Heterojunction-based photocatalytic nitrogen fixation: principles and current progress

Nitrogen fixation is considered one of the grand challenges of the 21st century for achieving the ultimate vision of a green and sustainable future. It is crucial to develop and design sustainable nitrogen fixation techniques with minimal environmental impact as an alternative to the energy-cost intensive Haber-Bosch process. Heterojunction-based photocatalysis has recently emerged as a viable solution for the various environmental and energy issues, including nitrogen fixation. The primary advantages of heterojunction photocatalysts are spatially separated photogenerated charge carriers while retaining high oxidation and reduction potentials of the individual components, enabling visible light-harvesting. This review summarises the fundamental principles of photocatalytic heterostructures, the reaction mechanism of the nitrogen reduction reaction, ammonia detection methods, and the current progress of heterostructured photocatalysts for nitrogen fixation. Finally, future challenges and prospects are briefly discussed for the emerging field of heterostructured photocatalytic nitrogen fixation.

[Ankylosing spondylitis in Senegal: epidemiological, diagnostic, therapeutic and evolutionary features at the Hospital Center University Aristide Le Dantec, Dakar]

Introduction

la spondylarthrite ankylosante (SA) est une maladie évolutive, pouvant s'aggraver par une invalidité. Le but de notre étude est de décrire les aspects épidémiologiques, diagnostiques, thérapeutiques et évolutifs de la SA dans le service de rhumatologie du Centre Hospitalier Universitaire Aristide LeDantec à Dakar.

Méthodes

il s´agissait d´une étude transversale descriptive et analytique, avec un recueil de données à la fois prospectif et rétrospectif sur une période de 8 ans, entre janvier 2012 et décembre 2020, sur des patients atteints de SA de diagnostic établi en accord avec les critères diagnostiques d´Amor, de l´ESSG (European Seronegative Spondylarthropathy Group), d´ASAS (Assessment of Spondyloarthritis International Society) et les critères de New York modifié pour la SA. Les données ont été recueillies par le biais d'un questionnaire structuré et analysées à l´aide du logiciel SPSS25 (Statistical Package for the Social Sciences).

Résultats

six cent quarante-sept (647) patients ont répondu aux critères d´inclusions; 414 femmes et 233 hommes soit un sex ratio de 1,77F/1H. Différentes formes symptomatiques étaient obtenues: les formes axiales (55,65%), les formes mixtes (44,35%) et les formes systémiques avec manifestation extra-articulaires: uvéites (12,21%), insuffisance aortique (5,71%) et maladie fibrobulleuse des poumons (3,86%). Soixante pourcent (60%) des patients étaient sous antiinflammatoires non stéroïdiens (AINS), 47% sous méthotrexate et 0,92% sous biothérapie. Les indices d´activité de la maladie, les indices fonctionnels et les indices de la qualité de vie ont permis le suivi de la maladie.

Conclusion

nos résultats ont montré une prédominance féminine. Les formes axiales étaient les plus représentées. Plus de la moitié de nos patients étaient sous antiinflammatoires, 47% sous méthotrexate et 0,92% sous biothérapie. Cette étude a permis de comprendre le poids de la SA dans les spondyloarthrites et son évolution dans le temps.

A Diagnostic Pitfall in the Evaluation of CD138-Positive Plasmacytoid Cells in a Fine Needle Aspiration Biopsy

Introduction/Objective

The identification of plasmacytoid cells on rapid assessment leads to a wide range of differential diagnoses.

Methods/Case Report

We present a 51-year-old female with a parotid mass and cervical lymphadenopathy. The fine needle aspiration biopsy of the lymph node showed clusters of plasmacytoid cells. Flow cytometric studies showed cells positive for CD19, CD45, CD138 and kappa, but negative for CD38 and lambda. The kappa to lambda ratio was greater than 100. Histological sections showed plasmacytoid cells that were positive for AE1/AE3, S100, and SOX10, weakly positive for CK7 and GATA3, but negative for CD79a, CD45, EMA, p40, p63, and pan-melanoma markers. Kappa and lambda had a 1:1 ratio. Due to the discrepancy between the flow cytometric results and the immunohistochemistry, excision was recommended. The subsequent excision specimen showed classic morphology for myoepithelial carcinoma, plasmacytoid variant.

Results (if a Case Study enter NA)

NA

Conclusion

Myoepithelial carcinomas of the salivary glands are rare neoplasms, and they have various morphologies. The plasmacytoid variant can pose as a diagnostic pitfall. In fine needle aspiration biopsies, carcinoma cells with plasmacytoid morphology can be confused with a plasma cell neoplasm. CD138 is nonspecific marker, and it can be expressed in plasma cells as well as carcinomas. To further complicate matters, pancytokeratin and SOX10 can aberrantly expressed in some plasma cell myelomas. Flow cytometry studies is a valuable tool to define various cell types. However, it can be misleading if it is used as a sole source for interpreting plasmacytoid cells. Epithelial and myoepithelial neoplasms should be considered as differential diagnoses when CD138-positive plasmacytoid cells are encountered. Extended immunohistochemistry panel including multiple epithelial and myoepithelial markers play pivotal role in settling the diagnosis.

Spondyloarthritis in Senegal: a study of 770 cases

BACKGROUND

Very few studies have focused on spondyloarthritis (SpA) in sub-Saharan Africa. The majority of these studies have focused on series of HLA B27-negative SpA.

OBJECTIVE

To determine the epidemiological, diagnostic, therapeutic and evolutionary aspects of SpA in the rheumatology department of the CHU Aristide LeDantec in Dakar, Senegal.

METHODS

We conducted a retrospective, descriptive, analytical study from January 1, 2012 to December 31, 2020, of patients with spondyloarthritis diagnosed according to the ESSG (54.5%), Amor (52.5%), modified New York criteria (48.3%) and ASAS (23%). For each patient, the following information was collected: sex, age, occupation, family history of spondyloarthritis in the parents, time to diagnosis, type of SpA.

RESULTS

770 observations were collected from 273 men (35.5%) and 497 women (64.5%). Ankylosing spondylitis (AS) was the most frequent type of SpA in our series with 84% of cases. A biological inflammatory syndrome was present in 77.27% of our patients. HLA B27 phenotyping was performed in 437 patients, of which 225 were HLA B27 positive (51.48%). The majority of our patients were under conventional treatment due to the high cost of biotherapies which limits their prescription.

