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ABSTRACT: In avian species, male fertility significantly impacts reproductive success. This study investigates the relationship between proctodeal gland size in male Japanese quails and sperm function, as well as female fertility duration. Six hundred adult Japanese quails were selected and housed in individual cages. Males (n = 300) were divided into 6 groups (50/group) based on the size of their proctodeal glands. Females (n = 300) were randomly assigned to corresponding groups. After acclimatization, sperm kinematics and the frequency and weight of foam discharge were evaluated. Males were paired with females for 24 h, and eggs were collected for 20 d postcopulation. Eggs were incubated to assess fertility duration. Fresh eggs (n = 20/group/d) were used to assess sperm penetration into the perivitelline membrane on the 2nd, 9th, and 16th d postinsemination. Plasma testosterone levels and the testes' relative weight were determined. The results indicated a significant increase (p < 0.0001) in sperm concentration, total and progressive motility, and nearly all sperm kinematic parameters such as VSL, VCL, VAP, LIN, WOB, and STR values as the size of the proctodeal gland increased. Quails copulated with males having a small and average proctodeal gland area (400 mm2). The proctodeal gland size was positively correlated with testicular weight, plasma testosterone concentrations, and sperm kinetic variables. The results indicate that the size of the proctodeal gland in males can be used to predict sperm function and the duration of fertility in Japanese quail.

Deep neural networks (DNNs), while powerful, often suffer from a lack of interpretability and vulnerability to adversarial attacks. Concept bottleneck models (CBMs), which incorporate intermediate high-level concepts into the model architecture, promise enhanced interpretability. This study delves into the robustness of Concept Bottleneck Models (CBMs) against adversarial attacks, comparing their original and adversarial performance with standard Convolutional Neural Networks (CNNs). The premise is that CBMs prioritize conceptual integrity and data compression, enabling them to maintain high performance under adversarial conditions by filtering out non-essential variations in input data. Our extensive evaluations across different datasets and adversarial attacks confirm that CBMs not only maintain higher accuracy but also show improved defense capabilities against a range of adversarial attacks compared to traditional models. Our findings indicate that CBMs, particularly those trained sequentially, inherently exhibit higher robustness against adversarial attacks than their standard CNN counterparts. Additionally, we explore the effects of increasing conceptual complexity and the application of adversarial training techniques. While adversarial training generally boosts robustness, the increment varies between CBMs and CNNs, highlighting the role of training strategies in achieving adversarial resilience.

Abstract This paper addresses the challenge of protecting electrical networks in the presence of distribution generators (DGs). The use of DGs affects fault currents, leading to miscoordination between protection relays and causing constraints on network reliability. To tackle this issue, the authors propose an adaptive protection scheme (APS) based on a modified pelican optimization algorithm (MPOA) and active database management system (ADBMS). The APS coordinates directional overcurrent relays and distance relays, while the MPOA simulates a pelican mating strategy and includes a modified internal equation. The proposed APS is further upgraded with ADBMS to save system resources by storing relay settings in the database and calling them when the state of DGs changes without running optimization algorithms. The effectiveness of the proposed APS is validated on the Institute of Electrical and Electronics Engineers (IEEE) eight‐bus test system and the IEEE 14‐bus distribution network. Results indicate that the APS can effectively protect electrical networks in the presence of DGs, while the ADBMS upgrade saves system resources.

Background: Fractures of the greater tuberosity of humerus account for one fifth of all fractures affecting the proximal ⅓ of humerus. Although a displacement of 3-5 mm in fractured greater tuberosity indicates surgical intervention, less displaced tuberosities can be managed nonoperatively in young athletes as well as more displacement in older groups. Surgical modalities include open reduction and internal fixation (ORIF) using plate and screws, fragment excision, and percutaneous fixation.Aim of the Work: This study aims to compare between the operative and conservative treatment of un-displaced isolated greater tuberosity fracture of the humerusPatients and Methods: We performed a prospective interventional study involved 20 patients with isolated greater tuberosity fractures. Divided equally into 10 patients in each group (conservative group and operative group). Radiographic healing was evaluated in the follow-up images. For the objective evaluation, the DASH score was used.Results: The mean age in conservative group was 37.7 years and in operative was 36.9 years. Male patients represented 60% and 70% within conservative and operative groups respectively. Four patient (40%) had anterior shoulder dislocation within operative group. The two groups were not different statistically regarding range of motion. The median DASH score of operative group 13.49, while it was 20.83 within the conservative group.Conclusion: Un-displaced greater tuberosity fractures can be treated without surgery with good outcome; however, there are indications for surgical interventional with benefit of provides early return to life activity as it enhances early union.

