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Purpose: Septal perforations (SPs) present a distinct challenge. There are many described surgical approaches with variable success rates. The goal of this study is to describe a new technique in repairing SP. Methods: A case series of eighteen patients with anterior septal perforation who underwent endoscopic repair with the "tunnel technique" based on anterior ethmoid artery flap (AEA) were analyzed. Demographic data, etiology, size of perforation, and success rate were collected. Results: Eighteen cases with male predominance (67%) were enrolled from 2019 to 2022. The average perforation size was 1.5 cm (0.5- 3.6 cm). The success rate of complete SP closure was 94% (n = 17/18) with no complications after surgery. The patients were followed up for 7 ± 5.2 months. Conclusions: AEA flap reconstruction with the tunnel technique is associated with favorable outcomes in SP closure. The tunnel technique provides a useful flap bolster and minimizes the use of other supportive measures. This technique offers an addition to other techniques for septal perforation repair. Level of evidence: Level 4. [ABSTRACT FROM AUTHOR]

Marburg virus disease (MVD) is caused by the Marburg virus, a one-of-a-kind zoonotic RNA virus from the genus Filovirus. Thus, this current study employed AI-based QSAR and molecular docking-based virtual screening for identifying potential binders against the target protein (nucleoprotein (NP)) of the Marburg virus. A total of 2727 phytochemicals were used for screening, out of which the top three compounds (74977521, 90470472, and 11953909) were identified based on their predicted bioactivity (pIC50) and binding score (< − 7.4 kcal/mol). Later, MD simulation in triplicates and trajectory analysis were performed which showed that 11953909 and 74977521 had the most stable and consistent complex formations and had the most significant interactions with the highest number of hydrogen bonds. PCA (principal component analysis) and FEL (free energy landscape) analysis indicated that these compounds had favourable energy states for most of the conformations. The total binding free energy of the compounds using the MM/GBSA technique showed that 11953909 (ΔGTOTAL = − 30.78 kcal/mol) and 74977521 (ΔGTOTAL = − 30 kcal/mol) had the highest binding affinity with the protein. Overall, this in silico pipeline proposed that the phytochemicals 11953909 and 74977521 could be the possible binders of NP. This study aimed to find phytochemicals inhibiting the protein's function and potentially treating MVD. [ABSTRACT FROM AUTHOR]

This paper develops and tests a new conceptual model incorporating the indirect impact of two ethical ideologies (idealism and relativism) on Chinese consumers' ethical judgments under four ethically problematic consumption situations (active benefit, passive benefit, deceptive practice, and no/indirect harm) through two cultural values (integration and moral discipline). Data from a large-scale online consumer survey in five major Chinese cities (N = 1046) support most hypotheses. The findings are consistent with the postulated global impact of ethical ideology on forming an individual's beliefs and values and highlight the importance of a thorough understanding of the significant determinants of consumer ethics to promote ethically responsible consumption behaviors. This study also uses an emic approach to conceptualize and measure Chinese cultural values by using cultural constructs and measures that are designed explicitly in the Chinese context. [ABSTRACT FROM AUTHOR]

Sustained pumping of groundwater can lead to declining water levels in wellfields and concerns regarding the sustainability of groundwater resources. Aquifer Storage and Recovery (ASR) is a promising approach for maintaining water levels in wells and increasing the sustainability of groundwater resources. Herein, an analytical model relying on superposition of the Theis equation is used to resolve water levels at 40 wells in three vertically stacked ASR wellfields operating in the Denver Basin Aquifers, Colorado (USA). Fifteen years of dynamic recovery/recharge data are used to estimate aquifer and well properties, which are then used to predict water levels at individual wells. Close agreement between modeled and observed water levels supports the validity of the analytical model for ASR wellfield applications. During the study period, 45 million m3 of groundwater is produced and 11 million m3 is recharged, leading to a net withdrawal of 34 million m3 of groundwater. To quantify the benefits of recharge, the analytical model is applied to predict water levels at wells absent the historical recharge. Results indicate that during recovery and no-flow periods, recharge has increased water levels at wells up to 60 m compared to the no-recharge scenario. On average, the recharge increased water levels during the study period by 3, 4, and 11 m for wells in the Denver, Arapahoe, and Laramie Fox-Hills Aquifers, respectively. This study demonstrates the utility of analytical modeling to quantify the effects of long-term ASR at wells. [ABSTRACT FROM AUTHOR]

