Impact of Escherichia coli, Candida non-albicans, and Trichomonas vaginalis on Semen Chemical and Functional Parameters: an In-Vitro Study.

BACKGROUND: Infertility is a worldwide medical issue in which infection is recognized to play a major role. Pathogens trigger various mechanisms that impact fertility, either directly by affecting the physiological indices of semen or indirectly by disrupting the process of spermatogenesis. In the current work, the effect of in-vitro cultivation of Escherichia coli (E. coli), Candida non-albicans (C. non-albicans), and Trichomonas vaginalis (T. vaginalis) (as the most frequently reported sexually transmitted infections) was assessed on the physiological functions of the spermatozoa and the chemical characteristics of the seminal fluid. METHOD: The semen samples were exposed to cultures of E. coli, C. non-albicans, and T. vaginalis. The study analyzed the changes in motility, agglutination, viability, DNA fragmentation index (DFI%), seminal pH, and biochemical parameters at 1/2, 1, 1.5, 2, 2.5, 3.5 and 4 hours. RESULTS: Incubation of the semen samples with E. coli resulted in a progressive increase in agglutination, pH, and nitrite. The seminal glucose and the sperm motility, on the other hand, were reduced. The sperm vitality and seminal protein remained unaffected. C. non-albicans induced three forms of agglutination (head-to-head, tail-to-tail, and head-to-tail), lowered pH values and decreased the sperm motility, but did not alter the seminal protein, glucose, nitrite, nor the spermatozoa viability at the different tested time intervals. T. vaginalis resulted in increased seminal protein, and reduced glucose, pH, and motility. It also induced minimal agglutination and caused unchanged nitrite and sperm viability. The DFI% was increased in all pathogens with the C. non-albicans showing the highest DNA fragmentation index. CONCLUSION: Urogenital infection with E. coli, C. non-albicans, or T. vaginalis is assumed to affect the quality of semen through DNA fragmentation, agglutination and altered seminal chemical microenvironment.

To B or not to B: the application of uterine compression sutures to reduce blood loss after myomectomy.

Introduction: The aim was to assess the hemostatic impact of B-Lynch sutures following an open myomectomy for efficacy. Material and methods: In this prospective clinical research, performed in Alazhar university hospitals (Al-Hussain, Damietta, Assiut) and Minia University Maternity Hospital, 250 women scheduled for open myomectomy between January 2021 and January 2023 had multiple fibroid uteri with uterine sizes corresponding to 12-22 weeks. There were two groups of women. Group I (125) underwent standard open myomectomy surgery, whereas Group II (125) underwent normal open laparotomy surgery followed by B-Lynch sutures. Certain inclusion and exclusion criteria were applied to every patient. We recorded vital data, length of the procedure, complications (bleeding during the procedure, bleeding from multiple bites, bladder injury, fever, wound infection), complete blood count before and after surgery, need for blood transfusion, postoperative vital data, time until ambulation, passing flatus, and ability to eat and drink, as well as the amount of blood lost during and after the procedure. Results: There was no statistically significant difference between the two groups in age, parity, weight, number of fibroids, or uterine size as measured by ultrasonography. Between groups I and II, there was a significant difference in the average intraoperative blood loss (Group I lost 562.6 ml, whereas Group II lost 411.3 ml) as well as the mean blood loss following surgery (205 ±82 ml in Group I and 117 ±41 ml in Group II). No significant difference was observed in the mean length of hospital stay between groups I and II (2 ±0.3 days and 2 ±0.6 days, respectively). Conclusions: Using a B-Lynch suture can help minimize blood loss during and after an open myomectomy. Therefore, if the uterus is large and has a lot of fibroids, it is recommended to be done frequently.

Logistic regression and other statistical tools in diagnostic biomarker studies.

