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Introduction: The arthroscopic repair of a massive rotator cuff tear could be surgically challenging. There is a continuous argument regarding the best surgical technique and suture configuration used to treat massive rotator cuff tears. The purpose of this study was to assess the in vitro strength of the new double Mason-Allen suture and compare it to the commonly used other suture configurations. Methods: Twenty-five fresh sheep shoulders were randomly divided into five equal groups. Each group had their infraspinatus tendons cut and repaired with one of five suture configurations (simple, horizontal mattress, Mason-Allen, modified Mason-Allen, and double Mason-Allen) using Arthrex® 1.3 mm suture tape. The specimens were fixed to the test apparatus through their scapulae and hung with the repair tape to Sartorius® precision balance with sequential load increments till failure. The load to failure was measured for each of the five suture configurations. Results: Study data found the double Mason-Allen configuration to have the highest mean load to failure 423.30 ± 23.05 (Newtons), followed by modified Mason-Allen, Mason-Allen, horizontal mattress, and simple suture respectively. Conclusion: The double Mason-Allen repair configuration has the highest load to failure compared to the other known suture configuration to repair rotator cuff tears.

In the current work, a blend matrix that combines polyvinyl alcohol and polyvinyl pyrrolidone (PVA/PVP) was reinforced by titanium dioxide (Ti[O.sub.2]) nanoparticles via the casting technique. The FTIR spectra and XRD examinations of nanocomposites offer insight into the structural changes that have taken place with the inclusion of Ti[O.sub.2] in the blend matrix. Ti[O.sub.2] elements were detected via the EDX detector linked to a scanning electron microscope (SEM). The transmission and absorption of the PVA/PVP-Ti[O.sub.2] blend were evaluated via a UV-visible spectrophotometer. Tauc's model demarcated the optical bandgap ([E.sub.g]), which declined from 4.91 eV for the pure to 4.66 eV for PVA/PVP--0.75 wt.%Ti[O.sub.2] film. The refractive index increases from 1.903 to 6.646 for pure blend and PVA/PVA/0.75 wt%Ti[O.sub.2], respectively. The nonlinear optical features (as predicted by the Wemple-DiDomenico model) are enriched. The proliferation of Ti[O.sub.2] into the blend matrix significantly increased the third-order nonlinear optical susceptibility [[chi].sup.(3)], from 1.87 * [10.sup.-14] for pure blend to 5.091 * [10.sup.-13] for PVA/PVP-0.75 wt.% Ti[O.sub.2], attributed to the oscillation of surface plasmons of Ti[O.sub.2] NPs. The thermal stability of the films was inspected. Doping the blend with Ti[O.sub.2] enhanced its thermal stability. The Ti[O.sub.2]-filled PVA/PVP films demonstrate hopeful features for various requests and can be utilized in optoelectronics and optical devices due to their tunable optical parameters and thermal stability. Highlights * Thermal stability was enhanced with loading Ti[O.sub.2] nanoparticles in PVA/PVP matrix. * The PVA/PVP-Ti[O.sub.2] films optical parameters were studied. * Extinction coefficient and refractive index were enhanced with loading Ti[O.sub.2] in PVA/PVP matrix. * Proliferation of Ti[O.sub.2] into the matrix significantly increased the nonlinear optical susceptibility of third-order/(3). KEYWORDS linear and nonlinear refractive index, polymer blends, thermal stability, third-order nonlinear optical susceptibility, titanium dioxide, 1 | INTRODUCTION The usage of nanocomposite substances in scientific studies has spiked in recent times, with the advancement of physical qualities and improvements in storing energy capabilities as vital [...]