This work aimed at using Little Egrets (Egretta garzetta), for the first time in Egypt, as a bioindicator of heavy metal contamination from three different Egyptian land use types (Qillin within Kafr El-Sheikh (S1, agricultural), Toukh within Qalyubia (S2, semi-rural area), and Abu Rawash within Giza (S3, urban)). Concentrations of aluminum (Al), barium (Ba), cobalt (Co), cadmium (Cd), chromium (Cr), copper (Cu), manganese (Mn), iron (Fe), nickel (Ni), lead (Pb), and zinc (Zn) were analyzed in liver and kidney samples of twenty-six adult Little Egrets collected from the three localities during winter 2018. Moreover, the study calculated the Metal Pollution Index (MPI) to highlight the health of the surrounding environment using birds' internal organs as a mirror. Results revealed that, throughout the three sampling sites, the total metal concentrations in liver samples exceeded that of the kidney, indicating that the liver is the target organ of metal accumulation. The Little Egret's liver was found to be the best-recommended organ to use in future biomonitoring of Cu, Zn, Fe, Mn, and Ni, whereas Al, Co, Cr, Ba, Pb, and Cd can be monitored in the kidney. Cu and Pb were higher in the Little Egret's tissues collected from the agricultural site (S1), whereas Ba, Ni, and Fe were higher in the semi-rural site (S2), followed finally by Cd in the urbanized site (S3). The concentrations of trace elements reported in Little Egrets were within the known background level for water birds. However, alarming concentrations were found for Ni levels in liver (from Qillin and Toukh), as well as Pb and Cr levels in kidney samples (from the three localities). MPI of the eleven studied metals in both liver and kidney of the studied species decreased in the order Qillin (24.36) > Abu Rawash (17.98) > Toukh (3.90). In the three investigated localities, the overall calculated MPI values were higher than one, indicating that the ecosystem is polluted. The study suggested using Little Egrets as a bioindicator of metal contamination. [ABSTRACT FROM AUTHOR]

We have synthesized nineteen (1–19) bisindolylmethane sulfonamide analogs, characterized by different spectroscopic techniques such as 1HNMR and EI-MS and tested for α-amylase inhibitory potential. All compounds showed excellent to moderate degree of α-amylase inhibitory potential with IC50 values ranging between 1.192 ± 0.51 to 3.057 ± 0.18 μM as equated with standard acarbose (IC50 values 0.83 ± 0.36 μM). Among the series, six analogs such as 1, 4, 5, 6, 10, and 14 showed potent α-amylase inhibition with IC50 values 1.747 ± 0.2, 1.208 ± 0.15, 1.192 ± 0.51, 1.858 ± 0.08, 1.358 ± 0.27 and 1.527 ± 0.17 μM, respectively, as equated with standard acarbose. The structure-activity relationship based upon different substituents on phenyl part. Molecular docking studies performed to recognize the binding interaction of the most active compounds. [ABSTRACT FROM AUTHOR]

Objective: To study the feasibility of designing a human cadaveric simulation model of real CSF leak for rhinology training.Method: The laboratory investigation took place at the surgical academic center of Prince Sultan Military Medical City between 2016 and 2017. Five heads of human cadaveric specimens were cannulated into the intradural space through two frontal bone holes. Fluorescein-dyed fluid was injected intracranialy, then endoscopic endonasal iatrogenic skull base defect was created with observation of fluid leak, followed by skull base reconstruction. The outcome measures included subjective assessment of integrity of the design, the ability of creating real CSF leak in multiple site of skull base and the possibility of watertight closure by various surgical techniques.Results: The fluid filled the intradural space in all specimens without spontaneous leak from skull base or extra sinus areas. Successfully, we demonstrated fluid leak from all areas after iatrogenic defect in the cribriform plate, fovea ethmoidalis, planum sphenoidale sellar and clival regions. Watertight closure was achieved in all defects using different reconstruction techniques (overly, underlay and gasket seal closure).Conclusion: The design is simulating the real patient with CSF leak. It has potential in the learning process of acquiring and maintaining the surgical skills of skull base reconstruction before direct involvement of the patient. This model needs further evaluation and competence measurement as training tools in rhinology training. [ABSTRACT FROM AUTHOR]

