A Study on Semaphorin 3A Level in Juvenile-onset Systemic Lupus Erythematosus Patients.

BACKGROUND: Juvenile-onset systemic lupus erythematosus (jSLE) is an uncommon yet severe autoimmune/inflammatory condition affecting multiple bodily systems, typically manifest-ing before the age of 18. This disease exhibits significant complexity, displaying considerable variation among patients. Its effects can range in severity from minor to fatal, characterized by a pattern of recurring flare-ups and periods of remission, making its natural progression difficult to predict. AIM OF THE WORK: The aim of this work is to investigate the correlation between semaphorin 3A and systemic lupus erythematosus patients who follow up at Pediatric Rheumatology Unit Chil-dren's Hospital at Cairo University. PATIENTS & METHODS: This cross-sectional research was performed at the Pediatric Rheumatology Unit Cairo University Children's Hospital and included cases with jSLE under treatment and fol-low-up from the period of August 2021 to August 2022. RESULTS: Regarding demographic data of the studied subjects, highly significant variances were noted among the patient group & control group regarding age (years) & sex. However, there were non-significant variances among the patient group and control group concerning weight. In the current research, median (IQR) onset of disease was 2 (1 3) years, mean ± SD age at dis-ease diagnosis was 8.98 ± 2.13 years, median (IQR) disease duration 2 (1 3) years, family history was negative in 36 (90.0%) patients and consanguinity was negative in 28 (70.0%). The distribution of the manifestations within the patients group was as follow 7 (17.5%) with mu-cocutaneous, 7 (17.5%) with vasculitis, 4 (10.0%) with serositis, 11 (27.5%) with cardiac, 17 (42.5%) with renal, 11 (27.5%) with GIT, 5 (12.5%) with hematological, and 4 (10.0%) with neu-rological manifestations. In addition, there were 2 (5.0%) with arthritis, 31 (77.5%) with arthral-gia, and 2 (5.0%) with fever mean ± SD systolic BP was 115.95 ± 8.38 & mean ± SD diastolic BP was 75.60 ± 6.11. Regarding treatments in the patients' group, the median steroid dose was 15mg (5-25) with medi-an duration of 2 (1 3), 38 (95.0%) patients received hydroxychloroquine with mean ± SD hy-droxychloroquine dose of 205.26 mg ± 51.71. 23 (57.5%) patients received cyclophosphamide with mean ± SD number of cyclophosphamide doses 7.17 mg ± 2.42. Mycophenolate was re-ceived in 27 (67.5%) with mean ± SD dose of 614.07 mg ± 225.85. There were highly statistically significant differences between control group and patients' group concerning TLC, creatinine, & ESR. Highly statistically significant variance was noted among the control group and patients group concerning CRP. Regarding the patients' group, the mean ± SD serum C3 was 99.89 mg/dl ± 28.45, median (IQR) serum C4 was 14.5 mg/dl (8.8 25.5), and median (IQR) albumin creatinine ratio was 27 IU/ML (16 186). There was positive ANA with titre and pattern in 34 patients (85.0%), positive antids-DNA in 25 patients (62.5%), and positive anticardiolipin IgM and IgG in 5 patients (12.5%). Renal biopsy was found to be normal in 23 (57.5 percent), lupus nephritis class II, III in 3 (7.5 percent), lupus nephritis class III in 10 (25.0%), and lupus nephritis class IV in 4 (10.0%). Urine analysis results showed the following: normal in 28 (70.0%), albumin in 2 (5.0%), casts in 2 (5.0%), pus cell in 4 (10.0%), albumin + casts in 2 (5.0%) and albumin + pus cell in 2 (5.0%). Regarding semaphorin 3A level, a highly statistically significant variance was noted among the control & patients group concerning semaphorin 3A level found to be lower in cases than control with a p-value below 0.001. In patients' group, a negative correlation for semaphorin 3A with SBP, DBP, AST and ESR and also a positive correlation with steroid duration in the studied pa-tients. In addition, highly significant association between semaphorin 3A & positive CRP. How-ever, no significant relationship between semaphorin 3A & SLE manifestations except arthritis was found related to semaphorin 3A level. ROC curve shows that the semaphorin 3A cut-off point to predict SLE ≤ 3 with sensitivity = 47.50, specificity=92.50, PPV=86.4, and NPV=63.8. CONCLUSION: Reduced plasma Semaphorin 3A levels were found in this study; furthermore, their clinical relationship in SLE proposes their significant job in this illness. Furthermore, the ROC results demonstrated that Semaphorin 3A could be a new symptomatic biomarker in SLE with very high sensitivity for the determination of SLE, demonstrating that they might be helpful bi-omarkers for the evaluation of SLE. However, extra studies that focus on the potential role of Semaphorin 3A in SLE are needed.

