Magnetic resonance imaging of pilonidal sinus disease: interobserver agreement and practical MRI reporting tips.

OBJECTIVE: To evaluate the interobserver agreement for the features of natal cleft pilonidal sinus disease (PSD) on magnetic resonance imaging (MRI) and propose a standardized checklist for reporting PSD on MRI. MATERIALS AND METHODS: Forty MRI studies of 39 discrete patients with PSD were retrospectively evaluated by five independent radiologists using a standardized checklist. Fleiss' Kappa (k) coefficients of agreement were used to test the agreement between categorical variables. The MRI features of the natal cleft sepsis associated with PSD were classified into four main categories: morphology, branching and extensions, external skin openings, and the relationship of the PSD to the coccyx. A survey was created and disseminated online among general surgeons who treat patients with PSD to assess the relevance of the MRI features proposed in the standardized checklist. RESULTS: The overall agreement regarding the identification of morphology of the natal cleft sepsis was moderate (k = 0.59). Lateral and caudal extensions interobserver agreement was substantial (k = 0.64 and 0.71, respectively). However, the overall agreement regarding the individual parts of anal sphincter involved was moderate (k = 0.47). Substantial interobserver agreement was found in assessing the proximity of the PSD to the coccyx (k = 0.62). CONCLUSION: Preoperative MRI can delineate the extensions and branching of PSD with substantial agreement. MRI is superior in describing the deep extensions of PSD with better reliability than assessing the number and locations of the external openings. Expert consensus agreement is needed to establish the MRI features necessary for optimal reporting of PSD. CLINICAL RELEVANCE STATEMENT: MRI can offer valuable information about the extent of sepsis associated with pilonidal sinus disease, particularly in cases with involvement of critical anatomical structures such as the coccyx and anal triangle. MRI can potentially contribute to more accurate patient stratification and surgical planning. KEY POINTS: • The interobserver agreement for assessing PSD's lateral and caudal extension on MRI is substantial. • MRI can describe deep extensions and branching of PSD with superior reliability than assessing the number and site of external openings. • Reporting the relationship between natal cleft sepsis in PSD and the anal region may influence the surgical approach and postoperative healing.

Risk factors of congenital hydrocephalus: a case-control study in a lower-middle-income country (Egypt).

OBJECTIVE: Hydrocephalus is the most common brain disorder in children and is more common in low- and middle-income countries. Research output on hydrocephalus remains sparse and of lower quality in low- and middle-income countries compared with high-income countries. Most studies addressing hydrocephalus epidemiology are retrospective registry studies entailing their inherent limitations and biases. This study aimed to investigate child-related, parental, and socioeconomic risk factors of congenital hydrocephalus (CH) in a lower-middle-income country. METHODS: An investigator-administered questionnaire was used to query parents of patients with CH and controls who visited the authors' institution from 2017 until 2021. Patients with secondary hydrocephalus and children older than 2 years of age at diagnosis were excluded. Uni- and multivariable logistic regression was performed to identify the factors affecting CH development. RESULTS: Seven hundred forty-one respondents (312 cases and 429 controls) were included in this study. The authors showed that maternal diseases during pregnancy (OR 3.12, 95% CI 1.96-5.03), a lack of periconceptional folic acid intake (OR 1.92, 95% CI 1.32-2.81), being a housewife (OR 2.66, 95% CI 1.51-4.87), paternal illiteracy (OR 1.65, 95% CI 1.02-2.69), parental consanguinity (OR 3.67, 95% CI 2.40-5.69), a history of other CNS conditions in the family (OR 2.93, 95% CI 1.24-7.34), conceiving a child via assisted fertilization techniques (OR 3.93, 95% CI 1.57-10.52), and the presence of other congenital anomalies (OR 2.57, 95% CI 1.38-4.87) were associated with an independent higher odds of a child having CH. Conversely, maternal hypertension (OR 0.22, 95% CI 0.09-0.48), older maternal age at delivery (OR 0.93, 95% CI 0.89-0.97), and having more abortions (OR 0.80, 95% CI 0.67-0.95) were negatively correlated with CH. CONCLUSIONS: Multiple parental, socioeconomic, and child-related factors were associated with higher odds for developing CH. These results can be utilized to guide parental counseling and management, and direct social education and prevention programs.

