Search

Abstract Objective In‐office ablation of the posterior nasal nerve (PNN) has emerged as an effective treatment option for chronic rhinitis patients. This study explored questions patients commonly search online regarding this therapy and the quality of content available. Study Design A retrospective analysis of online search criteria and sources was performed with subsequent analysis of results. Setting Search and data acquisition was in September of 2023. Methods Most common search terms related to cryotherapy and radiofrequency neurolysis of the PNN were identified with associated People Also Ask (PAA) questions. Questions were categorized and organized into subtopics and sources evaluated using readability and quality metrics. Results A total of 255 unique PAA questions and 175 unique websites were identified. The most common subtopics were related to facts about chronic rhinitis (26.7%) and rhinitis treatment options (25.1%). Nearly a quarter (24.3%) of websites were from commercial sources. Quality metrics indicate difficult‐to‐read and low‐quality materials. Conclusion Existing online resources need improvement to provide patients material that is easier to read. Physicians counseling patients should be aware of these areas for adequate shared decision making.

Abstract Objectives Posterior nasal nerve (PNN) ablation is a minimally invasive treatment option for patients with chronic rhinitis. Recent evidence shows that parasympathetic innervation of the nasal cavity is more extensive and there are many fibers posterior to the lateral attachment of the middle turbinate. We describe a modified ablative technique that targets the extensive innervation of the posterior nasal nerves. Methods Description of the technique and retrospective cohort analysis. In addition to the traditional radiofrequency and cryoablation targets, three additional treatment sites posterior to the middle turbinate were targeted using radiofrequency ablation, as well as one focused treatment posteroinferior to the middle turbinate attachment using cryotherapy ablation. The primary outcome collected was a 30% improvement in overall rhinitis symptoms. Results Forty‐five patients received treatment and completed 3‐month follow‐up using the modified technique for radiofrequency and cryotherapy PNN ablation. Previously, our institution documented a 64.5% responder rate at 3 months. After introducing the modified technique, the response rate at 3 months significantly improved (64.5% vs. 91.1%, p = .004). Conclusions This report suggests improved efficacy with implementation of the modified technique for in‐office PNN ablation. Given the extensive nature of the post‐ganglionic parasympathetic fibers of the nasal cavity which often emerge posterior to the middle turbinate attachment, a modified technique to target these branches should be considered. Prospective randomized studies comparing this modified technique to the traditional technique are needed. Level of Evidence III.

BackgroundSevere mental illnesses (SMIs), including schizophrenia, bipolar affective disorder, and major depressive disorder, are associated with an increased risk of physical health comorbidities and premature mortality from conditions including cardiovascular disease and diabetes. Digital technologies such as electronic clinical decision support systems (eCDSSs) could play a crucial role in improving the clinician-led management of conditions such as dysglycemia (deranged blood sugar levels) and associated conditions such as diabetes in people with a diagnosis of SMI in mental health settings. ObjectiveWe have developed a real-time eCDSS using CogStack, an information retrieval and extraction platform, to automatically alert clinicians with National Health Service Trust–approved, guideline-based recommendations for dysglycemia monitoring and management in secondary mental health care. This novel system aims to improve the management of dysglycemia and associated conditions, such as diabetes, in SMI. This protocol describes a pilot study to explore the acceptability, feasibility, and evaluation of its implementation in a mental health inpatient setting. MethodsThis will be a pilot hybrid type 3 effectiveness-implementation randomized controlled cluster trial in inpatient mental health wards. A ward will be the unit of recruitment, where it will be randomly allocated to receive either access to the eCDSS plus usual care or usual care alone over a 4-month period. We will measure implementation outcomes, including the feasibility and acceptability of the eCDSS to clinicians, as primary outcomes, alongside secondary outcomes relating to the process of care measures such as dysglycemia screening rates. An evaluation of other implementation outcomes relating to the eCDSS will be conducted, identifying facilitators and barriers based on established implementation science frameworks. ResultsEnrollment of wards began in April 2022, after which clinical staff were recruited to take part in surveys and interviews. The intervention period of the trial began in February 2023, and subsequent data collection was completed in August 2023. Data are currently being analyzed, and results are expected to be available in June 2024. ConclusionsAn eCDSS can have the potential to improve clinician-led management of dysglycemia in inpatient mental health settings. If found to be feasible and acceptable, then, in combination with the results of the implementation evaluation, the system can be refined and improved to support future successful implementation. A larger and more definitive effectiveness trial should then be conducted to assess its impact on clinical outcomes and to inform scalability and application to other conditions in wider mental health care settings. Trial RegistrationClinicalTrials.gov NCT04792268; https://clinicaltrials.gov/study/NCT04792268 International Registered Report Identifier (IRRID)DERR1-10.2196/49548

