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ABSTRACTObjectiveTo detect and assess obstructive sleep apnea (OSA) before and after repair of different types of mandibular fractures.MethodsIn patients with traumatic isolated mandibular fractures who were indicated for open reduction and internal fixation (OR/IF), polysomnography (PSG) was done before and 3 months after surgery.ResultsOf 51 patients (80 mandibular fractures), fractures were unilateral in 29 patients (56.9%) and bilateral in 22 patients (43.1%). PSG was normal in 33 patients (64.7%), and OSA was detected in 18 cases (35.3%); all had bilateral fracture. Mild OSA was reported in 9 cases (17.65%), and moderate OSA was detected in 9 cases (17.65%). Three months after OR/IF of the fractures, successful reduction was obtained, and PSG was within normal limits in all patients.ConclusionBilateral mandibular fractures often lead to OSA, which could be cured with proper OR/IF of the fractures. OSA is not encountered in unilateral fractures.

In the present study, Ti-6Al-4V alloy was fabricated by Selective Laser Manufacturing (SLM) technique and subsequently subjected to an annealing treatment at, above and below the βtransition temperature. We emphasized the influence of porosity, oxygen and phase morphology on the strength, ductility and elongation of SLM-manufactured Ti-6Al-4V and compared the alloy's properties with conventionally manufactured Ti-6Al-4V from the literature. The as-built Ti-6Al-4V sample showed a very high strength due to acicular martensite, and the growth of α+β lamellae on heat treatment improved ductility. Energy Dispersive Spectroscopy (EDS), Optical and Scanning Electron Microscopy (SEM) were used to identify the chemical composition, calculate lamellar width and analyze the fracture mechanisms. The grain size and the average thickness of α lamellae, inter-granular βand prior βgrain boundary increased with annealing temperature. The porosity and oxygen content of the samples were found to have a consequential effect on the strength, especially in as-built and high-temperature annealing conditions and optimum mechanical properties were observed in SLM Ti-6Al-4V annealed at 800 °C.

A weak implant‐soft tissue interface may lead to bacterial ingression, breakdown of underlying tissues, and eventually implant failure. This study proposes a surface modification technique of titanium alloy (Ti), using a nano‐biopolymer scaffold to enhance soft tissue attachment in dental implants. Gelatin (20% w/v) embedded with 10 ± 2 nm silver nanoparticles (AgNPs) was electrospun to form a gelatin electrospun mat (GEM) scaffold, bonded to Ti alloy surface using chemical surface functionalization. Antimicrobial activity of AgNPs was tested against representative Gram‐positive (Staphylococcus aureus) and Gram‐negative bacteria (Escherichia coli) at 4, 24, and 48 hours and after embedding in scaffold at 48 hours. Cytotoxicity analysis (MTT assay) was performed using the 3T3 mouse fibroblast cell line at 24 and 72 hours for two groups: control (unmodified Ti disc) and experimental (GEM embedded with AgNPs); and further validated by scanning electron microscopy. The AgNPs‐embedded GEM showed good antimicrobial activity at 48 hours, with the AgNPs showing complete (99.99%) inhibition of bacterial colony counts at 24 and 48 hours. Cell viability and proliferation over the GEM modified Ti discs were seen to be significantly increased (P< 0.05) at 72 hours as compared with control. SEM images revealed intimate spreading of fibroblasts, with differentiated cell morphology and pseudopodial processes, indicative of enhanced fibroblastic adhesion, growth, and differentiation over the scaffold. Results show good antifouling properties and biocompatibility of the fabricated coating, making it a promising strategy to reduce postoperative infections and peri‐implant diseases in Ti dental implants.

Objectives: To evaluate the efficacy of a novel surgical technique in management of nasopharyngeal stenosis (NPS), describing its steps and results. Study Design: Prospective clinical trial.Setting: This study was conducted at the Otolaryngology, Head and Neck Surgery Department, Zagazig University.Methods: This prospective study was conducted on patients with snoring ± obstructive sleep apnea due to acquired postsurgical NPS of grade Ι and ΙΙ. New surgical repair was employed on the patients and the pre and postoperative results were statistically compared.Results: The grade of NPS improved significantly postoperatively (P= .00136) throughout a follow-up of 1 year. Postoperatively, there was statistically significant improvement of apnea hypopnea index (P= .0005), Visual Analog Scale (VAS) of nasal obstruction (P< .0001) and VAS of snoring (P< .0001). Dysphagia showed early worsening, but it improved completely at 3 months postoperatively.Conclusion: The utilized novel procedure appears effective, low cost, and easily applicable, and it does not require implants, special tools, or suture materials. Furthermore, it gives excellent results, with negligible pain, and rapid recovery without significant complications.Level of Evidence: 4.

