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The study proposes a supply chain contractual coordination model based on the product lifecycle information sharing effort and consumers' price sensitivity to a product with the Blockchain system. This paper examined the following five scenarios: (1) centralized supply chain with Blockchain system-based product lifecycle information sharing investment; (2) Stackelberg leader retailer processed and invested Blockchain system scenario; (3) retailer processed the Blockchain system cost-sharing scenario; (4) retailer processed Blockchain system investment through bargaining the revenue-sharing model; (5) Blockchain system investment under the cost and revenue-sharing contract. The study used the game theory reverse induction method to compare the Nash equilibrium solutions under different decision-making scenarios and discussed the chain member’s constraint condition of Blockchain system investment. We simulated and analysed the products’ lifecycle information sharing effort cost factor, the influence of price sensitivity coefficient, and expected profits of the supplier and retailer. The study results show that the product lifecycle information sharing effort under the Blockchain system increases the profit of the whole chain and decreases with the increase of customer’s price sensitivity coefficient.

There is emerging evidence suggesting that vitamin D and fibrinogen play contrasting roles in ACS pathophysiology and their combined impact, expressed as the vitamin D/fibrinogen ratio, can be a potential biomarker for ACS severity. This study aimed to investigate the relationship between vitamin D, fibrinogen, and their ratio with ACS types, and assess their potential as risk stratification biomarkers. This multicenter observational study was conducted in tertiary care hospitals in Afghanistan, Egypt, and Pakistan, including 300 ACS patients. Serum vitamin D and fibrinogen levels were measured using electrochemiluminescence immunoassay and the Clauss method, respectively. Statistical analyses included ANOVA, Kruskal-Wallis, post-hoc Games-Howell tests, Spearman's correlation, Fisher's Z-test, and multivariable logistic regression. Vitamin D levels were significantly lower (p < 0.001) and fibrinogen levels significantly higher (p < 0.001) in STEMI patients compared to NSTEMI and UA. The vitamin D/fibrinogen ratio showed a stronger correlation with ACS severity (Spearman's rho = -0.45, p = 0.01) than vitamin D alone (-0.41, p = 0.01), but this difference was not statistically significant (Fisher Z = 0.34, p = 0.73). Logistic regression revealed that a 1 nmol/L increase in vitamin D reduced ACS severity by 7.1% (p = 0.043), while a unit increase in the vitamin D/fibrinogen ratio reduced severity by 6.2% (p = 0.048). The contrasting effects of vitamin D and fibrinogen can prove useful biomarkers and modifiable risk factors for ACS. The superiority of the vitamin D/fibrinogen ratio over vitamin D only, however, needs further validation in larger studies.

More land must be reclaimed for farming due to the expanding population and lack of arable land. Since weeds are considered to be one of the primary causes of agricultural obstacles, the current study sets out to ascertain the weed diversity of the recovered lands in Middle Egypt. We selected eight crop plants, five winter crops and two summer crops — along with five orchards to identify their weed diversity. We found 121 weed species from 91 genera across 26 families — 90 annuals, one biennial and 30 perennials — in the investigated crops and orchards. On the one hand, peach and pomegranate (pome) orchards had the fewest weed species (29 each), while wheat crops had the most (79 species). With six genera, Euphorbia was the largest genus and Poaceae had 29 species, the most abundant family. Therophytes were the most prevalent life form amongst weed species, accounting for an average of 72.5%, followed by phanerophytes (5.2%) and geophytes (7.5%). According to the Ward classification of crops and orchards, based on the weeds found there, the planting season had a major influence on the diversity of weeds, followed by the type of plant grown (crop or orchard). The findings demonstrated that the number of years of cultivation had an impact on the weed flora and soil properties in reclaimed fields. Additionally, the old reclaimed areas had higher soil salinity, which reduced the diversity of weeds. Furthermore, xerophytic weed species declined and hydrophytic weed species increased with longer reclamation periods. The current study aims to shed light on the diversity of weeds and their most common species in newly-reclaimed lands in Middle Egypt to facilitate a way to combat them.

The tracking of optimal current trajectories in an interior permanent magnet (IPM) synchronous machine is traditionally realized by a complex online tracking, inaccurate analytical equations, or tiresome offline calibration methods. This paper proposes a modified hybrid feed-forward/feedback flux-weakening algorithm for IPM synchronous machines. In this paper, the utilized power converter is a standard T-type multilevel inverter, and hence, the voltage and current harmonics contents of the conventional two-level inverter are improved. The control algorithm utilizes the optimal current profile for maximum torque per ampere (MTPA) operation and a voltage regulation (VR) feedback control for efficient flux-weakening operation. For infinite-speed IPM machine drives, the d-q current components are limited to follow the maximum torque per voltage (MTPV) trajectory. A low-complexity model predictive control (MPC) is employed to minimize the conflict that arises from using cascaded PI control loops for current and speed control. The performance of the drive is investigated based on the Prius 2004 IPM parameters. Extensive simulation scenarios were performed using the MATLAB/SIMULINK which validates the effectiveness of the proposed algorithm. Real-time simulations based on the dSPACE DS 1103 platform are conducted to confirm the system validity for real hardware implementation. The proposed IPM drive system proves simple structure, fast response, and low harmonic contents.

