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AIM: To explore the disruptive influence of workplace gaslighting behaviours and mobbing on nurses' career entrenchment across multiple healthcare centres. DESIGN: A multi-centre cross-sectional. METHODS: Data were collected from 483 nurses from various healthcare settings in Egypt, spanning from January 2024 to February 2024. The Gaslighting at Work Questionnaire, Luxembourg Workplace Mobbing Scale and Career Entrenchment Scale were employed for data collection. RESULTS: The study revealed moderate levels of gaslighting, mobbing and nurses' career entrenchment. Also, there is a negative correlation between nurses' career entrenchment and both gaslighting and mobbing, while gaslighting and mobbing exhibit a positive correlation. The study also highlighted regional disparities in the prevalence of these phenomena, with the highest incidences noted in urban healthcare settings. CONCLUSION: The findings underscore the critical impact of workplace gaslighting and mobbing on nurses' career entrenchment. REPORTING METHOD: The relevant reporting method has been adhered to, that is, STROBE. IMPLICATION FOR THE PROFESSION: The future of the nursing profession requires building productive nurses who can cope with negative workplace experiences. This could be achieved by cultivating a workplace culture that has zero tolerance for these experiences. Offering counselling services or employee assistance programmes to help nurses cope with the emotional toll of these negative experiences is a promising strategy. IMPACT: This study is the first to examine serious workplace practices like gaslighting and mobbing in a nursing context, emphasizing their effect on nursing-sensitive indicators like career entrenchment. It is one of the important initiatives geared towards upgrading the competitiveness and magnetism of healthcare organizations in the era of green human resources management. Results provide valuable insights for nurse leaders to control nursing turnover and shortage crises in different endeavours. PATIENT OR PUBLIC CONTRIBUTION: In our study, nurses from diverse geographical regions and varied specialties actively participate, offering a rich tapestry of experiences and perspectives.
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BACKGROUND: Controlling smartphone addiction and procrastination among nurses is crucial for enhancing the productivity of both nursing and the healthcare system. Critical care nurses are highly vulnerable to smartphone addiction and procrastination behaviors than other groups. They may purposefully delay their tasks, a practice known as active procrastination, or inadvertently delay them, a practice known as passive procrastination. AIM: This study was designed to assess the prevalence of smartphone addiction and procrastination behavior among nurses, examine the effect of smartphone addiction on the active and passive procrastination behaviors, and explore the correlation between active and passive procrastination behaviors among nurses. METHOD: This is a descriptive correlational exploratory study that was conducted at 23 critical care units of one large educational hospital in Egypt. Data were collected from 360 nurses who were conveniently selected using three tools: the Smartphone Addiction Inventory, the New Active Procrastination Scale, and the Unintentional Procrastination Scale. Correlation and regression analyses were conducted to test the hypothetical relationship among the study variables. RESULTS: This study revealed that 55.0%, 80.0%, and 45.3% of nurses had a moderate perceived level of smartphone addiction, active procrastination behavior, and passive procrastination behavior, respectively. There is a significant positive correlation between smartphone addiction and both nurses' active and passive procrastination behaviors. Smartphone addiction accounts for 25% of the variance in nurses' active procrastination behavior and 18% of the variance in their passive procrastination. Furthermore, there is a moderately significant negative correlation between nurses' active procrastination behavior and their passive procrastination behavior. CONCLUSION: Nurses are exhibiting moderate levels of smartphone addiction and procrastination, which is a significant threat to the healthcare industry and nursing productivity. This requires technological, educational, and organizational interventions that foster active procrastination and combat passive procrastination behaviors among nurses. IMPLICATIONS: Continuous training programs are required to enhance time management skills among nurses and increase the awareness of nurse managers with the symptoms of smartphone addiction among nurses. Nurse leaders should early detect and address the addictive use of smartphones among nurses, identify potential procrastinators, and provide counseling to eradicate these behaviors in the workplace.
