A Novel Polyester Varnish Nanocomposites for Electrical Machines with Improved Thermal and Dielectric Properties Using Functionalized TiO2 Nanoparticles.

Recently, there has been a growing interest in polymer insulating materials that incorporate nanoscale inorganic additives, as they have shown significantly improved dielectric, thermal, and mechanical properties, making them highly suitable for application in high-voltage insulating materials for electrical machines. This study aims to improve the dielectric and thermal properties of a commercial polyester varnish by incorporating different concentrations of titanium dioxide nanoparticles (TiO2) with proper surface functionalization. Permafil 9637 dipping varnish is the varnish used for this investigation, and vinyl silane is the coupling agent used in the surface functionalization of TiO2 nanoparticles. First, nanoparticles are characterized through Fourier transform infrared spectroscopy to validate the success of their surface functionalization. Then, varnish nanocomposites are characterized through field emission scanning electron microscopy to validate the dispersion and morphology of nanoparticles within the varnish matrix. Following characterization, varnish nanocomposites are evaluated for thermal and dielectric properties. Regarding thermal properties, the thermal conductivity of the prepared nanocomposites is assessed. Regarding dielectric properties, both permittivity and dielectric losses are evaluated over a wide frequency range, starting from 20 Hz up to 2 MHz. Moreover, the AC breakdown voltage is measured for varnish nanocomposites, and the obtained data are incorporated into a finite element method to obtain the dielectric breakdown strength. Finally, the physical mechanisms behind the obtained results are discussed, considering the role of nanoparticle loading and surface functionalization.

Revision anterior cruciate ligament reconstruction using the ipsilateral Quadriceps tendon autograft: a modular reconstructive option.

PURPOSE: Failed ACL reconstruction is a common occurrence nowadays due to the increased incidence of ACL surgeries and return to full activities following the surgery. Several challenges might stand in the face of this revision surgery particularly the graft harvest and its suitability to the situation with possible widening of the tunnel and the avoidance of additional morbidity at the contralateral side or anterior knee pain as in patellar tendon harvest. The aim of this study is to evaluate the ipsilateral quadriceps tendon as a source of autograft in revision ACL surgery which constitutes a viable option that can potentially decrease the morbidity of the procedure, and meanwhile provide a graft substitute that can be tailored to suit the dilated tunnels commonly encountered in revision surgery, thus giving the patients a good potential for better functional outcome. METHODS: Revision anterior cruciate ligament reconstruction was done in 30 patients using the ipsilateral quad tendon as a pure soft tissue or with a bony fragment. RESULTS: The mean subjective international Knee Documentation Committee score (IKDC score) at two years follow-up was 65.83 ± 7.20. There is statistically significant improvement of the objective as well as the subjective IKDC scores at the end of follow-up when compared to the preoperative as well as the 6-month evaluation figures. The KT1000 arthrometer recorded a mean of 4.50 ± 1.07. Significant improvement of the limb symmetry index was at two years duration. CONCLUSIONS: The quadriceps tendon can be a solution for several challenges that might appear during the revision ACL surgery with comparable results to other tendons and with minimal morbidity on the function of the harvested muscle tendon.

Condition Assessment of Natural Ester-Mineral Oil Mixture Due to Transformer Retrofilling via Sensing Dielectric Properties.

Mineral oil (MO) is the most popular insulating liquid that is used as an insulating and cooling medium in electrical power transformers. Indeed, for green energy and environmental protection requirements, many researchers introduced other oil types to study the various characteristics of alternative insulating oils using advanced diagnostic tools. In this regard, natural ester oil (NEO) can be considered an attractive substitute for MO. Although NEO has a high viscosity and high dielectric loss, it presents fire safety and environmental advantages over mineral oil. Therefore, the retrofilling of aged MO with fresh NEO is highly recommended for power transformers from an environmental viewpoint. In this study, two accelerated aging processes were applied to MO for 6 and 12 days to simulate MO in service for 6 and 12 years. Moreover, these aged oils were mixed with 80% and 90% fresh NEO. The dielectric strength, relative permittivity, and dissipation factor were sensed using a LCR meter and oil tester devices for all prepared samples to support the condition assessment performance of the oil mixtures. In addition, the electric field distribution was analyzed for a power transformer using the oil mixtures. Furthermore, the dynamic viscosity was measured for all insulating oil samples at different temperatures. From the obtained results, the sample obtained by mixing 90% natural ester oil with 10% mineral oil aged for 6 days is considered superior and achieves an improvement in dielectric strength and relative permittivity by approximately 43% and 48%, respectively, compared to fresh mineral oil. However, the dissipation factor was increased by approximately 20% but was at an acceptable limit. On the other hand, for the same oil sample, due to the higher molecular weight of the NEO, the viscosities of all mixtures were at a higher level than the mineral oil.

