Total knee arthroplasty at Gaza Strip Palestine: compliance and retrospective comparative study

Background: In Gaza Strip, arthroplasty only performed at our center. This study is to assess the compliance and improve current practices.Methods: Study is based on medical records review of all patients underwent total knee arthroplasty (TKA) between January 2016 and December 2017.Results: Forty eight TKA were performed on 41 patients. Neuraxial anesthesia used in 43 operations (30 spinal, 13 epidural). Tranexamic acid used in 20 operations and those show less frequently decrease in hemoglobin level after surgery and for blood transfusion. Simultaneous bilateral TKA used in one patient. Drain used in 26 operations, 2 of them had infection. No one started physiotherapy at same day surgery, this may be due to repeat doses of Epidural anesthesia, performed surgeries before weekend and using the drain. Delayed physiotherapy is associated with prolong hospitalization and increase suspicion of deep venous tthrombosis. The result from our retrospective comparative study was similar to guidelines.Conclusions: We concluded that there is overall good management of TKA in our hospital according to the best available evidence. We recommend to use the international guidelines like the American Academy of Orthopaedic Surgeons (AAOS) guidelines as a standard guidelines to our Hospital, and increase awareness of our staff to the good practice guidelines. Emphasize the important elements that we have shorten of good practice as listed in the discussion.

Language dominance modulates the perception of spanish approximants in late bilinguals

© 2020 by the authors. The ability to discriminate phonetically similar first language (L1) and second language (L2) sounds has significant consequences for achieving target-like proficiency in second-language learners. This study examines the L2 perception of Spanish approximants [Β, δ, γ] in comparison with their voiced stop counterparts [b, d, g] by adult English-Spanish bilinguals. Of interest is how perceptual effects are modulated by factors related to language dominance, including proficiency, language history, attitudes, and L1/L2 use, as measured by the Bilingual Language Profile questionnaire. Perception of target phones was assessed in adult native Spanish speakers (n = 10) and Spanish learners (n = 23) of varying proficiency levels, via (vowel-consonant-vowel) VCV sequences featuring both Spanish approximants and voiced stops during an AX discrimination task. Results indicate a significant positive correlation between perceptual accuracy and a language dominance score. Findings further demonstrate a significant hierarchy of increasing perceptual difficulty: Β \u3c δ \u3c γ. Through an examination of bilingual language dominance, composed of the combined effects of language history, use, proficiency, and attitudes, the present study contributes a more nuanced and complete examination of individual variables that affect L2 perception, reaching beyond proficiency and experience alone

Impact of Bat Guano Otonycteris hemprichii Camd and Seaweed Extract on Some Growth and Yield Traits of Barakaseed Nigella Sativa L

Barakaseed was improved as medicinal plant using some agricultural processes. For example, organic farmyard manure was efficiently applied to enhance growth and yield. Therefore, a field experiment was conducted out during 2012/2013 season to investigate the impact of bat guano (0, 75, 125 and 175 kg.ha-1), seaweed extract as kelpak (0, 1, 2, 3ml.l-1) on some growth and yield traits. Two factors were arranged in a factorial experiment system in completely randomized block design with three replicates. Results revealed that application of bat guano at 175 kg. ha-1 was superior in enhancing plant height, fruit branch per plant, dry weight, capsules per plant, seeds per capsule, 1000 seed weight and seed yield of 66.93cm, 13.32 fruit branch. plant-1, 44.75g. plant-1, 14.12caps. plant-1, 93.35seed. caps-1, 5.64g and 943.0 kg. ha-1 than other levels, respectively. Seaweed (kelpak) at 3 ml.l-1 also significantly increased these traits of 61.64cm, 12.11fruit branch.plant-1, 43.93g.plant-1, 12.27caps.plant-1, 82.90seed.caps-1, 5.34g and 805.0kg.ha-1, respectively. Moreover, the interactive combination of the highest level of bat guano with the highest level of kelpak (175Kg. ha-1X3ml. l-1) gave the highest seed yield of 1154.2 kg. ha-1. It could be concluded that bat guano and kelpak efficiently improved some growth traits. Therefore, consequently increased seed yield. The improvement and increase were gradually occurred. Thus, it could be recommended to use bat guano as shifting source over to chemical fertilizer supported with foliar spraying of seaweed extract as kelpak

Applications in Bioastronautics and Bioinformatics: Early Radiation Cataracts Detected by Noninvasive, Quantitative, and Remote Means

