Analyzing the impacts of climate change on ecosystem services provided by apple orchards in Southeast France using a process-based model.

We know that fruit production, especially in the Mediterranean, will need to adapt to climate change to ensure the sustainability of fruit tree-based agroecosystems. However, there is a lack of evidence on the long-term effects of this change on sustainability indicators. To fill this gap, we used a fruit tree model, QualiTree, to analyze the impacts ofclimate change on the ecosystem services provided by apple orchards in south-eastern France. To do this, a blooming model was parameterized to simulate blooming date on the basis of climate data, and QualiTree was supplemented with a model of nitrogen processes in the tree and a soil module describing resource input (irrigation, mineral and organic fertilization), transfer in the soil (water and nitrogen) and metabolic transformation-immobilization (mineralization, (de)nitrification). This type of extension makes it possible to simulate a wide array of ecosystem services, including C sequestration, nitrate leaching and nitrous oxide emissions. The model was compared with data from an apple orchard in southeastern France. The predicted daily mean and variability over time of fruit growth, composition and soil water content were consistent with observed data. QualiTree was then used to assess the potential impacts of climate change on the ecosystem services supplied by apple orchards. For this purpose, weather variables from 2020 to 2100 were generated for three contrasted greenhouse gas emission scenarios, and simulations were performed under two irrigation schemes (no restriction and restricted use of water). Model outputs indicated that, on average, marketable apple yields would increase until 2050 and then subsequently decrease. The fruit refractometric index, an indicator of fruit quality, was projected to sharply decrease with the intensity of climate change. Ecosystem services such as C sequestration by the orchard will decrease with climate change severity, mainly due to a higher mineralization of soil humus, whereas N2O emissions will increase with larger denitrification rates. Soil water availability, fertility, drainage and leaching were predicted to depend more on the irrigation strategy than on climate change severity. The new functions performed in QualiTree broadened its predictive capabilities and allowed for a better understanding of ecosystem service delivery in fruit orchards under varying climate conditions.

The effect of two preparation designs on the fracture resistance and marginal adaptation of two types of ceramic crowns using CAD/CAM technology (In vitro study).

BACKGROUND: Recently, prosthodontic approaches involve more conservative procedures that include less invasive finish line preparations that use less ceramic thickness. AIM OF THE STUDY: This in vitro study aimed to evaluate the effect of vertical preparation and modified vertical preparation designs on the marginal adaptation and fracture resistance of two types of ceramic crowns using CAD/CAM technology. MATERIALS AND METHODS: Two typodont maxillary first premolars were embedded in acrylic resin. Forty positive replicas of epoxy resin dies were used that were divided into two groups depending on the preparation design (n = 20); Group V (Vertical): dies with feather edge finish line and Group MV (Modified vertical): dies with feather edge finish line, where a reverse shoulder of 1 mm depth was placed on the buccal surface 1.5 mm from the occlusal surface. Each group was further subdivided into two subgroups according to the type of ceramic material (n = 10): Subgroup Va and subgroup MVa for lithium disilicate (e.max CAD) and subgroup Vb and subgroup MVb for zirconia (zolid ht+). Crown restorations were made with CAD-CAM technology. The marginal adaptation was assessed using a stereomicroscope both prior to cementation and after cementation and aging. Fracture resistance was tested with a universal testing machine, and the data were statistically analyzed. RESULTS: Marginal adaptation showed no significant differences between subgroups before or after cementation and aging. Three-way ANOVA indicated that preparation design (p = 0.516) and material (p = 0.269) had no significant effect, but cementation had a significant effect (p < 0.0001) on the marginal adaptation. According to two-way ANOVA test, Subgroup (MVb) showed the highest result followed by subgroup (Vb) and subgroub (MVa) and the least was subgroub (Va). Fracture modes showed no significant differences among the subgroups (p = 0.982). CONCLUSIONS: Marginal adaptation of lithium disilicate and zirconia crowns remained clinically acceptable regardless of preparation design. While the modified vertical preparation with a reverse shoulder notably enhanced the fracture resistance of both materials, with zirconia demonstrating superior fracture resistance compared to lithium disilicate with average values exceeding premolar biting force.

