Peritoneal drainage versus laparotomy as an initial treatment in complicated necrotizing enterocolitis: a single institution experience

Objective To determine whether initial peritoneal drainage (PD) or primary laparotomy is the most effective intervention in very-low-birth-weight and extremely lowbirth- weight infants who are diagnosed with necrotizing enterocolitis (NEC, Bell’s stage II and stage III).Patients and methods It is a retrospective chart review study. Demographic data, clinical characteristics, and outcome were reviewed from records of neonates with severe NEC requiring surgical intervention (Bell’s stage II and stage III) at our institution from 2003 to 2009.Results Thirty-two patients were included in our study. Seventeen patients (53.1%) underwent PD and 15 patients (46.8%) underwent laparotomy. Out of 17 patients in the drainage group, 11 patients (64.7%) underwent laparotomy and six patients (35.2%) did not undergo laparotomy because they were sick and died within few days. Difference in gestational age, sex, and birth weights between two groups was not statistically significant. Similarly, difference in variables as mode of delivery and days of enteral feeding was not statistically significant. Mean age at diagnosis was 31.5 days for the laparotomy group and 18.4 days for the drainage group. P value was 0.026 in the univariate analysis, but P value in the final model of analysis was found to be statistically not significant. It was found from our study that patients with many associated diseases were more in the PD group (P value was 0.008). Almost all patients were mechanically ventilated. Mean pH was 7.29 in the laparotomy group and 7.25 in the drainage group, which was statistically not significant. In the PD group, 13 patients required vasopressors; however, only four patients in the laparotomy group were on vasopressors (P value was 0.017). Difference in variables such as indomethacin, white blood cell count, and platelet count was found to be statistically not significant between the two groups. Six patients were on steroids in the PD group and only one patient was on steroid in the laparotomy group (P value is 0.007). In addition, outcome at 90 days was analyzed; nine patients died in the PD group, whereas four patients died in the laparotomy group (P value is 0.081). Data were also analyzed for complications such as stricture, short bowel syndrome, and cholestasis and the difference was not significant. Finally, total parenteral nutrition dependency difference was found to be statistically not significant between two groups.Conclusion Patients were very sick in the PD group and they were on vasopressors and steroids. Moreover, it was found that diagnosis of NEC early in life signifies a higher mortality. Insertion of a PD is still useful in resuscitating small critically ill infants with NEC; however, the majority of these infants will require subsequent laparotomy. Early diagnosis and early intervention are necessary to decrease the inflammatory insults to the body systems and this reflects on survival.Keywords: drainage versus laparotomy, less than 1500 g, necrotizing enterocoliti

EFFECT OF MULTIMEDIA ACTIVITIES IN BLENDED LEARNING ON LISTENING SKILLS AND SATISFACTION IN A COLLEGE ENGLISH LANGUAGE COURSE

This study aimed to investigate the effect of proposed multimedia activities in blended learning on students’ listening skills and satisfaction in a college English language course at the Royal University for Woman (RUW) in Bahrain. The study attempted to assess the effects of the proposed strategy on the students’ listening skills and satisfaction with the multimedia listening activities in the OPL (Orientation Program Lower). Results indicated that experimental group students scored higher level in their listening post-test than those in the control group. Experimental group students were satisfied with the courses designed.KEYWORDS: multimedia activities, interactive multimedia, listening comprehension, blended learning

COVID-19 Pandemic Driven Knowledge, Attitude, Clinical Practice, Distress Reactions, and Post-Traumatic Growth of Dental Care Providers in Riyadh City, Saudi Arabia: A Cross-Sectional Study