CONCLUSION

The profile of SpA patients in our series was characterised by : the predominance of females, the later age of onset, the frequency of radiographic axial forms of SpA and the biological inflammatory syndrome. HLA B27 was present in one patient out of two, as in the North African series.

Honey as a bioindicator of environmental organochlorine insecticides contamination

Honey is a suitable matrix for the evaluation of environmental contaminants including organochlorine insecticides. The present study was conducted to evaluate residues of fifteen organochlorine insecticides in honey samples of unifloral and multifloral origins from Dir, Pakistan. Honey samples (5 g each) were extracted with GC grade organic solvents and then subjected to Rotary Evaporator till dryness. The extracts were then mixed with n-Hexane (5 ml) and purified through Column Chromatography. Purified extracts (1μl each) were processed through Gas Chromatograph coupled with Electron Capture Detector (GC-ECD) for identification and quantification of the insecticides. Of the 15 insecticides tested, 46.7% were detected while 53.3% were not detected in the honey samples. Heptachlor was the most prevalent insecticide with a mean level of 0.0018 mg/kg detected in 80% of the samples followed by β-HCH with a mean level of 0.0016 mg/kg detected in 71.4% of the honey samples. Honey samples from Acacia modesta Wall. were 100% positive for Heptachlor with a mean level of 0.0048 mg/kg followed by β-HCH with a mean level of 0.003 mg/kg and frequency of 83.3%. Minimum levels of the tested insecticides were detected in the unifloral honey from Ziziphus jujuba Mill. Methoxychlor, Endosulfan, Endrin and metabolites of DDT were not detected in the studied honey samples. Some of the tested insecticides are banned in Pakistan but are still detected in honey samples indicating their use in the study area. The detected levels of all insecticides were below the Maximum Residue Levels (MRLs) and safe for consumers. However, the levels detected can cause mortality in insect fauna. The use of banned insecticides is one of the main factors responsible for the declining populations of important insect pollinators including honeybees.

Serratus Anterior Plane Block in Pediatric Patients Undergoing Thoracic Surgeries: A Randomized Controlled Trial

OBJECTIVE(S)

This study was designed to evaluate the efficacy and safety of serratus anterior plane block (SAPB) as an analgesic technique for thoracotomies in pediatric patients.

DESIGN

Double-blinded randomized controlled trial.

SETTING

A single-center study at Aboelrish Pediatric Hospital, one tertiary hospital of Cairo University Hospitals.

PARTICIPANTS

Seventy pediatric patients aged six months-to-three years scheduled for thoracotomies.

INTERVENTIONS

Patients were randomized into two groups, group SF and group F. Group SF received an ultrasound-guided SAPB (n = 35), whereas group F (n = 35) did not. All groups received an intraoperative fentanyl infusion (at 0.5 μg/kg /h).

MEASUREMENTS

The primary outcome was the total dose of postoperatively administrated fentanyl in the first 24 hours. The secondary outcomes included the total dose of intraoperative additional fentanyl boluses; time of the first postoperative rescue analgesia; and postoperative Face, Legs, Activity, Cry, Consolability scale (FLACC) score values.

MAIN RESULTS

The main results of this study showed that the administrated fentanyl in the 24 hours postoperatively was significantly lower in SF group than in F group (p value ˂ 0.001). In addition, significant decreases of the postoperative FLACC pain score (p value ˂ 0.001), reduction of intraoperative fentanyl consumption (p value ˂ 0.001), and delay of the first rescue analgesia (p value ˂ 0.001) were recorded in SF group in relation to F group without significant complications in both groups.

CONCLUSIONS

Serratus anterior plane block can provide a safe, effective, and easy-to-perform regional technique for children undergoing thoracotomies.

Humor of the Leader: A Source of Creativity of Employees Through Psychological Empowerment or Unethical Behavior Through Perceived Power? The Role of Self-Deprecating Behavior

Although we use humor in our daily communication, there still needs to cognize its effects on the attitudes and behavior of the employees. Based on benign violation theory (BVT), the study proposes that leader's humor (LH) conveys social information about counter norms. The BVT has been amalgamated with social information processing theory (SIPT) to develop hypotheses assuming the consequences of LH on the attitude and behavior of the employees. This study hypothesizes that even though LH is linked positively with employee creativity via leader-member exchange and psychological empowerment in sequence (blessing path), it may also send information to the employees about the acceptability of norm violation. This perception ultimately leads to power perception and, causes unethical behavior in the series (curse path). Moreover, this study also postulates that leader's self-deprecating humor (LSDH) moderates these indirect effects by enhancing the blessing and reducing the curse, which emerged from LH. Quantitative data of 630 software engineers from software houses based in Pakistan provided support to test the hypotheses. The results demonstrate that LH is a double-edge sword that enhances blessing (creativity) as well as curse (employee unethical behavior), whereas LSDH augments the blessing and throttles back the curse. Theoretical and managerial implications have also been discussed.

Tuneable exchange-spring stiffness in amorphous magnetic trilayer structures

We investigate the magnetic properties of amorphous Sm₁₀Co₉₀/Co₆₀(Al₇₀Zr₃₀)₄₀/Co₈₅(Al₇₀Zr₃₀)₁₅exchange-spring magnet trilayers. The magnetically soft Co₈₅(Al₇₀Zr₃₀)₁₅layer is coupled to the magnetically hard Sm₁₀Co₉₀layer through the weakly magnetic low-T_cCo₆₀(Al₇₀Zr₃₀)₄₀spacer layer. The strength of the coupling can be controlled with temperature and the coupling persists above the intrinsicT_cof the spacer layer due to a long-range magnetic proximity effect. Polarized neutron reflectivity is used to examine the magnetic profile of the trilayers during magnetization reversal. A two-step switching occurs, with the switching angle of the soft layer strongly dependent on the strength of the coupling. In the strong coupling regime a magnetic state can be achieved where the soft layer magnetization is perpendicular to the hard layer whereas in the weak coupling regime the soft layer reverses fully.

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

BACKGROUND

Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality.

METHODS

We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung's disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis.

