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Dentists' working day involves awkward and static standing and sitting positions to work within a precise mouth area, resulting in musculoskeletal problems. Objective: To determine frequency of musculoskeletal pain and disorders along with the body-site–specific upper limb (UL) symptoms among dentists. Methods: A cross-sectional study with non-probability convenience sampling was done from March to December 2021. Data were collected using three validated questionnaires, Rapid Upper Limb Assessment (RULA), Visual Analog Scale (VAS) and Upper Extremity Functional Index (UEFI). SPSS was used to analyze data. Results: Fifty-three dentists were enrolled, with 5 (9.4%) males and 48 (90.6%) females. Pain regions were assessed in terms of frequency and severity of pain. There were significant differences found in different regions with p-value less than 0.001. Severe pain was found more in elbow with 42.9%, moderate pain in shoulder was observed with 37.5% however, 31.8% mild pain was observed in neck region with significant p-value of 0.004. Mean Posture Score (Neck, Shoulder, Elbow and Wrist) was found to be 5.32 ± 0.85 and Mean Posture Score (Upper Back) was found to be 4.08 ± 1.68. Female Gender was found common 25.8% in neck pain, 20.9% in shoulder pain, 16.1% in elbow, 12.9% in upper back with significant p-value of 0.016. Conclusions: Elbow was the most painful area in upper limb among dentists working with Clients. Female were more vulnerable in pain than male and majority reported pain related problem, which results in restricted range of motion

The presence of various organic pollutants in surface and ground waters has raised serious environmental threats across the world. In the present work, the solvothermal process was applied to prepare a ternary composite of barium defect-modified graphitic carbon nitride (DM g. C3N4) decorated with silver and titanium oxide for the photocatalytic removal of dyes and pesticides in visible light. Methylene blue (MB) and glyphosate were targeted pollutants. Enhanced structural defects in the carbon nitride framework were reported and characterized by using FTIR, SEM, EDS, XRD, and UV/Visible spectroscopy. Various analytical techniques confirmed the proficient coating of titanium oxide and silver on the surface of DM g. C3N4. The photocatalytic efficiency of synthesized materials for the degradation of persistent organic pollutants and various parameters such as the effect of pH, catalytic dosage, the concentration of pollutant, reusability of the catalyst, etc., were estimated by using UV/Visible spectroscopy. Batch experiments were performed to estimate the degradation efficiency and other parameters by using an absorption study. A scavenger analysis confirmed hydroxyl radicals as the main reactive species for the degradation of various pollutants. The results confirm that the ternary composite of barium DM g. C3N4 showed an increased response in the visible region, greater stability, and excellent photocatalytic efficiency toward the degradation of the organic compounds. The results confirm that the maximum degradation of the said organic pollutants occurs in 105 min.

Heavy metal contamination has increased over the globe, causing significant environmental issues owing to direct and indirect releases into water bodies. As a result, metal removal from water entities must be addressed soon. Various adsorbents such as MOFs and chitosan have demonstrated promising results in water treatment. The present study prepared a composite material (chitosan-UiO-66-glycidyl methacrylate MOF) by a microwave-assisted method. The structure and morphology of the chitosan-MOF composite were studied using FE-SEM, EDX, XRD, BET, FT-IR, and TGA techniques. In addition, the adsorption of Pb(II) from aqueous solution onto the chitosan-MOF composite was analyzed in a batch study concerning pH, contact time, initial metal ion concentration, and adsorbent dosage. The composite has a large surface area of 867 m

A cross- sectional survey was conducted in Erbil province from April to July 2021 to estimate the prevalence of major Ixodid ticks on ruminants and to identify tick species using morphological and molecular tools. A total of 687 animals (202 cattle, 287 sheep and 198 goats) examined, and 254 (36.9 %) were infested. About 381 ticks were collected from examined animals. The result identified two genera of six species of the hard ticks based on morphological, molecular investigation. The identified adult ticks morphologically were belonging to the two Ixodid genera, among which three species belonged to the genus Hyalomma (Hyalomma marginatum, Hyalomma anatolicum and H. exacavatum), and three species belonged to the genus Rhipocephalus (Rhipocephalus sanguineu, Rhipocephalus turanicus, and Rhipocephalus B. annulatus). R. annulatus was the dominant tick species infesting cattle with 50% which was significantly higher at P>0.05 than the other isolated species. Whereas H. excavatum and R. sanguineus was the prodominant tick species infesting sheep with 29.1% and 28.3 %respectively. While the infestation rate on goats was 16.7%, R. sanguineus was the most prevailed species infesting goats with 45.4% at (P>0.05). R. sanguineus were the predominant tick reported in Erbil governorate with 29.1% at (P>0.05)., while H. excavatum was reported in low percentage in Erbil at 10.2%. DNA samples from sixty ticks were chosen for molecular studies in order to detect tick species using a conventional PCR targeting the 16S rRNA gene. All sequences were subjected to a Basic Local Alignment Search Tool (BLAST) to determine their identities and assess their homologues and similarities to those in the Gen Bank. PCR and the sequencing have confirmed the morphological-based identification, Phylogenetic study revealed that the three Rhipicephalus genotypes revealed from the current study with accession number (MZ663757-MZ663759) were have a highly identical nucleotide sequence 99-100% with a strain of a Rhipicephalus turanicus, R. annulatus and R. sanguineus strain sequence (KY583068, MN594491 and MN594492) from China, and Iraq respectively. On the other hand phylogenetic analysis of Hyalomma genotypes from the present work with accession number (MZ663760-MZ663762) were closely related to a Hyalomma anatolicum, H. marginatum and Hyalomma exacavatum (MK829042, MG418663, and KP210047) from Egypt, Turkey and India respectively.