Complications associated with subaxial placement of pedicle screws versus lateral mass screws in the cervical spine (C2-T1): systematic review and meta-analysis comprising 4,165 patients and 16,669 screws.

Lateral mass screw (LMS) and cervical pedicle screw (CPS) fixation are among the most popular techniques for posterior fusion of the cervical spine. Early research prioritized the LMS approach as the trajectory resulted in fewer neurovascular complications; however, with the incorporation of navigation assistance, the CPS approach should be re-evaluated. Our objective was to report the findings of a meta-analysis focused on comparing the LMS and CPS techniques in terms of rate of various complications with inclusion of all levels from C2 to T1. We conducted a systematic review of PubMed and EMBASE databases with final inclusion criteria focused on identifying studies that reported outcomes and complications for either the CPS or LMS technique. These studies were then pooled, and statistical analyses were performed from the cumulative data. A total of 60 studies comprising 4165 participants and 16,669 screws placed within the C2-T1 levels were identified. Within these studies, the LMS group had a significantly increased odds for lateral mass fractures (odds ratio [OR] = 43.2, 95% confidence interval [CI] = 2.62-711.42), additional cervical surgeries (OR = 5.56, 95%CI = 2.95-10.48), and surgical site infections (SSI) (OR = 5.47, 95%CI = 1.65-18.16). No other significant differences between groups in terms of complications were identified. Within the subgroup analysis of navigation versus non-navigation-guided CPS placement, no significant differences were identified for individual complications, although collectively significantly fewer complications occurred with navigation (OR = 5.29, 95%CI = 2.03-13.78). The CPS group had significantly fewer lateral mass fractures, cervical revision surgeries, and SSIs. Furthermore, navigation-assisted CPS placement was associated with a significant reduction in complications overall.

Transformational Leadership, Employee Engagement, Job Satisfaction, and Psychological Well-Being among Hotel Employees after the Height of the COVID-19 Pandemic: A Serial Mediation Model.

Over the past few years, great attention has been given to the impacts of the COVID-19 pandemic and its consequences on employee psychological well-being (PWB), particularly in the hospitality industry. Like many aspects of human life, employee PWB is influenced by multiple factors. One of the factors that may affect employee PWB is transformational leadership (TLS). Accordingly, we aim through this study to empirically (1) examine the direct effect of transformational leadership on employee PWB and (2) investigate the potential independent and serial mediation effects of employee engagement (EEG) and job satisfaction (JS) on the TLS-PWB relationship after the height of the COVID-19 pandemic. Data were gathered using an online questionnaire from a convenience sample of 403 front-line employees from five-star hotels in Saudi Arabia. The partial least squares structural equation modeling (PLS-SEM) with the bootstrapping technique was utilized to test the study hypotheses. Based on the demands-resources (JD-R) theory, the findings of this study reveal a significant positive effect of TLS on hotel employees' PWB. Additionally, drawing on the stimulus-organism-response (S-O-R) model, the two main contributions of this study are: (1) EEG and JS serially and independently have a significant partial mediational effect on the TLS-PWB relationship among hotel employees, and (2) EEG has a greater impact on the TLS-PWB relationship as an intervening variable than the two other mediators (JS, as well as EEG and JS serially). Based on these findings, hotel management should mainly consider developing and encouraging TLS behavior among their managers to promote EEG and increase JS among their followers, which consequently enhances their PWB and alleviates negative psychological outcomes due to experiencing a disaster such as the COVID-19 pandemic.

Travelers' Subjective Well-Being as an Environmental Practice: Do Airport Buildings' Eco-Design, Brand Engagement, and Brand Experience Matter?