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BACKGROUND: Carpal tunnel syndrome (CTS) is a prevalent condition characterized by hand pain, tingling, and numbness. The severity of symptoms and functional status in CTS patients may be influenced by perceived stress and how individuals cope with it. However, scarce knowledge exists about the role of coping strategies as moderators in this relationship. Unfolding the role of perceived stress and coping strategies for CTS management will help the nurse to provide comprehensive and tailored nursing care. This will ultimately improve patient comfort, functionality, and quality of life. PURPOSES: This study aimed to examine the role of coping strategies (adaptive and maladaptive) in the relationship between perceived stress and both symptoms severity and function status among those patients. METHOD: We employed a multisite, correlational study design with moderation analysis. The study included 215 patients with CTS from neurosurgery outpatient clinics at three hospitals in Egypt. After obtaining their consent to participate, eligible participants completed anonymous, self-reported measures of perceived stress, the brief COPE inventory, and the Boston Carpal Tunnel Questionnaire. Demographic and biomedical data were also collected. The questionnaire took about 20 min to be completed. The data was collected over six months, starting in February 2023. RESULTS: The results showed that perceived stress, adaptive coping, and maladaptive coping were significant predictors of symptoms severity and functional status. Adaptive coping moderated the relationships between perceived stress and both symptoms severity and function status, while maladaptive coping did not. The interaction between perceived stress and adaptive coping explained a moderate effect on symptoms severity and function status after controlling for the main effects and the covariates. CONCLUSION: This study explored the relationship between perceived stress, coping strategies, and outcomes in patients with CTS. The results indicate that nurses play a vital role in assessing and assisting patients to adopt effective coping strategies to manage perceived stress and alleviate symptoms and functional impairment. Moreover, the findings support the need for psychological interventions that address both perceived stress and coping strategies as a way to enhance the functioning status and quality of life of patients with CTS.
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AIM: This study aims to explore the relationship between collaborative leadership and nurses' productive work performance as well as the mediating role of nurses' innovative behavior in this relationship. BACKGROUND: Collaborative leadership is an imperative necessity in the contemporary turbulent healthcare environment as it provides a collaborative atmosphere where innovative behavior and productive performance of nurses are fostered, hence moving healthcare organizations toward competitiveness and sustainability. METHOD: A cross-sectional descriptive correlational exploratory research design was used to conduct the study. Data were collected from 550 nurses recruited from three large university hospitals in Alexandria, Egypt, using three instruments, namely, interprofessional collaborative leadership in healthcare teams scale, productive work performance questionnaire, and innovative behavior inventory. The instruments of the study are Likert-type questionnaires through which nurses' perspectives regarding study variables were investigated. We used descriptive statistics, inferential statistics as well as structured equation modeling (SEM). RESULTS: SEM revealed that collaborative leadership accounted for 83% of the variance of individual productive work performance and 77% of the variance of nurses' innovative behavior. Moreover, nurses' innovative behavior partially mediates the relationship between collaborative leadership and their productive work performance. CONCLUSION: Collaborative leadership practices are powerful strategies to enhance the innovative behavior of nurses and sustain their productive work performance. IMPLICATIONS FOR NURSING AND HEALTH POLICY: Fostering a collaborative atmosphere in workplace is mandatory for nurses' innovativeness. Replacing hierarchal leadership styles with collaborative ones is a promising strategy to enhance the productive performance of nurses. Healthcare managers and leaders could cultivate an interprofessional collaborative culture in the workplace in order to sustain productivity and eradicate counterproductive work behaviors among healthcare providers.
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AIM: This study was designed to examine the relationship between humble leadership and nurses' turnover intention and investigate the moderating role of leader expertise in this relationship. BACKGROUND: Leader humility and expertise are two key dimensions of professional spirit in competitive magnet organizations. Many organizational factors could make nurses take a decision to leave their organization; however, leader humility and expertise could help nurses retract from this decision. METHOD: This is a multisite cross-sectional study that was conducted at all medical-surgical units of four university hospitals. Using scales for assessing leader humility, nurses' turnover intention, and leader expertise, 385 nurses were surveyed. Data were investigated via descriptive and inferential statistics, where correlation, path analysis, and structured equation modeling were used to test the hypothetical relationship among study variables. RESULTS: There is a statistically significant negative relationship between humble leadership and nurses' turnover intention. Humble leadership and leader expertise were significant predictors of nurses' turnover intention. The moderating effect of leader expertise on the relationship between humble leadership and nurses' turnover intention was statistically significant, making it more negative, implying that leader expertise amplifies the effect of leader humility on reducing nurses' turnover. CONCLUSION: Incorporating leader expertise with humility could provide an efficient panacea for reducing turnover intentions among nurses in different healthcare organizations. IMPLICATIONS FOR NURSING AND HEALTH POLICY: Healthcare organizations could develop an efficient retention plan for nurses by cultivating humility among both leaders and nurses. In addition, building nurse leaders' expertise through opening avenues for professional development is a good strategy in the face of nurses' shortage and high turnover. Furthermore, succession planning in healthcare organizations must consider humility as a vital skill among anticipated leaders.
