Transversus abdominis plane block versus caudal block with bupivacaine and dexmedetomidine for unilateral inguinal hernia repair in pediatric patients: a randomized clinical trial.

BACKGROUND: This study compared the transversus abdominis plane (TAP) block with bupivacaine and dexmedetomidine to the same mixture in the caudal block in delivering postoperative analgesia in children after unilateral inguinal hernia surgery. METHODS: The current study included 80 children aged two to eight years who were scheduled for unilateral inguinal hernia surgery under general anesthesia. A caudal block (1 mL/kg 0.25% bupivacaine and one µg /kg dexmedetomidine) or a TAP block (1 mL/kg 0.25% bupivacaine and one µg /kg dexmedetomidine) was given to each participant at random. The time it took to request analgesia for the first time, the postoperative pain score, total analgesic use, sedation, family satisfaction, and side effects were all measured. The primary outcome was time to first analgesic request. RESULTS: The caudal block group had a considerably shorter time to first analgesic request than the TAP block group. The caudal block group received more rescue analgesia doses within 24 hours than the TAP block group. The mean total dose of intravenous paracetamol within the first 24 hours postoperatively was greater in the caudal block group. The caudal block group had much higher family satisfaction. CONCLUSIONS: The TAP block and caudal block provide good postoperative analgesia in children undergoing unilateral inguinal hernia repair. Adding dexmedetomidine to the TAP block was superior to the caudal block in terms of extending the length of the initial analgesic request, lowering analgesic requirement, and lowering pain scores without causing substantial adverse effects.

Preoperative lignocaine nebulisation for attenuation of the pressor response of laryngoscopy and tracheal intubation in patients with severe preeclampsia undergoing caesarean section delivery: A randomised double-blind controlled trial.

Background and Aims: Following induction of general anaesthesia, direct laryngoscopy and endotracheal intubation usually cause tachycardia and hypertension due to increased sympathetic activity. This response is generally exaggerated in hypertensive patients. This study aimed to evaluate the effectiveness of preoperative lignocaine nebulisation in attenuating the pressor response to laryngoscopy and endotracheal intubation in patients with severe preeclampsia undergoing caesarean delivery. Methods: After ethical approval, we conducted this randomised, double-blind study, which included 110 patients with severe preeclampsia who underwent caesarean delivery under general anaesthesia. These patients were randomly allocated into two groups to receive either preoperative nebulisation of lignocaine 2% in a dose of 4.5 mg/kg (not exceeding 400 mg) in the lignocaine group or nebulisation of an equivalent volume of 0.9% NaCl in the saline group. The primary objective was the systolic blood pressure after tracheal intubation. The secondary objectives included heart rate, maternal serum cortisol and blood glucose levels, grade of cough during emergence, postoperative sore throat and hoarseness of voice, neonatal Apgar score and umbilical blood gas. Results: The systolic blood pressure was significantly lower in the lignocaine group compared to the saline group at 1, 3 and 5 min after endotracheal intubation and after delivery of the foetus (P = 0.001, 0.003, 0.002 and 0.019, respectively). Similarly, the heart rate was significantly lower in the lignocaine group versus saline group at 1 and 3 min after endotracheal intubation (P = 0.041 and 0.042, respectively). Conclusion: Preoperative lignocaine nebulisation in a dose of 4.5 mg/kg effectively attenuated the pressor response to laryngoscopy and endotracheal intubation in patients with severe preeclampsia undergoing caesarean delivery.

Mitigating Osmotic Stress and Enhancing Developmental Productivity Processes in Cotton through Integrative Use of Vermicompost and Cyanobacteria.