The physical environment of airports plays a crucial role in improving travelers' perceptions and well-being. Adopting a green physical environment may elicit customers' cognitive and emotional responses and provide a convenient consumption environment. Brand experience and engagement are other important consumer-firm interactions that influence the attributes of the passengers' well-being. The current study sought to assess the impact of the eco-design of buildings, brand experience and engagement on the well-being of travelers at an international airport in Saudi Arabia. Additionally, the current study investigated the possible effects of eco-design on airport experience and engagement. The results of the structural equation modeling analysis revealed that the eco-design of airport buildings was independently associated with passengers' well-being and brand engagement, but not with brand experience. Additionally, well-being was significantly predicted by brand engagement and experience. Airport managers are advised to adopt an internal eco-design to help promote passengers' connection with the brand and improve their well-being, which would eventually be reflected in their behavioral attributes and decision-making.

Service Value and Repurchase Intention in the Egyptian Fast-Food Restaurants: Toward a New Measurement Model.

Service value is a crucial dominant indicator in customer decision-making. However, there is a lack of hospitality literature that investigates the multi-dimensional service value in emerging markets. Thus, this study aims to create a multi-dimensional scale for service value and to analyze how different service value dimensions affect customers repurchase intentions at fast-food restaurants. We make a conceptual framework with eight constructs, including service value and repurchase intention. A self-administrated questionnaire is used to gather empirical data from fast-food restaurant customers in Egypt. We employ confirmatory factor analysis to extract the model's reliability and validity. Moreover, we use a structural equation model to extract the model regressions and correlations using AMOS software. We find that each of the eight proposed service value variables impacts fast-food restaurant customers' repurchase intention. However, the factors that strongly influence customers' preferences to make more purchases are service equity, confidence benefits, service quality, and service reputation. We contribute to the literature on hospitality customer value and repurchasing intentions by presenting a comprehensive multi-dimensional service value framework that affects customers' repurchase intentions in fast-food restaurants. Practically, eight service value variables can help managers of fast-food restaurants meet customer needs and gain a competitive advantage. We suggest many crucial recommendations to restaurant managers regarding the priority of the service value constructs. For example, managers should consider service equity, service quality, and service reputations as a priority of the restaurant service value.

COVID-19 vaccine acceptance and associated factors among people living with HIV in the Middle East and North Africa region.

Background: Identifying coronavirus disease 2019 (COVID-19) vaccine acceptance and associated factors among people living with HIV (PLHIV) in the Middle East and North Africa region is important to meet the need for broad-scale vaccination against COVID-19. Objectives: To investigate the COVID-19 vaccine acceptance rate and factors among PLHIV in the Middle East and North Africa region. Method: An online cross-sectional survey was conducted among PLHIV currently living in Egypt, Tunisia and Saudi Arabia between March 2021 and August 2021. Results: Of the 540 respondents, 19.3% reported already being vaccinated against COVID-19 (n = 104), 32.0% responded 'definitely yes' (n = 173), and 13.3% responded 'probably yes' (n = 72) for intention to receive a COVID-19 vaccine, with an overall COVID-19 vaccine acceptance rate of 64.6% among PLHIV in the region. The most significant predictors of COVID-19 vaccine acceptance included feeling less worried about COVID-19 transmission post-vaccination (221.0% higher odds), and believing the disease is vaccine-preventable (160.0% higher odds). Reported barriers to COVID-19 vaccine acceptance include concerns about vaccine effectiveness and belief that HIV medications protect against COVID-19 transmission, living in a rural area and reporting less-frequent engagement with HIV care. Nine out of 10 participants reported that the chances of them getting COVID-19 vaccine would increase if given adequate information and if their doctor recommended it. Conclusion: Findings of the study can help researchers, health officials, and other health system actors understand the predictors and barriers to COVID-19 vaccine acceptance reported by PLHIV. This understanding could inform the future planning of interventions tailored to PLHIV.

Meta-analysis of overall survival and postoperative neurologic deficits after resection or biopsy of butterfly glioblastoma.

