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Background Gamma-glutamyl transpeptidase (GGT) is an important molecule produced by hepatocytes that has been noticed as a prooxidative enzyme. GGT has been found to be included in the inflammation process and oxidative damage in multiple diseases in human. Psoriatic arthritis (PsA) is an inflammatory disorder leading to high mortality and morbidity due to cardiovascular events. However, GGT role in PsA remains unclear. The aim of this study is to determine the association of GGT with PsA activity and atherosclerosis in PsA patients. Also, to investigate if GGT can serve as an indicator of subclinical atherosclerosis in PsA patients. Results This study was performed on 30 PsA patients and 30 matched healthy subjects. All patients underwent detailed history taking and clinical assessment. Disease activity in PsA (DAPSA) score was used to assess disease activity in PsA patients. GGT level in serum was quantified by utilizing enzyme-linked immunosorbent assay and correlated with carotid intima media thickness (CIMT) and PsA disease activity. Patients’ mean age and disease duration was 43.37 ± 7.65 years (30–55 years) and 7.97 ± 4.214 years (2–15 years) respectively. Levels of GGT in serum were significantly increased in patients compared to GGT serum levels in controls ( p  < 0.001). Serum GGT levels showed significant positive correlation with DAPSA score, LDL, cholesterol triglycerides, and right and left CIMT ( r  = 0.913, 0.587, 0.779, 0.803, 0.736, 0.728 and p  < 0.001 respectively) and significant negative correlation with HDL ( r  = − 0.681 and p  < 0.001). However, GGT serum levels and PsA disease duration did not show significant correlation. Conclusion Serum GGT was associated with high disease activity, high lipid profile, and large CIMT in PsA patients. GGT might be an indicator of subclinical atherosclerosis and increased disease activity in patients with PsA.

The aim of this study was to assess and compare the efficacy of fractional CO2 laser, Q-switched Nd:YAG laser (1064 nm), and their combined use in treatment of keratosis pilaris. The study included twenty female patients. For each patient, three areas were randomly assigned to treatment by either fractional CO2 laser (area A) or Q-switched laser (1064 nm) (area C), or both types of laser (area B). All patients were assessed by digital photography at baseline and 1 month after the last session. Assessment was done by two non-blinded and two blinded investigators (blinded investigators do not know which area is treated with which machine and non-blinded knows). Patients reported the degree of satisfaction or any adverse effects also after 1 month from the last session. The three treatment modalities led to overall improvement in the KP lesions. According to patients’ score and investigator two, area B showed statistically significant improvement compared to areas A and C ( p =0.001 and p =0.039, respectively). The first blinded investigators’ assessment revealed that there was statistically significant improvement in area C compared to A and B ( p  = 0.023). The assessment of both investigator one and the second blinded investigator revealed that there was improvement in the three areas with no statistically significant difference between them. Both fractional CO2 and Q-switched Nd:YAG laser (1064 nm) proved to be safe and effective in the treatment of keratosis pilaris regarding not only pigmentation but also follicular prominence; their combination may have an additive effect.

Electrical submersible pumps (ESPs) are multistage centrifugal pumps driven by specially designed three-phase induction motors. They are used in many applications such as nuclear and petroleum industries. In the presented paper, we study the speed control of an ESP pump using a rule-based fuzzy logic controller (FLC). As a case study, an oil well is considered to analyze the effects of changing the speed of an ESP pump on both the ESP pump and motor parameters. The proposed speed control model of ESP pumps provides the ability to optimize wells production and power consumption, as well as soft starting of ESP motors. This is done by using a variable speed drive (VSD), which changes the frequency of the voltage supplied to the ESP motor. The utilized VSD model consists of a two-level voltage source inverter (VSI), space vector pulse width modulator (SVPWM) and a rule-based fuzzy logic speed controller. Also, in this study a dynamic hydraulic model of an oil well is implemented. In this study, a mathematical model of the ESP motor and ESP pump is developed. The obtained simulation results show that the combination of the FLC speed Controller and SVPWM provides a faster and more effective method of controlling the speed of electrical submersible pumps than the conventional PID speed controllers. The MATLAB/ SIMULINK software is used to achieve simulative validation of the complete system.

