A novel technique with butterfly splint for middle turbinate stabilization in sinus surgery.

OBJECTIVE: To assess the efficacy of newly designed butterfly splint with special technique for middle turbinate stabilization in preventing adhesion following bilateral endoscopic sinus surgery (ESS) for chronic rhinosinusitis with nasal polyps (CRSwNP). STUDY DESIGN: Prospective, double-blind, randomized controlled. SETTING: University hospitals. METHODS: Following ESS, in cases of traumatized and/or unstable middle turbinates, newly designed butterfly plastic splint was randomly inserted in the middle meatus of one nasal side, while no splint was inserted in the other (control). Patients were followed up on after 1 week, 1 month, and 6 months. Endoscopic examination and a visual analog scale were used to evaluate each side of the nasal cavity for adhesion, crusting, pus, pain, nasal obstruction, and nasal discharge. RESULTS: Thirty patients (60 nasal sides) were included. For all investigated parameters, there was no significant difference between the splinted and non-splinted sides at the first week visit. Adhesion was found significantly less in the splinted sides (3%) than the non-splinted sides (27%) after 1 month (P = 0.038). The adhesion rate in the splinted sides remained 3% at the 3 month follow-up visit, however, in the non-splinted sides, the rate increased up to 30% (P = 0.007). Throughout the follow-up visits, all other investigated parameters remained statistically insignificant between both sides. CONCLUSIONS: The newly designed butterfly plastic splints to avoid middle turbinate adhesion is safe and effective in both reducing middle meatal adhesion with low complication rate in CRSwNP patients undergoing ESS and middle turbinate stabilization in its intermediate position.

Demethylnobiletin ameliorates cerebral ischemia-reperfusion injury in rats through Nrf2/HO-1 signaling pathway.

BACKGROUND: Demethylnobiletin (DN), with a variety of biological activities, is a polymethoxy-flavanone (PMF) found in citrus. In the present study, we explored the biological activities and potential mechanism of DN to improve cerebral ischemia reperfusion injury (CIRI) in rats, and identified DN as a novel neuroprotective agent for patients with ischemic brain injury. METHODS: Rat CIRI models were established via middle cerebral artery occlusion (MCAO). Primary nerve cells were isolated and cultured in fetal rat cerebral cortex in vitro, and oxygen-glucose deprivation/reperfusion (OGD/R) models of primary nerve cells were induced. After intervention with DN with different concentrations in MCAO rats and OGD/R nerve cells, 2,3,5-triphenyltetrazolium chloride staining was used to quantify cerebral infarction size in CIRI rats. Modified neurological severity score was utilized to assess neurological performance. Histopathologic staining and live/dead cell-viability staining was used to observe apoptosis. Levels of glutathione (GSH), superoxide dismutase (SOD), reactive oxygen species (ROS) and malondialdehyde (MDA) in tissues and cells were detected using commercial kits. DN level in serum and cerebrospinal fluid of MCAO rats were measured by liquid chromatography tandem mass spectrometry. In addition, expression levels of proteins like Kelch like ECH associated protein 1 (Keap1), nuclear factor erythroid 2-related factor 2 (Nfr2) and heme oxygenase 1 (HO-1) in the Nrf2/HO-1 pathway, and apoptosis-related proteins like Cleaved caspase-3, BCL-2-associated X protein (Bax) and B-cell lymphoma-2 (Bcl-2) were determined by Western blot and immunofluorescence. RESULTS: DN can significantly enhance neurological function recovery by reducing cerebral infarction size and weakening neurocytes apoptosis in MCAO rats. It was further found that DN could improve oxidative stress (OS) injury of nerve cells by bringing down MDA and ROS levels and increasing SOD and GSH levels. Notably, DN exerts its pharmacological influences through entering blood-brain barrier. Mechanically, DN can reduce Keap1 expression while activate Nrf2 and HO-1 expression in neurocytes. CONCLUSIONS: The protective effect of DN on neurocytes have been demonstrated in both in vitro and in vivo circumstances. It deserves to be developed as a potential neuroprotective agent through regulating the Nrf2/HO-1 signaling pathway to ameliorate neurocytes impairment caused by OS.