Butterfly glioblastoma (bGBM) is a grade 4 glioma with a poor prognosis. Surgical treatment of these cancers has been reviewed in the literature with some recent studies supporting resection as a safe and effective treatment instead of biopsy and adjuvant therapy. This meta-analysis was designed to determine whether there are significant differences in overall survival (OS) and postoperative neurologic deficits (motor, speech, and cranial nerve) following intervention in patients who underwent tumor resection as part of their treatment, compared to patients who underwent biopsy without surgical resection. A literature search was conducted using PubMed (National Library of Medicine) and Embase (Elsevier) to identify articles from each database's earliest records to May 25, 2021, that directly compared the outcomes of biopsy and resection in bGBM patients and met predetermined inclusion criteria. A meta-analysis was conducted to compare the effects of the two management strategies on OS and postoperative neurologic deficits. Six articles met our study inclusion criteria. OS was found to be significantly longer for the resection group at 6 months (odds ratio [OR] 2.94, 95% confidence interval [CI] 1.23-7.05) and 12 months (OR 3.75, 95% CI 1.10-12.76) than for the biopsy group. No statistically significant differences were found in OS at 18 and 24 months. Resection was associated with an increased rate of postoperative neurologic deficit (OR 2.05, 95% CI 1.02-4.09). Resection offers greater OS up to 1 year postintervention than biopsy alone; however, this comes at the cost of higher rates of postoperative neurologic deficits.

A Novel Triazole Schiff Base Derivatives for Remediation of Chromium Contamination from Tannery Waste Water.

Tannery industries are one of the extensive industrial activities which are the major source of chromium contamination in the environment. Chromium contamination has been an increasing threat to the environment and human health. Therefore, the removal of chromium ions is necessary to save human society. This study is oriented toward the preparation of a new triazole Schiff base derivatives for the remediation of chromium ions. 4,4'-((1E)-1,2-bis ((1H-1,2,4-triazol-3-yl) imino)ethane-1,2-diyl) diphenol was prepared by the interaction between 3-Amino-1H-1,2,4-triazole and 4,4'-Dihydroxybenzil. Then, the produced Schiff base underwent a phosphorylation reaction to produce the adsorbent (TIHP), which confirmed its structure via the different tools FTIR, TGA, 1HNMR, 13CNMR, GC-MS, and Phosphorus-31 nuclear magnetic resonance (31P-NMR). The newly synthesized adsorbent (TIHP) was used to remove chromium oxyanions (Cr(VI)) from an aqueous solution. The batch technique was used to test many controlling factors, including the pH of the working aqueous solution, the amount of adsorbent dose, the initial concentration of Cr(VI), the interaction time, and the temperature. The desorption behaviour of Cr(VI) changes when it is exposed to the suggested foreign ions. The maximum adsorption capacity for Cr(VI) adsorption on the new adsorbent was 307.07 mg/g at room temperature. Freundlich's isotherm model fits the adsorption isotherms perfectly. The kinetic results were well-constrained by the pseudo-second-order equation. The thermodynamic studies establish that the adsorption type was exothermic and naturally spontaneous.

Digital-Free Tourism Holiday as a New Approach for Tourism Well-Being: Tourists' Attributional Approach.

Digital-free tourism (DFT) has recently attracted tourism service providers' attention for its benefits in terms of enhancing tourists' experiences and well-being at destinations. DFT refers to tourists who are likely to voluntarily avoid digital devices and the Internet on holiday, or travel to destinations without network signals. DFT has advantages for tourists in increasing well-being, mental health, and social networking during their journeys. DFT also has a benefit for tourism marketers in that they can consider it as a new tourism approach. However, there is a lack of studies into tourists' locus of control (LOC) while experiencing DFT holidays. LOC refers to how individuals assign the responsibility of event outcomes-whether they assign it to themselves (internal LOC) or they say it is beyond their control (external LOC). Therefore, the current study contributes to investigating tourists' LOC impacts while experiencing DFT holidays. The study relies on semi-structured interviews with millennial tourists who have experienced DFT holidays. The study findings reveal that millennial tourists with an internal LOC (vs. external) are more likely to perceive the DFT advantages (vs. obstacles) during and after the DFT holidays. However, millennial tourists with external LOC incrementally change their attitudes and perceive the DFT holiday benefits through their self-efficacy enhancement. The findings propose managerial strategies for developing effective DFT holidays for millennial tourists regarding their LOC.