Enhancing Time Reading and Recording Skills in First-Grade Children with Learning Difficulties Using the "Clock Motor Game".

This study aimed to explore the effect of the motor game, "Clock Motor Games", on the improvement of "Reading and Recording of Time" (RRT) in children with Grade 1 mathematical learning difficulties (MLDs). A within-school cluster-randomized intervention study was conducted with 232 children (aged 6-7 years) with limited physical education experience (0.7 ± 0.3 years). The participants were divided into two groups: a control group, which received conventional teaching on time without any additional motor activities, and an experimental group, which incorporated the concept of time with the "Clock Motor Game", for 3 weeks. The Clock-Reading Test was administered before the intervention (T0), immediately after each session (T1), and five weeks after the intervention (T2) in both groups. The results demonstrated that the experimental group exhibited significantly greater improvements in RRT performance compared to the control group (U = 4416.5; p < 0.001; r = 0.3; medium effect). Additionally, the experimental group was more likely to show progress and less likely to experience regression or stagnation compared to the control group (25% vs. 38.4%). The findings suggest that practicing "Clock Motor Games" can positively contribute to the RRT ability in children with Grade 1 MLD.

The Feeling of Pleasure for Overweight Children during Different Types of Physical Activity.

The feeling of pleasure during physical education (PE) could increase with physical activity participation and adherence for overweight children. While traditional games are known to have positive benefits on motor skill development, especially for children with poorer motor skills, and on the body mass of children, little is known about overweight children's feelings of enjoyment when playing these games. To identify a program of physical activity appreciated by overweight children, we tested the effect of different activities, namely soccer (SO), shot put (SP), and traditional motor games (TMGs), on the feelings of pleasure for 28 overweight male children (aged 12.11 ± 0.63 years, BMI 26.89 ± 0.15 kg·m-2) participating in a 3-month cross-over study. To measure affective responses to exercises, we applied a validated feeling scale. The data were collected during eight PE lessons, which were organized for each cycle taught. Post hoc pairwise comparisons revealed a significant difference (Z = -3.195, p < 0.01) between the mean feeling score reported after the SO cycle (2.48 ± 0.41) and that after the TMGs (3.04 ± 0.32). A similar significant difference (Z = -3.304, p < 0.01) was found between the mean feeling scores reported after the SP cycle (2.27 ± 0.32) and the TMGs (3.04 ± 0.32). There was no significant difference between the mean feeling scores reported after the SO (2.48 ± 0.41) and SP cycles (2.27 ± 0.32). In conclusion, the findings of the present study suggest that TMGs may have beneficial effects on the feelings of pleasure for overweight children. Therefore, TMGs might potentially be considered as an alternative to conventional physical activities.

The Positive Impact of Combining Motor Imagery, Action Observation and Coach's Feedback on Archery Accuracy of Young Athletes.

In recent years, learning and motor control researchers have examined, in diverse ways, the practical strategies that enhance motor skill acquisition in sport. In this study we investigated the impact of combining Motor Imagery (MI), Feedback (F), and Action Observation (AO) on the quality of archery longbow shooting at a 10-meter target. We randomly assigned 60 young athletes to (a) a Control group (Control), (b) a Feedback and Motor Imagery group (F + MI), and (c) a Feedback, Motor Imagery, and Action Observation group (F + MI + AO). Over an 8-week intervention period athletes performed two training sessions per week. During each session, all participants engaged in two blocks of ten effective shots. Performance improvement was significantly greater in the F + MI + AO group than in the two other groups, confirming the beneficial impact of combining all three methods of improving archery accuracy. These findings suggest practical recommendations for athletes and trainers for delivering optimal mental training to improve shooting accuracy for these archers.