Liver toxicity is a common condition that can be induced by environmental pollutants. The present study explored the hepatoprotective activity of steroidal saponins extracted from the yam plant versus CC14-induced hepatotoxicity in albino rats. Twenty-five albino rats were classified into 5 groups. Rats of group (G1) were provided a basal diet and drinking water and served as un-treated controls. Other groups were administered CC14 orally twice a week at a dose of 400 mg/kg. The second group (G2) did not receive any further treatment and served as positive controls while rats in the groups G3, G4 and G5 were administered saponins (50,100 and 200 mg/kg body weight, respectively) for six weeks in the remaining groups. The hepatoprotective activity of saponins was assessed by measurement of liver enzymes, kidney function tests, malondialdehyde content, and antioxidant defense enzymes activities in serum of these rats. Saponins administration improved liver and renal function and significantly increased the activities of catalase, glutathione peroxidase (GSH-PX), glutathione reductase GSH-RD and superoxide dismutase SOD. These increases were linked to a considerable decrease in serum malondialdehyde levels, indicating that lipid peroxidation was being mitigated. Thus, the concentration of saponins (200 mg/kg) is the best concentration of protection against CC14-induced hepatic injury, improved liver and renal function, and reduced oxidative stress in rats.

Background: Proning is an evidence-based method that has been used frequently in patients diagnosed with ARDS. There is scarce evidence on the prone positioning of alert patients who are not on a mechanical ventilator.Case presentation: A 59-year-old male patient presented to the emergency room complaining of respiratory distress. The findings from the CT scan was consistent with coronavirus pneumonia. The patient tested positive for SARS- Cov-2 after RT-PCR amplification testing. The laboratory findings were within the normal limits apart from the partial arterial oxygen pressure [PaO2] which was relatively low. The patient was started on Favipiravir, multivitamins, anti-PUD, and anti-DVT prophylaxis. The patient was transferred to ICU on the 2nd day on NIMV because of deoxygenation and started on Methylprednisolone, Interferon Alpha 2B, Camostat mesylate, and Levofloxacine. The patient was instructed to be in a proning position. A sample of arterial blood gas [ABG] was taken two and three hours following proning, and throughout the patient’s stay in the ICU, the findings revealed perfect outcomes during the prone position. As a result, the patient was transferred from the ICU to the normal ward. On the 21st day after hospital admission, the patient was discharged.Conclusion: Prone positioning is associated with improved oxygenation as reported in several case reports and case series.

BackgroundAccess to data is crucial for decision-making; this fact has become more evident during the pandemic. Data collected using mobile apps can positively influence diagnosis and treatment, the supply chain, and the staffing resources of health care facilities. Developers and health care professionals have worked to create apps that can track a person’s COVID-19 status. For example, these apps can monitor positive COVID-19 test results and vaccination status. Regrettably, people may be concerned about sharing their data with government or private sector organizations that are developing apps. Understanding user perceptions is essential; without substantial user adoption and the use of mobile tracing apps, benefits cannot be achieved. ObjectiveThis study aimed to assess the factors that positively and negatively affect the use of COVID-19 tracing apps by examining individuals’ perceptions about sharing data on mobile apps, such as testing regularity, infection, and immunization status. MethodsThe hypothesized research model was tested using a cross-sectional survey instrument. The survey contained 5 reflective constructs and 4 control variables selected after reviewing the literature and interviewing health care professionals. A digital copy of the survey was created using Qualtrics. After receiving approval, data were collected from 367 participants through Amazon Mechanical Turk (MTurk). Participants of any gender who were 18 years or older were considered for inclusion to complete the anonymized survey. We then analyzed the theoretical model using structural equation modeling. ResultsAfter analyzing the quality of responses, 325 participants were included. Of these 325 participants, 216 (66.5%) were male and 109 (33.5%) were female. Among the participants in the final data set, 72.6% (236/325) were employed. The results of structural equation modeling showed that perceived vulnerability (β=0.688; P