Background: Retro-maxillary recess of the nasal cavity is an area that has not yet described in the literature. Objective: To report, present, and describe a previously non-reported case which has bilateral retro-maxillary nasal recess by multi-slices computed tomography (MSCT). Case presentation: A CT of a 22-year-old male showed bilateral retro-maxillary nasal recess extends beyond the posterior maxillary sinus wall and anterior to the pterygopalatine fossa as an extension of the middle meatus laterally and bounded by the maxillary sinus anterior, the orbital floor superior, the inferior turbinates lateral attachment inferior, and the pterygopalatine fossa anterior. The retro-maxillary nasal recess anteroposterior, lateral, and vertical dimensions were 11.53, 8.24, and 11.6 mm respectively at the left side and 5.6, 4.61, and 6.16 mm respectively at the right side. Conclusion: This study reports and describes a new retro-maxillary nasal recess that could represent a new hidden challenging area for ESS.

Purpose: To evaluate post-tonsillectomy healing process using combined cold dissection and bipolar cautery for hemostasis. Methods: This case series included patients for whom tonsillectomy was done by cold dissection and limited the bipolar cautery for hemostasis and dealing with the lower pole only. Saline irrigation was used for the tonsillar bed after tonsillectomy and a wet saline-moistened pack was placed into the tonsil fossa. Intra-oral digital photographs were reviewed postoperative, at 3rd, 5th, 7th, 9th, 11th, 13th, 15th, and 21st day after surgery. Patients were asked to register their postoperative pain using a standardized visual analog scale. The time of separation of the healing membrane (HM) and any blood clot and/or bleeding surface were recorded. Results: Among included 114 patients, the HM color was white without odor in all cases. Extension of the HM was limited to the tonsillar bed in 112 patients (98%) and exceeded in 2 patients (2%). The mean time for HM separation was 8.8 ± 1.1 days (range = 7–14) with a significantly longer period of separation in females (p= 0.0008). There was no significant correlation between the time of the HM separation and the age of the patients (P= 0.9). Conclusion: Cold dissection tonsillectomy with limited hot tools usage for hemostasis by bipolar cautery with frequent saline wash leads to odorless HM and a good healing process with an average separation of the HM and so less pain and post-tonsillectomy bleeding.

Background: The computed tomography (CT) details of the dimensions of the trachea and the subglottic area are not fully covered in the literature, so it is important to build up a database for the CT measurements of that area. Preoperative details of the trachea are crucial prior to any approach or procedure involving the trachea.So, the aim of this study was to determine the different dimensions of the trachea and subglottic area by computed tomography (CT). Methods: From 100 CTs of the trachea acquiring the axial images via the multiplanar reformates for all subjects to get the delicate details measuring the transverse diameter (width) and the anteroposterior diameter (depth) of the trachea and subglottic area. Results: The mean tracheal width was 15.5 ± 2.1 mm (range = 11.5–21.7), and its mean anteroposterior diameter was 16.56 ± 2.77 mm (range = 11.8–25.1), while the mean width of the subglottic area was 15.1 ± 1.86 mm (range = 12.3–21.1), and its mean anteroposterior diameter was 17.75 + 2.76 (range = 12.9–25.2). All the dimensions of the trachea and the subglottic area were found significantly smaller in female than males. There was positive correlation between anteroposterior and transverse diameters of the trachea with the subglottic area with more tendency for more subglottic area dimension with increase tracheal dimensions and vice versa. Conclusion: The current work updates the CT knowledge about the tracheal and subglottic area dimensions enhancing the surgeons, anesthetist, and radiologists data and orientation of the tracheal dimensions and could aid effective and safe tracheolaryngeal surgery.

In this study, we aim to quantify the impact of COVID-19 on burns provision at an adult regional burn center. Two cohorts of patients were identified for comparison: one during the beginning of the COVID-19 lockdown in April 2020 and a comparator cohort in April 2019. There was a 30% decrease in the incidence of adult burns in 2020. The mean total body surface area (TBSA) was 1.8% and 4.3% in 2019 and 2020, respectively. Scald injuries were the commonest mechanism of burns in both cohorts. Depth of burns was deeper in 2019, with 17.6% of patients presenting with deep burns, compared with 9.6% in 2020. Eight percent of patients in 2019 required theater compared with zero patients in 2020. A similar percentage of patients were admitted in both cohorts. In 2019, admitted patients had an average inpatient stay of 0.57 days per TBSA. In 2020, the average stay per TBSA in all patients was 0.6 days and 1.5 days in survivors. In the lockdown period, 54% of patients were followed up by telemedicine. This difficult period has taught us how important a functioning healthcare system is and how we can be better prepared in the future.