Olive oil mill wastewater (OMWW) poses an undeniable environmental problem due to its high organic loads and phenolic compounds (PCs) content. This study determined the optimal conditions for preparing a new bio-sorbent from olive pomace (OP) and the adsorptive treatment of OMWW by this bio-sorbent. The activation reaction was performed with hydrogen peroxide. The results of the combination effect optimization of the three preparation variables: the activation temperature (°C) X1, the activation time (min) X2 and the impregnation ratio X3, are presented by the response surface methodology (RSM). The maximum adsorption capacity was obtained at activation time 300 min, temperature 80 °C and ratio equal to 6.2:1. The bio-sorbent was characterized by Fourier transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDS) and X-ray diffractometer (XRD). The adsorption process performance of this bio-sorbent was examined in batch and fixed-bed columns. An adsorption capacity of 446 mg g-1 has been achieved for 4000 mg L-1 concentration of PCs. The adsorption isotherm and kinetics were consistent with the Langmuir and pseudo-second-order models. Therefore, the Thomas model best fit the fixed bed column experimental data. The bio-sorbent gave a high desorption percentage of PCs, which was above 70% using HCl (0.1M).

OBJECTIVES: The purpose of this study is to compare the critical view of safety technique with the infundibular technique in laparoscopic cholecystectomy in terms of mean operative time and bile duct injuries (BDI). METHODOLOGY: Between 2018 and 2020, 220 patients had laparoscopic cholecystectomy in the Surgical "A" unit at Hayatabad Medical Complex in Peshawar, Pakistan. The patients were divided into two groups, with the first receiving a critical view of safety and the second receiving an infundibular procedure. Operation time and bile duct injury were compared between the two groups. RESULTS: The operative time was significantly reduced with the critical view of safety (CVS) approach, with a mean time of 35.07 minutes for CVS and 40.58 minutes for infundibular technique, with a significant P-value (0.013). About 17 (7.7%) cases required open cholecystectomy; the conversion rate was higher in the infundibular group, with a significant P-value (

Khalid Aziz Ansari,1 Marwan Jabr Alwazzeh,2 Feras Ahmed Alkuwaiti,2 Faraz Ahmed Farooqi,3 Noor Al Khathlan,1 Hussain Almutawah,1 Mustafa Alahmed,1 Hussain Alfaraj,1 Ahmed Aljarrash,1 Jaffar Almadhary,1 Sarah Alwarthan,2 Ahmed Mohammed Alsahlawi,2 Abdullah Bandar Almashouf,2 Moammer Alqasim,2 Elaf Alkuwaiti4 1Department of Respiratory Care, College of Applied Medical Science, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; 2Department of Internal Medicine, College of Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; 3Department of Dental Education, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; 4College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi ArabiaCorrespondence: Khalid Aziz Ansari, Email kaansari@iau.edu.saPurpose: This study investigated the clinical determinants of mortality in hospitalized patients infected with COVID-19.Patients and Methods: A retrospective multicenter large cohort of COVID-19 patients hospitalized between March 2020 and February 2021. We included patients admitted with a confirmed COVID-19 infection with positive COVID-19 through real-time polymerase chain reaction (RT-PCR). SPSS version 25.0 (Armonk, NY: IBM Corp.) was used to analyze the data.Results: Among the study participants (n = 1444), the mean age of the population was 49.22± 17.69 years, of which 63.9% were males (n = 924). Overall, the mean age for non-survivors was 55.65 ± 16.41 years and the length of ICU stay was 13.95 ± 12.4 years. The most common comorbidity among the study subjects was hypertension (HTN) (32.7%), followed by cardiovascular disease (CVD) (10.7%). Patients who were mechanically ventilated (MV) had higher mortality than those who did not require MV (p < 0.001).Conclusion: Our study concluded that old age, the presence of underlying cardiovascular conditions, an abnormal WBC count (leukopenia or leukocytosis), and abnormal blood urea nitrogen (BUN) levels are among the independent predictors of mortality in the Saudi population. These findings may guide health care providers to manage COVID-19 patients more effectively with better outcomes.Keywords: COVID, predictors, KSA, mortality, healthcare

BACKGROUND AND AIM Dysmenorrhea is the most common gynecological problem in women, associated with painful menstruation, diarrhea, headache, low back pain, lower abdominal pain, nausea, fatigue, vertigo, etc. The current study is designed to compare the effectiveness of Kinesio-taping and core strengthening exercises in the pain management of dysmenorrhea. METHODOLOGY The current study was Randomized Controlled Trial with Probability, random sampling technique carried out at Bahria University Medical and Dental College Karachi from January to June 2021. Total 40 female students between 18-35 years with diagnosed dysmenorrhea and VAS Score 4 ≥ were randomly selected. Two groups A and B were separately treated with Kinesio-taping and core strengthening exercises respectively. The intensity and duration of pain are evaluated in both groups. The study questionnaire was completed and VAS was assessed in both groups after the first, second, and third menstrual cycles. RESULTS The result of second Menstrual cycle Post Treatment VAS in group A revealed 16 (80%) with moderate pain and 2 (10%) with severe pain, whereas in group B there were 10 (50%) with mild pain and 10 (50%) with moderate pain with significant P-value of 0.002. Third Menstrual cycle Post Treatment VAS in group A was present in 16 (80%) with moderate pain and 3 (15%) with severe pain, whereas in group B there were 5 (25%) with no pain, 14 (70%) with mild pain and 1 (5%) with moderate pain with significant P-value of 0.000. CONCLUSION There was a significant effect found in participants with Core strengthening exercises for managing dysmenorrhea. KEYWORDS Strengthening Exercise, Kinesiotaping, Dysmenorrhea, Pain, Physical Therapy, Gynecological problem, Menstural cycle.

