CLINICIANS' PERCEPTIONS OF MANUAL HANDLING POLICIES IN STROKE REHABILITATION: A QUALITATIVE FOCUS GROUP STUDY.

Objectives: The professional literature guides manual handling in numerous health care settings. The effects of these guidelines on stroke rehabilitation and the clinical communication of health care professionals are unknown. This paper aims to investigate the perspectives of nurses and physiotherapists on handling guidelines in their professions to identify conflicts in opinions to provide optimum care to people with stroke. Design: A qualitative focus group study. Methods: Three focus groups were conducted. The participants were physiotherapists or nurses with 1 year of stroke care experience. The data were thematically analysed. Results: Nineteen participants (12 physiotherapists and 7 nurses) were interviewed. The data analysis revealed 3 themes. First, "The application of handling in stroke rehabilitation" includes clinical reasoning and real-world handling practices. The second theme, "Physical Effects on Therapists," examines the long-term effects of manual handling on therapists, including work-related musculoskeletal disorders. The final theme, "Conflicts among health care professionals," investigates stroke rehabilitation equipment conflicts between nurses and physiotherapists. Conclusion: The study concludes that stroke transfer guidelines in the specialised literature may impact health care professionals' perspectives. Conflicts among health care professionals can impair teamwork. Thus, health care professionals should work together as stroke rehabilitation teams to develop unified transfer guidelines that aid rehabilitation and avoid work-related musculoskeletal disorders.

Effects of Neuromuscular Electrical Stimulation on Spasticity and Walking Performance among Individuals with Chronic Stroke: A Pilot Randomized Clinical Trial.

BACKGROUND: Stroke and its associated complications are a major cause of long-term disability worldwide, with spasticity being a common and severe issue. Physical therapy, involving stretching exercises and electrical stimulation, is crucial for managing spasticity. Therefore, this study aimed to evaluate the effects of neuromuscular electrical stimulation (NMES) combined with a conventional rehabilitation program (CRP) on plantarflexor muscle spasticity and walking performance among individuals with chronic stroke. METHODS: A pilot randomized clinical trial (RCT) with two groups (active NMES and placebo) was conducted at the physical therapy departments of King Fahad Specialist Hospital, Buraydah, and Sultan Bin Abdulaziz Humanitarian City, Riyadh, Saudi Arabia (November 2020). The assessor and participants were blinded for the group assignment. The active NMES group received exercise and stimulation at the dorsiflexor muscles on the paretic leg for 30 min for 12 sessions. The placebo group received exercise and sham stimulation at the same position and duration as the active group. Of interest were the outcomes for plantarflexor muscle spasticity measured by the modified Ashworth scale (MAS), gait speed measured by 10 m walk test (10-MWT), and functional mobility measured by functional ambulatory category (FAC). RESULTS: Nineteen participants were randomized into active NMES (n = 10) and sham NMES (n = 9) groups, with no significant baseline differences. Within the active NMES group, significant improvements were observed in MAS (p = 0.008), 10-MWT (p = 0.028), and FAC (p = 0.046), while only 10-MWT time improved significantly in the sham NMES group (p = 0.011). Between-group analysis showed that only MAS was significantly lower in the active NMES group (p = 0.006). Percent change analysis indicated a significantly higher increase in percent change for MAS in the active NMES group compared to the sham NMES group (p = 0.035), with no significant differences in other outcome measures. CONCLUSIONS: This study showed that NMES in the active group led to significant improvements in spasticity, walking performance, and functional ambulation. Further research is needed to determine the ideal parameters, protocols, and patient selection criteria for NMES interventions in stroke rehabilitation.

Prediction of birth weight using body measurements of local caprine population kids raised in a low-input breeding mode under arid environment.