Role of DISE in the surgical outcome for patients with obstructive sleep apnea.

PURPOSE: To investigate and compare the surgical outcomes of DISE and non-DISE-guided surgery in cases with obstructive sleep apnea. METHODS: Sixty-three patients with severe OSA and BMI ≤35 kg/m2 were included in the study. Patients were randomly divided into group A where surgical intervention was performed without DISE, and group B where surgery was planned according to the findings of DISE. RESULTS: In group A, the mean AHI, LO2, and Snoring index showed a highly significant improvement (P < 0.0001). Group B had highly significant improvements as regards PSG data (P < 0.0001). High significant differences exist when comparing the operative time of both groups (P < 0.0001). On comparing the success rates in both groups, no statistically significant differences were reported (p = 0.6885). CONCLUSION: Preoperative topo-diagnosis with DISE does not significantly affect the surgical outcomes in OSA. Primary OSA cases could benefit from a no-DISE cost-effective surgical protocol that entails multilevel surgical interventions in a reasonable time.

Suspension-expansion pharyngoplasty: a modified technique for oropharyngeal collapse in obstructive sleep apnea.

BACKGROUND AND PURPOSE: Lateral pharyngeal wall (LPW) collapse plays a fundamental role in the pathogenesis of obstructive sleep apnea (OSA) and might determine the severity of the disease. This study presents the suspension/expansion pharyngoplasty (SEP) for the treatment of selected cases of OSA. The procedure aimed to splint LPW collapse via supporting and lateralization of both superior constrictor muscle (SCM) and palatopharyngeal muscle (PPM) individually and in two different planes. METHODS: Twenty-one adult patients with single-level OSA who showed a lateral pattern of collapse at the oropharyngeal region had the modified procedure (SEP). The basic steps are the individual dissection of the muscular components of the lateral pharyngeal wall: SCM which was sutured anteriorly to the anterior tonsillar pillar and the PPM which was suspended to the pterygomandibular raphe. The supra-tonsillar fat was preserved. RESULTS: At 9-12 months, highly significant improvement was reported as regards the mean Apnea hypopnea index and the mean lowest oxygen saturation (p < 0.000). The Epworth Sleepiness Scale and VAS-snoring showed a significant (p < 0.05) reduction. The oxygen desaturation index showed significant improvement. Non-significant improvements were reported as regards the percentage of total sleep time with oxygen saturation below 90%. According to Sher criteria, successful outcomes were reported in 17 patients. CONCLUSION: SEP could widen the pharyngeal airway and could support the collapsible lateral pharyngeal wall guarding against soft tissue collapse. In selected subjects, SEP had reported subjective and objective favorable outcomes with no significant comorbidities. The procedure could be combined with other procedures in multilevel surgery.

Efficient Approach for Anomaly Detection in IoT Using System Calls.

The Internet of Things (IoT) has shown rapid growth and wide adoption in recent years. However, IoT devices are not designed to address modern security challenges. The weak security of these devices has been exploited by malicious actors and has led to several serious cyber-attacks. In this context, anomaly detection approaches are considered very effective owing to their ability to detect existing and novel attacks while requiring data only from normal execution. Because of the limited resources of IoT devices, conventional security solutions are not feasible. This emphasizes the need to develop new approaches that are specifically tailored to IoT devices. In this study, we propose a host-based anomaly detection approach that uses system call data and a Markov chain to represent normal behavior. This approach addresses the challenges that existing approaches face in this area, mainly the segmentation of the syscall trace into suitable smaller units and the use of a fixed threshold to differentiate between normal and malicious syscall sequences. Our proposed approach provides a mechanism for segmenting syscall traces into the program's execution paths and dynamically determines the threshold for anomaly detection. The proposed approach was evaluated against various attacks using two well-known public datasets provided by the University of New South Mexico (UNM) and one custom dataset (PiData) developed in the laboratory. We also compared the performance and characteristics of our proposed approach with those of recently published related work. The proposed approach has a very low false positive rate (0.86%), high accuracy (100%), and a high F1 score (100%) that is, a combined performance measure of precision and recall.

Multi-Mobile Agent Trust Framework for Mitigating Internal Attacks and Augmenting RPL Security.

