From promise to progress: the dynamic landscape of glioblastoma immunotherapy.

Glioblastoma multiforme (GBM) is the most common CNS cancer, it has dismal survival rates despite several effective mediators: intensified cytotoxic therapy, chimeric antigen receptor (CAR)-T cell therapy, viral therapy, adoptive cell therapy, immune checkpoint blockade therapy, radiation therapy and vaccine therapy. This review examines the basic concepts underlying immune targeting and examines products such as checkpoint blockade drugs, CAR-T cells, oncolytic viruses, combinatory multimodal immunotherapy and cancer vaccines. New approaches to overcoming current constraints and challenges in GBM therapy are discussed, based on recent studies into these tactics, findings from ongoing clinical trials, as well as previous trial results.

Thermal slip and variable viscosity analysis on heat rate and magnetic flux through accelerating non-conducting wedge in the presence of induced magnetic field.

The focus of present study is to incorporate the variable viscosity and temperature slip impact on heating rate and induced magnetic gradient along the moving non-conducting wedge under magnetic field. In industrial and engineering procedures, the impact of induced magnetization improves the efficiency of thermal systems to main the heating rates. The similarity transformations and stream functions are applied to reduce the governing equations into ordinary form. During this transformation, the pertinent parameters such as wedge parameter, moving parameter, Prandtl factor, viscosity parameter and temperature-slip parameter is obtained. These parameters play a prominent role on the physical values of fluid velocity, induced magnetic field and temperature distributions. The skin friction, Nusselt coefficient and induced magnetic gradient are incorporated through these parameters. The numerical values are executed by using the Keller box analysis with Newton-Raphson technique. It is depicted that the maximum slip in fluid velocity and temperature distribution is obtained for each values of thermal-slip parameter. It is noticed that maximum magnitude in induced magnetic field is reported for each wedge factor. The maximum velocity slip and temperature slip is observed for each choice of moving parameter. It is reported that the maximum variation in heating rate and induced magnetic gradient is obtained for magnetic force and viscosity parameter. The enhancing behavior of skin friction is observed for maximum values of Prandtl number.

Prevalence and Risk Factors of Pressure Ulcers in Bedbound Diabetic vs. Non-diabetic Patients in a Lower-Middle-Income Country.

Introduction Pressure ulcers, also known as bedsores, are a significant concern for bedridden individuals, presenting both physical and socioeconomic challenges. Factors such as prolonged immobility, chronic medical conditions, and poor nutrition contribute to their development. Despite extensive research in some regions, studies comparing diabetic and non-diabetic populations remain limited, particularly in low-income settings. This study aimed to investigate the risk factors and frequency of pressure ulcers among bedridden patients, addressing this gap in understanding and guiding targeted interventions. Materials and methods A cross-sectional study was conducted across four government hospitals in Peshawar, Pakistan. A total of 388 bedridden patients with pressure ulcers were included, and data were collected through a questionnaire. The questionnaire covered demographics, comorbidities, duration of bedbound status, BMI, and caregivers' awareness of pressure ulcer care. Data analysis was performed using SPSS version 22.0 (Armonk, NY: IBM Corp.), with qualitative data presented as frequencies and percentages and quantitative data as mean and standard deviation. Chi-square tests were utilized for significance, with p<0.05 considered significant. Results Of the 388 patients analyzed, 230 (59.3%) were diabetic, highlighting the prevalence of diabetes among pressure ulcer cases. The majority of diabetic patients with ulcers were over 41 years old, and 293 (75.5%) had comorbidities. Surgical intervention was the primary cause of ulcers in 213 (54.8%) cases, followed by stroke in 77 (19.8%) cases. Notably, 252 (65%) of caregivers exhibited inadequate knowledge regarding ulcer care. Stage II ulcers were prevalent in both diabetic and non-diabetic cohorts. Conclusions Pressure ulcers are poorly controlled complications observed in bedridden individuals, highlighting a critical need for comprehensive preventive measures and caregiver education to alleviate the burden of pressure ulcers, especially in diabetic patients. Factors such as prolonged immobility, surgical interventions, and insufficient caregiver knowledge contribute to the development of pressure ulcers. Understanding these complexities is essential for implementing effective care approaches and mitigating the impact of pressure ulcers.