Human exploration of Mars is a key goal in NASA's exploration planning in the next 20 years. Maintaining crew health and good vision is certainly an important aspect of achieving a successful mission. Continuous radiation exposure is a risk factor for radiation-induced cataracts in astronauts because radiation exposure in space travel has the potential of accelerating the aging process (ref. 1). A patented compact device (ref. 2) based on the technique of dynamic light scattering (DLS) was designed for monitoring an astronaut's ocular health during long-duration space travel. This capability of early diagnosis, unmatched by any other clinical technique in use today, may enable prompt initiation of preventive/curative therapy. An Internet web-based system integrating photon correlation data and controlling the hardware to monitor cataract development in vivo at a remote site in real time (teleophthalmology) is currently being developed. The new technology detects cataracts very early (at the molecular level). Cataract studies onboard the International Space Station will be helpful in quantifying any adverse effect of radiation to ocular health. The normal lens in a human eye, situated behind the cornea, is a transparent tissue. It contains 35 wt % protein and 65 wt % water. Aging, disease (e.g., diabetes), smoking, dehydration, malnutrition, and exposure to ultraviolet light and ionizing radiation can cause agglomeration of the lens proteins. Protein aggregation can take place anywhere in the lens, causing lens opacity. The aggregation and opacification could produce nuclear (central portion of the lens) or cortical (peripheral) cataracts. Nuclear and posterior subcapsular (the membrane's capsule surrounds the whole lens) cataracts, being on the visual optical axis of the eye, cause visual impairment that can finally lead to blindness. The lens proteins, in their native state, are small in size. As a cataract develops, this size grows from a few nanometers (transparent) to several micrometers (cloudy). Ansari and Datiles have shown that DLS can detect cataracts at least two to three orders of magnitude earlier noninvasively and quantitatively than the best imaging (Scheimpflug) techniques in clinical use today (ref. 3)

Ocular Blood Flow Measured Noninvasively in Zero Gravity

In spaceflight or a reduced-gravity environment, bodily fluids shift to the upper extremities of the body. The pressure inside the eye, or intraocular pressure, changes significantly. A significant number of astronauts report changes in visual acuity during orbital flight. To date this remains of unknown etiology. Could choroidal engorgement be the primary mechanism and a change in the curvature or shape of the cornea or lens be the secondary mechanism for this change in visual acuity? Perfused blood flow in the dense meshwork of capillaries of the choroidal tissue (see the preceding illustration) provides necessary nutrients to the outer layers of the retina (photoreceptors) to keep it healthy and maintain good vision. Unlike the vascular system, the choroid has no baroreceptors to autoregulate fluid shifts, so it can remain engorged, pushing the macula forward and causing a hyperopic (farsighted) shift of the eye. Experiments by researchers at the NASA Glenn Research Center could help answer this question and facilitate planning for long-duration missions. We are investigating the effects of zero gravity on the choroidal blood flow of volunteer subjects. This pilot project plans to determine if choroidal blood flow is autoregulated in a reduced-gravity environment

Dynamic Light-Scattering Probe Used for the Very Early Detection of Cataracts and to Measure Response to Therapy (or Treatment)

Half of all blindness worldwide is due to cataracts, and 34 million Americans over the age of 65 have cataracts. This figure is expected to rise to 70 million by the year 2030. Currently, no medical treatment is available to prevent or halt the progression of a cataract; nor is there any way to reverse a cataract once it has been detected by conventional methods. The only known treatment is surgical removal of the lens. It is estimated that over $5 billion will be spent this year for the treatment of cataract patients in the United States alone. According to Carl Kupfer, M.D., former Director of the National Eye Institute at the National Institutes of Health, "A delay in cataract formation of about 10 years would reduce the prevalence of visually disabling cataracts by about 45 percent." However, this vision remains a dream because of the lack of objective methods that can be used to detect cataracts very early and, hence, can be used for screening potential anticataract drugs. This is about to change. The National Eye Institute and NASA entered into a formal interagency agreement in late 1996 to develop and test a dynamic light-scattering (DLS) device to detect the earliest changes due to cataract formation. The new DLS probe developed by Dr. Ansari at the NASA Glenn Research Center is several orders of magnitude more sensitive than conventional clinical systems. This ultrahigh sensitivity enables the probe to detect the onset of a cataract before it has any effect on vision and allows researchers to test the effectiveness of anticataract drugs in reversing cataracts. This device (see the following illustration) was originally designed to study transport phenomena in microgravity fluid physics experiments onboard the space shuttle orbiters and space station. It will be very useful in testing anticataract drugs to halt or reverse the progression of cataracts during longitudinal clinical trials

A Synergistic Antiproliferation Effect of Curcumin and Docosahexaenoic Acid in SK-BR-3 Breast Cancer Cells: Unique Signaling Not Explained by the Effects of Either Compound Alone.

