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Background: Children with spastic diplegia experience tonicity, lack of selective motor control, subnormal postural stability and delayed motor development. Selective dorsal rhizotomy followed by physical therapy is a permanent procedure aimed to alleviate hypertonicity., Objective: To explore the efficacy of selective dorsal rhizotomy (SDR) followed by a physical training on gross motor function (GMF), functional balance, walking capacity, selective motor control (SMC) and energy cost of walking (ECW) of ambulant children with spastic diplegia., Methods: Forty-two children with spastic diplegia aged 5 to 8 years were randomly assigned into the control or SDR-group. Both groups received a designed physical training of progressive functional strength training and standard orthotic management (SOM) 3 times a week for 6 months. GMF, functional balance, ECW, functional capacity and SMC were assessed by gross motor function measure (GMfM-88), pediatric balance scale (PBS), energy expenditure index (EEI), six-minute walking test (6MWT) and selective control assessment of lower extremity (SCALE), respectively. Assessment was carried out before the treatment (baseline), after 6 months (post I) and 1-year follow-up (post II)., Results: From baseline to post I and post II assessments, changes of GMF, functional balance, ECW, functional capacity and SMC within the control and SDR groups showed significant improvements (P < 0.001). Moreover, group comparison showed significant differences in favor of the SDR group., Conclusion: Integrated physical training followed SDR demonstrated qualitative changes and enhancement in motor function, achieved by spasticity reduction.

Traumatic aortic injuries can be a lethal event. Almost 88% of patients with traumatic aortic injuries die within the first hour and only 2% survive long enough to develop a chronic aneurysm. Injury to the ascending aorta, whether acute or chronic, are typically managed with surgery, and those in the descending aorta, are managed conservatively or in some cases with stents. We present a rare case of a 53-year old gentleman with intra-aortic migration of a left clavicular prosthesis used for restoration of the left shoulder girdle.

Given the ever-changing business environment, organizations are forced to consider innovation as an essential prerequisite to enhance their efficiency, productivity, and sustainability. In this regard, organizations pay increased attention to enhancing employees' engagement (EE) and stimulating their innovative work behaviors (IWBs). Research emphasizes the importance of employees' IWBs in achieving competitive advantages and organizational sustainability. In this research, we address the question of whether employee engagement leads to stimulating IWBs of the Chinese millennial workforce in service industries. In addition, we explore the potential mediating effect of work-life balance (WLB) and the moderating influence of psychological empowerment (PE) on the relationship between EE and IWBs. Self-administered questionnaires were used to collect data from 372 Chinese senior employees working in the IT, trade, real estate, financial, and telecommunication industries. Our empirical findings showed that highly engaged employees are most likely to exhibit IWBs and maintain a WLB. In addition, the relationship between EE and IWB was partially mediated by WLB. Moreover, the interaction between EE and PE was found to strengthen employees' IWBs. Our study contributes to understanding the importance of EE as an essential prerequisite for millennials' IWBs and provides new insights for service organizations to encourage employees' IWBs. This study contributes to the human resource management field by offering valuable implications vis-à-vis how service organizations operating in a turbulent business environment stimulate the IWBs of their millennial workforce., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Ali, Li and Qiu.)