Recently, the Internet of Things (IoT) has emerged as an important way to connect diverse physical devices to the internet. The IoT paves the way for a slew of new cutting-edge applications. Despite the prospective benefits and many security solutions offered in the literature, the security of IoT networks remains a critical concern, considering the massive amount of data generated and transmitted. The resource-constrained, mobile, and heterogeneous nature of the IoT makes it increasingly challenging to preserve security in routing protocols, such as the routing protocol for low-power and lossy networks (RPL). RPL does not offer good protection against routing attacks, such as rank, Sybil, and sinkhole attacks. Therefore, to augment the security of RPL, this article proposes the energy-efficient multi-mobile agent-based trust framework for RPL (MMTM-RPL). The goal of MMTM-RPL is to mitigate internal attacks in IoT-based wireless sensor networks using fog layer capabilities. MMTM-RPL mitigates rank, Sybil, and sinkhole attacks while minimizing energy and message overheads by 25-30% due to the use of mobile agents and dynamic itineraries. MMTM-RPL enhances the security of RPL and improves network lifetime (by 25-30% or more) and the detection rate (by 10% or more) compared to state-of-the-art approaches, namely, DCTM-RPL, RBAM-IoT, RPL-MRC, and DSH-RPL.

Trans-hyoid hyoidthyroidpexy: A modified technique for selected cases of obstructive sleep apnea.

OBJECTIVE: Hypopharyngeal collapse (HC) considered a challenge in surgery of obstructive sleep apnea (OSA). Several procedures were presented to deal with HC indirectly via providing support to the lateral walls of the hypopharynx preventing transverse collapse but hyoidthryoidpexy had gained more popularity. The procedure aimed to fix the mobile hyoid bone to a rigid mid-line neck structure, thus preventing the bone and its attached muscles from collapsing during sleep with the negative intrathoracic pressure on inspiration. STUDY DESIGN: A prospective case series study. METHODS: From April 2018 to January 2020, A Modified Technique of Trans hyoid hyoidthyroidpexy was applied for all included patients (24) patients with symptoms of OSA showing predominant lateral wall collapse of the hypopharynx (with retro-palatal collapse) with other OSA surgery. RESULTS: 6-8 months postoperatively, the Apnea Hypopnea index dropped from 43.75 ± 8.44 to 16.28 ± 7.35 (P < 0.0001; t = 10.6988). 14 patients (58.33%) were reported as successful while 7 patients (29.17%) were considered responders and three patients (12.5%) were considered non responders. The mean lowest oxygen desaturation elevated from 77.56 ± 5.64 to 92.38 ± 6.25 (p < 0.0001). Epworth Sleepiness Scale improved (P < 0.0001) from 16.85 ± 4.23 to 5.17 ± 3.89. CONCLUSION: Trans-hyoid hyoidthyroidpwxy is a modified technique of hyoidthyroidpexy. The procedure reported good outcomes in treating OSA. It is a simple, cost-effective and less traumatic technique. It could be combined with other multilevel surgical procedures.

Modified anterior palatoplasty and double suspension sutures (with or without tonsillectomy) in selected patients with obstructive sleep apnea: a preliminary report.

BACKGROUND: Retropalatal region might be considered the most common site of obstruction in patients with snoring and OSA. We aimed at presentation of two combined techniques: modified anterior palatoplasty (MAP) and bilateral double suspension suture (DSS). METHODS: This prospective study was conducted on OSA patients with retro-palatal collapse only that was confirmed by nasoendoscopy during Muller's maneuver and drug induced sleep endoscopy. MAP and DSS were performed for all patients. Preoperative and 6 months after surgery, all patients underwent fiber-optic nasoendoscopy using the Muller maneuver and polysomnography, snoring scores, and Epworth Sleepiness Scale (ESS) values were assessed. RESULTS: Mean apnea hypopnea index (AHI) dropped significantly (p < 0.0001) from a mean of 28.6 ± 5.5 preoperatively to 8.3 ± 2.96 postoperatively. Successful outcome was reported in 26 patients (98.65%) while 3 patients (10.35%) were responders. The mean lowest oxygen (O2) saturation level increased significantly from 79.4 ± 3.5 to 93.1 ± 3.1 (p < 0.0001). ESS showed significant improvement (p < 0.0001) as its mean diminished from 14.5 ± 2.4 preoperatively to 3.4 ± 1 postoperatively. Visual analog scale of snoring was significantly (p < 0.0001) decreased from 7.9 ± 1.3 preoperatively to 1.9 ± 1.2 postoperatively. No early or late complications were reported. CONCLUSION: Combined MAP and DSS (± tonsillectomy) could be considered as simple, reliable, easily trained, effective, and safe surgical treatment option for OSA patients with predominant retropalatal obstruction. It could be employed in a single-stage, multilevel work-up.