Fluorescence imaging-guided surgery: current status and future directions.

Surgery is one of the most important paradigms for tumor therapy, while fluorescence imaging (FI) offers real-time intraoperative guidance, greatly boosting treatment prognosis. The imaging fidelity heavily relies on not only imaging facilities but also probes for imaging-guided surgery (IGS). So far, a great number of IGS probes with emission in visible (400-700 nm) and near-infrared (NIR 700-1700 nm) windows have been developed for pinpointing disease margins intraoperatively. Herein, the state-of-the-art fluorescent probes for IGS are timely updated, with a special focus on the fluorescent probes under clinical examination. For a better demonstration of the superiority of NIR FI over visible FI, both imaging modalities are critically compared regarding signal-to-background ratio, penetration depth, resolution, tissue autofluorescence, photostability, and biocompatibility. Various types of fluorescence IGS have been summarized to demonstrate its importance in the medical field. Furthermore, the most recent progress of fluorescent probes in NIR-I and NIR-II windows is summarized. Finally, an outlook on multimodal imaging, FI beyond NIR-II, efficient tumor targeting, automated IGS, the use of AI and machine learning for designing fluorescent probes, and the fluorescence-guided da Vinci surgical system is given. We hope this review will stimulate interest among researchers in different areas and expedite the translation of fluorescent probes from bench to bedside.

Chemodynamic Therapy of Glioblastoma Multiforme and Perspectives.

Glioblastoma multiforme (GBM), a potential public health issue, is a huge challenge for the advanced scientific realm to solve. Chemodynamic therapy (CDT) based on the Fenton reaction emerged as a state-of-the-art therapeutic modality to treat GBM. However, crossing the blood-brain barrier (BBB) to reach the GBM is another endless marathon. In this review, the physiology of the BBB has been elaborated to understand the mechanism of crossing these potential barriers to treat GBM. Moreover, the designing of Fenton-based nanomaterials has been discussed for the production of reactive oxygen species in the tumor area to eradicate the cancer cells. For effective tumor targeting, biological nanomaterials that can cross the BBB via neurovascular transport channels have also been explored. To overcome the neurotoxicity caused by inorganic nanomaterials, the use of smart nanoagents having both enhanced biocompatibility and effective tumor targeting ability to enhance the efficiency of CDT are systematically summarized. Finally, the advancements in intelligent Fenton-based nanosystems for a multimodal therapeutic approach in addition to CDT are demonstrated. Hopefully, this systematic review will provide a better understanding of Fenton-based CDT and insight into GBM treatment.

NIR-II Fluorescent Probes for Fluorescence-Imaging-Guided Tumor Surgery.

Second near-infrared (NIR-II) fluorescence imaging is the most advanced imaging fidelity method with extraordinary penetration depth, signal-to-background ratio, biocompatibility, and targeting ability. It is currently booming in the medical realm to diagnose tumors and is being widely applied for fluorescence-imaging-guided tumor surgery. To efficiently execute this modern imaging modality, scientists have designed various probes capable of showing fluorescence in the NIR-II window. Here, we update the state-of-the-art NIR-II fluorescent probes in the most recent literature, including indocyanine green, NIR-II emissive cyanine dyes, BODIPY probes, aggregation-induced emission fluorophores, conjugated polymers, donor-acceptor-donor dyes, carbon nanotubes, and quantum dots for imaging-guided tumor surgery. Furthermore, we point out that the new materials with fluorescence in NIR-III and higher wavelength range to further optimize the imaging results in the medical realm are a new challenge for the scientific world. In general, we hope this review will serve as a handbook for researchers and students who have an interest in developing and applying fluorescent probes for NIR-II fluorescence-imaging-guided surgery and that it will expedite the clinical translation of the probes from bench to bedside.

Effect of hydrothermal pretreatment on leachate fed Scenedesmus sp. biomass solubilization and biogas production.

