The Outcome of the WALANT Technique in Primary Hand Flexor Tendons Repair.

Introduction: Wide-awake local anesthesia and no tourniquet (WALANT) represents a revolutionary technique for hand surgeons who dismiss tourniquets and sedation. In this study, we present our experience with the WALANT technique in primary flexor tendon injuries of the hand. Patient and methods: This prospective research was carried out on 30 patients undergoing hand primary, flexor tendon repair surgery. Flexor tendon injury zones 2, 3, 4, and 5 were included. WALANT was prepared and injected. The tendons were surgically managed by a cruciate single cross-stitched locked 4-strand technique. The pain was assessed using a visual analog scale (VAS) score. The range of motion (ROM) of affected fingers was assessed according to the Strickland evaluation system. Results: There was a highly significant relationship between the patient's compliance with physiotherapy and obtained ROM of the affected finger with a P value <0.001. During injection of WALANT solution, 4 cases (13.3%) had no pain, 25 cases (83.3%) had mild pain (score 1-4), and 1 case (3.3%) had moderate pain (score 5-7). Conclusion: WALANT provides an optimal bloodless and comfortable field with an opportunity to assess the strength of tendon repair, gapping or triggering and managing them intra-operatively.

Cytogenetic Subclone Burden: A New Biomarker Predicting Chronic Lymphocytic Leukemia Patients Outcome.

BACKGROUND: Chronic lymphocytic leukemia is the most prevalent adult leukemia that occurs in older patients and presents a variable course of the disease. Risk stratification of CLL is a matter of continuous improvement. Thus, this study aimed to assess the impact of the quantification of 17p del and 11q del cytogenetic subclones on the outcome of patients with chronic lymphocytic leukemia. PATIENTS AND METHODS: This is a prospective study that involved 100 subjects with CLL. For all included patients; assessment of the cytogenetic subclones burden for 17p del and 11q del using the FISH technique was carried out. RESULTS: CLL patients with a high 17p del (>33%) cytogenetic subclone burden showed significantly shorter lymphocyte doubling time (LDT), time to first treatment (TTFT), and progression free survival (PFS) compared to those with a lower burden. On contrary 11q del subclone(>30%) burden had an insignificant impact on LDT, TTFT and PFS. CONCLUSION: Quantification of 17pdel burden (>vs.≤33%) could be used for refining risk stratification of CLL patients.

Stability indicating eco-friendly quantitation of terbutaline and its pro-drug bambuterol using quantitative proton nuclear magnetic spectroscopy.

Quantitative 1H-NMR became an increasingly important issue in pharmaceutical analytical chemistry. This study used NMR spectroscopy to assay the bronchodilator drug terbutaline sulfate and its pro-drug bambuterol hydrochloride in pure form and pharmaceutical preparations. The technique proceeded using deuterium oxide (D2O) as an 1H-NMR solvent and phloroglucinol anhydrous as an internal standard (IS). Comparatively, to the phloroglucinol signal at 5.9 ppm, the resulting quantitative signals of the studied drugs were corrected. The terbutaline singlet signal at 6.3 ppm was chosen for quantification, while the bambuterol quantitative singlet signal was at 2.9 ppm. The two drugs were rectilinear over the concentration range of 1.0-16.0 mg/mL. LOD values were 0.19 and 0.21 mg/mL while LOQ values were 0.58 and 0.64 mg/mL for terbutaline and bambuterol respectively. The developed method has been validated according to the International Conference of Harmonization (ICH) regarding linearity, accuracy, precision, specificity, and robustness. A greenness profile assessment was applied, and the method proved to be green. The method enables the assay of the two drugs in pure drug and pharmaceutical preparations. The method also enables the assay of the two drugs in the presence of each other; thus, it is considered a stability-indicating method where terbutaline is an acid degradation product of bambuterol.

Cross-leg flaps: Case series, review, and proposed classification.

