Trends in pressure injury prevalence rates and average days to healing associated with adoption of a comprehensive wound care program and technology in skilled nursing facilities in the United States.

INTRODUCTION: A large SNF system in the United States adopted a holistic wound care model that included an AI DWMS to improve PI care. OBJECTIVE: To compare the trend in PI point prevalence rates and average days to healing linked to adopting technology in practice from 2021 to 2022, and to assess the rate of received PI F686 citations in facilities that adopted the technology compared with those that did not. METHODS: The study used the DWMS database to compare anonymized PI data assessed in 2021 (15 583 patients) vs 2022 (30 657 patients) from all SNF facilities that adopted the technology in 2021 and 2022. F686 citations data were provided by the SNF organization. RESULTS: There was a 13.1% reduction in PI prevalence from 2021 to 2022 across all PI stages. Facilities that adopted the technology demonstrated a significant reduction in days to healing from 2021 to 2022, with an average of 17.7 days saved per PI or a 37.4% faster healing rate (P < .001). A significant reduction in the average days to healing was noted for all PI stages, with the most significant savings observed for stages 3 and 4, with an average savings of 35 days (stage 3) and 85 days (stage 4) in 2022 vs 2021 (P < .001). From 2021 to 2022, facilities that adopted the technology reported an overall 8.2% reduction in F-686 citations severity >G compared to those that did not adopt the technology. CONCLUSION: Use of technology as part of a comprehensive wound care program has the potential to not only improve patient care and quality of life, but to realize considerable annual savings in additional PI out-of-pocket expenses (up to $1 410 000) and of clinicians' time (44 808 hours).

Ameliorative effects of androstenediol against acetic acid-induced colitis in male wistar rats via inhibiting TLR4-mediated PI3K/Akt and NF-κB pathways through estrogen receptor ß activation.

5-androstenediol (ADIOL) functions as a selective estrogen receptor ß (ERß) ligand with a protective effect against many diseases. So, we conducted a novel insight into its role in acetic acid (AA)-induced colitis and investigated its effect on TLR4-Mediated PI3K/Akt and NF-κB Pathways and the potential role of ERß as contributing mechanisms. METHODS: Rats were randomized into 5 Groups; Control, Colitis, Colitis + mesalazine (MLZ), Colitis + ADIOL, and Colitis + ADIOL + PHTPP (ER-ß antagonist). The colitis was induced through a rectal enema of acetic acid (AA) on the 8th day. At the end of treatment, colons were collected for macroscopic assessment. Tissue levels of malondialdehyde (MDA), superoxide dismutase (SOD), nuclear factor kappa b (NF-κB), toll-like receptor (TLR4), and phosphorylated Protein kinase B (pAKT) were measured. Besides, Gene expression of interleukin-1beta (IL-1ß), metalloproteases 9 (Mmp9), inositol 3 phosphate kinase (PI3K), Neutrophil gelatinase-associated lipocalin (NGAL), ERß and NLRP6 were assessed. Histopathological and immunohistochemical studies were also investigated. RESULTS: Compared to the untreated AA group, the disease activity index (DAI) and macroscopic assessment indicators significantly decreased with ADIOL injections. Indeed, ADIOL significantly decreased colonic tissue levels of MDA, TLR4, pAKT, and NF-κB immunostainig while increased SOD activity and ß catenin immunostainig. ADIOL mitigated the high genetic expressions of IL1ß, NGAL, MMP9, and PI3K while increased ERß and NLRP6 gene expression. Also, the pathological changes detected in AA groups were markedly ameliorated with ADIOL. The specific ERß antagonist, PHTPP, largely diminished these protective effects of ADIOL. CONCLUSION: ADIOL could be beneficial against AA-induced colitis mostly through activating ERß.

Can Orthopaedic Surgeons adequately assess an Electrocardiogram (ECG) trace paper? A cross sectional study.

