Comparison of eyelid function following frontalis suspension and levator dissection-resection in congenital ptosis with poor levator function.

PURPOSE: A levator dissection-resection technique (LDR) in which the levator is dissected free from all fibrous attachments including Whitnall's ligament was compared to two commonly used frontalis-based procedures in the management of congenital ptosis with poor levator function. METHODS: Thirty patients having congenital ptosis with poor levator function were randomized to one of the three surgical groups (ten patients for each group), namely, frontalis sling (FS), frontalis advancement flap (FAF), and (LDR) technique. Marginal reflex distance-one (MRD-1), levator function, symmetry in different levels of vertical gaze, lagophthalmos, and any other surgical complications were assessed 6 months following the intervention. RESULTS: Patients in the three groups achieved statistically significant improvement in MRD-1 in the primary position of gaze (p = 0.001 for FS, 0.003 for FAF, 0.001 for LDR). Patients who underwent a frontalis-based procedure acquired an additional ability to elevate the upper eyelid by using their eyebrows. Patients who underwent LDR technique have acquired an additional mean of 5.79 ± 1 mm improvement in levator function with better symmetry during up and down gaze in unilateral cases. Patients from all groups had an equal degree of lagophthalmos with forced eyelid closure, and during sleep. CONCLUSION: Patients with ptosis and poor levator function who were managed with LDR technique achieved a similar degree of eyelid elevation in the primary gaze to that of frontalis-based procedures, acquired additional levator function, achieved more symmetry in up and down gaze in unilateral cases, and had no additional risk to the cornea.

Spent coffee waste-derived biochar improves physical properties, water retention, and maize (Zea mays L.) growth in sandy soil.

Adding organic soil amendments can improve the physical and hydrological properties of soil, subsequently enhancing fertility for better crop production. In this study, spent Arabica and Columbian coffee wastes and their respective biochars were evaluated as soil amendments to improve the physical and hydrological properties of loamy sand soil and enhance maize (Zea mays L.) crop growth. Spent Arabica coffee (AC) and Columbian coffee (CC) wastes were collected and transformed into biochar through pyrolysis process at 550 °C with a residence time of 3 h and pyrolysis rate of 5 °C per minute. The AC and CC derived biochar were termed as ABC and CBC, respectively. The produced soil amendments were applied to soil at 0% (control), 1%, 3%, and 5% in a column setup. The moisture characteristics, including water infiltration, evaporation, and water retention, were investigated. Thereafter, the prepared amendments were applied to loamy sand soils at 0% (control), 1%, 3%, and 5% (w/w) application rates. Maize growth was then observed for a period of 30 days under greenhouse conditions. Results of the column trials showed that ABC and CBC applied at 5% reduced the cumulative water evaporation by 57%-66% and cumulative infiltration by 124%-181% compared to control. Likewise, 5% application of ABC and CBC resulted in 101 to 130% higher water retention in loamy sand soil. Results of the greenhouse experiment showed that 5% application of ABC and CBC amendments resulted in root biomass of 2.12 and 2.38 g, respectively, as compared to 0.51 g in control treatment. Similar treatments resulted in shoot biomass of 9.70 and 9.93 g respectively, as compared to 7.37 g in control. Likewise, 5% application of CBC and ABC increase plant height from 15.71 to 30.94 cm in ABC and 33.23 cm in CBC. Overall, 5% application of coffee waste-derived biochars significantly reduced water evaporation and infiltration, while increasing soil water retention and maize plant height, root biomass, and shoot biomass. Therefore, spent coffee waste-derived biochar could effectively be employed to improve physical and hydrological properties of loamy sand soils for better crop productivity.

Effect of Stabilized nZVI Nanoparticles on the Reduction and Immobilization of Cr in Contaminated Soil: Column Experiment and Transport Modeling.