The aim of this study is to establish linear measurements of local goat kids at birth and their factors of variation, as well as their possible correlations with birth weight. Additionally, the study analyses statistical models and barymetric functions to predict birth weight of kids based on their morphometric data. The database includes data on 128 goat kids born to 89 goats and 9 bucks in the experimental goat herd at the El GORDHAB station of IRA. Average BW, withers height (L1), heart girth (L2), rump height (L3), and body length (L4) of all kids were 2.45kg, 32.66cm,30.56cm, 33.41cm, and 31.21cm respectively. Results show that in general, local goat kids are small in size and weight at birth, which varies depending on sex, dam age, and type of birth. Highest and positive correlation coefficient value between birth weight and heart girth were observed (r = 0.95). The coefficient of determination (R2) for heart girth (0.78) was higher than other body measurements in single trait evaluation indicating it as the best trait for the predication of birth weight. The most appropriate combination of body measurements (R2 = 0.82) was observed between height at withers and heart girth for predication of birth weight estimation. Developing a system for recording birth weight based on easily obtainable body measurements could be a useful approach for rural areas. Result join the study objective by conceiving feasible genetic improvement plans for agropastoral herds by establishing individual phenotypes estimation even when the classical animal management does not already allowed.

Translation and cross-cultural adaptation of the functional mobility scale in children with cerebral palsy into Arabic.

Introduction: Cerebral palsy (CP) is a lifelong disorder of posture and movement which often leads to a myriad of limitations in functional mobility. The Functional Mobility Scale (FMS) is a parent-report measure of functional mobility for children with CP at three different distances (5 m, 50 m, and 500 m). This is a cross-sectional study which sought to translate and culturally adapt the FMS into Arabic and to validate the translated version. Functional mobility for children and adolescents with CP in Saudi Arabia was examined. Methods: The translation methodology complied with the World Health Organization Disability Assessment Schedule 2.0 translation package. A total of 154 children with CP were recruited (mean age 8.16 ± 3.32 years). Parents were interviewed to rate the usual walking ability of their children on the Arabic FMS. The re-test assessment was done with 34 families. The mean time interval between the first and second sessions was 14.3 days (SD = 8.5), with a range of 6-37 days. Results: Concurrent validity was explored using Spearman's rank correlation coefficient between scores of the Arabic FMS with their corresponding score on the Gross Motor Function Classification System (GMFCS). Spearman's r values ranged between (-0.895 and -0.779), indicating strong to very strong correlations. The Test-retest reliability was examined using Cohen's weighted kappa, which showed almost perfect agreements. There was greater limitation for functional mobility at longer distances as 55.2% of children could not complete 500 meters (FMS score N). Overall, there was limited use of wheelchairs for all distances (ranging from 9.1% to 14.3%). Levels IV and V on the GMFCS had less variation in FMS scores and most of the children in these levels either did not complete the distances (no functional mobility at all distances) or used a wheelchair for mobility. Discussion: The Arabic FMS was shown to be a reliable and valid measure of functional mobility for children with CP in their environment based on the parental reports. Functional mobility varied at different distances and within each GMFCS level. The use of both the GMFCS and FMS when assessing children with CP is recommended.

A Comparison of Three Common Rehabilitation Interventions Used to Improve Cardiovascular Fitness after Stroke: An Overview of the Literature.

Background: One of the most frequent consequences of stroke is a reduction in heart function. After a stroke, one of the main aims of physiotherapy practice is to improve cardiovascular fitness (CVF). This paper is aimed at identifying the best effective intervention of improving the cardiovascular fitness (CVF) after stroke while focusing on body weight-supported treadmill training (BWSTT), over gait training (OGT), and therapeutic exercise. Methods: Different electronic databases were searched until July 2022. Controlled randomized trials examining the effects of BWSTT, OGT, and therapeutic exercise to improve CVF on an ambulatory person with stroke, written in English and reporting cardiovascular fitness or at least one of its indicators, such as peak oxygen consumption (VO2), gait speed, gait energy expenditure, and functional independence measure for locomotion (FIM-L), were included. The quality of the methodology was evaluated using the Physiotherapy Evidence Database (PEDro) scale. Results: The research yielded 3854 relevant studies, of which 22 met the eligibility criteria. The primary indicators of the CVF, VO2 and energy expenditure, were used to examine the CVF in only three studies, while the rest used other indicators of the CVF. There was a lack of sufficient evidence to establish the superiority of one intervention over another. However, it appears that utilizing BWSTT to improve the CVF after stroke is effective. Conclusion: Physiotherapy has the potential to enhance the CVF of stroke patients. However, effective interventions and long-term effects remain debatable.