Background: Cervical spine allow maximum and necessary movements for the functioning of head and sensory organs. Any issue with the flexibility and joint movement can be determined by assessing the cervical range of motion. Cervical range of motion (CROM) assessment is commonly used in clinical practice. The current study aims to find the effects of wearing a hijab on the cervical range of motion compared to the normal cervical range of motions. Methodology: A cross-sectional study was conducted among hijab-wearing female students from Bahria University Medical and Dental College, from November 2019 to January 2020. The study subjects were recruited using a CROM device. Hijab-wearing female students between 18–23 years of age who wear hijab for at least 3 months, with the duration of wearing hijab for at least or at most 6 hours/day were included in the study. Results: A total of 384 students were recruited. Mean Cervical flexion for wearing hijab ≤ 6 hours was 61.06 ± 17.19, and > 6 hours was 55.28 ± 16.09 (p 6 hours was 37.96 ± 10.94 (p=0.008). Mean Lateral flexion for wearing hijab ≤ 6 hours was 42.66 ± 10.32, and > 6 hours was 38.96 ± 11.01 (p=0.002). While mean right rotation for wearing hijab ≤ 6 hours was 59.50 ± 14.27, and 6 hours was 63.47 ± 14.13 (p=0.010). Moreover, the mean Left rotation for wearing hijab ≤ 6 hours was 64.66 ± 17.86, and >6 hours was 70.58 ± 14.34 (p=0.001). Conclusion: The routine wearing of the hijab affects cervical mobility. Moreover, it is concluded that wearing a hijab for > 6 hours greatly affects the range of the head for movement, by decreasing the cervical range of motion.

Nanomaterials have been widely used in many fields in the last decades, including electronics, biomedicine, cosmetics, food processing, buildings, and aeronautics. The application of these nanomaterials in the medical field could improve diagnosis, treatment, and prevention techniques. Graphene oxide (GO), an oxidized derivative of graphene, is currently used in biotechnology and medicine for cancer treatment, drug delivery, and cellular imaging. Also, GO is characterized by various physicochemical properties, including nanoscale size, high surface area, and electrical charge. However, the toxic effect of GO on living cells and organs is a limiting factor that limits its use in the medical field. Recently, numerous studies have evaluated the biocompatibility and toxicity of GO in vivo and in vitro. In general, the severity of this nanomaterial’s toxic effects varies according to the administration route, the dose to be administered, the method of GO synthesis, and its physicochemical properties. This review brings together studies on the method of synthesis and structure of GO, characterization techniques, and physicochemical properties. Also, we rely on the toxicity of GO in cellular models and biological systems. Moreover, we mention the general mechanism of its toxicity.

This article aims to provide guidance to health care workers for the provision of basic and advanced life support to children and neonates with suspected or confirmed coronavirus disease 2019 (COVID-19). It aligns with the 2020 American Heart Association Guidelines for Cardiopulmonary Resuscitation (CPR) and Emergency Cardiovascular care while providing strategies for reducing risk of transmission of severe acute respiratory syndrome coronavirus 2 to health care providers. Patients with suspected or confirmed COVID-19 and cardiac arrest should receive chest compressions and defibrillation, when indicated, as soon as possible. Because of the importance of ventilation during pediatric and neonatal resuscitation, oxygenation and ventilation should be prioritized. All CPR events should therefore be considered aerosol-generating procedures. Thus, personal protective equipment (PPE) appropriate for aerosol-generating procedures (including N95 respirators or an equivalent) should be donned before resuscitation, and high-efficiency particulate air filters should be used. Any personnel without appropriate PPE should be immediately excused by providers wearing appropriate PPE. Neonatal resuscitation guidance is unchanged from standard algorithms, except for specific attention to infection prevention and control. In summary, health care personnel should continue to reduce the risk of severe acute respiratory syndrome coronavirus 2 transmission through vaccination and use of appropriate PPE during pediatric resuscitations. Health care organizations should ensure the availability and appropriate use of PPE. Because delays or withheld CPR increases the risk to patients for poor clinical outcomes, children and neonates with suspected or confirmed COVID-19 should receive prompt, high-quality CPR in accordance with evidence-based guidelines.

Water plays an essential purpose in agricultural yield. Unfortunately, water shortages have led to desertification and salination of soils, threatening the durable progress of agriculture, horticulture, and food security, especially in dried regions, where water resources are a severe problem. The hydrogel absorbed the water, released it to the plants as required while maintaining the soil moist during long periods. Biopolymer as guar gum-based hydrogel is becoming one of the most green ways to hydrogel materials for water retention. Artificial intelligence (AI) is used in hydrogel technology as a result of high energy consumption to make process control and optimization of synthesis and development. Sustainable environment for hydrogel technology was integrated by AI model.

