Feasibility of using self-compacting concrete in civil engineering applications

This research aimed to investigate the feasibility of using self-compacting concrete in civil engineering applications as a producing a precast hollow unit. The behavior of the hollow sections cast with self-compacted concrete beneath line-load was evaluated. An experimental work was carried out and a finite element model with ANSYS (version 15) was adopted. A total of fourteen hollow beams were cast and tested. The most variables taken into thought were; the types of reinforcement (reinforced steel bar and steel wire meshes), the types of steel wire meshes (expanded and welded steel wire mesh), number of layers of steel meshes (one layer and two layers), cross section thickness of concrete (40 mm and 60mm), concrete cover thickness (15mm and 20 mm) and also the shapes of cross section (square or circular). Special attention to initial cracking load, ultimate load, deflection, cracking pattern, energy absorption and ductility index were investigated. Good agreement was found compared with the experimental results. Out of this research; this paper presents applications of self-compacted concrete for casting skinny structural hollow members. These members can be used as precast units within the construction of the tunnel to decrease the problems in highway roads due to the difficulty of using crossing bridges particularly for kids and old people which are very useful for developing countries with great economic advantages

Central Venous Oxygen Saturation as a Predictor of the Outcome of Weaning From Mechanical Ventilation

Weaning from mechanical ventilation represents a corner stone of management of critically ill patients. Successful weaning represents a great achievement in patient's critical course in the ICU. This makes the process of weaning one of the most difficult steps in ICU care, for those reason, such a study was done to create a new thinking about the predictors that facilitate patient weaning from mechanical ventilator. The aim of this study is to evaluate the central venous saturation as a predictor of the outcome of weaning from mechanical ventilation. Cohort, unicentric, clinical study research design was utilized in the current study. Sample consists of one hundred and twenty patients over a one year period, all patients passed the first SBT (spontaneous breathing trial) and weaned successfully from mechanical ventilation were extubated after undergoing a two-step weaning protocol (measurements of predictors followed by a T-tube trial). Extubation failure was defined as the need of re-intubation within 48 hrs. The weaning protocol evaluated hemodynamic, ventilation parameters, arterial and venous gases during mechanical ventilation (Immediately before T-tube trial), and at the 30th min of spontaneous breathing trial. Findings of this study show that re-intubation rate was 30%. Analysis by logistic regression revealed that central venous saturation was the only variable able to discriminate outcome of extubation. Reduction of central venous saturation by >5% was an independent predictor of re-intubation, with odds ratio of 52.6 (95% confidence interval =16.34–169.42), a sensitivity of 87%, and a specificity of 90%. Reduction of central venous saturation during spontaneous breathing trial was associated with extubation failure and could reflect the increase of respiratory muscles oxygen consumption. Results of the present study indicated that central venous saturation was an early and independent predictor of extubation failure and may be a valuable accurate parameter to be included in weaning protocols. Keywords: Central Venous Saturation - Mechanical Ventilation - Extubation

Encapsulation of bioactive compounds extracted from date palm seeds (Phoenix dactylifera L.) and their use in functional food

Publisher Copyright: Copyright © 2022 Hashim, Huang, Nadtochii, Baranenko, Boulkrane and El-Messery.Liposomes have been used as a novel phytoconstituent delivery system to encapsulate lyophilized palm seed phenolic extract (PSPE) and incorporate it into yogurt as a food model to enhance the bioavailability of PSPE. Phenolic compounds were extracted with aqueous ethanol from palm seed powder using the solvent-maceration approach assisted by ultrasonication. Lyophilized PSPE (0.2–1% w/v) was enclosed in a liposome structure coated with or without chitosan (primary/secondary liposome). Particle size, zeta potential, encapsulation efficiency (EE), Fourier transform infrared spectroscopy (FTIR), and transmission electron microscopy (TEM) were applied to investigate the primary and secondary liposomes. To assess the in vitro bioaccessibility of PSPE and primary/secondary liposomes, the total phenolic content (TPC) and the antioxidant activity were studied during the oral, gastric, and intestinal digestion stages. Three concentrations of lyophilized secondary liposomes (1.25, 2.5, and 3.75% w/v) were added to the yogurt food model. During the 14 days of storage, the physical, chemical, and sensory properties were assessed. Compared to the primary liposomes (87%), the secondary liposomes (91%) showed a higher encapsulation efficiency. Comparing the secondary liposomes to the original liposomes and the non-encapsulated PSPE, the bioaccessibility of phenolic compounds was improved. Fortified yogurt with secondary liposomes had a lower syneresis and viscosity than the reference yogurt. The encapsulated PSPE provided a good level of protection, and its release increased throughout the intestinal phase. Thus, PSPE in a microencapsulated form has been proven to be a rich and cost-effective source of phenolics that can be used successfully to produce functional yogurt.Peer reviewe