Objectives: The primary objective was to evaluate the ECG trace paper evaluation current knowledge level in a group of Orthopaedic surgeons divided into juniors and seniors according to M.D. degree possession. Methods: A cross sectional study through self-administered questionnaires at a university hospital Orthopaedic and Trauma Surgery Department. The questionnaire included five sections: 1-Basic participants' characteristics, 2-Participants' perception of their ECG evaluation current knowledge level, 3-The main body of the questionnaire was an ECG quiz (seven); the participant was asked to determine if it was normal and the possible diagnosis, 4-Participants' desired ECG evaluation knowledge level, and 5-Willingness to attend ECG evaluation workshops. Results: Of the 121 actively working individuals in the department, 96 (97.3 %) finished the questionnaire, and 85 (77.3 %) were valid for final evaluation. The participants' mean age was 30.4 ± 6.92 years, 76.5 % juniors and 23.5 % seniors. 83.5 % of the participants perceived their current ECG evaluation knowledge as none or limited. For participants' ability to evaluate an ECG, higher scores were achieved when determining if the ECG was normal or abnormal, with a mean score percentage of 79.32 % ± 23.27. However, the scores were lower when trying to reach the diagnosis, with a mean score percentage of 43.02 % ± 27.48. There was a significant negative correlation between the participant's age and answering the normality question correctly (r = -0.277, p = 0.01); and a significant positive correlation between answering the diagnosis question correctly and the desired level of knowledge and the intention to attend a workshop about ECG evaluation, r = 0.355 (p = 0.001), and r = 0.223 (p = 0.04), respectively. Only 56.5 % of the participants desired to get more knowledge, and 81.2 % were interested in attending ECG evaluation workshops. Conclusion: Orthopaedic surgeons showed sufficient knowledge when determining the normality of ECG trace papers; however, they could not reach the proper diagnosis, and Junior surgeons performed slightly better than their senior peers. Most surgeons are willing to attend ECG evaluation and interpretation workshops to improve their knowledge level.

Comparison of wound surface area measurements obtained using clinically validated artificial intelligence-based technology versus manual methods and the effect of measurement method on debridement code reimbursement cost.

BACKGROUND: Evidence shows that ongoing accurate wound assessments using valid and reliable measurement methods is essential to effective wound monitoring and better wound care management. Relying on subjective interpretation in measuring wound dimensions and assuming a rectilinear shape of all wounds renders an inconsistent and inaccurate wound area measurement. OBJECTIVE: The authors investigated the discrepancy in wound area measurements using a DWMS versus TPR methods and compared debridement codes submitted for reimbursement by assessment method. METHODS: The width and length of 177 wounds in 56 patients were measured at an outpatient clinic in the United States using the TPR method (width × length formula) and a DWMS (traced wound dimensions). The maximal allowable payment for debridement was calculated for both methods using the reported CPT codes based on each 20-cm2 estimated surface area. RESULTS: The average wound surface area was significantly higher with the TPR method than with the DWMS (20.20 and 12.81, respectively; P = .025). For patients with dark skin tones, ill-defined wound edges, irregular wound shapes, unhealthy tissues, and the presence of necrotic tissues, the use of the DWMS resulted in significantly lower mean differences in wound area measurements of 14.4 cm2 (P < .008), 8.2 cm2 (P = .040), 6.8 cm2 (P = .045), 13.1 cm2 (P = .036), and 7.6 cm2 (P = .043), respectively, compared with the TPR method. Use of the DWMS for wound surface area measurement resulted in a 10.6% lower reimbursement amount for debridement, with 82 fewer submitted codes, compared with the TPR method. CONCLUSIONS: Compared with the DWMS, TPR measurements overestimated wound area more than 36.6%. This overestimation was associated with dark skin tones and wounds with irregular edges, irregular shapes, and necrotic tissue.

Impact of In- Service Training Program on Nurses' Performance for Minimizing Chemotherapy Extravasation.

OBJECTIVE: The objective of this study was to evaluate the impact of an in-service training program on nurses' performance in minimizing chemotherapy extravasation. METHOD: Quasi-experimental (Pre /Posttest) research design was utilized to conduct this study. The study was conducted at the internal medical oncology departments at South Egypt Cancer Institute. A convenience sample was used to select all available nurses working in medical oncology departments (40) nurses. Data was collected by using a pre/post questionnaire sheet for nurses' knowledge, Pre/post observation checklist for nurses' practice, and an in-service nursing training program on nurses' knowledge and practice for minimizing chemotherapy extravasation. RESULTS: The majority of nurses have attained any training program related to chemotherapy extravasation in their last 10 years of educational and professional training, There was a Positive correlation between nurses' knowledge scores pre and post-implementation of in-service training program with ±SD mean 23.77±.97 and with P. value <0.001** There were highly statistical significant differences between total score checklist nurses' practice pre/ post implementation of in-service training program on nurses to minimize chemotherapy extravasation through mean 234.97± .15 and Value < 0.001**. CONCLUSION: The In-service training program had statistically significant improvement on totally nurses' knowledge and practice on minimizing chemotherapy extravasation.