The stability of the medicinal product is a major concern in the pharmaceutical industry and health authorities, whose goal is to guarantee that drugs are delivered to patients without loss of therapeutic properties. This study aims to evaluate the effect of environmental conditions and packaging on the stability of paracetamol instant jelly sachets based on both chemical and physical stability. The paracetamol instant jelly was packaged in plastic sachets (packaging 1) and sealed aluminium bags in screw-capped amber glass bottles (packaging 2), which were stored in real-time and accelerated stability chambers for 3 months. Samples were taken out from the chambers and were characterised for appearance, moisture content, texture, viscosity, in vitro drug release, paracetamol content, and 4-aminophenol level at different time points. The real-time storage condition at a lower temperature maintained the stability of the paracetamol instant jelly, while the accelerated condition led to a significant change in the formulation properties. In addition, the proper packaging of paracetamol instant jelly maintained the paracetamol’s stability, regardless of environmental conditions, for three months. The results show that the environmental conditions and packaging play a significant role in maintaining paracetamol instant jelly stability.

Ibuprofen is a well-known non-steroidal anti-inflammatory (NSAID) medicine that is often used to treat inflammation in general. When given orally, it produces gastrointestinal issues which lead to lower patient compliance. Ibuprofen transdermal administration improves both patient compliance and the efficacy of the drug. Nanoconjugation hydrogels were proposed as a controlled transdermal delivery tool for ibuprofen. Six formulations were prepared using different compositions including chitosan, lipids, gum arabic, and polyvinyl alcohol, through ionic interaction, maturation, and freeze–thaw methods. The formulations were characterised by size, drug conjugation efficiency, differential scanning calorimetry (DSC), and Fourier transform infrared spectroscopy (FTIR). Further analysis of optimised hydrogels was performed, including X-ray diffraction (XRD), rheology, gel fraction and swelling ability, in vitro drug release, and in vitro macrophage prostaglandin E2 (PGE2) production testing. The effects of ibuprofen’s electrostatic interaction with a lipid or polymer on the physicochemical and dissolution characterisation of ibuprofen hydrogels were evaluated. The results showed that the S3 (with lipid conjugation) hydrogel provided higher conjugation efficiency and prolonged drug release compared with the S6 hydrogel.

Ashraf Khater,1 Alaa Mazy,2 Mona Gad,2 Ola Taha Abd Eldayem,2 Mohamed Hegazy1 1Department of Surgical Oncology, Mansoura Oncology Center (OCMU), 2Anesthesia and Surgical Intensive Care Department, Mansoura University Hospital, Faculty of Medicine, Mansoura University, Mansoura, Egypt Background: Tumescent mastectomy refers to usage of a mixture of lidocaine and epinephrine in a diluting saline solution that makes flaps firm and tense, thus minimizing systemic drugs toxicity and making surgery possible with minimal bleeding. This technique is very useful in elder women and those with American Society of Anesthesiologists; score III and IV. The objective was to establish an alternative safe technique to general anesthesia in some selected mastectomy patients.Patients and methods: Twenty candidate women for total mastectomy and axillary dissection were enrolled and consented to participate. After preparation, an anatomically directed infiltration was made under sedation, using a cocktail of lidocaine, bupivacaine, and epinephrine, followed after 20 minutes by the surgical incision and completion of mastectomy. All intraoperative and postoperative outcomes were recorded.Results: Although 7 cases required added analgesic medications, no conversion for general anesthesia was recorded. Mean operative time was 81±15.8 minutes. Mean blood loss was 95.8±47.5 mL. There was no recorded intraoperative hemodynamic instability. Postoperative visual analog score was not exceeding 4 till the end of the first 24 hours. Opioids were not required in any case, and the mean dosage of Ketorolac used was 30±8.75 mg. Drains output and the incidence of postoperative complications were acceptable.Conclusion: We can consider tumescent mastectomy in well-selected patients a safe alternative for performing mastectomy when general anesthesia is hazardous, with minimal blood loss and long lasting postoperative analgesia without an additive effect on the operative time, hospital stay, and intraoperative and postoperative complications. Keywords: tumescent, mastectomy, anesthesia, lidocaine

