An unusual case of clavicular prosthesis migration causing traumatic injury to the ascending aorta.

Traumatic aortic injuries can be a lethal event. Almost 88% of patients with traumatic aortic injuries die within the first hour and only 2% survive long enough to develop a chronic aneurysm. Injury to the ascending aorta, whether acute or chronic, are typically managed with surgery, and those in the descending aorta, are managed conservatively or in some cases with stents. We present a rare case of a 53-year old gentleman with intra-aortic migration of a left clavicular prosthesis used for restoration of the left shoulder girdle.

Efficacy of plyometric exercises on upper extremity function, selective motor control and hand grip strength in children with unilateral cerebral palsy: A randomized controlled study.

BACKGROUND: Impairment in unimanual upper limb function is frequent among children with unilateral cerebral palsy (UCP), which affects their ability to perform functional activities. AIM: To assess the efficacy of plyometric exercises on the function of upper extremity, selective motor control (SMC) and hand grip strength (HGS) in children with UCP. DESIGN: This was a double-masked, randomized, controlled clinical trial. SETTING: Outpatient Clinics of Faculty of Physical Therapy, Cairo University and Center for Physical Medicine, Rehabilitation and Rheumatology, Al-Agouza Hospital, Giza, Egypt. POPULATION: Forty children with UCP, ranging in age from 8 to 12 years, were randomly allocated to two groups equal in numbers. METHOD: Children were allocated to receive conventional therapy (CONV-group; n = 20) or plyometric exercises (PLYO-group; n = 20) for 45 min. In addition, children of both groups received selected physical and occupational therapy programs (each lasted for 30 min) twice a week over 3-month. The intervention was delivered on non-consecutive days. Upper extremity function, SMC and HGS were assessed by using quality of upper extremity skills test (QUEST), Test of arm selective control and pneumatic squeeze bulb dynamometer, respectively. RESULTS: Overall, 35 children (18 in the CONV-group, 17 in the PLYO-group) completed data collection and treatment. With-in group comparison showed significant improvement in the study groups while post-treatment comparisons revealed a significant difference from mean difference in upper extremity function is 9.55 (8.71:10.39), SMC is 2.12 (1.51:2.72) and HGS is 2.91 (2.13:3.68) (p < 0.05; 95% Confidence interval) in favor of the PLYO-group. CONCLUSIONS: Plyometric exercises have the capability to enhance upper extremity function and strength in children with UCP.

Effect of physical training on motor function of ambulant children with diplegia after selective dorsal rhizotomy: A randomized controlled study.

BACKGROUND: Children with spastic diplegia experience tonicity, lack of selective motor control, subnormal postural stability and delayed motor development. Selective dorsal rhizotomy followed by physical therapy is a permanent procedure aimed to alleviate hypertonicity. OBJECTIVE: To explore the efficacy of selective dorsal rhizotomy (SDR) followed by a physical training on gross motor function (GMF), functional balance, walking capacity, selective motor control (SMC) and energy cost of walking (ECW) of ambulant children with spastic diplegia. METHODS: Forty-two children with spastic diplegia aged 5 to 8 years were randomly assigned into the control or SDR-group. Both groups received a designed physical training of progressive functional strength training and standard orthotic management (SOM) 3 times a week for 6 months. GMF, functional balance, ECW, functional capacity and SMC were assessed by gross motor function measure (GMfM-88), pediatric balance scale (PBS), energy expenditure index (EEI), six-minute walking test (6MWT) and selective control assessment of lower extremity (SCALE), respectively. Assessment was carried out before the treatment (baseline), after 6 months (post I) and 1-year follow-up (post II). RESULTS: From baseline to post I and post II assessments, changes of GMF, functional balance, ECW, functional capacity and SMC within the control and SDR groups showed significant improvements (P < 0.001). Moreover, group comparison showed significant differences in favor of the SDR group. CONCLUSION: Integrated physical training followed SDR demonstrated qualitative changes and enhancement in motor function, achieved by spasticity reduction.

