Background: The COVID-19 pandemic has caused not only the risk of death from the viral infection but also unbearable psychological stress to people throughout the world. Aim To assess psychological stressors facing employees working at El Fayoum University hospital during COVID-19 pandemic. Design: descriptive explanatory design was utilized. Setting: The study was conducted at El Fayoum University hospital. Sample: convenient sample of 300 employees working at El Fayoum university hospital. Tool: Two tools were used to collect study data; 1) Interview questionnaire to assess Socio-demographic data of employees working at El Fayoum university hospital, 2) The employees psychological Stress questionnaire to assess psychological stressors facing employees working at El Fayoum university hospital. Result: This study showed that more than one third of the employees working at El Fayoum university hospital were between the ages of 30 to less than 40 years. Meanwhile, more than two thirds of them are females and revealed that more than half of employees working at El Fayoum university hospital have high psychological stresses related to the covid-19 pandemic, on the other hand almost half of them have high social stresses related to the covid-19 pandemic and nearly half of them have moderate physical stresses related to the covid-19 pandemic. Conclusion: More than half of employees facing high level of psychological stressors during covid-19 pandemic, nearly half of them have high level of social stressors during covid-19 pandemic and less than half of them facing moderate level of physical stressors during covid-19 pandemic. Recommendation: Psycho-educational programs for employees about how to face their psychological stresses during covid-19 pandemic, that could curtail the negative impacts of this crisis and eliminates psychological stress of health care employees.

Iphiona grantioides (Boiss) Anderb. is a medicinal plant featuring several traditional uses. Nevertheless, this plant has not been widely investigated by modern medicinal chemistry yet, as also the properties of its extracts.In this study, we report the extraction of the essential oil by hydrodistillation from the leaves of I. grantioides. This was characterised by GC-MS analysis and ten chemical constituents were identified.Our findings demonstrate that the essential oil is effective in inhibiting the growth of bacterial strains, and of Klebsiela pneumonia and Staphylococcus aureus in particular. Additionally, its antioxidant properties were evaluated, and it showed radical scavenging activity in vitro.

Study design Systematic review.Objectives Primary Spinal Intradural Tumours (PSITs) are rare pathologies that can significantly impact quality of life. This study aimed to review patient reported outcomes (PROs) in PSITs.Methods A systematic search of Pubmed and Embase was performed to identify studies measuring PROs in adults with PSITs. PRO results were categorised as relating to Global, Physical, Social, or Mental health. Outcomes were summarised descriptively.Results Following review of 2382 records, 11 studies were eligible for inclusion (737 patients). All studies assessed surgically treated patients. Schwannoma was the commonest pathology (n = 190). 7 studies measured PROs before and after surgery, the remainder assessed only post-operatively. For eight studies, PROs were obtained within 12 months of treatment. 21 PRO measurement tools were used across included studies, of which Euro-Qol-5D (n = 8) and the pain visual/numerical analogue scale (n = 5) were utilised most frequently. Although overall QoL is lower than healthy controls in PSITs, improvements following surgery were found in Extramedullary tumours (EMT) in overall physical, social, and mental health. Similar improvements were not significant across studies of Intramedullary tumours (IMT). Overall QoL and symptom burden was higher in IMT patients than in brain tumour patients. No studies evaluated the effect of chemotherapy or radiotherapy.Conclusion Patients with PSITs suffer impaired PROs before and after surgery. This is particularly true for IMTs. PRO reporting in PSITs is hindered by a heterogeneity of reporting and varied measurement tools. This calls for the establishment of a standard set of PROs as well as the use of registries.

Antimicrobial resistance is a major health burden in Pakistan, and therefore new herbal medicine-based therapeutic regimens are being largely investigated. Limbarda crithmoides essential oil was extracted by using hydrodistillation method. Chemical profiling of essential was evaluated by using FTIR and GC-MS analysis. A total of 20 components were identified including, p-xylene, o-xylene, β-linalool, acetophenole and 3-isopropylphenyl methylcarbamate. The HOMO and LUMO analysis in DFT investigations presented that 3-isopropylphenyl methylcarbamate, p-xylene and o-xylene posess a substantial capacity to transfer charge through molecules. The antimicrobial potential of essential oil showed moderate inhibition against E. coli (MIC = 6.25 mg/mL), whereras a significant inhibition Staphylococos aureus was recorded (MIC = 3.12 mg/mL). Further, significant antioxidant activities were recorded in DPPH radical scavenging (IC50 = 80.5 µg/mL), H2O2 (64 ± 1.2%) and FRAP (60.3 µg ferrous equivalents) assays. It was therefore concluded that Limbarda crithmoides essential oil has potential antioxidant and anti-antimicrobial properties and can be used for further investigations.