Could Nasal Surgery Affect Multilevel Surgery Results for Obstructive Sleep Apnea?

OBJECTIVE: To study the role of nasal surgery as a part of multilevel surgery for management of obstructive sleep apnea (OSA). METHODS: All patients underwent multilevel surgery for relieving OSA symptoms and they were classified according to type of surgical intervention into: group A (20 patients), who underwent hyoid suspension (Hyoidthyroidpexy), tonsillectomy, suspension (El-Ahl and El-Anwar) sutures and nasal surgery (inferior turbinate surgery). Group B (20 patients), who underwent hyoid suspension (Hyoidthyroidpexy), tonsillectomy and suspension sutures. Pre and postoperative sleep study, Epworth sleepiness scale, snoring score were reported and compared. RESULTS: Apnea hypoapnea index (AHI) dropped significantly in both groups. The mean preoperative AHI was significantly less in patients who had no nasal obstruction (P = 0.0367), while the difference in postoperative values was nonsignificant (P = 0.7358).The mean Epworth sleepiness scale improved significantly in both groups, but the difference between pre and postoperative values in both groups was nonsignificant. The lowest oxygen saturation elevated significantly in both groups, but the difference between pre and postoperative values in both groups was nonsignificant. As regards snoring scores, they dropped significantly in both groups. The preoperative snoring score was reported to be significantly more in patients who had associated nasal obstruction (group A) (P = 0.0113). But after surgery the difference in postoperative values was nonsignificant (P = 0.1296). CONCLUSION: Treatment of nasal obstruction should be considered a crucial component in the comprehensive management plan for OSA patients as it has significant impact on the patients' AHI and snoring.

Cyber and Physical Security Vulnerability Assessment for IoT-Based Smart Homes.

The Internet of Things (IoT) is an emerging paradigm focusing on the connection of devices, objects, or "things" to each other, to the Internet, and to users. IoT technology is anticipated to become an essential requirement in the development of smart homes, as it offers convenience and efficiency to home residents so that they can achieve better quality of life. Application of the IoT model to smart homes, by connecting objects to the Internet, poses new security and privacy challenges in terms of the confidentiality, authenticity, and integrity of the data sensed, collected, and exchanged by the IoT objects. These challenges make smart homes extremely vulnerable to different types of security attacks, resulting in IoT-based smart homes being insecure. Therefore, it is necessary to identify the possible security risks to develop a complete picture of the security status of smart homes. This article applies the operationally critical threat, asset, and vulnerability evaluation (OCTAVE) methodology, known as OCTAVE Allegro, to assess the security risks of smart homes. The OCTAVE Allegro method focuses on information assets and considers different information containers such as databases, physical papers, and humans. The key goals of this study are to highlight the various security vulnerabilities of IoT-based smart homes, to present the risks on home inhabitants, and to propose approaches to mitigating the identified risks. The research findings can be used as a foundation for improving the security requirements of IoT-based smart homes.

Efficacies of DHA-PPQ and AS/SP in patients with uncomplicated Plasmodium falciparum malaria in an area of an unstable seasonal transmission in Sudan.

