Search

Minimally invasive ileocolic resection for complicated Crohn disease, defined as penetrating Crohn disease associated with intra-abdominal fistula, abscess, or phlegmon, is challenging. In addition, the impact of the minimally invasive approach on postoperative outcomes is still debated. This study aimed to compare the intraoperative and postoperative outcomes of minimally invasive ileocolic resection for complicated versus uncomplicated Crohn disease. A retrospective analysis of all consecutive adult patients with Crohn disease undergoing minimally invasive ileocolic resection from 2014 to 2021 was performed. Perioperative outcomes were compared between patients with complicated Crohn disease (complicated group) and patients without these lesions (uncomplicated group). Among the 274 patients undergoing minimally invasive ileocolic resection for Crohn disease, 101 (36.9%) had a robotic approach, and 84 (30.7%) had complicated Crohn disease. Complicated patients were more frequently malnourished (32.1% vs 16.1%, P =.004) and had more frequent previous bowel resections for Crohn disease (22.1% vs 9.5%, P =.002). There were no differences between both groups regarding intraoperative complications (1.1% uncomplicated group vs 2.4% complicated group, P =.463), conversion rate (2.6% uncomplicated group vs 4.8% complicated group, P =.463), postoperative morbidity (27.4% uncomplicated group vs 34.5% complicated group, P =.231), intra-abdominal septic complications (4.2% uncomplicated group vs 7.1% complicated group, P =.309), and length of stay (3.8 ± 2.0 days uncomplicated group vs 4.2 ± 3.0 complicated group, P =.188). Minimally invasive ileocolic resection for complicated Crohn disease is safe and feasible. Future prospective studies are needed to confirm these results. [ABSTRACT FROM AUTHOR]

This study aimed to compare the survival of patients with isolated inguinal lymph node metastases from rectal cancer to patients with inguinal and additional synchronous distant metastases from rectal cancer who treated with curative intent. A retrospective review of all consecutive adult patients with rectal adenocarcinoma and inguinal lymph node involvement who underwent curative therapy at our institution from 2002 to 2020 was conducted. Patients were classified as having synchronous inguinal lymph node metastasis (SILNM), or synchronous inguinal lymph node and distant organ metastasis (SILNDOM). Patients in the SILNM group had a median overall survival of 75 months compared to 17.6 months in the SILNDOM group; p -value = 0.09. The recurrence-free survival for patients with SILNM was 19.6 months compared to 2.4 months in the SILNDOM group; p -value = 0.053. In conclusion, SILNM appears to represent a distinct subgroup of patients with metastatic rectal cancer. These patients warrant consideration of treatment with curative intent. Further studies are needed. [ABSTRACT FROM AUTHOR]

There is limited data about the safety of colorectal surgery after immune checkpoint inhibitors (ICI). We aimed to share our experience about postoperative outcomes of colorectal surgery for patients treated with ICI. Overall, 31 patients were identified, 22 (71%) underwent elective and nine (29%) underwent emergent/urgent surgery. The 30-day Clavien Dindo class ≥ III complication rates were 27.3% (n = 6) for elective and 55.5% (n = 5) for emergent/urgent cases. Four patients underwent emergency surgery for immune-related colonic perforation and developed postoperative septic shock; two died. Considering patients' comorbidities, cancer stage, and surgical complexity, elective colorectal surgery after ICI seems relatively safe. However, emergent/urgent colorectal surgery was associated with high postoperative morbidity. Indeed, colonic perforation in the setting of ICI treatment has a significant risk of postoperative mortality. Therefore, for patients on ICI with any acute abdominal symptoms, surgical consult should be involved, and colon perforation should be ruled out. [ABSTRACT FROM AUTHOR]

While minimally invasive surgery contributed to improved outcomes in bariatric surgery, less is known about current utilization trends and outcomes related to surgical technique for colorectal resections in super-obese patients (body mass index ≥50 kg/m2). The aim of this study was to compare surgical modalities and short-term outcomes of patients with super obesity who underwent elective colectomy in the United States. A retrospective review was performed of patients with super obesity who underwent elective colectomy between 2012 to 2018 using the American College of Surgeons National Quality Improvement Program data pool. Patients were categorized into an open, laparoscopic, or robotic group. Baseline characteristics and perioperative outcomes including 30-day complications and length of stay were compared between the 3 groups. Furthermore, utilization trends of surgical modalities were assessed. Of 1199 patients, 338 (28.2%) had open, 735 (61.3%) laparoscopic, and 126 (10.5%) robotic colectomy during the study period, primarily for colon cancer (50.8%). Patients in the open group tended to have more baseline co-morbidities. Laparoscopic approach showed better risk-adjusted outcomes compared with open for postoperative ileus (adjusted odds ratio [aOR]:.6, 95% confidence interval [CI;.383–.965]), overall medical complications (aOR:.4, 95%CI [.3–.8]), and length of stay (OR.6, 95% CI [.394–.968]). Trend utilization showed increasing utilization of the robotic platform over the study period, which was associated with less unplanned conversion to open (aOR.417, 95%CI [.199–.872]). Laparoscopic colectomy provides advantageous outcomes over open surgery for colectomy in super-obese patients. The robotic platform has been increasingly used over time, and potential benefits need to be further studied. [ABSTRACT FROM AUTHOR]