Employee Engagement and Innovative Work Behavior Among Chinese Millennials: Mediating and Moderating Role of Work-Life Balance and Psychological Empowerment.

Given the ever-changing business environment, organizations are forced to consider innovation as an essential prerequisite to enhance their efficiency, productivity, and sustainability. In this regard, organizations pay increased attention to enhancing employees' engagement (EE) and stimulating their innovative work behaviors (IWBs). Research emphasizes the importance of employees' IWBs in achieving competitive advantages and organizational sustainability. In this research, we address the question of whether employee engagement leads to stimulating IWBs of the Chinese millennial workforce in service industries. In addition, we explore the potential mediating effect of work-life balance (WLB) and the moderating influence of psychological empowerment (PE) on the relationship between EE and IWBs. Self-administered questionnaires were used to collect data from 372 Chinese senior employees working in the IT, trade, real estate, financial, and telecommunication industries. Our empirical findings showed that highly engaged employees are most likely to exhibit IWBs and maintain a WLB. In addition, the relationship between EE and IWB was partially mediated by WLB. Moreover, the interaction between EE and PE was found to strengthen employees' IWBs. Our study contributes to understanding the importance of EE as an essential prerequisite for millennials' IWBs and provides new insights for service organizations to encourage employees' IWBs. This study contributes to the human resource management field by offering valuable implications vis-à-vis how service organizations operating in a turbulent business environment stimulate the IWBs of their millennial workforce.

Effect of laparoscopic sleeve gastrectomy vs laparoscopic Roux-en-Y gastric bypass on weight loss in Egyptian patients with morbid obesity.

BACKGROUND: Bariatric surgical operation is taken into consideration to be the handiest remedy for extreme obesity. Durability is the main requirement for the broad usage of bariatric surgery. According to several factors, the present work tries to match the SG and RYGB techniques. METHODS: This is a retrospective work that studied 200 morbid obese patients randomized and categorized into two groups according to the treatment method: the laparoscopic sleeve gastrectomy (LSG) and LRYGB groups, within the period from 2014 to 2019 and matched weight dissipation, complications, quality of life, and adverse events. RESULTS: BMI had a mean value of 39.66 ± 3.770 kg/m2 in the RYGB group versus 39.38 ± 3.648 kg/m2. No significant differences were found according to comorbidity, height, and weight. There was no significant difference between the study groups according to complications and morbidity-no recorded unexpected histopathology results in the excised LSG specimens. CONCLUSION: There was no significant change in weight dissipation, fluctuations in comorbidities, increase in Quality of Life (QoL), and complications for pathological obesity patients according to the treatment methods of laparoscopic SG (sleeve gastrectomy) and RYGB at 2-years postoperative follow-up.

The impact of virtual reality on pain management during normal labor: A systematic review and meta-analysis of randomized controlled trials.

OBJECTIVE: To evaluate the impact of virtual reality on pain management during normal labor. METHODS: A systematic search was performed in September 2021 through PubMed, Cochrane Library, Scopus, and ISI web of science. We selected randomized clinical trials (RCTs) that compared virtual reality in the intervention group versus placebo or no intervention in the control group among laboring women during their normal delivery. Revman software was used for performing our meta-analysis. Our primary outcome was the pain score evaluated during the labor process by the Visual Analog Scale (VAS). Our secondary outcomes were anxiety and satisfaction scores during childbirth in addition to the duration of the first and second stages of labor. RESULTS: Eight RCTs met our inclusion criteria with a total number of 466 patients. We found virtual reality was linked to a significant reduction in the VAS pain score during labor compared to the control group (MD = -1.40, 95% CI [-1.83, -0.96], p < 0.001). The anxiety score during labor was significantly reduced among the virtual reality group (SMD = -1.15, 95% CI [-2.18, -0.12], p = 0.03). Moreover, virtual reality significantly improved the satisfaction score during labor (MD = 15.58, 95% CI [4.93, 26.22], p = 0.004). However, there were no significant differences between virtual reality and control groups regarding the duration of the first and second stages of labor. CONCLUSIONS: Virtual reality is an effective technique for reducing anxiety, increasing satisfaction, and improving pain management during normal labor.