Objective: To evaluate the impact of virtual reality on pain management during normal labor., Methods: A systematic search was performed in September 2021 through PubMed, Cochrane Library, Scopus, and ISI web of science. We selected randomized clinical trials (RCTs) that compared virtual reality in the intervention group versus placebo or no intervention in the control group among laboring women during their normal delivery. Revman software was used for performing our meta-analysis. Our primary outcome was the pain score evaluated during the labor process by the Visual Analog Scale (VAS). Our secondary outcomes were anxiety and satisfaction scores during childbirth in addition to the duration of the first and second stages of labor., Results: Eight RCTs met our inclusion criteria with a total number of 466 patients. We found virtual reality was linked to a significant reduction in the VAS pain score during labor compared to the control group (MD = -1.40, 95% CI [-1.83, -0.96], p < 0.001). The anxiety score during labor was significantly reduced among the virtual reality group (SMD = -1.15, 95% CI [-2.18, -0.12], p = 0.03). Moreover, virtual reality significantly improved the satisfaction score during labor (MD = 15.58, 95% CI [4.93, 26.22], p = 0.004). However, there were no significant differences between virtual reality and control groups regarding the duration of the first and second stages of labor., Conclusions: Virtual reality is an effective technique for reducing anxiety, increasing satisfaction, and improving pain management during normal labor., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Background: Obesity is an independent risk factor for cardiovascular diseases. Coronary artery calcium (CAC) is a direct measure of coronary atherosclerosis. The study investigated the effect of bariatric surgery on CAC scores in people with severe obesity subjected to laparoscopic sleeve gastrectomy (LSG)., Methods: This prospective study included 129 people with severe obesity in two groups; the LSG group (n=74) subjected to surgery and the diet group (n=55), managed by a diet regimen and lifestyle modification. Cardiovascular risk was assessed by Framingham risk score (FRS) and coronary calcium score (CCS) measured by computed tomography initially and after 3 years., Results: The two groups had a comparable CAD risk before treatment according to FRS or CCS. After treatment, CCS improved significantly in the LSG group (p=0.008) but not in the diet group (p=0.149). There was no correlation between FRS and CCS (r=0.005, p=0.952). Treatment resulted in significant weight reduction and improved fasting blood glucose and lipid profile in the two groups. The change of weight, blood glucose, and HDL, and remission of diabetes mellitus (DM) were significantly higher in the LSG group compared to the diet group., Conclusion: LSG may reduce the risk of developing future cardiovascular comorbidities evidenced by reducing CAC scores. Significant weight reduction and improvement of cardiovascular risk factors may recommend LSG as a cardioprotective procedure in people with severe obesity., (© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: Bariatric surgical operation is taken into consideration to be the handiest remedy for extreme obesity. Durability is the main requirement for the broad usage of bariatric surgery. According to several factors, the present work tries to match the SG and RYGB techniques., Methods: This is a retrospective work that studied 200 morbid obese patients randomized and categorized into two groups according to the treatment method: the laparoscopic sleeve gastrectomy (LSG) and LRYGB groups, within the period from 2014 to 2019 and matched weight dissipation, complications, quality of life, and adverse events., Results: BMI had a mean value of 39.66 ± 3.770 kg/m2 in the RYGB group versus 39.38 ± 3.648 kg/m2. No significant differences were found according to comorbidity, height, and weight. There was no significant difference between the study groups according to complications and morbidity-no recorded unexpected histopathology results in the excised LSG specimens., Conclusion: There was no significant change in weight dissipation, fluctuations in comorbidities, increase in Quality of Life (QoL), and complications for pathological obesity patients according to the treatment methods of laparoscopic SG (sleeve gastrectomy) and RYGB at 2-years postoperative follow-up., Competing Interests: The authors declare no competing interests., (© 2022 The Authors.)

COVID-19 has been a worldwide concern since the outbreak. Many strategies have been involved such as suppression and mitigation strategies to deal with this epidemic. In this paper, a new mathematical-engineering strategy is introduced in order to control the COVID-19 epidemic. Thereby, control theory is involved in controlling the unstable epidemic alongside with the other suggested strategies until the vaccine will hopefully be invented as soon as possible. A new robust control algorithm is introduced to compensate the COVID-19 nonlinear system by propose a proper controller after using necessary assumptions and analysis are made. In addition, the Variable Transformation Technique (VTT) is used to simplify the COVID-19 system. Furthermore, the Most Valuable Player Algorithm (MVPA) is applied in order to optimize the parameters of the proposed controller. The simulation results are based on the daily reports of two cities Hubei (China) and Lazio (Italy) since the outbreak. It can be concluded that the proposed control algorithm can effectively compensate the COVID-19 system. In addition, it can be considered as an effective mathematical-engineering strategy to control this epidemic alongside with the other strategies., (© 2020 Elsevier Ltd. All rights reserved.)