Batch and transport experiments were used to investigate the remediation of loamy sand soil contaminated with Cr(VI) using zero-valent iron nanoparticles (nZVI) stabilized by carboxymethylcellulose (CMC-nZVI). The effect of pH, ionic strength (IS), and flow rate on the removal efficiency of Cr(VI) were investigated under equilibrium (uniform transport) and non-equilibrium (two-site sorption) transport using the Hydrus-1D model. The overall removal efficiency ranged from 70 to over 90% based on the chemical characteristics of the CMC-nZVI suspension and the transport conditions. The concentration and pH of the CMC-nZVI suspension had the most significant effect on the removal efficiency and transport of Cr(VI) in the soil. The average removal efficiency of Cr(VI) was increased from 24.1 to 75.5% when the concentration of CMC-nZVI nanoparticles was increased from 10 to 250 mg L-1, mainly because of the increased total surface area at a larger particle concentration. Batch experiments showed that the removal efficiency of Cr(VI) was much larger under acidic conditions. The average removal efficiency of Cr(VI) reached 90.1 and 60.5% at pH 5 and 7, respectively. The two-site sorption model described (r2 = 0.96-0.98) the transport of Cr(VI) in soil quite well as compared to the uniform transport model (r2 = 0.81-0.98). The average retardation of Cr(VI) was 3.51 and 1.61 at pH 5 and 7, respectively, indicating earlier arrival for the breakthrough curves and a shorter time to reach maximum relative concentration at lower pH. The methodology presented in this study, combining column experiment and modeling transport using the Hydrus-1D model, successfully assessed the removal of Cr(VI) from polluted soils, offering innovative, cost-effective, and environmentally friendly remediation methodologies.

Raring to go? A cross-sectional survey of student paramedics on how well they perceive their UK pre-registration course to be preparing them to manage suspected seizures.

BACKGROUND: Paramedics convey a high proportion of seizure patients with no clinical need to emergency departments (EDs). In a landmark study, only 27% of UK paramedics reported being "Very…"/ "Extremely confident" making seizure conveyance decisions. Improved pre-registration education on seizures for paramedics is proposed. Clarity is needed on its potential given recent changes to how UK paramedics train (namely, degree, rather than brief vocational course). This study sought to describe UK student paramedics' perceived readiness to manage seizures and educational needs; compare this to what they report for other presentations; and, explore subgroup differences. METHODS: Six hundred thirty-eight students, in year 2 or beyond of their pre-registration programme completed a cross-sectional survey. They rated perceived confidence, knowledge, ability to care for, and educational needs for seizures, breathing problems and, headache. Primary measure was conveyance decision confidence. RESULTS: For seizures, 45.3% (95% CI 41.4-49.2) said they were "Very…"/"Extremely confident" to make conveyance decisions. This was similar to breathing problems, but higher than for headache (25.9%, 95% CI 22.6-29.5). Two hundred and thirty-nine participants (37.9%, 95% CI 34.1-41.8) said more seizure education was required - lower than for headache, but higher than for breathing problems. Subgroup differences included students on university-based programmes reporting more confidence for conveyance decisions than those completing degree level apprenticeships. CONCLUSIONS: Student paramedics report relatively high perceived readiness for managing seizures. Magnitude of benefit from enhancements to pre-registration education may be more limited than anticipated. Additional factors need attention if a sizeable reduction to unnecessary conveyances for seizures is to happen.

Upper airway multilevel radiofrequency under local anesthesia can improve CPAP adherence for severe OSA patients.

OBJECTIVE: To evaluate the effect of upper airway radiofrequency (RF) tissue reduction under local anesthesia (LA) in severe obstructive sleep apnea (OSA) patients using continuous positive airway pressure (CPAP) in order to improve their compliance and adherence. DESIGN: Thirty (30) patients were included in this randomized clinical trial, suffering from severe OSA seeking medical advice for better upper airway management while using CPAP. Multilevel RF tissue reduction at tongue base, soft palate and inferior nasal turbinates was done under LA in multiple sessions. The Apnea hypopnea index (AHI), arousal index, lowest SpO2, CPAP pressure, and CPAP using time were recorded pre-operatively and six months after the last RF session. RESULTS: Post-operatively, there were significant reduction in AHI (86.03 ± 20.5 vs. 54.65 ± 16.6 p < 0.001), arousal index (71.14 ± 17.7 vs. 35.90 ± 11.8 p < 0.001), and CPAP Pressure (17.13 ± 1.7 vs. 10.97 ± 1.5 p < 0.001). Also there was a significant increase in the lowest SpO2 (60.2 ± 0.2 vs. 75 ± 0.1 p < 0.001), and CPAP using time in hours (1.57 ± 0.56 vs. 3.75 ± 0.41 p < 0.001). Visual analogue scale (VAS) for pain was recorded showing that all patients reported throat pain mainly in the first five post-operative days which was well controlled on analgesia. CONCLUSION AND RELEVANCE: Upper airway multilevel RF tissue reduction of tongue base, soft palate and inferior nasal turbinates under local anesthesia significantly improves the tolerance and adherence of severe OSA patients using CPAP.