BACKGROUND: Artemisinin-based combination therapy (ACT), together with other control measures, have reduced the burden of falciparum malaria in sub-Saharan countries, including Sudan. Sudan adopted ACT in 2004 with a remarkable reduction in mortality due to falciparum malaria. However, emergence of resistance to the first-line treatment artesunate and sulfadoxine/pyrimethamine (AS/SP) has created new challenges to the control of malaria in Sudan. A search for an alternative drug of choice for treating uncomplicated malaria has become inevitable. The objective of this study was to evaluate the therapeutic efficacies of dihydroartemisinin/piperaquine (DHA-PPQ) and AS/SP in an area of unstable transmission in Blue Nile State, Sudan in 2015-16. METHODS: A total of 148 patients with uncomplicated malaria were recruited in the study from November 2015 to end of January 2016. Seventy-five patients received DHA-PPQ while 73 received AS/SP. Patients were monitored for clinical and parasitological outcomes following the standard WHO protocol for a period of 42 days for DHA-PPQ and 28 days for AS/SP; nested PCR (nPCR) was performed to confirm parasite re-appearance from day 7 onwards. RESULTS: Fifty-five patients completed the DHA-PPQ arm protocol with success cure rate of 98.2% (95% CI 90.3-100%) and one late clinical failure 1.8% (95% CI 0.0-9.7%). The AS/SP showed adequate clinical and parasitological response (ACPR) of 83.6% (95% CI 71.9-91.8%), early treatment failure was 1.6% (95% CI 0.0-8.8%) and late parasitological failure (LPF) was 14.8% (95% CI 7-26.2%). The respective PCR uncorrected LPF was 20%. CONCLUSION: DHA-PPQ is an efficacious ACT and candidate for replacement of first-line treatment in Sudan while AS/SP showed high treatment failure rate and must be replaced.

Voice and Swallowing Outcomes after Hyoid Suspension Surgery in Patients with Obstructive Sleep Apnea.

OBJECTIVE: The role of hyoidthyroidpexia (HTP) surgery in the management of patients with obstructive sleep apnea (OSA) is well described with good reported outcomes. The effect of HTP on other laryngeal functions is not well discussed. This study was designed to evaluate voice and swallowing outcomes after HTP. PATIENTS AND METHODS: This study was applied on a selected group of OSA patients. HTP (as a sole procedure) was performed in 17 patients and 14 patients had simultaneous palatal procedures (e.g., anterior palatoplasty). Pre- and postoperative assessment of voice and swallowing were done. RESULTS: Comparison between pre- and postoperative results of voice and swallowing measures revealed a nonsignificant difference. CONCLUSION: HTP (as a sole technique or as part of a multilevel intervention) could help with airway collapse and might be considered a safe, simple, and effective technique in the management of selected patients experiencing OSA. In addition, it seems to have no hazardous effect on either the voice or swallowing function of patients.

High efficacy of artemether-lumefantrine and declining efficacy of artesunate + sulfadoxine-pyrimethamine against Plasmodium falciparum in Sudan (2010-2015): evidence from in vivo and molecular marker studies.

BACKGROUND: The present paper reports on studies that evaluated artesunate + sulfadoxine-pyrimethamine (AS + SP) which is the first-line drug and artemether-lumefantrine (AL) which is a second-line drug against uncomplicated falciparum malaria in Sudan. This evaluation was performed in twenty studies covering six sentinel sites during five successive annual malaria transmission seasons from 2010 to 2015. METHODS: The standard World Health Organization protocol was used for a follow-up period of 28 days. The frequency distribution of molecular markers for antifolate resistance in dihydrofolate reductase (dhfr) and dihydropteroate synthase (dhps) genes was studied in pre-treatment samples in four sites in 2011. RESULTS: In the nine studies of AL conducted at five sites (n = 595), high PCR-corrected cure rates were found, ranging from 96.8 to 100 %. Among the eleven studies of AS + SP (n = 1013), a decline in the PCR-corrected cure rates was observed in Gedaref in Eastern Sudan: 91.0 % in the 2011-12 season and 86.5 % in the 2014-15 season. In the remaining sites, the AS + SP cure rates ranged between 95.6 and 100 %. The rate of clearance of microscopic gametocytaemia after treatment was not significantly different with AL or AS + SP on days 7, 14, 21 and 28 of follow-up. A total of 371 pre-treatment samples were analysed for molecular markers of SP resistance. The temporal changes and geographical differences in the frequency distribution of SP-resistance genotypes showed evidence of regional differentiation and selection of resistant strains. CONCLUSION: The findings of this study call for a need to review the Sudan malaria treatment policy. Epidemiological factors could play a major role in the emergence of drug-resistant malaria in eastern Sudan. AUSTRALIAN NEW ZEALAND CLINICAL TRIALS REGISTRY: Trial registration numbers 2011-2012: ACTRN12611001253998, 2013-2015: ACTRN12613000945729.