There is an urgent demand for biostimulant amendments that can sustainably alleviate osmotic stress. However, limited information is available about the integrated application of vermicompost and a cyanobacteria extract on cotton plants. In 2020 and 2021, two field experiments were carried out in which twelve combinations of three irrigation intervals were employed every 14 days (Irrig.14), 21 days (Irrig.21), and 28 days (Irrig.28) along with four amendment treatments (a control, vermicompost, cyanobacteria extract, and combination of vermicompost + cyanobacteria extract) in salt-affected soil. The integrative use of vermicompost and a cyanobacteria extract resulted in an observed improvement in the physicochemical attributes; non-enzymatic antioxidants (free amino acids, proline, total soluble sugars, and phenolics); and antioxidant enzyme activities of catalase (CAT), superoxide dismutase (SOD), and peroxidase (POD) and a decrease in the levels of oxidative damage indicators (H2O2 and MDA). Significant augmentation in the content of chlorophyll a and b, carotenoid concentration, relative water content, stomatal conductance, and K+ was also observed. In conjunction with these findings, noticeable decreases in the content of Na+ and hydrogen peroxide (H2O2) and the degree of lipid peroxidation (MDA) proved the efficacy of this technique. Consequently, the highest cotton yield and productivity as well as fiber quality were achieved when vermicompost and a cyanobacteria extract were used together under increasing irrigation intervals in salt-affected soil. In conclusion, the integrated application of vermicompost and a cyanobacteria extract can be helpful for obtaining higher cotton productivity and fiber quality compared with the studied control and the individual applications of the vermicompost or the cyanobacteria extract under increasing irrigation intervals within salt-affected soil. Additionally, it can also help alleviate the harmful impact of these abiotic stresses.

High-speed reflectance confocal microscopy of human skin at 1251-1342 nm.

OBJECTIVES: Reflectance confocal microscopy (RCM) is an imaging method that can noninvasively visualize microscopic features of the human skin. The utility of RCM can be further improved by increasing imaging speed. In this paper, we report high-speed RCM imaging of human skin with a frame rate that is over 10 times faster and an area imaging rate that is 6-9 times faster than those of commercially available RCM devices. METHODS: The higher imaging speed was achieved using a high-speed RCM technique, termed spectrally encoded confocal microscopy (SECM). SECM uses a diffraction grating and a high-speed, wavelength-swept source to conduct confocal imaging at a very high rate. We developed a handheld SECM probe using a scanned-grating approach. The SECM probe was used in conjunction with a wavelength-swept source with a spectral band of 1251-1342 nm. RESULTS: The SECM probe achieved high lateral resolution of 1.3-1.6 µm and an axial resolution of 3.5 µm. SECM images of the human skin (image size = 439 × 439 µm2 ) obtained at 100 frames/s clearly show previously reported RCM features of the human skin in vivo with adequate image quality. The fast imaging speed allowed for the rapid acquisiton of volumetric SECM image data (200 frames covering a depth range of 200 µm) within 2 s. The use of 1251-1342 nm provided sufficient signal level and contrast required to visualize key cellular morphologic features. CONCLUSIONS: These preliminary results demonstrate that high-speed SECM imaging of the human skin at 1251-1342 nm is feasible.

Peri-anal infiltration versus caudal block for multimodal analgesia in paediatric patients with Hirschsprung's disease undergoing transanal endorectal pull-through procedure: A randomised trial.

Background and Aims: Transanal endorectal pull-through (TERPT) is a standard procedure for managing paediatric patients with Hirschsprung's disease (HD). This study aimed to evaluate peri-anal infiltration versus caudal block as a part of multimodal analgesia for paediatric patients with HD undergoing the TERPT procedure. Methods: This randomised trial included 60 patients of both genders, aged 6 to 18 months who underwent the TERPT procedure under general anaesthesia. The patients were randomly assigned into two groups to receive either peri-anal infiltration or caudal block with 1 ml/kg bupivacaine 0.25% and dexmedetomidine 1 µg/kg in 0.5 ml normal saline. The primary outcome was the time to the first rescue analgesia. The secondary outcomes were the total consumption, the frequency of nalbuphine administration as rescue analgesia within 24 hours and the level of postoperative sedation. Results: The time to first rescue analgesia was significantly shorter in the peri-anal infiltration group versus the caudal block group (median [interquartile range] 10 [7.5-12.5] h versus 16 [13.5-18.5] h, respectively, P = 0.008). The frequency of administration and the total dose of nalbuphine was significantly higher in the peri-anal infiltration group (P = 0.003 and 0.013, respectively). The sedation score was significantly higher in the caudal block group postoperatively. Conclusion: For paediatric patients undergoing the TERPT procedure, peri-anal infiltration was less effective than caudal block in terms of the duration of postoperative analgesia. However, both techniques were comparable during the first 6 hours postoperatively.