FINDINGS

We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung's disease) from 264 hospitals (89 in high-income countries, 166 in middle-income countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36-39) and median bodyweight at presentation was 2·8 kg (2·3-3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in low-income countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88-4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59-2·79], p<0·0001), sepsis at presentation (1·20 [1·04-1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4-5 vs ASA 1-2, 1·82 [1·40-2·35], p<0·0001; ASA 3 vs ASA 1-2, 1·58, [1·30-1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02-1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41-2·71], p=0·0001; parenteral nutrition 1·35, [1·05-1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47-0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50-0·86], p=0·0024) or percutaneous central line (0·69 [0·48-1·00], p=0·049) were associated with lower mortality.

INTERPRETATION

Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between low-income, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030.

FUNDING

Wellcome Trust.

Shoulder Function Assessment After Head And Neck Reconstruction With Pedicled Supraclavicular Flap

The supraclavicular artery flap is used for reconstruction of defects of the head and neck. One of the major implications of this procedure is injury to the nerve roots of C3 and C4 of the superficial cervical plexus, which provides sensation over the clavicle, shoulder and proximal chest, thereby causing problems in overall shoulder function. The objective of this study was to assess shoulder function, range of motion, pain, daily activities and overall satisfaction of the patient after using this flap. This study was conducted at the Department of Plastic & Reconstructive Surgery, Dow University of Health Sciences & Dr. Ruth KM Pfau Civil Hospital Karachi, Pakistan, from May 2015 to November 2018. Supraclavicular flap was used in 35 patients who underwent soft tissue reconstruction of defect of the neck after release of post burn contracture. Penn Shoulder Score and Constant Murley Score were used as assessment tools. Assessment by Penn Shoulder Score resulted in 25 (71.4%) patients within the upper quartile and 10 (18.6%) patients within the lower quartile. Constant Murley Score showed 19 (54.2%) of patients had 161°-180° shoulder abduction and lateral elevation. Forward flexion of 161°-180° was seen in 17 (48.5%) patients, 17 (48.5%) had internal rotation till the inter scapular region, 15 (42.8%) had no impairment of external rotation, 19 (54.2%) patients had no impairment of work/recreation, 25 (71.4%) had felt no change in their sleep and 22 (62.8%) were able to position their arm above their head. Overall parameters indicate better function, good range of motion, less pain, resumption of daily activities, and overall satisfaction.

High-Fidelity Controlled-Z Gate with Maximal Intermediate Leakage Operating at the Speed Limit in a Superconducting Quantum Processor

Simple tuneup of fast two-qubit gates is essential for the scaling of quantum processors. We introduce the sudden variant (SNZ) of the net zero scheme realizing controlled-Z (CZ) gates by flux control of transmon frequency. SNZ CZ gates realized in a multitransmon processor operate at the speed limit of transverse coupling between computational and noncomputational states by maximizing intermediate leakage. Beyond speed, the key advantage of SNZ is tuneup simplicity, owing to the regular structure of conditional phase and leakage as a function of two control parameters. SNZ is compatible with scalable schemes for quantum error correction and adaptable to generalized conditional-phase gates useful in intermediate-scale applications.

Prevalence and Associated Factors of Depression among Patients with HIV/AIDS in Lahore, Pakistan: Cross-Sectional Study

Background

Depression is defined as a psychiatric disorder characterized by depressed mood, lack of concentration, diminished energy, disturbed sleep, and low self-esteem. Depression is more prevalent in HIV/AIDS patients than the general population. There is no published study available that reveals the present status of depression among HIV patients in Pakistan. As such, the present study was conducted to determine the prevalence and associated factors of depression among HIV/AIDS patients attending the HIV clinic of Jinnah Hospital, Lahore, Pakistan.

Methods

A hospital-based cross-sectional study was carried out from February to March 2019 in Lahore. Data were collected from 158 HIV/AIDS patients using a pretested, standardized, structured interviewer-administered questionnaire. Nonprobability convenience sampling was used to recruit the study participants. Depression was evaluated using the Patient Health Questionnaire. SPSS version 23 was used to analyze the data. Binary logistic regression models were used to determine the various factors associated with depression. AORs with 95% CIs were used to assess the magnitude of associations between depression and associated factors.

Results

The mean age of the study participants was 35.03 years±9.123. Prevalence of depression among HIV/AIDS patients was 32.2%. Living in a rural area (AOR 5.60, 95% CI 2.20, 14.15), fear of stigma and discrimination (AOR 3.505, 95% CI 1.364, 9.008), having worked abroad (AOR 3.017, 95% CI 1.134, 8.031), and history of substance abuse (AOR 4.147, 95% CI 1.673, 10.28) were significantly associated with depression.

Conclusion

The prevalence of depression among HIV/AIDS patients is very high in Pakistan. Therefore, it is suggested that guidelines formulated to screen and treat depression among HIV patients.

Low-Dose Ketamine Infusion Versus Morphine Infusion During Abdominoplasty to Change the Postoperative Pain Profile

BACKGROUND

With the increased number of abdominoplasty all over the world, and the need to manage postoperative pain, it is a must to find proper and effective drugs to decrease opioid consumption in the postoperative period.

OBJECTIVES

In this double-blind randomized controlled clinical trial, we assumed that low-dose ketamine infusion will reduce the postoperative pain profile than the conventional method of morphine.

METHODS

The scheduled patients for abdominoplasty under general anesthesia were recruited in two groups: group (K) with low-dose ketamine infusion intra-operatively (80 patients) and group (M) with morphine infusion intra-operatively (80 patients). Both groups were monitored intraoperatively and postoperatively for rescue doses of fentanyl, visual analogue scale (VAS), and side effects.

RESULTS

There were no statistical differences between both groups regarding the fentanyl rescue doses intra- and postoperative with no remarkable side effects.

CONCLUSIONS

Low-dose ketamine has a useful analgesic effect in abdominoplasty similar to morphine without remarkable side effects, such as sedation or hallucinations.

Attenuation of LPS-induced acute lung injury by continentalic acid in rodents through inhibition of inflammatory mediators correlates with increased Nrf2 protein expression

Background

Acute lung injury (ALI) together with acute respiratory distress syndrome (ARDS) are associated with high rate of mortality and morbidity in patients. In the current study, the anti-inflammatory effects of continentalic acid (CNT) in LPS-induced acute lung injury model was explored.