Perforated gallbladder in neonates with review of literature.

INTRODUCTION: Neonatal perforated gallbladder is a rare and implausible surgical emergency. Pneumoperitonium and neonatal intestinal obstruction are the main clinical presentations. Many cases of neonatal perforated gallbladder had no clear pathology. Most proper treatment is cholecystectomy during formal exploration. CASE PRESENTATION: We reported a case of male neonate in his first days of life, presented with abdominal distention and pneumoperitonium and so, surgical exploration revealed perforated gallbladder for which cholecystectomy done. CLINICAL DISCUSSION: Idiopathic gallbladder perforation is seldom condition and is hard to discover before exploration. Besides, pathogenesis remains unknown. In our presented case, the real cause of perforation was unknown and main presentation was pneumoperitonium. CONCLUSION: Although perforated gallbladder is a rare entity and in most of cases does not cause pneumoperitonium, but perforated gallbladder should be taken in account of all cases of pneumoperitonium.

Working Memory in Overweight Boys during Physical Education Classes.

This study examined the effect of small-sided football games (SSFG) and small-sided Ultimate Frisbee games (SSUFG) on working memory, response times, and feeling mood of boys with overweight. Twenty-eight boys (age 12.23 ± 1.58 years) participated in two trials during physical education lessons (20-min SSFG and 20-min SSUFG) in a counterbalanced, randomized crossover design. The response times and feeling mood were measured for all participants post-exercise through the Sternberg paradigm and feeling scale. For the response times, the paired samples t-test revealed a significantly better reaction time after SSUFG at the "One item level" of the Sternberg paradigm (p = 0.014, Hedges' g = 0.27, small effect) and (p = 0.010, Hedges' g = 0.74, medium effect), at "Three item level" (p = 0.000106, Hedges' g = 1.88, very large effect). The SSFG also showed vigor at the "Five item level" (p = 0.047, Hedges' g = 0.61, medium effect). For the feeling mood, the feeling score was significantly higher after the SSUFG session than the SSFG session and the increase in feeling scores observed after switching from SSFG to SSUFG was significantly different (p < 0.001) from the decrease observed in feeling scores after switching from SSUFG to SSFG. Therefore, the results of the study allow the teacher to introduce new sports and reflect on the motor tasks he or she proposes for boys with overweight during physical education classes.

IL-4Rα (rs1801275) A>G polymorphism in Egyptian immune thrombocytopenia (ITP) patients: a single center experience.

INTRODUCTION: Chronic immune thrombocytopenia (cITP) is characterized by dysregulation of the immune response. Until recently, the role of Th2-related cytokine gene polymorphisms was unclear. Interleukin 4 (IL-4) exerts its functions by binding to three types of IL-4 receptor (IL-4R) complexes. We aimed to explore the potential association between the gene polymorphism of IL-4Rα and cITP. METHODS: We investigated the clinical impact of the IL-4Rα (rs1801275) A>G single nucleotide polymorphism (SNP) using the polymerase chain reaction (PCR) followed by the restriction fragment length polymorphism (RFLP) method in 82 cITP patients and 60 healthy controls (HCs). RESULTS: The IL-4Rα (rs1801275) A>G polymorphism analysis showed the mutant GG genotype was significantly higher in control females (p = 0.033). The wild AA genotype had a higher bleeding score (p = 0.02) in the adulthood onset group. Furthermore, the wild AA genotype in the cITP childhood onset group was significantly associated with the disease severity, as well as the response to treatment (p = 0.040). CONCLUSION: The mutant G allele is protective against the susceptibility to cITP in the Egyptian females. The IL-4Rα (rs1801275) A>G polymorphism may affect the clinical severity of cITP and treatment response in the Egyptian population.

Effects of Ramadan fasting on the diurnal variations of physical and cognitive performances at rest and after exercise in professional football players.