Recurrence of allergic fungal rhinosinusitis (AFRS) is well recognized. However, there is scarcity in the literature describing involvement of the non-diseased sinuses. We aimed to evaluate the recurrence forms of unilateral AFRS as well as to study the possible predictor factors of developing the disease in the contralateral side. Patients with exclusive unilateral AFRS from (2010 to 2015) were enrolled in multi-institutional case-control study. All patients were evaluated after endoscopic sinus surgery for recurrence. Patient's records were reviewed for demographics, medical treatment, and clinical, radiological, and surgical data. A total of 68 patients were identified. Delayed contralateral involvement after the initial surgery was found in 30.8% with mean duration of recurrence 16.9 months. A significant association was found with the presence of pre-operative contralateral symptoms and signs of inflammation (OR 3.49, 95% CI 1.19-10.22, p value 0.02). Post-operative use of budesonide irrigation was associated with less contralateral involvement (OR 0.11, 95% CI 0.01-0.87, p value 0.01). Association of other variables like: comorbidities, perioperative use of systemic steroid, radiological signs, extent of surgery, additional surgery to the contralateral side, and post-operative use of systemic steroids did not show statistical significance. Involvement of the contralateral sinuses in 30% of unilateral AFRS cases is considered significant. The non-diseased sinuses should be involved in the routine endoscopic examination and post-operative treatment. Further studies are necessary to investigate the possibility of prophylactic surgical intervention of the non-diseased sinuses. [ABSTRACT FROM AUTHOR]

Despite advances in endoscopic approaches, instrumentations and imaging guidance systems, the management of frontal sinus is still challenging. Failure of the endoscopic procedure and restenosis of the newly formed ostium have been demonstrated even with large frontal sinusotomy. We describe a newly designed double nasoseptal flap to cover the bare bone after endoscopic modified Lothrop procedure (EMLP). Five fresh, double-injected cadavers were dissected through an endoscopic endonasal approach. Posteriorly based nasoseptal flap on one side and laterally based nasoseptal flap on the other side were harvested before performing wide EMLP. Feasibility of the procedure, versatility of the flap, coverage area and measurements were calculated. Harvesting the mucoperichondrial/mucoperiosteal flap over the septectomy site was straightforward step. Two different designed flaps (one on each side) are more practical to avoid torsion of the flap. The flap measures 2 × 3 cm on average that was able to cover the bare bone of the anterior and posterior wall of frontal sinus. Osteoneogenesis and progressive osteoplastic activity after EMLP plays a major role in restenosis of frontal sinus. Vascularized nasoseptal flap helps in preventing closure of the newly formed ostium. Applying these flaps over the bare bone enhances the healing process and minimizes the crust formation. [ABSTRACT FROM AUTHOR]

Background: The aim of this study is to present our experience in treating paediatric sinonasal and skull base malignancies with exclusively endonasal endoscopic approach and measure its feasibility. Methods: This study is a retrospective review of seven patients under age of 19 years who have sinonasal and skull base malignancies and treated with endoscopic endonasal approach. The main outcome measures are the surgical resection, complications, survival rate, recurrence and gross facial growth. Results: Radical tumour resection was achieved in all cases with negative margins; no major complications were observed. Mean follow-up was 65 months and no evidence of recurrences. Facial growth assessment showed no gross changes. Conclusion: In selected cases, endoscopic endonasal approach of paediatric sinonasal and skull base malignancies could be an alternative approach. Despite of our few cases, it showed a feasibility of this technique with satisfactory oncological control. A further collaborative study with larger number is needed to have more valid conclusion. [ABSTRACT FROM AUTHOR]