Investigating the Mechanical Properties of Annealed 3D-Printed PLA-Date Pits Composite.

Biomedical applications are crucial in rehabilitation medicine, assisting individuals with disabilities. Nevertheless, materials failure can sometimes result in inconvenience for users. Polylactic Acid (PLA) is a popular 3D-printed material that offers design flexibility. However, it is limited in use because its mechanical properties are inadequate. Thus, this study introduces an artificial intelligence model that utilizes ANFIS to estimate the mechanical properties of PLA composites. The model was developed based on an actual data set collected from experiments. The experimental results were obtained by preparing samples of PLA green composites with different weight fractions of date pits, which were then annealed for varying durations to remove residual stresses resulting from 3D printing. The mechanical characteristics of the produced PLA composite specimens were measured experimentally, while the ANSYS model was established to identify the composites' load-carrying capacity. The results showed that ANFIS models are exceptionally robust and compatible and possess good predictive capabilities for estimating the hardness, strength, and Young's modulus of the 3D-printed PLA composites. The model results and experimental outcomes were nearly identical.

Adaptive Neuro-Fuzzy-Based Models for Predicting the Tribological Properties of 3D-Printed PLA Green Composites Used for Biomedical Applications.

Tribological performance is a critical aspect of materials used in biomedical applications, as it can directly impact the comfort and functionality of devices for individuals with disabilities. Polylactic Acid (PLA) is a widely used 3D-printed material in this field, but its mechanical and tribological properties can be limiting. This study focuses on the development of an artificial intelligence model using ANFIS to predict the wear volume of PLA composites under various conditions. The model was built on data gathered from tribological experiments involving PLA green composites with different weight fractions of date particles. These samples were annealed for different durations to eliminate residual stresses from 3D printing and then subjected to tribological tests under varying normal loads and sliding distances. Mechanical properties and finite element models were also analyzed to better understand the tribological results and evaluate the load-carrying capacity of the PLA composites. The ANFIS model demonstrated excellent compatibility and robustness in predicting wear volume, with an average percentage error of less than 0.01% compared to experimental results. This study highlights the potential of heat-treated PLA green composites for improved tribological performance in biomedical applications.

Urgent coronary artery bypass graft surgery supported by veno-arterial extracorporeal membrane oxygenation: a report of two cases.

Mechanical circulatory support (MCS) devices, especially veno-arterial extracorporeal membrane oxygenation (VA-ECMO) devices, are increasingly used to shore complex cardiac procedures in high-risk patients. We are reporting two cases where patients underwent coronary artery bypass grafting (CABG) under support of VA-ECMO in the setting of cardiogenic shock complicating acute myocardial infarction. The patients had different courses, but both survived the initial insult and were weaned successively from VA-ECMO. Our report indicates that VA-ECMO can be used instead of the cardiopulmonary bypass machine (CPB) to support the circulation during CABG surgery in patients with complex coronary anatomy and unstable haemodynamics. Future studies focusing on the long-term outcomes of such patients will probably help to establish the optimal management of this type of patients.

Prevalence and Species Identification of Ixodid Ticks of Small Ruminants in Benadir Region, Somalia.

Ixodid ticks are one of the major health constraints on small ruminant productivity and contribute to significant economic losses in Somalia. An across-sectional study was conducted from November 2019 through December 2020 to identify hard tick species and determine the prevalence of tick infestation in small ruminants in the Benadir region, Somalia. Ticks were identified at the genera and species level by using morphological identification keys under a stereomicroscope. During the study period, a total of 384 small ruminants were examined for the presence of ticks through purposive sampling. All visible individual adult ticks were collected from the bodies of 230 goats and 154 sheep. A total of 651 Ixodid adult ticks were collected, of which 393 were male and 258 were female. The overall prevalence of tick infestation in the study area was 66.15% (254/384). The prevalence of tick infestation in goats and sheep was found to be 76.1% (175/230) and 51.3% (79/154), respectively. In the present study, nine species of hard ticks, which were grouped into three genera, were identified. The most abundant species found in this study were Rhipichephalus pulchellus (64.97%), Rhipichephalus everstieversti (8.45%), Rhipichephalus pravus (5.53%), Rhipichephalus lunulatus (5.38%), Amblyomma lepidum (5.22%), Amblyomma gemma (3.38%), and Hyalomma truncatum (2.62%) according to predominance. Rhipichephalus bursa (2.46%) and Rhipichephalus turanicus (1.99%) were the minor species observed in both species in the study area. The difference in the prevalence of tick infestation was found to be a statistically significant variation (p < 0.05) between species groups but not sex groups. In all cases, male ticks dominated female ticks. In conclusion, the findings of this study suggest that ticks were the most prevalent ectoparasites of small ruminants in the study areas. Therefore, the increasing threat of ticks and tick-borne pathogens of small ruminants warrants the urgent strategic application of acaricides and the creation of awareness among livestock owners to prevent and control tick infestations of sheep and goats in the study area.