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BACKGROUND: Stress and conflict in emergency departments are inevitable but can be managed. A supportive work environment is key to helping emergency care providers, especially nurses, constructively manage work-related stress and conflict. AIM: The aim of this study was to assess the influence of supportive work environments on work-related stress and conflict management style among emergency care nurses. METHODS: A descriptive correlational research design was utilized. Data were collected from 221 staff nurses recruited from two university hospital emergency departments in Alexandria, Egypt. Three instruments were used: (1) perceived organizational support scale, (2) nurses' occupational stressors scale, and (3) conflict management style inventory. RESULTS: There was a highly significant correlation between supportive work environments and work-related stress (p = .000) and a significant correlation between supportive work environments and conflict management style (p = .026). Supportive work environments had a significant inverse negative relationship with work-related stress experienced by nurses (p = .001) and accounted for 51% of variance in work-related stress. Meanwhile, supportive work environments had a significant positive relationship with conflict management styles of nurses (p = .026). Work-related stress had a significant relationship with nurses' conflict management style (p = .000) and accounted for 45% of the variance in conflict management style. LINKING EVIDENCE TO ACTION: The style of conflict management modeled by staff within emergency departments can positively or negatively influence the work environment and level of work-related stress. There is a necessity to cultivate a supportive culture for nurses in emergency departments to develop skills for constructive conflict management styles to reduce work-related stress.
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Servicios Médicos de Urgencia , Personal de Enfermería en Hospital , Estrés Laboral , Humanos , Conflicto Psicológico , Condiciones de Trabajo , Encuestas y CuestionariosRESUMEN
Organic-inorganic metal hybrids with their tailorable lattice dimensionality and intrinsic spin-splitting properties are interesting material platforms for spintronic applications. While the spin decoherence process is extensively studied in lead- and tin-based hybrids, these systems generally show short spin decoherence lifetimes, and their correlation with the lattice framework is still not well-understood. Herein, we synthesized magnetic manganese hybrid single crystals of (4-fluorobenzylamine)2MnCl4, ((R)-3-fluoropyrrolidinium)MnCl3, and (pyrrolidinium)2MnCl4, which represent a change in lattice dimensionality from 2D and 1D to 0D, and studied their spin decoherence processes using continuous-wave electron spin resonance spectroscopy. All manganese hybrids exhibit nanosecond-scale spin decoherence time τ2 dominated by the symmetry-directed spin exchange interaction strengths of Mn2+-Mn2+ pairs, which is much longer than lead- and tin-based metal hybrids. In contrast to the similar temperature variation laws of τ2 in 2D and 0D structures, which first increase and gradually drop afterward, the 1D structure presents a monotonous rise of τ2 with the temperatures, indicating the strong correlation of spin decoherence with the lattice rigidity of the inorganic framework. This is also rationalized on the basis that the spin decoherence is governed by the competitive contributions from motional narrowing (prolonging the τ2) and electron-phonon coupling interaction (shortening the τ2), both of which are thermally activated, with the difference that the former is more pronounced in rigid crystalline lattices.
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BACKGROUND: Clinical experience is an important component of nursing education because it translates students' knowledge into practice, which serves as the cornerstone of nursing practice in health care delivery. PURPOSE: The study aims to explore the quality attributes required for optimizing the training system of nursing internship students using Kano model. METHODS: A concurrent exploratory sequential triangulation design was used for mixed-methods research. A total of 295 nursing internship students (Target Population) were recruited (whole-population sampling) from the study settings in Egypt. Of them, 280 (97.2%) agreed to participate in the study and completed the interview and the self-administered questionnaire. Data collection was done over 6 months from February to August, 2022. Inferential statistics and thematic data analysis were used to analyze the results. RESULTS: Findings revealed that there were 35 fundamental attributes required for high-quality nursing students' internship training. Kano model was used to categorize and prioritize the 35 quality attributes. Kano analysis revealed that 22 attributes were categorized as "attractive" and 11 attributes were as categorized as "must be" and two were indifferent attributes. CONCLUSION: Incorporating the voice of nurse interns during their training is the key to providing efficient and high-quality internship training experience. It could give realistic impressions about the drawbacks of training and proposed solutions. IMPLICATIONS OF THE STUDY: Nurse managers and educators in clinical settings and educational institutions should put much emphasis on the training attributes and pillars to ensure that nursing internship students are mastering the skills of competent alumni. Provision of conducive training environment that fulfill the basic needs of internship students to maintain passion for learning as well as commitment of internship students to nursing profession will improve the satisfaction level and quality of education, training, and practice. Also, incorporating internship students support system with motivation strategies are helpful tools to maintain exemplary performance of internship students during the training period.
