Chest wall reconstruction still has place in Today’s modern practice:" a tertiary center experience"

Background: The key factor following chest wall resection is the preservation of the stability and integrity of the chest wall to support the respiration and protect the underlying organs. The present study aims to evaluate the use of the available grafts and prosthetic materials at our center in chest wall reconstruction with adherence to the proper surgical techniques, good perioperative and postoperative care to obtain good results. Methods: This is a retrospective single center study that concludes all patients underwent chest wall reconstruction for a variety of defects resulting from resection of tumors, trauma due to primarily firearms or motor car accidents, resection of radio necrotic tissues, infection and dehiscence of median sternotomy wounds after cardiac surgery.  Results: Study population consisted of 30 patients between January 2015and may 2018, among them were 20 male (70%) and 10 female patients (30%), with a median age of 43 ± 16.3 years, resection and reconstruction was performed in 23 cases (15 neoplastic,5 infective and  3 firearm cases) while reconstruction alone was performed in 7 (traumatic flail chest)  cases. Eighteen patients, underwent rib resection with an average 4.18 ± 2.2 ribs (range 2-6). Associated lung resection was performed in 5 patients (27.8 %): diaphragmatic resection was done in 2 cases in addition total sternal resection was performed in 5 cases. Most of the patients (96.7%) had primary healing of their wounds. there was one death (3.3%) in the early postoperative period. The average length of hospital stay for all patients was 8.7 days (range: 5–15). Respiratory complications occurred in three cases in the form of atelectasis and pneumonia at the ipsilateral side of reconstruction. Three cases suffered wound seroma which successfully managed by daily dressing and antibiotic coverage. Conclusions: according to our study and the analysis of similar studies, adequate perioperative preparation of patient undergoing chest wall resection and reconstruction with adherence to effective surgical techniques allowed us to use the available materials at our center for chest wall reconstruction with good and effective results without adding burden in terms of cost on the patient

Towards a parametric plug-in for conservation of built heritage

It is an undeniable fact that heritage buildings are a valuable asset for society, it reveals their achievements over the years. Therefore, the need to conserve built heritage has become an increasingly urgent case to experts and the community, they exploit any possible tool to achieve this aim. However, the concept of heritage conservation has completely changed due to the new technologies and inventions which opened up new opportunities to the conservation process of built heritage. This paper focuses on the theoretical parametric approach in generating digital heritage models which will help in the restoration and reconstruction process. A library of parametric heritage models will be designed from architectural books and historic scripts which will then be embedded in a new plug-in for BIM software. This new plug-in will provide multiple solutions for historical buildings which facing certain problems while using manual modelling methods in restoration and reconstruction processes, it will also automate the modelling process by using parametric modelling techniques. Keywords: Built heritage, Conservation, Digital heritage models, New plug-in, Parametric approac

Comparison between the toxicity of nano and bulk formulations of imidacloprid against wheat aphid, bird cherry-oat aphid, Rhopalosiphum padi L

Recently, nano-insecticide formulations and new insecticide application methods are promised in pest control improvement. Wheat crop is infested by many sucking pests, such as cereal aphids in Upper Egypt. The toxicity of the recommended dose of imidacloprid (70% WS GAUCHO®) as positive control, the full and half recommended dose of nano and bulk imidacloprid 25% WP (BEST®) formulations were investigated under laboratory and field conditions against bird cherry-oat aphid, Rhopalosiphum padi L. The leaf-dip bioassay results indicated that the nano-imidacloprid formulations had higher potency ratio than the bulk formulations by 2.53 to 7.17 folds. Significant reduction percentage of aphids was recorded in seed treatments of field wheat crops, the aphid reductions reached 95% after 60 days. All insecticide treatments showed significant increasing in grain yield ranging from 10.55% to 22.02% higher than the control. The results concluded that the nano-imidacloprid formulation is promising formulation in cereal aphid control. Moreover, the seed-treatment is better than foliar treatment as a pest control tool for protecting the wheat seedling against sucking insect pests

Synthesis and Antimicrobial Evaluation of a New Series of Heterocyclic Systems Bearing a Benzosuberone Scaffold