Background Breast cancer is a collection of diseases in which molecular phenotypes can act as both indicators and mediators of therapeutic strategy. Therefore, candidate therapeutics must be assessed in the context of multiple cell lines with known molecular phenotypes. Docosahexaenoic acid (DHA) and curcumin (CCM) are dietary compounds known to antagonize breast cancer cell proliferation. We report that these compounds in combination exert a variable antiproliferative effect across multiple breast cell lines, which is synergistic in SK-BR-3 cells and triggers cell signaling events not predicted by the activity of either compound alone. Methods Dose response curves for CCM and DHA were generated for five breast cell lines. Effects of the DHA+ CCM combination on cell proliferation were evaluated using varying concentrations, at a fixed ratio, of CCM and DHA based on their individual ED50. Detection of synergy was performed using nonlinear regression of a sigmoid dose response model and Combination Index approaches. Cell molecular network responses were investigated through whole genome microarray analysis of transcript level changes. Gene expression results were validated by RT-PCR, and western blot analysis was performed for potential signaling mediators. Cellular curcumin uptake, with and without DHA, was analyzed via flow cytometry and HPLC. Results CCM+DHA had an antiproliferative effect in SK-BR-3, MDA-MB-231, MDA-MB-361, MCF7 and MCF10AT cells. The effect was synergistic for SK-BR-3 (ER- PR- Her2+) relative to the two compounds individually. A whole genome microarray approach was used to investigate changes in gene expression for the synergistic effects of CCM+DHA in SK-BR-3 cells lines. CCM+DHA triggered transcript-level responses, in disease-relevant functional categories, that were largely non-overlapping with changes caused by CCM or DHA individually. Genes involved in cell cycle arrest, apoptosis, inhibition of metastasis, and cell adhesion were upregulated, whereas genes involved in cancer development and progression, metastasis, and cell cycle progression were downregulated. Cellular pools of PPARγ and phospho-p53 were increased by CCM+DHA relative to either compound alone. DHA enhanced cellular uptake of CCM in SK-BR-3 cells without significantly enhancing CCM uptake in other cell lines. Conclusions The combination of DHA and CCM is potentially a dietary supplemental treatment for some breast cancers, likely dependent upon molecular phenotype. DHA enhancement of cellular curcumin uptake is one potential mechanism for observed synergy in SK-BR-3 cells; however, transcriptomic data show that the antiproliferation synergy accompanies many signaling events unique to the combined presence of the two compounds

Spread, circulation, and evolution of the Middle East respiratory syndrome coronavirus

The Middle East respiratory syndrome coronavirus (MERS-CoV) was first documented in the Kingdom of Saudi Arabia (KSA) in 2012 and, to date, has been identified in 180 cases with 43% mortality. In this study, we have determined the MERS-CoV evolutionary rate, documented genetic variants of the virus and their distribution throughout the Arabian peninsula, and identified the genome positions under positive selection, important features for monitoring adaptation of MERS-CoV to human transmission and for identifying the source of infections. Respiratory samples from confirmed KSA MERS cases from May to September 2013 were subjected to whole-genome deep sequencing, and 32 complete or partial sequences (20 were ≥99% complete, 7 were 50 to 94% complete, and 5 were 27 to 50% complete) were obtained, bringing the total available MERS-CoV genomic sequences to 65. An evolutionary rate of 1.12 × 10−3 substitutions per site per year (95% credible interval [95% CI], 8.76 × 10−4; 1.37 × 10−3) was estimated, bringing the time to most recent common ancestor to March 2012 (95% CI, December 2011; June 2012). Only one MERS-CoV codon, spike 1020, located in a domain required for cell entry, is under strong positive selection. Four KSA MERS-CoV phylogenetic clades were found, with 3 clades apparently no longer contributing to current cases. The size of the population infected with MERS-CoV showed a gradual increase to June 2013, followed by a decline, possibly due to increased surveillance and infection control measures combined with a basic reproduction number (R0) for the virus that is less than 1

Cell adhesion molecule CD166 drives malignant progression and osteolytic disease in multiple myeloma

Multiple myeloma (MM) is incurable once osteolytic lesions have seeded at skeletal sites, but factors mediating this deadly pathogenic advance remain poorly understood. Here we report evidence of a major role for the cell adhesion molecule CD166, which we discovered to be highly expressed in MM cell lines and primary bone marrow (BM) cells from patients. CD166+ MM cells homed more efficiently than CD166− cells to the BM of engrafted immunodeficient NSG mice. CD166 silencing in MM cells enabled longer survival, a smaller tumor burden and less osteolytic lesions, as compared to mice bearing control cells. CD166 deficiency in MM cell lines or CD138+ BM cells from MM patients compromised their ability to induce bone resorption in an ex vivo organ culture system. Further, CD166 deficiency in MM cells also reduced formation of osteolytic disease in vivo after intra-tibial engraftment. Mechanistic investigation revealed that CD166 expression in MM cells inhibited osteoblastogenesis of BM-derived osteoblast progenitors by suppressing RUNX2 gene expression. Conversely, CD166 expression in MM cells promoted osteoclastogenesis by activating TRAF6-dependent signaling pathways in osteoclast progenitors. Overall, our results define CD166 as a pivotal director in MM cell homing to the BM and MM progression, rationalizing its further study as a candidate therapeutic target for MM treatment