Model predictive control (MPC) is an efficient and growing approach to power converter control. This paper proposes an improved and simplified model predictive current control (MPCC) technique for a four-level nested neutral point clamped (4L-NNPC) converter. Conventional MPCC exhibits better performances as compared to the conventional linear control system such as fast dynamic response, consideration of the system constraints, and nonlinearities. However, the application of the conventional model predictive current control (MPCC) approach on complex systems provokes a significant number of calculations, which is the main hurdle to its practical implementation. To fix this flaw, this paper proposes an effective algorithm to shorten the execution time of the conventional MPCC. In this proposed technique, 216 current predictions of the conventional MPCC are skipped and converted into one required voltage vector (RVV) prediction. With this equivalent reference voltage transformation, the calculation burden of MPCC is significantly reduced, while the output performance is not influenced. The results of the simplified MPCC for the 4L-NNPC converter are analyzed and compared with the conventional MPCC. The computational time is reduced by 19.56% using the simplified MPCC, while keeping an approximately similar error of output currents. The switching frequency and total harmonic distortion (THD) of the proposed method are reduced by 8.16% and 0.07%, respectively, as compared to the conventional technique. These results demonstrate the fact that that the performance of a conventional MPCC is enhanced with the proposed MPCC. The proposed algorithm can be applied to several inverter topologies.

Background Lectures are one of the most common teaching methods in medical education. Didactic lectures were perceived by the students as the least effective method. Teaching methods that encourage self-directed learning can be effective in delivering core knowledge leading to increased learning. Problem based learning has been introduced as an active way of learning but it has some obstacles in developing countries where the intake is huge with minimum resources. This study introduces a new teaching approach: lectures based on problems (LBP) and evaluates their effectiveness compared to traditional lectures (TL) in physiology teaching. Methods LBP and TL were applied in physiology teaching of medical students at University of Science and Technology during their study of introduction to physiology and respiratory physiology courses. Equal number of lectures was given as LBP and as TL in each course. Students were given quizzes at the end of each course which were used to compare the effectiveness of the two types of lectures. A questionnaire was used to assess students’ satisfaction about LBP and the perceived effects of the two methods on the students’ attitude and practice towards learning physiology. Results In LBP the students have better attention ( P  = 0.002) and more active role ( P  = 0.003) than in TL. Higher percentage of students think that LBP stimulated them to use references more ( P  = 0.00006) and to use the lecture time more effectively ( P  = 0.0001) compared to TL. However, there was no significant difference between LBP and TL in the awareness of the learning objectives. About 64% of students think that LBP is more enjoyable and it improved their understanding of physiology concepts. Comparison of the students’ quiz marks showed that the means of the students’ marks in the introduction to physiology and respiratory courses were higher in the quizzes of LBP than in TL with a significant difference between them (( P  = .000), ( P  = .006) respectively. Conclusions LBP improved students’ understanding of physiology concepts and increased students’ satisfaction about physiology learning. LBP achieved some of the objectives of PBL with the minimum resources and it can be used to improve the effectiveness of the lectures.

Amikacin (AK) has the largest spectrum of aminoglycosides. However, its use is constrained because of nephrotoxicity and ototoxicity. Ellagic acid (EA) is a polyphenol present in plants. It has antioxidant, anticarcinogenic, and antimutagenic characteristics. Cilostazol (CTZ) is a phosphodiesterase Ш inhibitor, it is a potent vasodilator and antiplatelet drug. CTZ has an inhibitory effect on reactive oxygen species and superoxide generation in addition to hydroxyl radicals scavenging action. This study determines whether EA and cilostazol have a protective effect against AK-induced nephrotoxicity. Forty-nine rats were divided into seven equal groups: control normal; AK 400 mg/kg; EA 10 mg/kg; CTZ 10 mg/kg; AK 400 mg/kg plus EA 10 mg/kg; AK 400 mg/kg plus CTZ 10 mg/kg; AK 400 mg/kg plus EA 10 mg/kg and CTZ 10 mg/kg. For seven days, drugs were administered using gavage one hour before intramuscular injection of AK. Twenty-four hours after the last AK dosage, blood samples were collected to determine blood urea nitrogen and creatinine levels. Kidneys were removed for histopathological examination and measurement of: malondialdehyde (MDA), catalase (CAT), decreased glutathione (GSH), superoxide dismutase (SOD), interleukin 6 (IL6), tumor necrosis factor-alpha (TNFα), nuclear factor kappa B (NFκB), and Bcl-2 associated x protein (BAX). AK caused kidney damage, inflammatory mediator elevation, and oxidative stress and apoptotic markers. Rats receiving EA or CTZ indicated significant improvement in kidney function, decrease in oxidative stress and inflammation through NF-kB down-regulation and BAX expression. The combination of EA and CTZ showed a synergistic effect. In conclusion, EA and CTZ might play a beneficial role in preventing nephrotoxicity induced by AK partially by inhibition of tissue inflammation and apoptosis.