Methods

The acute lung injury model was established by administering LPS (5 mg/kg) intraperitonealy. Following LPS administration, the survival rate, temperature changes and lung Wet/Dry ratio were assessed. The antioxidants (GSH, GST, Catalase and SOD) and oxidative stress markers (MDA, NO, MPO) were evaluated in all the treated groups. Similarly, the cytokines such as IL-1β, IL-6 and TNF-α were analyzed using ELISA assay. The histological changes were determined using H and E staining, while Nrf2 and iNOS level were determined using immunohistochemistry analysis. The molecular docking analysis was performed to assess the pharmacokinetics parameters and interaction of the CNT with various protein targets.

Results

The results showed that CNT dose dependently (10, 50 and 100 mg/kg) reduced mortality rate, body temperature and lungs Wet/Dry ratio. CNT post-treatment significantly inhibited LPS-induced production of pro-inflammatory cytokines such as IL-1β, IL-6 and TNF-α. The CNT post-treatment markedly improved the hematological parameters, while significantly reduced the MPO (indicator of the neutrophilic infiltration) activity compared to the LPS treated group. Furthermore, the CNT (100 mg/kg) post-administration remarkably inhibited the lung Wet/Dry ratio. The CNT (100 mg/kg) treated group showed marked reduction in the oxidative stress markers such as malonaldehyde (MDA) and Nitric oxide (NO) concentration, while induced the level of the anti-oxidant enzymes such as GST, GSH, Catalase and SOD. Similarly, the CNT markedly reduced the iNOS expression level, while induced the Nrf2 protein expression. Additionally, the molecular docking study showed significant binding interaction with the Nrf2, p65, Keap1, HO-1, IL-1β, IL-6, TNF-α and COX-2, while exhibited excellent physicochemical properties.

Conclusion

The CNT showed marked protection against the LPS-induced lung injury and improved the behavioral, biochemical and histological parameters. Furthermore, the CNT showed significant interaction with several protein targets and exhibited better physicochemical properties.

Is implantable loop recorder the answer to reduce the increased risk of stroke in cancer patients?

Introduction

Recent epidemiologic data suggests increased risk of ischaemic stroke in cancer patients. The etiology of increased ischaemic stroke is unknown. Atrial fibrillation (AF) is among the potential etiologies. The risk of AF has not been studied among cancer patients in the United States.

Purpose

Ascertain the association of AF in cancer patients in the USA by using the largest database i.e. National Inpatient Sample (NIS).

Methods

Patients ≥18 years old were selected in the NIS database for years 2010 to 2014 and stratified based on presence or absence of any of four cancers (lung, colon, breast and prostate; 4CA) using ICD 9 codes. Atrial fibrillation and stroke/TIA were also identified using ICD 9 codes. Components of CHADS2 score (CHF, hypertension, Age&gt;75, diabetes and stroke/TIA) were identified using ICD 9 codes. χ2 tests performed for prevalence of AF in patients with or without these cancers stratified by CHADS2 score. Binary logistic regression was used to analyze individual components of CHADS2 score.

Results

AF and stroke/TIA were significantly higher among 4CA than non-4CA group (18.7% vs 12.0%, P&lt;0.001 and 5.4% vs 4.8%, P&lt;0.001 respectively). AF prevalence increased with CHADS2 and was significantly higher in 4CA group with CHADS2 score 0 to 4 (Table 1 and Figure 1). Logistic regression for the outcome of AF showed “Age &gt;75” OR (3.0), CHF (2.8), CVA (1.2), HTN (1.3) and DM (1.1).

Conclusion

This is the first study using a national database of USA patients to estimate prevalence of AF in cancer patients compared to non-cancer patients and reaffirms the higher burden of AF in cancer patients. Prevalence of both AF and stroke were greater in cancer patients when stratified by CHADS2 score. This may indicate not just an increased risk of AF but an increased risk of stroke/TIA for the same CHADS2 score. Stroke incidence was also higher in the 4CA group (5.4% vs. 4.8% P&lt;0.001). Cancer patients with CHADS2 score &gt;1 may benefit from screening with loop recorder to identify previously undetected AF and initiate anticoagulation therapy. Prospective longitudinal studies are needed to validate this retrospective study.

Funding Acknowledgement

Type of funding source: None

Echo State Networks and Long Short-Term Memory for Continuous Gesture Recognition: a Comparative Study

Recent developments of sensors that allow tracking of human movements and gestures enable rapid progress of applications in domains like medical rehabilitation or robotic control. Especially the inertial measurement unit (IMU) is an excellent device for real-time scenarios as it rapidly delivers data input. Therefore, a computational model must be able to learn gesture sequences in a fast yet robust way. We recently introduced an echo state network (ESN) framework for continuous gesture recognition (Tietz et al., 2019) including novel approaches for gesture spotting, i.e., the automatic detection of the start and end phase of a gesture. Although our results showed good classification performance, we identified significant factors which also negatively impact the performance like subgestures and gesture variability. To address these issues, we include experiments with Long Short-Term Memory (LSTM) networks, which is a state-of-the-art model for sequence processing, to compare the obtained results with our framework and to evaluate their robustness regarding pitfalls in the recognition process. In this study, we analyze the two conceptually different approaches processing continuous, variable-length gesture sequences, which shows interesting results comparing the distinct gesture accomplishments. In addition, our results demonstrate that our ESN framework achieves comparably good performance as the LSTM network but has significantly lower training times. We conclude from the present work that ESNs are viable models for continuous gesture recognition delivering reasonable performance for applications requiring real-time performance as in robotic or rehabilitation tasks. From our discussion of this comparative study, we suggest prospective improvements on both the experimental and network architecture level.

Mental Stress in Anesthesia and Intensive Care Physicians During COVID-19 Outbreak

Background

Since the announcement of the World Health Organization of COVID-19 as a global pandemic, the probability of experiencing psychological disturbances and mental health problems among the frontline doctors who deal early with the suspected or confirmed patients is expected to increase, especially among anesthesia and ICU physicians.

Objectives

The objective of this study was to assess the magnitude of mental stress among anesthesia and ICU physicians in Cairo university hospitals, Egypt, treating patients exposed to COVID-19.