Whether Latinx families use youth mental health services (MHS) depends on complex influences of barriers and facilitators within and outside of the home. This research sought to shed light on caregiver strain as part of the equation focused on parental identification and responses to youth mental health needs. We examined multiple dimensions of caregiver strain as potential mediators between youth mental health symptom severity and psychological counseling utilization. The present sample consisted of 598 Latinx caregivers to youths ages 6-18 who provided information on youth internalizing and externalizing problems, caregiver strain, and youth psychological counseling service utilization within the last year. Our findings suggest that youth symptom severity (internalizing and externalizing problems) was generally positively associated with dimensions of caregiver strain. Youth symptom severity through objective and subjective internalized strain pathways were associated with greater odds of youth MHS utilization. In contrast, youth symptom severity through subjective externalized strain reduced the odds that Latinx caregivers would report utilizing youth MHS. These models only partially mediated the relationship between youth problems and service use. Findings suggest that Latinx caregivers may navigate conflicting sources of strain related to their child's mental health problem severity in ways that may differentially impact the odds that they access youth MHS. Along with addressing structural and systemic barriers to care, utilization of psychological counseling services may also be improved through interventions that help Latinx caregivers view youth services as avenues for addressing caregiver strain and providing psychoeducation that frames externalized strain within a mental health lens.

Abstract Objective To review new drugs and devices relevant to otolaryngology approved by the Food and Drug Administration (FDA) in 2022. Data Sources Publicly available FDA data on drugs and devices approved in 2022. Review Methods A preliminary screen was conducted to identify drugs and devices relevant to otolaryngology. A secondary screen by members of the American Academy of Otolaryngology–Head and Neck Surgery's (AAO‐HNS) Medical Devices and Drugs Committee differentiated between minor updates and new approvals. The final list of drugs and devices was sent to members of each subspecialty for review and analysis. Conclusion A total of 1251 devices and 37 drugs were identified on preliminary screening. Of these, 329 devices and 5 drugs were sent to subspecialists for further review, from which 37 devices and 2 novel drugs were selected for further analysis. The newly approved devices spanned all subspecialties within otolaryngology. Many of the newly approved devices aimed to enhance patient experience, including over‐the‐counter hearing aids, sleep monitoring devices, and refined CPAP devices. Other advances aimed to improve surgical access, convenience, or comfort in the operating room and clinic. Implications for Practice Many new devices and drugs are approved each year to improve patient care and care delivery. By staying up to date with these advances, otolaryngologists can leverage new innovations to improve the safety and quality of care. Given the recent approval of these devices, further studies are needed to assess long‐term impact within the field of otolaryngology.

Central compartment atopic disease (CCAD) is a distinct phenotype within chronic rhinosinusitis with nasal polyps (CRSwNP) with a pathophysiology that bridges the gap between allergy and CRSwNP, an association that was previously ambiguous. Understanding this endotype and its link to allergic disease is crucial for improved CCAD management. Using a systematic search and an independent dual-reviewer evaluation and data extraction process, this scoping review examines the clinical features, management options, and treatment outcomes of CCAD. Central compartment (CC) polypoid changes of the MT predominantly correlate with allergic rhinitis, increased septal inflammation, oblique MT orientation, and decreased nasal cavity opacification and Lund–Mackay scores compared to other CRSwNP subtypes. CCAD patients also exhibit higher rates of asthma, allergen sensitization, and hyposmia or anosmia. Surgical outcomes, including revision rate and SNOT-22 improvement, are favorable in CCAD as well. In conclusion, CCAD primarily affects atopic individuals and is managed using endoscopic sinus surgery combined with treating the underlying allergy. Continued research is needed to further refine understanding and develop optimal treatment strategies of this emerging CRS subtype.

Introduction: Cortical reaction is a secretory process that occurs after a spermatozoon fuses with the oocyte, avoiding the fusion of additional sperm. During this exocytic event, the cortical granule membrane fuses with the oocyte plasma membrane. We have identified several molecular components involved in this process and confirmed that SNARE proteins regulate membrane fusion during cortical reaction in mouse oocytes. In those studies, we microinjected different nonpermeable reagents to demonstrate the participation of a specific protein in the cortical reaction. However, the microinjection technique has several limitations. In this work, we aimed to assess the potential of cell-penetrating peptides (CPP) as biotechnological tools for delivering molecules into oocytes, and to evaluate the functionality of the permeable tetanus toxin (bound to CPP sequence) during cortical reaction.Methods: Arginine-rich cell-penetrating peptides have demonstrated the optimal internalization of small molecules in mammalian cells. Two arginine-rich CPP were used in the present study. One, labeled with 5-carboxyfluorescein, to characterize the factors that can modulate its internalization, and the other, the permeable light chain of tetanus toxin, that cleaves the SNAREs VAMP1 and VAMP3 expressed in mouse oocytes.Results: Results showed that fluorescent CPP was internalized into the oocyte cytoplasm and that internalization was dependent on the concentration, time, temperature, and maturation stage of the oocyte. Using our functional assay to study cortical reaction, the light chain of tetanus toxin bound to arginine-rich cell-penetrating peptide inhibited cortical granules exocytosis.Discussion: Results obtained from the use of permeable peptides demonstrate that this CPP is a promising biotechnological tool to study functional macromolecules in mouse oocytes.