Controlled synthesis of graphene oxide/silica hybrid nanocomposites for removal of aromatic pollutants in water.

The remarkable characteristics of graphene make it a model candidate for boosting the effectiveness of nano-adsorbents with high potential owing to its large surface area, π-π interaction, and accessible functional groups that interact with an adsorbate. However, the stacking of graphene reduces its influence adsorption characteristics and also its practical application. On the other hand, the widespread use of aromatic compounds in the industry has aggravated the contamination of the water environment, and how to effectively remove them has become a research hotspot. Herein, we develop the functionalization of silica nanoparticles on graphene oxide nanosheet (FGS) by a facile, cheap, and efficient synthesis protocol for adsorption of Trypan Blue (TB) and Bisphenol A (BPA). It was demonstrated that chemical activation with KOH at high autoclaving temperature successfully transformed rice husk ash (RHA) into FGS. The graphene oxide layered interlamination was kept open by using SiO2 to expose the interlayers' strong adsorption sites. XRD, EDX, FTIR, Raman spectroscopy, SEM, HR-TEM, and BET surface area are used to investigate the chemical composition, structure, morphology, and textural nature of the as-produced FGS hybrid nanocomposite. The various oxygen-containing functional groups of the hybrid nanocomposites resulted in a significantly increased adsorption capacity, according to experimental findings. In addition, FGS2, the best composite, has a specific surface area of 1768 m2g-1. Based on Langmuir isotherms, the maximal TB dye and BPA removal capacity attained after 30 min were 455 and 500 mg/g, respectively. The Langmuir isotherm model, a pseudo-second-order kinetic model, and an intraparticle diffusion model have all been used to provide mechanistic insights into the adsorption process. This suggests that BPA and TB adsorption on FGS2 is mostly chemically regulated monolayer adsorption. Due to its unique sp2-hybridized single-atom-layer structure, the exposed graphene oxide nanosheets' extremely hydrophobic effect, hydrogen bonding, and strong-electron donor-acceptor interaction contributed to their improved adsorption of BPA and TB. According to adsorption thermodynamics, FGS2 adsorption of TB and BPA is a spontaneous exothermic reaction that is aided by lowering the temperature. For adsorption-based wastewater cleanup, the produced nanocomposites with a regulated amount of carbon and silica in the form of graphene oxide and silica can be used. These findings suggest that functionalized GO/SiO2 hybrid nanocomposites could be a viable sorbent for the efficient and cost-effective removal of aromatic chemicals from wastewater.

Improved anti-biofouling resistances using novel nanocelluloses/cellulose acetate extracted from rice straw based membranes for water desalination.

Cellulose and Nanocellulose acetate (NCA) have attractive novel properties like excellent mechanical properties, rich hydroxyl groups for modification, and natural properties with environmental friendliness. Cellulose was extracted from rice straw wastes as an extra value, then it had been further transformed into NCA using the acidic hydrolysis technique. The structural, crystalline, morphological, were characterized by Fourier transform infrared spectroscopy (FTIR), Proton nuclear magnetic resonance (1HNMR), X-ray diffraction (XRD), Scanning microscopy, respectively. The particle size of the Nanocellulose extracted from rice straw was about 22 nm with a spherical shape. Development membranes were prepared with different concentrations of NCA to improve the performance and the anti-biofouling properties of cellulose acetate reverse osmosis (RO) membranes using a phase inversion technique. The structural of membranes were characterized by FTIR, water contact angle measurements, while the anti-biofouling properties were studied by static protein adsorption. The results indicated the development membrane features a lower contact angle accomplished with exhibits pore-forming ability and enhanced hydrophilicity of prepared membrane, furthermore the development cellulose acetate reverse osmosis (CA-RO) membranes with 40:60% RNCA:CA produced a salt rejection of 97.4% and a water flux of 2.2 L/m2 h. the development membrane have resists effectively protein adsorption and microbial growth showed from the results of Static protein adsorption.