Improvement of Coronary Calcium Scores After Bariatric Surgery in People with Severe Obesity.

BACKGROUND: Obesity is an independent risk factor for cardiovascular diseases. Coronary artery calcium (CAC) is a direct measure of coronary atherosclerosis. The study investigated the effect of bariatric surgery on CAC scores in people with severe obesity subjected to laparoscopic sleeve gastrectomy (LSG). METHODS: This prospective study included 129 people with severe obesity in two groups; the LSG group (n=74) subjected to surgery and the diet group (n=55), managed by a diet regimen and lifestyle modification. Cardiovascular risk was assessed by Framingham risk score (FRS) and coronary calcium score (CCS) measured by computed tomography initially and after 3 years. RESULTS: The two groups had a comparable CAD risk before treatment according to FRS or CCS. After treatment, CCS improved significantly in the LSG group (p=0.008) but not in the diet group (p=0.149). There was no correlation between FRS and CCS (r=0.005, p=0.952). Treatment resulted in significant weight reduction and improved fasting blood glucose and lipid profile in the two groups. The change of weight, blood glucose, and HDL, and remission of diabetes mellitus (DM) were significantly higher in the LSG group compared to the diet group. CONCLUSION: LSG may reduce the risk of developing future cardiovascular comorbidities evidenced by reducing CAC scores. Significant weight reduction and improvement of cardiovascular risk factors may recommend LSG as a cardioprotective procedure in people with severe obesity.

Control of COVID-19 system using a novel nonlinear robust control algorithm.

COVID-19 has been a worldwide concern since the outbreak. Many strategies have been involved such as suppression and mitigation strategies to deal with this epidemic. In this paper, a new mathematical-engineering strategy is introduced in order to control the COVID-19 epidemic. Thereby, control theory is involved in controlling the unstable epidemic alongside with the other suggested strategies until the vaccine will hopefully be invented as soon as possible. A new robust control algorithm is introduced to compensate the COVID-19 nonlinear system by propose a proper controller after using necessary assumptions and analysis are made. In addition, the Variable Transformation Technique (VTT) is used to simplify the COVID-19 system. Furthermore, the Most Valuable Player Algorithm (MVPA) is applied in order to optimize the parameters of the proposed controller. The simulation results are based on the daily reports of two cities Hubei (China) and Lazio (Italy) since the outbreak. It can be concluded that the proposed control algorithm can effectively compensate the COVID-19 system. In addition, it can be considered as an effective mathematical-engineering strategy to control this epidemic alongside with the other strategies.

Sengers syndrome: a rare case of cardiomyopathy combined with congenital cataracts in an infant: post-mortem case report.

Sengers syndrome is a rare autosomal recessive disorder caused by a mutation in the Acylglycerol Kinase (AGK) gene with subsequent mitochondrial dysfunction. It is a combination of cardiomyopathy, skeletal myopathy, congenital bilateral cataracts, and lactic acidosis following exertion. The current study describes an extremely rare case of Sengers syndrome that is diagnosed during post-mortem examination. A four-month-old female child underwent sudden cardiac arrest immediately following the induction of general anesthesia for lens extraction surgery. This infant was the first child born to healthy, non-consanguineous, Egyptian parents. There were unremarkable medical problems either during pregnancy or during delivery. This infant was born at term with a normal APGAR score and weight. She had congenital bilateral cataracts since birth, easily-fatigued, and delayed milestones for her age. A post-mortem examination revealed a hypertrophied heart that weighed 96.6 grams with left ventricular hypertrophy. The left ventricle free wall thickness was 1cm, and an interventricular septum thickness of 1.3 cm. Histopathologically, the myocardium showed myocytes disarray. Also, the myocytes were hypertrophied, and vacuolated. The Gömöri trichrome stain revealed vacuolated cardiomyocytes surrounded by collagenous connective tissue, and the Periodic Acid Schiff (PAS) stain excluded that these vacuolations were related to glycogen storage disease. Focal lymphocytic infiltrations were observed within the myocardium. Thus, Sengers syndrome should be taken into consideration as a possible diagnosis whenever a congenital cataract is present for clinical and medicolegal cases.