Fraud is an ancient yet ever-changing profession. Because of the digitization of money, financial transactions, banks, fraudsters now have a limitless number of possibilities to perpetrate crime from behind a screen, anywhere around the world. Fraud has a broad influence, with direct ramifications for business and the economy. It is of great worry to cybercrime organizations as recent studies have proven that ML algorithms may successfully be utilized to identify fraudulent transactions in massive amounts of payment data. Such techniques may identify fraudulent transactions in real time, which human auditors may miss. In this research, we apply supervised ML algorithms to the issue of fraud identification by analyzing simulated financial transaction data that is available to the public. Our aim is to show how supervised ML methods may be utilized to successfully identify data with extreme class disproportion. By way of example, we show how exploratory analysis may be utilized to identify fraudulent from real purchases. We also show that Random Forest outperform Logistic Regression when applied to a clearly distinguished dataset.

MiR-494-5p expression has been suggested to be associated with colorectal cancer (CRC) and its metastases in our previous studies. However, functional investigations on the molecule-mediating actions of this miR in CRC are lacking. In silico analysis in the present study revealed a putative binding sequence within the 3′UTR of JAK1. Overexpression of miR-494-5p in cultured CRC significantly reduced the luciferase activity of a reporter plasmid containing the wild-type JAK1-3′UTR, which was abolished by seed sequence mutation. Furthermore, the overexpression of miR-494-5p in CRC cell lines led to a significant reduction in JAK1 expression, proliferation, in vitro migration, and invasion. These effects were abolished by co-transfection with a specific double-stranded RNA that inhibits endogenous miR-494-5p. Moreover, IL-4-induced migration, invasion, and phosphorylation of JAK1, STAT6, and AKT proteins were reduced after an overexpression of this miR, suggesting that this miR affects one of the most essential pathways in CRC. A Kaplan–Meier plotter analysis revealed that patients with high JAK1 expression show reduced survival. Together, these data suggest that miR-494-5p physically inhibits the expression of JAK1 at the translational level as well as in migration and invasion, supporting the hypothesis of miR-494-5p as an early tumor suppressor and inhibitor of early steps of metastasis in CRC.

Abstract Background Improvements to the primary prevention of physical health illnesses like diabetes in the general population have not been mirrored to the same extent in people with serious mental illness (SMI). This work evaluates the technical feasibility of implementing an electronic clinical decision support system (eCDSS) for supporting the management of dysglycaemia and diabetes in patients with serious mental illness in a secondary mental healthcare setting. Methods A stepwise approach was taken as an overarching and guiding framework for this work. Participatory methods were employed to design and deploy a monitoring and alerting eCDSS. The eCDSS was evaluated for its technical feasibility. The initial part of the feasibility evaluation was conducted in an outpatient community mental health team. Thereafter, the evaluation of the eCDSS progressed to a more in-depth in silico validation. Results A digital health intervention that enables monitoring and alerting of at-risk patients based on an approved diabetes management guideline was developed. The eCDSS generated alerts according to expected standards and in line with clinical guideline recommendations. Conclusions It is feasible to design and deploy a functional monitoring and alerting eCDSS in secondary mental healthcare. Further work is required in order to fully evaluate the integration of the eCDSS into routine clinical workflows. By describing and sharing the steps that were and will be taken from concept to clinical testing, useful insights could be provided to teams that are interested in building similar digital health interventions.

Several studies have been conducted to investigate the barriers to implementing evidence-based practice (EBP) worldwide. In Saudi Arabia, a few studies were conducted in hospital and mental health settings, and no study has explored the topic in primary healthcare settings. This study aimed to examine the barriers perceived by primary healthcare nurses in implementing EBP. This study employed a correlational and cross-sectional design. A total of 284 nurses were surveyed using the BARRIERS scale. Regression analysis was performed to identify the effects of predictor variables on the four subscales. The overall raw score on the BARRIERS scale was 86.21 (standard deviation = 16.15). The highest mean score was reported in the organizational subscale, followed by the innovation and communication subscales, whereas the lowest mean score was reported in the adopter subscale. The findings showed that the three top-ranked barriers were: (1) results of the studies are not generalizable to nurses’ setting, (2) facilities are inadequate, and (3) physicians do not cooperate with the implementation. Findings showed that nurses encounter organizational-related barriers to a moderate extent and EBP implementation varies depending on gender, level of education, and job position. There is a need to create and implement educational interventions and programs to overcome the barriers to effective EBP implementation among primary healthcare nurses.