Background: Cross-leg (CL) flap procedures have a long history in reconstructive surgery, having been described for the first time in 1854. The application of these flaps can potentially solve many reconstructive issues with satisfactory outcomes. Patients and methods: During our research into the history and development of CL flaps, we identified a variety of flaps for which a classification system can be proposed based on blood supply and flap modifications. In this study, 10 patients with different complaints were managed using posterior tibial artery (PTA) perforator CL flap and superiorly based sural CL flap with satisfactory outcomes. Results: All flaps survived and healed smoothly; consequently, the flaps provided stable coverage, and the donor sites were reconstructed using skin grafts, which provided satisfactory results to the patients and/or their guardians. Conclusion: To our knowledge, this is the first study to propose a simple classification and group different types of flaps mentioned in the literature under one category. CL flaps are a common reconstructive option for patients with injuries that limit their mobility.

Global waterfowl production: stocking rate is a key factor for improving productivity and well-being-a review.

Waterfowl is an important animal-protein source, which has the potential to get a bigger share in the animal production sector. However, waterfowl farming practices and welfare standards are not well established yet. Stocking rate is one of the farming standards that can enhance the productivity, behavior, and well-being of birds; however, rare studies are available in this area. Thus, this article (1) gives an overview of the recent global waterfowls' meat and egg production and their population distribution, (2) reviews the effects of stocking rate on social, feeding, and sexual behaviors, (3) shows the effects of stocking rate on growth performance, carcass weight, and meat quality of ducks and geese, and (4) declares the relationship between the stocking rate and egg production. Conclusively, an optimal stocking rate standard can improve behaviors, productivity (meat-egg), and meat quality. Moreover, using weight (kg)/m2 will help in affording the required space allowance for different ducks and geese under various housing systems. The fish-waterfowl production system could be a promising and sustainable solution for increasing waterfowl production, maintaining the welfare of birds, saving energy, and reducing the water footprint of waterfowl meat. Based on prior research findings, we recommended adopting the stocking rate (SR) standard for specific duck and goose breeds to achieve an optimal production-welfare balance.

Thermoluminescence Characteristics of Copper and Terbium Co-Doped Lithium Tetraborate Glass.

In this study, the preparation and characterization of copper (Cu) and terbium (Tb) co-doped lithium borate glass using spectroscopic and thermoluminescence techniques are reported. A thermal treatment was introduced to increase the degree of crystallinity. The thermoluminescence glow curve signal of the samples displayed upon exposure to beta radiation was measured and analyzed. It was found that the samples doped with 0.1% of copper and co-doped with 0.3% terbium showed the highest thermoluminescent (TL) signal in response to the irradiated dose. The analyses revealed that the glow curves of the doped samples were composed of nine overlapping glow peaks with activation energies between 0.73 and 2.78 eV. As a whole area under the glow curve, the TL signals displayed a linear dose response in the range from 110 mGy to 55 Gy. The minimum detectible dose of the samples was found to be 10.39 µGy. It was found that peaks 1 and 2 disappear after one day of storage. The rest of the peaks (3-9) remain almost constant up to 74 days of storage.

Quantitative and molecular aspects of water intake in meat-type chickens.

Even though water is the most essential nutrient for poultry production, adequate data on individual water intake in broiler chickens and its relationship with other traits of economic importance is scant. Water is provided to chickens in an unrestricted manner in spite of being a finite resource. Climate change continues to affect water sources and efficient bird use of water is long overdue. Understanding the biological basis of water intake is essential for sustainability of the poultry industry. Individual water and feed intake, and growth data was collected on 520 commercial broilers aged 14 to 42 days. We introduced the concepts of water conversion ratio (WCR) and residual water intake (RWI) as parameters that can be used to assess water intake efficiency. Water conversion ratio was defined as the amount of water consumed per unit of body weight gain, and RWI was defined as the difference between the actual water intake (WI) of a given bird and the expected WI by an average bird from the population with the same metabolic body weight, feed intake (FI) and body weight gain (BWG). The correlation between WI and FI was positive (r=0.77; P<0.0001), and the correlation between WI and BWG was positive (r=0.80; P<0.0001). Based on the distribution of RWI, the bottom 5 birds (LRWI) and the top 5 birds (HRWI) for RWI were selected for mRNA expression differences. The average broiler consumed about 7.8 L (± 1L) of water from 14 to 42 days of age. The mRNA expression of arginine vasopressin (AVP) antidiuretic hormone, calcium sensing receptor (CasR), sodium channel epithelial 1 subunit alpha (SCNN1A) and SCNN1D in the hypothalamus was upregulated in the LRWI group compared to the HRWI group. Similarly, kidney aquaporins (AQP) 2, 3, and 4 were upregulated in the LRWI group compared with the HRWI group. Given that water was provided ad libitum, the up-regulation of AVP and AQP gene mRNA expressions seem to indicate that the LRWI birds were more efficient in water reabsorption in the kidney compared to their HRWI counterparts. Increased water reabsorption will reduce the amount of water consumed to attain hydration. The water reabsorption potential was reflected in the excreta moisture levels as the LRWI birds had significantly lower excreta moisture than the HRWI birds. Excreta moisture level require further studies and could be considered as a potential proxy trait for water intake.

