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INTRODUCTION: The Air-Q Self Pressurized Airway Device with Blocker (SP Blocker) was compared to the Proseal Laryngeal Mask Airway (PLMA) during positive pressure ventilation regarding the primary outcome (oropharyngeal leak pressure [OLP]), secondary outcomes (peak inspiratory pressure [PIP], inspired tidal volume [ITV], expired tidal volume [ETV], leak volume [LV] and leak fraction [LF]), insertion time, ventilation score, fiber-optic glottis view score, and postoperative laryngopharyngeal parameters (LPM). MATERIAL AND METHODS: Adult healthy female patients scheduled for elective gynecological laparotomies under general anesthesia using controlled mechanical ventilation were recruited to a prospective randomized comparative clinical trial. Exclusion criteria were body mass index (BMI) ≥ 35 kg m -2 , El-Ganzouri score ≥ 5, upper airway problems, hiatus hernia or pregnancy. Patients were classified into an SP Blocker group ( n = 75) and a PLMA group ( n = 75). Primary and secondary outcomes were assessed initially and at fixed time points after successful insertion of devices. RESULTS: Initially after successful device insertion: the SP Blocker group showed statistically significant higher mean OLP (cmH 2 O) (29.46 ± 2.11 vs. 28.06 ± 1.83 respectively; 95% CI: -2.037 to -0.76, P < 0.0001), lower mean PIP (cmH 2 O) (15.49 ± 0.61 vs. 17.78 ± 1.04 respectively; 95% CI: 2.02 to 2.56, P < 0.0001), higher mean ITV (mL) (411 ± 30 vs. 403 ± 15 respectively; 95% CI: -15.65 to -0.347, P = 0.041), higher mean ETV (mL) (389 ± 12 vs. 354 ± 11 respectively; 95% CI: -38.72 to -31.29, P < 0.0001), lower mean LV (mL) (22 ± 18 vs. 49 ± 10 respectively; 95% CI: 22.3 to 31.7, P < 0.0001) and lower mean LF (%) (5 ± 2.04 vs. 12 ± 6.8 respectively; 95% CI: 5.38 to 8.62, P < 0.0001) than the PLMA group. Mean insertion time (seconds) was shorter in the SP Blocker group than the PLMA group (16.39 ± 2.81 vs. 18.63 ± 3.44 respectively; 95% CI: 1.23 to 3.25, P < 0.0001). The SP Blocker group offered a better fiber-optic glottis view score than the PLMA group without differences concerning ventilation score and LPM. CONCLUSIONS: SP Blocker provided as safe anesthesia during controlled mechanical ventilation as PLMA.
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Anestesia Geral , Procedimentos Cirúrgicos em Ginecologia , Máscaras Laríngeas , Humanos , Feminino , Adulto , Procedimentos Cirúrgicos em Ginecologia/métodos , Estudos Prospectivos , Anestesia Geral/métodos , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Eletivos , Respiração com Pressão Positiva/métodos , Paralisia/etiologiaRESUMO
Of all complications from central venous catheters (CVC) in end-stage renal disease (ESRD) patients, catheter-related bloodstream infection (CRBSI) is one of the most devastating consequences. The option of catheter salvage is not an effective measure with metastatic infections. However, in patients with severe vasculopathy and/or near end-stage vascular disease, preservation of the venous access should be given utmost importance as the luxury of utilizing another vascular site is markedly limited. Providing adequate renal replacement therapy in this group of patients can be remarkably challenging for nephrologists. We are presenting an ESRD patient with advanced vascular disease who developed metastatic CRBSI with worsening uremia who was successfully converted from intermittent hemodialysis (IHD) to peritoneal dialysis (PD). Our rationale was to minimize repeated intravascular procedures coupled with the presence of another intravascular device. This has led to a complete resolution of persistent bacteremia, with a steady improvement in the uremic state. Conversion from IHD to PD for persistent bacteremia with metastatic complications was seldom addressed in literature. In the absence of a significant contraindication to PD, it can be considered as a valid alternative possibility in order to interrupt this viscous cycle, especially in vasculopathic patients.