Stimulating the Growth, Anabolism, Antioxidants, and Yield of Rice Plants Grown under Salt Stress by Combined Application of Bacterial Inoculants and Nano-Silicon.

The growth and development of rice face many issues, including its exposure to high soil salinity. This issue can be alleviated using new approaches to overwhelm the factors that restrict rice productivity. The objective of our investigation was the usage of the rhizobacteria (Pseudomonas koreensis and Bacillus coagulans) as plant growth-promoting rhizobacteria (PGPRs) and nano-silicon, which could be a positive technology to cope with the problems raised by soil salinity in addition to improvement the morpho-physiological properties, and productivity of two rice varieties (i.e., Giza 177 as salt-sensitive and Giza 179 as salt-tolerant). The findings stated that the application of combined PGPRs and nano-Si resulted in the highest soil enzymes activity (dehydrogenase and urease), root length, leaf area index, photosynthesis pigments, K+ ions, relative water content (RWC), and stomatal conductance (gs) while resulted in the reduction of Na+, electrolyte leakage (EL), and proline content. All these improvements are due to increased antioxidant enzymes activity such as catalase (CAT), superoxide dismutase (SOD), and peroxidase (POD), which decreased hydrogen peroxide (H2O2) and malondialdehyde (MDA) under soil salinity in rice plants compared to the other treatments. Combined application of PGPRs and nano-Si to Giza 177 significantly surpassed Giza 179, which was neither treated with PGPR nor nano-Si in the main yield components (number of grains/panicles, 1000 grain weight, and grain yield as well as nutrient uptake. In conclusion, both PGPRs and nano-Si had stimulating effects that mitigated the salinity-deleterious effects and encouraged plant growth, and, therefore, enhanced the grain yield.

Efficacy of Levobupivacaine Versus Levobupivacaine Plus Dexmedetomidine Infiltration for Post-Tonsillectomy Analgesia: A Randomized Controlled Trial.

Background: The study evaluated the analgesic effects of levobupivacaine infiltration in the tonsil bed, and a combination of levobupivacaine and dexmedetomidine in patients undergoing tonsillectomy. Methods: Ninety children (ages 3 to 7 years) who were scheduled for a tonsillectomy were allocated randomly into two groups. (L Group): peritonsillar infiltration with 0.25% levobupivacaine (2 ml + 0.5 ml saline 0.9% per tonsil). (LD Group): levobupivacaine 0.25% (2 ml) plus dexmedetomidine 1 µg/kg diluted in 1 ml saline 0.9% (0.5 ml in each tonsil), and administered by peritonsillar infiltration (2.5 ml per tonsil) following intubation 3-5 minutes before operation. To avoid bias, infiltrate a total volume of 2.5 ml in each tonsil. The first analgesic request time was the primary outcome, with postoperative pain score, total analgesic consumption, total oral intake, sedation, and side effects as secondary outcomes. Results: The first rescue analgesia time in the LD group was longer (644.31 ± 112.89 min) than in the L group (551.51 ± 146.16 min, P-value <0.001). The number of patients who required >1 analgesic dose in the L group (n = 13) was higher than in the LD group (n = 5). The LD group consumes a lower total dose of IV paracetamol in the first 24 hours postoperatively (321.89 ± 93.25 mg) than the L group (394.89 ± 183.71 mg, P < 0.00-value < 0.050). On the first day postoperatively, patients in the LD group had a higher total oral intake (P < 0.001). Except for a slight increase in laryngospasm in the L group, there were no side effects. Conclusions: The Children's peritonsillar infiltration of levobupivacaine and dexmedetomidine improved postoperative pain after adenotonsillectomy. The topically applied levobupivacaine and dexmedetomidine were concomitant with no systemic effects, greater total oral intake on the first day postoperative, and higher family satisfaction.