The current study focuses on the effect of Hall current on an unsteady free convection slip flow of a Casson fluid past an infinite vertical permeable plate in presence of variable suction. The non-linear coupled partial differential equations of the momentum and energy, which control the flow field, are converted into a system of ordinary differential equations using perturbation technique. The resulting equations are solved analytically with the objective of getting non-dimensional velocity and temperature fields. The study has also presented graphically the velocity and temperature profiles for different values of the parameters entering into the problem. Skin friction coefficient and Nusselt number which are of physical interest are sorted out and presented in the form of graphics. [ABSTRACT FROM AUTHOR]

The using of solar energy has been increased since it is a clean source of energy. In this way, the design of photovoltaic cells has attracted the attention of researchers over the world. There are two main problems in this field: having a useful model to characterize the solar cells and the absence of data about photovoltaic cells. This situation even affects the performance of the photovoltaic modules (panels). The characteristics of the current vs. voltage are used to describe the behavior of solar cells. Considering such values, the design problem involves the solution of the complex non-linear and multi-modal objective functions. Different algorithms have been proposed to identify the parameters of the photovoltaic cells and panels. Most of them commonly fail in finding the optimal solutions. This paper proposes the Chaotic Whale Optimization Algorithm (CWOA) for the parameters estimation of solar cells. The main advantage of the proposed approach is using the chaotic maps to compute and automatically adapt the internal parameters of the optimization algorithm. This situation is beneficial in complex problems, because along the iterative process, the proposed algorithm improves their capabilities to search for the best solution. The modified method is able to optimize complex and multimodal objective functions. For example, the function for the estimation of parameters of solar cells. To illustrate the capabilities of the proposed algorithm in the solar cell design, it is compared with other optimization methods over different datasets. Moreover, the experimental results support the improved performance of the proposed approach regarding accuracy and robustness. [ABSTRACT FROM AUTHOR]

Abstract: The effect of radiation on the heat and fluid flow over an unsteady stretching surface is analyzed. Using a similarity transformation the governing time dependent boundary layer equations for momentum and thermal energy are reduced to a set of ordinary differential equations. The resulting three-parameter problem is solved numerically for some representative values of the unsteadiness parameter A, the radiation parameter R and Prandtl number Pr. It is shown that the heat transfer rate is increased with increasing R, A and Pr. Also the effect of radiation parameter on the heat transfer rate is found to be more noticeable at larger values of A and Pr. [Copyright &y& Elsevier]

Abstract: The problem of steady, laminar, hydromagnetic, simultaneous heat and mass transfer by laminar flow of a Newtonian, viscous, electrically conducting and heat generating/absorbing fluid over a continuously stretching surface in the presence of the combined effect of Hall currents and mass diffusion of chemical species with first and higher order reactions is investigated. The fluid is permeated by a strong transverse magnetic field imposed perpendicularly to the plate on the assumption of a small magnetic Reynolds number. Certain transformations are employed to transform the governing differential equations to a local similarity form which are solved numerically. Comparisons with previously published work have been conducted and the results are found to be in good agreement. A parametric study is performed to illustrate the influence of the magnetic field parameter, Hall parameter, the coefficients of space-dependent and temperature-dependent internal heat generation/absorption, the chemical reaction parameter and order of reaction on the fluid velocity, temperature and concentration distributions. Numerical data for the local skin-friction coefficient, the local Nusselt number and the local Sherwood number have been tabulated for various values of parametric conditions. [Copyright &y& Elsevier]