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Amid heightened inter-company competition and the global drive towards ESG reforms, this study investigates whether enhancing the ESG performance of listed companies in China assists in elevating their reputation. It also examines the mediating role of investor attention in the relationship between ESG performance and company reputation, and further delves into whether there's a threshold effect of investor attention on the ESG-performance relationship. Utilizing sample data from Chinese listed companies spanning 2011 to 2021, and employing methods such as the panel two-way fixed-effects regression model, mediation effect testing, and threshold effect models, the study reveals that there is a significant positive relationship between ESG performance and the reputation of these companies. Moreover, a unique threshold effect is observed in the relationship between ESG performance and reputation. Innovatively, our research confirms the mediating role of investor attention in the relationship between ESG performance and company reputation, noting a more pronounced mediation effect in non-state-owned companies as opposed to state-owned ones. This study builds upon the existing literature on the relationship between CSR and company reputation, as well as between investor attention and reputation. By elucidating the mediating role of investor attention and its dual threshold effect, we provide a nuanced perspective on how ESG performance influences company reputation. Practically speaking, this research offers strategic recommendations for companies, investors, and regulators in the Chinese market on reputation management aligned with ESG principles. For instance, companies should prioritize their ESG performance, striving to maintain it above the market average, thus optimizing its effect on their reputation. Furthermore, companies should nurture their relationships with investors, aiming to elevate investor attention above the market mean. Policymakers should encourage companies to bolster their ESG performance, even contemplating more rewards and incentives for those with notable ESG achievements. Lastly, auditors should intensify their focus on non-financial information during audits, especially ensuring the accuracy and completeness of a company's ESG reports.
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Environmental and occupational lead (Pb) exposures continue to pose major public health problems. Wastewater treatment plant (WWTP) workers proved are exposing to high Pb concentrations in sludge departments. The aim of the work was to investigate the role of MTHFR C677T and MTHFR A1298C gene polymorphisms on alteration of oxidative stress and homocysteine levels in WWTP workers exposed to high Pb concentrations, and study its relations with renal functions. The study included 90 WWTP workers from Abu-Rawash WWTP. Homocysteine, creatinine, urea, malondialdehyde (MDA), and total antioxidant capacity (TAC) were measured. Polymorphisms of MTHFR C677CT and MTHFR A1298C genes were studied using PCR/RFLP. Urine Pb concentrations were also measured. About 32.2% of the workers were with detectable Pb levels. Pb, homocysteine, and MDA levels were significantly higher among workers carrying TT polymorphism compared to other MTHFR C677T gene polymorphisms, while TAC was significantly lower among them compared to other polymorphisms. The same results were found among workers carrying CC compared to other MTHFR A1298C gene polymorphisms. WWTP workers carrying MTHFR 677TT and MTHFR 1298CC are more susceptible to elevation of homocysteine and the urinary Pb compared to the workers with the other polymorphisms. Furthermore, those workers were found to have increase in urea and creatinine. Therefore, MTHFR C677T and MTHFR A1298C gene polymorphisms could be used for prediction of the susceptibility to the risk of kidney impairments among WWTP workers in the sludge departments caused by their exposure to high Pb in their workplace.