Heavy metal pollution and associated health risk assessment of urban dust in Riyadh, Saudi Arabia.

Depending on their particle size and concentration, heavy metals in urban dust pose a health hazard to humans. This study investigated the total concentration, health risk, integrated pollution load index (IPI), and enrichment factor (EF) of various heavy metals in urban dust at different locations in Riyadh City. Surface dust samples were collected from 50 different residential yards in the north, south, west, east, and central corners of the city and analyzed for cadmium (Cd), chromium (Cr), copper (Cu), manganese (Mn), nickel (Ni), lead (Pb), and zinc (Zn). With respect to concentrations heavy metals were in the following order Zn > Cu > Mn > Cr > Ni > Pb > Cd. The EF trends exposed repeated anthropogenic activities were responsible for Mn, Cr, and Ni, while Pb, Zn, and Cu appeared to come from Earth's crust. Since the heavy metal concentrations were lower than the threshold values, children and adults are exposed to lower health risk in investigated area. Also, there are no pollution of heavy metals in the dust with respect to IPI which is less than the critical limit (<1) with the exception of a sampling location in north side of the city with higher IPI showed unhealthy respiration conditions in particular areas. It was concluded that rapid industrialization and urbanization and their concentrations in dust may cause health problems in near future in north side as well as other sides of Riyadh City.

Acute toxicity assessment of polyaniline/Ag nanoparticles/graphene oxide quantum dots on Cypridopsis vidua and Artemia salina.

Nanotoxicology is argued and considered one of the emerging topics. In this study, polyaniline (PANI)/2-acrylamido-2-methylpropanesulfonic acid (AMPSA) capped silver nanoparticles (NPs)/graphene oxide (GO) quantum dots (QDs) nanocomposite (PANI/Ag (AMPSA)/GO QDs NC) as a nanoadsorbent has a potential for removal of toxic hexavalent chromium (Cr(VI)) ions from water. The acute toxicity of this NC was evaluated on Artemia salina and freshwater Ostracods (Cypridopsis vidua) larvae for 48 h. The measurements were made at 24 and 48 h with 3 repetitions. The 50% effective concentration (EC50) values of the NC were determined after the exposure of these organisms. According to the results of the optical microscope, it was found that both experimental organisms intake the NC. In the toxicity results of Ostracods, the NC had a highly toxic effect only at 250 mg/L after 48 h and the EC50 value was 157.6 ± 6.4 mg/L. For Artemia salina individuals, it was noted that they were less sensitive than the Ostracods and EC50 value was 476 ± 25.1 mg/L after 48 h. These results indicated that PANI/Ag (AMPSA)/GO QDs NC has low toxicity towards both investigated organisms.

Polyaniline/Ag nanoparticles/graphene oxide nanocomposite fluorescent sensor for recognition of chromium (VI) ions.

Selective determination of toxic hexavalent chromium (Cr(VI)) is a stringent important due to its huge negative impact on the health and environment. Recently, the high sensitivity, rapidness, and cost-effectiveness of the fluorescent sensors for Cr(VI) have been developed. A fluorescent nanocomposite (NC) has been synthesized based on doped polyaniline (PANI), 2-acrylamido-2-methylpropanesulfonic acid (AMPSA) capped Ag nanoparticles (NPs) and graphene oxide (GO) quantum dots (QDs) via in situ reaction for highly selective sensing of Cr(VI) ions based on the luminescent quenching in the range from 0.01 to 7.5 mg/L. This NC showed an emission peak at 348 nm with a linear range from 0.01 to 0.05 mg/L and the low limit of detection (LOD) was 0.0065 mg/L (~ 6 µg/L). PANI/Ag (AMPSA) GO QDs NC displayed high selectivity for Cr(VI) over other common metal ions. Notably, the PANI/Ag (AMPSA) GO QDs NC can be used for distinguishing Cr(VI) and Cr(III) in solutions. The sensitive determination of Cr(VI) in real surface water samples was also confirmed and demonstrated recoveries in the range 95.3-99.2%. This NC will emerge as a new class of fluorescence materials that could be suitable for practical applications.