Objective: To assess serum interleukin-6 (IL-6)level in patients with systemic sclerosis (SSc) and its correlations with European Scleroderma Study Group activity score (EUSTAR), Scleroderma Assessment Questionnaire (SAQ), disability index and cardiopulmonary involvement., Methods: Twenty SSc patients and 10 matched healthy controls were included. Serum IL-6 was measured in patients and controls. Disease activity, status,and disability were assessed.Cardiopulmonary involvement was evaluated by pulmonary function tests (PFTs), six minute walk test, echocardiography, and high resolution computed tomography (HRCT) of chest., Results: Serum level of IL-6 was significantly higher in patients with SSc (6.3± 1.4pg/ml) versus healthy controls (3.2± 0.4pg/ml) (P=0.002). IL-6 level showed positive correlations with disease duration (r=0.49, P=0.03), EUSTAR score (r=0.64, P=0.002), Index of Respiratory Status "IRS" (r=0.46, P=0.001), Index of Musculoskeletal Status "IMSS" (r=0.45, P=0.049), Index of Vascular Status "IVS" (r=0.39, P=0.04), mean and peak of pulmonary artery pressure (r=0.44 & 0.55, P=0.02 & 0.002 respectively). Negative correlations of IL-6 level with DLCO% (r=-0.49, P=0.006),six minute walk distance (6MWD) (r=-0.52, P= 0.003) and right ventricle fraction area change (r=-0.48, P=0.03) were found, while there were strong positive correlations with HRCT-ground glass score (r=0.77, P=0.0001) and HRCT-fibrosis score (r=0.62, P=0.003)., Conclusion: IL-6 level is increased in patients with SSc and significantly correlates with EUSTAR score, IRS, DLCO, 6MWD, HRCT scores, and echocardiographic abnormalities of the right side of the heart. These results support the role of IL-6 in the disease activity and in the development of cardiopulmonary manifestations in SSc patients.

Five faba bean genotypes (Vicia faba L.) were selfed for two cycles to produce S1 and S2 generations. A half-diallel cross was carried out among them in each level of inbreeding (S0, S1 and S2) to obtain 10 F1 hybrids. Parental materials as well as their respective F1s were evaluated during the winter season of 2012. All studied traits except total dry seed yield showed significant inbreeding depression after the first generation of selfing (S1). No further decrease was noticed at the S2 generation. In the S1 generation the degree of inbreeding depression was highest for No. of branches/plant (-14.0%) and the least for weight of 100-seeds (-2.7). Some parents showed inbreeding vigor i.e. positive difference between S2 and S1 for some traits in S2 generation. Most studied traits showed significant positive heterosis values over mid-parent. The highest value of heterosis over the mid-parent was detected for total dry seed yield (128.8) and the lowest value of hybrid vigor was shown by weight of 100-seeds (1.2%). Specific combination among the 5 parental genotypes showed the highest value for heterosis for example cross Misr 2 × Giza 429 was the best cross for total dry seed yield, cross Giza 429 × Misr 1 for No. of branches/plant. Giza 429 is the best general combiner for most traits. Some crosses showed heterosis depression i.e. negative heterosis value in some traits. Hybridization among parental genotypes is recommended to be at the S1 or S2 generation. Twelve arbitrary primers produced different degrees of genetic polymorphism among the parental genotypes. A total of 65 amplification products were scored polymorphic. The percentage of polymorphic bands detected ranged from 33% to 100% with an average of 66.47%. The average of amplified bands was 5.42 polymorphic bands per primer. A positive, but non-significant, correlation (r = 0.085) between Euclidean distance and RAPD distance was observed.