Innovative UPLC technique for concurrent quantification of etofenamate and benzyl nicotinate in the presence of methylparaben and benzyl alcohol in their topical cream: Greens, white, and Six Sigma methodologies.

The efficacious treatment of muscle and joint pain relies heavily on etofenamate (ETO) and benzyl nicotinate (BN), which possess robust anti-inflammatory and pain-relieving properties when paired with methylparaben (MP) or benzyl alcohol (BA). In this study, we have established and validated innovative RP-UPLC methods for assessing ETO and BN in the presence of MP or BA in their dosage forms, employing eight green tools to evaluate their eco-friendliness and effectiveness. Reversed phase-ultra-performance liquid chromatography (RP-UPLC) technique employs a flow rate of 0.3 mL/min on Waters Acquity UPLC BEH Column (C18, 1.7 µm, 100 mm × 2.1 mm), detection at 254 nm using a photo diode array (PDA) detector and mobile phase of 0.05 M KH2PO4 buffer, acetonitrile, and methanol (50:15:35, v/v/v) adjusted pH 6.0 with 0.2% triethylamine. For ETO, BN, MP, and BA, the calibration curves were linear and ranged from 0.005 to 1.0, from 0.001 to 0.2, from 0.002 to 0.08, and from 0.0001 to 0.1 mg/mL, respectively. The correlation value was 0.9999, and the accuracy findings ranged from 98.81% to 100.56%. Consequently, the methodology has been successfully implemented in assay testing for the pharmaceuticals in the presence of the MP or BA, demonstrating the high selectivity of these approaches. The present study presents the Blue Applicability Grade Index (BAGI), an innovative approach that complements green metrics in practical white analytical chemistry. According to the International Council for Harmonisation (ICH) criteria, the procedures were effectively validated.

Effect of Adding Integrated Core and Graduated Upper Limb Exercises to Inpatient Cardiac Rehabilitation on Sternal Instability After Coronary Artery Bypass Grafting: A Randomized Controlled Trial.

OBJECTIVE: To evaluate the effect of adding integrated core and graduated resistance upper limb exercises to an inpatient cardiac rehabilitation program in patients with acute sternal instability after coronary artery bypass grafting (CABG). DESIGN: This was a single-center, randomized, controlled, parallel-group intervention study. SETTING: This study was conducted at the National Heart Institute. PARTICIPANTS: Forty patients with post-CABG with sternal instability aged 50-60 years completed this study and were randomized into 2 groups: an intervention group (n=20) and an active control group (n=20). INTERVENTION: The intervention group (A) received a routine inpatient rehabilitation program from the first postoperative day plus integrated core and graduated resistance upper limb exercises, which started from the seventh postoperative day for approximately 4 weeks, whereas the control group (B) received only the routine inpatient rehabilitation program. MAIN OUTCOME MEASURES: Sternal separation measured by ultrasonography, visual analog scale for measuring pain, and activities of daily living (ADL) index were main outcome measures. RESULTS: Patients in the intervention group (A) showed a significant reduction in sternal separation from the supine and long sitting positions, whereas those in the control group (B) showed a significant increase in sternal separation (P=.0001). Both groups showed a reduction in pain, and an increase in the ADL score was observed in group A. There was a significant interaction between the time and group effects (P=.0001). CONCLUSION: Adding integrated core and graduated upper limb exercises to inpatient cardiac rehabilitation for patients with sternal instability after coronary artery bypass grafting significantly improved sternal healing, pain, and ADL.

Antral membrane balloon technique versus Densah bur in crestal sinus lift with simultaneous implant placement: a randomized clinical trial.