Methods

This cross-sectional, survey-based study collected the demographic and mental health data from anesthesia and ICU physicians working in Cairo university hospitals from March 15 to April 15, 2020, in Egypt. The level of stress was assessed by the perceived stress scale (PSS-10).

Results

A total of 193 out of 315 contacted physicians completed the survey. A significant proportion of participants (65%) experienced high levels of psychological distress during this acute situation, with the PSS-10 median score of 21 in the registrar group and 18 in the consultant group; the difference was statistically significant (P = 0.03). The most common causes of stress among the participants were the fears that they might transmit the disease to their loved people and the lack of a clear protocol on how to deal with COVID-19 cases, either suspected or confirmed.

Conclusions

In this survey study, anesthesia and ICU physicians responding to the spread of COVID-19 reported high rates of symptoms of mental stress.

Dexmedetomidine as an Additive to Local Anesthesia for Decreasing Intraocular Pressure in Glaucoma Surgery: A Randomized Trial

Background

Nowadays, the peribulbar block is used as a tool in glaucoma surgery. As a side effect, it increases intraocular pressure that raises the need for adjuvant medication to overcome this problem in the diseased eye. Dexmedetomidine has proven to decrease intraocular pressure (IOP) in the non-glaucomatous eye.

Objectives

In a triple-blinded randomized study, dexmedetomidine as an adjuvant to the peribulbar block was used to decrease IOP in the diseased eye.

Methods

We randomized 98 eyes to three groups, including D50 (35 eyes) with dexmedetomidine 50 µg, D25 (33 eyes) with dexmedetomidine 25 µg, or control group (C) (30 eyes) with the plain peribulbar block. The study was randomized triple-blinded, aiming at testing the effect of dexmedetomidine on IOP after block injection.

Results

The pre-injection IOP was 27.71 ± 2.52, 27.25 ± 3.53, and 26.2 ± 3.57 mmHg in groups D50, D25, and C, respectively, then increased to 29.71 ± 1.69, 30.25 ± 2.36 and 29.4 ± 3.756 in groups D50, D25 and C, respectively, with P >0.05. The pressure decreased after the surgery to 10.86 ± 1.478 in group D50, 10.75 ± 1.63 in group D25, and 10.6 ± 1.589 in group C, with no statistical differences (P > 0.05) between the groups.

Conclusions

Dexmedetomidine did not decrease IOP in the glaucomatous eye.

Agronomic efficiency and profitability of cotton on integrated use of phosphorus and plant microbes

Cotton crop, plays a significant role in Pakistan's economy by ruling a prominent place in edible oil and local textile industry. Phosphorus (P) inaccessibility and deficiency of soil organic matter are the key restraints for low crop productivity in cotton. Therefore, a two years field study was designed during 2014-15, to explore the influence of phosphate solubilizing bacteria (PSB), farmyard manure (FYM), poultry manure (PM) and inanimate sources of P on various physiological, growth, yield and quality parameters of cotton crop at CCRI Multan. Field responses of seeds inoculated with two distinctive phosphate solubilizing bacteria (PSB) strains viz. S0 = control, S1 =strain-1, S2 = strain-2 and eight organic, inorganic P sources viz., P0= control, P1 = 80 kg ha-1 P from inorganic source, P2 = 80 kg ha-1 P from FYM, P3 = 80 kg ha-1 P from PM, P4 = 40 kg ha-1 P from FYM + 40 kg ha-1 P from inorganic source, P5 = 40 kg ha-1 P from PM + 40 kg ha-1 P from inorganic source, P6 = 80 kg ha-1 P from FYM + 40 kg ha-1 P from inorganic source, P7 = 80 kg ha-1 P from PM + 40 kg ha-1 P from inorganic source and P8 = 40 kg ha-1 P from FYM + 40 kg ha-1 P from PM were evaluated. Results revealed that inoculation of seeds with PSB and collective use of inorganic and organic sources of P had considerably increased the yield contributing attributes in cotton. However, the treatment P7 (80 kg P ha-1 from PM + 40 kg P ha-1 from inorganic source) in coincidence with seeds inoculated with PSB (S1) produced taller plant, maximum boll weight, significantly higher LAI and CGR. Significantly higher seed cotton yield, lint yield, fiber length and maximum BCR of 1.95 and 1.81 was also obtained from the P7 treatment during both crop-growing seasons. In conclusion, combined use of 80 kg P ha-1 from PM + 40 kg P ha-1 from inorganic source and cotton seeds inoculated with strain-1 improved phosphorus uptake ensuing in greater consumption of photo-assimilates for maximum growth and yield.

AB0139 T FOLLICULAR HELPER CELLS MAY BE INVOLVED IN THE LUPUS DEVELOPMENT IN HIGH FAT DIET-INDUCED OBESITY MICE

Background:

System lupus erythematosus (SLE) is an autoimmune disease that is associated with skin rash and multiple organs lesion. It is known that obesity is a major factor contributing to the onset and progression of autoimmune diseases including SLE. Our previous study showed that circulating T follicular helper (Tfh) cells played an important role in autoantibody production in SLE patients. A recent study showed that Tfh cells promote B cell production of IgA antibodies, which help shape the composition of the gut microbiota and may modulate obesity.

Objectives:

By establishing an obesity-associated lupus mouse model, we investigated the pathophysiologic link of obesity, SLE and Tfh cells using MRL/lpr lupus prone mice.

Methods:

Twenty MRL/lpr mice (10 male and 10 female) were randomized equally fed with a regular diet (RD) or high fat diet (HFD, 60% calories comprised of fat). Their body weights were recorded weekly as an indicator of obesity achievement. SLE progression was monitored weekly by development of skin lesion and urine protein levels assessed by Bradford assay. Blood was collected for IgG, anti-dsDNA and anti-nuclear antibody (ANA) detection. At the endpoint of week 14, spleen was measured and weighted. Spleen, kidney, and dorsum of neck skin were collected and embedded for H&E, PAS, Masson’s staining, and immune complex staining to detect active histopathological lupus lesions and be quantified as histological skin score and kidney index. Tfh cells in spleen was identified by immunohistochemistry (IHC) staining glomerulus of kidney.