Objective: The present study aimed to assess knowledge, attitude, clinical practices, distress reactions, and post-traumatic growth of dentists during the COVID-19 pandemic in Riyadh City. Methodology: An online questionnaire was developed to assess various dental professionals from both governmental and private sectors during the early COVID-19 outbreak in Riyadh City, Saudi Arabia. The questionnaire was framed to assess the demographic variables, knowledge, attitude, and clinical practices towards handling the COVID-19 pandemic. Furthermore, the general anxiety disorder-7 (GAD-7), worry questionnaire items, short form of post-traumatic growth inventory (PTGI-SF), and life satisfaction questionnaire items were developed to assess the anxiety, worries, post-traumatic growth, and life satisfaction of dental care providers following the traumatic events. Data were analysed using SPSS 22.0 and R environment ver.3.2.2. Continuous measurement results were presented as mean ± SD, and categorical measurements results were presented in number (%). Results: Our study's significant findings revealed that a majority of the dentists were in the age group of 21-30 and practiced general dentistry. The study participants in age groups 51–60 and 41–50 years old showed more liability in perceiving COVID-19 as an extremely dangerous disease than 31–40 and 21–30 age groups. The majority of respondents (63.4%) had an anxiety scale score of greater than 40, followed by 22.8% with scores 20-40 and 13.9% with scores less than 20, respectively. The mean scores for the GAD-7 and the worry items were 8.24 ± 3.21 and 13.92 ± 4.77, respectively. The data showed that most survey participants had adopted moderate post-traumatic changes during the pandemic, as evident by their mean score of 34.17 ± 3.40. The life satisfaction of the participants was neutral, as demonstrated by their mean score of 20.16 ± 4.03. Conclusion: This study’s findings delineated that the COVID-19 pandemic situation has influenced dentists' mental health, with a moderate level of anxiety, and worries among other psychological symptoms. Furthermore, there was adequate knowledge regarding the COVID-19 among dentists; however, the pandemic affected the financial conditions of the respondents. There was a moderate level of post-traumatic growth and neutral life satisfaction of the dental providers

Sustainable Remedy Waste to Generate SiO2 Functionalized on Graphene Oxide for Removal of U(VI) Ions

The Hummer process is applied to generate graphene oxide from carbon stocks’ discharged Zn-C batteries waste. SiO2 is produced from rice husks through the wet process. Subsequently, SiO2 reacted with graphene oxide to form silica/graphene oxide (SiO2/GO) as a sorbent material. XRD, BET, SEM, EDX, and FTIR were employed to characterize SiO2/GO. Factors affecting U(VI) sorption on SiO2/GO, including pH, sorption time, a dosage of SiO2/GO, U(VI) ions’ concentration, and temperature, were considered. The experimental data consequences indicated that the uptake capacity of SiO2/GO towards U(VI) is 145.0 mg/g at a pH value of 4.0. The kinetic calculations match the pseudo second-order model quite well. Moreover, the sorption isotherm is consistent with the Langmuir model. The sorption procedures occur spontaneously and randomly, as well as exothermically. Moreover, SiO2/GO has essentially regenerated with a 0.8 M H2SO4 and 1:50 S:L phase ratio after 60 min of agitation time. Lastly, the sorption and elution were employed in seven cycles to check the persistent usage of SiO2/GO. © 2022 by the authors. Licensee MDPI, Basel, Switzerland.The authors express their gratitude to Princess Nourah bint Abdulrahman University Researchers Supporting Project number (PNURSP2022R13), Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia

Occurrence and sources of natural and anthropogenic lipid tracers in surface soils from arid urban areas of Saudi Arabia

Soil particles contain a variety of natural and anthropogenic organic components, and in urban areas can be considered as local collectors of pollutants. Surface soil samples were taken from ten urban areas in Riyadh during early winter of 2007. They were extracted with dichloromethane-methanol mixture and the extracts were analyzed by gas chromatography-mass spectrometry. The major compounds were unresolved complex mixture (UCM), plasticizers, n-alkanes, carbohydrates, n-alkanoic acids, hopanes, n-alkanols, and sterols. Vegetation detritus was the major natural source of organic compounds (24.0 ± 15.7%) in samples from areas with less human activities and included n-alkanes, n-alkanoic acids, n-alkanols, sterols and carbohydrates. Vehicular emission products and discarded plastics were the major anthropogenic sources in the soil particles (53.3 ± 21.3% and 22.7 ± 10.7%, respectively). The anthropogenic tracers were UCM, plasticizers, n-alkanes, hopanes and traces of steranes. Vegetation and human activities control the occurrence and distribution of natural and anthropogenic extractable organic matter in this arid urban area.Keywords: Petroleum residues, Biomarkers, Soils, Lipids, Plasticizer