Posterior ischemic optic neuropathy following burns is a rare but devastating condition that can result in total bilateral visual loss. Numerous treatment modalities have been trialed, yet there is no effective therapy to delay or reverse the disease. Hence, it is imperative for burns surgeons to be aware of the potential risk factors and have a high index of suspicion right from the outset to prevent this outcome. Here, we discuss the case of a patient that developed posterior ischemic optic neuropathy subsequent to a major burn injury. We also present a literature review on optic neuropathies following burns to describe the etiology, clinical signs, and potential management.

The primary method of heating residential dwellings in the developed world is through central heating radiators. These appliances are a major risk factor for contact burns, especially in individuals at the extremes of age. This article presents our findings of radiator contact burns in adults treated at a regional burns service during a 6-year period. We identified a total of 116 patients and 60% were male. The mean age was 58 (range 16–97), 71% had at least one comorbidity, with a mean of 1.88 comorbidities for each patient (range 0–8). The mean TBSA was 1.7% (range 0.1–8). Thirty-three patients (26%) required at least one operation with the average number of procedures being 1.45 (range 1–4). The mean length of stay was 16 days (range 0–98) compared to 7.5 days for all admitted patients across the same period. Four patients died within 30 days of their injury, 7 within 90 days, and 16 had died within 1 year of their injury. There have been previous smaller studies looking at contact burns from radiators in both adult and pediatric populations, demonstrating a bi-modal distribution at the extremes of age. This study is the largest of its kind looking specifically at an adult population and demonstrates that these injuries tend to occur in a population with a number of other comorbidities. These patients often required prolonged hospital care.

An experimental study to determine the effect of Cu doping on structural properties of ZnO nanoparticle has been conducted. Zn1-xCuxO (CZO) were prepared by co-precipitation method by varying Cu concentration with x = 0.00, 0.10, 0.11 and 0.12. The structural properties of the CZO sample were characterized by X-Ray diffraction (XRD) and X-ray Absorption Spectroscopy (XAS), which consist of XANES (X-ray Absorption Near-Edge Spectroscopy) and EXAFS (Extended X-ray Absorption Fine Structure). XAS measurements were performed in the energy of Cu K-edge and Zn K-edge using synchrotron radiation at SLRI (Synchrotron Light Research Institute) in Thailand. Both Cu K-edge and Zn K-edge XANES spectra indicate that the oxidation states of Cu and Zn ions are 2+. Analysis of XRD data with refinement method using Rietica software confirms the presence of Cu as doping in ZnO host lattice with the crystallite size ranging between 26 and 44 nm. Moreover, it shows that the obtained CZO samples are polycrystalline with (002) predominant reflection and exhibit a hexagonal wurtzite structure.

Cu-doped ZnO (CZO) with Cu %mole of 0, 13, 14, and 15% have been synthesized by the co-precipitation method with controlled pH at 9. The diffraction pattern of CZO shows that a single phase of ZnO with wurtzite structure (w-ZnO) was achieved in the parent compound. In contrast, small fractions of the secondary phase of CuO monoclinic (m-CuO) were identified in the doped compounds. Rietveld-refinement on the X-Ray Diffraction (XRD) patterns reveals that the crystallite size of CZO is estimated in the range of 84 - 148 nm with instrumental correction factor and that CZO14 exhibits the most considerable fraction of m-CuO among the samples. Interestingly, lattice constants decrease by Cu doping. The effects of Cu doping on the valence state and the local structure were investigated by X-Ray Absorption Spectroscopy (XAS). Based on our analysis on both Cu K-edge and Zn K-edge XANES spectra, oxidation states of Cu and Zn ions are about +2 with no evidence of other valence states. Cu atom is likely to incorporate into wurtzite crystal lattice by occupying Zn sites in a small portion, and the doped compounds create a few oxygen vacancies.

