830, 2.100, and white space Wi-Fi bands between 2.38 to 2.68 GHz, respectively. At 2.100 GHz, the proposed RF harvester achieved a maximum (radio frequency direct current) RF-to-DC power conversion efficiency (PCE) of 73.00% and an output DC voltage [Formula: see text] of 1.61 V for an RF power of 2 dBm. The outdoor performance of the rectenna shows a [Formula: see text] of 0.440 V and drives a low-power bq25504-674 evaluation module (EVM) at 1.362 V. The dimension of the RF-rectifier on the FR-4 PCB board is 0.27[Formula: see text] [Formula: see text] 0.29[Formula: see text]. The RF-rectifier demonstrates the capacity to effectively utilize the frequency domain by employing multi-band operation and exhibiting a good impedance bandwidth through a sequential matching technique. Thus, by effectively controlling the rectenna's ambient performance, the proposed design holds the potential for powering a range of low-power biomedical implantable devices. (BIDs).

One-pot Synthesis, Molecular Modeling and In Vitro Antibacterial Activity of Novel 3-(1,3,4-Oxadiazol-2-yl) Quinoxaline 1,4-Dioxide and Pyrazolyl Analogs.

The new 1,3,4-oxadiazolylquinoxaline ring system was synthesized by the condensation of the quinoxaline 1,4-dioxide acid hydrazide 6 with acetyl chloride in one-pot synthesis. In which the hydrazide was refluxed in excess of acetyl chloride, acetic anhydride or acetic acid in the presence of phosphorus oxychloride forming the 1,3,4-oxadiazolylquinoxaline ring system. Molecular modeling studies have been performed to evaluate their recognition at the hDHFR binding-pocket as potential hDHFR inhibitors. The antibacterial properties of these compounds showed reasonable activities towards gram negative bacteria, Escherichia coli. Compound 20 performed appropriate complementarity study rather well; the conserved amino acids of hDHFR enzyme imitating the MTX docking pattern. Besides, compound 20 showed highest antibacterial activity against E. coli in comparison with the well known bacteriostatic chloramphenicol; the pyrazolyl analogues also have moderate affinity toward the applied bacteria.

Triazine-Based Functionalized Activated Carbon Prepared from Water Hyacinth for the Removal of Hg2+, Pb2+, and Cd2+ Ions from Water.

A novel chelating adsorbent, based on the functionalization of activated carbon (AC) derived from water hyacinth (WH) with melamine thiourea (MT) to form melamine thiourea-modified activated carbon (MT-MAC), is used for the effective removal of Hg2+, Pb2+, and Cd2+ from aqueous solution. Fourier transform infrared spectroscopy (FTIR), X-ray photoelectron spectroscopy (XPS), scanning electron microscopy (SEM), and Brunauer-Emmett-Teller (BET) theory confirm the successful functionalization of AC with the melamine thiourea chelating ligand through the amidation reaction between the carboxyl groups of oxidized activated carbon (OAC) and the amino groups of melamine thiourea (MT) in the presence of dicyclohexylcarbodiimide (DCC) as a coupling agent. The prepared MT-MAC exhibited extensive potential for the adsorption of the toxic metal ions Hg2+, Pb2+, and Cd2+ from wastewater. The MT-MAC showed high capacities for the adsorption of Hg2+ (292.6 mg·g-1), Pb2+ (237.4 mg·g-1), and Cd2+ (97.9 mg·g-1) from aqueous solution. Additionally, 100% removal efficiency of Hg2+ at pH 5.5 was observed at very low initial concentrations (25-1000 ppb).The experimental sorption data could be fitted well with the Langmuir isotherm model, suggesting a monolayer adsorption behavior. The kinetic data of the chemisorption mechanism realized by the melamine thiourea groups grafted onto the activated carbon surface have a perfect match with the pseudo-second-order (PSO) kinetic model. In a mixed solution of metal ions containing 50 ppm of each ion, MT-MAC showed a removal of 97.0% Hg2+, 68% Pb2+, 45.0% Cd2+, 17.0% Cu2+, 7.0% Ni2+, and 5.0% Zn2+. Consequently, MT-MAC has exceptional selectivity for Hg2+ ions from the mixed metal ion solutions. The MT-MAC adsorbent showed high stability even after three adsorption-desorption cycles. According to the results obtained, the use of the MT-MAC adsorbent for the adsorption of Pb2+, Hg2+, and Cd2+ metal ions from polluted water is promising.

Physical activity questionnaire for older children (PAQ-C): Arabic translation, cross-cultural adaptation, and psychometric validation in school-aged children in Saudi Arabia.