Influence of Mineral Oil-Based Nanofluids on the Temperature Distribution and Generated Heat Energy Inside Minimum Oil Circuit Breaker in Making Process.

The enhancement of the thermal properties of insulating oils has positively reflected on the performance of the electrical equipment that contains these oils. Nanomaterial science plays an influential role in enhancing the different properties of liquids, especially insulating oils. Although a minimum oil circuit breaker (MOCB) is one of the oldest circuit breakers in the electrical network, improving the insulating oil properties develops its performance to overcome some of its troubles. In this paper, 66 kV MOCB is modeled by COMSOL Multiphysics software. The internal temperature and the internally generated heat energy inside the MOCB during the making process of its contacts are simulated at different positions of the movable contact. This simulation is introduced for different modified insulating oils (mineral oil and synthetic ester oil) with different types of nanoparticles at different concentrations (0.0, 0.0025, 0.005, and 0.01 wt%). From the obtained results, it is noticed that the thermal stress on the MOCB can be reduced by the use of high thermal conductivity insulating oils. Nano/insulating oils decrease internal temperature and generate heat energy inside the MOCB by about 17.5%. The corresponding physical mechanisms are clarified considering the thermophoresis effect.

Seroprevalence and Risk Factors of African Horse Sickness in Three Agroecological Zones of Cameroon.

African horse sickness (AHS), a highly fatal arbovirosis of equines is endemic in sub-Saharan Africa. However, its epidemiology is poorly known in Cameroon. This study aimed to investigate the prevalence profile and risk factors of African horse sickness in Cameroon. Horse sera were subjected to the ELISA blocking test for the determination of antibodies against African horse sickness virus, and positive samples were submitted to capture ELISA to determine the presence of antigens. Potential risk factors associated with AHS were assessed based on the information collected in the field. The chi-square test and the odd ratio (OR) were used to test the association between serology and the different variables. Of the 336 sera obtained, 198 were positive for antibodies with a prevalence of 58.93% (CI: 53.67-64.19). From the 198 positive sera to antibodies, only one revealed positivity to antigens with a prevalence of 0.51% (CI: 0-1.5). Agroecological zone I (94.31%, CI: 91.83-96.79, OR: 34.92) was significantly (p < 0.05) associated with the higher risk of disease dissemination than agroecological zone II (66.67%, CI: 61.63-71.71, OR: 4.21) and agroecological zone III (32.18%, CI: 27.18-37.18; OR: 1). Males (63.59%, CI: 58.44-68.74, OR: 1) were significantly (p < 0.05) affected than females (50.42%, CI: 45.07-55.77; OR: 0.58). Horses of more than 8 years (76.00%, CI: 71.43-80.57) were significantly (p < 0.05) at risk than young animals of less than 3 years old (32.14%, CI: 27.15-37.13, OR: 0.15). This study highlights a high seroprevalence of antibodies of African horse sickness in Cameroon. Agroecological zone, age, and the importation of horses were highly associated with the distribution of disease at the national level.

Is intravenous tranexamic acid effective in reduction of blood loss during pelvic and acetabular surgery?