IntroductionTomita En-bloc spondylectomy of L5 is one of the most challenging techniques in radical oncological spine surgery. A 42-year-old female was referred with lower back pain and L5 radiculopathy with a background of right shoulder liposarcoma excision. CT-PET confirmed a solitary L5 oligometastasis. MRI showed thecal sac indentation hence wasn't suitable for Stereotactic Ablative Radiotherapy (SABR) alone. The seeding nature of sarcoma prevents the indication of separation surgery hence excisional surgery is considered for radical curative treatment. This case report demonstrates dual-staged modified TES including the utilisation of novel techniques to allow for maximum radical oncological control in the era of SABR and lesser invasive surgery.MethodsFirst-stage: Carbonfibre pedicle screws planned from L2 to S2AI-Pelvis, aligned, to her patient-specific rods. Radiofrequency ablation of L5 pedicles prior to osteotomy was performed to prevent sarcoma cell seeding. Microscope-assisted thecal sac tumour separation and L5 nerve root dissection was performed. Novel surgical navigation of the ultrasonic bone-cutter assisted inferior L4 and superior S1 endplate osteotomies. Second-stage: Vascular-assisted retroperitoneal approach at L4–S1 was undertaken protecting the great vessels. Completion of osteotomies at L4 and S1 to En-bloc L5: (L4 inferior endplate, L4/5 disc, L5 body, L5/S1 disc and S1 superior endplate). Anterior reconstruction used an expandable PEEK cage obviating the need for a third posterior stage. Reinforced with a patient-specific carbon plate L4–S1 promontory.ResultsPatient rehabilitated well and was discharged after 42 days. Cyberknife of 30Gy in 5 fractions was delivered two months post-op. Despite left foot drop, she's walking independently 9 months post-op.ConclusionThese are challenging cases require a truly multi-disciplinary team approach. We share this technique for a dual stage TES and metal-free construct with post adjuvant SABR to achieve maximum local control in spinal oligometastatic disease. This case promotes our modified TES technique in the era of SABR and separation surgery in carefully selected cases.

Abstract Background Gastric antral vascular ectasia (GAVE) is an uncommon but important cause of gastrointestinal bleeding in cirrhotic patients. Argon plasma coagulation (APC) is the standard therapy for GAVE. Endoscopic band ligation (EBL) is an emerging, safe and effective treatment for GAVE. The best way of applying EBL in the management of GAVE is not clear yet. Aim We aimed to determine the safety and efficacy of APC alternating with EBL versus EBL alone for managing GAVE in cirrhotic patients. Patients and methods Forty cirrhotic patients with bleeding GAVE were randomized to receive either APC alternating with EBL (20 patients) or EBL alone (20 patients) until GAVE lesions are eradicated. Gastroscopy was done 6 months after eradication of GAVE lesions to document recurrence. Cessation of bleeding, rise of hemoglobin level, need for transfusion, hospitalization, complications, number of sessions, and recurrence of GAVE in both groups were statistically analyzed. Results Patients in both groups showed significantly high rate of bleeding cessation, improvement in hemoglobin levels, reduction in transfusions, and hospitalizations. There was no statistically significant difference regarding the recurrence of GAVE between the two groups. There were no complications seen in the combined therapy group. Twenty percent of the patients in the EBL group had complications including hypertrophied polyp formation and post-band ulcerations. Conclusion APC alternating with EBL and EBL alone are effective methods in the treatment of bleeding GAVE. Combined therapy has the potential to decrease the number of banding sessions and the number of rubber bands required to treat GAVE, consequently decreasing the incidence of band-related complications.