We reported the synthesis of γ-Fe2O3@SiO2-2-(2-benzothiazolyl azo)-4-methoxyaniline and CoFe2O4@SiO2-2-(2-benzothiazolyl azo)-4-methoxyaniline electrodes for effieicent and highly stable supercapacitor performance by using Stober method. The two electrodes illustrated high specific capacitance of 640 and 580F.g−1 and excellent stability up to 1000 cycles charge–discharge cycles. The results appeared that the capacitance value of CoFe2O4@SiO2-2-(2-benzothiazolyl azo)-4-methoxyaniline is higher than γ -Fe2O3@SiO2-2-(2-benzothiazolyl azo)-4-methoxyaniline, which revealed the extraordinary performance of CoFe2O4 electrode. The electrochemical activity of CoFe2O4 electrode is attributed to the synergistic effect of oxidation–reduction coupling between copper and ferric ions.

Because of the sustained growth of information and mobile users transmitting a great amount of data packets, modern network performances are being seriously affected by congestion problems. In fact, congestion management is a challenging task that can be roughly summarized as a trade off between transmission latency and cost. In order to contribute to solve the congestion problem on communication networks, a novel framework based on a quantum game model is proposed, where network packets compete selfishly for their fastest route. Simulations show that final network routing and traveling times achieved with the quantum version outperform those obtained with a classical game model with the same options for packet transmission for both. Pareto optimality and Nash equilibrium are studied as well as the influence of simulated and real noise in the quantum protocol. This leads to the opportunity of developing full-stack protocols that may be capable of taking advantage of the quantum properties for optimizing communication systems. Due to its generality, this game approach can be applied both in classical complex networks and in future quantum networks in order to maximize the performance of the quantum internet.

Se analiza el aumento del nivel del mar tomando como base el nivel promedio de mareas altas para la región del Pacífico Norte de Costa Rica. Este estudio se realizó a partir de modelos, observaciones y mediciones efectuadas en campo, que presentan un nivel del mar y su respectivo ascenso para cuatro escenarios de acuerdo con los siguientes años: 2030, 2050, 2070 y 2100. Se elaboran escenarios reales para simular el comportamiento del nivel del mar en los próximos 100 años para las zonas de Playas del Coco, Tamarindo y Sámara. Se estudian los niveles de mareas astronómicas a partir de predicciones mareales. El aumento del nivel del mar en los próximos años por calentamiento global es según los escenarios de Nerem et al., (2018) de alrededor 3 mm por año para la Costa Pacífica en general y se utiliza como base para crear las distintas combinaciones y generar los niveles mareográficos representados en este artículo. Los resultados muestran los niveles de inundación para cada uno de los años para las zonas del estudio, e indica las comunidades que podrían ser inundadas para el año 2100, pero sucediendo de forma creciente en el resto de los años. Este estudio pretende alertar a las instituciones gubernamentales sobre estos escenarios para que tomen las decisiones correspondientes ante el inminente cambio del nivel del mar. Se proponen combinaciones de nivel del mar, de tal forma que otros componentes no incluidos en este estudio, como tsunamis, puedan ser simulados también, y ayude en la toma de decisiones ante estos posibles eventos

Objective To evaluate new medical devices and drugs pertinent to otolaryngology–head and neck surgery that were approved by the Food and Drug Administration (FDA) in 2021. Data Sources Publicly available FDA device and drug approvals from ENT (ear, nose, and throat), anesthesia, neurosurgery, plastic surgery, and general surgery FDA committees. Review Methods FDA device and therapeutic approvals were identified and reviewed by members of the American Academy of Otolaryngology–Head and Neck Surgery’s Medical Devices and Drugs Committee. Two independent reviewers assessed the relevance of devices and drugs to otolaryngologists. Medical devices and drugs were then allocated to their respective subspecialty fields for critical review based on available scientific literature. Conclusions The Medical Devices and Drugs Committee reviewed 1153 devices and 52 novel drugs that received FDA approval in 2021 (67 ENT, 106 anesthesia, 618 general surgery and plastic surgery, 362 neurosurgery). Twenty-three devices and 1 therapeutic agent relevant to otolaryngology were included in the state of the art review. Advances spanned all subspecialties, including over-the-counter hearing aid options in otology, expanding treatment options for rhinitis in rhinology, innovative laser-safe endotracheal tubes in laryngology, novel facial rejuvenation and implant technology in facial plastic surgery, and advances in noninvasive and surgical treatment options for obstructive sleep apnea. Implications for Practice FDA approvals for new technology and pharmaceuticals present new opportunities across subspecialties in otolaryngology. Clinicians’ nuanced understanding of the safety, advantages, and limitations of these innovations ensures ongoing progress in patient care.