Objective: To assess the results of the new L pharyngeal flap for treatment of velopharyngeal insufficiency (VPI).Methods: This study included 60 patients who were diagnosed as persistent VPI (for > 1 year without response to speech therapy for 6 months at least). L-shaped superiorly based pharyngeal flap was tailored from oropharynx and inserted into the soft palate through a transverse full-thickness palatal incision 1 cm from the hard palate, then the distal horizontal part of the flap was spread 1 cm anteroposterior direction and 1 cm horizontally into the soft palate. Prior to and after surgery, patients were assessed by oral examination, video nasoendoscopy, and speech evaluation.Results: Postoperative speech assessment showed significant improvement in nasoendoscopic closure, speech assessment, and nasometric assessments. Grade 4 velopharyngeal valve closure (complete closure) could be achieved in 59 (98.3%) patients at 6 months postoperatively. No patients showed dehiscence (partial or total) of the flap and no obstructive sleep apnea was reported.Conclusion: The newly designed L pharyngeal flap was proved to be highly effective, reliable, and safe in treating patients with persistent VPI with easy applicability and without significant complication.

A blend of poly(3-hexylthiophene) (P3HT) and poly(n-hexyl isocyanate-block-2-vinylpyridine) (PHIC-b-P2VP) in a common solvent shows the formation of long-range (micrometer-scale) nanowires of P3HT through hydrophobic interactions between the hexyl arms of P3HT and PHIC in a parallel way, which increase the planarity that leads to the generation of vibration bands with a lower free exciton bandwidth (W= 67 meV) in the solution state, which is further decreased to 9 meV after 48 h annealing of the blend film. The resulting nanowires of the P3HT show a 100-fold increase in current in comparison to pristine P3HT.

Type 2 diabetes is routinely identified in clinical practice by tests that rely on a hyperglycemic index. However, people at risk for developing type 2 diabetes may not present with hyperglycemia. We identified several underlying risks for type 2 diabetes, insulin resistance, and associated co-morbidities, using a liquid chromatography mass spectrometry–based analysis of blood metabolites, in participants with normoglycemia and no clinical symptoms. Personalized lifestyle recommendations, including diet, exercise, and nutritional supplement recommendations, were conveyed to these participants by a web-based platform, and after 100 days of following their recommendations, these participants reported reductions in the health risks associated with type 2 diabetes and associated diseases. Our comprehensive metabolite-based assay can be used for type 2 diabetes risk stratification, and our personalized lifestyle recommendation system could be deployed as a preventative treatment option to improve health outcomes, reduce the incidence of chronic disease, and live healthier lives in an evidence-based way.

Elucidation of protein–protein interactions (PPIs) is often very challenging and yields complex and unclear results. Lectin–glycoprotein interactions are especially difficult to study due to the noncovalent nature of the interactions and inherently low binding affinities of proteins to glycan ligands on glycoproteins. Here, we report a “ligand-directed labeling probe (LLP)”-based approach to fabricate protein probes for elucidating protein–glycoprotein interactions. LLP was designed with dual photoactivatable groups for the introduction of an alkyne handle proximal to the carbohydrate-binding pocket of lectins, Ricinus communisagglutinin 120 (RCA120) and recombinant human Siglec-2-Fc. In proof-of-principle studies, alkynylated lectins were conjugated with a photoreactive diazirine cross-linker and an environment-sensitive fluorophore, respectively, by the bioorthogonal click reaction. The modified RCA120or Siglec-2-Fc was used for detecting the interaction with the target glycoprotein in the solution or endogenously expressed glycoproteins on live HeLa cells. We anticipate that the fabrication of these protein probes will accelerate the discovery of novel PPIs.

This study emphasizes the impact of economic, financial, and political institutions on environmental sustainability across 28 Asian countries from 1995 to 2022. Using a spatial Durbin model, we analyzed the direct effects of these institutional factors within each country as well as their spatial spillover effects on neighboring nations. Our findings demonstrate the interconnectedness of environmental risks and the broader regional implications. This highlights the critical need for collaborative policy initiatives at the regional level to promote environmental sustainability. The results provide important insights for policymakers and international organizations seeking to address environmental sustainability in an increasingly globalized context. By emphasizing the role of institutions and spatial interdependencies, this research offers a nuanced understanding of the drivers of emissions in Asia and the potential for coordinated action to mitigate climate change.

•rs74355478 is linked with the ablation of LGR6 expression on neutrophils, monocytes and NK cells and loss of MaR1 activity on phagocytes•rs74355478 leads to altered immune responses to viruses and associates with increased incidence of viral infections at the population level

This paper reviews and discusses the potential of papaya seed and stone fruit kernel biodiesels — the two sources of 2nd generation transport biodiesels in Australia. The challenges associated with biodiesel production and their possible solutions, particularly on feedstock selection, oil extraction, conversion of oil into biodiesel, biodiesel storage and transport, costs of production and the information needs for commercialising these sources of biodiesels are discussed, along with the eco-friendly attributes of these biodiesels to Australian transport sector. Some researchers report that the use of papaya seed and stone fruit kernel biodiesels reduce engine power only 2 to 5%), however significantly reduce harmful engine emission such as HC reductions of 9 to 19%, PM reductions of 19.5 to 35% and CO reductions of 11 to 29%.