Risk factors for polycystic ovary syndrome among women of reproductive age in Egypt: A case control study.

Polycystic Ovary Syndrome (PCOS) is the most common endocrine disorder among women of reproductive age, associated with an increased risk of multiple diseases, and its pathogenesis is not fully understood. Purpose: identify risk factors for Polycystic Ovary Syndrome in reproductive-aged Egyptian women attending an outpatient gynecological clinic at a specialized hospital of Obstetrics and Gynecology in Port Said City, Egypt. The study population included 248 women; 124 women suffered from PCOS and 124 Non-PCOS. Methods: - Case-control study was conducted among women. PCOS women were diagnosed clinically by transvaginal ultrasound and laboratory investigations. Data were collected using; I) a structured interview questionnaire, including socio-demographic status, medical and family history, menstrual and obstetrical history and lifestyle habits, and clinical examination; II) anthropometric parameters; III) perceived stress scale. The mean age of cases was 26.18±0.45 years. The most common risk factors for PCOS were urban residence, high education, working, insufficient income, history of anemia, hypertension, cancer, and family history of PCOS and infertility, increasing body mass index, fast food, and drinking of coffee. The study concluded that the significant risk factors for polycystic ovarian disease in Egypt women included socio-demographic characteristics, medical and family history, increasing body mass index, and lifestyle habits. This study recommended that Polycystic Ovary Syndrome women follow a healthy diet and exercise regularly.

Exploring cardiac impact of oral nicotine exposure in a transplantable Neoplasm Mice Model: Insights from biochemical analysis, morphometry, and molecular docking: Chlorella vulgaris green algae support.

Nicotine-induced cardiac tissue damage is a concern for cancer patients, but the exact pathogenesis from nicotine oral exposure is unclear. This study was designed to investigate the impact of nicotine and Chlorella vulgaris (Ch. V) on cardiac glutathione homeostasis, inflammatory response, cardiac damage markers, apoptotic proteins and histopathological findings in an experimentally transplantable neoplasm mouse model (Ehrlich ascites carcinoma; EAC). In the in-vivo experiment, the female Swiss mice were divided into four groups: control, Ch.V (100 mg/kg), Nicotine (100 µg/ml/kg), and a combination group ( Nocotine+ Ch.V) for 40 days. Furthermore, in this study,the effects of C. vulgaris components on caspase-3, TNF-α, and IL-1ß activity were explored using Molecular Operating Environment (MOE) docking software to ensure its ability to counteract the toxic effects of nicotine. The results indicated that nicotine has induced significant (P < 0.001) cardiopathic alterations in EAC-bearing mice with changes in cardiac tissue enzymes. C. Vulgaris attenuated the nicotine-induced cardiac glutathione inhibition, suppressed the inflammatory response, exerted antiapoptotic effects, mitigated myocardial injury biomarkers, and repaired cellular and tissue damage. Moreover, the molecular docking results revealed the ability of C. vulgaris to bind with interleukin-1 receptor type 1 (IL1R1) and tumor necrosis factor receptor superfamily member 1 A (TNFRSF1A) in the mice tissues, ameliorating apoptosis and inflammatory processes associated with nicotine-induced cardiotoxicity. This study provides a model for understanding nicotine-induced myocardial injury during experimentally transplantable neoplasm. It highlights C. vulgaris as a beneficial food supplement for cancer patients exposed to nicotine orally.

A Multicenter Assessment of Nurses' Knowledge Regarding Pressure Ulcer Prevention in Intensive Care Units Utilizing the PUKAT 2.0.