الهدف من البحث: بناء مقياس المركزية واللامركزية في صنع قرارات الاتحاد العراقي المركزي لكرة السلة. التعرف على ترتيب عوامل مركزية ولامركزية صنع القرارات في الاتحاد العراقي المركزي لكرة السلة من وجهة نظر العاملين في الاتحادات الرياضية الفرعية. اُستخدم المنهج الوصفي بطريقة المسح لملاءمته ولطبيعة البحث، وتألفت العينة من قسمين، القسم الأول شمل عينة البناء التي بلغ عددها (108) أفراد عاملون في الاتحادات الرياضية الفرعية لكرة السلة في العراق، في حين شمل القسم الثاني عينة التطبيق التي بلغ عددها (40) فرداً عاملاً في الاتحادات الرياضية الفرعية لكرة السلة في العراق. من وسائل جمع البيانات: أداة لقياس المركزية واللامركزية في صنع القرارات: قام الباحثان ببناء مقياس المركزية واللامركزية في صنع القرارات لدى الاتحاد العراقي لكرة السلة بعد أن توافرت الشروط العلمية للمقياس، وقد تضمن المقياس (20) فقرة. عُولجت البيانات إحصائياً باستخدام: الوسط الحسابي والانحراف المعياري وقانون النسبة المئوية والمتوسط الفرضي ومعامل ألفا ومعادلة جتمان، واُستخدمت معادلة سبيرمان براون. أهم الاستنتاجات هي: صلاحية مقياس المركزية واللامركزية في صنع القرارات في قياس طبيعة صنع قرارات الاتحاد العراقي لكرة السلة. أسلوب صنع قرارات الاتحاد العراقي لكرة السلة هو الأسلوب اللامركزي من وجهة نظر العاملين في الاتحادات الرياضية الفرعية. وفي ضوء النتائج قدم الباحثان عدداً من التوصيات من أهمها: تطبيق مقياس المركزية واللامركزية في صنع القرارات بعد تكييفه بطريقة علمية على اتحادات أخرى في أنحاء العراق كافة. ضرورة استمرارية الاتحاد العراقي لكرة السلة في دعم التوجه نحو اللامركزية في صنع القرارات، وذلك بمنح العاملين في الاتحادات الرياضية الفرعية المزيد من الصلاحيات الضرورية للقيام بواجباتهم بمرونة وفاعلية، وطرح القضايا المطلوب اتخاذ قرار بشأنها ومناقشتها مع العاملين الذين يقع على عاتقهم تنفيذ القرار. على القيادات الإدارية في الاتحاد العراقي المركزي لكرة السلة أن تقوم بالإجراء المناسب الذي يضمن المشاركة الأوسع للعاملين في الاتحادات الرياضية الفرعية في عملية صنع القرارات بشكل فعال وذلك من خلال زيادة عقد الاجتماعات وفتح قنوات الاتصال كافة معهم والقيام بزيارات ميدانية إلى المحافظات. وقدم الباحثان المقترحين الآتيين: إجراء دراسة مقارنة في مركزية ولامركزية صنع قرارات الاتحاد العراقي لكرة السلة مع اتحادات أُخر. 2. العمل على إصدار قانون لتفرغ العاملين في الاتحادات الرياضية للقيام بمهامهم في الاتحادات مع الاحتفاظ بحقوقهم الرسمية في المؤسسات التي يعملون بها، وذلك من أجل أن تتاح لهم فرصة الإبداع، وتقديم الخدمات في كلتا الوظيفتين.

Background Parents of infants in neonatal intensive care units (NICUs) are often unintentionally marginalized in pursuit of optimal clinical care. Family Integrated Care (FICare) was developed to support families as part of their infants’ care team in level III NICUs. We adapted the model for level II NICUs in Alberta, Canada, and evaluated whether the new Alberta FICare™ model decreased hospital length of stay (LOS) in preterm infants without concomitant increases in readmissions and emergency department visits. Methods In this pragmatic cluster randomized controlled trial conducted between December 15, 2015 and July 28, 2018, 10 level II NICUs were randomized to provide Alberta FICare™ (n = 5) or standard care (n = 5). Alberta FICare™ is a psychoeducational intervention with 3 components: Relational Communication, Parent Education, and Parent Support. We enrolled mothers and their singleton or twin infants born between 32 0/7 and 34 6/7 weeks gestation. The primary outcome was infant hospital LOS. We used a linear regression model to conduct weighted site-level analysis comparing adjusted mean LOS between groups, accounting for site geographic area (urban/regional) and infant risk factors. Secondary outcomes included proportions of infants with readmissions and emergency department visits to 2 months corrected age, type of feeding at discharge, and maternal psychosocial distress and parenting self-efficacy at discharge. Results We enrolled 654 mothers and 765 infants (543 singletons/111 twin cases). Intention to treat analysis included 353 infants/308 mothers in the Alberta FICare™ group and 365 infants/306 mothers in the standard care group. The unadjusted difference between groups in infant hospital LOS (1.96 days) was not statistically significant. Accounting for site geographic area and infant risk factors, infant hospital LOS was 2.55 days shorter (95% CI, − 4.44 to − 0.66) in the Alberta FICare™ group than standard care group, P = .02. Secondary outcomes were not significantly different between groups. Conclusions Alberta FICare™ is effective in reducing preterm infant LOS in level II NICUs, without concomitant increases in readmissions or emergency department visits. A small number of sites in a single jurisdiction and select group infants limit generalizability of findings. Trial registration ClinicalTrials.gov Identifier NCT02879799, retrospectively registered August 26, 2016.