A systemic review of rubidium-82 PET contrasted with 99mTc-MIBI SPECT for imaging coronary artery disease.

BACKGROUND: 99mTc-sestamibi single photon emission tomography (SPECT) method is widely used for imaging coronary artery disease (CAD). 82-Rubidium-PET is an alternative method that can be used to perform the same purpose. PURPOSE/AIM: This study aims to determine whether 82-Rubidium-PET can offer extra value over 99mTc-sestamibi SPECT in imaging CAD. METHODS: To achieve the study aim, a systematic review of the literature for the 2 tracers were conducted. The aim of the systemic review was to find every related previous study that corresponded to well-defined scientific criteria. The analysis of the results was restricted to peer-reviewed papers in order to avoid any selective outcome reports. Besides, extra analysis was carried out to curb or avoid any ascertainment bias. The qualified studies selected for this research were then assessed for the risk of bias. Furthermore, the details of the methods were rechecked to ensure that they were comparable, before synthesizing the results. RESULTS: Eighteen original studies were selected and included in the final analysis out of 803 articles identified at the initial research. Overall, the mean value of sensitivity and specificity for diagnosis of CAD was 84.3% and 75.4%, respectively for technetium 99m sestamibi (99mTc-MIBI). On the other hand, for 82-Rubidium-PET, the mean value of sensitivity and specificity for diagnosis of CAD was 81% and 81%, respectively. The accuracy of diagnostics of these imaging modalities was dependent on the radiotracers and stress agent used in these studies, with 99mTc-MIBI achieving the highest diagnostic value. CONCLUSION: This study concludes that 99mTc-MIBI-SPECT has higher diagnostic value for diagnosing CAD compared to 82-Rubidium-PET. This indicates that 99mTc-MIBI-SPECT is a more valuable technique for predicting CAD. Besides, for the stress agents used to stimulate the heart and increase workload, this research/study recommends the use of adenosine for the SPECT and the use of dipyridamole for positron emission tomography. However, it suggests the need for more systemic and theoretical studies to assess the real value of 82-Rubidium-PET and the value of stress agents.

Effectiveness of Kinesio taping and conventional physical therapy in the management of knee osteoarthritis: a randomized clinical trial.

BACKGROUND: Knee osteoarthritis (OA) is the most common kind of arthritis that occurs due to degeneration of the joint articular cartilage, producing pain, stiffness, and impaired movement. The objective of the study was to evaluate the short-term effectiveness of Kinesio taping (KT) plus conventional physical therapy (CPT) and CPT alone in subjects with knee OA. MATERIALS AND METHODS: Forty male subjects were divided into two groups at random using a parallel assignment, double-blinded study design, viz., KT with CPT (transcutaneous electrical nerve stimulation and exercise therapy), and CPT alone for the period of 6 weeks of treatment. At baseline, third, and sixth weeks, the following outcome measures were taken, such as pain intensity (NPRS), knee range of motion (goniometry), Western Ontario and McMaster Osteoarthritis Index (WOMAC), and the Time Up and Go (TUG) test. STATISTICAL ANALYSIS: To reveal the patient's demographic profile concerning the outcome parameters, a descriptive statistic was applied. Furthermore, two-way mixed ANOVA and Tukey HSD post hoc tests were used to analyze within and between-group comparisons in SPSS 20.0. RESULTS: In both groups, pain and knee flexion were significantly improved during the 6-week period of interventions (p < 0.05). WOMAC and TUG test scores improved only in the KT plus CPT group. CONCLUSION: KT combined with CPT was found to be more effective than CPT alone in the third and sixth weeks of the treatment. In knee OA, this combination of treatments was found to reduce pain, enhance range of motion, and improve physical functioning.