Background: Colorectal cancer (CRC) is known to be the third most frequently diagnosed cancer and the fourth leading cause of cancer death worldwide. In Egypt, colorectal carcinoma is considered the 7th prevalent cancer, accounting for 3.47% of male cancers and 3% of female malignancies. A localized CRC can be entirely cured via surgical resection. Metastasis remains the leading cause of cancer mortality. IMP3 is an independent prognostic biomarker that expects metastasis and poor prognosis in CRC. The upregulation of nuclear cyclin D1 plays an essential role in pathogenesis and metastases of CRC. We aimed to investigate the expression of IMP3 and cyclin D1 in colorectal carcinoma and their correlation with other clinicopathological features. Method: In this retrospective cohort study, 80 formalin-fixed and paraffin-embedded blocks of CRC were obtained from the subjects. The immunohistochemical expression of IMP3 and cyclin D1 were examined and found to be correlated with clinical-pathological parameters and the outcome of the patients. Results: Overexpression of IMP3 and cyclin D1 was noted in 68.75% and 56.25%, respectively. IMP3 expression was significantly correlated with tumor grade (P < 0.001), tumor, node, and metastases (TNM) stage (P = 0.040), and lymphovascular invasion (P = 0.005); cyclin D1 was significantly associated with TNM stage (P < 0.001), lymph node (LN) metastasis (P < 0.001), and distant metastasis (DM) (P = 0.004); cyclin D1 was significantly correlated with TNM stage (P < 0.001), LN metastasis (P < 0.001), and DM (P = 0.004). Conclusion: IMP3 and cyclin d1 were associated with poor prognosis in CRC, w hich makes them attractive targets for anticancer drug development.

Abstract Background and objectives The X-linked bleeding disorder, hemophilia A, is caused by defective production of factor VIII (FVIII). Hemophilic patients require regular FVIII infusions. Recombinant factor replacement poses the safest line of therapy. However, its main drawbacks are high expenses and the higher liability for formation of inhibitors. Recent studies confirmed the ability of bone marrow-derived stem cells to secrete FVIII. This study aims to generate bioscaffold from decellularized liver and subsequently seed it with trans-differentiated human stem cells into hepatic-like cells. This scaffold can then be implanted intraperitoneally or subcutaneously to provide FVIII. Methods After generation of the bioscaffold, seeding of discoid scaffolds with trans-differentiated human hepatocyte-like cells was performed. Then, the generated organoid was implanted into peritoneal cavity or subcutaneous tissue of experimental rats. Results Serum human FVIII was significantly increased in rats subjected to subcutaneous implantation compared intraperitoneal implantation. Immunostaining for detecting Cytokeratin 19 and human anti-globulin confirmed the presence of mature human hepatocytes that were significantly increased in subcutaneous implanted scaffold compared to the intraperitoneal one. Conclusion Implantation of decellularized bioscaffold seeded with trans-differentiated stem cells in rats was successful to establish production of FVIII. Subcutaneous implantation showed higher FVIII levels than intraperitoneal implantation.

This paper presents an adaptive load frequency control technique in both of isolated microgrid power system and two interconnected microgrids (MGs). A modified Jaya optimization method is used to make online tuning of the area controller. The Balloon Effect (BE) modification is designed to increase the sensitivity of the Jaya algorithm to both of the system load disturbance and parameters variations. In Jaya with BE technique, the objective function (OF) is affected by the on-time system problems. Communication delay time is considered in the dynamic model of interconnected MGs. System with proposed adaptive control method has been tested in several scenarios including step and variable load demand and parameters variations. Simulation results using Matlab software show that the proposed adaptive controller tuned by Jaya + BE technique provides better performance of frequency control than other methods such as conventional controller or adaptive one tuned by classical Jaya algorithm.