Potential short-term negative versus positive effects of olive mill-derived biochar on nutrient availability in a calcareous loamy sand soil.

In the present work, the olive mill solid waste (OMSW)-derived biochar (BC) was produced at various pyrolytic temperatures (300-700°C) and characterized to investigate its potential negative versus positive application effects on pH, electrical conductivity (EC), and nutrients (P, K, Na, Ca, Mg, Fe, Mn, Zn, and Cu) availability in a calcareous loamy sand soil. Therefore, a greenhouse pot experiment with maize (Zea mays L.) was conducted using treatments consisting of a control (CK), inorganic fertilizer of NPK (INF), and 1% and 3% (w/w) of OMSW-derived BCs. The results showed that BC yield, volatile matter, functional groups, and zeta potential decreased with pyrolytic temperature, whereas BC pH, EC, and its contents of ash and fixed carbon increased with pyrolytic temperature. The changes in the BC properties with increasing pyrolytic temperatures reflected on soil pH, EC and the performance of soil nutrients availability. The BC application, especially with increasing pyrolytic temperature and/or application rate, significantly increased soil pH, EC, NH4OAc-extractable K, Na, Ca, and Mg, and ammonium bicarbonate-diethylenetriaminepentaacetic acid (AB-DTPA)-extractable Fe and Zn, while AB-DTPA-extractable Mn decreased. The application of 1% and 3% BC, respectively, increased the NH4OAc-extractable K by 2.5 and 5.2-fold for BC300, by 3.2 and 8.0-fold for BC500, and by 3.3 and 8.9-fold for BC700 compared with that of untreated soil. The results also showed significant increase in shoot content of K, Na, and Zn, while there was significant decrease in shoot content of P, Ca, Mg, and Mn. Furthermore, no significant effects were observed for maize growth as a result of BC addition. In conclusion, OMSW-derived BC can potentially have positive effects on the enhancement of soil K availability and its plant content but it reduced shoot nutrients, especially for P, Ca, Mg, and Mn; therefore, application of OMSW-derived BC to calcareous soil might be restricted.

Stability and Dynamic Aggregation of Bare and Stabilized Zero-Valent Iron Nanoparticles under Variable Solution Chemistry.

Surface modification of nanoscale zero-valent iron (nZVI) using polymer stabilizers (e.g., sodium carboxymethyl cellulose, CMC) is usually used to minimize aggregation, increase stability, and enhance transport of nZVI. We investigated the stability and dynamic aggregation of bare and CMC-nZVI as affected by variations in pH, ionic strength (IS), and nZVI particle concentration. CMC coating of nZVI resulted in smaller hydrodynamic size and larger zeta potential. The largest hydrodynamic size of nZVI was associated with bare nZVI at high IS (100 mM), pH close to the point of zero charge (PZC, 7.3-7.6), and larger particle concentration (1.0 g L-1). The increase in the zeta potential of CMC-nZVI reached one- to four-fold of that for bare nZVI, and was greater at pH values close to PZC, high IS, and larger particle concentration. The stability of CMC-nZVI was increased by 61.8, 93.1, and 57.5% as compared to that of bare nZVI at IS of 1, 50 and 100 mM, respectively. Calculations of Derjaguin, Landau, Verwey and Overbeek (DLVO) interaction energy were in agreement with stability results, and showed the formation of substantial energy barriers at low IS indicating greater nZVI stability. Our results suggest that at IS above 50 mM and nZVI particle concentration larger than 0.1 g L-1, the likelihood of nZVI aggregation is high. Nevertheless, CMC polymer stabilizer would enhance the stability and transport of nZVI even under these unfavorable solution chemistry conditions.

Highly Luminescent Ternary Nanocomposite of Polyaniline, Silver Nanoparticles and Graphene Oxide Quantum Dots.