MySkinSelfie is a mobile phone application for skin self-monitoring, enabling secure sharing of patient-captured images with healthcare providers. This retrospective study assessed MySkinSelfie's role in remote skin cancer assessment at two centres for urgent (melanoma and squamous cell carcinoma) and nonurgent skin cancer referrals, investigating the feasibility of using patient-captured images without dermoscopy for remote diagnosis. The total number of lesions using MySkinSelfie was 814, with a mean patient age of 63 years. Remote consultations reduced face-to-face appointments by 90% for basal cell carcinoma and by 63% for referrals on a 2-week waiting list. Diagnostic concordance (consultant vs. histological diagnosis) rates of 72% and 83% were observed for basal cell carcinoma (n = 107) and urgent skin cancers (n = 704), respectively. Challenges included image quality, workflow integration and lack of dermoscopy. Higher sensitivities were observed in recent artificial intelligence algorithms employing dermoscopy. While patient-captured images proved useful during the COVID-19 pandemic, further research is needed to explore the feasibility of widespread patient-led dermoscopy to enable direct patient-to-artificial intelligence diagnostic assessment. MySkinSelfie, a mobile phone application, facilitated remote skin cancer assessments via patient-captured images without dermoscopy. The study, involving 814 lesions, showed a 72-83% diagnostic concordance for basal cell carcinoma and urgent skin cancers. While reducing face-to-face appointments significantly, challenges persist with image quality and the absence of dermoscopy, indicating the need for further exploration into patient-led dermoscopy for direct patient-to-artificial intelligence diagnosis.

Suspension thermal spraying is an emerging coating technology that enables the deposition of dense-structured ceramic coatings. As wear resistance is a main application field of alumina (Al 2 O 3 ) coatings, this study aimed to evaluate the dry reciprocating sliding wear resistance of suspension sprayed high velocity oxy-fuel (S-HVOF) alumina coatings and to compare it with atmospheric plasma sprayed (APS) and HVOF coatings. Coatings were analyzed in the as-sprayed state and post-treated at 910 °C (hot isostatically pressed, HIPed) conditions. Wear tests were conducted using a tribometer, following the ASTM G133-02 standard and a sintered WC-6 wt.% Co ball as the counterbody. Coating characterization was done using scanning electron microscopy, x-ray diffraction and nanoindentation technique. Results indicate that the HVOF, HVOF-HIP and S-HVOF coatings had a high α-Al 2 O 3 content, whereas the APS and APS-HIP coatings had a high γ-phase content together with high porosity. Sliding wear resistance was an order of magnitude higher for the S-HVOF and HVOF coatings than the APS and APS-HIPed coatings. This difference in wear performance was attributed to the high nanohardness, elastic modulus, dense microstructure and relatively high α-Al 2 O 3 content in the HVOF, S-HVOF and HVOF-HIP coatings. Results are discussed in terms of the wear mechanism and structure-property relationship.

Fibromyalgia is a debilitating chronic condition which poses a therapeutic challenge to the clinician. With a large backlog in patient flow subsequent to the COVID-19 pandemic and rising numbers of patients with post-acute sequelae of COVID-19 (PASC) presenting with fibromyalgia-like clinical features, there is an increasingly pressing need to identify broad cost-effective interventions. Low levels of vitamin D have previously been reported in patients with fibromyalgia, though any causative link has been difficult to establish. A systematic literature review on the association between vitamin D deficiency and fibromyalgia was performed examining retrospective evidence both for and against an association between vitamin D deficiency (VDD) and fibromyalgia and evaluating the therapeutic benefit from supplementation. A group of six studies were selected based on relevance, use of controls, quality of research and citations. Four primary studies assessing the prevalence of VDD in fibromyalgia patients versus controls were evaluated with a total 3,496 subjects. Three included females only and one larger study assessed males. Two (n = 313) concluded the presence of a statistically significant association, and two (n = 161) found none. Two randomised controlled trials assessing the effect of vitamin D supplementation in a total of 80 subjects found conflicting results, with pain reduction in one and none in the other. It is likely there exists an association between VDD deficiency and fibromyalgia in a large subset of patients, although establishing primary causation is difficult. There is a need for larger randomised controlled trial designs with more effective comparison with healthy subjects and control for confounding factors. Given VDD is a major problem in the general population, we recommend supplementation be recommended by healthcare professionals to fibromyalgia patients for the purpose of maintaining bone health given their potentially increased susceptibility to developing deficiency and its sequelae.