BACKGROUND: The posterior maxilla presents challenges for implant insertion because of the poor bone quality as well as the loss of vertical bone height. Indirect transcrestal sinus lift techniques are advised when a few millimeters of additional height are needed. This study aimed to evaluate the clinical and radiographic outcomes of antral membrane balloon technique versus Densah burs for transcrestal maxillary sinus lifting with simultaneous implant placement. MATERIALS AND METHODS: This randomized clinical trial was conducted on 22 patients received 32 dental implants for replacement of missed maxillary posterior teeth after crestal maxillary sinus lifting. The patients were randomly divided into two groups. Group 1, patients underwent crestal sinus floor elevation with simultaneous implant placement using antral membrane balloon technique. Group 2, patients underwent crestal sinus floor elevation with simultaneous implant placement using Densah burs. Patients were evaluated clinically and radiographically using cone beam computed tomography (CBCT) at regular time intervals immediately, 6 months and 12 months after surgery. All clinical and radiographic parameters were statistically analyzed. RESULTS: All dental implants were successful for 12 months of follow up. Regarding implant primary stability, there was a statistical significant difference between the study groups in favor of Densah group (P = 0.004), while there was no significant difference after 6 months (P = 0.07). Radiographically, balloon group showed a statistically significant immediate postoperative vertical bone height (P < 0.0001), and significant reduction in vertical bone height after 6 months (P < 0.0001). Densah group showed significant increase in bone density (P ≤ 0.05). CONCLUSION: Both techniques demonstrated successful clinical and radiographic outcomes for crestal sinus lift. The antral membrane balloon group demonstrated better immediate postoperative vertical bone gain, while Densah burs had higher implant primary stability and bone density. TRIAL REGISTRATION: This study was registered in Clinical-Trials.gov PRS ( https://register. CLINICALTRIALS: gov ) under identification number NCT05922592 on 28/06/2023.

Does strontium coated titanium implants enhance the osseointegration in animal models under osteoporotic condition? A systematic review and meta-analysis.

PURPOSE: The aim of this study was to systematically review the literature to address the effect of strontium modified titanium implants on the osseointegration in the presence of osteoporotic conditions through animal models. MATERIALS AND METHODS: The databases (PubMed, Scopus, Web of Science, and EBSCO) were searched electronically, and manual searches were performed till December 2022 to identify preclinical studies on the osseointegration of strontium coated titanium implants in animals with induced osteoporotic conditions. The primary outcomes were the bone-implant contact percentage (BIC%), bone area (BA) from the histomorphometric analysis, and the osseointegration parameters from biomechanical tests; the secondary outcomes were the osseointegration parameters from the micro computed tomography. RESULTS: Nineteen articles were included for the quantitative analysis on basis of the inclusion criteria. The results revealed that Sr-modified implants showed a significant 19.05% increase in BIC, and 15.01% increase in BA. The results of biomechanical tests indicated a significant effect in favor of Sr-coated implants. Furthermore, Results of the secondary outcomes supported the significant advantages of Sr-coated implants over the un-coated implants. The overall, systematic analysis of implants osteointegration parameters proved a significant increase in favor of Sr-coated titanium implants (P < 0.01). CONCLUSION: The present results provide evidence that strontium-coated titanium implants enhanced the osseointegration in animal models under osteoporotic condition as this surface modification techniques have improved the mechanical and biological properties of the titanium implants.

Formulation of a stable diesel microemulsion using eco-friendly ionic liquids and investigation of particle size and fuel properties as an alternative fuel.

Ecofriendly ionic liquids (ILs) were synthesized through amidation of ricinoleic acid, the main fatty acid in castor oil, followed by a quaternization reaction to solubilize ethanol in IL/diesel blends at different ratios. As a result, stable and highly renewable, low viscous microemulsion biofuels with high oxygen content were prepared. The prepared fuel samples combine the advantages of green ionic liquids and microemulsion properties. The chemical structures of ILs were confirmed with the aid of NMR and FTIR spectroscopy. DLS analysis revealed that the ethanol particles ranged in size from 8 to 18.1 nm in all samples. As ILs ratios decrease in microemulsion from 37 to 69%, the ethanol particle sizes increase from 10 to 25%. Ethanol shows good solubilization in diesel and IL-1 is more effective than IL-2 in ethanol solubilization at low percentages of ethanol due to more oxygen atoms besides three hydroxyl groups. The ternary phase diagram indicated that the microemulsion area in the case of using IL-1 is larger than that of IL-2. The fuel properties of the prepared microemulsions are nearly close to those of neat diesel and fall within the permitted range of ASTM D975. The viscosity and density values at low ratios of ILs are found to be very close to the values of the neat diesel at different temperatures. The prepared samples show a slight decrease in cetane number and heating value compared to diesel. However, they have improved flash points, cloud points, sulfur content, and acid value. The particle sizes were checked every week and the prepared samples showed high stability with the aid of the synthesized ILs. Moreover, the prepared microemulsions stayed in a transparent appearance for more than a year and no phase separation was observed.