Intraoperative endomanometric laparoscopic Nissen fundoplication improves postoperative outcomes in large sliding hiatus hernia with severe gastroesophageal reflux disease. A retrospective cohort study

Background: Laparoscopic Nissen Fundoplication (LNF) is the gold standard surgical intervention for gastroesophageal reflux disease (GERD). LNF can be followed by recurrent symptoms or complications affecting patient satisfaction. The aim of this study is to assess the value of the intraoperative endomanometric evaluation of esophagogastric competence and pressure combined with LNF in patients with large sliding hiatus hernia (> 5 cm) with severe GERD (DeMeester score >100). Materials and methods: This is a retrospective, multicenter cohort study. Baseline characteristics, postoperative dysphagia and gas bloat syndrome, recurrent symptoms, and satisfaction were collected from a prospectively maintained database. Outcomes analyzed included recurrent reflux symptoms, postoperative side effects, and satisfaction with surgery. Results: 360 patients were stratified into endomanometric LNF (180 patients, LNF+) and LNF alone (180 patients, LNF). Recurrent heartburn (3.9% vs. 8.3%) and recurrent regurgitation (2.2% vs. 5%) showed a lower incidence in the LNF+ group (P=0.012). Postoperative score III recurrent heartburn and score III regurgitations occurred in 0% vs. 3.3% and 0% vs. 2.8% cases in the LNF+ and LNF groups, respectively (P=0.005). Postoperative persistent dysphagia and gas bloat syndrome occurred in 1.75% vs. 5.6% and 0% vs. 3.9% of patients (P=0.001). Score III postoperative persistent dysphagia was 0% vs. 2.8% in the two groups (P=0.007). There was no redo surgery for dysphagia after LNF+. Patient satisfaction at the end of the study was 93.3% vs. 86.7% in both cohorts, respectively (P=0.05). Conclusions: Intraoperative high-resolution manometry (HRM) and endoscopic were feasible in all patients, and the outcomes were favorable from an effectiveness and safety standpoint

In vitro evaluation of electroporated gold nanoparticles and extremely-low frequency electromagnetic field anticancer activity against Hep-2 laryngeal cancer cells

Introduction. The extremely-low frequency electromagnetic field (ELFEMF) has been proposed for use in cancer therapy since it was found that magnetic waves interfere with many biological processes. Gold nanoparticles (Au-NPs) have been widely used for drug delivery during cancer in vitro studies due to their low cytotoxity and high biocompatibility. The electroporation of cancer cells in a presence of Au-NPs (EP Au-NPs) can induce cell apoptosis, alterations of cell cycle profile and morphological changes. The impact of ELFEMF and EP Au-NPs on morphology, cell cycle and activation of apoptosis-associated genes on Hep-2 laryngeal cancer cell line has not been studied yet. Materials and methods. ELFEMF on Hep-2 cells were carried out using four different conditions: 25/50 mT at 15/30 min, while Au-NPs were used as direct contact (DC) or with electroporation (EP, 10 pulses at 200V, equal time intervals of 4 sec). MTT assay was used to check the toxicity of DC Au-NPs. Expression of CASP3, P53, BAX and BCL2 genes was quantified using qPCR. Cell cycle was analyzed by flow cytometry. Hematoxylin and eosin (HE) staining was used to observe cell morphology. Results. Calculated IC50 of DC Au-NPs 24.36 μM (4.79 μg/ml) and such concentration was used for further DC and EP AuNPs experiments. The up-regulation of pro-apoptotic genes (CASP3, P53, BAX) and decreased expression of BCL2, respectively, was observed for all analyzed conditions with the highest differences for EP AuNPs and ELFEMF 50 mT/30 min in comparison to control cells. The highest content of cells arrested in G2/M phase was observed in ELFEMF-treated cells for 30 min both at 25 or 50 mT, while the cells treated with EP AuNPs or ELFEMF 50 mT/15 min showed highest ratios of apoptotic cells. HE staining of electroporated cells and cells exposed to ELFEMF’s low and higher frequencies for different times showed nuclear pleomorphic cells. Numerous apoptotic bodies were observed in the irregular cell membrane of neoplastic and necrotic cells with mixed euchromatin and heterochromatin. Conclusions. Our observations indicate that treatment of Hep-2 laryngeal cancer cells with ELFEMF for 30 min at 25–50 mT and EP Au-NPs can cause cell damage inducing apoptosis and cell cycle arrest

Impact of Nurses’ Work Patterns on Nurses and Patients in Critical Care and Toxicology Care Units of Alexandria University Hospitals