Introduction: Pressure ulcer (PU) care is pivotal in the practice of nurses working in intensive care units (ICUs). Therefore, nurses must possess adequate knowledge about the potential risks leading to the development of PUs, as well as managing complications that worsen patient conditions. Objective: To evaluate the level of knowledge of ICU nurses concerning PU prevention in tertiary hospitals in Saudi Arabia. Methods: In this cross-sectional study, the researchers recruited 320 ICU nurses from four tertiary hospitals using convenience sampling. Nurses' knowledge regarding PU prevention was assessed using the revised and updated version of the Pressure Ulcer Knowledge Assessment Tool (PUKAT) 2.0. Data were collected between May and June 2022. The CROSS checklist was observed for reporting. Results: The mean scores of nurses' level of knowledge regarding PU prevention according to the themes of the revised and updated version of the PUKAT 2.0 were as follows-etiology: 62.81 ± 23.77; classification and observation: 50.86 ± 23.28; risk assessment: 31.19 ± 24.26; nutritious diet: 46.04 ± 25.96; prevention: 22.36 ± 12.41; and specific patient groups: 14.84 ± 22.88. Furthermore, the score for nurses' overall level of knowledge of PU prevention was 39.55 ± 8.84 out of 100, interpreted as low based on the 60% cutoff; the minimum knowledge score was 0. Notably, knowledge of PU etiology, classification, observation, and specific patient groups differed based on the hospital of affiliation. Interestingly, gender was the only demographic characteristic based on which nurses' knowledge regarding specific patient groups differed. Conclusion: This study identified insufficient knowledge among ICU nurses regarding PU prevention, which can lead to complications among patients. Simulation scenarios related to PU prevention and management will be an effective way to help nurses gain appropriate knowledge that can be applied in clinical practice.

Stigma and discrimination against people living with HIV by health care providers in Egypt.

OBJECTIVE: HIV/AIDS has been recently increasingly observed in developing countries including Egypt. This study aimed to explore stigma and discrimination attitudes of health care providers (HCPs) in Egypt, as elimination of stigma in healthcare settings is a priority to improve case detection and management. METHODS: A Google form questionnaire using the validated Arabic version of Health Care Provider HIV/AIDS Stigma Scale (HPASS) was sent to physicians and nurses of Ministry of health (MOH) hospitals and University hospitals in 10 randomly selected Governorates in Egypt. Data was collected from July to August, 2022 from 1577 physicians and 787 nurses. Bivariate and multivariable linear regression analyses were used to identify the predictors of the stigmatizing attitude of HCPs towards People living with HIV (PLHIV). RESULTS: The majority of HCPs had worries about contracting HIV infection from their patients (75.8% of physicians and 77% of nurses). They believed that protective measures are not good enough to protect them from getting infected (73.9% of physicians and 74.7% of nurses). About half of the participants had worries about the safety of performing blood investigations to PLHIV (54% of physicians and 59.9% of nurses). Less than half of HCPs believed they have the right to refuse providing care to patients to protect themselves (44.6% of physicians and 50.1% of nurses). Only 10.5% of physicians and 11.9% of nurses have previously refused to provide health care to PLHIV. There was a significantly higher mean score of prejudice and stereotype among nurses compared to physicians (prejudice; 27.34 ± 7.88 vs 26.17 ± 7.5, stereotype; 18.54 ± 4.61 vs 16.43 ± 5.21, for nurses and physicians, respectively). Less years of physicians' experience (B = -0.10, p < 0.01) and rural residence (B = 1.48, p < 0.05) were significantly associated with higher prejudice score while having lower qualification (B = -1.47, p < 0.001) was significantly associated with higher stereotype score. CONCLUSION: Standards of practice should be developed to adjust the services and prepare HCPs to provide medical care free from stigma and discrimination against PLHIV. Improving knowledge of HCPs regarding the methods of transmission of HIV, the use of infection control measures and the emotional factors shaping lives of PLHIV should be targeted through updated training programs. More concern should be directed to young providers in the training programs.

Repurposing of carvedilol to alleviate bleomycin-induced lung fibrosis in rats: Repressing of TGF-ß1/α-SMA/Smad2/3 and STAT3 gene expressions.