Applications of Bioactive Strontium Compounds in Dentistry.

Divalent cations have captured the interest of researchers in biomedical and dental fields due to their beneficial effects on bone formation. These metallic elements are similar to trace elements found in human bone. Strontium is a divalent cation commonly found in various biomaterials. Since strontium has a radius similar to calcium, it has been used to replace calcium in many calcium-containing biomaterials. Strontium has the ability to inhibit bone resorption and increase bone deposition, making it useful in the treatment of osteoporosis. Strontium has also been used as a radiopacifier in dentistry and has been incorporated into a variety of dental materials to improve their radiopacity. Furthermore, strontium has been shown to improve the antimicrobial and mechanical properties of dental materials, promote enamel remineralization, alleviate dentin hypersensitivity, and enhance dentin regeneration. The objective of this review is to provide a comprehensive review of the applications of strontium in dentistry.

Measuring availability of and facility readiness to deliver comprehensive abortion care: experiences and lessons learnt from integrating abortion into WHO's health facility assessments.

Routine assessment of health facility capacity to provide abortion and post-abortion care can inform policy and programmes to expand access and improve quality. Since 2018, abortion and/or post-abortion care have been integrated into two WHO health facility assessment tools: the Service Availability and Readiness Assessment and the Harmonised Health Facility Assessment. We discuss lessons learnt through experiences integrating abortion into these standardised tools. Our experiences highlight the feasibility of including abortion in health facility assessments across a range of legal contexts. Factors facilitating the integration of abortion include cross-country collaboration and experience sharing, timely inputs into tool adaptations, clear leadership, close relationships among key stakeholders as in assessment coordination groups, use of locally appropriate terminology to refer to abortion and reference to national policies and guidelines. To facilitate high-quality data collection, we identify considerations around question sequencing in tool design, appropriate terminology and the need to balance the normalisation of abortion with adequate sensitisation and education of data collectors. To facilitate appropriate and consistent analysis, future work must ensure adequate disaggregation of recommended and non-recommended abortion methods, alignment with national guidelines and development of a standardised approach for measuring abortion service readiness. Measurement of abortion service availability and readiness should be a routine practice and a standardised component of health facility assessment tools. Evidence generated by health facility assessments that include abortion monitoring can guide efforts to expand access to timely and effective care and help normalise abortion as a core component of sexual and reproductive healthcare.

Evaluation of microhardness, degree of conversion, and abrasion resistance of nanoglass and multiwalled carbon nanotubes reinforced three-dimensionally printed denture base resins.

PURPOSE: To assess the effect of nanoglass (NG) particles and multiwalled carbon nanotubes' (MWCNTs) addition on Vickers hardness (VH), degree of conversion (DC), and abrasion resistance of 3D-printed denture base resin. MATERIALS AND METHODS: 3D-printed denture base resin was reinforced using silanized NG and MWCNTs to obtain four groups: Control, 0.25 wt% NG reinforced resin, 0.25 wt% MWCNTs reinforced resin, and a combination group of 0.25 wt% of both fillers. All specimens (N = 176) were tested before and after thermal aging (600 cycles) for VH (n = 22), DC, and abrasion resistance (n = 22). Abrasion resistance specimens were subjected to 60,000 brushing strokes, and then assessed for surface roughness (Ra) and weight loss. Specimens were then scanned with a benchtop scanner before and after abrasion to produce a color map of topographical changes from superimposed images. Data were analyzed using ANOVA tests followed by Tukey post hoc test. Kruskal-Wallis test was used to compare percent change among groups, followed by Dunn post hoc test (α = 0.05). RESULTS: The interaction between nanofiller content and thermal cycling displayed a significant effect on VH and DC. The 0.25% NG expressed the highest VH before aging but revealed the highest percent decrease after aging. Nanofiller content, thermal aging, and brushing displayed a significant interaction impact on the Ra values. CONCLUSIONS: The addition of nanofillers resulted in an overall improvement in resin microhardness and abrasion resistance. The 0.25% MWCNTs group revealed the lowest Ra with the least percent change in VH and DC, while the combination one displayed the least change in weight.