The use of natural carotenoids as food colorants is an important trend of innovation in the industry due to their low toxicity, their potential as bio-functional ingredients, and the increasing demand for natural and organic foods. Despite these benefits, their inclusion in food matrices presents multiple challenges related to their low stability and low water solubility. The present review covers the main concepts and background of carotenoid inclusion complex formation in cyclodextrins as a strategy for their stabilization, and subsequent inclusion in food products as color additives. The review includes the key aspects of the molecular and physicochemical properties of cyclodextrins as complexing agents, and a detailed review of the published evidence on complex formation with natural carotenoids from different sources in cyclodextrins, comparing complex formation methodologies, recovery, inclusion efficiency, and instrumental characterization techniques. Moreover, process flow diagrams (PFD), based on the most promising carotenoid-cyclodextrin complex formation methodologies reported in literature, are proposed, and discussed as a potential tool for their future scale-up. This review shows that the inclusion of carotenoids in complexes with cyclodextrins constitutes a promising technology for the stabilization of these pigments, with possible advantages in terms of their stability in food matrices.

Abstract Aim This study determines the impact of traditional and interactive learning activities on personal and professional development among Saudi intern nurses. Design A comparative research design was adopted by recruiting 48 intern nurses, who were divided into two equal groups. Methods Data were collected through the clinical assessment tool for nursing education. Results Enthusiasm (p

Summary: Saccharomyces cerevisiae is a leading model system for genome-wide screens, but low-frequency events (e.g., point mutations, recombination events) are difficult to detect with existing approaches. Here, we describe a high-throughput screening technique to detect low-frequency events using high-throughput replica pinning of high-density arrays of yeast colonies. This approach can be used to screen genes that control any process involving low-frequency events for which genetically selectable reporters are available, e.g., spontaneous mutations, recombination, and transcription errors.For complete details on the use and execution of this protocol, please refer to (Novarina et al., 2020a, 2020b).

The development in the use of polyaniline (PANI) in advanced studies makes us draw attention to the presented research and combine it into one study like this one. The unique composition of PANI qualifies it for use in electrochemical applications in addition to many other applications whose use depends on its mechanical properties. Based on this, it is necessary to limit the reactions that produce PANI and the cheapest cost, and then limit the current uses in the formation of nanocomposites with metals, their oxides, and/or carbon nanocomposites in order to determine what is missing from them and work on it again to expand its chemistry. The development in the use of PANI in advanced studies makes us draw attention to the research presented on PANI and combine it into one study. One of the very important things that made PANI possess a very huge research revolution are preparation in a variety of ways, easy and inexpensive, from which a daily product can be obtained with very high purity, as well as its distinctive properties that made it the focus of researchers in various scientific departments. The unique structure of PANI, which is easy to prepare in its pure form or with various chemical compounds including metals, metal oxides, and carbon nanomaterials (such as carbon nanotubes, graphene, graphene oxide, and reduced graphene oxide), qualifies it for use in electrochemical applications. The various studies reviewed showed that PANI gave good results in the applications of super capacitors. In some of the studies mentioned later, it gave a specific capacitance of 503 F/g, cycle stability 85% at 10,000 cycles, energy density 8.88 kW/kg, and power density 96 W h/kg. It was also noted that these values improved significantly when using PANI with its nanocomposites. Because of its good electrical conductivity and the possibility of preparing it with a high surface area with nanostructures in the form of nanowires, nanofibers, and nanotubes, PANI was used as a gas sensor. We have noticed, through the studies conducted in this field, that the properties of PANI as a basic material in gas sensors are greatly improved when it is prepared in the form of PANI nanocomposites, as explained in detail later. From this review, we tried with great effort to shed light on this attractive polymer in terms of its different preparation methods, its distinctive properties, its nanocomposites, and the type of polymerization used for each nanocomposites, as well as its applications in its pure form or with its nanocomposites in the supercapacitor and gas sensor applications.