PURPOSE: Pelvic and acetabular surgery is associated with one of the highest amounts of blood loss. Tranexamic acid is a good choice to reduce blood loss during this type of surgery. However, being antifibrinolytic drug, the chance to have coagulation complications including DVT is a risk that should be considered particularly in such major trauma patients with the body's response to trauma and with possible prolonged bed stay. The aim of this study is to evaluate the effectiveness of intravenous tranexamic acid injection during pelvic and acetabular surgery for reduction of blood loss during surgery and after surgery and to evaluate any possible complications for its use. METHODS: This prospective randomized clinical trial includes 97 patients divided between two groups; group 1 (G1) which received TXA, while the second group (G2) is the control group. The primary outcome measures were total blood loss (TBL), allogenic blood units transfused, and the blood lost intra-operatively (IBL). The TBL was calculated by the haemoglobin balance method while the intra-operative blood loss was measured by the gravimetric method. Any complications related to the drug were evaluated particularly DVT. RESULTS: The study showed significantly less TBL (G1 = 829.7 ± 219.2, G2 = 1036.9 ± 314.9) and blood transfusion (G1 = 52.4 ± 40 g, G2 = 89.4 ± 60.6 g) in G1 compared to the G2. CONCLUSION: This study proved the possible reduction of TBL and the need of blood transfusion by the use of TXA in pelvic and acetabular injuries.

Therapeutic assessment of N-formyl-methionyl-leucyl-phenylalanine (fMLP) in reducing periprosthetic joint infection.

Despite many preventive measures, including prophylactic antibiotics, periprosthetic joint infection (PJI) remains a devastating complication following arthroplasty, leading to pain, suffering, morbidity and substantial economic burden. Humans have a powerful innate immune system that can effectively control infections, if alerted quickly. Unfortunately, pathogens use many mechanisms to dampen innate immune responses. The study hypothesis was that immunomodulators that can jumpstart and direct innate immune responses (particularly neutrophils) at the surgical site of implant placement would boost immune responses and reduce PJI, even in the absence of antibiotics. To test this hypothesis, N-formyl-methionyl-leucyl-phenylalanine (fMLP) (a potent chemoattractant for phagocytic leukocytes including neutrophils) was used in a mouse model of PJI with Staphylococcus aureus (S. aureus). Mice receiving intramedullary femoral implants were divided into three groups: i) implant alone; ii) implant + S. aureus; iii) implant + fMLP + S. aureus. fMLP treatment reduced S. aureus infection levels by ~ 2-Log orders at day 3. Moreover, fMLP therapy reduced infection-induced peri-implant periosteal reaction, focal cortical loss and areas of inflammatory infiltrate in mice distal femora at day 10. Finally, fMLP treatment reduced pain behaviour and increased weight-bearing at the implant leg in infected mice at day 10. Data indicated that fMLP therapy is a promising novel approach for reducing PJI, if administered locally at surgical sites. Future work will be toward further enhancement and optimisation of an fMLP-based therapeutic approach through combination with antibiotics and/or implant coating with fMLP.

Proposed ANFIS Based Approach for Fault Tracking, Detection, Clearing and Rearrangement for Photovoltaic System.

In the last few decades, photovoltaics have contributed deeply to electric power networks due to their economic and technical benefits. Typically, photovoltaic systems are widely used and implemented in many fields like electric vehicles, homes, and satellites. One of the biggest problems that face the relatability and stability of the electrical power system is the loss of one of the photovoltaic modules. In other words, fault detection methods designed for photovoltaic systems are required to not only diagnose but also clear such undesirable faults to improve the reliability and efficiency of solar farms. Accordingly, the loss of any module leads to a decrease in the efficiency of the overall system. To avoid this issue, this paper proposes an optimum solution for fault finding, tracking, and clearing in an effective manner. Specifically, this proposed approach is done by developing one of the most promising techniques of artificial intelligence called the adaptive neuro-fuzzy inference system. The proposed fault detection approach is based on associating the actual measured values of current and voltage with respect to the trained historical values for this parameter while considering the ambient changes in conditions including irradiation and temperature. Two adaptive neuro-fuzzy inference system-based controllers are proposed: (1) the first one is utilized to detect the faulted string and (2) the other one is utilized for detecting the exact faulted group in the photovoltaic array. The utilized model was installed using a configuration of 4 × 4 photovoltaic arrays that are connected through several switches, besides four ammeters and four voltmeters. This study is implemented using MATLAB/Simulink and the simulation results are presented to show the validity of the proposed technique. The simulation results demonstrate the innovation of this study while proving the effective and high performance of the proposed adaptive neuro-fuzzy inference system-based approach in fault tracking, detection, clearing, and rearrangement for practical photovoltaic systems.