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Chumbo , Esgotos , Humanos , Creatinina , Polimorfismo Genético , Metilenotetra-Hidrofolato Redutase (NADPH2)/genética , Homocisteína , Ureia , GenótipoRESUMO
INTRODUCTION: The evaluation of the quality of information (QOI) and clarity of information (COI) among oral health-related videos on the video-streaming Web site YouTube is scarce. This study evaluated QOI and COI regarding temporary anchorage devices contained within videos uploaded by dental professionals (DPs) on YouTube. METHODS: YouTube videos were systematically acquired with 4 search terms. The top 50 videos per search term by the number of views were stored in a YouTube account. A set of inclusion/exclusion criteria were applied, videos were assessed for viewing characteristics, a 4-point scoring system (0-3) was applied to evaluate QOI in 10 predetermined domains, and a 3-point scoring system (0-2) was applied to evaluate COI. Descriptive statistical analyses and intrarater and interrater reliability tests were performed. RESULTS: Strong intrarater and interrater reliability scores were observed. Sixty-three videos from the top 58 most-viewed DPs were viewed 1,395,471 times (range, 414-124,939). Most DPs originated from the United States (20%), and orthodontists (62%) uploaded most of the videos. The mean number of reported domains was 2.03 ± 2.40 (out of 10). The mean overall QOI score per domain was 0.36 ± 0.79 (out of 3). The "Placement of miniscrews" domain scored highest (1.23 ± 0.75). The "Cost of miniscrews placement" domain scored the lowest (0.03 ± 0.25). The mean overall QOI score per DP was 3.59 ± 5.64 (out of 30). The COI in 32 videos was immeasurable, and only 2 avoided using technical words. CONCLUSIONS: The QOI related to temporary anchorage devices contained within videos provided by DPs through the YouTube Web site is deficient, particularly in the cost of placement. Orthodontists should be aware of the importance of YouTube as an information resource and ensure that videos related to temporary anchorage devices contain comprehensive and evidence-based information.
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Mídias Sociais , Humanos , Estados Unidos , Reprodutibilidade dos Testes , Gravação em Vídeo , Assistência Odontológica , Ortodontistas , Disseminação de InformaçãoRESUMO
Ternary PANI@Bi2O3-BiOCl nanocomposites were successfully synthesized during the oxidative polymerization of aniline monomer in the presence of Bi2O3. PANI@Bi2O3-BiOCl nanocomposites were characterized by several analytical techniques, including X-ray diffraction (XRD), Fourier Transform Infrared spectroscopy (FTIR), N2 physisorption, UV-Vis Diffuse reflectance spectroscopy (DRS), X-ray photoelectron spectroscopy (XPS), transmission electron microscopy (TEM), and scanning electron microscopy with energy dispersive spectroscopy (SEM-EDS). The effective PANI-semiconductor interaction promotes the fast separation and transfer of photogenerated electrons and holes, enhancing the photocatalytic efficiency of the materials towards methylene blue (MB) degradation under solar light irradiation. The best results were obtained by 0.5%PANI@Bi2O3-BiOCl, leading to 80% MB degradation in 2 h, four times higher than pristine Bi2O3-BiOCl. Moreover, 0.5%PANI@Bi2O3-BiOCl maintained stable photocatalytic performances for four cycles without significant activity loss. Various scavengers (isopropyl alcohol, formic acid, and benzoquinone) were used to identify the active species by trapping holes and radicals generated during the photocatalytic degradation process. Finally, a probable photocatalytic mechanism of PANI@Bi2O3-BiOCl photocatalyst was suggested.
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This study reports the synthesis of two novel thiazolylazo dyes (4 and 5) bearing coumarin-thiophene moiety. UV-Vis spectroscopy was used to investigate the photophysical properties of 4 and 5 in different solvents. The dyes displayed good potential for hydroxide sensing in different mediums. The reversibility was also studied, and it was found that 4 and 5 could be reverted to their original state by adding acid. Furthermore, the acidochromic properties were studied in protic and aprotic media. Both dyes displayed a good acidochromic response in DCM. Moreover, 4 and 5 were investigated for pH sensing, and it was found that both compounds displayed changes in absorption spectra in a basic media. The theoretical calculations were carried out to investigate the deprotonation and protonation mechanisms using density functional theory (DFT). The thermal properties of the dyes were investigated using thermogravimetric analysis (TGA). The results showed good thermal stability up to around 200 °C.