Plant hormones and neurotransmitter interactions mediate antioxidant defenses under induced oxidative stress in plants.

Due to global climate change, abiotic stresses are affecting plant growth, productivity, and the quality of cultivated crops. Stressful conditions disrupt physiological activities and suppress defensive mechanisms, resulting in stress-sensitive plants. Consequently, plants implement various endogenous strategies, including plant hormone biosynthesis (e.g., abscisic acid, jasmonic acid, salicylic acid, brassinosteroids, indole-3-acetic acid, cytokinins, ethylene, gibberellic acid, and strigolactones) to withstand stress conditions. Combined or single abiotic stress disrupts the normal transportation of solutes, causes electron leakage, and triggers reactive oxygen species (ROS) production, creating oxidative stress in plants. Several enzymatic and non-enzymatic defense systems marshal a plant's antioxidant defenses. While stress responses and the protective role of the antioxidant defense system have been well-documented in recent investigations, the interrelationships among plant hormones, plant neurotransmitters (NTs, such as serotonin, melatonin, dopamine, acetylcholine, and γ-aminobutyric acid), and antioxidant defenses are not well explained. Thus, this review discusses recent advances in plant hormones, transgenic and metabolic developments, and the potential interaction of plant hormones with NTs in plant stress response and tolerance mechanisms. Furthermore, we discuss current challenges and future directions (transgenic breeding and genome editing) for metabolic improvement in plants using modern molecular tools. The interaction of plant hormones and NTs involved in regulating antioxidant defense systems, molecular hormone networks, and abiotic-induced oxidative stress tolerance in plants are also discussed.

Does Radial Artery Cannulation Affect the Perfusion of the Dominant Hand in Adult Patients with Normal Modified Allen's Test Undergoing Cardiac Surgeries? Data Derived from the Peripheral Perfusion Index.

OBJECTIVES: This study aimed to evaluate the effect of radial artery cannulation on hand perfusion in patients with normal modified Allen's test undergoing cardiac surgeries using cardiopulmonary bypass (CPB). DESIGN: Prospective follow-up study. SETTING: Single institution, Assiut University Cardiothoracic Hospital. PARTICIPANTS: Forty-nine patients who underwent cardiac surgeries using cardiopulmonary bypass were enrolled. INTERVENTIONS: Cannulation of radial artery in the dominant hand using a 20-gauge catheter. MEASUREMENTS AND MAIN RESULTS: The primary outcomes were the mean peripheral perfusion index (PPI) >60 seconds (mean PPI60) and the thumb temperature, which were measured at different times before and during the surgery. There was a statistically significant difference in the mean PPI60 between both hands (p = 0.033). Before skin incision, the mean PPI60 was significantly higher in the noncannulated hand (p < 0.001). Also, there was a statistically significant difference in the thumb temperature between both hands (p = 0.013). At low core body temperature, the thumb temperature was significantly lower in the noncannulated hand (p = 0.017). CONCLUSIONS: In adult patients undergoing cardiac surgeries using CPB, even with normal modified Allen's test, radial artery cannulation may affect the perfusion of the dominant hand, especially at low arterial blood pressure or low core body temperature. Since the PPI is one of the noninvasive methods used for intraoperative assessment of the peripheral perfusion, the authors recommend the use of the noncannulated hand for this purpose to not misguide this assessment.

Collaborative Impact of Compost and Beneficial Rhizobacteria on Soil Properties, Physiological Attributes, and Productivity of Wheat Subjected to Deficit Irrigation in Salt Affected Soil.