The validity of the Physical Activity Questionnaire for Older Children (PAQ-C) has been mostly studied in North America and Europe. We investigated the psychometric validation of the Arabic version of the PAQ-C in students in Saudi Arabia. The students (n = 327, age = 8-14 years) of six primary schools in the Majmaah region participated in the study. Participants completed the PAQ-C, and their demographics were recorded. The PAQ-C scores satisfied the following factor analysis assumptions: diagonal elements of the anti-image correlation matrix (>0.5), Bartlett's test of sphericity (p < 0.001), determinant (>0.00001), Kaiser-Meyer-Olkin test of sampling adequacy (>0.8), and communality (all values > 0.2). Exploratory factor analysis results were inconclusive, with two measures favoring a 2-factor solution (Kaiser's criteria (Eigenvalue ≥ 1), and cumulative variance rule (>40%)); whereas, the scree test and the Monte Carlo parallel analysis favored a 1-factor structure. The confirmatory factor analysis favored a 1-factor solution: highest CFI, lowest RMSEA, non-significant χ2 statistics, and lowest χ2/df. The values of item-total correlation, corrected item-total correlation, and Cronbach's alpha if an item was deleted, ranged from 0.20-0.57, 0.42-0.64, and 0.70-0.75, respectively. The PAQ-C showed a Cronbach's alpha of 0.74. A 1-factor structure of the Arabic version of the PAQ-C had adequate psychometric validity in schoolchildren in Saudi Arabia.

Prevalence of text neck posture, smartphone addiction, and its association with neck disorders among university students in the Kingdom of Saudi Arabia during the COVID-19 pandemic.

The smartphone emerges as an inevitable gadget in modern society and its increased usage results in neck disorders among its users. However, the factors associated with neck disorders among smartphone users are ambiguous and less explored in the literature. The purpose of this research was to determine the prevalence of text neck posture, smartphone addiction/overuse, and its association with neck disorders among university students in the Kingdom of Saudi Arabia during the COVID-19 pandemic. A total of 313 university students who were aged 18 years and older, owned a smartphone, and used it during the preceding 12 months participated in this cross-sectional study. A self-administered questionnaire was used to collect data regarding the prevalence of text neck posture, smartphone addiction/overuse, neck disorders, and the level of physical activity. Binary logistic regression was used to determine the association between the prevalence of neck disorders and text neck posture, smartphone addiction/overuse, and level of physical activity. The 12 months prevalence of neck disorders due to smartphone use among the participants was found to be 46%. The neck disorders were more prevalent among participants who reported text neck posture (P < 0.001) and categorized as smartphone-addicted/overuse (P < 0.001). Measures to promote the awareness of healthy use of smartphones including postural education and to decrease its screen time are warranted to reduce neck disorders.

A Study of the Synthesis and Characterization of New Acrylamide Derivatives for Use as Corrosion Inhibitors in Nitric Acid Solutions of Copper.

The objective of this research was to explore the impact of corrosion inhibition of some synthetic acrylamide derivatives 2-cyano-N-(4-hydroxyphenyl)-3-(4-methoxyphenyl)acrylamide (ACR-2) and 2-cyano-N-(4-hydroxyphenyl)-3-phenylacrylamide (ACR-3) on copper in 1.0 M nitric acid solution using chemical and electrochemical methods, including mass loss as a chemical method and electrochemical impedance spectroscopy (EIS) and potentiodynamic polarization (PP) as electrochemical methods. By Fourier-transform infrared spectroscopy (FTIR), proton nuclear magnetic resonance (1HNMR), and mass spectroscopy (MS) methods, the two compounds were verified and characterized. There is evidence that both compounds were effective corrosion inhibitors for copper in 1.0 M nitric acid (HNO3) solutions, as indicated by the PP curves, which show that these compounds may be considered mixed-type inhibitors. With the two compounds added, the value of the double-layer capacitance was reduced. In the case of 20 × 10-5 M, they reached maximum efficiencies of 84.5% and 86.1%, respectively. Having studied its behavior during adsorption on copper, it was concluded that it follows chemical adsorption and Langmuir isotherm. The theoretical computations and the experimental findings were compared using density functional theory (DFT) and Monte Carlo simulations (MC).

Prevalence of Upper Limb Musculoskeletal Disorders and Their Association with Smartphone Addiction and Smartphone Usage among University Students in the Kingdom of Saudi Arabia during the COVID-19 Pandemic-A Cross-Sectional Study.