A biomarker is a measured indicator of a variety of processes, and is often used as a clinical tool for the diagnosis of diseases. While the developmental process of biomarkers from lab to clinic is complex, initial exploratory stages often focus on characterizing the potential of biomarkers through utilizing various statistical methods that can be used to assess their discriminatory performance, establish an appropriate cut-off that transforms continuous data to apt binary responses of confirming or excluding a diagnosis, or establish a robust association when tested against confounders. This review aims to provide a gentle introduction to the most common tools found in diagnostic biomarker studies used to assess the performance of biomarkers with an emphasis on logistic regression.

Knowledge, Perceptions and Attitude of Researchers Towards Using ChatGPT in Research.

INTRODUCTION: ChatGPT, a recently released chatbot from OpenAI, has found applications in various aspects of life, including academic research. This study investigated the knowledge, perceptions, and attitudes of researchers towards using ChatGPT and other chatbots in academic research. METHODS: A pre-designed, self-administered survey using Google Forms was employed to conduct the study. The questionnaire assessed participants' knowledge of ChatGPT and other chatbots, their awareness of current chatbot and artificial intelligence (AI) applications, and their attitudes towards ChatGPT and its potential research uses. RESULTS: Two hundred researchers participated in the survey. A majority were female (57.5%), and over two-thirds belonged to the medical field (68%). While 67% had heard of ChatGPT, only 11.5% had employed it in their research, primarily for rephrasing paragraphs and finding references. Interestingly, over one-third supported the notion of listing ChatGPT as an author in scientific publications. Concerns emerged regarding AI's potential to automate researcher tasks, particularly in language editing, statistics, and data analysis. Additionally, roughly half expressed ethical concerns about using AI applications in scientific research. CONCLUSION: The increasing use of chatbots in academic research necessitates thoughtful regulation that balances potential benefits with inherent limitations and potential risks. Chatbots should not be considered authors of scientific publications but rather assistants to researchers during manuscript preparation and review. Researchers should be equipped with proper training to utilize chatbots and other AI tools effectively and ethically.

Micro-Morphological Features of the Er:YAG-Lased Interface in Primary Teeth: 12 Months Randomized Split-Mouth Trial.

Despite considerable improvements in oral health, dental caries remains a public health issue. The most frequently used technique to remove caries is through rotating drills. New minimally invasive strategies were introduced into dental practice, such as the use of lasers to perform highly controlled tissue ablation while limiting pain and discomfort, as well as overcoming drill phobia. The objective was to assess and compare treatment with Er:YAG laser versus a conventional rotary treatment during cavity preparation in children with regard to bond interface quality. In a randomized trial using a split-mouth design, 40 (9-12 year-old) children with 80 carious primary molars were included. The cavity in one quadrant was treated conventionally using a bur, while the cavity in the other quadrant was prepared using an Er:YAG laser. Twenty restored teeth were extracted after one year. The SEM histological evaluation of bond interface results demonstrated no statistically significant differences between restorations placed following bur preparation and those placed following the Er:YAG laser preparation, and both treatments demonstrated promising results. Over a one-year period, no statistically significant differences in the bond interface quality were observed following class I cavity preparation in primary teeth with either Er:YAG laser or a conventional rotary bur.

Researchers' Perspectives Regarding Ethical Issues of Biobank Research in the Arab Region.

Background: The recent expansion of genomic biobank research in the Arab region in the Middle East North Africa has raised complex ethical and regulatory issues. However, there is a lack of studies regarding the views of Arab researchers involved in such research. We aimed to assess the perceptions and attitudes of Arab researchers regarding these issues in biobank research. Methods: We developed a questionnaire to assess the perceptions and attitudes regarding genetic research of researchers from Egypt, Sudan, Morocco, and Jordan. The questionnaire requested demographic data, perceptions, and attitudes regarding the collection, storage, and use of biospecimens and data, the use of broad consent, data security, data sharing, and community engagement. We used multiple linear regressions to identify predictors of perceptions and attitudes. Results: We recruited 383 researchers. Researchers favored equally the use of broad and tiered consent (44.1% and 39.1%, respectively). Most respondents agreed with the importance of confidentiality protections to ensure data security (91.8%). However, lower percentages were seen regarding the importance of community engagement (64.5%), data sharing with national colleagues and international partners (60.9% and 41.1%, respectively), and biospecimen sharing with national colleagues and international partners (59.9% and 36.2%, respectively). Investigators were evenly split on whether the return of individual research results should depend on the availability or not of a medical intervention that can be offered to address the genetic anomaly (47.5% and 46.4%, respectively). Predictors of attitudes toward biospecimen research included serving on Research Ethics Committees, prior research ethics training, and affiliation with nonacademic institutions. Conclusions: We recommend further exploratory research with researchers regarding the importance of community engagement and to address their concerns about data sharing, with researchers within and outside their countries.