A series of novel benzosuberone derivatives were synthesized and evaluated as antimicrobial agents by using substituted benzosuberone derivatives 1a,b as starting materials. Treatment of 1a,b with phenyl isothiocyanate in dimethylformamide was followed by treatment with cold HCl solution to afford the thioamides 4a,b, which was reacted with methyl iodide to obtain methylated products 5a,b. Cyclocondensation of 4a,b with chloroacetone 6 and phenacyl chloride 7 gave the corresponding thiophene derivatives 9a–c. Reaction of 4a,b with C-acetyl-N- arylhydrazonoyl chlorides 14a and 14b in boiling EtOH in the presence of triethylamine, afforded the corresponding 1,3,4-thiadiazoline derivatives 16a–d. The thioamides 4a,b were reacted with C-ethoxycarbonyl-N-arylhydrazonoyl chlorides 18a,b which afforded 1,3,4-thiadiazoline derivatives 19a–d. The benzosuberones 1a,b were treated with 3-mercaptopropanoic acid to give compounds 21a,b, which were cyclized to tricyclic thiopyran-4(5H)-one derivatives 22a,b. The latter compounds 22a,b were reacted with 3-mercaptopropanoic acid to give compounds 23a,b, which were cyclized tetracyclic ring systems 24a,b. Finally, compounds 24a,b were oxidized using hydrogen peroxide under reflux conditions to afford the oxidized form of the novel tetracyclic heterogeneous ring systems 25a,b. The newly synthesized compounds were screened for antimicrobial activities. The structures of new compounds were characterized by 1H-NMR, 13C-NMR, IR, and EI-MS

Quaternized Chitosan Thiol Hydrogel-Thickened Nanoemulsion: A Multifunctional Platform for Upgrading the Topical Applications of Virgin Olive Oil

(1) Background: Virgin olive oil (VOO) has attracted the attention of many researchers due to its nutritional and medicinal values. However, VOO’s biological applications have been limited due to a lack of precise chemical profiling and approach to increase the physicochemical characteristics, bioactivity, and delivery of its bioactive components; (2) Methods: The current study intended to evaluate the chemical composition of VOO using the GC-MS technique and determine its major components. Furthermore, the effect of incorporating VOO into Tween 80-lecithin nanoemulsion (OONE) and a quaternized trimethyl chitosan-thiol (TMCT) hydrogel-thickened nanoemulsion system (OOHTN) on its physicochemical characteristics and biological potentials will be investigated; (3) Results: The VOO-based NEs’ physicochemical properties (particle size and zeta potential) were steady during storage for four weeks owing to the inclusion of the protective TMCT hydrogel network to OONE. Excessive fine-tuning of olive oil nanoemulsion (OONE) and the TMCT protective network’s persistent positive charge have contributed to the oil’s improved antimicrobial, anti-biofilm, and antioxidant potentials; (4) Conclusions: The Tween 80-lecithin-TMCT nanosystem might provide a unique and multifunctional nanoplatform for efficient topical therapy as well as the transdermal delivery of lipophilic bioactive compounds

SARS-CoV-2 vaccination modelling for safe surgery to save lives: data from an international prospective cohort study

Background: Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods: The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18-49, 50-69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results: NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst case 3066). NNVs for surgical patients remained favourable at a range of SARS-CoV-2 incidence rates in sensitivity analysis modelling. Globally, prioritizing preoperative vaccination of patients needing elective surgery ahead of the general population could prevent an additional 58 687 (best case 115 007, worst case 20 177) COVID-19-related deaths in 1 year. Conclusion: As global roll out of SARS-CoV-2 vaccination proceeds, patients needing elective surgery should be prioritized ahead of the general population

Effects of pre-operative isolation on postoperative pulmonary complications after elective surgery: an international prospective cohort study an international prospective cohort study

We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05–1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4–7 days or ≥ 8 days of 1.25 (1.04–1.48), p = 0.015 and 1.31 (1.11–1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care. We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05–1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4–7 days or ≥ 8 days of 1.25 (1.04–1.48), p = 0.015 and 1.31 (1.11–1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care