This study aimed to investigate the prevalence of upper limb musculoskeletal disorders (MSDs) and their association with smartphone addiction and smartphone usage among university students in the Kingdom of Saudi Arabia during the COVID-19 pandemic. A total of 313 university students aged 18 years and older who owned a smartphone and used it during the preceding 12 months participated in this cross-sectional study. The prevalence of upper limb MSDs, smartphone addiction/overuse, and levels of physical activity were recorded using the standardized Nordic musculoskeletal questionnaire, the smartphone addiction scale (short version), and the international physical activity questionnaire (short form), respectively. Data collection was performed on campus between March and May 2021. Binary logistic regression was used to determine the association between the prevalence of upper limb MSDs and smartphone addiction/overuse and levels of physical activity. The 12-month prevalence of MSDs of the shoulder, elbow, and wrist/hand regions due to smartphone use among participants was found to be 20.13%, 5.11%, and 13.42%, respectively. Shoulder (odds ratio (OR) = 11.39, 95% confidence interval (CI) = 4.64−27.94, p < 0.001), elbow (OR = 15.38, 95% CI = 1.92−123.26, p = 0.01), and wrist/hand MSDs (OR = 7.65, 95% CI = 2.75−21.22, p < 0.001) were more prevalent among participants who were categorized as having smartphone addiction/overuse measures. Promoting awareness about the healthy use of smartphones, including postural education and decreasing screen time, is necessary to reduce smartphone-related MSDs.

A Novel Application of the Hydrophobic Polyurethane Foam: Expansive Soil Stabilization.

The reversible shrink-swell behavior of expansive soil imposes a serious challenge that threatens the overlying structures' safety and durability. Traditional chemical additives such as lime and cement still exhibit satisfying performance over their counterparts in terms of swelling potential reduction. Nevertheless, significant concerns are associated with these chemicals, in addition to their environmental impact. This paper proposes a novel application of the closed-cell one-component hydrophobic polyurethane foam (HPUF) to stabilize the swelling soil. An extensive experimental study was performed to assess the efficiency of HPUF in mitigating both the swelling and shrinkage response of high montmorillonite content expansive soil. Expansive soil was injected/mixed with different weight ratios of the proposed stabilizer, and the optimum mixing design and injection percentage of the foam resin were identified to be ranged from 10% to 15%. The shrink-swell behaviors of both injected and noninjected samples were compared. Results of this comparison confirmed that HPUF could competently reduce both the swelling potential and the shrinkage cracking of the reactive expansive soil, even after several wet-shrink cycles.

Economic Reliable Technique for Tunnel Grafting Using Iliac Crest Bone Graft in Two-Staged Revision Anterior Cruciate Ligament Surgery.

Revision anterior cruciate ligament surgery is a technically demanding procedure. Mal-positioned tunnels together with bone loss and its management are some of the difficulties and challenges faced. Two-staged procedures have successfully been used to tackle those challenges. We present a technique that is safe, reliable, reproducible, and economic in the management of bone defects faced in anterior cruciate ligament revision surgery by using iliac crest bone graft. Preoperative assessment of tunnel position and size is done by computed tomography. Tri-cortical iliac crest bone graft is harvested through a trap door. It is then shaped to fit the tunnels to be filled. It is tapered at the advancing end to facilitate introduction. Mounted on a passing pin and a drill bit, the graft is arthroscopically introduced into the femoral and tibial tunnels. The second stage is performed after the graft has incorporated, as seen on postoperative computed tomography, done at approximately 3 months after the first stage. Iliac crest provides a natural abundant reservoir for bone graft and has all the advantages of being an autograft. With good meticulous technique, complications can be avoided with less donor-site morbidity. This technique is safe, reliable, and reproducible. It provides an ample amount of graft and harvest does not rely on implants; hence, it is economic.

Epidemiological trends of malaria in the Western regions of Saudi Arabia: a cross sectional study.

INTRODUCTION: Saudi Arabia has successfully reduced malaria cases to be constrained largely in the western regions. This study aimed to determine the epidemiological trends of malaria infection in five western regions of Saudi Arabia. METHODOLOGY: A retrospective analysis was conducted to investigate the epidemiological trends of malaria infection in the western regions, based on the published registry of the Saudi Ministry of Health, during the period from 2014 to 2017 using the appropriate statistical tools. RESULTS: A total of 8925 confirmed cases of malaria were reported in the western regions during the period from 2014 to 2017 with the mean of 2231 malaria cases per year. The minimum (n = 1097) and maximum (n = 4075) number of cases were reported in 2014 and 2016 respectively. The highest (n = 5919, 66.3%) number of cases were reported from Jazan region, while lowest (n = 86, 1.0%) number of cases were reported from Al-Bahah region. Plasmodium falciparum was the most frequently reported species with 7485 (83.9%) cases, while Plasmodium vivax accounted 1386 (15.5%) cases. Plasmodium malariae and mixed infections were insignificant and accounted 0.5% (n = 48) and 0.1% (n = 6) cases respectively. In relation to malaria infection and age group, malaria was predominant in > 15 age group. The highest number of malaria cases in almost all years was observed from January until March and the lowest number was reported from May until July. CONCLUSIONS: Plasmodium falciparum was the most dominant species in this survey and Jazan was the most affected region.