Background: Nowadays, there are difficulties in recruiting and retaining nursing staff with increasing pressures and demands on nurses working in critical care areas. The role of nursing care in patients' safety and healthcare outcomes has led to increased interest in measuring and reporting nurses’ work patterns and their consequences on nurses and patients. Objectives:  Describe nurses’ work patterns and their impacts on nurses and patient outcomes. Methods: Self-report forms were used to collect data regarding nurses’ time spent on direct and indirect nursing activities, non- nursing care and personal activities as well as care left undone. Questionnaires were used to measure stress, tension, conflict, nurses’ intent to leave, nurses' satisfaction and  patient satisfaction  Results: nurses spent their working time on direct nursing care (36.64 %); indirect nursing care (28.18 %), non-nursing care (30.64 %) and personal activities ( 4.7%). Profile of direct and indirect patient care and personal activities increased in night shifts, while the profile of non-nursing tasks increased in morning shifts.  There was a positive correlation between care left undone and three non-nursing tasks. Besides, there was a positive correlation between left care undone, non-nursing duties and four nursing job outcomes. There also was a negative correlation between care left undone, non-nursing tasks and nurses' and patients' satisfaction.  Conclusion:  the study focused on the importance of direct patient care on improving quality of care and patient safety. Reducing the performance of non-nursing duties by nurses and decreasing care left undone will most likely result in greater nurses’ and patients’  satisfaction, reduced stress, tension, and conflict and decreased numbers of  nurses’ leaving their jobs. Keywords: work, patterns, nurses, patients, outcome

Management of Extremity Venous Thrombosis in Neonates and Infants: An Experience From a Resource Challenged Setting

We aimed to evaluate the outcome of different treatment modalities for extremity venous thrombosis (VT) in neonates and infants, highlighting the current debate on their best tool of management. This retrospective study took place over a 9-year period from January 2009 to December 2017. All treated patients were referred to the vascular and pediatric surgery departments from the neonatal intensive care unit. All patients underwent a thorough history-taking as well as general clinical and local examination of the affected limb. Patients were divided into 2 groups: group I included those who underwent a conservative treated with the sole administration of unfractionated heparin (UFH), whereas group II included those who were treated with UFH plus warfarin. Sixty-three patients were included in this study. They were 36 males and 27 females. Their age ranged from 3 to 302 days. Forty-one (65%) patients had VT in the upper limb, whereas the remaining 22 (35%) had lower extremity VT. The success rate of the nonsurgical treatment was accomplished in 81% of patients. The remaining 19% underwent limb severing, due to established gangrene. The Kaplan-Meier survival method revealed a highly significant increase in both mean and median survival times in those groups treated with heparin and warfarin compared to heparin-only group (P < .001). Nonoperative treatment with anticoagulation or observation (ie, wait-and-see policy) alone may be an easily applicable, effective, and a safe modality for management of VT in neonates and infants, especially in developing countries with poor or highly challenged resource settings

Hepatobiliary manifestations following two-stages elective laparoscopic restorative proctocolectomy for patients with ulcerative colitis: A prospective observational study

BACKGROUNDHepatobiliary manifestations occur in ulcerative colitis (UC) patients. The effect of laparoscopic restorative proctocolectomy (LRP) with ileal pouch anal anastomosis (IPAA) on hepatobiliary manifestations is debated.AIMTo evaluate hepatobiliary changes after two-stages elective laparoscopic restorative proctocolectomy for patients with UC.METHODSBetween June 2013 and June 2018, 167 patients with hepatobiliary symptoms underwent two-stage elective LRP for UC in a prospective observational study. Patients with UC and having at least one hepatobiliary manifestation who underwent LRP with IPAA were included in the study. The patients were followed up for four years to assess the outcomes of hepatobiliary manifestations.RESULTSThe patients' mean age was 36 +/- 8 years, and males predominated (67.1%). The most common hepatobiliary diagnostic method was liver biopsy (85.6%), followed by Magnetic resonance cholangiopancreatography (63.5%), Antineutrophil cytoplasmic antibodies (62.5%), abdominal ultrasonography (35.9%), and Endoscopic retrograde cholangiopancreatography (6%). The most common hepatobiliary symptom was Primary sclerosing cholangitis (PSC) (62.3%), followed by fatty liver (16.8%) and gallbladder stone (10.2%). 66.4% of patients showed a stable course after surgery. Progressive or regressive courses occurred in 16.8% of each. Mortality was 6%, and recurrence or progression of symptoms required surgery for 15%. Most PSC patients (87.5%) had a stable course, and only 12.5% became worse. Two-thirds (64.3%) of fatty liver patients showed a regressive course, while one-third (35.7%) showed a stable course. Survival rates were 98.8%, 97%, 95.8%, and 94% at 12 mo, 24 mo, 36 mo, and at the end of the follow-up.CONCLUSIONIn patients with UC who had LRP, there is a positive impact on hepatobiliary disease. It caused an improvement in PSC and fatty liver disease. The most prevalent unchanged course was PSC, while the most common improvement was fatty liver disease