The aim of the present study was to assess the effect of hydrothermal pretreatment on the solubilization and anaerobic digestion (AD) of Scenedesmus sp. biomass. At first, the microalgae was cultivated in 5% fresh leachate (FL) to recover nutrients such as nitrogen and phosphorus. Scenedesmus sp. grown in 5% FL obtained 100%, 77% and 97% removal efficiency of ammonium nitrogen (NH4+ - N), total Kjeldahl nitrogen (TKN) and phosphate phosphorous (PO43- -P), respectively. In the following step, the hydrothermal pretreatment of Scenedesmus sp. biomass was carried out at 120, 150 and 170 °C and retention time of 0, 30 and 60 min to evaluate its solubilization and biogas production through AD in batch test. Soluble chemical oxygen demand (sCOD) increased by 260% compared to untreated microalgae at 170 °C for 60 min. In comparison to untreated microalgae, the highest increase in biogas (70%) and methane yield (100%) was observed for 150 °C and 60 min pretreated microalgae as a consequence of hydrothermal pretreatment. Hydrothermal pretreatment has shown effectiveness in enhancing biomass solubilization and increasing biogas yield. Nevertheless, further research at the pilot scale is necessary to thoroughly evaluate the potential and feasibility of hydrothermal pretreatment for full-scale implementation.

Advancements in intrusion detection: A lightweight hybrid RNN-RF model.

Computer networks face vulnerability to numerous attacks, which pose significant threats to our data security and the freedom of communication. This paper introduces a novel intrusion detection technique that diverges from traditional methods by leveraging Recurrent Neural Networks (RNNs) for both data preprocessing and feature extraction. The proposed process is based on the following steps: (1) training the data using RNNs, (2) extracting features from their hidden layers, and (3) applying various classification algorithms. This methodology offers significant advantages and greatly differs from existing intrusion detection practices. The effectiveness of our method is demonstrated through trials on the Network Security Laboratory (NSL) and Canadian Institute for Cybersecurity (CIC) 2017 datasets, where the application of RNNs for intrusion detection shows substantial practical implications. Specifically, we achieved accuracy scores of 99.6% with Decision Tree, Random Forest, and CatBoost classifiers on the NSL dataset, and 99.8% and 99.9%, respectively, on the CIC 2017 dataset. By reversing the conventional sequence of training data with RNNs and then extracting features before applying classification algorithms, our approach provides a major shift in intrusion detection methodologies. This modification in the pipeline underscores the benefits of utilizing RNNs for feature extraction and data preprocessing, meeting the critical need to safeguard data security and communication freedom against ever-evolving network threats.

Breaking barriers in cancer treatment: nanobiohybrids empowered by modified bacteria and vesicles.

Cancer, the leading global cause of mortality, poses a formidable challenge for treatment. The effectiveness of cancer therapies, ranging from chemotherapy to immunotherapy, relies on the precise delivery of therapeutic agents to tumor tissues. Nanobiohybrids, resulting from the fusion of bacteria with nanomaterials, constitute a promising delivery system. Nanobiohybrids offer several advantages, including the ability to target tumors, genetic engineering capabilities, programmed product creation, and the potential for multimodal treatment. Recent advances in targeted tumor treatments have leveraged bacteria-based nanobiohybrids. Here, we outline the progress in cancer treatment using nanobiohybrids. Our focus is particularly on various therapeutic approaches within the context of nanobiohybrid systems, where bacteria are integrated with nanomaterials to combat cancer. It has been demonstrated that bacteria-based nanobiohybrids present a robust and effective method for tumor theranostics.

Development of Polymethine Dyes for NIR-II Fluorescence Imaging and Therapy.

Fluorescence imaging in the second near-infrared window (NIR-II) is burgeoning because of its higher imaging fidelity in monitoring physiological and pathological processes than clinical visible/the second near-infrared window fluorescence imaging. Notably, the imaging fidelity is heavily dependent on fluorescence agents. So far, indocyanine green, one of the polymethine dyes, with good biocompatibility and renal clearance is the only dye approved by the Food and Drug Administration, but it shows relatively low NIR-II brightness. Importantly, tremendous efforts are devoted to synthesizing polymethine dyes for imaging preclinically and clinically. They have shown feasibility in the customization of structure and properties to fulfill various needs in imaging and therapy. Herein, a timely update on NIR-II polymethine dyes, with a special focus on molecular design strategies for fluorescent, photoacoustic, and multimodal imaging, is offered. Furthermore, the progress of polymethine dyes in sensing pathological biomarkers and even reporting drug release is illustrated. Moreover, the NIR-II fluorescence imaging-guided therapies with polymethine dyes are summarized regarding chemo-, photothermal, photodynamic, and multimodal approaches. In addition, artificial intelligence is pointed out for its potential to expedite dye development. This comprehensive review will inspire interest among a wide audience and offer a handbook for people with an interest in NIR-II polymethine dyes.