The Efficacy of Intercostal Nerve Block in the Management of Postoperative Pain After Costal Cartilage Harvest for Craniofacial Reconstruction Systematic Review and Meta-analysis.

INTRODUCTION: Autologous costal cartilage harvest is a common procedure in craniofacial reconstruction due to its stability, dependability, and diversity. However, such a procedure is associated with severe donor-site pain postoperatively. Therefore, we aim through this study to compare the efficacy of intercostal nerve block in the management of postoperative pain in patients undergoing costal cartilage harvest for craniofacial reconstruction. METHOD: This systematic review was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. The study systematically reviewed MEDLINE, Cochrane, and EMBASE databases without time-limitation. RESULTS: As a result of reviewing the literature, 33 articles were screened by full-text resulting in 14 articles which met our inclusion/exclusion criteria. However, only four high-quality RCT articles were included in the quantitative synthesis (meta-analysis). The findings of this study suggest that there is no significant difference in pain scores between ICNB and control groups at 12, 24, and 48 h postoperatively, both at rest and with coughing. Therefore, both techniques are considered safe and effective. CONCLUSION: Our results show evidence of favorable outcome of preventive donor-site analgesia with ICNB for harvesting autologous costal cartilage in multiple studies. However, the overall outcomes were insignificant between the two arms. NO LEVEL ASSIGNED: This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Circulating ESR1, long non-coding RNA HOTAIR and microRNA-130a gene expression as biomarkers for breast cancer stage and metastasis.

Breast cancer, the most prevalent cancer among women, has posed a significant challenge in identifying biomarkers for early diagnosis and prognosis. This study aimed to elucidate the gene expression profile of Estrogen Receptor-1 (ESR-1), long non-coding RNA HOTAIR, and microRNA-130a in the serum of Egyptian breast cancer patients, evaluating the potential of HOTAIR and miR-130a as biomarkers for predicting pathological parameters in BC. The study involved 45 patients with primary BC, with serum samples collected preoperatively and postoperatively twice. The expression levels of ESR-1, HOTAIR, and miR-130a were quantified using real-time PCR and analyzed for correlations with each other and with the clinical and pathological parameters of the patients. Serum HOTAIR levels exhibited a strong positive association with metastasis and demonstrated a significant increase after 6 months in all patients with locally advanced and stage IV BC. Conversely, tumors with advanced stages and metastatic lesions showed significantly lower expression levels of miR-130a. Notably, a significant positive correlation was observed between preoperative ESR-1 expression and both HOTAIR and miR-130a levels. Serum HOTAIR and miR-130a levels have emerged as promising non-invasive biomarkers with the potential to predict the pathological features of BC patients. HOTAIR, an oncogenic long non-coding RNA (lncRNA), and miR-130a, a tumor suppressor miRNA, play crucial roles in tumor progression. Further investigations are warranted to elucidate the intricate interplay between HOTAIR and miR-130a and to fully comprehend the contribution of HOTAIR to BC recurrence and its potential utility in early relapse prediction.

Experimental Analysis and Optimization Approach of Self-Clocked Rate Adaptation for Multimedia Congestion Control Algorithm in Emulated 5G Environment.