How Can We Use the Promoting Action on Research in Health Services (PARIHS) Framework to Move from What We Know to What We Should Do for the Rehabilitation of a Painful Hemiplegic Shoulder (PHS)?

Introduction: Several theoretical frameworks currently promote the evidence-based clinical practice. One of these is Promoting Action on Research Implementation in Health Services (PARIHS) framework. However, The PARIHS framework emphasizes the use and implementation of pre-existing knowledge. This study aims to integrate of PARIHS conceptual framework to categorize evidence, context, and facilitation elements for the successful implementation of evidence-based painful hemiplegic shoulder (PHS) rehabilitation. Methods: Stroke therapists (n=21) were interviewed to elicit important PHS rehabilitation concepts. Following that, a consensus approach was undertaken to tailor PHS recommendations to the local context. All consensus recommendations have been included in the PARIHS framework. The consensus level was set at 75% or more. Results: The interviews revealed four broad themes of PHS rehabilitation, each further subdivided. Based on the themes and subthemes, 74 recommendations were deemed pertinent to PSH rehabilitation from a reliable source. Out of 74 recommendations, 63 recommendations reach the consensus level for PHS practice. Secondary prevention of PHS (n=10), assessment (n=14), PHS care management (n=19), and service delivery (n=20). A consensus was not reached for the remaining 11 recommendations. Each recommended guideline was integrated into the appropriate element of the PARIHS framework as follows: evidence (28), context (18), and facilitation (17). Discussion: The findings showed how the PARIHS framework has been configured to empirically support the implementation of robust stroke rehabilitation recommendations in the field of rehabilitation. Using an implementation intervention theory (for example, PARIHS) as a guide, provide a thorough picture of the many levels that may affect implementation requirements. Conclusion: Many prior studies on evidence-based stroke rehabilitation in physical therapy practice lacked knowledge of translation theories. This result illustrates how to use an intervention implementation (such as PARIHS) to enhance evidence-based practice implementation in routine stroke rehabilitation. Further study is required for the clinical use of the PARIHS framework.

Electrical performance of efficient quad-crescent-shaped Si nanowire solar cell.

The electrical characteristics of quad-crescent-shaped silicon nanowire (NW) solar cells (SCs) are numerically analyzed and as a result their performance optimized. The structure discussed consists of four crescents, forming a cavity that permits multiple light scattering with high trapping between the NWs. Additionally, new modes strongly coupled to the incident light are generated along the NWs. As a result, the optical absorption has been increased over a large portion of light wavelengths and hence the power conversion efficiency (PCE) has been improved. The electron-hole (e-h) generation rate in the design reported has been calculated using the 3D finite difference time domain method. Further, the electrical performance of the SC reported has been investigated through the finite element method, using the Lumerical charge software package. In this investigation, the axial and core-shell junctions were analyzed looking at the reported crescent and, as well, conventional NW designs. Additionally, the doping concentration and NW-junction position were studied in this design proposed, as well as the carrier-recombination-and-lifetime effects. This study has revealed that the high back surface field layer used improves the conversion efficiency by [Formula: see text] 80%. Moreover, conserving the NW radial shell as a low thickness layer can efficiently reduce the NW sidewall recombination effect. The PCE and short circuit current were determined to be equal to 18.5% and 33.8 mA[Formula: see text] for the axial junction proposed. However, the core-shell junction shows figures of 19% and 34.9 mA[Formula: see text]. The suggested crescent design offers an enhancement of 23% compared to the conventional NW, for both junctions. For a practical surface recombination velocity of [Formula: see text] cm/s, the PCE of the proposed design, in the axial junction, has been reduced to 16.6%, with a reduction of 11%. However, the core-shell junction achieves PCE of 18.7%, with a slight reduction of 1.6%. Therefore, the optoelectronic performance of the core-shell junction was marginally affected by the NW surface recombination, compared to the axial junction.