Towards Precise Interpretation of Oil Transformers via Novel Combined Techniques Based on DGA and Partial Discharge Sensors.

Power transformers are considered important and expensive items in electrical power networks. In this regard, the early discovery of potential faults in transformers considering datasets collected from diverse sensors can guarantee the continuous operation of electrical systems. Indeed, the discontinuity of these transformers is expensive and can lead to excessive economic losses for the power utilities. Dissolved gas analysis (DGA), as well as partial discharge (PD) tests considering different intelligent sensors for the measurement process, are used as diagnostic techniques for detecting the oil insulation level. This paper includes two parts; the first part is about the integration among the diagnosis results of recognized dissolved gas analysis techniques, in this part, the proposed techniques are classified into four techniques. The integration between the different DGA techniques not only improves the oil fault condition monitoring but also overcomes the individual weakness, and this positive feature is proved by using 532 samples from the Egyptian Electricity Transmission Company (EETC). The second part overview the experimental setup for (66/11.86 kV-40 MVA) power transformer which exists in the Egyptian Electricity Transmission Company (EETC), the first section in this part analyzes the dissolved gases concentricity for many samples, and the second section illustrates the measurement of PD particularly in this case study. The results demonstrate that precise interpretation of oil transformers can be provided to system operators, thanks to the combination of the most appropriate techniques.

Deep Learning-Based Industry 4.0 and Internet of Things towards Effective Energy Management for Smart Buildings.

Worldwide, energy consumption and saving represent the main challenges for all sectors, most importantly in industrial and domestic sectors. The internet of things (IoT) is a new technology that establishes the core of Industry 4.0. The IoT enables the sharing of signals between devices and machines via the internet. Besides, the IoT system enables the utilization of artificial intelligence (AI) techniques to manage and control the signals between different machines based on intelligence decisions. The paper's innovation is to introduce a deep learning and IoT based approach to control the operation of air conditioners in order to reduce energy consumption. To achieve such an ambitious target, we have proposed a deep learning-based people detection system utilizing the YOLOv3 algorithm to count the number of persons in a specific area. Accordingly, the operation of the air conditioners could be optimally managed in a smart building. Furthermore, the number of persons and the status of the air conditioners are published via the internet to the dashboard of the IoT platform. The proposed system enhances decision making about energy consumption. To affirm the efficacy and effectiveness of the proposed approach, intensive test scenarios are simulated in a specific smart building considering the existence of air conditioners. The simulation results emphasize that the proposed deep learning-based recognition algorithm can accurately detect the number of persons in the specified area, thanks to its ability to model highly non-linear relationships in data. The detection status can also be successfully published on the dashboard of the IoT platform. Another vital application of the proposed promising approach is in the remote management of diverse controllable devices.

Promising MPPT Methods Combining Metaheuristic, Fuzzy-Logic and ANN Techniques for Grid-Connected Photovoltaic.

This paper addresses the improvement of tracking of the maximum power point upon the variations of the environmental conditions and hence improving photovoltaic efficiency. Rather than the traditional methods of maximum power point tracking, artificial intelligence is utilized to design a high-performance maximum power point tracking control system. In this paper, two artificial intelligence-based maximum power point tracking systems are proposed for grid-connected photovoltaic units. The first design is based on an optimized fuzzy logic control using genetic algorithm and particle swarm optimization for the maximum power point tracking system. In turn, the second design depends on the genetic algorithm-based artificial neural network. Each of the two artificial intelligence-based systems has its privileged response according to the solar radiation and temperature levels. Then, a novel combination of the two designs is introduced to maximize the efficiency of the maximum power point tracking system. The novelty of this paper is to employ the metaheuristic optimization technique with the well-known artificial intelligence techniques to provide a better tracking system to be used to harvest the maximum possible power from photovoltaic (PV) arrays. To affirm the efficiency of the proposed tracking systems, their simulation results are compared with some conventional tracking methods from the literature under different conditions. The findings emphasize their superiority in terms of tracking speed and output DC power, which also improve photovoltaic system efficiency.