Impact of Rural Tourism Development on Residents' Satisfaction with the Local Environment, Socio-Economy and Quality of Life in Al-Ahsa Region, Saudi Arabia.

Tourism has a significant role in destination development, particularly in rural regions. However, within the context of the highly sensitive nature of rural areas to the ecological, economic, and socio-cultural effects of tourism development, it is important to assess the levels of satisfaction among the residents of rural destinations. The current study aimed to assess the impact of rural tourism development in the Al-Ahsa region, Saudi Arabia on the overall resident satisfaction and three relevant subdomains. The findings revealed that the three tourism development impacts under investigation, including the social, economic and environmental effects, were positively associated with resident overall satisfaction. The three influential developmental categories were also independent predictors of the satisfaction with the quality of life and environment subdomains. National policy makers are required to implement adequate rural tourism development measures and regulations to improve tourism services and activities, which would eventually be reflected in the quality of life of local residents.

A multivariable prediction model for recovery patterns and time course of symptoms improvement in hemifacial spasm following microvascular decompression.

BACKGROUND: Microvascular decompression (MVD) success rates exceed 90% in hemifacial spasm (HFS). However, postoperative recovery patterns and durations are variable. OBJECTIVE: We aim to study factors that might influence the postoperative patterns and duration needed until final recovery. METHOD: Only patients following de-novo MVD with a minimum follow-up of 6 months were included. Overall trend of recovery was modeled. Patients were grouped according to recognizable clinical recovery patterns. Uni- and multivariable analyses were used to identify the factors affecting allocation to the identified patterns and time needed to final recovery. RESULTS: A total of 323 (92.6%) patients had > 90% symptom improvement, and 269 (77.1%) patients had complete resolution at the last follow-up. The overall trend of recovery showed steep remission within the first 6 months, followed by relapse peaking around 8 months with a second remission ~ 16 months. Five main recovery patterns were identified. Pattern analysis showed that evident proximal indentation of the facial nerve at root exit zone (REZ), males and facial palsy are associated with earlier recovery at multivariable and univariable levels. anterior inferior cerebellar artery (AICA), AICA/vertebral artery compressions and shorter disease durations are related to immediate resolution of the symptoms only on the univariable level. Time analysis showed that proximal indentation (vs. distal indentation), males and facial palsy witnessed significantly earlier recoveries. CONCLUSION: Our main finding is that in contrast to peripheral indentation, proximal indentation of the facial nerve at REZ is associated with earlier recovery. Postoperative facial palsy and AICA compressions are associated with earlier recoveries. We recommend a minimum of 1 year before evaluating the final outcome of MVD for HFS.

Complications associated with subaxial placement of pedicle screws versus lateral mass screws in the cervical spine: systematic review and meta-analysis comprising 1768 patients and 8636 screws.

Lateral mass screw (LMS) fixation for the treatment of subaxial cervical spine instability or deformity has been traditionally associated with few neurovascular complications. However, cervical pedicle screw (CPS) fixation has recently increased in popularity, especially with navigation assistance, because of the higher pullout strength of the pedicle screws. To their knowledge, the authors conducted the first meta-analysis comparing the complication rates during and/or after CPS and LMS placement for different pathologies causing cervical spine instability. A systematic literature search of PubMed and Embase from inception to January 12, 2021 was performed to identify studies reporting CPS and/or LMS-related complications. Complications were categorized into intraoperative and early postoperative (within 30 days of surgery) and late postoperative (after 30 days from surgery) complications. All studies that met the prespecified inclusion criteria were pooled and cumulatively analyzed. A total of 24 studies were conducted during the time frame of the search and comprising 1768 participants and 8636 subaxially placed screws met the inclusion criteria. The CPS group experienced significantly more postoperative C5 palsy (odds ratio [OR] = 3.48, 95% confidence interval [CI] = 1.27-9.53, p < 0.05). Otherwise, there were no significant differences between the LMS and CPS groups. There were no significant differences between the CPS and LMS groups in terms of neurovascular procedure-related complications other than significantly more C5 palsy in the CPS group.