The purpose of this study is to determine the effect of heating temperature and the chemical exfoliation process on the reflection loss of r-GO synthesized from coconut shell. The heating process is carried out at temperature of 400°C and 700°C. The chemical exfoliation process is carried out by adding 1M H2SO4 solution in a ratio of 1: 1, 1: 5, and 1:10. Then, the process of washing is done using an ultrasonic cleaner. The XRD pattern indicates that coconut shell charcoal has formed the r-GO phase. In the chemical exfoliation process with the addition of 1M H2SO4 solution in a ratio of 1: 10 at a temperature of 400°C, it shows that the maximum reflection loss is -7.186 dB at 10.48 GHz with an electrical conductivity of 1.075 x 10-3 S/cm.

ABSTRACTBusiness process outsourcing (BPO) is seen by the South African government as key to employment generation. BPO operations are reasonably footloose and the industry’s immense focus on workplace control and high levels of attrition means that the development potential of the BPO industry on workers in South Africa is a matter of critical concern. This article uses the global production network (GPN) framework to understand the developmental potentials of contact center jobs for workers in South Africa. The key argument is that economic upgrading among contact center firms can lead to both social upgrading and downgrading among workers.

The information of vital parameters within the concrete form the basis of maintenance, rehabilitation, repairing, upgradation or rebuilding of concrete structures. The information from the concrete helps in preempting further action or sequence of procedures, for long and sustainable service life. The objective of this review paper is to update and analyze the research that has been undertaken to capture and assess the thermal and humidity changes in concrete structure through sensors. The review while discussing the importance of structural health monitoring of concrete structures assesses the performances of the latest relevant sensor technology in vogue. Due to the environmental robustness, minimal size, quick response and high accuracy, major emphasis has been laid on the design of sensors based on fiber optic and Bragg grating. Both these technologies shall continue progress and generate more efficient and path breaking sensors in near future. Currently, the problems of relay, recalibration or replacement over a long period of time remain the big issues, in sensor technology and its advancement.

We conducted an animal experiment to assess the effect of adding pentoxifylline to amikacin to prevent amikacin-induced ototoxicity. This research was conducted on 24 rats arranged in four groups of 6. One group was injected with 200 mg/kg of intramuscular amikacin once daily for 14 days (AMK-only group). Another received 25 mg/kg of oral pentoxifylline and 200 mg/kg of intramuscular amikacin once daily for 14 days (PTX-AMK 14/14 group). A third group received 25 mg/kg of oral pentoxifylline for 28 days and 200 mg/kg of intramuscular amikacin once daily for 14 days on days 15 through 28 of the pentoxifylline regimen (PTX-AMK 28/14 group). Finally, a control group was administered 1 ml/day of 0.5% carboxymethyl cellulose for 28 days. Transient otoacoustic emissions (TOAEs) were statistically analyzed and serum urea and creatinine levels were measured before and after treatment. We found no significant differences in TOAEs among the groups at the study's onset, but after the experiment, TOAEs disappeared in all frequency bands in the AMK-only and PTX-AMK 14/14 groups. However, TOAEs were preserved in the PTX-AMK 28/14 group. In addition, the serum urea and creatinine levels in the PTX/AMK28/14 group were significantly lower than the levels in the other two treatment groups(p < 0.05 for all), but not significantly different from those of the control group. We conclude, therefore, that 28 days of pentoxifylline treatment exerted a protective effect against amikacin-induced ototoxicity in rats.

We conducted a prospective study to assess the effectiveness of a platelet-rich plasma hourglass graft in the repair of small tympanic membrane perforations as an office-based procedure. Our study population was made up of 25 patients—10 men and 15 women, aged 19 to 45 years (mean: 30.4 ± 7.2)—who each underwent repair of one eardrum. After administration of topical anesthesia, a single piece of platelet-rich plasma approximately double the size of the perforation was obtained from each patient's intravenous blood sample. After the margin of the perforation was freshened, the platelet-rich plasma was placed in an hourglass configuration, with equal portions lying medial and lateral to the perforation. Successful perforation repair was achieved in 21 of the 25 ears (84%). No patient developed an infection, hearing impairment, tinnitus, vertigo, bleeding, taste disturbance, or hyperkeratosis. We conclude that office-based platelet-rich plasma myringoplasty is a safe and effective minimally invasive procedure that is suitable for repairing small tympanic membrane perforations.