Introduction: Sustaining a healthy work environment is a major challenge for health care organizations worldwide. Nursing professionals are often exposed to workplace bullying, which imposes serious challenges to nursing retention. Objectives: To determine the prevalence of workplace bullying and turnover intention among nurses, and to investigate the relationship between workplace bullying and nurse turnover. Methods: A cross-sectional correlational design. Convenience sampling was applied, whereby 347 nurses working in a tertiary medical city in Riyadh, Saudi Arabia, were recruited. Data were collected using the Negative Acts Questionnaire and the Anticipated Turnover Scale. Results: The rate of workplace bullying was high, bullying occurred at a cumulative rate of 33.4% ( n = 116). Work related bullying behaviors formed the most common bullying acts with (34.5%) followed by personal bullying with (31.1%) meanwhile physical intimidating accounted by (25.6%). Among the participants, 31.7% exhibited a high turnover intention. The demographic variable age was revealing an inverse correlation with workplace bullying. There was a positive significant correlation between workplace bullying and turnover intentions ( r = .24, p

Objectives To evaluate new drugs and devices relevant to otolaryngology–head and neck surgery that were approved by the US Food and Drug Administration (FDA) in 2020. Data Sources Publicly available device and therapeutic approvals from ENT (ear, nose, and throat), anesthesia, neurology (neurosurgery), and plastic and general surgery FDA committees. Review Methods Members of the American Academy of Otolaryngology–Head and Neck Surgery’s Medical Devices and Drugs Committee reviewed new therapeutics and medical devices from a query of the FDA’s device and therapeutic approvals. Two independent reviewers assessed the drug’s or device’s relevance to otolaryngology, classified to subspecialty field, with a critical review of available scientific literature. Conclusions The Medical Devices and Drugs Committee reviewed 53 new therapeutics and 1094 devices (89 ENT, 140 anesthesia, 511 plastic and general surgery, and 354 neurology) approved in 2020. Ten drugs and 17 devices were considered relevant to the otolaryngology community. Rhinology saw significant improvements around image guidance systems; indications for cochlear implantation expanded; several new monoclonal therapeutics were added to head and neck oncology’s armamentarium; and several new approvals appeared for facial plastics surgery, pediatric otolaryngology, and comprehensive otolaryngology. Implications for Practice New technologies and pharmaceuticals offer the promise of improving how we care for otolaryngology patients. However, judicious introduction of innovations into practice requires a nuanced understanding of safety, advantages, and limitations. Working knowledge of new drugs and medical devices approved for the market helps clinicians tailor patient care accordingly.

Nashwa M Abd-Allah,1 Amal Aly Hassan,1 Gihan Omar,1 Mona Hamdy,1 Sahar Torky A Abdelaziz,2 Waleed Mahmoud Abd El Hamid,3 Rabab A Moussa4 1Rheumatology and Rehabilitation Department, Faculty of Medicine, Minia University, Minia, Egypt; 2Ophthalmology Department, Faculty of Medicine, Minia University, Minia, Egypt; 3Clinical Pathology Department, Faculty of Medicine, Minia University, Minia, Egypt; 4Pathology Department, Faculty of Medicine, Minia University, Minia, EgyptCorrespondence: Nashwa M Abd-AllahRheumatology and Rehabilitation Department, Faculty of Medicine, Minia University, New Minia City, first district, Youssef El-Sbaie Street, building (1), Minia 61511, EgyptTel +20 111 667 2116Email abdallahnashwa@yahoo.comPurpose: To assess the frequency of Sjӧgren’s syndrome (SS), either primary or secondary to rheumatic disease, in a cohort of patients with aqueous-deficient dry eye and to determine the most accurate objective test for diagnosis of SS.Methods: A total of 111 patients with dry eye were recruited from Minia University’s ​Ophthalmology Outpatient Clinic (69 patients) and Rheumatology Outpatient Clinic (42 patients). The patients were screened for aqueous tear–deficient dry eye by abnormal test results of Schirmer test I (

Objective In consideration of the current nursing shortage in Saudi Arabia, we aimed to investigate the association among perceptions of work environment, communication satisfaction, and intentions to quit nursing profession among nurses. In addition, we aimed to investigate the mediating effect of communication satisfaction on the association between nurses’ perception of work environment and their intentions to quit nursing profession. Methods This predictive correlational study was conducted at one of the major hospitals in Saudi Arabia from January 2020 to March 2020. It included a convenience sample of 367 full-time registered nurses who completed three types of close-ended questionnaires. We used IBM SPSS version 24.0 to analyze the collected data. Regression analyses were used to test the study’s hypotheses. All regression assumptions were assessed and confirmed. Significance for all tests was set at p ≤ .05. Results The findings indicated an affirmative association between work environment perception and communication satisfaction (b = .764, p < .05) among nurses. In addition, findings showed that work environment perception (b = −.187, p < .05) and communication satisfaction (b = −.226, p < .05) have negative impacts on the nurses’ intentions to quit; indicating that as work environment perception or communication satisfaction increases, the intention to quit decreases among nurses. Further, a mediation effect of communication satisfaction on the relationship between work environment perception and intention to quit was confirmed. Conclusion This study presents a novel conceptual framework developed based on the literature about the predisposing factors for nurses’ intentions to quit nursing profession. Our results suggest that work environment perception and communication satisfaction among the most contributing factors for nurses resignation. Effective communication was established as a crucial factor for establishing attractive and healthy working environment. Nursing managers can benefit by applying these findings to develop appropriate strategies to inhibit the shortage of nurses in Saudi Arabia.