Comparative Evaluation of Surface Quality, Tool Wear, and Specific Cutting Energy for Wiper and Conventional Carbide Inserts in Hard Turning of AISI 4340 Alloy Steel.

This paper presents an experimental study into the comparative response of wiper and round-nose conventional carbide inserts coated with TiCN + AL2O3 + TiN when turning an AISI 4340 steel alloy. The optimal process parameters, as identified by pre-experiments, were used for both types of inserts to determine the machined surface quality, tool wear, and specific cutting energy for different cutting lengths. The wiper inserts provided a substantial improvement in the attainable surface quality compared with the results obtained using conventional inserts under optimal cutting conditions for the entire range of the machined lengths. In addition, the conventional inserts showed a dramatic increase in roughness with an increased length of the cut, while the wiper inserts showed only a minor increase for the same length of cut. A scanning electron microscope was used to examine the wear for both types of inserts. Conventional inserts showed higher trends for both the average and maximum flank wear with cutting length compared to the wiper inserts, except for lengths of 200-400 mm, where conventional inserts showed less average flank wear. A higher accumulation of deposited chips was observed on the flank face of the wiper inserts than the conventional inserts. The experimental results demonstrated that edge chipping was the chief tool wear mechanism on the rake face for both types of insert, with more edge chipping observed in the case of the conventional inserts than the wiper inserts, with negligible evidence of crater wear in either case. The wiper inserts were shown to have a higher specific cutting energy than those detected with conventional inserts. This was attributed to (i) the irregular nose feature of the wiper inserts differing from the simpler round nose geometry of the conventional inserts and (ii) a higher tendency of chip accumulation on the wiper inserts.

Dissolution and powder flow characterization of solid self-emulsified drug delivery system (SEDDS).

In this study, the dynamics of powder flow upon griseofulvin-self-emulsified drug delivery system (SEDDS) addition to silica and silicates and the effect of these adsorbents on drug release were investigated. SEDDS was adsorbed at SEDDS/adsorbent ratios from 0.25:1 to 3:1 on magnesium aluminum silicate [5 and 80 microm], calcium silicate [25 microm], and silicon dioxide [3.6, 20, and 300 microm]. Powder flow was evaluated using the powder rheometer and compared to angle of repose. Release of drug from a 1:1 SEDDS/adsorbent powder was determined by dissolution using USP Type 2 apparatus. Powder rheometer profiles indicated that effect of SEDDS on the flow behavior of the adsorbents could be correlated to stepwise or continuous growing behavior as observed in wet granulation process. However, due to their porous nature, adsorbents exhibited an initial lag phase during which no change in flow was observed. Dissolution of drug from adsorbed-SEDDS was found to be dependent on pore length and nucleation at the lipid/adsorbent interface. Increase in dissolution rate was observed with an increase in surface area and was independent of the chemical nature of the adsorbents. Therefore, in order to manufacture free flowing powder containing liquid SEDDS, special attention should be given to particle size, specific surface area, type and amount of adsorbent.

Comparison between lipolysis and compendial dissolution as alternative techniques for the in vitro characterization of alpha-tocopherol self-emulsified drug delivery systems (SEDDS).

In vitro characterization of alpha-tocopherol SEDDS formulations was performed by (1) lipolysis in bio-relevant media, and (2) physical assessment by dissolution, particle size, and turbidity analyses. Both methods were statistically correlated using a 25-run, five-factor multiple-level d-optimal mixture design. Independent variables were SEDDS composition [vitamin E (12.5-25%), Tween 80 (10-40%), labrasol (0-10%), alcohol (0-10%), and captex 355 (20-50%)]. Measured responses were percent lipolysis, percent vitamin E retained in the aqueous layer of the digestion medium, and percent vitamin E dissolved in the dissolution medium. Percent lipolysis ranged from 0% to 66.3%. Percent vitamin E retrieved in the aqueous layer of the digestion and dissolution media ranged from 3% to 29.3% and from 25.9% to 101.7%, respectively. Turbidity ranged from 28 to 403JTU and the average droplet size was >1.0 microm. All formulation ingredients had significant (p<0.05) effect on percent lipolysis. Only two factors, Tween and vitamin E had significant effect on vitamin retention in the aqueous layer post-lipolysis. Tween, labrasol, and captex 355 had significant effect on vitamin E dissolution. Poor correlation was observed between the responses. Formulation ingredients influenced each response differently; and therefore, each method can only reveal distinctive characteristics of the SEDDS formulation and may not be used interchangeably.