Correction: The determinant factors for the adoption of CRM in the Palestinian SMEs: The moderating effect of firm size.

[This corrects the article DOI: 10.1371/journal.pone.0243355.].

Assessment of Freestyle Local Facial Perforator Flaps for Coverage of Facial Defects.

OBJECTIVE: To assess local freestyle facial perforator flaps in the reconstruction of small to medium-sized facial defects. MATERIALS AND METHODS: In a case series, local freestyle perforator flaps were used in Suez Canal University Hospital to reconstruct 28 facial defects in 26 patients between 2017 and 2019. Adequate perforators were identified near those defects and flaps were designed as propeller or VY advancement. Four scales from the FACE-Q (satisfaction with facial appearance, satisfaction with the outcome, psychological function, and appearance-related psychosocial distress) and 2 scales from the SCAR-Q (Appearance scale and Symptom scale) were used as well as the observer part of the Patient and Observer Scar Assessment Scale. The mean follow up period was 10 months. RESULTS: Complete reconstruction was achieved in all cases with a high rate of patient satisfaction which was assessed by FACE-Q and SCAR-Q. Moreover, observer assessment by Patient and Observer Scar Assessment Scale score showed high patient satisfaction with the scars with a mean (SD) 15.5 (3.4) and there was a positive correlation between subjective and objective: results (r2 from 0.27 to 0.41, P < 0.01). Regarding complications, bulkiness occurred in 2 flaps, congestion in 2 flaps, dehiscence in 1 flap, and tip necrosis in 5 flaps. Accordingly, secondary intervention in the form of medicinal leech therapy was used in 3 flaps, delayed closure for the dehisced flap and debulking for 1 flap. CONCLUSIONS: Local freestyle perforator flap reconstruction is one of the recommended techniques for small to medium-sized facial defects which gives a high aesthetic outcome and patient satisfaction.

The determinant factors for the adoption of CRM in the Palestinian SMEs: The moderating effect of firm size.

CRM adoption can provide innumerable benefits to the SMEs performance, including solving customer problems in a timely manner, enhancing customer satisfaction by appointing an expert to solve issues and queries, and the like. This study aims to examine the moderating effects of the firm size in the adoption of CRM in the Palestinian SMEs. A quantitative approach was used to investigate the relationships between the variables, which are compatibility, IT infrastructure, complexity, relative advantage, security, top management support, customer pressure, and competitive pressure. A questionnaire was designed to collect data from 420 SMEs in Palestine. A total of 331 respondents completed and returned the survey. The Partial Least Square-Structural Equation Model (PLS-SEM) approach was used to assess both the measurement and structural models. The Diffusion of Innovation Theory (DOI) and Technology, Organization, and Environment Framework (TOE) framework were employed to identify the determinant factors from the technological, organizational, and environmental perspectives. The findings and conclusions of this study provide show that the moderating effect of firm size has significant effect compatibility, top management support, customer pressure, and IT infrastructure factors.

Two episodes of remote ischemia preconditioning improve motor and sensory function of hind limbs after spinal cord ischemic injury.