Introduction: Ramadan fasting (RF) is characterized by daily abstinence from food and fluid intake from dawn to sunset. The understanding of the Ramadan effects on the diurnal variations of athletic and cognitive performance is crucial for practitioners, coach and researchers to prepare sport events and optimize performance. The aim of the present study was to reveal the effects of RF on the diurnal variation of physical and cognitive performances at rest and after exercise. Method: In a randomized order, 11 male football players (age: 19.27 ± 0.9; height: 1.79 ± 0.04 cm; body mass: 70.49 ± 3.97 kg; BMI: 21.81 ± 1.59 kg/m2) completed a 30-s Wingate test [i.e., mean (MP) and peak powers (PP)] at 07:00, 17:00, and 21:00 h on five occasions: 1 week before Ramadan (BR); the second (R2); the third (R3); the fourth (R4) week of Ramadan; and 2 weeks after Ramadan (AR), with an in-between recovery period of ≥72 h. Simple (SRT) and choice (CRT) reaction times, mental rotation test (MRT) and selective attention (SA) test were measured before and after Wingate test. Rating of perceived exertion (RPE), body composition, dietary intake, profile of mood states (POMS) and Pittsburgh Sleep Quality Index (PSQI) were assessed over the five periods. Results: Compared to BR, RF decreased MP at 17:00 h (p < 0.05, d = 1.18; p < 0.001, d = 2.21, respectively) and PP at 17:00 h (p < 0.05, d = 1.14; p < 0.001, d = 1.77, respectively) and 21:00 h (p < 0.01, d = 1.30; p < 0.001, d = 2.05, respectively) at R3 and R4. SRT (p < 0.001,d = 1.15; d = 1.32, respectively), number of correct answers (MRTE; p < 0.05, d = 1.27; d = 1.38, respectively) and SA (p < 0.01, d = 1.32; d = 1.64, respectively) increased during R2 and R3 in the evening before exercise compared to BR. Short term maximal exercise enhanced SRT (p < 0.01, d = 1.15; p < 0.001, d = 1.35, respectively), MRTE (p < 0.001, d = 2.01; d = 2.75 respectively) and SA (p < 0.05, d = 0.68; d = 1.18, respectively) during R2 and R3 in the evening. In comparison to BR, sleep latency and sleep duration increased during R3 (p < 0.001, d = 1.29; d = 1.74, respectively) and R4 (p < 0.001, d = 1.78; d = 2.19, respectively) and sleep quality increased in R2, R3 and R4 (p < 0.01, d = 1.60; p < 0.001, d = 1.93; d = 2.03, respectively). Conclusion: During RF, anaerobic and cognitive performances were unaffected in the morning but were impaired in the afternoon and evening. Short-term maximal exercise mitigates the negative effects of fasting on cognitive performance. Maximal exercise could thus partially counteract the effect of fasting on cognitive function.

Enhanced Cr(VI) bioreduction by biochar: Insight into the persistent free radicals mediated extracellular electron transfer.

Biochar can act as a shuttle to accelerate the extracellular electron transfer (EET) by exoelectrogens. However, it is poorly understood how the persistent free radicals (PFRs) in biochar affected EET and the redox reaction. Herein, the effects of the biochar and chitosan modified biochar (CBC) on the Cr(VI) bioreduction by Shewanella oneidensis MR-1 (MR-1) was investigated. Kinetic study indicated that the Cr(VI) bioreduction rate constant by MR-1 was increased by 1.8-33.7 folds in the presence of biochar, and by 2.7-60.2 folds in the presence of CBC, respectively. Moreover, Cr(VI) bioreduction rates increased with the decreasing pH. Results suggested that the electrostatic attraction between Cr(VI) and redox-active particles could accelerate the EET by c-cytochrome due to the promotion of the Cr(VI) migration from aqueous phase to biochar or CBC. Electron paramagnetic resonance analysis suggested that the PFRs affected the electron transfer from the ·O2- generated by MR-1 to Cr(VI) and accelerate the Cr(VI) bioreduction. Remarkably, in the presence of PFRs, this electron shuttling process was dependent on the non-metal-reducing respiratory pathway. Our results offer new insights that free radicals may be widely involved in the EET and strongly impact on the redox reaction in the environment.

Comparison of Renal Function before and after Autologous Stem Cell Transplantation in Egyptian Patients with Multiple Myeloma and Renal Insufficiency: A Retrospective Study.