Quantum dots (QDs) with photostability show a potential application in optical sensing and biological imaging. In this work, ternary nanocomposite (NC) of high fluorescent polyaniline (PANI)/2-acrylamido-2-methylpropanesulfonic acid (AMPSA) capped silver nanoparticles (NPs)/graphene oxide quantum dots (PANI/Ag (AMPSA)/GO QDs) have been synthesized by in situ chemical oxidative polymerization of aniline in the presence of Ag (AMPSA) NPs and GO QDs. Ag (AMPSA) NPs and GO QDs were prepared by AgNO3 chemical reduction and glucose carbonization methods, respectively. The prepared materials were characterized using UV-visible, Fourier transform infrared (FTIR), photoluminescence and Raman spectroscopies, X-Ray diffractometer (XRD) and high- resolution transmission electron microscopy (HRTEM). HRTEM micrographs confirmed the preparation of GO QDs with an average size of 15 nm and Ag (AMPSA) NPs with an average size of 20 nm. PANI/Ag (AMPSA)/GO QDs NC showed high and stable emission peak at 348 nm. This PANI/Ag (AMPSA)/GO QDs NC can emerge as a new class of fluorescence materials that could be suitable for practical sensing applications.

The development of a ternary nanocomposite for the removal of Cr(vi) ions from aqueous solutions.

The aim of this study is to develop a ternary nanocomposite (NC) of polyaniline (PANI)/2-acrylamido-2-methylpropanesulfonic acid (AMPSA)-capped silver nanoparticles (NPs)/graphene oxide quantum dots (PANI/Ag (AMPSA)/GO QDs) as an efficient adsorbent for the removal of the highly toxic hexavalent chromium (Cr(vi)) from polluted water. PANI/Ag (AMPSA)/GO QDs NC was synthesized via in situ oxidative polymerization. The effects of pH, adsorbent dose, initial concentration, temperature, contact time, ionic strength and co-existing ions on the removal of Cr(vi) by PANI/Ag (AMPSA)/GO QDs were investigated. The PANI/Ag (AMPSA)/GO QDs NC (25.0 mg) removed 99.9% of Cr(vi) from an aqueous solution containing 60 mg L-1 Cr(vi) ions at pH 2. Energy dispersive X-ray (EDX) and inductively coupled plasma spectrometry (ICP) studies confirmed the adsorption of Cr(vi) and that some of the adsorbed Cr(vi) was reduced to Cr(iii). Cr(vi) removal by the PANI/Ag (AMPSA)/GO QDs NC followed the pseudo-second order kinetic model, and the removal was highly selective for Cr(vi) in the presence of other co-existing ions. In summary, the PANI/Ag (AMPSA)/GO QDs NC has potential as a novel adsorbent for Cr(vi).

Modified Interscalene Approach for Resection of Symptomatic Cervical Rib: Anatomic Review and Clinical Study.

BACKGROUND: Cervical ribs have been reported to be present in about 0.5% of the general population, 10% of patients with cervical rib who are symptomatic usually have neurogenic symptoms, but some have arterial symptoms. In 1861, Coote was the first to excise a cervical rib through a supraclavicular approach and relieved the symptoms of thoracic outlet syndrome. OBJECTIVE: In this study, we address the efficacy and safety of a modification to the supraclavicular approach for resection of symptomatic cervical ribs. PATIENTS AND METHODS: The surgical team in collaboration with an anatomist performed cadaveric dissections of the posterior triangle of the neck in the Department of Anatomy, Ain Shams University. A prospective study was performed of 25 patients with moderate to severe neck or upper limb pain; this pain was resistant to medical treatment for at least 6 months. Preoperative cervical radiography showed cervical ribs. Pain was assessed by using the visual analog scale. Electrophysiologic tests were performed to confirm the diagnosis. In this study, we performed a modified supraclavicular interscalene approach with resection of the symptomatic rib and without resecting either of the scalene muscles or the first thoracic rib. RESULTS: A total of 25 patients were included in this study; the mean age was 36 years (± 12 standard deviation), and the mean follow-up period was 12.3 months. All patients had moderate (28%) to severe (72%) preoperative pain. Motor deficits were present in 6 cases (24%); Sensory manifestations were present in 80%. All patients had a relief of severe pain at the first postoperative visit in the first week. There were improvements in the motor power in 5 of the 6 patients who had preoperative motor deficit. CONCLUSIONS: A modified supraclavicular interscalene approach for resection of symptomatic cervical ribs has been shown to be effective in the treatment of neuralgic pain. Compared with other approaches, it proved to be less invasive, with small transverse incision and without resection of scalenus anterior muscle.