Efficacy of an anticoccidial live vaccine in prevention of necrotic enteritis in chickens.

Necrotic enteritis (NE) is an important disease in poultry caused by Clostridium perfringens combined with predisposing factors, mainly eimeriosis. In the present study, we investigated the protective effect of a commercial attenuated anticoccidial live vaccine against NE in a clinical infection model using 60 day-old chicks. Vaccination was performed on study day (SD) 1 with natural booster-infections for 4 weeks from Eimeria spp. oocysts present in litter. On SD 28, five groups were formed (n=12): group V+/C-E- (vaccinated, uninfected), group V+/C-E+ (vaccinated, infected with Eimeria spp.), group V+/C+E+ (vaccinated, infected with clostridia and Eimeria spp.), group V-/C+E+ (unvaccinated, infected with clostridia and Eimeria spp.), and group NC (negative control). Efficacy was measured by clinical parameters, pathogen multiplication, and pathological parameters assessed during two necropsies on SD 34 and SD 40, respectively. Additionally, cytokine expression was measured in gut and spleen tissues at necropsy. Clinical signs of NE were observed only in the coinfected groups, mainly in group V-/C+E+. Accordingly, lowest body weight gain was observed in group V-/C+E+ (301.8 g from SD 28 to SD 40; group NC: 626.2 g). Oocyst excretion varied significantly (P<0.01) between all Eimeria spp. infected groups and was highest in group V-/C+E+, followed by V+/C+E+, and lowest in group V+/C-E+. NE typical intestinal lesions showed only in groups V+/C+E+ and V-/C+E+. The intestinal mucosa featured partly severe lesions in the jejunum, C. perfringens colonization was histologically visible. Upregulation of IFN-γ, was observed in the jejunal tissue of group V-/C+E+ (P<0.01 (SD 34) or P<0.05 (SD 40) compared to all other groups). IL-10 and IL-12 were upregulated in group V-/C+E+, IL-10 also in group V+/C+E+ (SD 40) while IL-2 expression remained unaltered. In conclusion, vaccination against coccidiosis was effective in preventing NE in a mixed infection comparable to field situations.

Automatic brain-tumor diagnosis using cascaded deep convolutional neural networks with symmetric U-Net and asymmetric residual-blocks.

The use of various kinds of magnetic resonance imaging (MRI) techniques for examining brain tissue has increased significantly in recent years, and manual investigation of each of the resulting images can be a time-consuming task. This paper presents an automatic brain-tumor diagnosis system that uses a CNN for detection, classification, and segmentation of glioblastomas; the latter stage seeks to segment tumors inside glioma MRI images. The structure of the developed multi-unit system consists of two stages. The first stage is responsible for tumor detection and classification by categorizing brain MRI images into normal, high-grade glioma (glioblastoma), and low-grade glioma. The uniqueness of the proposed network lies in its use of different levels of features, including local and global paths. The second stage is responsible for tumor segmentation, and skip connections and residual units are used during this step. Using 1800 images extracted from the BraTS 2017 dataset, the detection and classification stage was found to achieve a maximum accuracy of 99%. The segmentation stage was then evaluated using the Dice score, specificity, and sensitivity. The results showed that the suggested deep-learning-based system ranks highest among a variety of different strategies reported in the literature.

A New Proposed Combined CT and MRI Staging System for Covid-19-Associated Rhino-Orbito-Cerebral Fungal Infection: A Multi-center Study with Pathological Correlation.