Helicobacter pylori is a spiral-shaped bacterium, which plays a role in the aetiology of gastric diseases in humans. Non-H. pylori Helicobacter (NHPH) species naturally colonise the stomach of animals and also induce gastric lesions in humans, highlighting their zoonotic importance. We evaluated the gastric bacterial colonisation density and gastric lesions and sought to identify the main phylogenetic groups of the Helicobacter spp. obtained from dogs in the central region of Rio Grande do Sul, Brazil, with this study aiming to investigate the occurrence of Helicobacter spp. in saliva and gastric samples from these dogs. This study included 35 dogs and used analysis such as cytology, histopathology, PCR, rapid urease testing, and phylogenetic analysis. Of the dogs, 94.3% were positive for Helicobacter spp., and these bacteria were present in the stomach of 32 dogs and saliva of eight. Respectively, eight, 15, and nine dogs had mild, moderate, and severe colonisation. Lymphocytic-plasmacytic infiltrate was the main gastric lesion. However, the presence of Helicobacter and the density appeared to be unrelated to the gastric lesions. The samples possessed a high nucleotide identity with remarkably similar sequences among some of the species of NHPH such as H. heilmannii s.s., H. salomonis, H. felis, and H. bizzozeronii. The saliva of domestic dogs, even of those who appear clinically healthy, can cause Helicobacter infection in humans and other animals, with, in these dogs, increased density, occurrence rate, and predominance of NHPH of zoonotic importance being found in the stomach with a lower occurrence of Helicobacter spp. in the saliva.

Introduction Silent sinus syndrome (SSS) is a condition characterized by ophthalmologic features, such as spontaneous enophthalmos and hypoglobus with ipsilateral maxillary sinus atelectasis and an otherwise asymptomatic presentation. SSS has been documented secondary to a number of external causes, including trauma or surgery, but has less commonly been described in the setting of a potential mass in the deep masticator space. Case Presentation A 56-year-old woman with a history of chronic headaches with normal prior sinonasal imaging presented with increasing right-sided facial pain and headaches that radiated to her occiput, subjective visual changes, sharp ear pain, and long-standing subjective diminished sense of smell. Physical examination was normal, while nasal endoscopy demonstrated lateral bowing of the medial maxillary wall on the right. Magnetic resonance imaging demonstrated a homogenous 2 × 2 × 2.4 cm T1- and T2-weighted, hyperintense mass lesion in the deep masticator space splaying the right medial and lateral pterygoid muscles concerning for a possible lipomatous lesion. Computed tomography revealed an atelectatic and opacified maxillary sinus with inward bowing of the posterior maxillary wall and increased orbital volume on that side. Endoscopic maxillary antrostomy was performed with biopsy of the retromaxillary space lesion and with near immediate resolution of the patient’s symptoms. Histologic examination of the mass demonstrated mature adipose tissue with few aggregates of benign small vessels. Discussion This is an unusual presentation of SSS, with an accompanying enlargement of the retromaxillary fat pad. We herein review our clinical experience with SSS and provide a literature review of the presentation, management, and perioperative considerations for SSS.

Schiff's Bases were synthesized from the reaction of furfuraldehyde and substituted benzaldehyde with 4-aminoantipyrine and 2,4-dinitrophenylhydrazine and reacted with 2-(triphenylphosphoranylidene) succinic anhydride in an anhydrous 1,4- dioxane at reflux conditions. The resulting products were found to be 1,5-disubstituted 2-hydroxypyrroles. The structures of the products were confirmed by their melting points, FT-IR, 1HNMR spectra and C.H.N. elemental analyses.

Aim: To find out the prevalence of “true” burning mouth syndrome and study the association between patients’ spontaneous complaints of burning mouth and systemic conditions in a group of middle age and elderly “denture wearers” patients in Jordan. Methods: A group of 129 patients (112 female and 17 male) of “complete denture wearers” subjects aged 40 years and over attended prosthetic clinic at King Hussein Medical Hospital complaining from oral burning, with no oral lesion possibly responsible for the burning sensations were selected. Assessment of oral and general status was done based on questioners, detailed history taking, medical records and extra and intraoral examination. The existed complete dentures retention, stability, jaw relationship and the free way space were evaluated. The current blood test and instrumental protocol for examination of patients with burning mouth complains were performed for each patient. Then those studied patients with burning mouth sensations including “true” burning mouth syndrome have been compared to the controls with regard to the presence of local problem, undermined local, systemic or psychological disease. Results: The diagnosis of “true” burning mouth syndrome was established in (2.3%) of the studied population two females and one male. In most patients (58%) more than one site was affected. Significant positive associations were found between local factors (i.e., wearing complete dentures with unsatisfactory retention or jaw relationship, dry mouth or candidasis) and patients suffering from burning mouth sensation. The results also show that some systemic or psychological disorders were significantly more present among patients with burning mouth symptoms when compared to the control group (p