The purpose of this study was to prepare dexamethasone-loaded polymeric nanoparticles and evaluate their potential for transport across human placenta. Statistical modeling and factorial design was applied to investigate the influence of process parameters on the following nanoparticle characteristics: particle size, polydispersity index, zeta potential, and drug encapsulation efficiency. Dexamethasone and nanoparticle transport was subsequently investigated using the BeWo b30 cell line, an in vitro model of human placental trophoblast cells, which represent the rate-limiting barrier for maternal-fetal transfer. Encapsulation efficiency and drug transport were determined using a validated high performance liquid chromatography method. Nanoparticle morphology and drug encapsulation were further characterized by cryo-transmission electron microscopy and X-ray diffraction, respectively. Nanoparticles prepared from poly(lactic-co-glycolic acid) were spherical, with particle sizes ranging from 140 to 298 nm, and encapsulation efficiency ranging from 52 to 89%. Nanoencapsulation enhanced the apparent permeability of dexamethasone from the maternal compartment to the fetal compartment more than 10-fold in this model. Particle size was shown to be inversely correlated with drug and nanoparticle permeability, as confirmed with fluorescently labeled nanoparticles. These results highlight the feasibility of designing nanoparticles capable of delivering medication to the fetus, in particular, potential dexamethasone therapy for the prenatal treatment of congenital adrenal hyperplasia., (Copyright © 2013 Elsevier B.V. All rights reserved.)

Background: The purpose of this work was to engineer polymeric nanoparticles to encapsulate and deliver 2-methoxyestradiol, a potential antitumor drug for treatment of uterine leiomyoma (fibroids), the most common hormone-dependent pathology affecting women of reproductive age., Methods/results: Encapsulation efficiency and drug release from the nanoparticles were monitored by HPLC. Cell morphology and in vitro cytotoxicity experiments were carried out in a human leiomyoma cell line. The nanoparticles displayed high encapsulation efficiency (>86%), which was verified by differential scanning calorimetry and x-ray diffraction. Excellent long-term stability of the nanoparticles and gradual drug release without burst were also observed. Cellular uptake of fluorescent nanoparticles was confirmed by confocal imaging. The drug-loaded poly(lactic acid) and poly(lactic-co-glycolic acid) nanoparticles induced cytotoxicity in human leiomyoma cells to a significantly greater extent than the free drug at 0.35 µM., Conclusion: This novel approach represents a potential fertility-preserving alternative to hysterectomy.

Nanostructured lipid carriers (NLCs), made from mixtures of solid and liquid lipids, were postulated to have superior properties over solid lipid nanoparticles (SLNs). Nonetheless, the architecture of their inner cores remains elusive. The objective of this study was to elucidate the mode by which tocotrienol-rich fraction (TRF) is entrapped within NLCs and the impact of TRF interaction with solid lipids on the long-term stability of the nanoparticles. The mode of TRF localization was postulated from TEM image analysis and (1)H NMR signals' amplitude. The size, polydispersity, and fusion enthalpy were found to decrease with an increase in TRF loading, which implied a distortion in the crystallinity of the nanoparticles and the preferential entrapment of TRF within the cores of the NLCs. Nonetheless, (1)H NMR spectra of TRF-NLCs broadened as TRF load decreased from 100 to 10%, which was attributed to partial TRF mobility on the surface of the nanoparticles. This was confirmed by TEM images of NLCs at 50% TRF loads. These data led to the conclusion that NLCs have limited capacity to accommodate TRF with the excess being expelled to the surface of the nanoparticles. Such arrangement may have implication on future utility of the NLCs as drug delivery vehicles., (Copyright 2010 Elsevier B.V. All rights reserved.)

Previously it was shown that combined low dose treatment of tocotrienols and statins synergistically inhibited the growth of highly malignant +SA mammary epithelial cells in culture. Therefore, the objective of the present work was to prepare and characterize lipid nanoparticles that combined simvastatin and tocotrienol rich fraction (TRF) as potential anticancer therapy. The entrapment of simvastatin in the oily nanocompartments, which were formed by TRF inclusion into the solid matrix of the nanoparticles, was verified by its high entrapment efficiency and the absence of endothermic or crystalline peaks when blends were analyzed by DSC and PXRD, respectively. The release of simvastatin from the nanoparticles in sink conditions was characterized by an initial burst release of approximately 20% in 10h followed by a plateau. No significant change in particle size (approximately 100 nm) was observed after storage for six months. The anticancer activity of the nanoparticles was verified in vitro by observing their antiproliferative effects on malignant +SA mammary epithelial cells. The IC(50) of the reference alpha-tocopherol nanoparticles was 17.7 microM whereas the IC(50) of the simvastatin/TRF nanoparticles was 0.52 microM, which confirmed the potency of the combined treatment and its potential in cancer therapy., (Copyright 2010 Elsevier B.V. All rights reserved.)