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BACKGROUND: Perioperative missed nursing care is a serious issue that can compromise patient safety and quality of care. However, little is known about the factors that influence perioperative missed nursing care. AIM: This study aimed to examine the effects of job embeddedness and polychronicity on perioperative missed nursing care as well as to test the mediating role of polychronicity on the relationship between job embeddeness and perioperative missed nursing care. METHOD: This was a cross-sectional correlational study that used a convenience sample of 210 operating room nurses from nine hospitals in Egypt. Data were collected using self-administered questionnaires that measured job embeddedness, polychronicity, and perioperative missed nursing care. Structural equation modeling was used to test the hypothesized relationships among the variables. RESULTS: The findings demonstrated a significant negative and moderate association between missed perioperative care and both nurses' job embeddedness and polychronicity. Moreover, there was a moderately positive and significant correlation between polychronicity and job embeddedness. Path analysis revealed a significant positive causal effect between job embeddedness and polychronicity. The results of mediation revealed that the indirect effect of job embeddedness on missed care through polychronicity was statistically significant; suggesting that polychronicity partially mediated this relationship. CONCLUSION: This study sheds light on the intricate relationship between nurses' job embeddedness, missed care, and polychronicity in the operating theater context. By enhancing job embeddedness and fostering polychronicity among nurses, healthcare organizations can reduce perioperative missed care and ultimately improve patient care outcomes in this critical healthcare setting.
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Ultrathin ferroelectrics hold great promise for modern miniaturized sensors, memories, and optoelectronic devices. However, in most ferroelectric materials, polarization is destabilized in ultrathin films by the intrinsic depolarization field. Here we report robust in-plane ferroelectricity in few-layer tin sulfide (SnS) 2D crystals that is coupled anisotropically to lattice strain. Specifically, the intrinsic polarization of SnS manifests as nanoripples along the armchair direction due to a converse piezoelectric effect. Most interestingly, such nanoripples show an odd-and-even effect in terms of its layer dependence, indicating that it is highly sensitive to changes in inversion symmetry. Ferroelectric switching is demonstrated in field-effect transistor devices fabricated on ultrathin SnS films, in which a stronger ferroelectric response is achieved at negative gate voltages. Our work shows the promise of 2D SnS in ultrathin ferroelectric field-effect transistors as well as nanoscale electromechanical systems.
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Hybrid organic-inorganic perovskites (HOIPs) are a new generation of high-performance materials for solar cells and light emitting diodes. Beyond these applications, ferroelectricity and spin-related properties of HOIPs are increasingly attracting interests. The presence of strong spin-orbit coupling, allied with symmetry breaking ensured by remanent polarization, should give rise to Rashba-type splitting of electronic bands in HOIP. However, the report of both ferroelectricity and Rashba effect in HOIP is rare. Here we report the observation of robust ferroelectricity and Rashba effect in two-dimensional Dion-Jacobson perovskites.
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Due to their layered structure, two-dimensional Ruddlesden-Popper perovskites (RPPs), composed of multiple organic/inorganic quantum wells, can in principle be exfoliated down to few and single layers. These molecularly thin layers are expected to present unique properties with respect to the bulk counterpart, due to increased lattice deformations caused by interface strain. Here, we have synthesized centimetre-sized, pure-phase single-crystal RPP perovskites (CH3(CH2)3NH3)2(CH3NH3)n-1PbnI3n+1 (n = 1-4) from which single quantum well layers have been exfoliated. We observed a reversible shift in excitonic energies induced by laser annealing on exfoliated layers encapsulated by hexagonal boron nitride. Moreover, a highly efficient photodetector was fabricated using a molecularly thin n = 4 RPP crystal, showing a photogain of 105 and an internal quantum efficiency of ~34%. Our results suggest that, thanks to their dynamic structure, atomically thin perovskites enable an additional degree of control for the bandgap engineering of these materials.