Objectives: To investigate the effect of one and two remote ischemia preconditioning episodes (1-RIPC or 2-RIPC, respectively) on neuro-protection after spinal cord ischemic injury (SCI) in rats. Design: Experimental animal study. Setting: College of Medicine, King Khalid University, Abha, KSA. Interventions: Male rats (n = 10/group) were divided into control, sham, SCIRI, 1-RIPC + SCIRI, and 2-RIPC + SCIRI. SCI was induced by aortic ligation for 45 min and each RIPC episode was induced by 3 cycles of 10 min ischemia/10 min perfusion. The two preconditioning procedures were separated by 24 h. Outcome measures: after 48 h of RIPC procedure, Tarlov's test, withdrawal from the painful stimulus and placing/stepping reflex (SPR) were used to evaluate the hind limbs neurological function. SC homogenates were used to measure various biochemical parameters. Results: Motor and sensory function of hind limbs were significantly improved and levels of MDA, AOPPs, PGE2, TNF-α, and IL-6, as well as the activity of SOD, was significantly decreased in SC tissue in either 1 or 2 episodes of RIPC intervention. Concomitantly, levels of total nitrate/nitrite and eNOS activity were significantly increased in both groups. Interestingly, except for activity of SOD, eNOS and levels of nitrate/nitrite, the improvements in all neurological biochemical endpoint were more profound in 2-RIPC + SCIRI compared with 1-RIPC + SCIRI. Conclusion: applying two preconditioning episodes of 3 cycles of 10 min ischemia/10 min perfusion, separated by 24 h, boost the neuro-protection effect of RIPC maneuver in rats after ischemic induced SCI in rats.

Protective effect of combined melatonin and alpha-tocopherol administration in spinal cord ischemia-reperfusion injury in rat / Efecto protector de la administración combinada de melatonina y alfa-tocoferol en la lesión por isquemia-reperfusión de la médula espinal en ratas

Oxidative stress and inflammation are the key players in the development of motor dysfunction post-spinal cord ischemic reperfusion injury (SC-IRI). This study investigated the protective effect of concomitant pre-administration of melatonin and alpha-tocopherol on the early complications (after 48 hours) of spinal cord IRI injury in rats. Melatonin or α-tocopherol were preadministered either individually or in combination for 2 weeks, then rats were exposed SC-IRI. Neurological examinations of the hind limbs and various biochemical markers of oxidative stress and inflammation in the SC tissue were assessed. Solely pre-administration of either melanin or α-tocopherol significantly but partially improved motor and sensory function of the hind limbs mediated by partial decreases in SC levels of MDA, AOPP and PGE2 levels and activities of SOD, partial significant decreases in plasma levels of total nitrate/nitrite and significant increases in AC activity of GSH-Px. However, combination therapy of both drugs resulted in the maximum improvements in all neurological assessments tested and biochemical endpoints. In conclusion, by their synergistic antioxidant and antiinflammatory actions, the combination therapy of melatonin and α-tocopherol alleviates SC-IRI induced paraplegia.

El estrés oxidativo y la inflamación son claves en el desarrollo de la disfunción motora posterior a lesión isquémica de la médula espinal (SC-IRI). Este estudio investigó acerca del efecto protector de la administración previa concomitante de la melatonina y alfa-tocoferol en las complicaciones tempranas (después de 48 horas) de la lesión de IRI de la médula espinal en ratas. La melatonina o el α-tocoferol se administraron individualmente o en combinación durante 2 semanas, luego las ratas fueron expuestas a SC-IRI. Se evaluaron los exámenes neurológicos de las miembros pélvicos y diversos marcadores bioquímicos de estrés oxidativo e inflamación en el tejido subcutáneo. Solo la administración previa de melatonina o α-tocoferol mejoró parcial y significativamente la función motora y sensorial de los miembros pélvicos mediadas por disminuciones parciales en los niveles de SC de los niveles de MDA, AOPP y PGE2 y las actividades de la SOD, disminuciones significativas parciales en los niveles plasmáticos del total nitrato / nitrito y aumentos significativos en la actividad de AC de GSH-Px. Sin embargo, se observaron los mejores resultados durante la combinación de ambos fármacos en todas las evaluaciones neurológicas y en los puntos finales bioquímicos. En conclusión, debido a sus acciones antioxidantes y antiinflamatorias sinérgicas, la terapia de melatonina y α-tocoferol alivia la paraplejía inducida por SC-IRI.

Microbial cellulose dressing compared with silver sulphadiazine for the treatment of partial thickness burns: A prospective, randomised, clinical trial.