Conocarpus biochar as a soil amendment for reducing heavy metal availability and uptake by maize plants.

The objective of this study was to assess the use of Concarpus biochar as a soil amendment for reducing heavy metal accessibility and uptake by maize plants (Zea mays L.). The impacts of biochar rates (0.0, 1.0, 3.0, and 5.0% w/w) and two soil moisture levels (75% and 100% of field capacity, FC) on immobilization and availability of Fe, Mn, Zn, Cd, Cu and Pb to maize plants as well as its application effects on soil pH, EC, bulk density, and moisture content were evaluated using heavy metal-contaminated soil collected from mining area. The biochar addition significantly decreased the bulk density and increased moisture content of soil. Applying biochar significantly reduced NH4OAc- or AB-DTPA-extractable heavy metal concentrations of soils, indicating metal immobilization. Conocarpus biochar increased shoot dry biomass of maize plants by 54.5-102% at 75% FC and 133-266% at 100% FC. Moreover, applying biochar significantly reduced shoot heavy metal concentrations in maize plants (except for Fe at 75% FC) in response to increasing application rates, with a highest decrease of 51.3% and 60.5% for Mn, 28% and 21.2% for Zn, 60% and 29.5% for Cu, 53.2% and 47.2% for Cd at soil moisture levels of 75% FC and 100% FC, respectively. The results suggest that biochar may be effectively used as a soil amendment for heavy metal immobilization and in reducing its phytotoxicity.

The balanced two-string technique for sulcus intraocular lens implantation in the absence of capsular support.

Purpose. To describe and explore an alternative approach for sulcus intraocular lens (IOL) implantation in the absence of capsular support. Methods. The commonly available one-piece poly(methyl methacrylate) (PMMA) lens is stabilized in the sulcus by two intraocular horizontal strings of 10/0 polypropylene suture passed through the lens dialing holes in opposite directions to achieve a mechanical balance. The horizontal strings of 10/0 polypropylene work as a rail track for the IOL optics, allowing some side to side lens adjustment even following wound closure. The stability of the IOL was tested in vitro. Six aphakic patients underwent in-sulcus IOL secondary implantation using the balanced two-string technique. Patients were followed up for a minimum of six months. Best spectacle corrected vision was assessed. Lens centration and lens tilt were measured by anterior segment optical coherence tomography (AS-OCT). Results. All patients had successful lens insertion. Best spectacle corrected visual acuity (BSCVA) improved in all patients. Lens decentration ranged between 0.21 mm and 0.9 mm (average 0.53 mm). Lens tilt ranged between 1.2° and 2.8° (average 2.17°). Conclusion. The mechanically balanced two-string technique is an alternative option for sulcus IOL implantation in absence of capsular support, allowing lens centration adjustment with no additional risks.

The use of Whitnall's ligament for sling redirection in frontalis suspension ptosis surgery.

PURPOSE: To evaluate the cosmetic and functional outcome of a modified frontalis suspension technique when the sling force vector is redirected through Whitnall's ligament. METHODS: Non-comparative retrospective study. Twenty-nine eyes of 23 patients with poor levator function of 4 mm or less. Patients underwent frontalis suspension with polytetrafluoroethylene (Gore-Tex) (PTFE). The sling was inserted in a single circular fashion through 3 brow incisions. An additional eyelid crease incision was created to allow the passage of the sling beneath Whitnalls' ligament, to permit securing the sling to the tarsus, to perform a limited blepharoplasty, and to reform the eyelid crease. Postoperatively, patients were followed up for at least 24 months. RESULTS: All cases achieved elevation of the ptotic eyelid in the primary position. Three eyes of 2 patients had under correction in the primary gaze. Twenty-eight of 29 eyes retained the same level of eyelid elevation after 2 years of follow up. Symmetry in the primary gaze was achieved in 4 of 6 (67%) patients with bilateral ptosis and in 12 of 17 (71%) patients with unilateral ptosis. One patient had sling infection with granuloma formation. Lagophthalmos was common, but none developed exposure keratitis. CONCLUSIONS: Frontalis suspention technique modified with redirecting the sling pulling force vector by passing beneath Whitnall's ligament can achieve a natural-looking eyelid in primary gaze and does not interfere with functional outcome.