Petrographic and geochemical study of Precambrian and Paleozoic rocks in the western Anti-Atlas belt, Morocco: Facies, weathering, provenance and economic exploitation.

Detrital and volcanic-detrital rocks from the Ifni Buttonhole and Lakhssas Plateau were analyzed to determine their provenance, compositional maturity, and alteration source. Geochemically, the sediments were classified as arkoses, lithic arenites, grauwackes, sandstones, lithic arenites, and Fe-rich sands, indicating low compositional and mineralogical maturity. A high average SiO2 concentration and low Al2O3 were consistent with a low abundance of shale and clay components. The geochemical signatures of the detrital and volcano-detrital (RDVD) rocks indicate that they have undergone a moderate to low degree of chemical alteration. The CIA study also suggests that the granitic, granodioritic rocks represent the source provenance which, during weathering and transport, supplied the detritus to the supra-crustal units. The major trace element data suggest that these rocks are largely derived from felsic igneous rocks, namely granitoids, with a minor contribution from intermediate sources. The carbonate rocks do not represent a wide variety of facies: dolomitic limestone, calcareous limestone, and calcaro-dolomitic chert. Calcitic and dolomitic samples show a linear increase in SiO2, regardless of their CaO/LOI ratio values, which remain relatively constant. The highest SiO2 contents are observed in the calc-dolomitic chert. Geochemical analysis of RDVD from the Ifni buttonhole determined their origin, maturity, and alteration. Major oxides decreased with higher silica content, indicating quartz control. Samples, formed under semi-arid conditions, show maturity under stable deposition. They suggest a felsic, recycled source, with moderate alteration and zircon enrichment during recycling. In the study area, limestones and dolomites serve as materials applicable in the building sector, suitable for all types of concrete. The Taliwine Formation harbors Lower Cambrian dolomites and limestones, ideal for mosaic aggregates. Described as variable in color, compact, homogeneous, very hard, and resistant to alteration, the plutonic rocks form prominent peaks. They exhibit both subalkaline characteristics in granitoids and an alkaline trend in dolerite dykes. Most samples display minimal alteration, indicating the reliability of their major element compositions for geochemical analyses. These granitoids constitute valuable deposits for ornamental and building rock purposes.

Electrophysiological and biochemical effect of zinc oxide nanoparticles on heart functions of male Wistar rats.

Zinc oxide nanoparticles (ZnO NPs) are one of the most abundantly used nanomaterials in cosmetics and topical products, and nowadays, they are explored in drug delivery and tissue engineering. Some recent data evidenced that they are responsible for cardiotoxic effects and systemic toxicity. The present study aimed to investigate the toxic effect of ZnO NPs (39 nm) on the heart of Wistar rats and to perform a dose-response relationship using three different dose levels (25, 50, 100 mg/kg bw) of ZnO NPs on the electrocardiogram (ECG) readings, the levels of biochemical function parameters of heart, and the oxidative stress and antioxidant biomarkers. Furthermore, zinc concentration level and histopathological examination of heart tissues were determined. ZnO NPs showed a dose-dependent effect, as the 100 mg/kg bw ZnO NPs treated group showed the most significant changes in ECGs parameters: R-R distance, P-R interval, R and T amplitudes, and increased levels of heart enzymes Creatine Kinase- MB (CK-MB) and Lactate dehydrogenase (LDH). On the other hand, elevated zinc concentration levels, oxidative stress biomarkers MDA and NO, and decreased GSH levels were found also in a dose-dependent manner, the results were supported by impairment in the histopathological structure of heart tissues. While the dose of 100 mg/kg bw of ZnO bulk group showed no significant effects on heart function. The present study concluded that ZnO NPs could induce cardiac dysfunctions and pathological lesions mainly in the high dose.

