Multivariate analysis and GIS approaches for modeling and mapping soil quality and land suitability in arid zones.

Assessing soil quality marks the initial step in precision farming and agricultural management. Developing countries like Egypt face numerous hurdles in ensuring food security due to increasing populations and limited agricultural resources. A geographic information system (GIS) and multivariate analysis were utilized in the current work to evaluate and map a soil quality index (SQI). Moreover, the land suitability of the land for two plantations of the tree's oak (Quercus robur), and pine (Pinus silvestris), respectively was assessed using a parametric approach. A total of 82 soil profiles were selected to fulfill the objectives of the study. Based on the samples' PC scores, and agglomerative hierarchical clustering (AHC, the data was divided into two clusters: Cluster I and Cluster II, which collectively account for approximately 57% and 43% of the total data, respectively.. . The findings indicated that land suitability for planting Q. robur planted identified 2.14% of the research area as highly suitable (S1), 37.98% as moderately suitable (S2), and 59.89% as not suitable (N). Furthermore, the assessment of suitability for P. silvestris indicated that 50.88% of the investigated area was classified into: S1, 48.73% as S2, and 0.39% as N, which means it is not suitable for conservation activities. The research identified that soil depth beside excessive salinity and calcium carbonate as the primary soil constraints in the area in both clusters. The average soil depth, ECd and CaCO3 were 113.62 ± 12.41, 17.27 ± 10.23, 16.83 ± 6.57 in Cluster 1 and 45.43 ± 15.21, 22.42 ± 12.43, 21.55 ± 5.63 in Cluster II. The study demonstrates that integrating multivariate analysis with GIS enables a precise and streamlined assessment of the Soil Quality Index (SQI). Soil suitability modelling underscores the importance of implementing efficient management practices to attain agricultural sustainability in arid regions, particularly amidst intensive land utilization pressures.

Nose-to-Brain Targeted Delivery of Donepezil Hydrochloride via Novel Hyaluronic Acid-Doped Nanotransfersomes for Alzheimer's Disease Mitigation.

Alzheimer's disease is the most serious neurodegenerative disorder characterized by cognitive and memorial defects alongside deterioration in behavioral, thinking and social skills. Donepezil hydrochloride (DPZ) is one of the current two FDA-approved cholinesterase inhibitors used for the management of Alzheimer's disease. The current study aimed to formulate hyaluronic acid-coated transfersomes containing DPZ (DPZ-HA-TFS) for brain delivery through the intranasal pathway to surpass its oral-correlated GIT side effects. DPZ-HA-TFS were produced using a thin film hydration method and optimized with a 24 factorial design. The influence of formulation parameters on vesicle diameter, entrapment, cumulative release after 8 h, and ex vivo nasal diffusion after 24 h was studied. The optimal formulation was then evaluated for morphology, stability, histopathology and in vivo biodistribution studies. The optimized DPZ-HA-TFS formulation elicited an acceptable vesicle size (227.5 nm) with 75.83% entrapment efficiency, 37.94% cumulative release after 8 h, 547.49 µg/cm2 permeated through nasal mucosa after 24 h and adequate stability. Histopathological analysis revealed that the formulated DPZ-HA-TFS was nontoxic and tolerable for intranasal delivery. Intranasally administered DPZ-HA-TFS manifested significantly superior values for drug targeting index (5.08), drug targeting efficiency (508.25%) and direct nose-to-brain transport percentage (80.32%). DPZ-HA-TFS might be deemed as a promising intranasal nano-cargo for DPZ cerebral delivery to tackle Alzheimer's disease safely, steadily and in a non-invasive long-term pattern.

Three dimensional custom-made PEEK cranioplasty.

BACKGROUND: An optimal reconstruction of calvarial skull defects is a challenge for neurosurgeons, and the strategy used to achieve the best result remains debatable. Therefore, we conducted this study to compare the esthetic and functional outcome of custom-made three-dimensional (3D) cranioprostheses to handmade bone cement in reconstructing calvarial skull defects. METHODS: We included 66 patients above 10 years of age with calvarial skull defects and undergoing reconstruction: 33 were enrolled in the custom-made 3D implants group and 33 in the handmade implants group in the period from August 2017 to December 2020 in the neurosurgery department of Fayoum University Hospital. RESULTS: Complete success of the esthetic end-point was insignificantly higher in the custom-made 3D prostheses group based on the doctor's and patients' assessment (60.6% vs. 42.4%; 33.3% vs. 9.1%, P > 0.05), respectively. Complete success of the functional end-point was significantly higher in the custom-made 3D group compared to the handmade cement bone group according to the doctor's and patients' assessment (60.6% vs. 0%; 21.2% vs. 0%, P < 0.05). There were no late complications noted in the custom-made 3D prosthesis group, whereas 50% of the handmade bone group had late complications (P < 0.05). Full improvement of the symptoms of the "syndrome of trephined" was achieved in the 3D custom-made group compared to the handmade bone cement group (20% vs. 0%). CONCLUSION: Cranioplasty using three dimensional customs made PEEK prosthesis is a reliable method which saves operative time, lowers cost and provides less complications if compared with other cranioplasty techniques. Custom-made 3D cranioprostheses are better than handmade bone cement in reconstructing calvarial defects in terms of esthetic and functional outcome as well as complications.