Factors influencing the development of gastrointestinal tract and nutrient transporters' function during the embryonic life of chickens-A review.

Intestinal morphology and regulation of nutrient transportation genes during the embryonic and early life of chicks influence their body weight and feed conversion ratio through the growing period. The intestine development can be monitored by measuring villus morphology and enzymatic activity and determining the expression of nutrient transporters genes. With the increasing importance of gut development and health in broiler production, considerable research has been directed towards factors affecting intestine development. Thus, this article reviews (1) intestinal development during embryogenesis, and (2) maternal factors, in ovo administration, and incubation conditions that influence intestinal development during embryogenesis. Conclusively, (1) chicks from heavier eggs may have a better-developed intestine than chicks from younger ones, (2) in ovo supplementation with amino acids, minerals, vitamins or a combination of several probiotics and prebiotics stimulates intestine development and increases the expression of intestine mucosal-related genes and (3) the long storage period, improper incubation temperature and imbalanced ventilation can negatively influence intestinal morphology and nutrient transporters gene expression. Finally, understanding the intestine development during embryonic life will enable us to enhance the productivity of broilers.

Araucaria heterophylla oleogum resin essential oil is a novel aldose reductase and butyryl choline esterase enzymes inhibitor: in vitro and in silico evidence.

The essential oil isolated by hydrodistillation of the oleogum resin of Araucaria heterophylla has been analyzed by GC-MS. Twenty-four components accounting to 99.89% of the total detected constituents of this essential oil were identified. The major ones were: caryophyllene oxide (14.8%), ( +)-sabinene (12.07%), D-limonene (11.22%), caryophyllene (10.36%), α-copaene (8.00%), ß-pinene (6.44%), trans-verbenol (5.88%) and α-pinene oxide (5.18%). The in vitro inhibitory activities of this oil against aldose reductase, BuCHE, COX-2 and SARS-CoV-2 Mpro enzymes were evaluated. This revealed promising inhibitory activity of the essential oil against both aldose reductase and BuCHE enzymes. The molecular docking study of the major components of the Araucaria heterophylla essential oil was carried out to correlate their binding modes and affinities for aldose reductase and BuCHE enzymes with the in vitro results. In conclusion, the in vitro inhibitory activity of the essential oil attributed to the synergistic effect between its components and the in silico study suggested that compounds containing epoxide and hydroxyl groups may be responsible for this activity. This study is preliminary screening for the oil to be used as antidiabetic cataract and Alzheimer's disease therapeutics and further investigations may be required.

Design and Synthesis of New 4-(3,4,5-Trimethoxyphenyl)Thiazole-Pyrimidine Derivatives as Potential Antiproliferative Agents.

A new series of 3,4,5-trimethoxyphenyl thiazole pyrimidines has been synthesized and biologically evaluated for its in vitro anticancer activity. Compounds 4a, 4b, and 4h with substituted piperazine showed the best antiproliferative activity. In the NCI-60 cell line screening, compound 4b showed promising cytostatic activity against multiple cell lines. Notably, it elicited a GI value of 86.28% against the NSCL cancer cell line HOP-92 at a 10 µM dose. Compounds 4a and 4h at 10 µM showed promising GI values of 40.87% and 46.14% against HCT-116 colorectal carcinoma and SK-BR-3 breast cancer cell lines, respectively. ADME-Tox prediction of compounds 4a, 4b, and 4h revealed their acceptable drug-likeness properties. In addition, compounds 4a, 4b, and 4h showed a high probability of targeting kinase receptors via Molinspiration and Swiss TargetPrediction.