Renal failure is a common feature of multiple myeloma (MM) that occurs in 20%-40% of newly diagnosed patients with MM and is the result of monoclonal immunoglobulin light chains. Many studies have examined the effect of autologous stem cell transplantation (ASCT) in MM patients with renal impairment and the safety of performing the transplantation in patients with renal failure. This study aimed to compare renal function before and after ASCT in Egyptian MM patients with renal insufficiency to evaluate the effect of ASCT on renal recovery. Our study included 31 MM patients with renal impairment out of 400 patients who met the criteria of the International Myeloma Working Group for symptomatic MM. The estimated glomerular filtration rate (eGFR) calculated by the Modification of Diet in Renal Disease formula was compared before and after the transplant. Only four patients (12.9%) were dependent on dialysis. Six of those with a history of hemodialysis (HD) who were either dependent on dialysis or dialyzed according to need achieved independence from HD. There was no significant correlation between the degree of renal impairment and the disease's status at the time of transplantation (P = 0.86). The study showed significant improvements in serum creatinine levels compared with its value before the transplant (P = 0.016) and in eGFR (P = 0.004). In total, 45% of patients achieved renal improvement, shown by a 25% increase in GFR above the baseline. There was a significant improvement of renal function after ASCT in MM patients with renal impairment.

Evaluation of Serum Visfatin as a Biomarker of Lupus Nephritis in Egyptian Patients with Systemic Lupus Erythematosus.

One of the most significant consequences of systemic lupus erythematosus (SLE) is lupus nephritis (LN). Visfatin, an adipokine that is significantly expressed in visceral fat and is a marker of endothelial dysfunction in chronic kidney disease, has multiple proinflammatory actions. We aimed to evaluate the state of serum visfatin in SLE patients and to detect its possible correlation with the disease's activity and effects on the kidney affection. Fifty patients with active LN, 50 patients with inactive lupus, and 50 healthy people had their serum visfatin levels tested. Chemical and immunological markers of SLE and LN were measured. The SLE Disease Activity Index (SLEDAI) was used to measure the disease's activity. Renal biopsies from the LN subgroup were collected and classified using the modified classification of the World Health Organization. The serum visfatin of patients with active LN was significantly greater than that of inactive lupus patients and the healthy controls (20.56 ± 1.07 ng/mL, 16.77 ± 1.02 ng/mL, and 9.96 ± 1.46 ng/mL, P <0.001). SLEDAI and serum visfatin levels were shown to be significantly correlated (P = 0.000057). Serum visfatin levels were likewise significantly correlated with the index of histological activity in the active group (P <0.00001). Serum visfatin was raised in individuals with active LN and was related to the SLEDAI and disease severity scores. Serum visfatin could be utilized as a noninvasive biomarker for evaluating the severity of LN and risk stratification of the risk.

YouTube as a complementary learning tool in times of COVID-19: Self-reports from sports science students.

OBJECTIVES: This study reports on sports science students' educational experience in times of the COVID-19 pandemic and explores their interactions with online technologies, exclusively for learning purposes. METHODS: A total of 181 Tunisian final-year sports science students were surveyed using, a custom-designed questionnaire, following the end of the academic year 2020/2021. Semi-structured interviews were conducted for triangulation and validation of the findings. FINDINGS: Participants reported that COVID-19-induced educational disruptions had detrimental effects on their learning experiences. Even though they deemed emergency remote teaching to be less effective than classroom-based teaching, participants recognized the role technology had played in mitigating the impact of the pandemic on their graduation year. They reported using a wide range of online technologies to complement remote curriculum delivery. Ranking second after Google Meet, with a marked difference from the rest of the list, YouTube seemed to be sports science students' best "learning companion" in times of COVID-19. YouTube helped them better understand instructional content delivered remotely and compensate for the missed opportunities for knowledge and motor skill acquisition. CONCLUSIONS: It is very likely that curriculum-based YouTube videos can smoothen emergency implementation of flipped classrooms during future crises that may force teachers and students into home confinement once again, but further empirical research is needed in this area.

Ionic Strength-Dependent Attachment of Pseudomonas aeruginosa PAO1 on Graphene Oxide Surfaces.