• Cardiovascular diseases are the leading cause of morbidity and mortality among people with diabetes. • The relation between plasma ADMA and endothelial dysfunction in subjects with neuropathic diabetic foot ulcer was evaluated. • The study found that the remarkable endothelial dysfunction in diabetic subjects with neuropathic foot ulcer is unlikely to be due to alteration in plasma ADMA. Asymmetric dimethyl arginine (ADMA) is an amino acid that acts as an endogenous competitive inhibitor of Nitric oxide synthase, leading to endothelial dysfunction (ED). The aim of this study was to evaluate the relationship between plasma ADMA (p-ADMA) level and ED in diabetic subjects with neuropathic foot ulcer (NFU), and the possible predictors of p-ADMA level. 80 diabetic subjects of matched age, sex and BMI were included; 40 with NFU (G1), 20 with peripheral nerve dysfunction (PND) (G2) and 20 without PND (G3), plus 20 matched healthy subjects (G4). Flow-mediated-dilatation (FMD) of brachial artery and Carotid-intima-media-thickness (CIMT) were measured to evaluate ED and subclinical atherosclerosis, respectively. G1&2 had a significantly lower FMD than G3&4 [−5.09 (−22.5 to 22.92), 4.67 (−15 to 23.91) vs. 15.74 (8.33−36.59) and 20.1 (10.0–46.15)%, respectively] (p < 0.001), and higher CIMT [0.9 (0.6–1.5), 0.9 (0.6–1.3) vs. 0.6 (0.5−0.8) and 0.7 (0.5−0.9) cm, respectively] (p < 0.001, r = 0.237, p = 0.034, r = 0.330, p = 0.003, respectively), with no significant correlation with FMD (r = −0.176, p = 0.118). FMD was inversely and strongly related to CIMT (r = −0.520, p < 0.001). p-ADMA levels were significantly higher in uncontrolled hypertensive patients in comparison to controlled and normotensive subjects [717 (286−3611) vs. 648 (335−874) and 686 (526−857) ng/L, respectively] (p = 0.026). Metformin users and hypertensive subjects on ACEIs or ARBs had the lowest p-ADMA levels than the non-users (p < 0.001, p = 0.007, respectively). The remarkable ED in diabetic subjects with NFU is unlikely to be due to alteration in p-ADMA. Further studies are needed in order to conclude a causal association between p-ADMA and ED in this group of patients. [ABSTRACT FROM AUTHOR]

Abstract Climate change poses a serious threat to arid and low elevation coastal zones. Kafrelsheikh governorate, as a large agricultural and coastal region on the Egyptian North Nile Delta, is one of the most vulnerable areas to higher temperature and global sea level rise. Two DSSAT wheat models (CERES and N-Wheat) were calibrated using a local cultivar (Misr3) grown under irrigated conditions in Egypt. Experimental data of two successive growing seasons during 2014/2015 and 2015/2016 were used for calibration using different treatments of irrigation, planting dates and fertilization. Both models simulated the phenology and wheat yield well, with root mean square deviation of <10%, and d-index > 0.80. Climate change sensitivity analysis showed that rising temperature by 1 °C to 4 °C decreased wheat yield by 17.6%. However, elevated atmospheric CO 2 concentrations increased yield and could overtake some of the negative temperature responses. Sea level rise by 2.0 m will reduce the extent of agricultural land on the North Nile Delta of Egypt by ~60% creating an additional challenge to wheat production in this region. Graphical abstract Unlabelled Image Highlights • Integrated impacts of T and CO 2 on wheat yield received little attention in Egypt. • DSSAT models showed a robust calibration with a recent high yielding wheat cultivar. • A SLR by 2.0 m decreased the agricultural land and wheat production significantly. • Higher levels of CO 2 alleviated impacts of temperature on wheat yield. • Misr3 is a high yielding cultivar responding to elevated T with higher CO 2 levels. [ABSTRACT FROM AUTHOR]

Abstract: Three series of novel pyrazole derivatives 2b–d, 4a–d and 6a–d were synthesized via two step procedure that utilizes hydrazonoyl chlorides 1a–d and enaminones 3a–d and 5a–d, respectively as starting materials. The structures of all the newly synthesized products have been established on the basis of analytical and spectral data. Moreover, some of the products 2–6 were tested against HCV and Subacute Sclerosing Panencephalitis (SSPE). In addition, compounds 2–6 were also tested for the inhibition of peroxynitrite-induced tyrosine nitration and antioxidant activity. The tested compounds are highly effective at very low concentration as anti-HCV, SSPE antioxidant and anticancer in the following ascending order 2d, 4c, 6b, 3b, 6c, 4d, 2b, 2c, 2a, 6a, 5b, 5a, 3a, 4b and 5c. It is worth to mention that all tested compounds are more potent than the reference standards used for comparing activity. All the measurements revealed that the mechanism of action of the anti cancer activities of all the tested compounds is topoisomerase I inhibitor. [Copyright &y& Elsevier]