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Egyptian breast cancer patients knew little about their condition. Less awareness was related to age and education level. Low knowledge of risk factors, early detection and management of breast cancer should be addressed by designing patient education programs, where less educated patients are supported by health care professionals to participate in the management of breast cancer. Moreover, we found that 67% and 97% of enrolled breast cancer patients were willing as well to participate in spreading awareness among their community and among their own families, respectively.

BackgroundIvabradine is approved to improve exercise tolerance and quality of life in patients with chronic heart failure; its use in acute heart failure (AHF) has not previously been studied.MethodsForty adult patients admitted with AHF were randomized into two groups; Group 1 patients were prescribed beta-blockers (BBs) and Group 2 patients were prescribed ivabradine. Both groups were given optimum anti-failure treatment for AHF. All patients were assessed for heart rate (HR), 6-minute walk test (6MWT), New York Heart Association (NYHA) classification, and Minnesota Living With Heart Failure Questionnaire (MLWHFQ) before and after 1 month of therapy.ResultsBBs or ivabradine among optimum medical therapy for AHF resulted in a significant improvement in all the studied parameters (NYHA class; 6MWT distance; HR and Borg scale dyspnea/fatigue score before and after the walk). The MLWHFQ was significantly worse during the follow-up in both groups. At the end of follow-up, there was a comparable beneficial effect attributed to the significant HR reduction observed in both groups.ConclusionThe results of this pilot study demonstrated the safety of the early use of ivabradine alone versus BBs when tolerated in patients admitted with AHF (both acutely decompensated as well as de novo). Both groups achieved comparable reduction in HR with improvement in functional capacity and exercise tolerance.

Sybil attacks are increasingly prevalent in online social networks. A malicious user can generate a huge number of fake accounts to produce spam, impersonate other users, commit fraud, and reach many legitimate users. For security reasons, such fake accounts have to be detected and deactivated immediately. Various defense schemes have been proposed to deal with fake accounts. However, most identify fake accounts using only the structure of social graphs, leading to poor performance. In this paper, we propose a new and scalable defense scheme, SybilTrap. SybilTrap uses a semi-supervised technique that automatically integrates the underlying features of user activities with the social structure into one system. Unlike other machine learning-based approaches, the proposed defense scheme works on unlabeled data, and it is effective in detecting targeted attacks, because it manipulates different levels of features of user profiles. We evaluate SybilTrap on a dataset collected from Twitter. We show that our proposed scheme is able to accurately detect Sybil nodes as well as huge conspiracies among them. KEYWORDS social network, Sybil attack, Sybil defense, targeted attack 1 | INTRODUCTION Online social networking services such as Facebook, Twitter, and YouTube have attracted millions of users in recent years, with individuals and companies scrambling to be part of the paradigm shift changing the world of communication. 1 The ability to address millions of users worldwideis desirable for many businesses; it is undeniable that social networks have had a massive impact in the realm of business. These platforms are so widely used that some users are now using them for malicious purposes. One of the most popular techniques is the Sybil attack. 2 During a Sybil attack, a malevolent user creates multiple fake accounts that can be used to increase the user 0 s influence within the target community. 2,3 In sufficient numbers, such fake accounts can affect public opinion on an individual or the popularity of an organization. 4 They can also change the characteristics of an audience or even create a legitimacy problem for individuals or organizations. At present, it is difficult to detect fake accounts because they do not make up a substantial proportion of users of social networks.Previous studies have proposed several defense schemes and techniques against Sybil attacks. 5-15 These approaches can be divided into graph-based detection and machine learning techniques. 2,16 Graph-based techniques assume that it is difficult for the fake accounts to quickly build relations with legitimate users, so the number of attack edges is limited for networks with a high level of trust. 17 In addition, they assume that the mixing time of benign users to be connected to each other is fast and thus detection schemes are built based on this assumption. Some researchers have questioned the effectiveness of graph-based systems in various social networks. 2,16-20 Other graph-based techniques use credit networks as a basis for Sybil tolerance. 21 Ho...

Background. Damage to the anterior cruciate ligament (ACL) is crippling and often requires an arthroscopic outpatient surgery. Nevertheless, many patients experience severe pain during the first day after ACL reconstruction (ACLR). The adductor canal block (ACB) has yielded conflicting results for post-ACLR pain relief. This research investigated the effect of a supplemental popliteal plexus block on postoperative pain outcomes compared to a sole ACB. Methods. Following a randomized design, 60 cases scheduled for knee arthroscopy with ACLR using an ipsilateral hamstring graft were separated into two categories. Subjects in group A (n = 30) received an ACB only, while subjects in group B (n = 30) received combined ACB and popliteal plexus block (PPB). Results. We found significant differences between the two groups. The time of the first analgesic request (TFR) was later for the combined ACB and PPB (median 8 h) compared to the ACB only group (median 0.5 h). Morphine consumption was lower for patients who received combined ACB and PPB (median 12 mg) compared to ACB only (median 30 mg). The number of the requested doses was lower for the combined ACB and PPB group (median 3 doses) compared to the ACB only group (median 7 doses). Conclusions. The addition of PPB to ACB was associated with improved analgesia and a reduced need for opioid-based sedatives following ACLR with an ipsilateral hamstring graft (https://clinicaltrials.gov/ct2/show/NCT04020133).