Graphene oxide (GO) is a widely used antimicrobial and antibiofouling material in surface modification. Although the antibacterial mechanisms of GO have been thoroughly elucidated, the dynamics of bacterial attachment on GO surfaces under environmentally relevant conditions remain largely unknown. In this study, quartz crystal microbalance with dissipation monitoring (QCM-D) was used to examine the dynamic attachment processes of a model organism Pseudomonas aeruginosa PAO1 onto GO surface under different ionic strengths (1-600 mM NaCl). Our results show the highest bacterial attachment at moderate ionic strengths (200-400 mM). The quantitative model of QCM-D reveals that the enhanced bacterial attachment is attributed to the higher contact area between bacterial cells and GO surface. The extended Derjaguin-Landau-Verwey-Overbeek (XDLVO) theory and atomic force microscopy (AFM) analysis were employed to reveal the mechanisms of the bacteria-GO interactions under different ionic strengths. The strong electrostatic and steric repulsion at low ionic strengths (1-100 mM) was found to hinder the bacteria-GO interaction, while the limited polymer bridging caused by the collapse of biopolymer layers reduced cell attachment at a high ionic strength (600 mM). These findings advance our understanding of the ionic strength-dependent bacteria-GO interaction and provide implications to further improve the antibiofouling performance of GO-modified surfaces.

Hemostatic system and COVID-19 crosstalk: A review of the available evidence.

Since the discovery of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its resultant coronavirus disease 2019 (COVID-19) pandemic, respiratory manifestations have been the mainstay of clinical diagnosis, laboratory evaluations, and radiological investigations. As time passed, other pathological aspects of SARS-CoV-2 have been revealed. Various hemostatic abnormalities have been reported since the rise of the pandemic, which was sometimes superficial, transient, or fatal. Mild thrombocytopenia, thrombocytosis, venous, arterial thromboembolism, and disseminated intravascular coagulation are among the many hemostatic events associated with COVID-19. Venous thromboembolism necessitating therapeutic doses of anticoagulants is more frequently seen in severe cases of COVID-19, especially in patients admitted to intensive care units. Hemorrhagic complications rarely arise in COVID-19 patients either due to a hemostatic imbalance resulting from severe disease or as a complication of over anticoagulation. Although the pathogenesis of coagulation disturbance in SARS-CoV-2 infection is not yet understood, professional societies recommend prophylactic antithrombotic therapy in severe cases, especially in the presence of abnormal coagulation indices. The review article discusses the various available evidence on coagulation disorders, management strategies, outcomes, and prognosis associated with COVID-19 coagulopathy, which raises awareness about the importance of anticoagulation therapy for COVID-19 patients to guard against possible thromboembolic events.

Evaluation of graphene oxide, chitosan and their complex as antibacterial agents and anticancer apoptotic effect on HeLa cell line.

Cancer and bacterial infection are the most serious problems threatening people's lives worldwide. However, the overuse of antibiotics as antibacterial and anticancer treatments can cause side effects and lead to drug-resistant bacteria. Therefore, developing natural materials with excellent antibacterial and anticancer activity is of great importance. In this study, different concentrations of chitosan (CS), graphene oxide (GO), and graphene oxide-chitosan composite (GO-CS) were tested to inhibit the bacterial growth of gram-positive (Bacillus cereus MG257494.1) and gram-negative (Pseudomonas aeruginosa PAO1). Moreover, we used the most efficient natural antibacterial material as an anticancer treatment. The zeta potential is a vital factor for antibacterial and anticancer mechanism, at pH 3-7, the zeta potential of chitosan was positive while at pH 7-12 were negative, however, the zeta potential for GO was negative at all pH values, which (p < 0.05) increased in the GO-CS composite. Chitosan concentrations (0.2 and 1.5%) exhibited antibacterial activity against BC with inhibition zone diameters of 4 and 12 mm, respectively, and against PAO1 with 2 and 10 mm, respectively. Treating BC and PAO1 with GO:CS (1:2) and GO:CS (1:1) gave a larger (p < 0.05) inhibition zone diameter. The viability and proliferation of HeLa cells treated with chitosan were significantly decreased (p < 0.05) from 95.3% at 0% to 12.93%, 10.33%, and 5.93% at 0.2%, 0.4%, and 0.60% concentrations of chitosan, respectively. Furthermore, CS treatment increased the activity of the P53 protein, which serves as a tumor suppressor. This study suggests that chitosan is effective as an antibacterial and may be useful for cancer treatment.