The congestion problem has driven many researchers to address it, among other networking issues. In a packet-switched network, congestion is essential; it leads to a high response time to deliver packets due to heavy traffic, which eventually causes packet loss. Hence, congestion control mechanisms are utilized to prevent such cases. Several interesting algorithms are proposed to focus on this dilemma, such as the Self-Clocked Rate Adaptation for Multimedia (SCReAM) designed for interactive real-time video streaming applications. One of the main issues of SCReAM is the high design complexity due to the large size of its documentation and coding. Furthermore, there is a considerable number of parameters that can be adjusted to accomplish the desired performance. This study proposes a guided parameters' tuning approach to assess and optimize the SCReAM algorithm in an emulated 5G environment through a detailed exploration of its parameters. The proposed approach consists of three phases, namely, the initialization phase, the standalone experimentation phase, and the hybrid experimentation phase. In the first phase, we illustrate the method of initializing and implementing the environment, followed by specifying the investigated parameters' settings, testing, and validation. The second phase aims to investigate SCReAM parameters in isolation to identify the effect on the performance in relation to network queue delay, smoothed Round Trip Time (sRTT), and throughput. The final phase discusses the possibility of achieving the optimum performance by combining various sets to provide researchers with clear and explicit guidelines to establish an adequate SCReAM behavior for the desired application. To the best of our knowledge, this is the first study that proposes a preliminary and comprehensive analysis of the SCReAM algorithm. Based on the proposed approach, when L4S/ECN is disabled, we reduced the network queue delay by 63.36% and increased the network throughput by 48.6% as compared to the results generated by the original design. In L4S/ECN-enabled mode, the network queue delay is reduced by 16.17% while the network throughput increased by 93%.

Monocyte to eosinophil ratio as a diagnostic biomarker for overlap syndrome and predictor of disease exacerbation.

Objectives: Chronic Obstructive Pulmonary Disease (COPD) is one of the most common pulmonary diseases. The concomitant association of Obstructive Sleep Apnea (OSA) and COPD is known as the Overlap Syndrome (OS). This study aimed to identify markers for predicting OS, among routine laboratory tests, including differential blood counts.Methods: One hundred twenty-five patients with exacerbated COPD were enrolled in the study and screened for OSA using the Epworth Sleepiness Scale (ESS). Those with a positive ESS score underwent polysomnography (PSG) for confirmation. All patients were followed for 90 days to monitor for subsequent exacerbations.Results: Out of the 125 patients with exacerbated COPD, 25 were confirmed to have OSA. Those with OS had a significantly higher body mass index (BMI) (p < 0.001). The monocyte to eosinophil ratio (MER) was significantly higher in the OS group, while the neutrophil to monocyte (NMR) ratio and platelets to monocyte (PMR) ratio were significantly lower. Younger age, male sex, and higher body mass index (BMI) were all associated with OS. During the 90-day follow-up period after hospital discharge, 60% of patients with OS were re-admitted due to acute exacerbations. The hazard ratio for a second exacerbation increased by two-fold for every one-unit increase MER. The MER demonstrated excellent utility in predicting a second exacerbation, with an area under the curve (AUC) of 83% and a p-value of .005.Conclusion: The monocyte to eosinophil ratio (MER) was independent predictors of OS among exacerbated COPD patients and had a very good prognostic utility for predicting the next exacerbation episodes. Long term follow up is recommended to evaluate the severity of exacerbations and the effect of complications of OS on the morbidity and mortality of these patients.

Proposal of a modified tip apex distance for prediction of lag screw cut-out in trochanteric hip fractures.