Stocking density, ambient temperature, and group size affectsocial behavior, productivity and reproductivity of goats- A review.

The stocking density (animal/area, SD) is one of the significant factors that influence the welfare and performance of animals. However, there are discrepancies in the recommended SD for fiber, meat, and dairy goats, which means farming practices and welfare standards for goats should be better defined. Therefore, this review article sheds light on 1) some differences between goats and sheep. 2) the geographical distribution of fiber, meat type, and dairy goat populations. 3) effects of interaction between SD and group size on social, feeding, and aggressive behaviors. 4) the effects of SD on meat and milk production. 5) the relationship between SD and reproductive performance. In conclusion, the larger space allowance with access to an outdoor yard can improve species-specific behaviors and meat and milk yield. Moreover, goats are more sensitive to high SD (less than 3 m2/ goat), especially during the last stage of the gestation period. Allowing optimal floor space for each breed is important to avoid the undesired behavioral response. Conclusively, improving the housing aspects, including floor space and enrichment tools, would assist in implementing welfare-economic production standards for goats.

Space allowance impacts behavior, productivity, reproductivity and immunity of sheep-a review.

Sheep is an important producing animal in subtropical and arid regions; however, sheep farming practices and welfare standards are still not well established. To move to either intensive or intensive sheep production, stocking density (animal/area, SD) is a significant factor that influencing the welfare and productivity of animals. However, there are discrepancies in space allowance standards for wool, meat, and dairy sheep at different stages. Thus, this review article sheds light on (1) the geographical distribution of wool, meat-type, and dairy sheep populations; (2) the effects of interaction among space allowances, housing systems, and group size on the social, feeding, and aggressive behaviors and human-sheep contact; (3) the effects of space allowance on wool, growth performance, and milk production of sheep; (4) the relationship between space allowance and reproductive performance; (5) the effects of stocking rate on immunity; and (6) suggestions to mitigate the stress and deleterious influences of SD on the productivity of sheep. In conclusion, the larger space allowance with access to an outdoor yard can improve social and feeding behaviors, meat and milk yield, and wool quality. Moreover, ewes are more sensitive to SD, so they should receive an adequate space allowance at each stage. The changes in behavioral responses of each sheep breed refer to their different requirements. Therefore, there is a need to determine the impact of housing aspects, especially space allowance and enrichment tools on the productive performance and welfare indices of sheep for implementing welfare-economic standards for sheep production.

Water scarcity can be a critical limitation for the poultry industry.

Water is essential for various physiological functions and the productive performance of animals. However, with climatic uncertainties exacerbated by climatic changes, water could become a scarce nutrient shortly. This is already the case in one-third of the world's countries, which are under medium to high levels of water stress. Accordingly, with the growth of poultry production, the availability of water at ad libitum level may not be guaranteed, and birds can be under water restriction for variable periods. Thus, this article aims at attracting the attention of animal scientists to the freshwater shortage challenge, as well as shedding light on (1) the effects of climate change on the freshwater resources; (2) the effects of limited access to water, either by water restriction (WR) or water deprivation (WD), on the growth, feed efficiency, and meat quality of broilers; (3) the effects of different levels of WR or WD on egg production and egg quality traits; (4) the effects of limited access to water on the health, behavior, and welfare status of chickens; and (5) suggested solutions to overcome future water shortage challenges. In conclusion, severe water shortage/restriction might negatively influence the productivity, behavior, and welfare status of the chickens. Genetic background and environmental conditions may interact with the WR effects. The tolerance level of indigenous chicken breeds to limited water access could provide the knowhow to potential solutions to overcome water shortage problems. Selection of chicken strains with high tolerance capacity to thirst and limited water access regimens may be a sustainable solution for solving water scarcity problems.

Lactococcus lactis endocarditis and liver abscess in an immunocompetent patient: a case report and review of the literature.