The Treated Patellidae Shells (TPS) packed in a fixed bed column for the removal of emerging contaminant such as bifenthrin provides novel insights into waste valorisation, application of environmentally harmless sorbents and removal of bifenthrin pesticide with extension possibilities for larger applications. The biosorbent was characterized by XRD, FTIR, SEM-EDS, TGA-DTA, pHPZC, and BET analysis. TPS biosorbent is composed of a single phase of calcium carbonate (CaCO3) having a high specific area of 158 m2/g. The effects of important parameters such as flow rate, bed height, particles size and bifenthrin feed concentration were studied. The results show that the column efficiency is higher with higher flow rate, higher bed height, higher bifenthrin inlet concentration and lower TPS particles size. The optimum adsorption capacity (40.53 mg) is achieved using a flow rate of 8 mL/min, a bed depth of 4 cm (1.6 g), in the TPS particles size range of 50–100 μm and a bifenthrin feed concentration of 20 mg/L. To model the experimental data, the Bohart-Adams (B-A), Thomas (T) and Yoon-Nelson (Y-N) models were used. The mathematical formulas of these three models are equivalent, that is why the Chu logistic model was developed to fit the experimental data with a single value of both adjusted correlation coefficient (Adj. R2) and chi-square (χ2), for each set. The non-linear form of Chu logistic model showed a good fit between predicted and observed values with higher Adj. R2 and smaller χ2 values. The Chu logistic model therefore made it possible to calculate the actual parameter values of B-A, T and Y-N models. The study of the adsorption isotherm allows to show that the Langmuir isotherm is suitable for describing experimental data. This adjustment of the Langmuir model with the observed data indicates the favorable adsorption and the higher bifenthrin adsorption capacity of TPS biosorbent. The TPS regenerative power study reveals that TPS has good regenerative capacity and can be recycled to remove pesticide molecules. The TPS biosorbent is effective in removing pesticides and can be considered as an alternative to the commercial adsorbent.

Highlights • COVID-19 pandemic has changed the risk-benefit balance for cardiopulmonary resuscitation [CPR]. • Amongst many aerosol producing procedures performed on patients, CPR is a highly aerosol-generating procedure. • Available literature is inadequate to direct clinicians towards keeping low or high threshold for performing CPR in COVID-19 patient.

espanolAntecedentes: Existe la necesidad de metodos de desinfeccion seguros sin un efecto perjudicial sobre la base de protesis acrilica. Objetivo: el objetivo del presente estudio fue evaluar el efecto del agua ozonizada y dos protocolos de desinfeccion por microondas sobre la resistencia a la traccion del acrilico de alto impacto. Material y Metodos: Ochenta muestras se dividieron en cuatro grandes grupos: un grupo control y tres grupos experimentales, 20 especimenes cada uno. Cada grupo experimental recibio desinfeccion con agua ozonizada, microondas de 850 W/1 min o microondas de 650 W/6 min. Los grupos principales se dividieron en dos subgrupos segun el numero de ciclos de desinfeccion y el tiempo total de inmersion en agua destilada: un ciclo y un dia versus siete ciclos y siete dias. Las muestras del grupo de control se sumergieron en agua destilada sin ninguna desinfeccion durante uno o siete dias, respectivamente. Se realizaron pruebas de resistencia a la traccion en las muestras de los ocho grupos. Los datos fueron analizados por SPSS version 21. Se utilizaron las pruebas de comparacion multiple ANOVA y Tukey-HSD para la comparacion entre grupos.. Resultados: Se observo una diferencia no significativa en la resistencia a la traccion en los grupos sometidos a un ciclo de desinfeccion con ozono o microondas a 850 W/1 min. Hubo una disminucion significativa en la resistencia a la traccion para las muestras sometidas a un ciclo de microondas de 650 W/6 min. El numero de ciclos de prueba junto al tiempo de almacenamiento en agua destilada tuvieron un impacto significativo en la resistencia a la traccion del acrilico en todos los grupos probados, al disminuirla. Conclusion: La desinfeccion con ozono y el microondas a 850 W durante un minuto no afectaron la resistencia a la traccion del acrilico, pero la desinfeccion repetida durante siete dias en un ciclo por dia afecto la resistencia a la traccion de la resina acrilica. EnglishBackground: There is a need for safe disinfection methods without a detrimental effect on the acrylic denture base. Aim: the purpose of the current study was to evaluate the effect of ozonated water and two protocols of microwave disinfection on tensile bond strength of high-impact acrylic. Material and methods: Eighty samples were divided into four major groups: one control and three experimental groups, 20 specimens each. The experimental groups each received either disinfection by ozonated water, microwave 850W/1min, or microwave 650W/6min. Further division of the major groups into two sub-groups depending on the number of disinfection cycles and total immersion time in distilled water: One cycle and one day versus seven cycles and seven days. The control group specimens were immersed in distilled water without any disinfection for either one day or seven days. Tensile strength testing was performed on the specimens from the eight groups. The data were analyzed by SPSS version 21#. The ANOVA and Tukey-HSD multiple comparison tests were used for comparison for groups. Results: A non-significant difference in the tensile strength was observed in the groups subjected to one cycle of ozone or microwave disinfection at 850W/1min. There was a significant decrease in tensile strength for the specimens subjected to one cycle of 650W/6min microwaving. The number of testing cycles and storage time in distilled water had a significant impact on the tensile strength of the acrylic in all tested groups, by decreasing it. Conclusion: Ozone disinfection and microwaving at 850W for one minute did not affect the tensile strength of the acrylic, but repeated disinfection over seven days at one cycle per day impaired the tensile strength of the acrylic resin.