There is a significant shortage of transplantable organs in the UK particularly from Black, Asian and Minority Ethnic (BAME) groups, of which Muslims make a large proportion. The British Islamic Medical Association (BIMA) held a nationwide series of community gatherings with the aim of describing the beliefs and attitudes to organ donation amongst British Muslims and evaluate the efficacy of a national public health programme on views and uncertainties regarding religious permissibility and willingness to register. Eight public forums were held across the UK between June 2019 and March 2020 by the British Islamic Medical Association (BIMA). A panel of experts consisting of health professionals and Imams discussed with audiences the procedures, experiences and Islamic ethico-legal rulings on organ donation. Attendees completed a self-administered questionnaire which captured demographic data along with opinions before and after the session regarding religious permissibility and willingness to register given permissibility. A total of 554 respondents across seven UK cities were included with a M:F ratio 1:1.1. Only 45 (8%) respondents were registered as organ donors. Amongst those not registered multiple justifications were detailed, foremost of which was religious uncertainty (73%). Pre-intervention results indicated 50% of respondents were unsure of the permissibility of organ donation in Islam. Of those initially unsure or against permissibility or willingness to register, 72% changed their opinion towards deeming it permissible and 60% towards a willingness to register indicating a significant change in opinion (p < 0.001). The effectiveness of our interventions suggests further education incorporating faith leaders alongside local healthcare professionals to address religious and cultural concerns can reduce uncertainty whilst improving organ donation rates among the Muslim community.

Background: Surgical site infection contributes to a significant proportion of postoperative morbidity in patients undergoing emergency laparotomy. Surgical site infections cause significant patient burden, increase duration of stay, and have economic implications. Closed incision negative pressure therapy has been shown to reduce surgical site infection rates in patients undergoing elective laparotomy; however, there is limited evidence for their use in the emergency setting. This study aims to compare rates of surgical site infection between patients receiving closed incision negative pressure therapy and standard surgical dressing after emergency laparotomy through a propensity matched analysis. Methods: A registry-based, prospective cohort study was undertaken using data from the National Emergency Laparotomy Audit database at our center. The primary outcome measure was surgical site infection as defined by the Centers for Disease Control criteria. Secondary outcomes included 30-day postoperative morbidity and grade, duration of stay, 30-day mortality, and readmission rates. A propensity-score matching was performed in a 1:1 ratio to mitigate for selection bias. Results: A total of 1,484 patients were identified from the National Emergency Laparotomy Audit data set, and propensity-score matching resulted in 2 equally matched cohorts with 237 patients in each arm. The rate of surgical site infection was significantly lower in the closed incision negative pressure therapy cohort (16.9% vs 33.8%, P < .001). There were no overall differences in 30-day morbidity, Clavien-Dindo grade, Comprehensive Complication Index severity, length of hospital stay, reoperation rates, and 30-day mortality between the 2 groups. Conclusions: Prophylactic closed incision negative pressure therapy in emergency laparotomy patients is associated with a reduction in surgical site infection rates. (c) 2021 Elsevier Inc. All rights reserved.

Video conference service is an application that offers video and audio at the same time, and it is one of the real-time applications that deplete the capacity of any system significantly.Fortunately, the IEEE 802.16e standard offers a specific quality of service that can support the desired applications for a limited number of users as there is a tradeoff between the quality and quantity of system capability.In this paper, the number of subscriber units which can be served successfully by a single base station based on the IEEE 802.16e standard for different video conference applications has been evaluated in three cases depending on the circumstance of the end terminal case in terms of modulation and coding rate schemes: the worst case, the random case, and the perfect case.Due To our best knowledge, this paper considered as the first one deals with the capacity in these three cases in term of modulation schemes.The metrics of performance for this study are the end-to-end delay (ETE), the difference between the received to transmitted traffic, the delay variation for different video conference applications, and the amount of the free resources of the cell.