Central lymph node dissection and permanent hypoparathyroidism after total thyroidectomy for papillary thyroid cancer: population-based study.

BACKGROUND: Papillary thyroid cancer is treated with total/near-total thyroidectomy (TT) with or without central lymph node dissection (CLND), depending on risk factors and tumour size. Balancing the risk of disease recurrence and surgical morbidity remains a challenge. A population-based nationwide study was undertaken to evaluate the risk of permanent hypoparathyroidism associated with CLND. METHOD: Data on patients with stage pT1-3 papillary thyroid cancer, who underwent TT with or without CLND between 1 July 2004 and 30 June 2014 were retrieved from the Scandinavian Quality Register for Thyroid, Parathyroid and Adrenal Surgery. Drug use was ascertained by cross-linking with the Swedish Prescribed Drug Register. Permanent hypoparathyroidism was defined as treatment with active D vitamin or oral calcium drugs for more than 6 months after surgery. Data were analysed separately for all patients and those who underwent TT + CLND. Univariable and multivariable logistic regression analyses were done, yielding odds ratios (ORs) with 95 per cent confidence intervals. RESULTS: A total of 722 patients were included in the study. Permanent hypoparathyroidism was more common in the TT + CLND group than the TT group: 30 of 265 patients (6·6 per cent) versus six of 457 (2·3 per cent) (P = 0·011). In multivariable logistic regression analysis, CLND was a risk factor for permanent hypoparathyroidism (OR 3·74, 95 per cent c.i. 1·46 to 9·59, based on use of combined therapy 6 months after surgery). In patients who had TT + CLND, node negativity was associated with a risk of permanent hypoparathyroidism (OR 3·08, 1·31 to 7·25). CONCLUSION: CLND is an independent risk factor for permanent hypoparathyroidism. Node negativity is associated with a higher risk of permanent hypoparathyroidism.

Analysis of highly efficient quad-crescent-shaped Si nanowires solar cell.

Nanostructured semiconductor nanowires (NWs) present a smart solution for broadband absorption solar cells (SCs) with high efficiency and low-cost. In this paper, a novel design of quad crescent-shaped silicon NW SC is introduced and numerically studied. The suggested NW has quad crescent shapes which create a cavity between any adjacent NWs. Such a cavity will permit multiple light scattering with improved absorption. Additionally, new modes will be excited along the NWs, which are highly coupled with the incident light. Further, the surface reflection from the crescent NWs is decreased due to the reduced surface filling ratio. The finite difference time domain method is utilized to analyze the optical characteristics of the reported structure. The proposed NW offers short circuit current density (Jsc) of 27.8 mA/cm2 and ultimate efficiency (ηul) of 34% with an enhancement of 14% and volume reduction of 40% compared to the conventional NWs. The Jsc and ηul are improved to 35.8 mA/cm2 and 43.7% by adding a Si substrate and back reflector to the suggested crescent NWs.

A scoping review of the nature of physiotherapists' role to avoid fall in people with Parkinsonism.

BACKGROUND: Parkinson's disease (PD) is considered a neurological disease with a high prevalence rate among population. One of its main problems is recurrent fall which has numerous contributing factors such as history of fall, fear of falling, gait deficits, impaired balance, poor functional mobility, and muscle weakness. OBJECTIVE: To review and explore the focus/nature of interventions which target the role of physiotherapy preventing fall in patients with PD. METHOD: A scoping review was led dependent on Arksey and O'Malley as discussed by Wood et al. (2002). This paper based on this structure to perceive intervention studies have been embraced in physiotherapy to prevent fall after Parkinson's disease. The search included various databases. The referencing arrangements of every pertinent paper were additionally filtered for more studies. FINDINGS: A total of 173 articles were included, 39 of which met the eligibility criteria. Fifteen studies reported on the direct impact of physiotherapy on fall, while the rest examined the impacts of physiotherapy on factors that are associated with fall. Different outcomes, interventions types, and duration were used in these studies. Findings showed a favorable result of physiotherapy on fall and near fall incidence, balance, gait, functional mobility, muscle strength, and fear of falling. CONCLUSION: Physiotherapy has the possibility to decrease fall incidence and fall risk in people with PD. However, the heterogeneity in the patients' selection, intervention studies, outcome measures chosen, time since the onset of disease, variation in intensity, and duration of treatment between included studies make the comparisons difficult. Consequently, more studies are needed on best intervention.