Regional income is a source of income for local governments that hold every activity that has an allocation of funds for people. The purpose of this study is to study and analyze the structure of regional income with regional investment as a moderator. This research was conducted at the Regency / City government in West Java Province, this study uses secondary data released from the APBD and PDRB realization report in the period 2014 to 2017. The sample research method used was purposive sampling technique. The analytical method used is the Moderated Regression Analysis using Eviews 9. Based on the results of the analysis obtained from regional original income, regional investment, balanced funds that are moderated by regional investment. Regional original income is moderated by significant regional investment on gross regional domestic product. The results of the study are used to include local governments in managing regional revenue sources and taking an assessment to make regional investments. This journal is the result of his own work and all sources, both quoted and referenced, have been properly approved.

Objective: This study aimed to determine the range of weight loss, at 3 days postnatal age, associated with the lowest risk of mortality/short-term morbidity in preterm infants

The engineering of a novel biocomposite based on Cerastoderma edule shells doped with copper and alginate (Ce-Cu@Alg) forming hydrogel beads was used for batch and dynamic adsorption thiabendazole (TBZ) pesticide from water. The prepared biosorbent was analyzed by various characterization techniques such as scanning electron microscopy (SEM), X-ray diffraction analysis (XRD), Brunauer-Emmett-Teller analysis (BET), and energy dispersive spectroscopy (EDS), thermogravimetric and differential analysis (TGA-DTA). The results of the TBZ batch biosorption by Ce-Cu@Alg composite showed that the Langmuir model was the most adequate to describe the adsorption process, with a maximum adsorption capacity value of 21.98 mg/g. Moreover, the adsorption kinetics were adjusted by the pseudo-second-order model. The optimal conditions determined by the RSM approach coupled with the CCD design were 100 ppm of initial TBZ concentration, a Ce-Cu@Alg beads dose of 6 g/L and a contact time of 180 min for maximum removal of 83.42%. On the other hand, the TBZ sorption on a fixed bed of Ce-Cu@Alg beads was effective at high column height, low effluent flow and low solution concentration. The Thomas model was best fitted to the kinetic data. This study shows the possibility of using this new hybrid biocomposite in the industrial sector to treat large effluent volumes.

Objective: The present study was oriented to estimate the effect of different surface treatments on the microleakage between the soft liner and acrylic with and without the use of autoclave as disinfection method. Material and Methods: Sixty samples were split into two groups: the autoclaved groups and non-autoclaved groups. Each one subdivided into three groups: first one without any treatments as a control group; in the second group surface of the samples were treated with CO2 laser (10.6 nm wavelength for 15 seconds), and in the third group the surface was treated with sandblasting. All the samples exposed to thermocycling, then the microleakage test was evaluated by gauging dye penetration depth between the soft liner and acrylic disc using a digital microscope. Data analyzed statistically by One-way ANOVA and Tukey's post-hoc tests. In addition, t-test was used for comparison between two groups . Results: The maximum mean values for the microleakage were observed in the untreated group (control) followed by the group treated by CO2 laser and the lowest mean value of microleakage was related to the third group for both non-autoclaved and autoclaved groups with significant differences among them. In addition, depending on the use of autoclave, there was non-significant in all studied groups. Conclusions: There was a decrease in the microleakage when the surface treated with CO2 laser and sandblast. The use of autoclave did not badly change the microleakage between the soft liner and denture base. Keywords Microleakage; Soft liner; Autoclave; CO2 laser; Sandblast.

Purpose Everyone is different and without making generalizations, millennials have been shown to behave differently to other generations. As coaches and organizational psychologists, it’s important to appreciate how these differences translate in a professional context, in order to get the most from them when investing in coaching programs. Design/methodology/approach The article offers insights based on our own experience of coaching millennials, sharing ten important characteristics to bear in mind. Findings As extensive research shows, there are some subtle intergenerational differences evident in the millennial demographic but they do not confirm to popular stereotypes. Coaches can draw on these insights to create powerful interventions that enable clients to engage and maximize the value of organizational talent across the generations. Originality/value A group of Aziz Corporate's most experienced coaches share their own personal insights gained whilst working with millennial coaches.

Calotropis procera (Ait.) Ait. is perennial medicinal obnoxious shrub growing in Pakistan up to 1500 m altitude. Hot and water aqueous extracts from leaves and young stems of C. procera were used against Pennisetum glaucum (Linn.) R. Br., Setaria italica (Linn.) P. Beauv., Brassica campestris Linn. and Lactuca sativa L. under laboratory condition. It was seen that germination, seedling growth, fresh and dry biomass reduced in concentration dependent manner. It was observed that the allelopathic effects depended upon the tested species, growth parameter measured, soaking duration and concentration of the donor plant material. The C. procera litter incorporated into the growth medium inhibited the test species used. The C. procera extracts from leaves were more inhibitory than stem extracts. The tendency of inhibition was radical growth > germination > plumule growth suggesting radicle growth to be a better measure of allelopathy. Leaf extracts significantly reduced division and size of cells. It is suggested that aqueous extract from C. procera can be further assessed against microbes and weed under laboratory and field condition.