Physicochemical properties of some bottled water brands in Alexandria Governorate, Egypt.

BACKGROUND: Many people use bottled water instead of tap water for many reasons such as taste, ease of carrying, and thinking that it is safer than tap water. Irrespective of the reason, bottled water consumption has been steadily growing in the world for the past 30 years. In Egypt, this is still increasing to reach 3.8 l/person/day, despite its high price compared with tap water. OBJECTIVE: The purpose of this study was to evaluate the physicochemical quality of some bottled water brands and to compare the quality with that reported on manufacture's labeling, Egyptian, and International standards. MATERIALS AND METHODS: Fourteen bottled water brands were selected from the local markets of Alexandria city. Three bottles from each brand were randomly sampled, making a total sample size of 42 bottles. Sampling occurred between July 2012 and September 2012. Each bottle was analyzed for its physicochemical parameter and the average was calculated for each brand. The results obtained were compared with the Egyptian standard for bottled water, Food and Drug Administration (FDA), and with bottled water labels. RESULTS: In all bottles in the study, pH values ranged between 7.21 and 8.23, conductivity ranged between 195 and 675 µs/cm, and total dissolved solids, sulfate, chloride, and fluoride were within the range specified by the FDA. Calcium concentrations ranged between 2.7373 and 29.2183 mg/l, magnesium concentrations ranged between 5.7886 and 17.6633 mg/l, sodium between 14.5 and 205.8 mg/l, and potassium between 6.5 and 29.8 mg/l. For heavy metals such as iron, zinc, copper, and manganese, all of them were in conformity with the Egyptian standards and FDA, but nickel concentration in 11 brands was higher than the Egyptian standards. Twelve brands were higher than the Egyptian standards in cadmium concentration, but on comparison with FDA there were only five brands exceeding limits. Lead concentrations were out of range for all brands. On comparison with the labeled values, the quality of bottled water was not complying with labeled values. CONCLUSION: Physicochemical parameters in all bottled water examined brands were consistent with the Egyptian Standard and FDA, except for total dissolved solids, nickel, cadmium, and lead. Statistical analysis showed that there was significant difference (P<0.05) in all parameters tested between different brands. Values on the bottled water labels were not in agreement with analytical results.

Serum resistin in acute myocardial infarction patients with and without diabetes mellitus.

AIM: Human resistin is an adipokine, with a possible link to coronary heart disease, and the relationship between serum resistin, insulin resistance, and type 2 diabetes mellitus (T2DM) remains controversial. Therefore, this study assessed serum resistin in patients with acute ST segment elevation myocardial infarction (STEMI), with and without T2DM. METHODS: Between June 2009 and July 2010, 55 subjects were recruited into three groups: 20 non-diabetic patients with acute STEMI (group 1), 20 diabetic patients with acute STEMI (group 2), and 15 healthy controls (group 3). Concentrations of serum lipids, fasting blood glucose (FBG), insulin, troponin I, creatine kinase (CK), lactate dehydrogenase (LDH), and resistin, were estimated. RESULTS: Concentrations of serum total cholesterol, low density lipoprotein cholesterol, FBG, troponin I, CK, LDH, and resistin were significantly higher in group 2 subjects, than in those in groups 1 and 3 (p<0.05). In group 2, serum resistin was positively correlated with serum troponin I and triglycerides (r=0.59, p<0.05, and r=0.47, p<0.05, respectively), but was negatively correlated with high density lipoprotein cholesterol (r=-0.46, p<0.05). However, in this group, serum resistin was not correlated with age, gender, body mass index (BMI), total cholesterol, FBG, insulin, CK, LDH, and the calculated homeostasis model for insulin resistance (HOMA-IR) (p>0.05). Regarding group 1, serum resistin was not correlated to any of these studied parameters (p>0.05). CONCLUSIONS: Serum resistin concentrations are elevated in patients with acute STEMI. This increase is more prominent in patients with T2DM than in those without. However, serum resistin is not correlated with age, gender, BMI, and insulin resistance. These data suggest that serum resistin concentration might be used as a diagnostic biomarker for acute STEMI.