Plant growth and crop productivity under unfavorable environmental challenges require a unique strategy to scavenge the severely negative impacts of these challenges such as soil salinity and water stress. Compost and plant growth-promoting rhizobacteria (PGPR) have many beneficial impacts, particularly in plants exposed to different types of stress. Therefore, a field experiment during two successive seasons was conducted to investigate the impact of compost and PGPR either separately or in a combination on exchangeable sodium percentage (ESP), soil enzymes (urease and dehydrogenase), wheat physiology, antioxidant defense system, growth, and productivity under deficient irrigation and soil salinity conditions. Our findings showed that exposure of wheat plants to deficit irrigation in salt-affected soil inhibited wheat growth and development, and eventually reduced crop productivity. However, these injurious impacts were diminished after soil amendment using the combined application of compost and PGPR. This combined application enhanced soil urease and dehydrogenase, ion selectivity, chlorophylls, carotenoids, stomatal conductance, and the relative water content (RWC) whilst reducing ESP, proline content, which eventually increased the yield-related traits of wheat plants under deficient irrigation conditions. Moreover, the coupled application of compost and PGPR reduced the uptake of Na and resulted in an increment in superoxide dismutase (SOD), catalase (CAT), and peroxidase (POX) activities that lessened oxidative damage and improved the nutrient uptake (N, P, and K) of deficiently irrigated wheat plants under soil salinity. It was concluded that to protect wheat plants from environmental stressors, such as water stress and soil salinity, co-application of compost with PGPR was found to be effective.

Soil Amendment Using Biochar and Application of K-Humate Enhance the Growth, Productivity, and Nutritional Value of Onion (Allium cepa L.) under Deficit Irrigation Conditions.

Water scarcity, due to physical shortage or inadequate access, is a major global challenge that severely affects agricultural productivity and sustainability. Deficit irrigation is a promising strategy to overcome water scarcity, particularly in arid and semiarid regions with limited freshwater resources. However, precise application of deficit irrigation requires a better understanding of the plant response to water/drought stress. In the current study, we investigated the potential impacts of biochar-based soil amendment and foliar potassium-humate application (separately or their combination) on the growth, productivity, and nutritional value of onion (Allium cepa L.) under deficient irrigation conditions in two separate field trials during the 2018/2019 and 2019/2020 seasons. Our findings showed that deficit irrigation negatively affected onion resilience to drought stress. However, these harmful effects were diminished after soil amendment using biochar, K-humate foliar application, or their combination. Briefly, integrated biochar and K-humate application increased onion growth, boosted the content of the photosynthetic pigments, enhanced the water relations, and increased the yield traits of deficient irrigation onion plants. Moreover, it improved the biochemical response, enhanced the activities of antioxidant enzymes, and enriched the nutrient value of deficiently irrigated onion plants. Collectively, these findings highlight the potential utilization of biochar and K-humate as sustainable eco-friendly strategies to improve onion resilience to deficit irrigation.

Interactive Impacts of Beneficial Microbes and Si-Zn Nanocomposite on Growth and Productivity of Soybean Subjected to Water Deficit under Salt-Affected Soil Conditions.

Water stress or soil salinity is considered the major environmental factor affecting plant growth. When both challenges are present, the soil becomes infertile, limiting plant productivity. In this work a field experiment was conducted during the summer 2019 and 2020 seasons to evaluate whether plant growth-promoting microbes (PGPMs) and nanoparticles (Si-ZnNPs) have the potential to maintain soybean growth, productivity, and seed quality under different watering intervals (every 11 (IW0), 15 (IW1) and 19 (IW2) days) in salt-affected soil. The most extended watering intervals (IW1 and IW2) caused significant increases in Na+ content, and oxidative damage indicators (malondialdehyde (MDA) and electrolyte leakage (EL%)), which led to significant reductions in soybean relative water content (RWC), stomatal conductance, leaf K+, photosynthetic pigments, soluble protein. Subsequently reduced the vegetative growth (root length, nodules dry weight, and total leaves area) and seeds yield. However, there was an enhancement in the antioxidants defense system (enzymatic and non-enzymatic antioxidant). The individual application of PGPMs or Si-ZnNPs significantly improved leaf K+ content, photosynthetic pigments, RWC, stomatal conductance, total soluble sugars (TSS), CAT, POD, SOD, number of pods plant-1, and seed yield through decreasing the leaf Na+ content, MDA, and EL%. The combined application of PGPMs and Si-ZnNPs minimized the adverse impact of water stress and soil salinity by maximizing the root length, heavier nodules dry weight, leaves area, TSS and the activity of antioxidant enzymes, which resulted in higher soybean growth and productivity, which suggests their use under harsh growing conditions.