Results:

Obesity was achieved with a significant difference of mouse body weight between the RD and HFD groups by week 3 and continued until week 14 (p<0.05 top<0.01). Evidence of SLE development, such as skin rash on the dorsal neck and back in HFD group showed up as earlier as week 6 and occurred in 55.6% of the HFD group vs 11.1% of the RD group (p<0.05), with a higher histological score of skin in HFD group (p<0.05). Proteinuria was increased from 11 to 14 week in male HFD group with an elevated kidney index and immune-complex deposits in their glomerulus of kidney. There was an increase trend of anti-dsDNA and IgG titer in HFD group, but no difference of ANA was observed between these two groups. Splenomegaly was observed in the HFD mice (p<0.05). The Tfh cells in the spleen of HFD group were higher than RD group.

Conclusion:

Our results show accelerated and greater severity of lupus development in MRL/lpr mice with HFD compared to mice on RD, indicating HFD-induced obesity exacerbates lupus development in mice. Tfh cells may be involved in the relation of SLE and obesity. This model could be used to investigate the mechanism underlying the link between obesity and SLE development. Interventions to reduce body weight or target Tfh cells may improve both lupus symptoms and outcomes in genetically predisposed SLE patients.

References:

[1]Tedeschi S, et al. Obesity and the risk of systemic lupus erythematosus among woman in the Nurses’ Health Studies. Semi in Arth and Rheu. 2017, 47:376-383

[2]Cozier YC, et al. A prospective study of obesity and risk of systemic lupus erythematosus (SLE) among Black woman. Semi in Arth and Rheu. 2019, 48:1030-1034

[3]Wang G, et al. Differential oxidative modification of proteins in MRL+/+and MRL/lpr mice: Increased formation of lipid peroxidation-derived aldehyde-protein adducts may contribute to accelerated onset of autoimmune response. Free Radic Res. 2012, 46(12):1472-1481

[4]Seth A, et al. Spatial and functional heterogeneity of follicular helper T cells in autoimmunity. Current Opinion in Immunology. 2019, 61:1-9

5.Petersen C, et al. T cell–mediated regulation of the microbiota protects against obesity. Science. 2019, 365 (6451): eaat9351

Disclosure of Interests:

None declared

Molecular epidemiology and genotype distribution of hepatitis C in Pakistan; a multicenter cross-sectional study

Pakistan has second highest burden of hepatitis C virus (HCV) infected patients in the World. Little is known about the molecular epidemiology and risk factors for prevailing HCV genotypes in Pakistan. Considering this a multicenter cross-sectional study was conducted at 23different viral hepatitis control and prevention centers. A total of 175,897 patients were registered and screened for HCV, out of which 73,180 (41.6%) were found positive on Architect screening test. The screened positive patients were sequentially tested on RT-PCR; where 41,241 (56.35%) were detected positive. Molecular characterization results showed genotype 3 (73.9%) as the most prevalent type, followed by genotype 1 (9.7%), and genotype 4 (0.3%) was isolated for the first time in Pakistan. On regression analysis; risk factors associated with genotype 3 and 1 included; age group of 30-50 years, rural residence, exposure to >10 injections, barber shaving, circumcision by barbers, and low literacy rate. Phylogenetic analysis based on genotypes identified in this study and sequences isolated from Pakistan in last 10 years demonstrated that genotype 3 and 1 are endemic locally in Punjab province. The high prevalence rate of HCV is a threat for a generalized epidemic and genetic recombination with such variability of genotypes identified here is an alarming condition. More focused attention and resources should be spent in awareness of the population to prevent the spread of HCV among high risk population.

Roles of a Mast Cell-Specific Receptor MRGPRX2 in Host Defense and Inflammation

Mast cells are multifunctional immune cells that are found most abundantly at host-environment interfaces, such as the skin, respiratory tract, and oral/gastrointestinal mucosa. Not surprisingly, mast cells act as sentinel cells that sense microbial attacks and initiate a protective immune response and promote healing. Although mast cells share many features with other innate immune effector cells, such as neutrophils and macrophages, they uniquely interact closely with blood vessels and release an extensive set of mediators for the recruitment of innate and adaptive immune cells. A novel human G protein-coupled receptor (GPCR), known as Mas-related GPCR-X2 (MRGPRX2, mouse ortholog, MrgprB2), has recently been identified, which is expressed on mast cells but not neutrophils and macrophages. Interestingly, activation of MrgprB2 by bacteria-derived quorum-sensing peptides inhibits bacterial growth, prevents biofilm formation, and leads to the recruitment of neutrophils to effectively clear bacteria. Furthermore, host defense antimicrobial peptides and small-molecule peptide mimetics also activate mast cells via MRGPRX2/B2. MrgprB2-mediated activation of local mast cells also clears cutaneous bacterial infection, promotes healing, and protects against reinfection. In addition to their role in host defense, mast cells contribute to a number of chronic inflammatory diseases such as periodontitis, neurogenic inflammation, and inflammatory pain likely via the activation of MRGPRX2. In this review, we discuss the roles of MRGPRX2/B2 in the clearance of bacterial infection, wound healing, periodontal disease, neurogenic inflammation, and inflammatory pain. We propose that harnessing mast cells' host defense and immunomodulatory properties via the activation of MRGPRX2 may lead to novel approaches for the treatment of drug-resistant bacterial infections. On the other hand, increased MRGPRX2 expression on mast cells and their inappropriate activation may contribute to periodontitis, neurogenic inflammation, and inflammatory pain. Thus, targeting MRGPRX2 could provide novel approaches to modulate these conditions.