Idiopathic pulmonary fibrosis (IPF) is the most widely studied interstitial lung disease. IPF eventually leads to respiratory insufficiency, lung cancer, and death. Carvedilol (CAR) is a third-generation ß-adrenergic receptor antagonist with an α1-blocking effect. CAR demonstrates antifibrotic activities in various experimental models of organ fibrosis. AIMS: This work is designed to explore the possible alleviating effects of CAR on bleomycin (BLM)-induced lung fibrosis in rats. MAIN METHODS: The BLM rat model of lung fibrosis was achieved by intratracheal delivery of a single dose of 5 mg/kg of BLM. Seven days following BLM injection, either prednisolone or CAR was orally administered at doses of 10 mg/kg once daily for 21 days to the rats. The actions of CAR were evaluated by lung oxidant/antioxidant parameters, protein concentration and total leucocyte count (TLC) in bronchoalveolar lavage fluid (BALF), fibrosis regulator-related genes along with the coexistent lung histological changes. KEY FINDINGS: CAR effectively decreased lung malondialdehyde level, increased superoxide dismutase activity, declined both protein concentration and TLC in BALF, downregulated TGF-ß1/α-SMA/Smad2/3 and STAT3 gene expressions, and repaired the damaged lung tissues. SIGNIFICANCE: CAR conferred therapeutic potential against BLM-induced lung fibrosis in rats, at least in part, to its antioxidant, anti-inflammatory, and antifibrotic activities. CAR could be utilized as a prospective therapeutic option in patients with lung fibrosis in clinical practice.

Ventricular Septal Defect Exposure by Tricuspid Valve Chordal Detachment-A Retrospective Matched Study.

Background: Transatrial approach is the standard method in repairing ventricular septal defects (VSD) in the pediatric population. However, the tricuspid valve (TV) apparatus might obscure the inferior border of the VSD risking the adequacy of repair by leaving residual VSD or heart block. Detachment of the TV chordae has been described as an alternative technique to TV leaflet detachment. The aim of this study is to investigate the safety of such a technique. Methods: Retrospective review of patients who underwent VSD repair between 2015 and 2018. Group A (n = 25) had VSD repair with TV chordae detachment were matched for age and weight to group B (n = 25) without tricuspid chordal or leaflet detachment. Electrocardiogram (ECG) and echocardiogram at discharge and at 3 years of follow-up were reviewed to identify new ECG changes, residual VSD, and TV regurgitation. Results: Median ages in groups A and B were 6.13 (IQR 4.33-7.91) and 6.33 (4.77-7.2) months. New onset right bundle branch block (RBBB) was diagnosed at discharge in 28% (n = 7) of group A versus 56% (n = 14) in group B (P = .044), while the incidence dropped to 16% (n = 4) in group A versus 40% (n = 10) in group B (P = .059) in the 3 years follow-up ECG. Echocardiogram at discharge showed moderate tricuspid regurgitation in 16% (n = 4) in group A and 12% (n = 3) in group B (P = .867). Three years of follow-up echocardiography revealed no moderate or severe tricuspid regurgitation and no significant residual VSD in either group. Conclusion: No significant difference in operative time was observed between the two techniques. TV chordal detachment technique reduces the incidence of postoperative RBBB without increasing the incidence of TV regurgitation at discharge.

Validity of immunoglobulin-binding protein 1 as a biomarker for lupus nephritis.