Durability of bond strength to dentin using two universal adhesives in different etching modes

Aim. To evaluate the bond durability of two universal adhesives; mild and ultra-mild in both etch-and-rinse and self-etch modes after simulated in-vitro degradation by long-term water storage or thermocycling. Methods. A total of 144 specimens were used in this study; 120 specimens (prepared from 30 teeth) for microshear bond strength testing and fracture mode assessment, and 24 specimens for scanning electron microscopic evaluation (prepared from 24 teeth). Specimens were prepared from 54 recently extracted caries free third molars and randomly divided into 12 groups, according to the adhesive treatment (All Bond or Scotchbond Universal), etching mode (etch-andrinse or self-etch) and aging method (thermocycling or water storage). Each tooth was sectioned mesio-distally into two halves exposing free dentin surface for bonding where dentin substrate 1 mm below the dentino-enamel junction was used. After adhesive application and composite build up, specimens were tested in shear mode after storing in distilled water at 37˚C for 24 hours or 1 year, or after being thermocycled between 5 and 55 °C for 10,000 cycles (n=10). Microshear bond strength (µSBS) was tested using a universal testing machine. Adhesive-dentin interface was examined using scanning electron microscope (SEM) (n=2). Data were analyzed using 3 way AN0VA and pairwise comparisons was performed using Bonferroni correction at significance level of α ≤0.05. Results. Statistical analysis revealed non-significant difference for etching mode in both adhesives (p=0.596). After aging, the bond strength was only reduced in Scotchbond Universal after one year of water storage in both modes (p<0.001). SEM evaluation revealed intact hybrid layer and longer resin tags for etch-and-rinse mode than selfetch mode of both adhesives. Conclusion. The bond strength of universal adhesives is not affected by the etching mode, however its durability was shown to be material dependent

Incidence of acute kidney injury among COVID-19 patients in Egypt.

BACKGROUND: Despite the fact that the fundamental characteristics of coronavirus disease-2019 (COVID-19) are respiratory manifestations, multi-organ failure including the kidney has been documented. There are no clear comparisons of COVID-19 cases with and without acute kidney injury (AKI) to show whether there are aspects of acute kidney injury progression path or outcome that are unique to this disease. METHODS: In this work, we analyzed the data of 734 COVID-19 cases admitted to the Ahmad Maher Teaching Hospital in Cairo, Egypt, between June 6 and July 25, 2020. Data on demographics, comorbidities, laboratory results, and outcomes were assessed. To assess the incidence rate of AKI in Egyptian COVID-19 patients, comparisons were carried out between home-isolated COVID-19 patients, hospitalized COVID-19 patients, and ICU COVID-19-patients with or without AKI. RESULTS: AKI was more common in hospitalized mild COVID-19 patients than in home-isolated and ICU COVID-19 patients (15.0% versus 10.8% and 14.2%, respectively). The overall occurrence rate of AKI was significantly higher in COVID-19 patients (n=91, 14%). Hemodialysis, on the other hand, was required in 76% of the extreme ICU COVID-19 patients who developed AKI (22/29). The absolute number of patients with AKI COVID-19 who required hemodialysis was 34 (37%). This accounted for 5.2% of all COVID-19 patients and 37% of those with AKI. The mortality rate in COVID-19 patients with or without AKI was 15.4% and 4.8%, respectively. CONCLUSION: AKI in our COVID-19 patients is associated with a high mortality rate in ICU-COVID-19 patients. Our findings suggest that COVID-19 patients, particularly ICU COVID-19 patients, should be closely monitored for the development of AKI. Early identification of AKI, as well as prompt intervention, can improve COVID-19 patient outcomes.