In vitro anti-diabetic activity of stingless bee honey from different botanical origins

The number of patients with diabetes mellitus is increasing at an alarming rate and this situation has triggered the interest of searching natural product as an alternative treatment. Stingless bee honey containing a diverse array of bioactive compounds is commonly utilized as a functional food and also found to possess various therapeutic effects including anti-diabetic through α-amylase and α-glucosidase inhibition. However, the composition level of bioactive compounds varying of geographical origins and botanical sources of honey leads to different enzyme inhibition abilities. Therefore, this study explored the total phenolic, total flavonoid, α-amylase and α-glucosidase inhibition activities of stingless bee honey from various botanical origins. In this study, stingless bee honey was collected from 6 different botanical origins namely, acacia, coconut, mangrove, starfruit, multifruit and multiflower plant. Honey from tualang tree was used as a positive control. Phenolic and flavonoid contents as well as α-amylase and α-glucosidase inhibition activities of honey were studied spectrophotometrically. Stingless bee honey from mangrove was found to have the highest phenolic content (141.74±0.03 mg GAE/100 g). The honey collected from coconut origin showed the highest flavonoid content with the value of 51.33±0.02 mg RE/100 g and also achieved the highest percentage inhibition against α-glucosidase (68.33% at 100 µg/mL). Furthermore, tualang honey and honey samples from mangrove, coconut and Acacia tree were found to have strong α-amylase inhibition abilities as their inhibition percentages were more than 70.00% at 100 µg/mL. This study showed that the presence of flavonoid and phenolic compounds in honey from different botanical origins yielded different degree of α-amylase and α-glucosidase inhibition and also recommended the uses of stingless bee honey in diabetes treatment.

Near-UV luminescence tomography with an aperture-free meta super oscillatory lens for single molecule detection

Medical physics offers super oscillatory lenses (SOL) to attain subwavelength focusing for efficient image resolution in the detection of a single molecule. In this paper, we propose a negative-indexed permeability-controlled meta SOL, which restores the light concentration via exciting surface plasmon resonance and enhances luminescence at our region of interest, i.e., fluid sample (${S_L}$S_L). The meta SOL is aperture-free in comparison with other techniques (zero-mode waveguides and nano antennas) and hence avoids the constraints, which are posed by nano apertures, to insert a small volume of $ S_L $S_L into these nano apertures for detection purposes. The meta SOL is a unique combination of gold split rings mounted on silicon dioxide (${{\rm SiO}_2}$SiO₂) substrate and operational in the near-ultraviolet (UV) region. We utilized the phenomena of negative index of refraction, and our simulated trails exploit the magnetic (${\mu _r}$μ_r) response of the meta SOL by analyzing its transmission spectra in the frequency range from 3.53 to 3.57 Peta Hz. We observe the methodical response of the meta SOL with its ample potential to surpass the resolution at a working wavelength of $\lambda ={84.173}\;{\rm nm}$λ=84.173nm, which enhances luminescence by restoring the evanescent UV magnetic field (${B_{\rm UV}}$B_UV) at ${S_L}$S_L. This technique will offer a new and easy approach to uplift the efficiency of super oscillatory lenses in the near-UV regime to benefit single molecule detection techniques and thus the novelty.

Post-burn neck contracture: effectively managed with supraclavicular artery flap

Post-burn neck contracture is one of the most common burn sequels. These contractures affect the patient significantly causing both functional limitations and esthetic disfigurements, which lead to cosmetic, functional and social problems. Our objective was to determine the role of supraclavicular artery island (SAI) flap as an option for the reconstruction of soft tissue defect of the neck after release of post-burn contracture. The study was conducted at the Department of Plastic & Reconstructive Surgery, Dow University of Health Sciences & Dr. Ruth KM Pfau Civil Hospital Karachi, Pakistan, from February 2015 to April 2018. Patients of both genders in any age group who required reconstruction of soft tissue defects after release of post-burn neck contracture were included. Patients with neck irradiation, trauma, failure of previous surgery, bleeding diathesis, or severe scarring at the supraclavicular region were excluded. A total of 31 supraclavicular flaps were performed in 28 cases for reconstruction of soft tissue neck defect. Mean age was 29.8 years. Patients were followed for 3 months postoperatively. Complete flap necrosis was observed in 1 (3.2%), distal necrosis in 2 (6.4%) cases, postoperative hematoma of the neck was found in 1 (3.2%) and wound dehiscence was reported in 2 (6.4%) cases. Donor site was closed primarily in 25 (81%) cases while the rest were skin grafted. Supraclavicular artery flap is an effective choice with impressive recovery, acceptable skin color match and restoration of anatomic function at the recipient site without any major complications.

nab-Paclitaxel plus carboplatin or gemcitabine versus gemcitabine plus carboplatin as first-line treatment of patients with triple-negative metastatic breast cancer: results from the tnAcity trial

Background

Metastatic triple-negative breast cancer (mTNBC) has a poor prognosis and aggressive clinical course. tnAcity evaluated the efficacy and safety of first-line nab-paclitaxel plus carboplatin (nab-P/C), nab-paclitaxel plus gemcitabine (nab-P/G), and gemcitabine plus carboplatin (G/C) in patients with mTNBC.

Patients and methods

Patients with pathologically confirmed mTNBC and no prior chemotherapy for metastatic BC received (1 : 1 : 1) nab-P 125 mg/m2 plus C AUC 2, nab-P 125 mg/m2 plus G 1000 mg/m2, or G 1000 mg/m2 plus C AUC 2, all on days 1, 8 q3w. Phase II primary end point: investigator-assessed progression-free survival (PFS); secondary end points included overall response rate (ORR), overall survival (OS), percentage of patients initiating cycle 6 with doublet therapy, and safety.

Results

In total, 191 patients were enrolled (nab-P/C, n = 64; nab-P/G, n = 61; G/C, n = 66). PFS was significantly longer with nab-P/C versus nab-P/G [median, 8.3 versus 5.5 months; hazard ratio (HR), 0.59 [95% CI, 0.38-0.92]; P = 0.02] or G/C (median, 8.3 versus 6.0 months; HR, 0.58 [95% CI, 0.37-0.90]; P = 0.02). OS was numerically longer with nab-P/C versus nab-P/G (median, 16.8 versus 12.1 months; HR, 0.73 [95% CI, 0.47-1.13]; P = 0.16) or G/C (median, 16.8 versus 12.6 months; HR, 0.80 [95% CI, 0.52-1.22]; P = 0.29). ORR was 73%, 39%, and 44%, respectively. In the nab-P/C, nab-P/G, and G/C groups, 64%, 56%, and 50% of patients initiated cycle 6 with a doublet. Grade ≥3 adverse events were mainly hematologic.

Conclusions

First-line nab-P/C was active in mTNBC and resulted in a significantly longer PFS and improved risk/benefit profile versus nab-P/G or G/C.