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In continuation of our research program aiming at developing new potent antimicrobial agents, new series of substituted 3,4-dihydrothieno[2,3-d]pyrimidines was synthesized. The newly synthesized compounds were preliminary tested for their in vitro activity against six bacterial and three fungal strains using the agar diffusion technique. The results revealed that compounds 7, 8a, 10b, 10d and 11b exhibited half the potency of levofloxacine against the Gram-negative bacterium, Pseudomonas aeruginosa, while compounds 5a, 8b, 10c and 12 displayed half the potency of levofloxacine against Proteus Vulgaris. Whereas, compounds 7, 10b, 10d and 11b showed half the activity of ampicillin against the Gram-positive bacterium, B. subtilis. Most of the compounds showed high antifungal potency. Compounds 3, 6, 7, 9b, 10a, 11a, 11b, 15 and 16 exhibited double the potency of clotrimazole against A. fumigatus. While compounds 3, 4, 5a, 5b, 9b, 10a, 10b, 10c, 13, 15, 16 and 18 displayed double the activity of clotrimazole against R. oryazae. Molecular docking studies of the active compounds with the active site of the B. anthracis DHPS, showed good scoring for various interactions with the active site of the enzyme compared to the co-crystallized ligand.
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Antibacterianos/farmacología , Antifúngicos/farmacología , Simulación del Acoplamiento Molecular , Pirimidinas/farmacología , Antibacterianos/síntesis química , Antibacterianos/química , Antifúngicos/síntesis química , Antifúngicos/química , Aspergillus fumigatus/efectos de los fármacos , Bacillus subtilis/efectos de los fármacos , Relación Dosis-Respuesta a Droga , Pruebas de Sensibilidad Microbiana , Estructura Molecular , Proteus vulgaris/efectos de los fármacos , Pseudomonas aeruginosa/efectos de los fármacos , Pirimidinas/síntesis química , Pirimidinas/química , Relación Estructura-ActividadRESUMEN
Antibiotic-resistant bacteria continue to play an important role in human health and disease. Inventive strategies are necessary to develop new therapeutic leads to challenge drug-resistance problems. From this perception, new quinoline hybrids bearing bioactive pharmacophores were synthesized. The newly synthesized compounds were evaluated for their in vitro antibacterial activity against nine bacterial pathogenic strains. The results revealed that most compounds exhibited good antibacterial activities. Seven compounds (2b, 3b, 4, 6, 8b, and 9c,d) displayed enhanced activity against methicillin-resistant Staphylococcus aureus compared to ampicillin. These compounds were subjected to an in vitro S. aureus DNA gyrase ATPase inhibition study, which revealed that compounds 8b, 9c, and 9d showed the highest inhibitory activity with IC50 values of 1.89, 2.73, and 2.14 µM, respectively, comparable to novobiocin (IC50 , 1.636 µM). Compounds 2a-c, 3a, 7c, 9c,d, and 10a,b revealed half the potency of levofloxacin in inhibiting the growth of Pseudomonas aeruginosa. As an attempt to rationalize the observed antibacterial activity for the most active compounds 8b, 9c, and 9d, molecular docking in the ATP binding site of S. aureus gyrase B was performed using Glide. Such compounds could be considered as promising scaffolds for the development of new potent antibacterial agents.
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Antibacterianos/síntesis química , Staphylococcus aureus Resistente a Meticilina/efectos de los fármacos , Quinolinas/síntesis química , Inhibidores de Topoisomerasa II/síntesis química , Antibacterianos/química , Antibacterianos/farmacología , Sitios de Unión , Diseño de Fármacos , Humanos , Concentración 50 Inhibidora , Staphylococcus aureus Resistente a Meticilina/enzimología , Pruebas de Sensibilidad Microbiana , Simulación del Acoplamiento Molecular , Estructura Molecular , Unión Proteica , Pseudomonas aeruginosa/efectos de los fármacos , Quinolinas/química , Quinolinas/farmacología , Inhibidores de Topoisomerasa II/química , Inhibidores de Topoisomerasa II/farmacologíaRESUMEN
Development of new antimicrobial agents is a good solution to overcome drug-resistance problems. From this perspective, new quinoxaline derivatives bearing various bioactive heterocyclic moieties (thiadiazoles, oxadiazoles, pyrazoles and thiazoles) were designed and synthesized. The newly synthesized compounds were evaluated for their in vitro antibacterial activity against nine bacterial human pathogenic strains using the disc diffusion assay. In general, most of the synthesized compounds exhibited good antibacterial activities. The thiazolyl 11c displayed significant antibacterial activities against P. aeruginosa (MIC, 12.5⯵g/mL vs levofloxacin 12.5⯵g/mL). Molecular docking studies indicated that the synthesized compounds could occupy both p-amino benzoic acid (PABA) and pterin binding pockets of the dihydropteroate synthase (DHPS), suggesting that the target compounds could act by the inhibition of bacterial DHPS enzyme. The results provide important information for the future design of more potent antibacterial agents.