Background: The preponderance of breast cancer-related deaths are the result of local invasion and distant metastasis; therefore, it is necessary to identify the factors underlying invasion and metastasis in order to develop novel treatment strategies and improve the survival of patients. In this regard, this study aimed to investigate the immunohistochemical expression and prognostic impact of aquaporin-3 (AQP3) and certain markers associated with epithelial-mesenchymal transition concerning invasive breast carcinoma of no special type. Method: Immunohistochemical expressions of AQP3, vimentin and E-cadherin were performed in 50 paraffin embedded specimens of such cases. We also assessed the relationship of their expressions with the clinicopathological variables and patients’ disease-free survival and overall survival. Results: There were significant associations between positive AQP3 and positive vimentin expressions and high tumor grade, large tumor size, lymph node metastasis, and advanced tumor stage. On other hand, negative E-cadherin expression had a significant correlation with high tumor grade, large tumor size, lymph node metastasis, distant metastasis, and advanced tumor stage. A significant association also existed between positive AQP3, positive vimentin and negative E-cadherin expressions and high tumor recurrence, short ‘three-year’ disease-free survival and overall survival. Conclusion: Positive AQP3, positive vimentin, and negative E-cadherin expressions are known as adverse prognostic markers and may predict survival in invasive breast carcinoma of no special type. It is proposed that AQP3 might play a role in breast cancer progression, invasion, and metastasis through induction of epithelial-mesenchymal transition.

New compounds 5 and 9 using DNA bases e.g. Adenine 1 and Guanine 6 derivatives have been synthesized. The use of simple methods to synthesize compounds 5 and 9 were done using pyrimidine as an alternative DNA base ring. Another design to synthesize new simple pyrimidine rings utilizing thiourea and ethylcyano acetate to afford 6-amino-2-thiouracil was adopted. The reaction of thiouracil 10 with chloro cyano or chloro ester and ketone, resulted in the formation of adduct compounds 18-21, rather than the formation of compound 17. All the synthesized compounds were subjected to docking study, in order to gain insights into their binding modes against cyclin-dependent protein kinase 2 (CDK-2) that is involved heavily in cell cycle regulation and receptor protein B-cell lymphoma 2 (BCL-2) which is involved in cell apoptosis. These targets were selected based on their key roles in cancer progression via the regulation of the cell cycle and DNA replication. Molecular-docking analyses showed that compound 14e was the best docked ligand against both targets, as it displayed the lowest binding energy, critical hydrogen bonds and hydrophobic interactions with the targets.

AIM: To study the changes in choroidal thickness in central serous chorioretinopathy(CSCR)over a 3mo follow-up using spectral domain optical coherence tomography(SD-OCT).METHODS: This prospective study included 60 eyes, both eyes of 20 patients(mean age: 33.65±5.24 years)with classic acute unilateral central serous chorioretinopathy and normal fellow eye and 20 eyes as healthy controls. Fluorescein angiography and OCT were done. The subfoveal choroidal thickness(SFCT), central macular thickness(CMT), 1000 μm temporal and nasal to the centre of the fovea and the subretinal fluid were measured.RESULTS: There was a statistically significant difference in SFCT among the three groups at the three different locations. SFCT in eyes with CSCR(372.40±34.39 μm)was significantly greater than that in each of the unaffected fellow eyes(302.10±8.9 μm)and control eyes(279.80±14.49 μm)at the base line and after 3mo follow-up. The mean CMT in CSCR was 317±141.86 μm, with a statistically significant positive correlation between SFCT and CMT.CONCLUSION: The increase in the choroidal thickness at different locations as well as hyper-dilated and hyper-permeable vessels known as “pachychoroid” seems to play an important role in a broad spectrum of diseases that includes central serous chorioretinopathy.

This paper suggests an adaptive control approach using water cycle algorithm optimization method (WCA) modified by a new technique called “Balloon Effect”. The main concept of Balloon Effect is to increase the ability of the WCA to tune individually the gains of the controller online. The proposed technique has been used to tune the gains of PID controller and applied to control both of the load frequency control in micro-grid power system (which minimize the fundamental frequency variations) and the position of armature-controlled DC motor. Digital simulations have been carried out to prove the efficiency of the proposed adaptive controller-based WCA with Balloon Effect. The obtained results showed that the proposed adaptive controller maintains robust performance, and effectively reduces the impact of identified disturbances and uncertainties.