The global thermal spray coatings market was valued at USD 10.1 billion in 2019 and is expected to grow at a compound annual growth rate of 3.9% from 2020 to 2027. Carbide coatings form an essential segment of this market and provide cost-effective and environmental friendly tribological solutions for applications in aerospace, industrial gas turbine, automotive, printing, oil and gas, steel, and pulp and paper industries. Almost 23% of the world’s total energy consumption originates from tribological contacts. Thermal spray WC-Co coatings provide excellent wear resistance for industrial applications in sliding and rolling contacts. Some of these applications in abrasive, sliding and erosive conditions include sink rolls in zinc pots, conveyor screws, pump housings, impeller shafts, aircraft flap tracks, cam followers and expansion joints. These coatings are considered as a replacement of the hazardous chrome plating for tribological applications. The microstructure of thermal spray coatings is however complex, and the wear mechanisms and wear rates vary significantly when compared to cemented WC-Co carbides or vapour deposition WC coatings. This paper provides an expert review of the tribological considerations that dictate the sliding wear performance of thermal spray WC-Co coatings. Structure–property relationships and failure modes are discussed to grasp the design aspects of WC-Co coatings for tribological applications. Recent developments of suspension sprayed nanocomposite coatings are compared with conventional coatings in terms of performance and failure mechanisms. The dependency of coating microstructure, binder material, carbide size, fracture toughness, post-treatment and hardness on sliding wear performance and test methodology is discussed. Semiempirical mathematical models of wear rate related to the influence of tribological test conditions and coating characteristics are analysed for sliding contacts. Finally, advances for numerical modelling of sliding wear rate are discussed.

Wireless local area network (WLAN) is the core of the classic wireless communications systems and owns the infrastructure which wide spreads in many regions in the world. IEEE 802.11n is an attractive standard of WLAN and offers a data capacity of the cell. This paper estimates the maximum limits of the IEEE 802.11n standard cell as a term of number of users which are successfully served by the cell in case of video conference application. The results shown that, the cell of 802.11n could serve about 9 users under the service of video conference in case of 20MHz channel bandwidth before congestion occurs while the 40MHz channel could support 18 users.

Adverse knee pain occurs in 10–34% of all total knee replacements (TKR), and 20% of TKR patients experience more pain post-operatively than pre-operatively. Knee pain is amongst the top five reasons for knee replacement revision in the United Kingdom. The number of TKRs is predicted to continue increasing due to the ageing population. A narrative literature review was performed on the different causes of pain following TKR. A database search on Scopus, PubMed, and Google Scholar was conducted to look for articles related to TKR, pain, and cause. Articles were selected based on relevance, publication date, quality of research and validation. Relevant sections were added to the review. One hundred and fourteen articles were identified and potential causes of TKR pain included: arthrofibrosis, aseptic loosening, avascular necrosis, central sensitization, component malpositioning, infection, instability, nerve damage, overstuffing, patellar maltracking, polyethylene wear, psychological factors and unresurfaced patella. It is important to tailor our approach to address the individual causes of pain. Certain controllable risk factors can be managed pre-operatively to minimize post-operative pain. Risk factors help to predict adverse pain outcomes and identify specific causes. There are multiple causes of pain following TKR. Some factors will require further extensive studies, and as pain is a commonly attributed reason for TKR revision, its underlying aetiologies should be explored. Understanding these factors helps to develop effective methods for diagnosis, prevention and management of TKR pain, which help to improve patient outcomes. Cite this article: EFORT Open Rev 2020;5:534-543. DOI: 10.1302/2058-5241.5.200031

Microstructural and sliding wear evaluations of nanostructured coatings deposited by Suspension High Velocity Oxy-Fuel (S-HVOF) spraying were conducted in as-sprayed and HIPed (Hot Isostatically Pressed) conditions. S-HVOF coatings were nanostructured via ball milling of the WC-12Co start powder, and deposited via an aqueous based suspension using modified HVOF (TopGun) spraying. Microstructural evaluations of these hardmetal coatings included TEM (Transmission Electron Microscopy), X-ray Diffraction (XRD) and Scanning Electron Microscopy (SEM). Sliding wear tests were conducted using a ball-on-flat test rig. Results indicated that nanostructured features inherited from the start powder in S-HVOF spraying were retained in the resulting coatings. The decarburisation of WC due to a higher surface area to volume ratio was also observed in the S-HVOF coatings. Nanostructured and amorphous phases caused by the high cooling rates during thermal spraying crystallized into complex eta-phases after the HIPing treatment. Sliding wear performance indicated that the coating wear was lower for the HIPed coatings.