RATIONALE AND OBJECTIVES: To propose a combined computed tomography (CT) and magnetic resonance imaging (MRI) based classification system in the management of COVID-19-associated rhino-orbito-cerebral (C-ROC) fungal infection and to assess the reliability of such proposed staging system. MATERIALS AND METHODS: This was a multi-center prospective study conducted on 122 adults with previously confirmed COVID-19 infection. CT and contrast-enhanced MRI (CE-MRI) were performed for all patients. Three radiologists (with experience of 8, 10, and 14 years) independently assessed all images. Then, each patient was assigned a radiological stage based on the five stages of the proposed system according to the radiological extent of the fungal infection. The intra-class correlation coefficient (ICC) test assessed the inter-rater agreement. Based on the pathological evaluation of post-operative specimens, a diagnosis of fungal infection was documented. RESULTS: The most prevalent severity stage among all raters was stage IV in 29.5-31.1% patients. The overall inter-rater agreement of the proposed staging system was excellent (ICC 0.971, 95% CI;0.960-0.979). Moreover, the most common detected pathogen was Mucormycosis (n = 87, 71.3%). Furthermore, there was a statistically significant association between the patients' outcome and the severity stage (P value 0.001) and there was no statistically significant association between ethmoid and sphenoid sinus affection and cranial extension (P value 0.081). CONCLUSION: Our proposed combined CT and MRI severity staging system has a high inter-rater agreement. Moreover, it can aid in the early detection of the C-ROC fungal infection, improve preoperative planning, and subsequently improve the patient's outcome.

Nickel-Tin Nanoalloy Supported ZnO Catalysts from Mixed-Metal Zeolitic Imidazolate Frameworks for Selective Conversion of Glycerol to 1,2-Propanediol.

The successful synthesis of finely tuned Ni1.5 Sn nanoalloy phases containing ZnO catalyst with a small particle size (6.7 nm) from a mixed-metal zeolitic imidazolate framework (MM-ZIF) is investigated. The catalyst was evaluated for the efficient production of 1,2-propanediol (1,2-PDO) from crude glycerol and comprehensively characterized using several analytical techniques. Among the catalysts, 3Ni1Sn/ZnO (Ni/Sn=3/1) showed the best catalytic performance and produced the highest yield (94.2 %) of 1,2-PDO at ~100 % conversion of glycerol; it also showed low apparent activation energy (15.4 kJ/mol) and excellent stability. The results demonstrated that the synergy between Ni-Sn alloy, finely dispersed Ni metallic sites, and the Lewis acidity of SnOx species-loaded ZnO played a pivotal role in the high activity and selectivity of the catalyst. The confirmation of acetol intermediate and theoretical calculations verify the Ni1.5 Sn phases provide the least energetic pathway for the formation of 1,2-PDO selectively. The reusability of solvent for successive ZIF synthesis, along with the excellent recyclability of the ZIF-derived catalyst, enables an overall sustainable process. We believe that the present synthetic protocol that uses MM-ZIF for the conversion of various biomass-derived platform chemicals into valuable products can be applied to various nanoalloy preparations.

Drying kinetics and thermo-environmental analysis of a PV-operated tracking indirect solar dryer for tomato slices.

The purpose of this study is to investigate how a tracking indirect solar dryer (SD) powered by photovoltaic cells affected the drying kinetics (DK) and thermo-environmental conditions of tomato slices. In this current investigation, three air speeds (1, 1.5, and 2 m/s) are used, as well as three slice thicknesses (ST) (4, 6, and 8 mm) and two SD, one of which is integrated with fixed collector motion (FCM) and another with SD tracking collector motion (TCM). The obtained results showed that the drying time (DT) isn't significantly change with increasing air speeds from 1 to 2 m/s, this may be due to many reasons such as short DT, high temperature inside drying room, and little difference between the exanimated air speeds. When the ST is changed from 4 to 8 mm and maintaining constant air speeds, the DT for FCM and TCM rose by roughly 1.667 and 1.6 times, respectively. In addition, the drying coefficient of the TCM is higher than the FCM due to higher temperature. At 1.5 m/s air speed and 8 mm ST, the maximum values of moisture diffusivity (MD) are 7.15×10-10 and 9.30×10-10 m2/s for both FCM and TCM systems, respectively. During the study of DK, nine drying models and chose the best based on higher R2 and lower χ2 and RMSE are used. The findings of the DK analysis revealed that the modified two term II model fit the experimental data of various air speeds well when TF was dried using TCM and FCM systems at varying ST. These findings are based on recorded observations. Where the models' R2 values varied from 0.98005 to 0.99942 for FCM system and varied from 0.99386 to 0.99976 for TCM system. Regarding environmental analysis, it is found that the CO2 mitigation per lifetime is ranged between 5334.9-6795.4 tons for FCM and 6305.7-6323.3 tons for TCM.