Synthesis of Plant-Mediated Iron Oxide Nanoparticles and Optimization of Chemically Modified Activated Carbon Adsorbents for Removal of As, Pb, and Cd Ions from Wastewater.

This research study was designed with the aim to prepare plant extract-mediated iron oxide nanoparticles (IONPs) and different chemically modified carbon adsorbents from the Parthenium hysterophorus plant and then optimize the carbon adsorbents by evaluating their adsorption applications in wastewater for the selected metal ions like arsenic (As3+), lead (Pb2+), and cadmium (Cd2+). The Fourier transform infrared spectroscopy (FTIR) technique was used to highlight functional groups in plant-mediated IONPs and chemically modified carbon adsorbents. A scanning electron microscopy study was conducted to explain the surface morphology of the adsorbents. Energy-dispersive X-rays was used for elemental analysis and X-ray diffraction for particle size and crystallinity of the adsorbents. From the study, it was found that the best optimum conditions were pH = 5-6, initial concentration of adsorbate of 10 mg/L, dose of adsorbent of 0.01 g, contact time of 90-120 min of adsorbent and adsorbate, and temperature of 25 °C. At optimum conditions, the adsorption capacities of IONPs for arsenic (As) 144.7 mg/g, lead (Pb) 128.01 mg/g, and cadmium (Cd) ions 122.1 mg/g were recorded. The activated carbon at optimum conditions showed adsorption capacities of 46.35 mg/g for As, 121.95 mg/g for Pb, and 113.25 mg/g for Cd ion. At equilibrium, Langmuir, Freundlich Temkin, and Dubinin-Radushkevich isotherms were applied on the experimental adsorption data having the best R2 values (0.973-0.999) by the Langmuir isotherm. High-correlation coefficient R2 values (0.996-0.999) were obtained from the pseudo-second-order for all cases, showing that the adsorption process proceeds through pseudo second-order kinetics. The apparent adsorption energy E value was in the range of 0.24-2.36 kJ/mol. The adsorption capacity of regenerated IONPs for As gradually decreased from 144.8 to 45.67 mg/g, for lead 128.15 to 41.65 mg/g, and cadmium from 122.10 to 31.20 mg/g in 5 consecutive cycles. The study showed that the synthesized IONPs and acid-activated carbon adsorbent were successfully used to remove selected metal ions from wastewater.

Cell membrane-coated biomimetic nanomedicines: productive cancer theranostic tools.

As the second-leading cause of human death, cancer has drawn attention in the area of biomedical research and therapy from all around the world. Certainly, the development of nanotechnology has made it possible for nanoparticles (NPs) to be used as a carrier for delivery systems in the treatment of tumors. This is a biomimetic approach established to craft remedial strategies comprising NPs cloaked with membrane obtained from various natural cells like blood cells, bacterial cells, cancer cells, etc. Here we conduct an in-depth exploration of cell membrane-coated NPs (CMNPs) and their extensive array of applications including drug delivery, vaccination, phototherapy, immunotherapy, MRI imaging, PET imaging, multimodal imaging, gene therapy and a combination of photothermal and chemotherapy. This review article provides a thorough summary of the most recent developments in the use of CMNPs for the diagnosis and treatment of cancer. It critically assesses the state of research while recognizing significant accomplishments and innovations. Additionally, it indicates ongoing problems in clinical translation and associated queries that warrant deeper research. By doing so, this study encourages creative thinking for future projects in the field of tumor therapy using CMNPs while also educating academics on the present status of CMNP research.

Revolutionizing Nanotechnology with Filago desertorum Extracts: Biogenic Synthesis of Silver Nanoparticles Exhibiting Potent Antioxidant and Antibacterial Activities.