Generalized joint hypermobility among school-aged children in Majmaah region, Saudi Arabia.

Generalized joint hypermobility (GJH) is common among schoolchildren and usually benign. However, it may progressively lead to joint pain and developmental delay. Identifying GJH in school-aged children would facilitate the monitoring of early changes and planning for early rehabilitative intervention. Epidemiological studies addressing the prevalence of GJH among children in the Gulf region and Arab ethnicity are lacking. Hence, we aimed to determine the prevalence, pattern, and factors associated with GJH among school-aged children in the Majmaah region, Saudi Arabia. Male and female school-aged children 8-14 years of age from the Majmaah region of Saudi Arabia participated in this cross-sectional study. Beighton score was used to assess GJH. Personal characteristics such as age, height, weight, body mass index, and handedness were also collected. Descriptive statistics were obtained for personal characteristics, the point prevalence of hypermobility, frequency of Beighton score distribution, and prevalence of GJH. The associations between specific factors and the presence of GJH were analyzed using chi-square and Mann-whitney tests. Using the Beighton score cutoff ≥ 4 and ≥ 6, 15.2% and 7.6% of the school children in our study were diagnosed with GJH respectively. The prevalence of GJH was higher among females (16.8%) than among males (13.4%), but the difference was not statistically significant. The elbow joints (17.2%) were the most common hypermobile joints and the trunk (0.7%) was the least involved. The children with GJH were younger and had lesser BMI compared to children without GJH (P < 0.05). The prevalence reported in this study among school-aged children was comparable with those reported worldwide.

Carbetocin versus rectal misoprostol for management of third stage of labor among women with low risk of postpartum hemorrhage.

OBJECTIVE: To compare effectiveness and safety of carbetocin and misoprostol for prevention of postpartum hemorrhage (PPH) among low-risk women. METHODS: Randomized controlled trial among 150 pregnant women with low risk of PPH admitted for vaginal delivery at Kasr Al Ainy Hospital, Cairo, Egypt, between July 2018 and May 2019. Participants were assigned to two groups by a web-based randomization system ensuring allocation concealment. After neonatal delivery, the carbetocin group received one ampoule of carbetocin (100 µg/mL) intravenously and the misoprostol group received two rectal tablets of misoprostol (800 µg) for active management of the third stage. Blood pressure, blood loss, and hemoglobin levels were monitored. The primary outcome measure was need for additional uterotonic drugs. RESULTS: The carbetocin group had significantly less blood loss (P<0.001), shorter third stage (P<0.001), and less need for additional uterotonics (P=0.013) or uterine massage (P=0.007). The two drugs were hemodynamically safe. Hemoglobin levels after delivery were comparable in the two groups (P=0.475). Adverse effects were more common in the misoprostol group (P<0.001). CONCLUSION: Among low-risk women, carbetocin seems to be a better alternative to misoprostol for active management of the third stage of labor; it reduced blood loss and use of additional uterotonic drugs. CLINICALTRIALS.GOV: NCT03556852.

Biofeedback flutter device for managing the symptoms of patients with COPD.

BACKGROUND: Flutter is a device used in removing excess lung secretions. The conventional flutter lacks a biofeedback component to facilitate optimal use by the patients. OBJECTIVE: The current research aims to compare the effects of biofeedback flutter devices with the conventional flutter in managing the symptoms of patients with chronic obstructive pulmonary diseases. METHODS: One hundred and sixty-eight participants were randomly allocated into four groups: Group A (conventional), Group B (visual biofeedback), Group C (auditory biofeedback) and Group D (visual and auditory biofeedback). All groups were treated five days for 20 minutes. Outcome measures included wet sputum weight [during intervention (T1) and 1 hour after intervention (T2)], oxygen saturation and dyspnea score (before and after intervention) on all days. RESULTS: The wet sputum expectorated (T2) by Group B was significantly higher than Group A (P< 0.001), Group C (P< 0.001) and Group D (P< 0.05). The dyspnea score for Group B (P< 0.05), Group C (P< 0.05) and Group D (P< 0.05) was significantly lower than Group A. The post-intervention oxygen saturation level was higher in Group D followed by Groups B, C and A. CONCLUSION: The use of biofeedback flutter is effective in the removal of secretion, reducing dyspnea and improving oxygen saturation when compared to conventional flutter.