Background  Operating notes are crucial in surgical practice for post-operative care, future medical reference, and legal needs. They provide vital details about the procedure, guaranteeing patient safety and improving communication among medical staff. These notes include patient health status, surgical method, operation results, problems, and post-surgery plans. Established protocols for recording surgical operative notes are essential for medical education, research, and quality improvement efforts. The audit aimed to evaluate and enhance Doka Hospital's surgical operation notes, focusing on their quality, completeness, and potential areas for development. The audit aimed to apply necessary adjustments to raise standards and ensure high standards in medical treatment. Material and methods  This retrospective-prospective study analyzed surgical postoperative notes from Doka Hospital's archives, following the implementation of a new format based on guidelines set by the Royal College of Surgeons of England. Staff training sessions were conducted to facilitate adoption. The audit population included surgical operative notes from the departments of general surgery and obstetrics and gynecology. The study collected 200 surgical operative notes, with 100 notes in the first cycle and 100 notes in the second cycle. Data was collected from the General Surgery and Obstetrics and Gynaecology departments using a predefined checklist, followed by analysis using the Microsoft Excel Sheets program (Microsoft Corporation, Redmond, USA). Ethical clearance was obtained from the ethical committee of Doka Hospital. The audit population consisted of 71 beds in a busy rural hospital with a majority of cases involving obstetrics and one-day surgical operations. Results  Doka Hospital's surgical operative note review showed a significant improvement in documentation quality following a revised structure based on the Royal College of Surgeons of England's recommendations. Compliance with the criteria improved from 50.5% in the first cycle to 82.5% in the second cycle. Notable progress was made in date and time documentation, with a 96% increase in the second cycle. The proportion of anaesthetists' names also rose from 60% to 90%. The accuracy of recording surgical operation details increased from 87% to 94%. Documenting operational results, issues, and tissue removal also improved. Factors like the identity of the prosthesis or materials used remained unchanged in both cycles. Conclusion  The introduction of a uniform style for recording surgical operational notes, together with focused training sessions, greatly improved the quality of surgical documentation at Doka Hospital.

Purpose: Coronary artery disease (CAD), clinically manifested as coronary syndrome (CS), is the leading cause of death and a significant contributor to morbidity worldwide. Elevated serum homocysteine levels have been associated with an increased risk of cardiovascular diseases, including CAD. Despite extensive research, the relationship between serum homocysteine and coronary syndromes with related short-term mortality is still under-studied. The main objective of this study is to evaluate the correlation between serum homocysteine levels and various types of CS, as well as in-hospital mortality in these patients. Patients and Methods: This multicenter study included 381 CS patients from Afghanistan, Egypt, and Pakistan tertiary care hospitals. The relation of serum homocysteine levels with different types of CS as well as with in-hospital mortality was measured and analyzed using inferential statistics (ANOVA, Kruskal--Wallis test, Tukey's post-hoc, Pearson correlation, etc.) and regression analysis (Binary regression). Results: Among 381 patients from both genders, 160 were from Pakistan, 130 from Egypt, and 91 from Afghanistan. There was no significant difference in baseline characteristics, like age, gender, homocysteine level, CS type, and mortality, among the three countries (p > 0.05). The one-way ANOVA, the Kruskal Wallis Test, and Tukey's post hoc test showed a significant difference among different CS groups based on serum homocysteine levels, and Pearson correlation showed a strong correlation between serum homocysteine and CS (r = 0.4). Binary regression analysis showed a 10.5% increase in in-hospital mortality for each 1 [micro]mol/L increase in homocysteine levels. Conclusion: Serum homocysteine could serve as a valuable biomarker and mortality predictor in CS patients. Keywords: serum homocysteine, coronary artery disease (CAD), coronary syndromes (CS), cardiac biomarkers, risk factors of CAD