Characterization of ITO/CdO/glass thin films evaporated by electron beam technique.

A thin buffer layer of cadmium oxide (CdO) was used to enhance the optical and electrical properties of indium tin oxide (ITO) films prepared by an electron-beam evaporation technique. The effects of the thickness and heat treatment of the CdO layer on the structural, optical and electrical properties of ITO films were carried out. It was found that the CdO layer with a thickness of 25 nm results in an optimum transmittance of 70% in the visible region and an optimum resistivity of 5.1×10-3 Ω cm at room temperature. The effect of heat treatment on the CdO buffer layer with a thickness of 25 nm was considered to improve the optoelectronic properties of the formed ITO films. With increasing annealing temperature, the crystallinity of ITO films seemed to improve, enhancing some physical properties, such as film transmittance and conductivity. ITO films deposited onto a CdO buffer layer heated at 450 °C showed a maximum transmittance of 91% in the visible and near-infrared regions of the spectrum associated with the highest optical energy gap of 3.61 eV and electrical resistivity of 4.45×10-4 Ω cm at room temperature. Other optical parameters, such as refractive index, extinction coefficient, dielectric constant, dispersion energy, single effective oscillator energy, packing density and free carrier concentration, were also studied.

Serum interleukin-6 in systemic sclerosis and its correlation with disease parameters and cardiopulmonary involvement.

OBJECTIVE: To assess serum interleukin-6 (IL-6)level in patients with systemic sclerosis (SSc) and its correlations with European Scleroderma Study Group activity score (EUSTAR), Scleroderma Assessment Questionnaire (SAQ), disability index and cardiopulmonary involvement. METHODS: Twenty SSc patients and 10 matched healthy controls were included. Serum IL-6 was measured in patients and controls. Disease activity, status,and disability were assessed.Cardiopulmonary involvement was evaluated by pulmonary function tests (PFTs), six minute walk test, echocardiography, and high resolution computed tomography (HRCT) of chest. RESULTS: Serum level of IL-6 was significantly higher in patients with SSc (6.3± 1.4pg/ml) versus healthy controls (3.2± 0.4pg/ml) (P=0.002). IL-6 level showed positive correlations with disease duration (r=0.49, P=0.03), EUSTAR score (r=0.64, P=0.002), Index of Respiratory Status "IRS" (r=0.46, P=0.001), Index of Musculoskeletal Status "IMSS" (r=0.45, P=0.049), Index of Vascular Status "IVS" (r=0.39, P=0.04), mean and peak of pulmonary artery pressure (r=0.44 & 0.55, P=0.02 & 0.002 respectively). Negative correlations of IL-6 level with DLCO% (r=-0.49, P=0.006),six minute walk distance (6MWD) (r=-0.52, P= 0.003) and right ventricle fraction area change (r=-0.48, P=0.03) were found, while there were strong positive correlations with HRCT-ground glass score (r=0.77, P=0.0001) and HRCT-fibrosis score (r=0.62, P=0.003). CONCLUSION: IL-6 level is increased in patients with SSc and significantly correlates with EUSTAR score, IRS, DLCO, 6MWD, HRCT scores, and echocardiographic abnormalities of the right side of the heart. These results support the role of IL-6 in the disease activity and in the development of cardiopulmonary manifestations in SSc patients.

Oxcarbazepine-loaded polymeric nanoparticles: development and permeability studies across in vitro models of the blood-brain barrier and human placental trophoblast.