Transfer kinetics of labeled aroma compounds from liquid media into coffee beans during simulated wet processing conditions.

The transfer kinetics of three labelled compounds (butanal, 2-phenyethanol, isoamyl acetate) was studied from a liquid medium into the coffee beans during simulated wet processing using four media (M) (M1: contained dehulled beans, M2: contained demucilaginated beans, M3: contained depulped beans, M4: contained depulped beans with yeast). Trials were carried out at 25 °C, under agitation and for five time periods (0, 6, 12, 24 and 48 h), and then the labelled volatiles were analyzed by SPME-GC-MS. The three labelled molecules were transferred into the coffee beans with different mass transfer rates; reaching at 12hrs in the M4, 0.2 ± 0.03, 11.2 ± 0.66 and 1.3 ± 0.04 µg/g of coffee respectively for butanal, 2-phenyethanol and isoamyl acetate. The parchment resistance significantly affected the mass transfer of the 2-phenylethanol. Butanal and isoamyl acetate underwent metabolic reactions, which decreased their amount in the coffee beans. Furthermore, an interaction between molecules and the yeast was observed and decreased significantly the butanal's transfer.

Association between knowledge of influenza vaccine and vaccination status among general population attending primary health care centers in Al-Madinah, Saudi Arabia.

BACKGROUND: Influenza vaccination is essential for population health. However, despite its strong recommendation, studies indicated a low rate of vaccine uptake. This study aimed to explore knowledge and attitudes towards influenza vaccinations among the general population attending primary health care centers in Al-Madinah, Saudi Arabia. MATERIALS AND METHODS: This cross-sectional study was conducted among 381 participants from four health care centers in Al-Madinah city. A validated self-administered questionnaire was used. It includes questions on sociodemographic variables, knowledge, attitude, and vaccine uptake. Chi square test and simple logistic regression test were used to assess association between vaccination status and study variables. RESULTS: Mean (SD) age of participant was 37 (12.5) and age ranged from 18 to 65 years. The majority were male (64.6%). Three out of seven items were answered correctly by most of the participants. The majority were classified as not knowledgeable (53.5%). More than half have been vaccinated with influenza vaccine (58.3%). Factors associated with vaccination uptake were Age group (P < 0.05), Marital status (P < 0.05), education level (P < 0.05) and Knowledge (P < 0.05). CONCLUSION: The study showed poor knowledge and attitude toward influenza vaccination among general population but a relatively accepted rate of vaccine uptake. Vaccination uptake was associated with knowledge, marital status, education, and age. This study recommends implementation of educational programs to increase the awareness among the general population.

From theory to practice: a conceptual framework to facilitate implementation of evidence in stroke rehabilitation for local context in Saudi Arabia.

INTRODUCTION: Implementing evidence into practice is a global priority with implications for patients, researchers, practitioners and policy-makers (stakeholders). The national clinical guideline (NCG) for stroke is one of the most important sources of robust evidence. However, implementation within real practice is often slow to respond. The knowledge to action (KTA) framework is one of several frameworks to facilitate implementation and enable evidence to be put into operation. This study aims to develop a conceptual framework to understand the process of implementation of an NCG for stroke in the local context of physiotherapy practice in the Kingdom of Saudi Arabia. METHODS: A qualitative-quantitative mixed methods study was conducted. The first method (panel meetings, 10 expert physiotherapists) was to chart the main concepts/domains of physiotherapy practice in the UK NCG for stroke. Drawing on panel meeting findings, 75 recommendations were released as an online questionnaire to 35 Saudi stroke specialist physiotherapists. This was followed by a focus group (second method) to capture the process of implementation of NCG for stroke in the Kingdom of Saudi Arabia. RESULTS: Sixty-one recommendations were accepted to be applied in real practice, whereas only 14 recommendations were rejected. The paper presents the first empirically derived framework that establishes the contribution of physiotherapy to stroke rehabilitation. This framework characterizes the real-world nature of the implementation of NCGs for stroke within physiotherapy practice. This framework reaffirms the importance of supportive organizational culture, the specific need of end users, patient factors, and finally transferability of the evidence. DISCUSSION: This conceptual framework appears to provide a reasonable approach for the development of implementation strategies for physiotherapist practice in stroke rehabilitation. Furthermore, it might be the first that reflects the real value of the KTA framework and tests it empirically. CONCLUSION: The finding of this study provides a useful comprehensive framework to implement existing NCGs for stroke.