INTRODUCTION: Lag screw cut-out is a serious complication of dynamic hip screw fixation of trochanteric hip fractures. The lag screw position has been acknowledged as one of the important factors affecting the lag screw cut-out. We propose a modification of the Tip Apex Distance (TAD) and hypothesise that it could improve the reliability of predicting lag screws cut-out in these injuries. MATERIALS AND METHODS: A retrospective study was conducted for hip fracture entries in the period from Jan 2018 to July 2022. A hundred and nine patients were suitable for the final analysis. The modified TAD was measured in millimetres based on the sum of the traditional TAD in the lateral view and the net value of two distances in the AP view, the first distance is from the tip of the lag screw to the opposite point on the femoral head along the axis of the lag screw while the second distance is from that point to the femoral head apex. The first distance is a positive value, whereas the second distance is positive if the lag screw is superior and negative if inferior. A receiver operating characteristic curve was used to evaluate the reliability of the different parameters assessing the lag screw position within the femoral head. RESULTS: Reduction quality, fracture pattern as per the AO/OTA classification, TAD, Calcar Referenced TAD, Axis Blade Angle, Parker's ration in the AP view, Cleveland Zone 1, and modified TAD were statistically associated with lag screw cut-out. Among the tested parameters, the modified TAD had 90.1% sensitivity and 90.9% specificity for lag screw cut-out at a cut-off value of 25 mm with a P-value < 0.001. CONCLUSION: The modified TAD had the highest reliability in the prediction of lag screw cut-out. A value ≤ 25 mm could potentially protect against lag screw cut-out in trochanteric hip fractures.

Elevation of D-dimer levels are associated with early need for mechanical ventilation support in patients with COVID-19.

BACKGROUND: Severe COVID-19 disease is typically associated with an urgent need for supplemental oxygen therapy that may be successfully delivered through conventional methods or require invasive mechanical ventilation. Early prediction of the need for invasive mechanical ventilation could significantly improve outcomes of COVID-19 patients. Plasma levels of D-dimer and a number of inflammatory markers as well as values of complete blood counts, all measured in the first two days of hospital admission of COVID-19 patients, were evaluated for their significance as predictors of the eventual need for invasive mechanical ventilation support as well as their values as predictors of post-ventilation morbidly and mortality. METHODS: This retrospective cohort study was conducted at a single center and included data pertaining to 200 patients with previously confirmed moderate to severe COVID-19 disease in the period between May 2021 and the end of December 2022. Data were retrieved from medical records for further analysis. RESULTS: The mean (SD) age of patients stood at 59 (14) years of age, and with a majority of patients being male (77%). About 18% of cases, all of significantly older age, had been connected to invasive mechanical ventilation (IMV). Total leucocytic count (TLC), as well as levels of urea, creatinine, D-dimer, ferritin, and CRP in IMV patients were significantly higher than non-ventilated patients (p < 0.01 for all). In contrast, lymphocytic count, hemoglobin level, and platelet count were significantly lower in IMV patients (p < 0.001, 0.04, and 0.002, respectively). The mortality rate was significantly higher in IMV patients (p < 0.001). D-dimer independently predicted IMV demand (OR = 1, p = 0.001 in adjusted and unadjusted models). The utility of D-dimer was excellent; and the cutoff level of above 1415 µ/L showed sensitivity and specificity of about 92% and 76%, respectively. Also, the D-dimer level was very effective in predicting post-IMV survival; the AUC = 0.86, p = 0.02, and a cutoff value below 4558 µ/L was associated with 100% and 66% sensitivity and specificity, respectively. CONCLUSIONS: High D-dimer levels independently correlated with the need for invasive mechanical ventilation. Low levels of this marker could evidently predict post-IMV survival of mechanically ventilated COVID-19 patients. Measuring D-dimer levels during routine follow up of those patients would thus be useful in predicting patient outcomes.

Recurrent Lumbar Disc Herniation: Does Transforaminal Lumbar Interbody Fusion Lead to Better Clinical and Radiological Outcomes than Redo-Discectomy?

STUDY DESIGN: randomized, prospective, and level I clinical study. PURPOSE: To compare the clinical outcomes and radiological findings of revision discectomy alone versus revision discectomy with fusion as surgical treatment for recurrent lumbar disc herniation (RDH). OVERVIEW OF LITERATURE: RDH is a common complication following a primary discectomy. The optimal surgical procedure for RDH is still debated. METHODS: Sixty patients with RDH were randomly divided into two equal groups: the first group underwent revision discectomy alone and the second underwent revision discectomy with fusion. The primary outcomes evaluated were Visual Analog Scale (VAS) for low back and limb pains, Oswestry Disability Index (ODI), disc height indexes, foraminal height index, and disc height subsidence. Secondary outcomes included operative time, blood loss, postoperative hospital stay, and complications. RESULTS: Revision discectomy with fusion showed superior pain relief and improved functional outcomes, including better VAS scores for both back and leg pain and ODI at 24-month follow-up. Additionally, it restored the stability of the spine better with lower disc height subsidence without significant complications. However, these advantages came at the cost of increased blood loss and longer operative time and hospital stays. CONCLUSIONS: Revision discectomy with fusion is recommended for RDH; however, the choice of the procedure should be made caseby- case basis, considering many factors related to the patient and surgical facilities.