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This study investigates the relationship between information asymmetry and cash holdings under the impact of the coronavirus disease 2019 (COVID-19) in China. It likewise explores how state ownership dominates their nexus, particularly during the pandemic. COVID-19 caused increases in cash holdings, and that the information asymmetry's effect on cash holdings is more pronounced over the COVID-19 period. Additionally, information asymmetry has a weaker effect on corporate cash holdings for state-owned enterprises (SOEs) under the pandemic. Overall, the study shows that state ownership moderates information asymmetry's impact on cash holdings and softens firms' precautionary motive for cash holdings during the pandemic.
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Sellar region is a rare localization for intracranial metastases. The diagnosis is frequently delayed as symptoms are generally non specific. Radiologic diagnosis may be difficult as these tumours present similiraities to other more frequent sellar tumours. There is still no consensus regarding therapeutic approach. Prognosis is related to several features.
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A biomarker for viral infection could improve the differentiation between viral and bacterial infections and reduce antibiotic overuse. We examined blood myxovirus resistance protein A (MxA) as a biomarker for viral infections in children with an acute infection. We recruited 251 children presenting with a clinical suspicion of serious bacterial infection, determined by need for a blood bacterial culture collection, and 14 children with suspected viral infection at two pediatric emergency departments. All children were aged between 4 weeks and 16 years. We classified cases according to the viral, bacterial, or other etiology of the final diagnosis. The ability of MxA to differentiate between viral and bacterial infections was assessed. The median blood MxA levels were 467 (interquartile range, 235 to 812) µg/L in 39 children with a viral infection, 469 (178 to 827) µg/L in 103 children with viral-bacterial coinfection, 119 (68 to 227) µg/L in 75 children with bacterial infection, and 150 (101 to 212) µg/L in 26 children with bacterial infection and coincidental virus finding (P < 0.001). In a receiver operating characteristics analysis, MxA cutoff level of 256 µg/L differentiated between children with viral and bacterial infections with an area under the curve of 0.81 (95% confidence interval [CI] = 0.73 to 0.90), a sensitivity of 74.4%, and a specificity of 80.0%. In conclusion, MxA protein showed moderate accuracy as a biomarker for symptomatic viral infections in children hospitalized with an acute infection. High prevalence of viral-bacterial coinfections supports the use of MxA in combination with biomarkers of bacterial infection. IMPORTANCE Due to the diagnostic uncertainty concerning the differentiation between viral and bacterial infections, children with viral infections are often treated with antibiotics, predisposing them to adverse effects and contributing to the emerging antibiotic resistance. Since currently available biomarkers only estimate the risk of bacterial infection, a biomarker for viral infection is needed in attempts of reducing antibiotic overuse. Blood MxA protein, which has broad antiviral activity and is rapidly induced in acute, symptomatic viral infections, is a potential biomarker for viral infection. In this diagnostic study of 265 children hospitalized because of an acute infection, blood MxA cutoff level of 256 µg/L discriminated between viral and bacterial infections with a sensitivity of 74% and specificity of 80%. MxA could improve the differential diagnostics of febrile children at the emergency department but, because of frequently detected viral-bacterial coinfections, a combination with biomarkers of bacterial infection may be needed.
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Biomarcadores/sangue , Proteínas de Resistência a Myxovirus , Infecções por Orthomyxoviridae/diagnóstico , Infecções por Orthomyxoviridae/virologia , Orthomyxoviridae/metabolismo , Adolescente , Antibacterianos/uso terapêutico , Antivirais/uso terapêutico , Infecções Bacterianas/diagnóstico , Infecções Bacterianas/tratamento farmacológico , Criança , Pré-Escolar , Diagnóstico Diferencial , Feminino , Febre/diagnóstico , Humanos , Lactente , Masculino , Proteínas de Resistência a Myxovirus/sangue , Orthomyxoviridae/genética , Proteína Estafilocócica A , Viroses/tratamento farmacológico , Viroses/virologiaRESUMO
A series of D-π-A chromophores based on allylidenemalononitrile electron-withdrawing group was designed. The influence of the amino-electron-donating group on the photophysical properties was studied. These compounds, highly thermally stable, exhibit orange-red emission in solution and in solid state. The experimental results have been rationalized by theoretical DFT calculations. The second order nonlinear optical properties were also studied using the electric field induced second harmonic generation (EFISH) method.