Encapsulation of antiepileptic drugs (AEDs) into nanoparticles may offer promise for treating pregnant women with epilepsy by improving brain delivery and limiting the transplacental permeability of AEDs to avoid fetal exposure and its consequent undesirable adverse effects. Oxcarbazepine-loaded nanoparticles were prepared by a modified solvent displacement method from biocompatible polymers (poly(lactic-co-glycolic acid) [PLGA] with or without surfactant and PEGylated PLGA [Resomer(®) RGPd5055]). The physical properties of the developed nanoparticles were determined with subsequent evaluation of their permeability across in vitro models of the blood-brain barrier (hCMEC/D3 cells) and human placental trophoblast cells (BeWo b30 cells). Oxcarbazepine-loaded nanoparticles with encapsulation efficiency above 69% were prepared with sizes ranging from 140-170 nm, polydispersity indices below 0.3, and zeta potential values below -34 mV. Differential scanning calorimetry and X-ray diffraction studies confirmed the amorphous state of the nanoencapsulated drug. The apparent permeability (Pe ) values of the free and nanoencapsulated oxcarbazepine were comparable across both cell types, likely due to rapid drug release kinetics. Transport studies using fluorescently-labeled nanoparticles (loaded with coumarin-6) demonstrated increased permeability of surfactant-coated nanoparticles. Future developments in enzyme-prodrug therapy and targeted delivery are expected to provide improved options for pregnant patients with epilepsy.

Inbreeding, outbreeding and RAPD markers studies of faba bean (Vicia faba L.) crop.

Five faba bean genotypes (Vicia faba L.) were selfed for two cycles to produce S1 and S2 generations. A half-diallel cross was carried out among them in each level of inbreeding (S0, S1 and S2) to obtain 10 F1 hybrids. Parental materials as well as their respective F1s were evaluated during the winter season of 2012. All studied traits except total dry seed yield showed significant inbreeding depression after the first generation of selfing (S1). No further decrease was noticed at the S2 generation. In the S1 generation the degree of inbreeding depression was highest for No. of branches/plant (-14.0%) and the least for weight of 100-seeds (-2.7). Some parents showed inbreeding vigor i.e. positive difference between S2 and S1 for some traits in S2 generation. Most studied traits showed significant positive heterosis values over mid-parent. The highest value of heterosis over the mid-parent was detected for total dry seed yield (128.8) and the lowest value of hybrid vigor was shown by weight of 100-seeds (1.2%). Specific combination among the 5 parental genotypes showed the highest value for heterosis for example cross Misr 2 × Giza 429 was the best cross for total dry seed yield, cross Giza 429 × Misr 1 for No. of branches/plant. Giza 429 is the best general combiner for most traits. Some crosses showed heterosis depression i.e. negative heterosis value in some traits. Hybridization among parental genotypes is recommended to be at the S1 or S2 generation. Twelve arbitrary primers produced different degrees of genetic polymorphism among the parental genotypes. A total of 65 amplification products were scored polymorphic. The percentage of polymorphic bands detected ranged from 33% to 100% with an average of 66.47%. The average of amplified bands was 5.42 polymorphic bands per primer. A positive, but non-significant, correlation (r = 0.085) between Euclidean distance and RAPD distance was observed.

Developmental analysis of carbohydrate metabolism in tomato (Lycopersicon esculentum cv. Micro-Tom) fruits.

Carbohydrate metabolism during the development of fruits of the tomato cultivar Micro-Tom was studied. The metabolism of the pericarp and placental tissues was found to be different. Starch was degraded more slowly in the placenta in comparison with the pericarp, whereas soluble sugars accumulated to a greater extent in the pericarp. The activities of glycolytic enzymes tended to peak at 40 days after flowering. Two of these, phosphoenolpyruvate phosphatase and pyruvate kinase, showed a dramatic increase in activity just before this peak, possibly indicating a role in up-regulating glycolysis to generate increased ATP that would be used during climacteric respiration. The expression of plastidial transporters was studied. Both the TPT and Glu6P transporter were expressed greatest in green fruits, before declining. The expression of the triose-phosphate transporter was greater than that of the glucose 6-phosphate transporter. The ATP/ADP transporter was expressed to a low level throughout fruit development.