BACKGROUND: Over the last two decades, several cases of infections caused by Lactococcus lactis have been reported. This Gram-positive coccus is considered non-pathogenic for humans. However, in some rare cases, it can cause serious infections such as endocarditis, peritonitis, and intra-abdominal infections. CASE PRESENTATION: A 56-year-old Moroccan patient was admitted to the hospital because of diffuse abdominal pain and fever. The patient had no past medical history. Five days before his admission, he developed abdominal pain in the right lower quadrant along with chills and feverish sensations. Investigations showed a liver abscess, which was drained, and the microbiological study of the pus revealed Lactococcus lactis subsp. cremoris. Three days after admission, control computed tomography objectified splenic infarctions. Cardiac explorations were performed and showed a floating vegetation on the ventricle side of the aortic valve. We retained the diagnosis of infectious endocarditis according to the modified Duke criteria. The patient was declared afebrile on day 5 and the evolution was clinically and biologically favorable. Lactococcus lactis subsp. cremoris, formerly known as Streptococcus cremoris, is a rare cause of human infections. The first case of Lactococcus lactis cremoris endocarditis was reported in 1955. This organism includes three subspecies: lactis, cremoris, and hordniae. A MEDLINE and Scopus search showed only 13 cases of infectious endocarditis due to Lactococcus lactis, with subsp. cremoris identified in four of the cases. CONCLUSIONS: To our knowledge, this is the first case report of the co-occurrence of Lactococcus lactis endocarditis and liver abscess. Despite its reported low virulence and good response to antibiotic treatment, Lactococcus lactis endocarditis must be considered a serious disease. It is imperative for a clinician to suspect this microorganism of causing endocarditis when they notice signs of infectious endocarditis in a patient with a history of consumption of unpasteurized dairy products or contact with farm animals. The finding of a liver abscess should lead to an investigation of endocarditis, even in previously healthy patients without obvious clinical signs of endocarditis.

Hardware-in-the-loop testing of simple and intelligent MPPT control algorithm for an electric vehicle charging power by photovoltaic system.

In this paper, an electric vehicle (EV) charging station powered by a photovoltaic (PV) system has been created to charge EVs. Furthermore, the maximum available power from the PV system was extracted using a new algorithm called the simplified universal intelligent PID (SUIPID) controller, which has the advantages of simplicity in design and intelligence. The SUIPID controller was compared to the artificial neural networks (ANNs), the fuzzy logic controller (FLC) based on linear membership functions, and the FLC based on particle swarm optimization (PSO) to optimize its parameters under various conditions. The system simulation was first performed using MATLAB software, then an experimental set up was conducted to confirm the theoretical work. The proposed SUIPID responds 28.5%, 44.4%, and 61.5% faster than the PSO-FLC, ANN, and FLC, respectively, whereas the ITAE error was reduced by 27.3%, 52.9%, and 65.2%, respectively. Also, the charging procedure of the EV battery is precisely steady under different atmospheric conditions. The SUIPID controller has several advantages over other intelligent algorithms, most notably its ease of design and implementation.

The Outcomes of PBMV in Pregnancy, and When is the Best Time?

Background: Percutaneous balloon mitral valvuloplasty (PBMV) is considered the most suitable option for managing symptomatic severe mitral valve stenosis (MS) during pregnancy with favorable anatomy. We do not know the best time to perform PBMV during pregnancy to achieve the best maternal and fetal outcomes. Therefore, we conducted this study to clarify the best procedure timing. Methods: This prospective, observational, single-center study involved 44 pregnant patients suffering from symptomatic MS who underwent PBMV from May 2017 to May 2020. A detailed history is taken, full clinical examination, laboratory assessment, 2 D echocardiography, and follow-up during the hospital stay and monthly until labor. Results: We found that the mean mitral valve area (MVA) had significantly increased from 1.12 ± 0.24 to 2.09 ± 0.46 cm2 (P < 0.001). The mean pressure gradient across the mitral valve reduced from 17.22 ± 5.55 to 8.94 ± 3.75 mmHg (P < 0.001). The procedures were successful in 91% of the patients. Regarding obstetric outcomes, the incidence of preterm labor, fetal death, and composite adverse outcomes was significantly lower in patients who had the procedure during the second trimester than those who had the procedure during the third trimester. All preterm deliveries and intrauterine fetal deaths occurred at least 21 days after PBMV. The patients showed a statistically significant improvement in NYHA functional classification. Conclusion: We can conclude that PBMV performed in pregnant patients is an effective and safe treatment modality, and we observed better obstetric outcomes achieved with early intervention during the second trimester.

The impact of magnetized drinking water on semen quality, fertility and hatchability rates of Fayoumi chicken.