BACKGROUND: The current treatment for partial thickness burns at the trial site is silver sulphadiazine, as it minimises bacterial colonisation of wounds. Its deleterious effect on wound healing, together with the need for repeated, often painful, procedures, has brought about the search for a better treatment. Microbial cellulose has shown promising results that avoid these disadvantages. The aim of this study was therefore to compare microbial cellulose with silver sulphadiazine as a dressing for partial thickness burns. METHOD: All patients who presented with partial thickness (superficial and deep dermal) burns from October 2014 to October 2016 were screened for this randomised clinical trial. Twenty patients were included in each group: the cellulose group was treated with microbial cellulose sheets and the control group with silver sulphadiazine cream 10mg/g. The wound was evaluated every third day. Pain was assessed using the Face, Legs, Activity, Cry, Consolability (FLACC) scale during and after each procedure. Other variables recorded were age, sex, percentage total body surface area burned (TBSA%), clinical signs of infection, time for epithelialisation and hospital stay. Linear multivariable regression was used to analyse the significance of differences between the treatment groups by adjusting for the size and depth of the burn, and the patient's age. RESULTS: Median TBSA% was 9% (IQR 5.5-12.5). The median number of dressing changes was 1 (IQR 1-2) in the cellulose group, which was lower than that in the control group (median 9.5, IQR 6-16) (p<0.001). Multivariable regression analysis showed that the group treated with microbial cellulose spent 6.3 (95% CI 0.2-12.5) fewer days in hospital (p=0.04), had a mean score that was 3.4 (95% CI 2.5-4.3) points lower during wound care (p<0.001), and 2.2 (95% CI 1.6-2.7) afterwards (p<0.001). Epithelialisation was quicker, but not significantly so. CONCLUSION: These results suggest that the microbial cellulose dressing is a better first choice for treatment of partial thickness burns than silver sulphadiazine cream. Fewer dressings of the wound were done and, combined with the low pain scores, this is good for both the patients and the health care system. The differences in randomisation of the area of burns is, however, a concern that needs to be included in the interpretation of the results.

Autologous Bone Marrow Concentrates and Concentrated Growth Factors Accelerate Bone Regeneration After Enucleation of Mandibular Pathologic Lesions.

Stem cell therapy is a revolutionary new way to stimulate mesenchymal tissue regeneration. The platelets concentrate products started with platelet-rich plasma (PRP), followed by platelet-rich fibrin (PRF), whereas concentrated growth factors (CGF) are the latest generation of the platelets concentrate products which were found in 2011. The aim of the present study was to evaluate the potential of combining autologous bone marrow concentrates and CGF for treatment of bone defects resulting from enucleation of mandibular pathologic lesions. Twenty patients (13 males and 7 females) with mandibular benign unilateral lesions were included, and divided into 2 groups. Group I consisted of 10 patients who underwent enucleation of the lesions followed by grafting of the bony defects with autologous bone marrow concentrates and CGF. Group II consisted of 10 patients who underwent enucleation of the lesions without grafting (control). Radiographic examinations were done immediately postoperative, then at 1, 3, 6, and 12 months, to evaluate the reduction in size and changes in bone density at the bony defects. Results indicated a significant increase in bone density with respect to the baseline levels in both groups (P < 0.05). The increase in bone density was significantly higher in group I compared with group II at the 6- and 12-month follow-up examinations (P < 0.05). The percent of reduction in the defects' size was significantly higher in group I compared with group II after 12 months (P = 0.00001). In conclusion, the clinical application of autologous bone marrow concentrates with CGF is a cost effective and safe biotechnology, which accelerates bone regeneration and improves the density of regenerated bone.

Impact of High Altitude on Maternal Serum Leptin Level and its Correlation With Oxidative Stress and Endothelial Inflammatory Markers in Preeclamptic Women.