Preclinical trials indicate that CD34+ cells represent an effective angiogenic stem cell component. Early-phase clinical trials suggest that intramyocardial administration of autologous CD34+ cells may improve functional capacity and symptoms of angina. RENEW is a pivotal phase 3 trial designed to determine the efficacy of granulocyte colony-stimulating factor (G-CSF)–mobilized CD34+ stem cells for the treatment for patients with refractory angina and chronic myocardial ischemia. Patients (n = 444) receiving maximally tolerated antianginal therapies and lacking conventional revascularization options with Canadian Cardiovascular Society class III or IV angina and ischemia on stress testing will be randomized 2:1:1 to cell therapy (G-CSF–mediated stem cell mobilization, apheresis, and intramyocardial injection of 1 × 105 autologous CD34+ cells/kg), active control (G-CSF–mediated stem cell mobilization, apheresis, and intramyocardial placebo injection), or open-label standard of care. The primary efficacy end point is change in exercise treadmill time in the treated vs active control patients, with 90% power to detect a 60-second difference in exercise time between cell-treated (n = 200) and active control (n = 100) patients. Key secondary end points include total number of anginal episodes per week and the incidence of independently adjudicated major adverse cardiac events and serious adverse events. RENEW will be the first adequately powered study aimed at definitively determining the efficacy of a cell therapy (intramyocardially delivered autologous CD34+ cells) for improvement of functional capacity in patients with refractory angina.

Recent advances in electrocardiographic monitoring and waveform analysis have significantly improved the ability to detect drug-induced changes in cardiac repolarization manifested as changes in the QT/corrected QT interval. These advances have also improved the ability to detect drug-induced changes in cardiac conduction. This White Paper summarizes current opinion, reached by consensus among experts at the Cardiac Safety Research Consortium, on the assessment of electrocardiogram-based safety measurements of the PR and QRS intervals, representing atrioventricular and ventricular conduction, respectively, during drug development.

The main objective of this randomized controlled trial was to study the impact of LOD on the pregnancy rate after ICSI-ET in PCOS. The study was conducted in Egypt in the period 2015-2017 and included 212 clomiphene-resistant PCOS patients, with at least 1-year infertility. The study group was the drilling group who underwent LOD and then ICSI-ET, while the control group did not undergo LOD but directly proceeded to ICSI-ET. The primary outcome was the clinical pregnancy rate per ET cycle. The baseline characteristics and hormonal profiles were comparable (p > 0.05) between the two groups. Ovarian stimulation days were (p < 0.001) higher in the drilling group. Endometrial thickness, estradiol at triggering day, and the number of oocytes retrieved were (p < 0.001) lower in the drilling group. The numbers of embryos transferred were not different (p > 0.05). The clinical pregnancy rate per ET cycle was higher in the drilling group (51%) than in the control group (37%) (p = 0.046). Multiple pregnancies were not significantly (p = 0.265) different between groups. The rate of OHSS was (p = 0.046) higher in the control group. Coasting was (p < 0.001) higher in the control group (18%) compared to the drilling group (2%). Laparoscopic ovarian drilling for PCOS patients before ICSI-ET improves the clinical pregnancy rate with a reduction of OHSS.

This paper described a self-supply smart microgrid which may be a low voltage or medium voltage distribution network. It considered an efficient energy system in which different renewable sources as photo-voltaic array, wind, or conventional as diesel generator, and storage called distributed generators which organized to chance the load power demand at any time with reliability. It can operate either on-grid or off-grid configuration, especially limited areas far from the utility grid needed another backup power. By using Matlab/Simulink, a solar PV system is modeled, simulated, and determined the characteristic of a particular photovoltaic cell panel under the influence of different values of ambient conditions. Taking into consideration MPPT algorithm which increases the solar energy efficiency by Incremental conductance technique to track MPP correctly with fast response. Power electronic DC/DC converter and DC/AC inverter are used with PWM technique. To compensate the power fluctuations of the system under different possible transient cases, a high performance control based on an improved virtual synchronous generator is added to confirm smooth variants in voltage, frequency and active power during transient conditions. The results show the PV/Diesel generator/battery/power/frequency and voltage performance at two different conditions.