Comparative effect of desflurane and sevoflurane on liver function tests of patients with impaired hepatic function undergoing cholecystectomy: A randomized clinical study.

BACKGROUND AND AIM: Desflurane and sevoflurane are the most common volatile anesthetics used during laparoscopic and hepatic surgery. The objective of the study was to evaluate the effect of desflurane and sevoflurane in patients with elevated preoperative liver functions undergoing laparoscopic cholecystectomy. METHODS: The study was a randomized study and included 162 patients classified randomly into two groups: Desflurane group: The patients received desflurane (end-tidal concentration 4%-6%) as an inhalational agent during the whole procedure. Sevoflurane group: The patients received sevoflurane (end-tidal concentration 2%-4%) as an inhalational agent during the whole procedure. The investigations included serum level of aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), gamma-glutamyltransferase (GGT), and total bilirubin. The values were serially collected at the following timepoints; T0:at the preoperative period, T1:directly after surgery, T2:1st postoperative day, T3:2nd postoperative day, T4:3rd postoperative day, T5:5th postoperative day, T6:7th postoperative day, and T7:10th postoperative day. The statistics were described in terms of mean ± standard deviation, frequencies, and percentages. RESULTS: The preoperative liver enzymes and total bilirubin were higher than the normal range in patients of the two groups. Postoperatively, there was a decrease in the AST and ALT with desflurane more than sevoflurane from T1 to T6(P < 0.05). The ALP, GGT, and bilirubin decreased in patients of the two groups, but the comparison was insignificant (P > 0.05). CONCLUSION: The desflurane is a safe inhalational volatile for maintenance of anesthesia in patients with impaired liver function undergoing laparoscopic cholecystectomy. It was associated with a decrease in the liver enzymes more than the sevoflurane.

Fetus in Fetu: Lessons Learned from a Large Multicenter Cohort Study.

INTRODUCTION: Fetus in fetu (FIF) is an extremely rare condition of abnormal twinning during embryogenesis. Most publications are single case reports. We describe the combined experience of four large tertiary referral centers with FIF which were not previously reported or published, and thereby draw conclusions to establish criteria for the workup, diagnosis, and management including intraoperative risk. MATERIALS AND METHODS: A survey was forwarded to a national pediatric surgery group which includes members from all pediatric surgery centers in the country enquiring about unpublished cases of FIF encountered over a 20-year interval. The cohort was analyzed for age of presentation, type of presentation, diagnostic workup, surgical management, and outcome. RESULTS: From 1998 to 2018, a total of 10 FIF cases were included in the study. Mean age of presentation was 4 months. Computed tomography and ultrasound were the main preoperative diagnostic modality in our cohort. Resection of the mass was curative in nine cases. Two cases in which the FIF was in direct topographic proximity to the biliary tree suffered severe intraoperative or lethal postoperative complications. CONCLUSION: Complete excision of FIF is the treatment of choice and generally results in excellent long-term quality of life. Mortality is rare and may be associated with biliary involvement and retroperitoneal right upper quadrant location of the FIF tends to be associated with increased risk in excision, and there is also a possible association with the presence of immature elements in the pathology report.

Continuous Lumbar Drainage for the Prevention and Management of Perioperative Cerebrospinal Fluid Leakage.

BACKGROUND: Cerebrospinal fluid (CSF) leak is an unfortunate, yet well-recognized complication of skull base fractures, skull base surgeries, and variety of spinal procedures. Continuous lumbar drainage (CLD) of leaking CSF has shown a high success rate with minimal morbidities in handling CSF leak in these patients. Therefore, we conducted this study to illustrate the efficacy of CLD as a prophylactic and therapeutic method for CSF leakage with the assessment of clinical outcome and early postoperative sequel. MATERIALS AND METHODS: In the period from January to December 2017, patients with traumatic or postoperative CSF leak and those susceptible for postoperative CSF leak as skull base and spinal intradural surgeries at the Neurosurgery Department, Fayoum University, were included in our study. RESULTS: A total of 20 eligible patients were included in the study. All patients showed successful cessation of CSF leakage at different durations of CLD. Fifteen patients showed excellent results; four showed good results; and one showed fair results. Besides a minimal pneumocephalus, headache was the most common presenting complication in our population, which occurred to all patients. Six patients had vomiting beside headache, whereas two patients experienced vomiting and nausea in addition to headache. There were neither mortalities nor life-threatening complications noted; however, a superficial wound infection occurred in a single case. CONCLUSION: CLD is a simple, safe, and efficient method in the management of CSF leakage at operative sites, CSF rhinorrhea, and CSF otorrhea of various etiologies.