Involvement of leptin in the pathogensis of preeclampsia (PE) is still a controversy subject. Several researches reported the changes in serum leptin in high altitude (HA) residents. The aim of the present work was to investigate the impact of oxidative stress (OS) induced by HA residence on maternal serum leptin in PE and if there was a significant correlation between the serum leptin with either OS or endothelial inflammatory markers. One hundred fifty eight pregnant women were included in this study, divided into: low altitude normal pregnancies (NL), HA normal pregnancies (NH), low altitude preeclamptic (PL), and HA preeclamptic (PH) who presented to the obstetrics and gynecology outpatient clinic in both Muhayl (500 m over sea level) and Abha General Hospitals (all of them resident at Alsoda district with the average altitude 2700 m over sea level). Serum leptin, superoxide dismutase (SOD) activity, malondialdehyde (MDA), plasma nitrite/nitrate (NOx), serum tumor necrosis factor alpha (TNF-α), interleukin 6 (IL-6), blood urea nitrogen (BUN) and creatinine were determined. Both NH and PL groups showed significant increases in leptin (P < 0.01), SOD (P < 0.01), MDA (P < 0.001), NOx (P < 0.001), TNF-α (P < 0.001) and IL-6 (P < 0.001) compared with the NL group without any significant changes between both groups. The PH group showed significant accentuation of the previously measured parameters (P < 0.001 for all) compared with all other groups (NL, NH and PL groups). We can conclude that the combination of PE and HA residence resulted in significantly elevated maternal serum leptin suggesting involvement of leptin in the pathogenesis of PE accentuated by HA residence.

17ß-Estradiol sensitizes ovarian surface epithelium to transformation by suppressing Disabled-2 expression.

Estrogen replacement therapy increases the risk of human ovarian cancer and exogenous estradiol accelerates the onset of ovarian cancer in mouse models. This study uses primary cultures of mouse ovarian surface epithelium (OSE) to demonstrate that one possible mechanism by which estrogen accelerates the initiation of ovarian cancer is by up-regulation of microRNA-378 via the ESR1 pathway to result in the down-regulation of a tumour suppressor called Disabled-2 (Dab2). Estrogen suppression of Dab2 was reproducible in vivo and across many cell types including mouse oviductal epithelium and primary cultures of human ovarian cancer cells. Suppression of Dab2 resulted in increased proliferation, loss of contact inhibition, morphological dysplasia, and resistance to oncogene-induced senescence - all factors that can sensitize OSE to transformation. Given that DAB2 is highly expressed in healthy human OSE and is absent in the majority of ovarian tumours, this study has taken the first steps to provide a mechanistic explanation for how estrogen therapy may play a role in the initiation of ovarian cancer.

Penile calcific uremic arteriolopathy occurring postparathyroidectomy in a hemodialysis patient.

Calcific uremic arteriolopathy (CUA), also known as calciphylaxis, is a rare condition most frequently seen in patients with advanced chronic kidney disease. The clinical picture is characterized by painful skin lesions and ulcerations. The underlying pathology is medial calcification and intimal proliferation with microthrombi of small arteries. CUA is commonly associated with secondary hyperparathyroidism and high serum calcium and phosphate products. This article reports an atypical case where CUA developed after parathyroidectomy and in the course of treatment of hungry bone syndrome. The patient was on hemodialysis for 14 years. He had developed secondary hyperparathyroidism and severe osteodystrophy. Calcium, Vitamin-D supplements, and calcimimetics failed to control his condition. He underwent parathyroidectomy but developed hungry bone syndrome postoperatively. He was managed with large doses of calcium and active Vitamin-D analogs to maintain his serum calcium. Two weeks later, he developed a painful single lesion on the tip of the penis which was diagnosed as CUA on clinical and radiographic evidence. The patient refused surgical intervention and opted for traditional treatment with honey and herbs with an excellent outcome. The case highlights the risk of CUA complicating the aggressive management of post-parathyroidectomy hungry bone syndrome.

Prevalence and comorbidity of depression, anxiety and obsessive compulsive disorders among Saudi secondary school girls, Taif Area, KSA.

BACKGROUND: Previous Saudi studies have shown the psychiatric comorbidity among adolescent girls. This article was done to assess the prevalence and comorbidity of psychiatric disorders among secondary school girls in Taif area. METHODS: A cross-sectional multistage cluster-sampling methodology was carried out on 1024 secondary school female students. Psychometric evaluation of students was carried out using the Beck depression inventory, Castello and Comery Anxiety scale and Obsessive - compulsive disorder scale. RESULTS: Out of the 1024 participants, 42.9%, 54.9%, and 23.1% had significant depression, anxiety and obsessive compulsive symptoms, respectively. In addition, 64.7% of them had symptoms of the three studied disorders. A highly significant positive correlation was found between depression score and both anxiety and OC symptoms scores and between anxiety score and OC symptoms score. CONCLUSIONS: There is a need for a national intervention program for promotion of adolescent mental health. The program should include screening of students using the psychometric scales.