Foliar-Applied Potassium Silicate Coupled with Plant Growth-Promoting Rhizobacteria Improves Growth, Physiology, Nutrient Uptake and Productivity of Faba Bean (Vicia faba L.) Irrigated with Saline Water in Salt-Affected Soil.

The continuity of traditional planting systems in the last few decades has encountered its most significant challenge in the harsh changes in the global climate, leading to frustration in the plant growth and productivity, especially in the arid and semi-arid regions cultivated with moderate or sensitive crops to abiotic stresses. Faba bean, like most legume crops, is considered a moderately sensitive crop to saline soil and/or saline water. In this connection, a field experiment was conducted during the successive winter seasons 2018/2019 and 2019/2020 in a salt-affected soil to explore the combined effects of plant growth-promoting rhizobacteria (PGPR) and potassium (K) silicate on maintaining the soil quality, performance, and productivity of faba bean plants irrigated with either fresh water or saline water. Our findings indicated that the coupled use of PGPR and K silicate under the saline water irrigation treatment had the capability to reduce the levels of exchangeable sodium percentage (ESP) in the soil and to promote the activity of some soil enzymes (urease and dehydrogenase), which recorded nearly non-significant differences compared with fresh water (control) treatment, leading to reinstating the soil quality. Consequently, under salinity stress, the combined application motivated the faba bean vegetative growth, e.g., root length and nodulation, which reinstated the K+/Na+ ions homeostasis, leading to the lessening or equalizing of the activity level of enzymatic antioxidants (CAT, POD, and SOD) compared with the controls of both saline water and fresh water treatments, respectively. Although the irrigation with saline water significantly increased the osmolytes concentration (free amino acids and proline) in faba bean plants compared with fresh water treatment, application of PGPR or K-silicate notably reduced the osmolyte levels below the control treatment, either under stress or non-stress conditions. On the contrary, the concentrations of soluble assimilates (total soluble proteins and total soluble sugars) recorded pronounced increases under tested treatments, which enriched the plant growth, the nutrients (N, P, and K) uptake and translocation to the sink organs, which lastly improved the yield attributes (number of pods plant-1, number of seeds pod-1, 100-seed weight). It was concluded that the combined application of PGPR and K-silicate is considered a profitable strategy that is able to alleviate the harmful impact of salt stress alongside increasing plant growth and productivity.

Intensive care outcome of left main stem disease surgery: A single center three years' experience.

BACKGROUND: Left main coronary artery (LMCA) supplies more than 80% of the left ventricle, and significant disease of this artery carries a high mortality unless intervened surgically. However, the influence of coronary artery bypass grafting (CABG) surgery on patients with LMCA disease on morbidity intensive care unit (ICU) outcomes needs to be explored. However, the impact of CABG surgery on the morbidity of the ICU population with LMCA disease is worth exploring. AIM: To determine whether LMCA disease is a definitive risk factor of prolonged ICU stay as a primary outcome and early morbidity within the ICU stay as secondary outcome. METHODS: Retrospective descriptive study with purposive sampling analyzing 399 patients who underwent isolated urgent or elective CABG. Patients were divided into 2 groups; those with LMCA disease as group 1 (75 patients) and those without LMCA disease as group 2 (324 patients). We correlated ICU outcome parameters including ICU length of stay, post-operative atrial fibrillation, acute kidney injury, re-exploration, perioperative myocardial infarction, post-operative bleeding in both groups. RESULTS: Patients with LMCA disease had a significantly higher prevalence of diabetes (43.3% vs 29%, P = 0.001). However, we did not find a statistically significant difference with regards to ICU stay, or other morbidity and mortality outcome measures. CONCLUSION: Post-operative performance of Patients with LMCA disease who underwent CABG were comparable to those without LMCA involvement. Diabetes was more prevalent in patients with LMCA disease. These findings may help in guiding decision making for future practice and stratifying the patients' care.