Outbreak of Pseudomonas aeruginosa on a neonatal intensive care unit: Lessons from a Qatari setting.

Background: Pseudomonas aeruginosa is a major cause of morbidity and mortality in neonatal intensive care units (NICUs). Robust infection prevention and control is key to reducing risk. Aims: We describe lessons learnt from an NICU outbreak of P.aeruginosa in the main maternity hospital in the country. Methods: Cases were identified from clinical samples and active screening. Clinical information was collected from the electronic patient record. Infection prevention and control (IPC) practice observations were made using organisational checklists and unit observations. Microbiological testing was by conventional microbiological methods. Statistical analyses were performed using R program. Associations were assessed using the Mann-Whitney U or Fisher exact test. Isolates were typed by pulsed field gel electrophoresis; gel was analysed in Bionumerics software from Applied Maths, Belgium. Results: Five cases were identified - one was excluded as maternal acquisition. Typing showed a polyclonal outbreak. Widespread contamination of tap outlets of handwashing sinks in clinical areas was found. Main contributing factors were extensive misuse of hand wash sinks for waste disposal, improper sink cleaning, poor hand hygiene compliance and inadequate environmental cleaning. Discussion: Successful management required a multi-disciplinary approach. All potential water sources and moist environments within and outside the unit were investigated. Interventions successfully addressed the main contributing factors, supported by good communication and robust auditing. With a diverse workforce, the challenge was to ensure housekeeping staff understood handwash sink cleaning procedures; existing training programmes were delivered in multiple languages tailored to the workforce.

Enhancing the Physical, Antimicrobial, and Osteo/Odontogenic Properties of a Sol-Gel-Derived Tricalcium Silicate by Graphene Oxide for Vital Pulp Therapies.

OBJECTIVES: This study developed a sol-gel tricalcium silicate/graphene oxide (TCS-GO) composite and examined its physicochemical properties, antimicrobial activity, and osteo/odontogenic effect on dental pulp stem cells. METHODS: Tricalcium silicate was synthesized and combined with graphene oxide at three different concentrations, namely 0.02%, 0.04%, and 0.08% w/w, while tricalcium silicate and mineral trioxide aggregate served as controls. The setting time, compressive strength, pH, and calcium ion release of the composites were evaluated, as well as antimicrobial properties against Streptococcus mutans and Lactobacillus acidophilus. Additionally, the viability of dental pulp stem cells; apatite forming ability; and the gene expression of Alkaline phosphatase, Dentin sialophosphoprotein, and Runt-related transcription factor 2 were assessed. RESULTS: TCS-GO (0.08%) showed a significantly shorter setting time and higher compressive strength when compared to MTA (p < 0.05). Additionally, tricalcium silicate and TCS-GO groups showed a higher release of Ca ions than MTA, with no significant difference in pH values among the different groups. TCS-GO (0.08%) also demonstrated a significantly stronger antimicrobial effect against Lactobacillus acidophilus compared to MTA (p < 0.05). ALP expression was higher in TCS-GO (0.08%) than MTA on days 3 and 7, while DSPP expression was higher in TCS-GO (0.08%) than MTA on day 3 but reversed on day 7. There was no significant difference in RUNX2 expression between TCS-GO (0.08%) and MTA on days 3 and 7. CONCLUSIONS: The TCS-GO (0.08%) composite demonstrated superior physicochemical characteristics and antimicrobial properties compared to MTA. Moreover, the early upregulation of ALP and DSPP markers in TCS-GO (0.08%) indicates that it has the potential to promote and enhance the osteo/odontogenic differentiation of DPSCs.