Nanomedicine for uterine leiomyoma therapy.

BACKGROUND: The purpose of this work was to engineer polymeric nanoparticles to encapsulate and deliver 2-methoxyestradiol, a potential antitumor drug for treatment of uterine leiomyoma (fibroids), the most common hormone-dependent pathology affecting women of reproductive age. METHODS/RESULTS: Encapsulation efficiency and drug release from the nanoparticles were monitored by HPLC. Cell morphology and in vitro cytotoxicity experiments were carried out in a human leiomyoma cell line. The nanoparticles displayed high encapsulation efficiency (>86%), which was verified by differential scanning calorimetry and x-ray diffraction. Excellent long-term stability of the nanoparticles and gradual drug release without burst were also observed. Cellular uptake of fluorescent nanoparticles was confirmed by confocal imaging. The drug-loaded poly(lactic acid) and poly(lactic-co-glycolic acid) nanoparticles induced cytotoxicity in human leiomyoma cells to a significantly greater extent than the free drug at 0.35 µM. CONCLUSION: This novel approach represents a potential fertility-preserving alternative to hysterectomy.

Preparation, characterization, and transport of dexamethasone-loaded polymeric nanoparticles across a human placental in vitro model.

The purpose of this study was to prepare dexamethasone-loaded polymeric nanoparticles and evaluate their potential for transport across human placenta. Statistical modeling and factorial design was applied to investigate the influence of process parameters on the following nanoparticle characteristics: particle size, polydispersity index, zeta potential, and drug encapsulation efficiency. Dexamethasone and nanoparticle transport was subsequently investigated using the BeWo b30 cell line, an in vitro model of human placental trophoblast cells, which represent the rate-limiting barrier for maternal-fetal transfer. Encapsulation efficiency and drug transport were determined using a validated high performance liquid chromatography method. Nanoparticle morphology and drug encapsulation were further characterized by cryo-transmission electron microscopy and X-ray diffraction, respectively. Nanoparticles prepared from poly(lactic-co-glycolic acid) were spherical, with particle sizes ranging from 140 to 298 nm, and encapsulation efficiency ranging from 52 to 89%. Nanoencapsulation enhanced the apparent permeability of dexamethasone from the maternal compartment to the fetal compartment more than 10-fold in this model. Particle size was shown to be inversely correlated with drug and nanoparticle permeability, as confirmed with fluorescently labeled nanoparticles. These results highlight the feasibility of designing nanoparticles capable of delivering medication to the fetus, in particular, potential dexamethasone therapy for the prenatal treatment of congenital adrenal hyperplasia.

Cancer incidence in Jordan from 1996 to 2009--a comprehensive study.

BACKGROUND: Cancer is a major health problem facing the entire world, and Jordan is no exception. However, patterns of cancer incidence and cancer burden in Jordan have never been explored thoroughly, and the aim of this study was to close this knowledge gap. MATERIALS AND METHODS: The study was based on data obtained from the Jordan cancer registry from 1996 to 2009. All cancer cases that were diagnosed during the study period were registered and included in this study. RESULTS: A total of 51,626 cases were registered in Jordan during the 14- year period. The incidence rate showed no significant increase in males (percent change PC 6.8%), while in females a marked increase was observed (PC 14.8%). The major cancer sites for males were bronchus and lung, colorectal, bladder, leukemia and prostate. In females, the leading cancer sites were breast, colorectal, leukemia, thyroid and NHL. CONCLUSIONS: Compared to other countries in the region, Jordan has comparable rates. On the other hand the rates of cancer are markedly lower in Jordan compared to more industrialized countries such as the US and Europe. There was an overall increase in the incidence of cancer in Jordan, especially among females, which stresses the need for programs to raise awareness on the importance of early diagnosis and preventive life style measures.