Anticryptosporidial effect of pomegranate peels water extract in experimentally infected mice with special reference to some biochemical parameters and antioxidant activity.

Cryptosporidiosis is a zoonotic disease caused by a well-known parasitic protozoan called Cryptosporidium. Infection in livestock causes important economic losses among farm animals and its control has a global concern. In this study, internal white and external red layers were separated from pomegranate peels (Punica granatum) then; they were grinded to reach Nano form. Anticryptosporidial effect of their water extracts was investigated in experimentally infected mice. Also, their antioxidant activity, biochemical and histopathological changes were studied. Briefly, hot aqueous extracts of pomegranate peels were prepared regarding its good sensory attributes at concentration of 10% W/V. Analysis of total phenolics, individual phenolics by HPLC-DAD and antioxidant activities have been done. Forty-five mice were divided into five groups each one containing nine mice. The first group was healthy mice and the 2nd one was infected orally with 104 Cryptosporidium parvum (C. parvum) oocysts/mice and not treated. The other 3 groups were infected and orally treated with Nitazoxanide (NTZ) for the 3rd group, pomegranate red peel extract for the 4th group and pomegranate white peel extract for the 5th group. Blood samples were collected after 1 and 2 weeks post treatment for protein profile, liver enzymes and antioxidant activity evaluation. After 3 weeks, all animals were sacrificed and ileal tissues were embedded in paraffin for histopathological examination. The results showed that pomegranate peel extracts were rich in phenolic compounds, had high antioxidant activity and therapeutic effect on C. parvum in experimentally infected mice. Red peel extract diminished C. parvum oocysts count significantly in experimentally infected mice than white peel and NTZ treatments. Also, the histopathological examination revealed that red peel treated mice ileal sections showed a great enhancement in the shape and structure of villi towards normal structure than other treated groups. Most of the measured biochemical parameters after 2 weeks' treatment with red pomegranate peel and NTZ were enhanced in their concentrations towards the healthy normal status. In conclusion, this study showed the effectiveness of Nano-form of pomegranate white and red peel extracts against C. parvum oocysts. Pomegranate red peel extract was found to have antioxidant activity that could significantly enhance the serum biochemical parameters and oxidative stress towards the healthy normal status. Furthermore, it is suggested that pomegranate peel should be separated and used in the daily animal diet or as a functional beavarage for human as accepted from the panelists to give protective effects against this parasite as well as to improve health benefits.

Real-time PCR HPV genotyping in fine needle aspirations of metastatic head and neck squamous cell carcinoma: Exposing the limitations of conventional p16 immunostaining.