Reliable Industry 4.0 Based on Machine Learning and IoT for Analyzing, Monitoring, and Securing Smart Meters.

The modern control infrastructure that manages and monitors the communication between the smart machines represents the most effective way to increase the efficiency of the industrial environment, such as smart grids. The cyber-physical systems utilize the embedded software and internet to connect and control the smart machines that are addressed by the internet of things (IoT). These cyber-physical systems are the basis of the fourth industrial revolution which is indexed by industry 4.0. In particular, industry 4.0 relies heavily on the IoT and smart sensors such as smart energy meters. The reliability and security represent the main challenges that face the industry 4.0 implementation. This paper introduces a new infrastructure based on machine learning to analyze and monitor the output data of the smart meters to investigate if this data is real data or fake. The fake data are due to the hacking and the inefficient meters. The industrial environment affects the efficiency of the meters by temperature, humidity, and noise signals. Furthermore, the proposed infrastructure validates the amount of data loss via communication channels and the internet connection. The decision tree is utilized as an effective machine learning algorithm to carry out both regression and classification for the meters' data. The data monitoring is carried based on the industrial digital twins' platform. The proposed infrastructure results provide a reliable and effective industrial decision that enhances the investments in industry 4.0.

Recent Advances in Polymer Nanocomposites Based on Polyethylene and Polyvinylchloride for Power Cables.

Polymer nanocomposites used in underground cables have been of great interest to researchers over the past 10 years. Their preparation and the dispersion of the nanoparticles through the polymer host matrix are the key factors leading to their enhanced dielectric properties. Their important dielectric properties are breakdown strength, permittivity, conductivity, dielectric loss, space charge accumulation, tracking, and erosion, and partial discharge. An overview of recent advances in polymer nanocomposites based on LDPE, HDPE, XLPE, and PVC is presented, focusing on their preparation and electrical properties.

No difference in sensory outcome between vertical and oblique incisions for hamstring graft harvest during ACL reconstruction.

PURPOSE: To compare the incidence, extent of sensory loss, its clinical effect and natural course caused by sensory nerve injury, during two different skin incisions used for autogenous hamstring graft harvest during ACL reconstruction. METHODS: This randomized prospective study was carried out on 84 patients, divided into two groups, all of them underwent arthroscopic ACL reconstruction using hamstring tendon graft with two incisions; a vertical incision used in 43 patients, and an oblique incision in 41 patients. The location and area of sensory loss were evaluated during follow-up as well as the degree of improvement and patient satisfaction. RESULTS: The average age in this study was 29.8 ± 7.2 in the vertical group and 29.9 ± 6.3 in the oblique group. Both semitendinosus and gracilles were harvested in 34 patients, semitendinosus in 49 patients and gracilles in one patient. In the vertical group, a higher incidence of sensory loss was recorded with 21 patients (51.2%), relative to the oblique group with 18 patients (41.9%). However, there was no statistically significant difference (p = n.s). Most of the sensory loss affected the distribution of the IPBSN (infrapatellar branch of saphenous nerve) in 27 patients (69.2%) in both groups, and to a lesser extent in the lower medial area [distribution of SBSN (sartorial branch of saphenous nerve)] in 12 patients (30.8%). CONCLUSION: This study clearly revealed the high incidence of nerve injury particularly the IPBSN during hamstring graft harvest, but did not prove a difference between oblique and vertical incisions, with regard to postoperative sensory loss. It was clear that harvesting the semitendinosus alone is not a factor that can diminish nerve injury. LEVEL OF EVIDENCE: II.