Differences in Physiological and Biochemical Attributes of Wheat in Response to Single and Combined Salicylic Acid and Biochar Subjected to Limited Water Irrigation in Saline Sodic Soil.

Given the expectancy of the water supply becoming scarce in the future and more expensive, water conservation during wheat production processes has become very crucial especially in saline sodic soil. Biochar and salicylic acid (SA) were used to assess the potential to alleviate the influences of depletion of available soil moisture (DAM) on physicochemical, physiological, biochemical attributes, as well as wheat production absorption (Triticum aestivum L. cv. Misr 1) and macro-elements. Two seasons (2018/2019 and 2019/2020) of field trials were investigated using twelve combinations of three water treatments (50%, 70%, and 90% DAM) and foliar- and soil-applied treatments (control, biochar, salicylic acid, and biochar + SA). Biochar treated plots amplified soil physicochemical attributes, leading to improved physiological traits and antioxidant enzymes, as well as yield related traits under water limitation conditions in both years. Similarly, synergistic use of biochar and salicylic acid greatly augmented the designed characteristics such as chlorophyll a, b, K+ content, relative water content (RWC), stomatal conductance, photosynthetic rate, and intrinsic water use efficiency, whilst exhibited inhibitory effects on proline content, electrolyte leakage, Na+ content SOD, POX, CAT, and MDA, consequently increased 1000-grain weight, number of grains spike-1, grain yield, as well nutrient uptake (N, P, K) under water limitation condition in both years, followed by treatment of sole biochar or SA compared to unamended plots treatment (control). Wheat productivity achieved further increasing at 70% DAM alongside synergistic use of biochar and SA which was on par with 50% DAM under unamended plots (control). It is concluded from the findings that coupled application of biochar alongside salicylic acid accomplished an efficient approach to mitigate the injurious influences of water limitation, along with further improvement of the soil, physiology, biochemical attributes, and wheat yield, as well nutrient uptake, under saline sodic soil.

Imaging intracellular motion with dynamic micro-optical coherence tomography.

This paper describes a new technology that uses 1-µm-resolution optical coherence tomography (µOCT) to obtain cross-sectional images of intracellular dynamics with dramatically enhanced image contrast. This so-called dynamic µOCT (d-µOCT) is accomplished by acquiring a time series of µOCT images and conducting power frequency analysis of the temporal fluctuations that arise from intracellular motion on a pixel-per-pixel basis. Here, we demonstrate d-µOCT imaging of freshly excised human esophageal and cervical biopsy samples. Depth-resolved d-µOCT images of intact tissue show that intracellular dynamics provides a new contrast mechanism for µOCT that highlights subcellular morphology and activity in epithelial surface maturation patterns.

Plaque burden can be assessed using intravascular optical coherence tomography and a dedicated automated processing algorithm: a comparison study with intravascular ultrasound.

AIMS: Plaque burden (PB) measurement using intravascular optical coherence tomography (IVOCT) is currently thought to be inferior to intravascular ultrasound (IVUS). We developed an automated IVOCT image processing algorithm to enhance the external elastic lamina (EEL) contour. Thus, we investigated the accuracies of standard IVOCT and an IVOCT enhancement algorithm for measuring PB using IVUS as the reference standard. METHODS AND RESULTS: The EEL-enhancement algorithm combined adaptive attenuation compensation, exponentiation, angular registration, and image averaging using three sequential frames. In two different laboratories with intravascular imaging expertise, PB was quantified on 200 randomized, matched IVOCT and IVUS images by four independent observers. Fibroatheroma, fibrocalcific plaque, fibrous plaque, pathological intimal thickening (PIT), and mixed plaque were included in each set. Pearson's correlation coefficients between IVUS and standard IVOCT measurements of PB were 0.61, 0.67, 0.76, 0.78, and 0.87 for fibroatheromas, mixed plaques, fibrocalcific plaques, fibrous plaques, and PIT plaques, respectively. Pearson's correlation coefficients increased to 0.81, 0.83, 0.83, 0.84, and 0.90 when using the EEL-enhanced images (P = 0.003, P = 0.004, P = 0.08, P = 0.12, and P = 0.23, respectively). EEL-enhanced IVOCT analysis was associated with a lower EEL-area measurement absolute error for fibroatheromas, mixed plaques, and all pooled plaques (P = 0.006, P = 0.02, and P < 0.001, respectively). Compared with standard IVOCT, the EEL-enhanced IVOCT images had a higher sensitivity (79% vs. 28%, P < 0.001) and specificity (98% vs. 85%, P = 0.03) for plaques with an IVUS PB ≥70%. CONCLUSION: EEL-enhanced IVOCT can be used to reliably measure PB in all types of coronary atherosclerotic lesions, including fibroatheromas and mixed plaques.