BackgroundFitness trackers allow users to collect, manage, track, and monitor fitness-related activities, such as distance walked, calorie intake, sleep quality, and heart rate. Fitness trackers have become increasingly popular in the past decade. One in five Americans use a device or an app to track their fitness-related activities. These devices generate massive and important data that could help physicians make better assessments of their patients’ health if shared with health providers. This ultimately could lead to better health outcomes and perhaps even lower costs for patients. However, sharing personal fitness information with health care providers has drawbacks, mainly related to the risk of privacy loss and information misuse. ObjectiveThis study investigates the influence of granting users granular privacy control on their willingness to share fitness information. MethodsThe study used 270 valid responses collected from Mtrurkers through Amazon Mechanical Turk (MTurk). Participants were randomly assigned to one of two groups. The conceptual model was tested using structural equation modeling (SEM). The dependent variable was the intention to share fitness information. The independent variables were perceived risk, perceived benefits, and trust in the system. ResultsSEM explained about 60% of the variance in the dependent variable. Three of the four hypotheses were supported. Perceived risk and trust in the system had a significant relationship with the dependent variable, while trust in the system was not significant. ConclusionsThe findings show that people are willing to share their fitness information if they have granular privacy control. This study has practical and theoretical implications. It integrates communication privacy management (CPM) theory with the privacy calculus model.

Several parameters are defined before the Selective Laser Melting printing process, which may depend on the manufacturer of the equipment, but in general, we commonly encounter hatch distance, scanning speed, layer thickness, laser power input, scanning strategy, overlap distance, and substrate preheating temperature as the parameters that mainly define the printing process. The last parameter is the focus of this study, which is applied to a finite element model to simulate temperature distributions over one layer thickness of the powder bed. The substrate temperature and power input affect the cooling rates and temperature gradients imposed on the powder bed, consequently influencing the component’s final property, surface finishing, and accuracy (dimensioning tolerances). The current FEM model showed that the preheat substrate temperature played different roles depending on which power input is used; however, there is an observed trend that is the reduction in temperature gradients in the powder bed overall when higher substrate temperatures are used.

Objective: We aimed to evaluate the relationship between fragmented QRS complex and plaque burden in patients presented with typical chest pain and deemed to have intermediate pretest probability of CAD using coronary computed tomography angiography (CCTA). Methods: We studied electrocardiograms (ECGs) obtained from 172 subjects (47.5 ± 9.5 years, 125 were men) presented with chest pain and had intermediate pretest probability for CAD. The presence was found and evaluation of CAD was performed with CCTA. Results: Seventy four (43%) of the study cohort had CCTA-documented CAD. Meanwhile the frequency of fQRS in our cohort was (57%). 70 (71.4%) patients with fQRS had CAD compared with only 4 (5.4%) patients without fQRS (p

Mobile microcontrollers are one of the areas of application artificial intelligent. The aim of this research is to develop an ideal design for mobile microcontrollers can move in a vacuum in order to conduct the installation with little cost. This design of mobile microcontrollers gives them the ability to move an arm with high starting torque enable it to perform their tasks efficiently. The main objective of this paper is to present an optimal design of mobile microcontrollers have an arm with high starting torque and with low cost. To verify this objective, Nelder Mead simplex search algorithm is used to obtain the optimal values of manufacturing parameters. The results depict a reduction of the total cost that represents cost of unit weight of copper, cost of unit weight of iron, the laminations cost, the copper cost and the rotor-end-ring cost by 4.64% and a reduction in the angular velocity by 25%. Keywords: Mobile microcontrollers, Robotic arm, Induction motor, Nelder Mead algorithm, Starting torque, Motor cost