Side-specific factors for intraoperative hemodynamic instability in laparoscopic adrenalectomy for pheochromocytoma: a comparative study.

BACKGROUND: Adrenalectomy for pheochromocytoma (PHEO) is challenging because of the high risk of intraoperative hemodynamic instability (HDI). This study aimed to compare the incidence and risk factors of intraoperative HDI between laparoscopic left adrenalectomy (LLA) and laparoscopic right adrenalectomy (LRA). METHODS: We retrospectively analyzed two hundred and seventy-one patients aged > 18 years with unilateral benign PHEO of any size who underwent transperitoneal laparoscopic adrenalectomy at our hospitals between September 2016 and September 2023. Patients were divided into LRA (N = 122) and LLA (N = 149) groups. Univariate and multivariate logistic regression analyses were used to predict intraoperative HDI. In multivariate analysis for the prediction of HDI, right-sided PHEO, PHEO size, preoperative comorbidities, and preoperative systolic blood pressure were included. RESULTS: Intraoperative HDI was significantly higher in the LRA group than in the LLA (27% vs. 9.4%, p < 0.001). In the multivariate regression analysis, right-sided tumours showed a higher risk of intraoperative HDI (odds ratio [OR] 5.625, 95% confidence interval [CI], 1.147-27.577, p = 0.033). The tumor size (OR 11.019, 95% CI 3.996-30.38, p < 0.001), presence of preoperative comorbidities [diabetes mellitus, hypertension, and coronary heart disease] (OR 7.918, 95% CI 1.323-47.412, p = 0.023), and preoperative systolic blood pressure (OR 1.265, 95% CI 1.07-1.495, p = 0.006) were associated with a higher risk of HDI in both LRA and LLA, with no superiority of one side over the other. CONCLUSION: LRA was associated with a significantly higher intraoperative HDI than LLA. Right-sided PHEO was a risk factor for intraoperative HDI.

Double Decker anterior cruciate ligament avulsion.

Distal anterior cruciate ligament avulsion from tibial side is an unusual injury. It can be either bony avulsion, which is more common, or rarely a soft tissue peeling of tibial spine with no bone injury. This case report represents a very infrequent injury of combined soft tissue peeling of distal anterior cruciate ligament along with bony avulsion of tibial spine in a 12-years-old boy after falling from his bike.

Resilience in the face of pandemic: exploring the influence of psychological flexibility on turnover intentions and burnout among critical care nurses in COVID-19 hospitals.

AIM: Assess the levels of psychological flexibility, burnout, and turnover intention among critical care nurses and assess the impact of psychological flexibility on burnout, and turnover intention among critical care nurses. BACKGROUND: Burnout and turnover intentions among critical care nurses are rapidly increasing because of the challenges of COVID-19. There is a need for evidence-based interventions like psychological flexibility to be addressed in research to overcome those challenges. METHODS: A descriptive correlational research. A convenient sample of 200 critical care nurses working in COVID-19 hospitals from two governorates in Egypt. The sociodemographic and clinical data sheet, the work-related acceptance and action questionnaire, the Copenhagen burnout inventory, and the adopted version of the staff nurses' intention to leave the nursing profession questionnaire were used. RESULTS: The majority of critical care nurses reported a moderate level of psychological flexibility (75.5%, Mean = 31.23), a moderate level of burnout (65.5%, Mean = 59.61), and low to moderate levels of intention to leave (73%, Mean = 5.95). Psychological flexibility has a statistically significant negative correlation with burnout (PC = -0.304, Sig = 0.000) and the intention to leave (PC = -0.258, Sig = 0.000). In addition, psychological flexibility has a predictable effect on decreasing burnout (R2 = 0.232) and intention to leave (R2 = 0.127) among critical care nurses. CONCLUSION: critical care nurses in COVID-19 hospitals reported varied levels of burnout and an intention to leave that must be considered. The effect of psychological flexibility on burnout and intention to turnover highlighted the importance of improving it among critical care nurses by applying acceptance and commitment therapy as a management intervention.