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Antibacterianos/farmacología , Dihidropteroato Sintasa/antagonistas & inhibidores , Diseño de Fármacos , Quinoxalinas/farmacología , Antibacterianos/síntesis química , Antibacterianos/química , Antibacterianos/metabolismo , Dominio Catalítico , Dihidropteroato Sintasa/química , Dihidropteroato Sintasa/metabolismo , Bacterias Gramnegativas/efectos de los fármacos , Bacterias Grampositivas/efectos de los fármacos , Enlace de Hidrógeno , Interacciones Hidrofóbicas e Hidrofílicas , Levofloxacino/farmacología , Pruebas de Sensibilidad Microbiana , Simulación del Acoplamiento Molecular , Estructura Molecular , Unión Proteica , Quinoxalinas/síntesis química , Quinoxalinas/química , Quinoxalinas/metabolismo , Relación Estructura-Actividad , Yersinia pestis/enzimologíaRESUMEN
The 2H-to-1T' phase transition in transition metal dichalcogenides (TMDs) has been exploited to phase-engineer TMDs for applications in which the metallicity of the 1T' phase is beneficial. However, phase-engineered 1T'-TMDs are metastable; thus, stabilization of the 1T' phase remains an important challenge to overcome before its properties can be exploited. Herein, we performed a systematic study of the 2H-to-1T' phase evolution by lithiation in ultrahigh vacuum. We discovered that by hydrogenating the intercalated Li to form lithium hydride (LiH), unprecedented long-term (>3 months) air stability of the 1T' phase can be achieved. Most importantly, this passivation method has wide applicability for other alkali metals and TMDs. Density functional theory calculations reveal that LiH is a good electron donor and stabilizes the 1T' phase against 2H conversion, aided by the formation of a greatly enhanced interlayer dipole-dipole interaction. Nonlinear optical studies reveal that air-stable 1T'-TMDs exhibit much stronger optical Kerr nonlinearity and higher optical transparency than the 2H phase, which is promising for nonlinear photonic applications.
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Chondromyxoid fibroma (CMF) is a rare benign cartilage congener tumor comprising less than 1 % of primary bone tumors. Although the age range is wide, it is most commonly seen in the second and third decades. The most frequent location of CMF is in the long tubular bones of the lower extremities, particularly the proximal tibia and distal femur. Although the majority of chondromyxoid fibromas present as intramedullary tumors, a subgroup of chondromyxoid fibromas arising as surface lesions of the bone has recently been described. These are associated with an older mean age and an increased incidence of matrix calcifications. Chondromyxoid fibromas are rare in the distal ulna. We report a CMF presenting as a surface lesion of the distal metaphysis of the left ulna in a 41-year-old woman. We reviewed the literature on chondromyxoid fibromas involving the ulna and found that out of 22 cases, 1 was in the distal ulna, 13 in the proximal ulna, and in the remaining 8 the ulnar sites were unspecified. No case of chondromyxoid fibroma in the published literature had been designated as a surface lesion. Our own unpublished data include 70 chondromyxoid fibromas, 4 of which are in the ulna. Two of these are in the distal portion.