BACKGROUND: Lupus nephritis (LN) is a major issue that adds a burden on patients with systemic lupus erythematosus (SLE). Immunoglobulin-binding protein 1 (IGBP1) is identified as a phosphoprotein that has been recently reported to be linked to the B-cell receptor complex and regulates differentiation, proliferation, apoptosis, and tolerance of B cells. Its diagnostic and/or prognostic role in LN has been highlighted only recently. OBJECTIVES: This study aims to evaluate the relation between serum IGBP1 and SLE disease activity and/or renal activity and to investigate the validity of IGBP1 as a biomarker for LN. METHODS: 96 participants were enrolled and divided into three groups: nephritis, nonnephritis, and control groups. The patients with SLE were diagnosed according to the Systemic Lupus International Collaborating Clinics classification (SLICC) criteria. The serum IGBP1 level was assayed using an enzyme-linked immunosorbent assay (ELISA). Assessments were conducted using the Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2k) and renal biopsy for LN patients. RESULTS: The nephritis and nonnephritis groups had higher IGBP1 levels than the controls; the nephritis group had the highest serum IGBP1 levels (p < .001). Significant correlations were found between IGBP1 levels and proteinuria (r = 0.568, p = .001) and renal SLEDAI (r = 0.475, p = .006) in the nephritis group; on the other hand, the correlation of serum IGBP1 levels with SLEDAI-2K was non-significant for both groups (nephritis and nonnephritis groups). The IGBP1 levels were significantly different among histopathologic classes (p < .001), with class V showing the highest level. Moreover, it showed a significant positive correlation with the pathologic activity index. Compared with renal SLEDAI for identifying active renal affection in patients with SLE, the serum IGBP1 level with a cut-off value of 547.45 ng/mL is a valid biomarker for detecting active nephritis with 93.8% sensitivity and 96.9% specificity. CONCLUSION: The serum IGBP1 levels were high in patients with LN and were positively correlated with the pathologic activity index. The serum IGBP1 level of 547.45 ng/mL is a valid biomarker for detecting active nephritis. Thus, we recommend that clinicians monitor the serum IGBP1 level of patients with SLE to detect LN.

The potential anti-osteoporotic effect of exercise-induced increased preptin level in ovariectomized rats.

Osteoporosis increases bone fragility and fractures. Preptin hormone is regulated by moderate exercise training and increases bone formation. Therefore, this study was conducted to see how estradiol administration and moderate exercise training affected osteoporotic changes in ovariectomized (OVX) rats. To achieve this aim, 36 healthy adult female Wistar albino rats were randomized into Sham, OVX, ovariectomized estradiol-treated (OVX + E) (OVX + E rats were treated using subcutaneous estradiol benzoate 2.5 µg/kg body weight/day), ovariectomized practicing moderate exercise training, ovariectomized estradiol-treated and practiced a moderate exercise training, and ovariectomized alendronate-treated (OVX + Alen) (OVX + Alen rats were treated orally with alendronate 3 mg/kg body weight/week) groups. Alendronate was used as a standard anti-osteoporotic drug. Moderate exercise training, including therapy with estradiol and alendronate for OVX rats began on the fourth week and lasted for six weeks. Results showed that OVX rats had estrogen and preptin deficiency in serum. These deficiencies were associated with a significant increase in bone resorption biomarkers (urinary deoxypyridinoline and hydroxyproline), and bone formation biomarkers (serum osteocalcin and bone-specific alkaline phosphatase). Also, serum pro-inflammatory cytokines (tumor necrosis factor alpha and interleukin-6) were increased, while bone osteopontin (OPN) expression was decreased. Subsequently, the osteoporotic alterations were verified based on histopathological changes. From the results, estradiol therapy and moderate exercise training significantly improved these findings to the same extent as that of the standard alendronate treatment. Therefore, through their anti-inflammatory properties, increasing bone OPN expression, and regulating serum preptin; estradiol therapy and moderate exercise training can reduce osteoporotic alterations in OVX rats. Thus, combined estradiol therapy and moderate exercise training could be a promising potential therapeutic protocol to reduce postmenopausal osteoporosis. Also, targeting serum preptin and bone osteopontin regulation could have a critical role in the treatment of postmenopausal osteoporosis.

Outcomes Post-Nick's Aortic Root Enlargement Technique: Single-Center Experience.

BACKGROUND: Different techniques for aortic root enlargement (ARE) have been reported in the literature. Each technique comes with its own advantages and disadvantages. We report our outcomes of Nick's technique for ARE. METHODS: A single-center retrospective data analysis of 31 patients was performed. Patients were operated between May 2015 and November 2017 at Assuit University Heart Hospital, Assuit, Egypt. RESULTS: The median cardiopulmonary bypass time was 125 minutes (range: 90.0-160.0 minutes), with 90 minutes of cross-clamp (range: 60.0-110.0 minutes). Altogether 59% of the patients had mixed aortic valve diseases. Median intensive care unit and total hospital stay were 2 and 5 days, respectively. Patient-prosthesis mismatch was reported in one patient only (3.25%). Two patients died within 30 days. Median pressure gradient across the aortic valve was 20 mm Hg at 3 years of follow-up. CONCLUSION: The benefits of Nick's technique for ARE can be demonstrated in populations with younger patients and complicated pathology. Further research is required in larger patient populations.