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The human respiratory tract pathogen Chlamydia pneumoniae, which causes mild to severe infections, has been associated with the development of chronic inflammatory diseases. To understand the biology of C. pneumoniae infections, several studies have investigated the interaction between C. pneumoniae and professional phagocytes. However, these studies have been conducted under nonopsonizing conditions, making the role of opsonization in C. pneumoniae infections elusive. Thus, we analyzed complement and antibody opsonization of C. pneumoniae and evaluated how opsonization affects chlamydial infectivity and phagocytosis in human monocytes and neutrophils. We demonstrated that IgG antibodies and activation products of complement C3 and C4 are deposited on the surface of C. pneumoniae elementary bodies when incubated in human serum. Complement activation limits C. pneumoniae infectivity in vitro and has the potential to induce bacterial lysis by the formation of the membrane attack complex. Coculture of C. pneumoniae and freshly isolated human leukocytes showed that complement opsonization is superior to IgG opsonization for efficient opsonophagocytosis of C. pneumoniae in monocytes and neutrophils. Neutrophil-mediated phagocytosis of C. pneumoniae was crucially dependent on opsonization, while monocytes retained minor phagocytic potential under nonopsonizing conditions. Complement opsonization significantly enhanced the intracellular neutralization of C. pneumoniae in peripheral blood mononuclear cells and neutrophils and almost abrogated the infectious potential of C. pneumoniae In conclusion, we demonstrated that complements limit C. pneumoniae infection in vitro by interfering with C. pneumoniae entry into permissive cells by direct complement-induced lysis and by tagging bacteria for efficient phagocytosis in both monocytes and neutrophils.
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Infecções por Chlamydophila/imunologia , Infecções por Chlamydophila/microbiologia , Chlamydophila pneumoniae/fisiologia , Monócitos/imunologia , Neutrófilos/imunologia , Fagocitose , Anticorpos Antibacterianos/imunologia , Ativação do Complemento/imunologia , Proteínas do Sistema Complemento/imunologia , Proteínas do Sistema Complemento/metabolismo , Humanos , Monócitos/metabolismo , Neutrófilos/metabolismoRESUMO
Blood myxovirus resistance protein A (MxA) has broad antiviral activity, and it is a potential biomarker for symptomatic virus infections. Limited data is available of MxA in coinciding viral and bacterial infections. We investigated blood MxA levels in children hospitalized with a febrile urinary tract infection (UTI) with or without simultaneous respiratory virus infection. We conducted a prospective observational study of 43 children hospitalized with febrile UTI. Nasopharyngeal swab samples were collected at admission and tested for 16 respiratory viruses by nucleic acid detection methods. Respiratory symptoms were recorded, and blood MxA levels were determined. The median age of study children was 4 months (interquartile range, 2-14 months). A respiratory virus was detected in 17 (40%) children with febrile UTI. Of the virus-positive children with febrile UTI, 7 (41%) had simultaneous respiratory symptoms. Blood MxA levels were higher in virus-positive children with respiratory symptoms (median, 778 [interquartile range, 535-2538] µg/L) compared to either virus-negative (155 [94-301] µg/L, P < 0.001) or virus-positive (171 [112-331] µg/L, P = 0.006) children without respiratory symptoms at presentation with febrile UTI. MxA differentiated virus-positive children with respiratory symptoms from virus-negative without symptoms by an area under the receiver operating characteristic curve of 0.96. Respiratory viruses were frequently detected in children with febrile UTI. In UTI with simultaneous respiratory symptoms, host antiviral immune response was demonstrated by elevated blood MxA protein levels. MxA protein could be a robust biomarker of symptomatic viral infection in children with febrile UTI.