A RP-HPLC method for the simultaneous analysis of tocotrienol isoforms (TRF) and simvastatin (SIM) in SIM-TRF nanoparticles (NPs) was developed. Analytes were monitored by UV detection at 238 and 295 nm for SIM and TRF, respectively, using a gradient methanol/water elution. Calibration curves for TRF and SIM were linear over concentration range of 20-80 microg/mL and 1-10 microg/mL with correlation coefficients 0.9990 and 0.9991, respectively. The recovery of TRF and SIM from the NPs was in the range from 97.35 to 102.19% and from 92.71 to 104.35%, respectively. This developed method was successfully employed in quantifying both drugs in NPs for future use in cancer therapy.

In vitro characterization of alpha-tocopherol SEDDS formulations was performed by (1) lipolysis in bio-relevant media, and (2) physical assessment by dissolution, particle size, and turbidity analyses. Both methods were statistically correlated using a 25-run, five-factor multiple-level d-optimal mixture design. Independent variables were SEDDS composition [vitamin E (12.5-25%), Tween 80 (10-40%), labrasol (0-10%), alcohol (0-10%), and captex 355 (20-50%)]. Measured responses were percent lipolysis, percent vitamin E retained in the aqueous layer of the digestion medium, and percent vitamin E dissolved in the dissolution medium. Percent lipolysis ranged from 0% to 66.3%. Percent vitamin E retrieved in the aqueous layer of the digestion and dissolution media ranged from 3% to 29.3% and from 25.9% to 101.7%, respectively. Turbidity ranged from 28 to 403JTU and the average droplet size was >1.0 microm. All formulation ingredients had significant (p<0.05) effect on percent lipolysis. Only two factors, Tween and vitamin E had significant effect on vitamin retention in the aqueous layer post-lipolysis. Tween, labrasol, and captex 355 had significant effect on vitamin E dissolution. Poor correlation was observed between the responses. Formulation ingredients influenced each response differently; and therefore, each method can only reveal distinctive characteristics of the SEDDS formulation and may not be used interchangeably.

A potato (Solanum tuberosum L.) cDNA coding for the chloroplastic isoform of fructose 1,6-bisphosphatase (cp-FBPase) was utilized to repress its activity in tomatoes (Lycopersicon esculentum Mill.) using antisense techniques. The patatin B33 promoter was used to ensure fruit specificity of the antisense effect. Transgenic plants were isolated in which fructose 1,6-bisphosphatase activity was reduced by more than 50% of the control in green fruits. Immunoblots indicated that the plastidial isoform was almost completely eliminated in the most strongly inhibited lines. Fruits of the transgenic plants were analyzed for levels of metabolites during fruit development. Glucose and fructose concentrations were increased in green fruits in the transgenic lines, but unchanged at later stages of development. The sucrose concentration was low, and was not significantly altered in the transgenic lines. There was net degradation of starch over the developmental period, but the starch content was not decreased. In green fruit the levels of hexose phosphates were unchanged, whilst the level of 3-phosphoglyceric acid was significantly increased in one line. Most importantly the deduced ratio of hexose phosphate to 3-phosphoglyceric acid decreased, consistent with an in vivo inhibition of fructose 1,6-bisphosphatase activity. One consequence of this reduction of in vivo activity of cp-FBPase was that the average weight of fully ripe fruits was significantly decreased by up to 20% in all transgenic lines in comparison with the control.