Gradual on top-of-acute correction of neglected adolescent tibia vara by percutaneous tibial osteotomy and two-ring Ilizarov frame.

OBJECTIVES: This study aims to assess the effect of gradual correction after acute translation of the tibia in tibia vara using a two-ring Ilizarov frame on the correction of mechanical axis deviation (MAD), union time, and the rate of complications. PATIENTS AND METHODS: Between September 2018 and January 2021, a total of 30 patients (25 males, 5 females; mean age: 20±5 years; range, 15 to 25 years) with adolescent tibia vara were included. The patients had a transverse fibular ostectomy and percutaneous tibial osteotomy below the level of the tibial tuberosity. Acute correction of the rotation deformity combined with acute translation was done. A two-ring Ilizarov frame with a medial distractor and two lateral hinges were used to fix the osteotomy and the coronal plane deformity was gradually corrected. RESULTS: The mean follow-up was 24±4 months. All patients had improvement in the mechanical medial proximal tibial angle (mMPTA) and MAD postoperatively. There was an improvement in the Hospital for Special Surgery knee score at one year postoperatively. No neurovascular complications or union complications were observed. CONCLUSION: Acute translation followed by gradual angulation of the proximal tibia in cases with adolescent tibia vara yields better correction of the mechanical axis with good functional and radiological outcomes.

Restoration Integrity in Primary Teeth Prepared Using Erbium/Yttrium-Aluminum-Garnet Laser: A Randomized Split-Mouth Clinical Study.

The most frequently used and universally accepted technique for removing caries is mechanical ablation of decayed tissues by rotating drills. New minimally invasive strategies, such as the use of lasers to perform highly controlled tissue ablation, have been introduced in dental practice. The aim of this study was to assess and compare treatment with a 2940 nm erbium/yttrium-aluminum-garnet (Er:YAG) laser versus a conventional rotary treatment during cavity preparation in children with regard to restoration integrity. In a randomized, controlled, blinded trial using a split-mouth design, 40 (9-12-year-old) children with 80 carious primary molars were included. The cavity in one quadrant was randomized to be treated conventionally using a bur, while the cavity in the other quadrant was prepared using an Er:YAG laser. At the one-year follow-up, clinical examinations were conducted to assess the integrity of the restorations according to the Ryge criteria. The data were analyzed using SPSS version 22 (IBM Inc., Chicago, IL, USA). The average age of the participants was 9.4 ± 1.29 years. Males accounted for 51.4% of the participants. The Ryge criteria showed clinical success of restorations, and there was no discernible difference between the conventional and laser intervention techniques. Over one year, no statistically significant differences in the clinical integrity based on the Ryge criteria were found following class I cavity preparation in primary teeth with either procedure.

Corrigendum: Factors influencing participation in COVID-19 clinical trials: a multinational study.

[This corrects the article DOI: 10.3389/fmed.2021.608959.].

Use of remote sensing-based pressure-state-response framework for the spatial ecosystem health assessment in Langfang, China.