Impact of Service Quality of Low-Cost Carriers on Airline Image and Consumers' Satisfaction and Loyalty during the COVID-19 Outbreak.

Low-cost carriers (LCCs) in Saudi Arabia operate in a competitive, highly demanding environment. Customer-related attributes may be influenced by the levels of service quality in a no-frills airline, which might impact satisfaction and loyalty. Given the unique traveler and market characteristics of the aviation sector in the kingdom, we sought to investigate the impact of service quality of LCCs on customer satisfaction and loyalty and the perceived airline image. A total of 299 passengers at two international airports were approached using a modified SERVQUAL scale. Results revealed that service quality was a significant predictor of customer satisfaction (ß = 0.46, p < 0.0001), airline image (ß = 0.55, p < 0.0001), and customer loyalty (ß = 0.16, p = 0.006). The responsiveness dimension was the most important dimension of service quality, since it predicted all other constructs (satisfaction, loyalty, and brand image). Airline tangibles and reliability were independently associated with brand image and loyalty, respectively. Based on these results, LCCs should tailor future strategic plans that rely heavily on improving different service quality measures, particularly the responsiveness domain.

Magnetically modified hydroxyapatite nanoparticles for the removal of uranium (VI): Preparation, characterization and adsorption optimization.

Recently, magnetically modified nanomaterials have gained a great interest in the field of wastewater remediation. In this regard, the present work introduces a facile microwave-assisted pathway for the preparation of magnetically modified hydroxyapatite nanoparticles (MNHA) and evaluates its adsorption capability towards the removal of uranium (VI) ions from wastewaters. The prepared magnetic nanocomposite went through a full characterization procedure using different techniques, such as transmission electron microscope (TEM), X-ray diffraction (XRD), FT-IR, Brunauer-Emmett-Teller (BET) surface area measurements and magnetization curve. Involvement of the prepared MNHA in the remediation of wastewater containing U(VI) ions was investigated and the factors that influence the adsorption capacity were considered and optimized. The adsorption's optimum pH was found to be 5.0 and equilibrium was attended after 120 min. A maximum adsorption capacity of 310 mg/g was achieved after 120 min at 25 °C. The experimental data were well explained by Langmuir adsorption isotherm model. Kinetically, the adsorption process follows the pseudo-second order model. Thermodynamically, it is endothermic, irreversible and spontaneous adsorption process. Removal of U(VI) ions was found to take place via complex formation between the phosphate groups on the adsorbent and uranyl ions. The recovery of U(VI) ions from MNHA beads and the reusability of the spent beads were also explored. It was concluded that the prepared MNHA nanocomposite is simple, fast, ecofriendly adsorbent for the removal of U(VI) ions from water with excellent adsorption capacity.

Skin microneedling plus platelet-rich plasma versus skin microneedling alone in the treatment of atrophic post acne scars: a split face comparative study.

INTRODUCTION: Acne scarring is a permanent disfiguring sequel, which can take varied morphological forms. Many therapeutic measures have been performed to improve acne scarring such as microneedling. Our objective is to evaluate the efficacy and safety of microneedling alone versus microneedling combined with platelet rich plasma in the treatment of post acne. METHODS: The study included 35 patients with mild to severe post acne atrophic scar. All the patients received four sequential treatments of skin microneedling alone on the right side of the face and skin microneedling followed by topical application of platelet rich plasma (PRP) on the left side of the face with an interval of 3 weeks. Two blinded dermatologists evaluated the clinical response according to qualitative global acne scarring system grading of Goodman & Baron. Patients are queried about their satisfaction with the treatment outcomes. RESULTS: The study included 35 patients with a mean age of 24.7 ± 6.8 years. There was a significant improvement in the degree of scar severity before and after treatment on both the sides. Regarding patient's satisfaction grades, there was a significant improvement after both treatment modalities with insignificant differences between both treatment modalities. CONCLUSIONS: Both microneedling and microneedling in combined with PRP showed satisfactory results.