In this study, we described the environmentally friendly biosynthesis of silver nanoparticles (AgNPs) utilizing ethanolic extract of Filago desertorum (F. desertorum) as a capping and reducing agent. We also looked at the antioxidant and antibacterial capacities of AgNPs. In order to determine the size, shape, and crystallinity of the created AgNPs, the current project was designed to produce AgNPs utilizing the crude extract of the F. desertorum. The effectiveness of the project was evaluated by UV-visible spectrophotometry, Fourier transform infrared spectroscopy, scanning electron microscopy, and X-ray diffraction. AgNPs are monodispersed and spherical and have 50 nm average particle diameters, as determined using Image J software calculations and SEM observation. Four significant peaks from an XRD study, located at 38.46, 44.63, 64.81, and 77.74 nm, were used to calculate the average crystalline size of AgNPs which was reported to be 15 nm. In the crude extract of F. desertorum, it is possible to see the functional group peaks of a number of substances that are essential for bioreduction and the stability of the AgNPs. Antibacterial and antioxidant properties of AgNPs in vitro (DPPH, ABTS, H2O2, phosphomolybdenum, and ferric reducing power) were examined using conventional methods. The AgNPs showed maximum DPPH (72.51% with IC50 = 144.61 µg/mL), ABTS (75.24% with IC50 = 131.21 µg/mL), hydrogen peroxide (73.33% with IC50 = 115.05 µg/mL), phosphomolybdenum activity (73.43% with IC50 = 75.25 µg/mL), and observing reducing power (0.25) at a concentration of 250 g/mL. Inhibition by the AgNPs against the bacterial strain Staphylococcus aureus was greatest (12 mm). According to the current findings, AgNPs produced by F. desertorum have the highest potential for free radical scavenging and antibacterial activity, which can result in antioxidant and antibiotic agents.

Achieving Critical View of Safety via a New Technique: The Triple One (111) Technique.

BACKGROUND: Misidentification of anatomical structures is one of the most common causes of bile duct injury following laparoscopic cholecystectomy. Achieving Critical View of Safety (CVS) is a standard step in conducting safe cholecystectomy all over the world. In our institute, we achieve CVS via a unique technique called Triple One or 111 and find it very helpful and easy to achieve CVS. Moreover, the rate of conversion has also decreased while achieving CVS via this technique. The unique aspect of the Triple One technique is that by following this method, even new laparoscopic surgeons can achieve CVS very easily in difficult cases and, hence, it decreases the chances of vasculobiliary injury (VBI). OBJECTIVE: This study aimed to determine how effective the Triple One technique is in achieving CVS as well as in lessening the chances of VBI. MATERIAL AND METHODS: A total of 545 patients were admitted through the outpatient department, ranging in age from 30 to 70 years, with a mean of 50 years. The study comprised patients with American Society of Anaesthesiologists (ASA) I & II, acute and chronic cholecystitis, and symptomatic cholelithiasis. The study excluded patients with co-morbidities, prior abdominal procedures, and suspected complications. On the second postoperative day, all patients received their discharge papers and on the seventh postoperative day, follow-up was completed. RESULTS: Successful gallbladder extraction using the Triple One technique was achieved in 540 (99%) cases. The other five (1%) cases converted to open cholecystectomy because of the difficult gallbladder anatomy and extensive scarring. No VBI or bile duct injury was noted. No mortality was recorded during the study period. CONCLUSION: By incorporating CVS using the Triple One technique into our policies and curriculum, we may encourage safe cholecystectomy practices and prevent bile duct injuries.

6-Aminoflavone Activates Nrf2 to Inhibit the Phospho-JNK/TNF-α Signaling Pathway to Reduce Amyloid Burden in an Aging Mouse Model.