The effect of time of day and high intensity exercise on cognitive performances of elite adolescent karate athletes.

To explore the effect of time of day (TOD) on several components of cognitive performance prior and post to a physically exhaustive task in a sample of adolescent elite athletes. In a counterbalanced and randomized order, fourteen highly trained male karate athletes (17 ± 0.96 years; 1.75 ± 0.07 m; 68.0 ± 9.50 kg; BMI 22.15 ± 0.54 kg.m-2) completed two test sessions at 09h00 and 16h00. Cognitive performance was evaluated before and after the karate specific test (KST). During each session, participants completed the profile of mood state (POMS), simple (SRT) and choice (CRT) reaction times, comparison test (COMT), mental rotation test (MRT), egocentric distance estimation (DE), and the rating of perceived exertion (RPE). KST was not TOD dependent (p > .05, d = 0.33). RPE scores were higher in the afternoon compared to the morning (p < .05, d = 0.68). Before the KST, SRT (p < .01, d = 0.69), CRT (p < .01, d = 0.47), COMT (p < .01, d = 0.62) and MRT (p < .001, d = 0.65) were better in the afternoon than in the morning. However, DE was not affected by the TOD (P > .05). KST improved SRT (p < .01, d = 0.078), CRT (p < .001, d = 0.72), COMT (p < .001, d = 1.31) and MRT (p < .001, d = 0.80) performances only in the morning. Cognitive performances are TOD dependent with higher performances realized in the afternoon. Performing a high intensity exercise in the morning, but not in the afternoon, enhanced several aspects of cognitive performances. The current results indicate that an intensive warm-up could be beneficial when a morning competition requires high cognitive readiness.

Improvement of Pancreatic Steatosis and Indices of Insulin Resistance After Metabolic Surgery.

Purpose: Obesity is associated with fat accumulation in ectopic sites such as the pancreas, the so-called pancreatic steatosis (PS). Bariatric surgery has been shown to be associated with reducing pancreatic fat. This study investigated the effect of laparoscopic sleeve gastrectomy (LSG) on pancreatic volume and its fat content and glucose homeostasis. Methods: The study enrolled 54 patients subjected to LSG. Metabolic variables and pancreatic exocrine function were assessed immediately before surgery and 12 months after. MRI of the abdomen was performed to measure pancreatic fat content and its total volume and visceral adipose tissue (VAT). Results: Surgery resulted in a significant reduction in body weight and BMI. HbA1c, fasting insulin, C-peptide levels, HOMA-IR, and Hs-CRP levels decreased significantly. Surgery resulted in significant improvement in lipid profile except for HDL-cholesterol and liver function tests. Total VAT volume decreased significantly. Total pancreas volume decreased by a mean of 9.0 cm3 (95% CI: 6.6-11.3). The median change of pancreatic fat was -26.1% (range: -55.6 to 58.3%). Pancreatic lipase decreased significantly (P < 0.001). There was a positive correlation between the percentage of total weight loss and decrease in pancreatic fat volume (r = 0.295, P = 0.030). Conclusion: Weight loss after LSG is associated with a reduction of total VAT volume, total pancreatic volume, and pancreatic fat content. These changes are associated with improved glucose homeostasis, reduced systemic inflammation, and decreased pancreatic lipase secretion.

Efficacy of dexmedetomidine versus magnesium sulfate as an adjuvant to intraperitoneal bupivacaine in pediatric laparoscopic surgery: a randomized clinical trial.