Delta-Aminolevulinic Acid-Mediated Photodiagnoses in Surgical Oncology: A Historical Review of Clinical Trials.

Fluorescence imaging is an emerging clinical technique for real-time intraoperative visualization of tumors and their boundaries. Though multiple fluorescent contrast agents are available in the basic sciences, few fluorescence agents are available for clinical use. Of the clinical fluorophores, delta aminolevulinic acid (5ALA) is unique for generating visible wavelength tumor-specific fluorescence. In 2017, 5ALA was FDA-approved for glioma surgery in the United States. Additionally, clinical studies suggest this agent may have utility in surgical subspecialties outside of neurosurgery. Data from dermatology, OB/GYN, urology, cardiothoracic surgery, and gastrointestinal surgery show 5ALA is helpful for intraoperative visualization of malignant tissues in multiple organ systems. This review summarizes data from English-language 5ALA clinical trials across surgical subspecialties. Imaging systems, routes of administration, dosing, efficacy, and related side effects are reviewed. We found that modified surgical microscopes and endoscopes are the preferred imaging devices. Systemic dosing across surgical specialties range between 5 and 30 mg/kg bodyweight. Multiple studies discussed potential for skin irritation with sun exposure, however this side effect is infrequently reported. Overall, 5ALA has shown high sensitivity for labeling malignant tissues and providing a means to visualize malignant tissue not apparent with standard operative light sources.

Could Short-Term Perioperative High-Dose Atorvastatin Offer Antiarrhythmic and Cardio-Protective Effects in Rheumatic Valve Replacement Surgery?

OBJECTIVES: To evaluate the role of prophylactic high-dose atorvastatin for prevention of postoperative atrial fibrillation (POAF), inflammatory response attenuation, and myocardial protection after valve replacement cardiac surgery. DESIGN: Randomized controlled trial. SETTING: Assiut University Hospitals. PARTICIPANTS: Sixty-four adult patients undergoing cardiac valve replacement surgery. INTERVENTIONS: The participants were equally divided into 2 groups. Group S received 80 mg of atorvastatin (oral tablets), 12 and 2 hours preoperatively, and on the 2nd, 3rd, 4th, and 5th postoperative days. Control group C received placebo at the same time periods. MEASUREMENTS: The incidence of POAF, postoperative white blood cell count, serum C-reactive protein, interleukin 6, and troponin I. MAIN RESULTS: Group S patients showed a lower incidence of POAF compared with the placebo group (p = 0.031). The white blood cell count showed significant reductions in group S compared with group C on the second, third, fourth, and fifth postoperative days. The C-reactive protein level showed significant reductions on the third, fourth, and fifth postoperative days in group S compared with group C (p = 0.001, 0.001, and 0.001, respectively). The serum level of interleukin 6 showed a significant reduction on the fifth postoperative day in group S compared with group C (p = 0.001). There was no significant difference between the 2 groups regarding the troponin I level and inotropic score. CONCLUSION: Prophylactic use of high dose atorvastatin can decrease the incidence of POAF and attenuate the inflammatory process in adult patients undergoing isolated rheumatic cardiac valve replacement surgery.