In the current study, we examined the antioxidant activity and anti-amyloidogenic potential of 6-aminoflavone in an adult mice model of d-galactose-induced aging. Male albino eight-week-old mice were assigned into four groups: 1. the control group (saline-treated), 2. d-galactose-treated mice (100 mg/kg/day, intravenously) for eight weeks, 3. d-galactose-treated mice (100 mg/kg/day, intravenously for eight weeks) and 6-AF-treated mice (30 mg/kg/day, intravenously for the final four weeks), and 4. 6-AF-treated mice (30 mg/kg/day i.p. for four weeks). We conducted many assays for antioxidant enzymes, including lipid peroxidation, catalase, glutathione (GSH), peroxidase (POD), and sulfoxide dismutase (SOD) (LPO). Western blotting was used to assess protein expression while the Morris water maze (MWM) and Y-maze (YM) were used to study behavior. The findings show that 6-AF greatly improved neuronal synapse and memory impairment brought on by d-galactose and it significantly inhibited BACE1 to reduce the amyloidogenic pathway of A (both amyloid ß production and aggregation) by upregulating Nrf2 proteins (validated through molecular docking studies) and suppressing phosphorylated JNK and TNF-α proteins in adult albino mice's brain homogenates. These findings suggest that 6-AF, through the Nrf2/p-JNK/TNF-α signaling pathway, can diminish the oxidative stress caused by d-galactose, as well as the amyloidogenic route of A formation and memory impairment.

Doctors' Perception Regarding Bariatric Surgery and Major Barriers in Referral of Morbidly Obese Patients for Surgery in Khyber Pakhtunkhwa.

INTRODUCTION: Obesity is on the rise worldwide and has emerged as a global health concern. It has presented itself as the leading cause of morbidity, disability, and healthcare utilization. Bariatric surgery is a viable treatment option that offers sustained weight loss and improvement in comorbidities. The aim of this study is to determine the perception of doctors regarding bariatric surgery and the major barriers to the referral of morbidly obese for surgery. METHOD: This study is a cross-sectional descriptive study conducted from November 1, 2022, to December 31, 2022. It involved prospective data collection through online questionnaires filled by doctors practicing in Peshawar. The sampling technique was non-probability convenience-based sampling. The sample size was 152. Doctors from all age groups and both genders were included in our study. Non-consenting doctors and those who were practicing bariatric surgery were excluded. Data were analyzed using a statistical package for social sciences (SPSS) version 25.0 (IBM Inc., Armonk, NY). Categorical variables have been presented as frequencies and percentages. Numerical variables have been presented as mean ± SD. RESULTS: A total of 152 doctors participated in our research study; 92 were physicians and 60 were surgeons. The majority of our study participants' patient load per week was >75. Around 47% believed bariatric surgery was a valuable tool in the treatment of morbid obesity. The most commonly reported barrier to referral was surgical complications or side effects (28.9%). CONCLUSION: The study concluded that the awareness regarding bariatric and metabolic surgery remains flimsy among the doctor community. Most of the physicians were unaware of the benefits of the surgical management of obesity. They also had doubts regarding the safety of the procedure. We need proper utilization of awareness strategies to overcome these barriers.

Computational analysis of Darcy-Forchheimer relation, reduced gravity, and external applied magnetic field influence on radiative fluid flow and heat transfer past a sphere: Finite difference method.

The study of radiation, Darcy-Forchheimer relation, and reduced gravity, effects on magnetohydrodynamic flow across a solid sphere immersed in porous material, is the focus of the current work. Coupled and nonlinear partial differential governing equations, are established to model the studied configuration. By using appropriate scaling variables, the resultant set of governing equations is converted to its dimensionless form. Based on these established equations, a numerical algorithm is written based on the finite element approach to solve the considered problem. A verification of the validity of the proposed model is done by comparing with already published results. Furthermore, to check the precision of solutions, a grid independence test has been accomplished. The unknown variables, such as fluid velocity and temperature, and their gradients are evaluated. This investigation's main objective is to demonstrate how the Darcy-Forchheimer law and reduced gravity due to density difference affect the natural convective heat transfer across a solid sphere immersed in a porous medium. Results show that the flow intensity decreases with the magnetic field parameter, local inertial coefficient, Prandtl number, and porosity parameter and becomes more important by increasing the reduced gravity and radiation parameters. In addition, the temperature increases with the inertial coefficient, porosity parameter, Prandtl number, radiation parameter, and magnetic field parameter and get declined with the reduced gravity parameter.

From Corporate Social Responsibility to Employee Well-Being: Navigating the Pathway to Sustainable Healthcare.