Breast cancer is known to be one of the most cancer affecting women around the globe and the second most common cancer in general. In third worlds countries, breast cancer is the most cause of cancer death. Early diagnosis and accurate follow-up of these patients affect the management. There are multiple prognostic factors most important one is the immunohistochemical molecular markers in the specimens including human epidermal growth factor, progesterone, and estrogen receptors (HER2, PR, ER). In breast cancer, the HER2 positive molecular subtype is associated with a bad prognosis and aggressive histological features, yet while following neoadjuvant chemotherapy, it achieves an increased pathological complete response rate. 18F-fluoro-2-deoxy-d-glucose positron emission tomography (FDG PET) has proved to be an effective and accurate imaging technique for lymph node and distant metastasis assessment, tumor staging, restaging of recurrence, treatment response, and follow-up. In breast cancer, tumor molecular subtype, tumor size, proliferation index, and histological grade correlated with 18F-fluoro-2-deoxy-d-glucose (FDG) uptake. This study evaluates the possible correlation between tumor to liver and tumor to spleen (standardized uptake value) SUV max ratio and the four different molecular subtypes in patients with pathologically proven primary breast cancer. Tumor to liver and tumor to spleen SUV max ratio (TLR, TSR) was a significant parameter for HER2 molecular subtype identification (P value = 0.0005 and 0.014 respectively) and luminal A molecular subtype identification (P value = 0.016 and 0.037 respectively). The specificity, sensitivity, and area under the receiver operating-characteristic curve (AUC) of TLR parameters for HER2-positive subtype identification were 89.4%, 83.3%, and 0.89, respectively. The specificity, sensitivity, and AUC of the TSR parameter for HER2-positive subtype identification were 57.9%, 100%, and 0.83, respectively. TLR and TSR appeared to be valuable for HER2- and luminal A molecular subtype detection. thus, 18F-FDG PET/CT could be a beneficial tool for prediction of tumor biological characteristics that help in management of breast cancer patients.

This paper presents a terminal voltage control approach of a Switched Reluctance Generator (SRG) based wind turbine generating systems. The control process is employed using a closed loop stimulated by the error between the reference voltage and the generator output voltage due to load and wind speed variation. This error feeds the tuned Proportional Integral controller (PI). Tuning of PI controller by conventional analysis methods is difficult by the existence of a significant non-linearity. A novel strategy method is presented here to determine optimum PI controller parameters of voltage control of SRG using Grasshopper Optimization Algorithm (GOA). This proposed approach is a simple and effective algorithm that is able to solve many optimization problems. The simplicity of algorithm provides high quality tuning of optimal PI controller parameters. The integral of time weighted squared error (ITSE) is used as the performance of the proposed GOA-PI controller. The effectiveness of the proposed strategy is tested with the three-phase 12/8 structure SRG. Outcomes indicate the supremacy of GOA over Whale Optimization Algorithm (WOA) and Particle Swarm Optimization (PSO) in terms of control performance measures.

This paper presents a tested proposal scheme to connect a DFIG driven by a wind turbine to the public grid. This scheme was implemented to drive an automatic transfer switch (ATS). Control of the phase sequence, phase difference, and the frequency of the injected power are achieved using these proposed control circuits. These circuits are practically implemented and laboratory tested. The system allows monitoring the rated frequency, synchronization, and fundamental magnitude. Simulation software such as Multi Sim and Proteus are used for system validation and compatibility. The implemented circuits are used for re-scaling the grid voltage to the logic level for real time comparison and calculations. In addition to the feature of data monitoring, the system can also log these data for the system debugging purposes. The system can be considered as a real time control where the measurements and the correction are made in few milliseconds (fractions of the fundamental cycle). The lower cost control circuits are implemented using an Arduino kit in addition to a discrete digital component. The simulation and experimental results are in satisfactory agreement showing the most salient features of this system.