Virtual collaboration and teamwork have long transformed many sectors like business and healthcare, and higher education is no exception. However, unlike many other sectors, literature in higher education has primarily focused on team learning in the online context. Most works center around recommendations for effective technology platforms, training, communication, and assessment measures for matriculated students and researchers (Cleary et al., 2018; Flammia et al., 2016; Hu, 2015), rather than for effective virtual team performance for professional educators (DeRosa & Lespinger, 2010; Zaccaro & Bader, 2003). Drawing on the domains of business, education, and the military, this article examines four key factors for fostering effective virtual teamwork among foreign language (FL) instructors: (a) trust, (b) communication, (c) autonomy, and (d) identity. It also offers implications for teacher trainers and educational leadership for building professional development for successful teamwork in an online teaching environment and post-COVID teaching contexts.

Sameh Roshdy,1 Osama Hussein,1 Ashraf Khater,1 Mohammad Zuhdy,1 Hend A El-Hadaad,2 Omar Farouk,1 Ahmad Senbel,1 Adel Fathi,1 Emadeldeen Hamed,1 Adel Denewer1 1Department of Surgical Oncology, Mansoura Oncology Center, 2Department of Clinical Oncology and Nuclear Medicine, Faculty of Medicine, Mansoura University, Mansoura, Egypt Background: Although therapeutic mammoplasty (TM) was introduced for treatment of localized ductal carcinoma in situ and invasive breast carcinoma (stages I and II) in females with large breast size, the suitability of medial pedicle TM for treatment of breast tumors at different locations has not been established. The objective of this study was to assess the safety and esthetic outcome of medial pedicle TM for breast tumors at different locations. Methods: The study was conducted from February 2012 to July 2014. Consecutive patients with early breast carcinoma with medium- and large-sized breasts, with or without ptosis, who were offered medial pedicle TM were included in the study. Patients who were not candidates for breast-conserving surgery or those with tumors located along the medial pedicle were excluded. All patients received immediate postoperative adjuvant chemoradiotherapy. Results: Thirty patients with a mean age of 48.5 years received medial pedicle TM in the breast harboring the tumor or, additionally, the other breast (N=14). The tumors were in the upper (60.0%), lower (26.7%), and lateral (13.3%) quadrants. Minor complications occurred in five cases (5/30, 16.7%) in the ipsilateral and in two (2/14, 14.3%) contralateral breasts. No wound dehiscence or areolar necrosis was recorded. A total of 22 (73.3%) patients were scored as excellent cosmesis. After a median follow-up of 20 months, no locoregional recurrence or distant metastases were observed. Conclusion: TM using a medial pedicle is a safe and appealing technique among women with tumors at different locations. Keywords: therapeutic mammoplasty, medial pedicle, breast cancer, mastectomy

This study delves into the exploration of the (3+1)-dimensional generalized nonlinear fractional Konopelchenko–Dubrovsky–Kaup–Kupershmidt (GFKDKK) system, a crucial nonlinear evolution equation governing wave motion across various physical domains. The core aim is to devise innovative analytical solutions for this system employing the Khater III technique and an enhanced Kudryashov methodology integrated with the conformable fractional derivative.The GFKDKK system holds pivotal significance in modeling and comprehending diverse scientific phenomena, ranging from fluid dynamics to plasma physics and nonlinear optics. This research endeavors to harness the potential of the Khater III technique and the updated Kudryashov approach to offer fresh analytical insights into nonlinear fractional differential equations, thus enriching the existing knowledge base in this domain.The attained solutions furnish invaluable insights into the dynamics of the system and its potential applications, thereby facilitating the development of effective numerical simulations and analytical frameworks. The study’s significance lies in its contribution to the ongoing exploration of nonlinear fractional differential equations and their practical implications across various industries.In conclusion, the research affirms the efficacy of the Khater III method and the enhanced Kudryashov technique, complemented by the conformable fractional derivative, in obtaining analytical solutions for the (3+1)-dimensional GFKDKK system. The novelty lies in the application of these methodologies to this specific system, resulting in the discovery of new analytical solutions that enhance our understanding of its behavior and characteristics.