Purpose: Despite extensive research on the impact of corporate social responsibility (CSR) on employee outcomes, only limited research has been conducted to investigate the impact of CSR on healthcare employees' burnout (BUO). Additionally, the underlying mechanism by which CSR may reduce BUO has not been fully understood. In order to fill these gaps, we explored the relationship between CSR and BUO, as well as the possible mediating effects of subjective wellbeing (SW) and compassion (CM). Also, employee admiration (AM) was examined as a moderating factor. Methods: The study utilized a questionnaire to collect data, which was distributed using the paper-pencil method. A total of 335 healthcare employees, including nurses, doctors, paramedics, and general administration, participated in the study. Specifically, we focused on the healthcare segment of Pakistan. A survey was conducted to assess participants' perceptions of CSR practices, BUO, AM, SW, and CM within their organizations. The questionnaire consisted of several standardized scales validated in previous research. Results: We investigated the relationship between CSR and BUO using the AMOS software. BUO was negatively associated with CSR, suggesting that organizations with strong CSR practices may be able to reduce employee burnout. Moreover, the relationship between CSR and BUO was mediated by both subjective wellbeing (SW) and compassion (CM), revealing how CSR may impact employee burnout. Furthermore, we found that employee admiration (AM) buffered the relationship between CSR and BUO. Findings: BUO is a growing concern among healthcare professionals and has the potential to negatively impact the quality of patient care, staff morale, and, ultimately, the success of healthcare organizations. BUO in healthcare settings can be effectively addressed by implementing CSR strategies. Effective CSR strategies should be implemented in a meaningful way to employees and provide them with opportunities to engage in activities that align with their values and interests.

Complex Fistula-in-Ano Extending From the Anal Canal to Mid-Thigh Treated With Combine Fistulectomy and Video-Assisted Anal Fistula Treatment (VAAFT): A Case Report.

An anal fistula is abnormal, chronic epithelial-lined communication between the anorectal lumen and the skin of the perineum or buttock. A complex fistula-in-ano is difficult to diagnose and treat; it requires careful approaches because of the high risk of complications and recurrences. We report a case of a 60-year-old male who presented with a discharging sinus on the posteromedial aspect of his left thigh for the past two years. On examination, there were two external openings on the posteromedial aspect of the left thigh, 20 cm away from the anal verge, extending toward the left buttock, with an internal opening on the right side of the anal canal at 11 o'clock in the lithotomy position. The MRI showed a fluid-filled marginally enhancing tract ascending obliquely from the skin of the posterior left thigh, passing through the left gluteus maximus to the bilateral ischioanal fossae. The distal 7 cm tract was excised, as the rest of the tract was deep, passing through the gluteus maximus. Therefore, a video-assisted anal fistula treatment (VAAFT) procedure was done for the remaining tract. The wound was left open for healing by secondary intention. The patient was monitored for six months during which time the wound healed completely.

Renessans Helps in Early Clearance of SARS-CoV-2: In-Vivo Activity of the Iodine Complex in Rhesus macaque.

Iodine complexes have known antimicrobial properties along with reported in-vitro antiviral activity for several viruses. Renessans is one such product with iodine complexes and ascorbic acid. The present study was designed to determine its efficacy for SARS-CoV-2 in Rhesus macaque. Rhesus macaque were assigned to: A) prophylactic group (n = 3), (B) treatment group (n = 3), (C) infection control group (n = 4), and (D) negative control group (n = 4). Groups A, B, and C were challenged with 2 × 106 TCID of SARS-CoV-2. The prophylactic group (A) was administered Renessans from 5 days before infection till 8 days postinfection (DPI). The treatment group (B) was administered Renessans from 3 till 8 DPI. Group C was administered water-insoluble fractions only. Nasal swabs from all monkeys of groups A, B, and C remained positive for SARS-CoV-2 till 2 and 7 DPI, while the swabs became negative for groups A and B at 14 DPI. Likewise, fecal matter of monkeys in group A returned negative results during the experiment, while that of group B had significantly decreased viral load (101.5 genome copies/mL) compared to group C (103 genome copies/mL). Hence, it is concluded that Renessans has in-vivo SARS-CoV-2 activity and may result in early clearance of SARS-CoV-2.