Bond durability of different resin cements to caries-affected dentin under simulated intrapulpal pressure.

OBJECTIVE: To evaluate the durability of the bond of different resin cement systems to normal dentin (ND) and caries-affected dentin (CAD) with and without simulated intrapulpal pressure (IPP). METHODS AND MATERIALS: Molars with midcoronal caries were used. Occlusal enamel was cut to expose both dentin substrates (ND and CAD). Dentin substrates were differentiated using visual, tactile, caries-detecting dye, and dye-permeability methods. Prepared crown segments were equally divided according to the tested resin cement systems: etch-and-rinse resin cement, self-etch resin cement containing methacryloyloxydecyl dihydrogen phosphate (MDP), and self-adhesive resin cement. In addition to the dentin substrates and the resin cement types, the effect of application/storage conditions (with or without simulated IPP and with or without thermocycling) were tested. A microtensile bond strength test was done using a universal testing machine. Failure modes were determined using a scanning electron microscope. RESULTS: Etch-and-rinse resin cement strength values were significantly affected by the difference in the dentin substrates as well as the different application/storage conditions. Self-etch adhesive containing MDP bonded equally to ND and CAD and remained stable under all tested conditions. Self-adhesive resin cement revealed a similar bond to ND and CAD; however, its values were the lowest, especially when IPP and thermocycling were combined. Mixed failure was the predominant failure mode. CONCLUSIONS: Etch-and-rinse resin cement was sensitive to dentin substrate and application/storage conditions. Resin cement with self-etch adhesive containing MDP revealed more reliable bonding to ND/CAD even when IPP and thermocycling were combined. The bonding of the self-adhesive resin cement could not compete with other resin cements.

The role of newborn gender in postpartum depressive symptoms among women in Upper Egypt.

OBJECTIVE: To assess the magnitude of postpartum depression among women in Upper Egypt, in addition to the role of newborn gender. METHODS: A cross-sectional study was conducted at the outpatient family-planning clinic of a university hospital. Women were enrolled if their first offspring was female and if they had 2 previous deliveries, the last within 3 months; no obstetric complications; regular marital life; middle social class or higher; and no past or family history of psychiatric illness. The Edinburgh Postnatal Depression Scale (EPDS) and Beck Depression Inventory (BDI) were used to assess the prevalence and severity of postpartum depressive symptoms. RESULTS: Of the 290 participants, 150 had a female second child (group 1) and 140 had a male second child (group 2). Overall, 113 (39.0%) women scored more than 13 on the EPDS: 70 in group 1 and 43 in group 2. Of the 113 women, 35 (31.0%) scored mild, 29 (25.7%) scored moderate, and 49 (43.4%) scored severe on the BDI. Significantly more women with a female second child had severe depression (P<0.001). CONCLUSION: Postpartum depressive symptoms were common among the present sample of women in Upper Egypt. Having female-only offspring is an important potential risk factor for postpartum depression and its severity.

Use of the non-pneumatic anti-shock garment (NASG) for life-threatening obstetric hemorrhage: a cost-effectiveness analysis in Egypt and Nigeria.

OBJECTIVE: To assess the cost-effectiveness of a non-pneumatic anti-shock garment (NASG) for obstetric hemorrhage in tertiary hospitals in Egypt and Nigeria. METHODS: We combined published data from pre-intervention/NASG-intervention clinical trials with costs from study sites. For each country, we used observed proportions of initial shock level (mild: mean arterial pressure [MAP] >60 mmHg; severe: MAP ≤60 mmHg) to define a standard population of 1,000 women presenting in shock. We examined three intervention scenarios: no women in shock receive the NASG, only women in severe shock receive the NASG, and all women in shock receive the NASG. Clinical data included frequencies of adverse health outcomes (mortality, severe morbidity, severe anemia), and interventions to manage bleeding (uterotonics, blood transfusions, hysterectomies). Costs (in 2010 international dollars) included the NASG, training, and clinical interventions. We compared costs and disability-adjusted life years (DALYs) across the intervention scenarios. RESULTS: For 1000 women presenting in shock, providing the NASG to those in severe shock results in decreased mortality and morbidity, which averts 357 DALYs in Egypt and 2,063 DALYs in Nigeria. Differences in use of interventions result in net savings of $9,489 in Egypt (primarily due to reduced transfusions) and net costs of $6,460 in Nigeria, with a cost per DALY averted of $3.13. Results of providing the NASG for women in mild shock has smaller and uncertain effects due to few clinical events in this data set. CONCLUSION: Using the NASG for women in severe shock resulted in markedly improved health outcomes (2-2.9 DALYs averted per woman, primarily due to reduced mortality), with net savings or extremely low cost per DALY averted. This suggests that in resource-limited settings, the NASG is a very cost-effective intervention for women in severe hypovolemic shock. The effects of the NASG for mild shock are less certain.