This paper proposes an adaptive protection scheme (APS) based on the original heap-based optimization (HBO) and a modified HBO (MHBO). APS is used to solve protection relays coordination problems that include directional overcurrent relays (DOCRs) as well as the distance relay’s second zone times. The complexity of the coordination problem increases with the impact of distributed generators (DGs) switching (ON/OFF). Topological changes in grid configuration frequently occur in distributing networks, equipped with DGs, causing changes in the values and direction of short circuit currents. This issue becomes a challenge for protection systems to avoid relays miscoordination and save a network’s reliability. In the proposed MHBO, the Original HBO is modified by three points, population are divided into subgroups, then they are unified into one group gradually, those subgroups are exchanging some search agents between themselves, these search agents are called travelling agents, and the last one is about, upgrading an internal equation in the original algorithm. For validating the proposed relays coordination, the IEEE 8-bus test system, and the IEEE 14-bus distribution network are selected as case studies. The obtained simulated results of the proposed algorithm show better performance compared with those obtained by the previous algorithms.

Introduction: Repair of peripheral nerve injuries is an intensive area of challenge and research in modern reconstructive microsurgery. Intensive research is being carried out to develop effective alternatives to the standard nerve autografting, avoiding its drawbacks. The aim of the study was to evaluate the effectiveness of a newly designed mechanical device for the reconstruction of the sciatic nerve in rats in comparison to nerve autografting and to assess the pain during the period of distraction neurogenesis. Methods: Fourteen Sprague Dawley rats were used and randomly assigned into 2 groups with 7 rats in each group group A (Nerve Autografting group) in which a 10-mm segment of the sciatic nerve was resected and rotated 180 degrees, then primary end-to-end neurorrhaphy was performed in the reverse direction group B (Nerve Lengthening group) in which the mechanical device was inserted after surgical resection of 10 mm of the sciatic nerve, then secondary endto- end neurorrhaphy was performed after completing the nerve lengthening. Thirteen weeks later, assessment of the functional sciatic nerve recovery using static sciatic index (SSI) was performed. Furthermore, fourteen weeks after the nerve resection, assessment of the nerve regeneration with electrophysiological study and histological analysis were performed. Also, gastrocnemius wet weight was measured. For pain assessment in group B, Rat Grimace Scale (RGS) score was used. Results: Significantly better functional recovery rate (using the SSI) was reported in the nerve lengthening group in comparison to autografting group. Also, a statistically significant higher nerve conduction velocity was detected in the nerve lengthening group. On histological analysis of the distal nerve section at 3 mm distal to the nerve repair site, significant myelin sheath thickness was detected in the nerve lengthening group. Discussion: Distraction neurogenesis with the new experimental device is a reliable therapeutic method for the reconstruction of nerve defects.

Background: Spinal anesthesia is commonly employed during inguinal hernial surgeries. Its short duration may, however, be considered a limitation, especially for bilateral hernial repair. The aim of this research is to investigate the analgesic and hemodynamic effects of intravenous infusion of both MgSO4 and dexmedetomidine on patients undergoing bilateral inguinal hernia surgeries under spinal anesthesia. Methods: This study was a prospective, randomized, double-blinded controlled trail. It included 60 male patients who had been scheduled for bilateral elective inguinal hernia surgery under spinal anesthesia at Kasr Al-Aini hospital. Patients were randomly allocated to one of three groups (n = 20 each) to receive 50 mL of 0.9% saline intravenous infusion of either dexmedetomidine 0.5 μg.kg-1. h-1 (Group D) or magnesium sulphate 15 mg.kg-1. h-1 (Group M) or normal saline (Group S). The primary outcome of this study was set as the total duration of analgesia. Secondary outcomes were set as the onset and duration of sensory and motor blockade, perioperative hemodynamics, and the total 24-hour postoperative morphine consumption. Results: Durations of sensory and motor blockades as well as durations of analgesia were all significantly longer among patients in Group D (mean 2.2, 3.5, 5.8 hours respectively) and Group M (mean 2.2, 3.3, 5.2 hours respectively), in comparison to Group S (mean 1.5, 2.7, 3.9 hours respectively). No significant differences were found in systolic or diastolic arterial blood pressure, heart rate oxygen saturation, cardiac output, or stroke volume among the study groups. Seven patients in Group D and four patients in Groups M and S developed hypotension. Conclusion: Intravenous infusion of either dexmedetomidine or MgSO4 with spinal anesthesia effectively improves the quality of spinal anesthesia and prolongs the duration of postoperative analgesia and decreases the 24-hour postoperative morphine consumption. Results also demonstrated that the use of dexmedetomidine resulted in a slightly longer duration of analgesia, whilst the use of MgSO4 resulted in slightly better hemodynamic stability.