BACKGROUND: Given the propensity for HPV-positive head and neck squamous cell carcinoma (HPV-HNSCC) to metastasize to cervical lymph nodes, fine needle aspiration (FNA) plays an important diagnostic role in their initial detection. Indeed, there is now an unwavering commitment to HPV testing of FNAs even in the absence of clear methodologic guidelines and threshold criteria. A particular difficulty pertains to the interpretation of p16 staining. DESIGN: Data was collected for 210 patients with suspected regionally metastatic HNSCC that had undergone FNA as part of standard clinical care. Initial HPV screening was performed on cell blocks with real-time PCR using primers targeting L1 of high-risk HPV types. Additional genotyping was performed on HPV-positive cases. The results were compared to p16 staining and subsequent excisions when available. RESULTS: Of the 207 samples with sufficient DNA, 175 (85%) were HPV positive. HPV-16 was the most commonly detected genotype (90%). Of the HPV-positive cases, the primary site was the oropharynx (n = 154, 88.0%), supraglottic larynx (n = 2, 1.1%), nasal cavity (n = 1, 0.6%), hypopharynx (n = 1, 0.6%) or unknown (n = 17, 9.7%). On comparison with 31 paired surgical excisions, HPV status was concordant in all cases (100% correlation). Of 142 HPV-positive cases with matching p16 stains, p16 staining was reported as positive (n = 85, 60%), focal (n = 27, 19%), negative (n = 24, 17%) or non-contributory (n = 6, 4%); and only 33% reached the standard threshold limit (i.e. 70%) for HPV positivity. CONCLUSION: For patients with metastatic HNSCC, real-time PCR of FNAs reliably reflects HPV status, and is superior to conventional p16 immunostaining.

A Nested Case-Control Study on the Risk of Surgical Site Infection After Thyroid Surgery.

INTRODUCTION: It is unclear if antibiotic prophylaxis reduces the risk of surgical site infection (SSI) in thyroid surgery. This study assessed risk factors for SSI and antibiotic prophylaxis in subgroups of patients. METHOD AND DESIGN: A nested case-control study on patients registered in the Swedish National Register for Endocrine Surgery was performed. Patients with SSI were matched 1:1 by age and gender to controls. Additional information on patients with SSI and controls was queried from attending surgeons using a questionnaire. Risk factors for SSI were evaluated by logistic regression analysis and presented as odds ratio (OR) with 95% confidence interval (CI). RESULTS: There were 9494 operations; 109 (1.2%) patients had SSI. Patients with SSI were older (median 53 vs. 49 years) than patients without SSI p = 0.01 and more often had a cancer diagnosis 23 (21.1%) versus 1137 (12.1%) p = 0.01. In the analysis of patients with SSI versus controls, patients with SSI more often had post-operative drainage 68 (62.4%) versus 46 (42.2%) p = 0.01 and lymph node surgery 40 (36.7%) versus 14 (13.0%) p < 0.01, and both were independent risk factors for SSI, drain OR 1.82 (CI 1.04-3.18) and lymph node dissection, OR 3.22 (95% CI 1.32-7.82). A higher number of 26(62%) patients with independent risk factors for SSI and diagnosed with SSI did not receive antibiotic prophylaxis. Data were missing for 8 (31%) patients. CONCLUSION: Lymph node dissection and drain are independent risk factors for SSI after thyroidectomy. Antibiotic prophylaxis might be considered in patients with these risk factors.

Orthogonal quasi-phase-matched superlattice for generation of hyperentangled photons.

A crystal superlattice structure featuring nonlinear layers with alternating orthogonal optic axes interleaved with orthogonal poling directions, is shown to generate high-quality hyperentangled photon pairs via orthogonal quasi-phase-matched spontaneous parametric downconversion. We demonstrate that orthogonal quasi-phase matching (QPM) processes in a single nonlinear domain structure correct phase and group-velocity mismatches concurrently. Compared with the conventional two-orthogonal-crystals source and the double-nonlinearity single-crystal source, the orthogonal QPM superlattice is shown to suppress the spatial and temporal distinguishability of the generated photon pairs by several orders of magnitude, depending on the number of layers. This enhanced all-over-the-cone indistinguishability enables the generation of higher fluxes of photon-pairs by means of the combined use of (a) long nonlinear crystal in noncollinear geometry, (b) low coherence-time pumping and ultra-wide-band spectral detection, and (c) focused pumping and over-the-cone detection. While each of these three features is challenging by itself, it is remarkable that the orthogonal QPM superlattice meets all of these challenges without the need for separate spatial or temporal compensation.