BACKGROUND: We evaluated the efficacy of dexmedetomidine versus magnesium sulfate as an adjuvant to intraperitoneal (IP) bupivacaine in pediatric laparoscopic inguinal herniorrhaphy. METHODS: Ninety-seven male children, ASA I-II, 1-6 years old, undergoing laparoscopic inguinal herniorrhaphy, were randomized to receive before peritoneal insufflation, IP 2 mg.kg-1 bupivacaine 0.5% combined with either 1 µg.kg-1 of dexmedetomidine (Group D), 30 mg.kg-1 of magnesium sulfate (Group M), or normal saline (Group C). All tested drugs were diluted to the volume of 10 mL with normal saline. FLACC pain scores, need for rescue analgesics, time to flatus and first stool, emetic events, adverse effects, functional recovery, and parents' satisfaction were recorded for the first 48 h postoperatively. RESULTS: FLACC scores were significantly higher in Group C than in the other two groups at 6, 8, 12, 18, 24, and 48 hours after surgery with no differences between Groups D and M. Rescue analgesia was significantly higher in Group C with none of the children in Groups D and M requiring rescue analgesia (p = 0.001). Times to first flatus and stool, emetic events, and adverse effects did not differ among groups. Times to return to normal functional activity were comparable in all groups. Parents' satisfaction was greater in Groups D and M than in Group C (p = 0.026). CONCLUSION: Dexmedetomidine and magnesium sulfate added to IP bupivacaine improved the analgesia afforded by bupivacaine in the first two postoperative days in children scheduled for laparoscopic herniorrhaphy.

Rectovestibular fistula: Which surgical approach is suitable? A randomized controlled trial.

The management of a vestibular fistula is a challenge for pediatric surgeons. We compared four different operative techniques in terms of postoperative complications, continence, and cosmetic appearance. This prospective, randomized, comparative study included female children with rectovestibular fistulae who were selected from patients with Anorectal Malformations (ARMs) treated between January 2016 and July 2020. The patients were randomly divided into four groups based on the operative technique: Trans-Sphincter Anorectoplasty (TSARP), Posterior Sagittal Anorectoplasty (PSARP), Classic Anterior Sagittal Anorectoplasty (ASARP), and modified ASARP. The incidence of vestibular fistulae among all patients with ARMs was 13.4%. The total number of patients with vestibular fistula was 112, including eighty-four (75%) with rectovestibular fistulae and twenty-eight (25%) with anovestibular fistulae. Associated congenital anomalies were found in nineteen (22.6%) patients. The percentage of parents satisfied with the cosmetic appearance and continence of their children was the highest after TSARP. PSARP had the lowest incidence regarding vaginal wall injuries. TSARP is the best operative technique for handling rectovestibular fistulae and is suitable for infants and children. In the TSARP technique, the external sphincter muscle can be preserved following complete dissection of the rectum without the need for a midline skin incision. A midline skin incision is required in the modified ASARP technique.

Size-dependent visible-light-enhanced Cr(VI) bioreduction by hematite nanoparticles.

Light irradiation would affect the electron transfer between dissimilatory metal-reducing bacteria (DMRB) and semiconducting minerals, which may impose a great influence on the biogeochemistry cycle of heavy metals. However, the size effect of semiconducting minerals on the its electron transfer with DMRB and microbial Cr(VI) reduction under visible light irradiation is little known. Herein, the Cr(VI) reduction by Shewanella oneidensis MR-1 (MR-1) was investigated in the presence of hematite nanoparticles with average diameters of 10 nm and 50 nm in dark and under visible light irradiation. It is found that hematite nanoparticles adhered onto MR-1 cells to form the composites, leading to the decrease in surface sites and Zeta potential. Hematite mediated-Cr(VI) bioreduction rate under visible light irradiation was 0.342 h-1, which is 3.4 folds enhancement compared with that in dark and 4.4 folds compared with the MR-1 alone under visible light irradiation. Decreasing nanoparticle size of hematite from 50 nm to 10 nm promoted the Cr(VI) reduction under visible light irradiation but impeded it in dark. It was deduced that the bioelectrons from MR-1 could promote the separation of photoelectron-hole pairs of light-irradiated hematite, which consequently enhanced the Cr(VI) bioreduction by MR-1-hematite composites. Moreover, mutant strains experiments demonstrated the vital role of c-cytochrome for the conducting network actively established by MR-1 with hematite nanoparticles. Those findings expand the understanding of the electron transfer pathway for enhancing Cr(VI) reduction by hematite-MR-1 composites, and the impact of particle size on the interaction between semiconducting mineral and electroactive bacteria under light irradiation.