The sorption capacity of cadmium (Cd (II)) on three new generated nanocomposite beads sodium alginate (SA) based; SA-Clay (SA-C) beads, SA-Phosphate (SA-P) beads, and SA- Activated Charcoal (SA-Ch) beads was investigated in a batch scale, then a continuous flow reactor. The highest adsorption capacity (137 mg/g) was obtained for SA-Ch using 1000 mg/L of initial Cd (II). The isotherm results showed that the adsorption equilibrium is compatible with the Langmuir isotherm and the sorption capacity of SA-Nano-adsorbent beads is very high. The models used for representing kinetic data was given that the removal of Cd (II) be well-fitted by second-order reaction kinetics. For the fixed bed column treatment, the maximum breakthrough times were 30, 38, and 48 h respectively for the SA-C, SA-P, and SA-Ch. According to the obtained results, it was concluded that SA-Nano-adsorbent bead is an excellent designed material as a nanocomposite for cadmium elimination from wastewater in a continuous treatment process.

Objective: To evaluate the physical activity levels among DPT students of Bahria University College of Physical therapy (BUCPT) by International Physical Activity Questionnaire (IPAQ) and to study the relationship between Body Mass Index (BMI) and Physical activity levels of DPT students of (BUCPT). Study design and Setting: This cross sectional study was conducted in BUCPT Bahria from March- April 2019 (1 month data collection). Methodology: Written consent form was obtained from each participant before taking part into study. Individual with cardio-respiratory diseases and fractures in last 12 months or any limb disability were excluded from the study. The study tool was IPAQ. Results:A total of 125 students were enrolled in this study. There were 121 (96.8%) female and 4 (3.2%) male observed. Mean age of students were 19.89±1.14 (18-22) years. In low physical activity level, 2 (28.6%) students were underweight, 8 (17.0%) were normal BMI, 3 (9.7%) were overweight and 6 (15.0%) were obese. In moderate physical activity level, 3 (42.9%) underweight, 22 (46.8%) normal, 19 (61.3%) overweight and 19 (47.5%) fall in obese criteria. High physical activity levels were found to be 2 (28.6%) in underweight group, 17 (36.2%) in normal group, 9 (29.0%) in overweight and 15 (37.5%) were obese. Conclusion: BUCPT students were moderately physically active and minority of them were low physically active and majority of them were lying the category of normal BMI. There was statistically insignificant relationship found between BMI and physical activities levels. Some students were obese and still have high physical activity level while some are normal in BMI and having low physical activity level

Background The Acute Care of at-Risk Newborns (ACoRN) program was developed in Canada to train health care providers in the identification and management of newborns who are at-risk and/or become unwell after birth. The ACoRN process follows a stepwise framework that enables evaluation, decision, and action irrespective of caregiver experience. This study examined the hypothesis that the ACoRN educational program improved clinical practices and outcomes in China. Methods In a before-and-after study, ACoRN training was provided to physicians, neonatal nurses, and administrators in 16 county hospitals in Zhejiang, PRC. Demographic and clinical data were collected on babies admitted to neonatal units before (May 1, 2008 to March 31, 2009) and after (June 1, 2010 to April 30, 2012) training. Results A total of 4,310 babies (1,865 pre- and 2,445 post-training) from 14 sites were included. There were more in-hospital births (97.8% versus 95.6%, P Conclusions ACoRN training significantly increased patient evaluations and changed clinical practices. However, we were unable to ascertain improvement in morbidity or mortality.

Quality improvement initiatives in neonatology have yielded positive results; however, few programs have demonstrated sustainability. We evaluated an ongoing, national quality improvement initiative (Evidence-based Practice for Improving Quality Phase 3 (EPIQ-3)) on outcomes of preterm neonates with a gestational age (GA) of 220–286weeks (i.e., from 22 weeks and 0 days of gestation to 28 weeks and 6 days of gestation). Data from 7459 neonates admitted to 25 Canadian centers between 2013 and 2017 were studied. Trends in mortality and major morbidities were evaluated. The number of neonates with a GA of 220–236weeks increased from 90 in 2013 to 139 in 2017 without a significant change in any other GA categories. In the entire cohort, the odds of composite outcome of mortality or any major morbidity (adjusted odds ratio (AOR) 0.72, 95% confidence interval (CI) 0.61–0.84) and of necrotizing enterocolitis (AOR 0.66, 95% CI 0.49–0.89) were lower in 2017 than in 2013. When calculated per year, the odds of composite outcome (AOR 0.93, 95% CI 0.89–0.97) and odds of necrotizing enterocolitis (AOR 0.89, 95% CI 0.82–0.96) decreased significantly. Among the subgroup of neonates with a GA of 260–286weeks, the odds of composite outcome (AOR 0.63, 95% CI 0.51–0.79), necrotizing enterocolitis (AOR 0.44, 95% CI 0.26–0.73), and nosocomial infection (AOR 0.64, 95% CI 0.49–0.84) were reduced. The collaborative, multidisciplinary, nationwide EPIQ-3 program improved outcomes of preterm neonates, and the improvement was sustainable over 5 years.