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Proteínas de Resistência a Myxovirus/sangue , Infecções Respiratórias/sangue , Infecções Respiratórias/epidemiologia , Infecções Urinárias/epidemiologia , Infecções Urinárias/virologia , Biomarcadores/sangue , Feminino , Febre , Humanos , Lactente , Masculino , Prevalência , Estudos Prospectivos , Curva ROC , Infecções Respiratórias/patologia , Infecções Respiratórias/virologia , Infecções Urinárias/microbiologia , Infecções Urinárias/patologiaRESUMO
In this review, we provide a Gulf region-centric view on autism with special focus on Qatar and Oman, including a review of seminal Qatari/Omani work from the literature. In addition, we offer a summary from the World Innovation Summit for Health and World Innovation Summit for Education autism reports as well as outline some of the main challenges, best practices and a path forward for the Gulf region from a healthcare perspective. Finally, we highlight the role of public outreach and awareness to lay the groundwork for enlightened policy for intervention and resource allocation to care for autistic individuals.
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Transtorno Autístico/diagnóstico , Transtorno Autístico/terapia , Educação de Pacientes como Assunto/métodos , Saúde Pública/métodos , Transtorno Autístico/genética , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Omã , Educação de Pacientes como Assunto/estatística & dados numéricos , Saúde Pública/estatística & dados numéricos , CatarRESUMO
Double right coronary artery is a relatively rare coronary anomaly. In this case report we aim to increase awareness of the importance of recognizing such anomaly and a brief literature review of similar cases and possible high risk features. Computed Tomography is well recognized modality to detect coronary anomaly and in our case we demonstrated this as well.
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Respiratory viruses frequently cause symptomatic infections in children but are often detected also in healthy children. We investigated myxovirus resistance protein A (MxA), viperin, and tripartite-motif 21 (TRIM21) messenger RNA indexes in nasal swabs as potential biomarkers of viral respiratory infection in children. Respiratory viruses were detected by polymerase chain reaction in the same swabs. Nasal MxA and viperin indexes were increased in symptomatic virus-positive children. Nasal viperin index was found to be a robust marker of viral respiratory tract infection with a sensitivity of 80% and specificity of 94% in distinguishing children with symptomatic virus infections from asymptomatic virus-negative children.
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Interações Hospedeiro-Patógeno/imunologia , Proteínas de Resistência a Myxovirus/sangue , Proteínas/análise , RNA Mensageiro/análise , Infecções Respiratórias/imunologia , Ribonucleoproteínas/sangue , Viroses/imunologia , Adolescente , Biomarcadores/sangue , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Proteínas de Resistência a Myxovirus/genética , Oxirredutases atuantes sobre Doadores de Grupo CH-CH , Proteínas/genética , Infecções Respiratórias/virologia , Ribonucleoproteínas/genéticaRESUMO
This work investigated the effect from exposure to insecticides carbofuran and deltamethrin on acetylcholinesterase (AChE) activity in the brain and muscle of common carp (Cyprinus carpio). Both pesticides were evaluated through two separate experiments, and carp were exposed in a semi-static system to three different concentrations of carbofuran (10, 50, and 100 µg/L) and deltamethrin (0.08, 0.4, and 0.8 µg/L) during a month with sampling times at 0, 4, 15, and 30 days (n = 7 from each aquarium). AChE activity was significantly inhibited in both organs of carps exposed to carbofuran at all sampling times depending on dose and time, reaching inhibition values of 73.5 and 67.1%, in brain and muscle tissues respectively, after 30 days with the highest concentration. On the contrary, AChE activity was not significantly affected after deltamethrin exposure at all concentrations and times of the assay. This study shows that the measurement of brain and muscle AChE activity in Cyprinus carpio is a useful biomarker of carbamates exposure and/or effects, but has no application with pyrethroids.