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Neoplasias Óseas/diagnóstico , Neoplasias Óseas/cirugía , Condroblastoma/diagnóstico , Fibroma/diagnóstico , Fibroma/cirugía , Adulto , Articulación del Codo/diagnóstico por imagen , Articulación del Codo/patología , Femenino , Humanos , Imagen por Resonancia Magnética , Radiografía , Resultado del Tratamiento , Cúbito/diagnóstico por imagen , Cúbito/patologíaRESUMEN
Background and Objectives: Stenotrophomonas maltophilia is an opportunistic pathogen causing nosocomial infections. Diclofenac is an anti-inflammatory drug that is considered a non-antibiotic drug. This study assessed the antibacterial and antibiofilm effects of diclofenac and levofloxacin/diclofenac combination against levofloxacin resistant isolates. Materials and Methods: Minimum inhibitory concentration was determined using broth microdilution method for levofloxacin, diclofenac, and levofloxacin/diclofenac combination. Biofilm forming capacity and biofilm inhibition assay were determined. Relative gene expression was measured for efflux pump genes; smeB, and smeF genes and biofilm related genes rmlA, spgM, and rpfF without and with diclofenac and the combination. Results: Diclofenac demonstrated MIC of 1 mg/ml. The combination-with ½ MIC diclofenac-showed synergism where levofloxacin MIC undergone 16-32 fold decrease. All the isolates that overexpressed smeB and smeF showed a significant decrease in gene expression in presence of diclofenac or the combination. The mean percentage inhibition of biofilm formation with diclofenac and the combination was 40.59% and 46.49%, respectively. This agreed with biofilm related genes expression investigations. Conclusion: Diclofenac showed an antibacterial effect against Stenotrophomonas maltophilia. The combination showed in-vitro synergism, significant reduction in biofilm formation and in the relative level of gene expression. Furthermore, it can potentiate the levofloxacin activity or revert its resistance.
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Withania somnifera (W. somnifera) has a long history of safety in the amelioration of neuro-active ailments. The current study aims to explore Withania somnifera phyto-active principle anti-microbial, ant-neuropathic, and anti-inflammatory activities, and to modify these activities utilizing nano-cubosomes exploiting their mechanisms of action. Bio-guided fractionation technique was utilized, to identify the most phyto-active compound, using LC-MS-NMR online technique and biological models of diabetes, neuropathy, and inflammation. In-vitro antibacterial activity was also monitored. The HbA1c, in-vivo antioxidant (serum-catalase, TBARS, and GSH), serum insulin, and pro-inflammatory serum cytokines (TNF alpha, IL-six, and IL-ten) levels have been assessed to establish the anti-neuropathic and anti-inflammatory mechanisms. The nano-cubosomal formulations (CUB 1-3) were utilized to improve the W. somnifera most active compound efficacy. W. somnifera has shown ten major peaks; coagulin Q (10.2 %), dihydrowithanolide A (2.4 %), dihydrowithaferin D (1.8 %), physagulin D (7.6 %), withanoside V (2.3 %), withanolide A (WDA, 10.3 %), withafrin A (4.9 %), withaferin D (7.7 %), withanone 9 (9.9 %), withanolide D (4.8 %). The bio-guided fractionation technique utilizing LC-MS-NMR technique has proved that withanolide A (WDA) is the most phyto-active compound in W. somnifera. The latter has shown better results than WDA, which might be due to other effective compounds in Ws. However, CUB 3 (WDA nano-cubosomes dispersion) has shown more prominent anti-diabetic, anti-neuropathic, anti-inflammatory, and anti-bacterial potentials than Ws and WDA. Thus, CUB 3 modified WDA activity, and improved its efficacy. The normalization of HbA1c levels, increased insulin secretagogue potential, and the amelioration of the oxidative-stress may be the underlying Ws, WDA, and CUB 3 antidiabetic neuropathy mechanism. Moreover, the Ws, WDA, and CUB 1-3 anti-inflammatory mechanism might be due to the amelioration of the pro-inflammatory serum cytokines (decreasing TNF alpha and IL-six levels and increasing IL-ten). Thus, CUB 3 might be a powerful tool in augmenting Withania somnifera activity as an oral drug-delivery system and improving its efficacy against neuropathy and inflammation.
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Two-dimensional hybrid organic-inorganic perovskites with chiral spin texture are emergent spin-optoelectronic materials. Despite the wealth of chiro-optical studies on these materials, their charge-to-spin conversion efficiency is unknown. We demonstrate highly efficient electrically driven charge-to-spin conversion in enantiopure chiral perovskites (R/S-MB)2(MA)3Pb4I13 (ãnã = 4), where MB is 2-methylbutylamine, MA is methylamine, Pb is lead, and I is iodine. Using scanning photovoltage microscopy, we measured a spin Hall angle θsh of 5% and a spin lifetime of ~75 picoseconds at room temperature in ãnã = 4 chiral perovskites, which is much larger than its racemic counterpart as well as the lower ãnã homologs. In addition to current-induced transverse spin current, the presence of a coexisting out-of-plane spin current confirms that both conventional and collinear spin Hall conductivities exist in these low-dimensional crystals.