The present study was conducted to interpret the effect of magnetic field on water pH and calcium form, and evaluate semen quality, fertility and hatchability rates of Fayoumi chickens receiving magnetized drinking water (MDW). A total of 180 Fayoumi chickens (20 roosters + 160 hens), 54 weeks of age, were divided into two groups. The first group served as control, which received regular drinking water, and the second group was treated with MDW. Semen was collected twice (at day 15 and day 30 of the experiment) to determine semen quality. Fertility and hatchability were determined in two patches of hatching eggs through 1-15 and 16-30 days of the experiment. Results showed that the roosters of MDW group had higher live sperm and sperm motility ratios than those of the control group throughout the experimental period (1-30 days). The abnormal sperm ratio and methylene blue reaction time of MDW-received roosters were significantly lower than those of control roosters. Fertility and hatchability percentages of MDW group were greater compared to those of regular drinking water. Conclusively, alterations in the physiochemical characteristics of MDW and the calcium form can play a role in improving semen quality, fertility, and hatchability percentages during the late laying phase.

Preliminary study of lithium tetraborate doped with Cu and in for external dosimetry.

A potentially tissue-equivalent dosimeter based on lithium tetraborate co-doped with Cu and In was successfully synthesized in two steps melting process. Basic material properties were characterized using Differential scanning calorimetry, X-ray diffraction, and Fourier Transform Infrared Spectroscopy, the dosimetric properties using Thermoluminescence. The highest sensitivity was observed for dopant concentrations of 0.1% Cu and 0.5% In. Tmax-Tstop analysis revealed the existence of eight individual peaks in the composite TL glow curve, which was confirmed by computerized glow curve deconvolution. A linear dose-response was seen up to about 30 Gy, for higher doses saturation effects occurred. The minimum detectable dose was estimated at about 670 µGy. TL peaks, with peak temperature above 150 °C faded to values between 3.3 and 14.9% of the respective of initial values after 70 days storage.

Cladamide: a new ceramide from the endophytic fungus Cladosporium cladosporioides.

A new ceramide, named cladamide (1), in addition to cinnamic acid (2), para-coumaric acid (3), stigmasterol-3-O-ß-D-glucoside (4), and uracil (5), was isolated from the white beans culture of Cladosporium cladosporioides, a marine-derived endohpytic fungus isolated from the leaves of the mangrove, Avicennia marina (Forssk.) Vierh. Structure elucidation of compound 1 was established on the basis of extensive 1D and 2D NMR spectroscopic techniques in combination with HR-ESI-MS. The ability of the isolated compounds to inhibit acetylcholine esterase was evaluated. Compound 3 showed the highest acetylcholine esterase inhibitory activity (IC50 = 0.057 ± 0.003 µM), followed by compound 4 (IC50 = 0.068 ± 0.003 µM) and compound 1 (IC50 = 0.099 ± 0.005 µM) compared to donepezil, the positive control, (IC50 = 0.044 ± 0.002 µM). Compounds 2 and 5 showed lower activity (IC50 = 0.182 ± 0.009 and 0.236 ± 0.012 µM, respectively). The results were further validated by molecular docking study.

Performance traits and selected blood constituents of broiler chicks as influenced by early access to feed post-hatch.

The present study aimed to investigate the effect of early access to feed and water post-hatch on broiler chicks' performance. One hundred and twenty chicks were transferred from the hatchery to the rearing house and randomly divided into two groups. The first group: chicks were immediately access to feed and water (F-time 0). The second group: was held without feed and water for 24 h (F-time 24). Then, feed and water were provided ad-libitum, for both groups until 35 days of age. Results indicated that F-time 0 increased body weight and body weight gain throughout the experimental period. It increased feed intake during all experimental periods except from (22-28 days). Additionally, the F-time 0 enhanced the European production efficiency factor index. The F-time 24, increased red blood cells (RBCs) count, hemoglobin (HGB), and packed cell volume (PCV) percentage after 24 h. However, the F-time 0 had a higher RBCs count, HGB, and PCV at 35 days of age. F-time 24 increased total plasma protein, albumin, cholesterol, and triglycerides, after 24 h. In conclusion, early access to feed and water post-hatch enhances broiler chicks' performance and productivity and increases producers' revenue.