Prevalence of Intestinal Parasitic Infections among Patients of King Fahd Medical City in Riyadh Region, Saudi Arabia: A 5-Year Retrospective Study.

This study is a retrospective analysis of the recorded intestinal parasitic infections for in- and outpatients visiting King Fahd Medical City, Riyadh, Saudi Arabia, from 2013 to 2017. In this study, a total of 5987 in- and outpatient were examined for intestinal parasitic infection. 30 patients out of 5987 were infected with 6 species of intestinal parasites with prevalence rate 0.5%. These parasites were Entamoeba histolytica (P = 0.27%), Cryptosporidium sp. (P = 0.1%), Giardia lamblia (P = 0.07%), Trichuris trichiura (P = 0.03%), Hymenolepis nana (P = 0.02%), and Chilomastix mesnili (P = 0.02%). The prevalence of infection in both males and females was 0.38% and 0.58%, respectively. Also, the prevalence of infection in different years and age groups as well as different seasons was provided. Intestinal parasitic infections are still a public health problem in Riyadh region, Saudi Arabia. Updating the epidemiologic survey of these parasites at regular intervals using the appropriate statistical methods is necessary to develop effective prevention and control strategies.

The prevalence of transfusion-transmitted infections and nucleic acid testing among blood donors in Majmaah, Saudi Arabia.

BACKGROUND: Few studies discussed the prevalence of TTIs in Saudi donor blood samples. Thus, this study investigated the prevalence of hepatitis B virus (HBV), hepatitis C virus (HCV), human immunodeficiency virus (HIV), human T-lymphotropic virus (HTLV), syphilis and malaria in such samples to determine the efficacy of conducting serological and NATs on blood donors at King Khalid General Hospital in Majmaah, Saudi Arabia. METHODS: A total of 3028 donated blood units were collected from August 2015 to March 2017. Serum samples were screened for hepatitis B surface antigens (HBsAgs), HBsAbs, total anti-core antibodies (HBcAbs), HCV antigens and HIV Ab/Ag combinations. Additionally, plasma was screened for syphilis (TPHA) and HTLV. Samples were also tested for malaria with rapid malaria antigen tests. Finally, NATs were performed for the simultaneous direct detection of HBV, HCV and HIV in each sample. RESULTS: Out of the 3028 blood samples, 10 (0.33%) reacted to HBsAgs; 12 (0.40%) reacted to HCV antigens; 4 (0.13%) reacted to HIV Ab/Ag combinations; 6 (0.20%) reacted to HTLV antibodies; 297 (9.81%) reacted to HBcAbs and 236 (7.80%) reacted to HBsAbs. Additionally, NATs showed that 14 (0.46%) reacted to NAT-HBV; 20 (0.66%) samples were reacted to NAT-HCV and 2 (0.07%) samples reacted to NAT-HIV. Finally, 16 (0.53%) were positive for syphilis. No samples were positive for malaria. CONCLUSIONS: The results indicated that NATs are more effective than serology tests for detecting TTIs. Moreover, correlations between standard serology tests and NATs indicated that using NATs could improve test sensitivities and decrease residual risks of TTIs and ensure safe blood transfusions.

Utilization of N-acyl compounds for the synthesis of tricyclic and bridged heterocyclic compounds.

N-acyl derivative 4 was prepared via the reaction of methyl anthranilate with ethyl bromoacetate then refluxing the formed amino ester 3 with acetic anhydride. Cyclization of 4 in presences of sodium methoxide and methanol forming 2,4-pyrrolidindione derivative 5. 2,4-Quinolidinone 6 was obtained via cyclization of 4 in dry toluene and sodium hydride. On the other hand, indolinone derivative 8 was obtained by cyclization of 4 in toluene and free from alcohol due to retro Diekmann-condensation. On treatment of 8 with sodium hydride, refluxing toluene and in presences of Crown ether gave tricyclic compound 9. Also, treatment of 2-pyrrolidinone with trimethylene chlorobromide produced 10 which cyclized using base and solvent to the bridged ring derivatives 11. The acidic hydrolysis of 11 afforded the corresponding amino acid 13. Whereas derivative 14 was obtained by the reaction of 2-pyrrolidinone with ethyl 3-bromopropionate which on cyclization gave azabicyclo[3,2,1]octan-4,8-dione derivative 15. Compound 15 underwent acidic hydrolysis to the amino ketone derivative azepanone hydrochloride 17.