Domestic violence against women during coronavirus (COVID-19) pandemic lockdown in Egypt: a cross-sectional study.

BACKGROUND: While it is necessary to limit the spread of the coronavirus (COVID-19) pandemic, efforts including social isolation, restricted travel, and school closures are anticipated to raise the probability of domestic violence (DV). This study aimed to estimate the prevalence, pattern, risk factors, and physical health outcomes of domestic violence against women during the COVID-19 pandemic. METHODS: A cross-sectional study was conducted using a convenient sample. The data collection tool was based on Sect. 11 of the Egyptian Demographic Health Survey, 2014, which is designed to measure domestic violence. We used a Google form-designed questionnaire and distributed the link to social media platforms from May 2020 to June 2020 till the collection of the required sample of 388 completed questionnaires. RESULTS: The prevalence of every form of DV was 31%. Emotional violence was the most prevalent (43.5%) followed by physical (38.9%) and sexual violence (17.5%). About 10.5% of women reported suffering from all types of violence. The husband was the most common perpetrator of DV. The determinants of ever experiencing any form of DV were low education level of women (OR = 7.3, 95% CI 2.8-18.8), unemployment (OR = 2.31, 95% CI 4-3.5), husband's use of alcohol or substance (OR = 14.4, 95% CI 4.1-50.2), and insufficient income (OR = 2.01, 95% CI 2-3.2). The most common health consequences of DV were injuries such as cuts, bruises, and aches. CONCLUSIONS: The prevalence of ever experiencing any form of DV was 31% which is considered high. Emotional violence was the most common whereas sexual violence was the least common. Identifying the risk factors of DV would support the development and implementation of preventive and screening programs for early identification and offering social support to the victims. Policies should be adopted for the early detection and protection of women suffering from violent behaviors. Access to adequate prompt support and health-care services is crucial in order to decrease the consequences of violence. It is necessary to implement alcohol or drug abuse interventions, preventive measures, and screening programs in families to reduce DV.

A time motion study of manual versus artificial intelligence methods for wound assessment.

OBJECTIVES: This time-motion study explored the amount of time clinicians spent on wound assessments in a real-world environment using wound assessment digital application utilizing Artificial Intelligence (AI) vs. manual methods. The study also aimed at comparing the proportion of captured quality wound images on the first attempt by the assessment method. METHODS: Clinicians practicing at Valley Wound Center who agreed to join the study were asked to record the time needed to complete wound assessment activities for patients with active wounds referred for a routine evaluation on the follow-up days at the clinic. Assessment activities included: labelling wounds, capturing images, measuring wounds, calculating surface areas, and transferring data into the patient's record. RESULTS: A total of 91 patients with 115 wounds were assessed. The average time to capture and access wound image with the AI digital tool was significantly faster than a standard digital camera with an average of 62 seconds (P<0.001). The digital application was significantly faster by 77% at accurately measuring and calculating the wound surface area with an average of 45.05 seconds (P<0.001). Overall, the average time to complete a wound assessment using Swift was significantly faster by 79%. Using the AI application, the staff completed all steps in about half of the time (54%) normally spent on manual wound evaluation activities. Moreover, acquiring acceptable wound image was significantly more likely to be achieved the first time using the digital tool than the manual methods (92.2% vs. 75.7%, P<0.004). CONCLUSIONS: Using the digital assessment tool saved significant time for clinicians in assessing wounds. It also successfully captured quality wound images at the first attempt.

A Histological Study on the Acute Effect of Zinc Oxide Nanoparticles Administered by Different Routes on Albino Rat Lung.