Poly(vinyl chloride) (PVC) undergoes photodegradation induced by ultraviolet (UV) irradiation; therefore, for outdoor applications, its photostability should be enhanced through the use of additives. Several carvedilol tin complexes were synthesized, characterized and mixed with PVC to produce thin films. These films were irradiated at 25 °C with a UV light (λ = 313 nm) for up to 300 h. The reduction in weight and changes in chemical structure and surface morphology of the PVC films were monitored. The films containing synthesized complexes showed less undesirable changes than the pure PVC film. Organotin with a high content of aromatics was particularly efficient in inhibiting photodegradation of PVC. The carvedilol tin complexes both absorbed UV light and scavenged radicals, hydrochloride, and peroxides and, therefore, photostabilized PVC.

Introducción. Las proteínas salivales de los mosquitos son capaces de inducir la producción de anticuerpos, lo que a su vez refleja el grado de contacto hombre-vector. Además, los anticuerpos IgG contra el virus del dengue son indicadores de una exposición previa a este virus. El riesgo de transmisión del virus del dengue está asociado no solo con factores relacionados con la biología del mosquito, o factores virales, sino también, con factores socioeconómicos, como la disponibilidad de agua en el hogar, que pueden desempeñar un papel importante durante la temporada epidémica. Objetivo. Determinar el efecto de la presencia de mosquitos Aedes aegypti en las casas y la exposición previa al virus del dengue, sobre los niveles de anticuerpos contra mosquitos en el contacto humano-vector en habitantes de un área endémica de Colombia. Materiales y métodos. Se hizo un estudio piloto de 58 casas y 55 participantes en Norte de Santander, Colombia. Se empleó un cuestionario para recopilar la información sobre los factores socioeconómicos y se examinaron las casas para detectar la presencia de sitios de cría de Ae. aegypti. Se recolectó una muestra de sangre humana total en papel de filtro y se estableció el nivel de anticuerpos IgG contra el virus del dengue, además del de los anticuerpos IgG e IgM anti-Ae. aegypti de extracto de glándula salival mediante ELISA. Resultados. Los resultados revelaron un mayor nivel de anticuerpos IgG de extracto de glándula salival en sujetos que vivían en casas con presencia de mosquitos Ae. aegypti en la fase acuática. Asimismo, se encontró una mayor concentración de anticuerpos IgG de extracto de glándula salival en personas previamente expuestas al virus del dengue. Los resultados evidenciaron una correlación positiva significativa entre los niveles de IgM de extracto de glándula salival y los de IgG anti-virus del dengue de extracto de glándula salival, y una correlación negativa con los de IgG de extracto de glándula salival , aunque esta última no fue significativa. Conclusión. La concentración de anticuerpos fue mayor en quienes vivían en casas con estadios acuáticos de Ae. aegypti, como también en las personas con anticuerpos IgG anti-virus del dengue.

Excellent quadratic non-linear optical (ONL-2) properties of the poly(2,5-bis(but-2-ynyloxy) benzoate, containing a polar diacetylene as a chromophore, were found. According with the Maker fringes method, oriented polymer films showing an order parameter of ∼0.23 can display outstanding and stable Second Harmonic Generation (SHG) effects under off-resonant conditions (SHG-532 nm). Also, the macroscopic non-linear optical (NLO)-coefficients were evaluated under the rod-like molecular approximation, obtaining: χzzz(2) and χzxx(2) in the order of 280 ± 10 and 100 ± 10 pm V−1, respectively. The mechanical and chemical properties, in addition to the large ONL-2 coefficients exhibited by this polymer, make it a promising organic material in the development of optoelectronic/photonic devices.

Previous studies showed that student nurses faced difficulties in clinical practice; thus, this study examined the clinical challenges encountered by Saudi nationals and the implications to learning outcomes using the descriptive cross-sectional approach. The study was conducted in nursing college in a university in Riyadh, Saudi Arabia. The survey questionnaires were completed by 220 conveniently selected student nurses who were enrolled in Bachelor’s Degree in Nursing from the academic level 5 to 8. Data analysis was done through the Statistical Package for the Social Sciences version 23. Clinical evaluation was perceived as the most common challenge, whereas competency development as the least. Significant associations were found between age and evaluation, academic level and competency development, and grade point average and learning outcomes. Nursing competency development significantly varied with civil status and stream of study. Students in the Regular Nursing Program faced more challenges in achieving learning outcomes then their counterparts. Overall, the challenges were perceived as occasional. Resolving clinical obstacles is crucial in helping student nurses achieve positive learning outcomes.