Cetylpyridinium Bromide/Polyvinyl Chloride for Substantially Efficient Capture of Rare Earth Elements from Chloride Solution

A new sorbent cetylpyridinium bromide/polyvinylchloride (CPB/PVC) was prepared and tested to extract rare earth elements (REEs) from their chloride solutions. It was identified by FTIR, TGA, SEM, EDX, and XRD. The impact of various factors such as pH, RE ion initial concentration, contacting time, and dose amount via sorption process was inspected. The optimum pH was 6.0, and the equilibrium contact time was reached at 60 min at 25 °C. The prepared adsorbent (CPB/PVC) uptake capacity was 182.6 mg/g. The adsorption of RE ions onto the CPB/PVC sorbent was found to fit the Langmuir isotherm as well as pseudo-second-order models well. In addition, the thermodynamic parameters of RE ion sorption were found to be exothermic and spontaneous. The desorption of RE ions from the loaded CPB/PVC sorbent was investigated. It was observed that the optimum desorption was achieved at 1.0 M HCl for 60 min contact time at ambient room temperature and a 1:60 solid: liquid phase ratio (S:L). As a result, the prepared CPB/PVC sorbent was recognized as a competitor sorbent for REEs. © 2022 by the authors. Licensee MDPI, Basel, Switzerland.The authors express their gratitude to Princess Nourah bint Abdulrahman University Researchers Supporting Project number (PNURSP2022R13), Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia

Stuttered swallowing: Electric stimulation of the right insula interferes with water swallowing. A case report

<p>Abstract</p> <p>Background</p> <p>Various functional resonance imaging, magnetoencephalographic and lesion studies suggest the involvement of the insular cortex in the control of swallowing. However, the exact location of insular activation during swallowing and its functional significance remain unclear.</p> <p>Case presentation</p> <p>Invasive electroencephalographic monitoring was performed in a 24-year-old man with medically intractable stereotyped nocturnal hypermotor seizures due to a ganglioglioma. During stimulation of the right inferior posterior insular cortex with depth electrodes the patient spontaneously reported a perception of a "stutter in swallowing". Stimulation of the inferior posterior insular cortex at highest intensity (4 mA) was also associated with irregular and delayed swallows. Swallowing was not impaired during stimulation of the superior posterior insular cortex, regardless of stimulation intensity.</p> <p>Conclusions</p> <p>These results indicate that the right inferior posterior insular cortex is involved in the neural circuitry underlying the control of swallowing.</p

Cell-based analysis of CAD variants identifies individuals likely to benefit from uridine therapy.

PURPOSE: Pathogenic autosomal recessive variants in CAD, encoding the multienzymatic protein initiating pyrimidine de novo biosynthesis, cause a severe inborn metabolic disorder treatable with a dietary supplement of uridine. This condition is difficult to diagnose given the large size of CAD with over 1000 missense variants and the nonspecific clinical presentation. We aimed to develop a reliable and discerning assay to assess the pathogenicity of CAD variants and to select affected individuals that might benefit from uridine therapy. METHODS: Using CRISPR/Cas9, we generated a human CAD-knockout cell line that requires uridine supplements for survival. Transient transfection of the knockout cells with recombinant CAD restores growth in absence of uridine. This system determines missense variants that inactivate CAD and do not rescue the growth phenotype. RESULTS: We identified 25 individuals with biallelic variants in CAD and a phenotype consistent with a CAD deficit. We used the CAD-knockout complementation assay to test a total of 34 variants, identifying 16 as deleterious for CAD activity. Combination of these pathogenic variants confirmed 11 subjects with a CAD deficit, for whom we describe the clinical phenotype. CONCLUSIONS: We designed a cell-based assay to test the pathogenicity of CAD variants, identifying 11 CAD-deficient individuals who could benefit from uridine therapy