Land use/land cover changes are occurring at an unprecedented rate and scale because of the economic development that has jeopardized the ecosystem's health. Ecosystem health should be studied and monitored at spatiotemporal scale to promote sustainable development and ecological civilization. The goal of this study was to assess the spatial ecosystem health of Langfang at the city and administrative levels using city's regional characteristics. Remote sensing-based pressure-state-response (PSR) framework, analytical hierarchy process (AHP), and principal component analysis (PCA) were utilized for spatial ecosystem health index (SEHI) formulation, indicator weighting, and indicator selection in several epochs (1990, 2003, 2013, and 2021), respectively. SEHI was formulated by combining subindices of pressure, state and response. The spatial ecosystem pressure index (SEIP) identified that the pressure was increasing on the ecosystem. In contrast, the spatial ecosystem state index (SEIS) pointed out an improvement in the state of the ecosystem since 1990. The worst state of the ecosystem was observed for the year 2013. The spatial ecosystem response index (SEIR) indicated that the response of the ecosystem towards the exerted pressures and states remained variable; however, it was reasonably good in 1990. All the administrative units of Langfang were associated with a healthy score for the spatial ecosystem health index (SEHI) for 1990 (pre-industrialization epoch), while the SEHI significantly reduced in 2013 (industrialization epoch) however improved for the later epochs (circular economy and ecological civilization epoch). The SEHI was moderately healthy for Dachang, Dacheng, Guan, Guangyang, and Yongqing while relatively healthy for the remaining administrative units in 2021. SEHI identified that spatial health has been improving since 2003 though not reaching the 1990's level for Langfang. Therefore, efforts should be focused on minimizing pressure and stabilizing the state to improve the spatial ecosystem health of Langfang. The developed SEHI can assist policymakers in analyzing regional health, identifying development strategies, driving environmental restoration, and quantifying needed changes.

Effect of exfoliation corrosion on the efficient hybrid joint of AA2024-T3 and AA2198-T8 formed by friction stir welding.

The third-generation alloy, AA2198-T8, is highly recommended for the aerospace industry. However, it has come under scrutiny due to its high cost. This study aims to decrease the cost of manufacturing through a hybrid design that uses AA2198-T8 alloys for the crucial parts and AA2024-T3 alloys for the remaining structure. The two main techniques for joining AA2024-T3 to AA2198-T8 are reversed double-sided friction stir welding (DS-FSW) and traditional single-sided friction welding (SS-FSW). They were carried out under unaltered tool rotation speed followed by five different welding speeds. The mechanical properties of the joints were explored, and the maximum joining efficiency of the welding process was 96% for reversed DS-FSW at 102 mm/min welding speed. The hybrid joint was tested for compliance with ASTM G34 standards to examine the welding joint's exfoliation corrosion (EXCO) for eight exposure times. The findings showed that joint efficiency decreased relative to as-welded joints, and mechanical property deterioration increased with EXCO exposure duration, reaching 40% for specimens exposed for 120 h to the corroding solution. It has been noted that morphology and grain size changes significantly impact EXCO.

Economic Reliable Arthroscopic Technique for Reduction and Fixation of Acute Acromioclavicular Joint Dislocation.

Separation of the acromioclavicular joint (ACJ) is a common orthopaedic injury among athletes involved in contact sports and victims of motor vehicle accidents. ACJ disruptions are common in athletes. Treatment is guided by the level of injury; grade 1 and 2 injuries are managed nonoperatively. Grades 4-6 are managed operatively, whereas grade 3 is an area of controversy. Several operative techniques have been described to restore anatomy and function. We present a technique that's safe, economic, and reliable in the management of acute ACJ dislocation. It allows intra-articular glenohumeral assessment and relies on a coracoclavicular sling. This is an arthroscopic-assisted technique. It entails a small transverse or vertical incision over distal clavicle 2 cm away from ACJ, which enables us to reduce the ACJ and maintain reduction with a k-wire, checked by the C-arm. Diagnostic shoulder arthroscopy is then performed to assess the glenohumeral joint. The rotator interval is liberated and the coracoid base is exposed, and PROLENE sutures are then passed anterior to the clavicle medial and lateral to the coracoid. It is the used to shuttle polyester tape and ultrabraid as a sling under the coracoid. A tunnel is then made in the clavicle, then one end of suture is passed through the tunnel whereas the other end remains anterior. Several knots are made to ensure it is secured, then the deltotrapezial fascia is closed as a separate layer.