WC-Co coatings were deposited using conventional High Velocity Oxy-Fuel Jet-Kote (HVOF-JK) and Suspension HVOF (S-HVOF) methods. Microstructural and mechanical properties along with the wear resistance of coatings were investigated. Reciprocating sliding wear tests were conducted against sintered Si3N4 counter-body with a normal load of 25N and total sliding distance of 500m following ASTM G133-2 standard. Coatings were characterised by Scanning Electron Microscope (SEM), X-Ray Diffraction (XRD) and nano-Indentation techniques. HVOF-JK coating showed good retention of WC whereas S-HVOF coating showed the presence of W, W2C and amorphous/nanocrystalline phases. Nano-indentation of HVOF-JK and S-HVOF showed that the relative hardness of the HVOF-JK coating was higher but their elastic modulus was lower. The lower total wear rate was exhibited by the HVOF-JK coating. This difference in wear performance is attributed to the difference in hardness of the coatings and decarburisation of WC particles.

The potential to improve the tribomechanical performance of HVOF-sprayed WC–12Co coatings was studied by using aqueous WC–12Co suspensions as feedstock. Both as-sprayed and hot-isostatic-pressed (HIPed) coatings were studied. Mathematical models of wear rate based on the structure property relationships, even for the conventionally sprayed WC–Co hardmetal coatings, are at best based on the semiempirical approach. This paper aims to develop these semiempirical mathematical models for suspension sprayed nanocomposite coatings in as-sprayed and heat-treated (HIPed) conditions. Microstructural evaluations included transmission electron microscopy, X-ray diffraction and scanning electron microscopy equipped with energy-dispersive X-ray spectroscopy. The nanohardness and modulus of the coated specimens were investigated using a diamond Berkovich nanoindenter. Sliding wear tests were conducted using a ball-on-flat test rig. Results indicated that the HIPing post-treatment resulted in crystallization of amorphous coating phases and increase in elastic modulus and hardness. Influence of these changes in the wear mechanisms and wear rate is discussed. Results are also compared with conventionally sprayed high-velocity oxy-fuel hardmetal WC–Co coatings.

Sliding wear evaluation of nanostructured coatings deposited by Suspension High Velocity Oxy-Fuel (S-HVOF) and conventional HVOF (Jet Kote (HVOF-JK) and JP5000 (HVOF-JP)) spraying were evaluated. S-HVOF coatings were nanostructured and deposited via an aqueous based suspension of the WC–Co powder, using modified HVOF (TopGun) spraying. Microstructural evaluations of these hardmetal coatings included X-ray Diffraction (XRD) and Scanning Electron Microscopy (SEM) equipped with Energy Dispersive X-ray Spectroscopy (EDX). Sliding wear tests on coatings were conducted using a ball-on-flat test rig against steel, silicon nitride (Si3N4) ceramic and WC–6Co balls. Results indicated that nanosized particles inherited from the starting powder in S-HVOF spraying were retained in the resulting coatings. Significant changes in the chemical and phase composition were observed in the S-HVOF coatings. Despite decarburization, the hardness and sliding wear resistance of the S-HVOF coatings was comparable to the HVOF-JK and HVOF-JP coatings. The sliding wear performance was dependent on the ball-coating test couple. In general a higher ball wear rate was observed with lower coating wear rate. Comparison of the total (ball and coating) wear rate indicated that for steel and ceramic balls, HVOF-JP coatings performed the best followed by the S-HVOF and HVOF-JK coatings. For the WC–Co ball tests, average performance of S-HVOF was better than that of HVOF-JK and HVOF-JP coatings. Changes in sliding wear behavior were attributed to the support of metal matrix due to relatively higher tungsten content, and uniform distribution of nanoparticles in the S-HVOF coating microstructure. The presence of tribofilm was also observed for all test couples.

A finite element analysis (FEA) based wear algorithm model is presented to predict sliding wear behavior of a composite cobalt-based (Stellite 6) alloy. This study aims to provide an understanding of FEA model behavior using: (a) free-mesh, (b) composite material microstructure, and (c) wear test conditions of loading and geometry which are consistent with ASTM G133-02. Results indicate that the wear model using free-mesh is able to predict wear in composite alloy within the limits of experimental deviation using a suitable kD (wear-rate) value. The rationale for the differences in the experimental setup and FEA model calculations is discussed in terms of the role of wear debris, wear mechanisms, and ball wear.

The goal of the paper is to obtain a good WLAN video conference services, including an increased number of users and reliable coverage area with minimum implementation cost. We presents a simulation study ( using OPNET Modeler 14.0 package) of a video conference services working over different wireless local area network (WLAN) standards (IEEE 802.11a and IEEE 802.11g) with two different modes of data transmission (multicast and multiple unicast). Also , we examined different video compression techniques to choose a suitable one to work on the system . Finally , a new WLAN access point architecture was used to enhance video conferencing performance and to maximize the number of its users . Practical implementation of a video conferencing system was achieved over WLAN when using classic and developed Access point .