P666Anti-platelet therapy in the primary prevention of cardiovascular disease in patients with chronic obstructive pulmonary disease: randomised controlled proof of concept trial (APPLE COPD-ICON 2)

Acknowledgement/Funding

Astra Zeneca (Funder reference number ISSBRIL0303)

Risk factors for unsuccessful tuberculosis treatment outcomes in children

OBJECTIVE

Pakistan has a high pediatric burden of tuberculosis, but few studies describe the treatment experience of children with tuberculosis in Pakistan. We sought to identify risk factors for unsuccessful treatment outcomes in children with drug-susceptible tuberculosis identified in eight hospitals in Karachi, Pakistan.

DESIGN

We conducted a retrospective cohort study among children (<15 years old) treated with first-line anti-tuberculosis drugs for presumed or confirmed drug-susceptible tuberculosis between 2016 and 2017. We assessed risk factors for experiencing an unsuccessful treatment outcome through multivariable logistic regression analysis.

RESULTS

In total, 1,665 children initiated tuberculosis treatment, including 916 (55.0%) identified through intensified case finding. Unsuccessful treatment outcomes were experienced by 197 (11.8%) children, comprising 27 (1.6%) deaths, 16 (1.0%) treatment failures, and 154 (9.3%) lost to follow-up. An additional 47 (2.8%) children had outcomes not evaluable. In multivariable analysis, children 0-4 years old (OR: 1.80, 95% CI: 1.07-3.04), males (OR: 1.48, 95% CI: 1.04, 2.11), and those with bacteriologic confirmation of disease (OR: 3.39, 95% CI: 1.98, 5.80) had increased odds of experiencing an unsuccessful treatment outcome.

CONCLUSION

Our findings suggest a need to deploy strategies to identify children earlier in the disease process and point to the need for interventions tailored for young children once treatment is initiated.

2-Methylimidazole assisted ultrafast synthesis of carboxylate-based metal-organic framework nano-structures in aqueous medium at room temperature

Carboxylate-based metal-organic frameworks (CMOFs) have received considerable attentions for their high stability, catalytic activity, and porosity. However, synthesis of CMOFs requires high temperature, pressure, and long reaction time. Here, we explored the activity of 2-methylimidazole (2-MIM) for ultrafast synthesis of CMOF nanostructures (CMOFNs), in aqueous medium at room temperature and reaction time of 10 min. Seven CMOFNs have been synthesized by using Al³⁺, Cr³⁺, Cu²⁺, Fe³⁺, In³⁺, or Cd²⁺ salt and 1,4-bezenedicarboxylic acid, or 1,3,5-benzenetricarboxylic acid. Through this technique, the CMOFs with space time yield 181-501 kg m^-3 day^-1 and crystal sizes of ca. 200-700 nm was obtained.

Frequency optimization of permeability metamaterial for enhanced resolution

We analyze and optimize the performance of unconventional negative permeability (μ) metamaterial and demonstrate its ability to focus and restore the decaying Fourier harmonics (FH) in microwave regime operating frequencies. We show that multiple real μr' and imaginary μr'' values of μ_r at same or multiple operating frequencies for a resonant type of -μ metamaterial could not exhibit finest resolution at the region of interest (ROI), unless and until the distance of the source plane with respect to metamaterial and ROI could be re-optimized in accordance with μr' and μr'' of μ_r. Using the variable parameters to enhance the resolution limit of -μ metamaterial, we optimize the metamaterial's configuration for maximum propagation field absorption and regeneration of decaying FH at ROI. The optimization of the test bed that contains the source plane, -μ metamaterial, and ROI followed by the regeneration of the decaying FH from the source plane at the surface of the material, yielded a high image resolution at ROI.

Depression in adults post burn injury: a descriptive study conducted in the burn centre of a tertiary care hospital in Karachi

Burns are a major cause of psychological disability in this modern era. Psychological aspects of burn have been studied throughout the world with vast differences in results. Depression is one of the psychological illnesses that affect the individual post burn injury. Our objective was to determine frequency of depression in burn patients, burn-related factors that may contribute to the development of depression and to assess demographic distribution. Ninety-four patients from the Burns Centre, Dow University of Health Sciences & Dr. Ruth KM Pfau Civil Hospital in Karachi were selected according to specific criteria. Duration of study was from September 2017 to February 2018, with 1-40% of burns patients included through non-probability purposive sampling. Data were collected through a questionnaire consisting of consent form, demographic details and burn details. Beck Depression Inventory II was used as a scoring instrument for depression. Standard statistical measures were calculated using SPSS version 22. Out of 94 patients, 58 were male (61.7%) and 36 (38.3%) female. The most common type of burn was thermal, seen in 58 (61.7%) patients. Thirty (31.9%) patients had depression: 15 (16%) had a mild form, eight (8.5%) a moderate form and seven (7.4%) had severe symptoms of depression. Depression in 32% of cases indicates the need for diagnosis in burn-injured patients. Therefore psychiatric rehabilitation is necessary for all cases of burn in order to manage depressive symptoms, whether these symptoms are mild or severe.

Laser processing of Ti6Al4V alloy: wetting state of surface and environmental dust effects

Laser processing of Ti6Al4V alloy surface, via repetitive pulses, is realized incorporating the nitrogen assisting gas. The texture characteristics of the surface and wetting state are analyzed. The free energy of the laser treated surface is estimated. The influence of the dust particles on the treated and untreated surfaces is examined. The solution formed due to water condensate on the dust particles is evaluated. The adhesion of the mud dried solution on the treated and untreated surfaces is assessed through determining the tangential force required for the removal of the solution from the surface. The findings demonstrate that the high power laser repetitive pulse heating results in formation of the hieratically distributed micro/nano pillars on the workpiece surface. The wetting state of the processed surface remains hydrophilic because of the large gap size between the micro/nano pillars. The free energy of the laser textured surface is similar to that obtained for the TiN coated surfaces, which is because of the nitride compounds developed during the processing. The dried liquid solution strongly adheres at the surface and the force needed for removing the dried liquid solution is almost four times of the friction force at the surface. The liquid solution gives rise to locally scattered shallow pit sites on as received surface. This phenomenon does not occur for the laser treated surface, which is related to the passive layer developed on the surface.