Nonatonic obstetric haemorrhage: effectiveness of the nonpneumatic antishock garment in egypt.

The study aims to determine if the nonpneumatic antishock garment (NASG), a first aid compression device, decreases severe adverse outcomes from nonatonic obstetric haemorrhage. Women with nonatonic aetiologies (434), blood loss > 1000 mL, and signs of shock were eligible. Women received standard care during the preintervention phase (226) and standard care plus application of the garment in the NASG phase (208). Blood loss and extreme adverse outcomes (EAO-mortality and severe morbidity) were measured. Women who used the NASG had more estimated blood loss on admission. Mean measured blood loss was 370 mL in the preintervention phase and 258 mL in the NASG phase (P < 0.0001). EAO decreased with use of the garment (2.9% versus 4.4%, (OR 0.65, 95% CI 0.24-1.76)). In conclusion, using the NASG improved maternal outcomes despite the worse condition on study entry. These findings should be tested in larger studies.

Emergency contraception in the context of marriage in Upper Egypt.

OBJECTIVE: To explore the degree of knowledge, perception, and practice of emergency contraception (EC) within marital relations in Egypt. METHODS: The present study was a pilot cross-sectional survey. Eligible participants were randomly selected from 4 governorates in Upper Egypt. A questionnaire was designed by the investigators and administered to an unselected sample of healthcare providers and potential users of EC. The questionnaire collected information in 4 domains: demographics; knowledge about EC; attitudes toward EC; and practice of EC in Egypt. RESULTS: In total, 240 healthcare providers and 60 potential users of EC completed the questionnaire. Approximately 85% of healthcare providers and 30% of potential users had heard about EC. A similar proportion of study participants said that EC methods are needed. Only 32.7% of healthcare providers and very few potential users had actually used EC. CONCLUSION: There is a need for EC in Egypt. However, a big gap in knowledge leads to nonuse or incorrect use of EC and negative attitude toward it. If health service planners and policy makers could fill this gap, a considerable decline in the prevalence of unwanted pregnancy may be achieved by using EC.

Implication of umbilical cord in preeclampsia.

OBJECTIVES: To investigate the role of biochemical changes in the umbilical cord and placenta in developing preeclampsia (PE). SUBJECTS AND METHODS: Thirty women with PE and 15 healthy pregnant women as controls were enrolled in this study. Vascular endothelial growth factor (VEGF), soluble vascular endothelial growth factor receptor 1 (sVEGFR-1), platelet-derived endothelial cell growth factor (PD-ECGF), neutrophil elastase and nitric oxide (NO) were measured. RESULTS: Both serum (maternal and fetal) and tissue (placenta and umbilical cord) levels of VEGF, sVEGFR-1, PD-ECGF and neutrophil elastase were significantly increased, whereas NO was significantly decreased (except placental tissue showed no changes) in preeclamptic patients. The cord serum level of PD-ECGF was significantly higher in severe PE compared to mild PE and normal pregnant women. The placental and cord tissue levels of PD-ECGF and neutrophil elastase were significantly higher in severe PE, while the cord tissue level of NO was significantly lower in severe PE. CONCLUSION: Our data showed that umbilical cord vessels and stroma can serve as an additional source of vasoactive and angiogenic substances that contribute to the biochemical changes occurring in PE.