The effect of arginine on the growth of probiotics.

OBJECTIVE(S): The study objective was to examine the effect of arginine (Arg) supplementation on the growth of probiotics. METHODS: Lacticaseibacillus rhamnosus GG, Lactiplantibacillus plantarum, and Lactobacillus acidophilus were identified as potential probiotics. L. rhamnosus GG and L. plantarum were selected for further experimentation. The probiotics were co-treated with 0.9 % NaCl (negative control), 0.5 % Arg, and 1.0 % Arg in a 1:1 ratio for 24 h at 5 % CO2, 37 °C. The probiotics were tested for growth profiles, spectroscopic turbidity assay, metabolic assays (XTT and WST-8), live/dead cell assessment using confocal laser scanning microscopy (CLSM), and colony forming units (CFU). RESULTS: The growth profiles of L. rhamnosus GG and L. plantarum were found to be similar, whereas L. acidophilus showed minimal or no transition from the initial lag phase. In the turbidity assay, the end-point absorbance for L. rhamnosus GG with 1.0 % Arg was significantly lower than 0.9 % NaCl and 0.5 % Arg (p < 0.05). For metabolic assays and CFU, increasing concentrations of Arg increased the viable cells for L. rhamnosus GG (p < 0.05), but decreased viability for L. plantarum (p < 0.05). Metabolic assays with dual-species bacterial suspensions indicated that Arg co-treatment inhibited viable proportions compared to control (p < 0.05). The dead cell proportion was significantly lower than live cell proportion for all tested interventions and probiotics (p < 0.05). CONCLUSION: Increasing concentrations of Arg promote the growth of L. rhamnosus GG, while conversely inhibiting the growth of L. plantarum. Therefore, the effect of prebiotic Arg on probiotics is concentration-dependent, leading to a selective promotion or inhibition of growth. CLINICAL SIGNIFICANCE: The present study results show that Arg supplementation can selectively enhance the growth of L. rhamnosus GG while inhibit the growth of L. plantarum. This underscores the need to consider strain-specific responses in probiotic formulations when developing Arg-based synbiotics for modulating biofilms and creating ecologically homeostatic biofilm microenvironments.

Case-control study: Unveiling human polyomaviruses and papillomavirus in Egyptian colorectal cancer patients.

BACKGROUND: Colorectal cancer (CRC) is a cancer type that is thought to be influenced by human papillomaviruses (HPVs) and human polyomaviruses (HPyVs). In Egypt, CRC ranks as the 7th most common cancer, accounting for 3.47% of male cancers and 3% of female cancers. However, there is currently a lack of information regarding the presence of PyVs and HPVs co-infection specifically in CRC cases in Egypt. Therefore, the aim of this study was to investigate the occurrence of HPVs and HPyVs (JCPyV, BKPyV, and SV40) infections, as well as co-infections, among CRC patients in Egypt. Additionally, the study aimed to assess any potential association between these viral infections and tumor stages. METHODS: In the present study, we analyzed a total of 51 tissue samples obtained from Egyptian CRC patients, along with 19 polyps' samples. Our investigation focused on the detection and genotyping of HPyVs using Real-Time PCR. Additionally, we employed real-time PCR for the detection of HPVs, and for their genotyping, we utilized a combination of PCR amplification followed by sequencing. RESULTS: In our study, we found evidence of HPyVs infection in the CRC patients, specifically SV40 (25.5%) and BKPyV (19.6%). However, JCPyV was not detected in the samples that were examined. Additionally, we discovered that HPV was present in 43.1% of the CRC patients. When considering viral co-infections, 19.6% of the CRC samples showed coexistence of multiple viruses, while no co-infections were found in the polyps samples. Importantly, we observed a significant correlation between the presence of HPVs and advanced colorectal tumor grades B2 and D. CONCLUSION: Our findings provide valuable data for the detection of oncogenic viruses in colorectal cancer (CRC) and underscore the association of viral co-infections with advanced tumor stages. However, further research with larger cohorts is necessary to validate these findings and strengthen their significance in the field of CRC.