Umbilical cord arterial and venous blood gas values reflect the acid-base balance status of a newborn at birth. Derangement in these values has been linked to poor neonatal outcomes in term and late preterm neonates; however, the utility of these values in preterm neonates of29 weeks' gestation is unclear.This study aimed to determine the associations of umbilical cord arterial and venous blood gas values with neonatal mortality and severe neurologic injury in extremely preterm neonates and to identify the cutoff values associated with 2.5-fold increases or decreases in the posttest probabilities of outcomes.This was a retrospective cohort study of neonates who were born at 23+0 to 28+6 weeks' gestation between January 1, 2018 and December 31, 2019, and who were admitted to neonatal units in Canada.Various cut-offs of umbilical cord blood gas values and lactate values were studied.The main outcomes were mortality before discharge from the neonatal unit and severe neurologic injury defined as grade 3 or 4 periventricular or intraventricular hemorrhage or periventricular leukomalacia. The outcome rates were calculated for various cutoff values of umbilical cord blood gas parameters and were adjusted for birthweight, gestational age, sex, and multiple births. Likelihood ratios were calculated to derive posttest probabilities.A total of 1040 and 1217 neonates had analyzable umbilical cord arterial and venous blood gas values, respectively. In the cohort, the mean (standard deviation) gestational age was 26.5 (1.5) weeks, the mean birthweight was 936 (215) g, the prevalence of mortality was 10% (105/1040), and the prevalence of severe neurologic injury was 9% (92/1016). An umbilical cord arterial pH of ≤7.1 and base excess of ≤-12 mmol/L were associated with2.5-fold higher posttest probability of mortality, and an umbilical cord arterial or venous lactate value of3 was associated with a 2.5-fold lower posttest probability of mortality. An umbilical cord arterial lactate value of3 was associated with a lower posttest probability of severe neurological injury.In preterm neonates of29 weeks' gestation, low umbilical cord arterial pH and high umbilical cord arterial base excess values were associated with a clinically important increase in the posttest probability of mortality, whereas low umbilical cord arterial or venous lactate values were associated with a decrease in the posttest probability of mortality.

Objective: To evaluate the association of a combined exposure to antenatal steroids and prophylactic indomethacin with the outcome of spontaneous intestinal perforation (SIP) among neonates born at 7 days before birth) exposures. The co-exposure was prophylactic indomethacin. The primary outcome was SIP. Multivariable logistic regression analysis was used to calculate aORs. Results: Among 4720 eligible infants, 4121 (87%) received antenatal steroids and 1045 (22.1%) received prophylactic indomethacin. Among infants exposed to antenatal steroids, those who received prophylactic indomethacin had higher odds of SIP (aOR 1.61, 95% CI 1.14-2.28) compared with no prophylactic indomethacin. Subgroup analyses revealed recent antenatal steroids exposure with prophylactic indomethacin had higher odds of SIP (aOR 1.67, 95% CI 1.15-2.43), but latent antenatal steroids exposure with prophylactic indomethacin did not (aOR 1.24, 95% CI 0.48-3.21), compared with the respective groups with no prophylactic indomethacin. Among those not exposed to antenatal steroids, mortality was lower among those who received prophylactic indomethacin (aOR 0.45, 95% CI 0.28-0.73) compared with no prophylactic indomethacin. Conclusions: In preterm neonates of

In this paper, Cellana tramoserica (CT) shells were modified by copper and used as an adsorbent to remove thiabendazole (TBZ) from aqueous media. The removal efficiency of TBZ onto CT shells and modified Cellana tramoserica (CT-Cu) shells was investigated by considering the following parameters: initial pesticide concentration, solution pH, agitation time, temperature, and adsorbent mass. The experimental results show that the pseudo-first-order and Langmuir models well describe the adsorption process. The maximum adsorption amount for CT and CT-Cu is 319.68 mg/g and 376.12 mg/g, respectively. CT-Cu showed higher TBZ removal efficiency than CT, explained by the ligand exchange between the water and the pesticide molecules in the metal coordination sphere. Response surface methodology combined with central composite design (RSM-CCD) was used to optimize the adsorption conditions. Optimized values were obtained at 5 for pH, 50 ppm, 120 min, and 20 mg of CT-Cu adsorbent. Under these optimal conditions, 91% of TBZ was removed by adsorption onto CT-Cu. Graphical abstract.

ObjectivesKangaroo Mother Care (KMC), prolonged skin-to-skin care of the low birth weight baby with the mother plus exclusive breastfeeding reduces neonatal mortality. Global KMC coverage is low. This study was conducted to develop and evaluate context-adapted implementation models to achieve improved coverage.DesignThis study used mixed-methods applying implementation science to develop an adaptable strategy to improve implementation. Formative research informed the initial model which was refined in three iterative cycles. The models included three components: (1) maximising access to KMC-implementing facilities, (2) ensuring KMC initiation and maintenance in facilities and (3) supporting continuation at home postdischarge.Participants3804 infants of birth weight under 2000 g who survived the first 3 days, were available in the study area and whose mother resided in the study area.Main outcome measuresThe primary outcomes were coverage of KMC during the 24 hours prior to discharge and at 7 days postdischarge.ResultsKey barriers and solutions were identified for scaling up KMC. The resulting implementation model achieved high population-based coverage. KMC initiation reached 68%–86% of infants in Ethiopian sites and 87% in Indian sites. At discharge, KMC was provided to 68% of infants in Ethiopia and 55% in India. At 7 days postdischarge, KMC was provided to 53%–65% of infants in all sites, except Oromia (38%) and Karnataka (36%).ConclusionsThis study shows how high coverage of KMC can be achieved using context-adapted models based on implementation science. They were supported by government leadership, health workers’ conviction that KMC is the standard of care, women’s and families’ acceptance of KMC, and changes in infrastructure, policy, skills and practice.Trial registration numbersISRCTN12286667; CTRI/2017/07/008988; NCT03098069; NCT03419416; NCT03506698.