Assessment of a LPG hybrid solar dryer assisted with smart air circulation system for drying basil leaves.

The fluctuation of solar radiation throughout the day presents a significant obstacle to the widespread adoption of solar dryers for the dehydration of agricultural products, particularly those that are sensitive to high temperatures, such as basil leaf drying during the winter season. Consequently, this recent study sought to address the limitations of solar-powered dryers by implementing a hybrid drying system that harnesses both solar energy and liquid petroleum gas (LPG). Furthermore, an innovative automatic electronic unit was integrated to facilitate the circulation of air between the drying chamber and the ambient environment. Considering the solar radiation status in Egypt, an LPG hybrid solar dryer has been developed to be suitable for both sunny and cloudy weather conditions. This hybrid solar dryer (HSD) uses indirect forced convection and a controlled auxiliary heating system (LPG) to regulate both temperature and relative humidity, resulting in increased drying rates, reduced energy consumption, and the production of high-quality dried products. The HSD was tested and evaluated for drying basil leaves at three different temperatures of50, 55, and 60 °C and three air changing rates of 70, 80, and 90%, during both summer and winter sessions. The obtained results showed that drying basil at a temperature of 60 °C and an air changing rate of 90% led to a decrease in the drying time by about 35.71% and 35.56% in summer and winter, respectively, where summer drying took 135-210 min and winter drying took 145-225 min to reach equilibrium moisture content (MC). Additionally, the effective moisture diffusivity ranged from 5.25 to 9.06 × 10- 9 m2/s, where higher values of effective moisture diffusivity (EMD) were increased with increasing both drying temperatures and air change rates. Furthermore, the activation energy decreased from 16.557 to 25.182 kJ/mol to 1.945-15.366 kJ/mol for the winter and summer sessions, respectively. On the other hand, the analysis of thin-layer kinetic showed that the Modified Midilli II model has a higher coefficient of determination R2, the lowest χ2, and the lowest root mean square error (RMSE) compared to the other models of both winter and summer sessions. Finally, the LPG hybrid solar dryer can be used for drying a wide range of agricultural products, and it is more efficient for drying medicinal plants. This innovative dryer utilizes a combination of LPG and solar energy, making it efficient and environmentally friendly.

Efficacy of early treatment with toltrazuril in prevention of coccidiosis and necrotic enteritis in chickens.

In the present study, efficacy of the toltrazuril treatment for prevention of coccidiosis and necrotic enteritis was tested. Ninety-six 14-day-old commercial broiler chickens were caged and divided into eight groups (n=12), designated groups 1 to 8. Chickens of groups 1 to 6 were inoculated orally at 18 days of age with 25,000 oocysts of Eimeria tenella and 75,000 oocysts of Eimeria brunetti. At 22 days of age, chickens of groups 1 to 6 were infected with 10(9) colony-forming unit Clostridium perfringens. Chickens of group 1 were treated with 75 parts/10(6) toltrazuril in drinking water for 8 h on two consecutive days up to 12 h before Eimeria infection, while chickens of groups 2 to 5 were treated with the same dose of toltrazuril at 12 h, 36 h, 60 h and 84 h after Eimeria infection, respectively. The non-treated group 6 served as a positive control. Chickens in group 7 were treated with toltrazuril at 17 and 18 days of age, and those of group 8 remained uninfected and non-treated as a negative control. The feed conversion ratio was higher in the positive control compared with other groups. The mortality rates were 16.8% and 41.7% in the late toltrazuril-treated (at 84 h) and infected non-treated chickens, respectively. Lesions scores of necrotic enteritis or coccidiosis in infected, non-treated chickens were significantly more severe compared with negative controls (P<0.01) and late toltrazuril-treated (at 84 h) chickens (P<0.05). In conclusion, application of toltrazuril before Eimeria challenge protected chickens from coccidiosis and indirectly from successive necrotic enteritis caused by C. perfringens infection.