Introduction and Aim of the Work: Zinc oxide nanoparticles (ZnO NPs) are considered the most frequently utilized NPs, so the potential for human exposure has increased tremendously. Hence, the study is aimed to compare the histopathological effects of high and low doses of ZnO NPs administered intranasally or intravenously on lung tissue of adult rat's male albino. Materials and Methods: Thirty-five male Wistar rats were divided into Group I; control group, Group II (intranasal administered group) was subdivided into Subgroup IIA and IIB, in which the animals were injected with 4 and 30 mg/kg of ZnO NPs, respectively. Group III (intravenous administered group) was subdivided into two subgroups with the same doses as Group II. Blood samples were collected after 24 h for estimating serum level of lactate dehydrogenase. Rat lungs were processed for histological, immunohistochemical, and ultrastructural analysis. Results: ZnO NPs caused thickening of interalveolar septa. Extravasated red blood cells were noticed in the alveolar lumen and in some bronchioles. Many dilated blood vessels exhibited focal disruption and focal thickening of their wall. Collagenous fibers were deposited in the interalveolar septa and the walls of bronchi. Tumor necrosis factor-alpha immune reactivity was significantly increased. These findings increased on dose increase, mainly in the intranasal administered group when compared with the intravenous group. Conclusion: ZnO NPs administration caused toxic effects on the histological structure of albino rat lung. These effects were route and dose-dependent, being more obvious after intranasal administration.

Validation of a modified cow's milk-related symptom score (CoMISS) for screening of lactose intolerance in adults.

INTRODUCTION: Lactose intolerance (LI) is the failure to digest foods and beverages containing the lactose present in milk. LI can present by many digestive symptoms. OBJECTIVE: To validate the modified CoMiSS score for prediction of LI, that was confirmed by a stool acidity test. PATIENTS AND METHODS: A cross-sectional study, was conducted at Ain Shams University Hospitals/Gastrointestinal Clinics, and included one hundred adult participants during the period from December 2018 to December 2019. Enrolled patients had one or more gastrointestinal symptoms and were subjected to a stool acidity test (fecal PH test) as a reference test and modified CoMiSS as an index test. RESULTS: The mean age of participants was 35.30 ± 10.714 years old; 55% were females, and their mean body mass index (BMI) was 23.08 ± 2.080 kg/m2, with no significant relation between LI and patients` gender or BMI. Out of the studied participants 24% had positive stool PH, LI diagnosed according to modified CoMISS was present among 19% of them. The mean value of modified CoMISS Score was significantly higher in positive cases (12.37) compared to negative LI participants (2.33) as p < .001. Area under ROC Curve was 0.998, at the selected cut-off value 8, the sensitivity was 89.5% and specificity was 100% thus, levels of questionnaire scoring of 8 or higher would indicate presence of lactose intolerance. CONCLUSION: Modified CoMiSS is a simple, fast, and easy-to-use tool that can predict LI, with a cut-off value of >8, the Area under the ROC Curve was 0.998, sensitivity 89.5%, and specificity was 100%.

Sustained Functioning Impairments and Oxidative Stress with Neurobehavioral Dysfunction Associated with Oral Nicotine Exposure in the Brain of a Murine Model of Ehrlich Ascites Carcinoma: Modifying the Antioxidant Role of Chlorella vulgaris.

Background: This study provides a model for studying the mechanism(s) responsible for the nervous tissue damage and misfunctioning that occurred due to oral nicotine exposure, considered a stress factor, during the presence of Ehrlich ascites carcinoma bearing in the mouse model (EAC). The mitigating role of Chlorella vulgaris (CV) against nicotine-induced brain damage was evaluated. Methods: Eighty Swiss female mice were classified into four groups, these were the control, the CV group, the nicotine group(100 µg/kg), and the combination group. Oxidant/antioxidant status, proinflammatory cytokines levels, DNA damage, quantitative microscopical lesions, and Caspase 3, Bcl-2 proteins were assessed in the current study. Levels of dopamine (DA) and gamma-aminobutyric acid (GABA) were also evaluated. Results: Nicotine was found to cause pronounced neurobehavioral alterations, increase the mortalities oxidative stress DNA damage, and augment the inflammatory response in brain tissue alongside the microstructural alteration. The administration of CV with nicotine in EAC-bearing mice rescued the detrimental effects of nicotine. Conclusions: CV aids in reducing the harmful effects of nicotine and returns the conditions caused by nicotine to near-control levels. Thus, we are in favor of giving it to cancer patients who are taking daily dosages of nicotine even by smoking cigarettes or being exposed to second-hand smoke.