Ulcerative colitis (UC) is a prevalent type of inflammatory bowel diseases that may predispose patients to acquire colitis-related cancer if treatment was not effective. Despite the presence of an array of established treatment options, current modalities are not successful for a substanial number of patients. The activation of the NLRP3 inflammasome is critical in the development of inflammatory processes in the colon. Additionally, the regulation of NLRP3 via HSP90 inhibition is a potential target to treat UC. Moreover, during inflammation, autophagy allows the turnover of malfunctioning proteins and therefore stands as a viable strategy for inactivating NLRP3 inflammasomes and halting hyperinflammation. Herein, we evaluated the effect of autophagy induction using metformin in the context of HSP90 inhibition by TAS-116 in the dextran sodium sulfate (DSS)-induced UC in rats. We revealed that TAS-116-induced interruption of the protein complex containing HSP90 and NLRP3 might hamper and delay the start of the inflammatory cascade ensued by the NLRP3 inflammasome oligomerization. In such circumstances, the unprotected NLRP3 is subjected to autophagic degradation in an environment of metformin-promoted autophagic signaling. As a result, such dynamic synergy was efficient in combating colon damage and immune-cell infiltration. This was confirmed by the macroscopic and microscopic investigations. Further, biochemical analysis revealed subdued inflammation cascade and oxidative injury. Therefore, simultaneous administration of TAS-116 and metformin is a new management paradigm aimed at inducing malfunction in the NLRP3 followed by augmenting its autophagic degradation, respectively. However, further studies should be conducted to assess the reliability and consistency of this novel approach.

Ulcerative colitis is an idiopathic disease that is widely incident worldwide. Canagliflozin, antidiabetic agent, exhibited significant anti-inflammatory effects in a variety of animal models. Additionally, hyaluronic acid is considered one of the key players in the tissue regeneration process. It has been proven to modulate inflammation and cellular migration, which are the main phases of wound healing. The combination of hyaluronic acid with chitosan in microsphere fabrication was anticipated to reveal a synergistic muco-adhesiveness potential with additional advantage of the chitosan penetration enhancing effect. The current study aimed to explore the potential of canagliflozin-loaded chitosan-hyaluronic acid microspheres intrarectal administration to mitigate acetic acid-induced colitis in rats. Colon tissues were examined for macroscopic and microscopic pathological changes. ELISA and qRT-PCR techniques were applied for the detection of cytokines involved in the AMPK/NF-κB/NLRP3 axis. Intrarectal administration of this formula alleviated colitis severity, which was reflected by the reduced DAI, MES, colonic weight/length ratio and histopathological scoring values. Interestingly, canagliflozin-loaded chitosan-hyaluronic acid microspheres significantly enhanced AMPK phosphorylation and depressed NF-κB and NLRP3 expression leading to a subsequent reduction in caspase-1 cleavage and the inhibition of several inflammatory cytokines, including IL-1β, and IL-18. Overall, the current study revealed that the protective effects of the formula against acetic acid-induced colitis are primarily mediated via augmenting AMPK phosphorylation and its consequences of NF-κB inactivation. Since canagliflozin is not associated with hypoglycemic effects, clinical application of canagliflozin-loaded chitosan-hyaluronic acid microspheres represent a novel therapeutic option for the treatment of patients with ulcerative colitis.