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Cecal volvulus is an uncommon cause of large bowel obstruction that typically presents in older adults with a history of chronic constipation or prior abdominal surgery. However, this report documents a rare and atypical case of cecal volvulus presenting in a middle-aged female with no significant past medical or surgical history. This case also highlights the benefits of adopting a synergistic approach between a physician's clinical judgment and the patient's presentation when making a diagnosis to ensure timely interventions and prevent life-threatening complications. A 40-year-old female with no significant medical or surgical history presented to the emergency department with acute onset of severe abdominal pain radiating to the lower back, associated with nausea, vomiting, and constipation. CT imaging revealed a markedly distended cecum with evidence of volvulus. Despite the absence of common predisposing factors of cecal volvulus, the patient was correctly diagnosed. She underwent an urgent right hemicolectomy with primary anastomosis, which was uneventful. The patient had a complete recovery and was discharged home on postoperative day 5. This case is particularly noteworthy due to the patient's atypical demographic profile and the absence of common risk factors associated with cecal volvulus. The timely recognition and surgical intervention were critical in preventing severe complications such as bowel ischemia or perforation. Furthermore, this case underscores the importance of considering cecal volvulus in the differential diagnosis of acute abdominal pain, even in patients who do not exhibit conventional risk factors. This case report highlights a rare presentation of cecal volvulus in a previously healthy middle-aged woman, emphasizing the importance of prompt diagnosis and intervention. The favorable outcome in this patient demonstrates the critical role of timely surgical management in such high risk cases. • Cecal volvulus is a rare and life-threatening condition characterized by the twisting of the cecum, terminal ileum, and ascending colon, leading to obstruction, ischemia, and potential perforation. • This case report highlights a unique presentation of cecal volvulus in a 40-year-old female with no significant past medical history but with a significant weight loss of 25 kg over one year, identifying rapid weight loss as a potential risk factor. • Despite the absence of typical risk factors such as prior abdominal surgery or advanced age, timely radiological imaging (CT scan) enabled the diagnosis and urgent surgical management. • This case emphasizes the need for high clinical suspicion of cecal volvulus in patients presenting with nonspecific abdominal pain, particularly those with significant recent weight loss. [ABSTRACT FROM AUTHOR]

The light photoresponse, the separation of photogenerated charge carriers and the specific surface area are of great importance for the development of semiconductor‐based photocatalysts. We report the anchorage of small‐sized ZnO nanorods with a length of ca. 38 nm at the surface of graphitic carbon nitride (gCN) sheets. The gCN loading in the ZnO/gCN composites was varied and the materials characterized by TEM, XRD, XPS, BET and UV‐vis diffuse reflectance spectroscopy. The ZnO/gCN (10 %) composite exhibits a high photocatalytic activity for the degradation of dyes (Orange II, Resazurin and Reactive Black 5) under visible light irradiation of low intensity (2.5 mW/cm2) and for salicylic acid under simulated sunlight irradiation (5 mW/cm2). These results are supported by photoluminescence, photocurrent and electrochemical impedance spectroscopy measurements. The photocatalytic activity originates from synergistic effects in ZnO/gCN composites including a high specific surface area (60.4 m2/g), an enhanced visible light absorption capacity and the charge carriers separation. The ZnO/gCN photocatalyst exhibits a high stability and could be reused up to ten times with no loss of efficiency. A mechanism is proposed for the degradation of dyes using the ZnO/gCN composites. Synergy. The growth of ZnO rods at the surface of graphitic carbon nitride sheets affords photocatalysts with high activity under visible light irradiation due to the improvement of separation efficiency of photogenerated electron‐hole pairs and to the increase of specific surface area. [ABSTRACT FROM AUTHOR]

Background Esophagectomy for cancer is a complex procedure with high morbidity. Minimally invasive approach offers the benefits of minimal access across the different fields required during this operation. Robotic surgery is becoming an integral part of modern practice. It holds the potential of more precision especially in narrow thoracic space. Currently, Many Robotic platforms exist. This video aims to demonstrate the feasibility of Robotic Mc Keown esophagectomy in the prone position using Versius platform. Methods 56 years old male patient presented with grade I dysphagia of 3 months duration. His complete assessment revealed an 11 cm long invasive non keratinizing squamous cell carcinoma located in the mid esophagus (cT3N1M0). Marked regressive course of the lesion occurred with neoadjuvant chemoradiation. Robotic assisted Mc Keown esophagectomy was performed in the prone position. Thoracic phase was performed with the robotic approach. Bed side units and Port placement is illustrated in the video. The abdominal phase was accomplished laparoscopically. Finally, the stomach was pulled up and the esophagogastric anastomosis was done in the neck. Results No intraoperative adverse events were encountered. The improved vision, dexterity and articulation of instruments facilitated the identification of the thoracic duct, ligation of azygos vein tributaries and dissection of the recurrent laryngeal lymph nodes. Instrument clash was insignificant due to patient's wide chest cavity and optimal positioning of ports and bed side units improving ergonomics. The operative time of the thoracic phase was 310 min. Blood loss was 300 mL. The postoperative course was uneventful except for chest infection which improved on conservative measures. The length of stay was 18 days. Pathology revealed complete clinical response with 0/25 lymph node yield. Conclusion Robotic assisted esophagectomy is feasible and can be safely performed using Versius robotic platform. The enhanced visualization and articulation enabled meticulous dissection of the recurrent laryngeal lymph nodes. Patient positioning, optimal port and bed side units placement were keys to achieving minimal instrument clash. Further research is needed to confirm these findings and to compare the long-term oncological outcomes and cost effectiveness of this modality. Video links: https://we.tl/t-rpkTHvNlXI or https://drive.google.com/drive/folders/1tOsFPrEBUHBpVn8C9jF7BGoNxlYPuBjq?usp=sharing. [ABSTRACT FROM AUTHOR]

A femoral hernia is a protrusion of the peritoneum through a defect in the femoral ring into the femoral canal. A rare form of a femoral hernia is a femorocele, which requires a highly skilled physician for accurate diagnosis and management. Clinical examination is the gold standard for diagnosis, with a CT used to confirm clinical suspicion. Once diagnosed, the only curative option is surgery. This case report provides evidence for the use of robotics to treat a femorocele. A 23-year-old female with a two-year history of a non-reducible fluid-filled swelling in the right groin presented to the surgical clinic. Upon clinical suspicion and CT imaging, a femorocele was diagnosed. The surgeon opted for a femoral hernia repair using the da Vinci surgical system. Peritoneal connection with the hernia sac was noted, confirming the diagnosis. The content of the cystic mass was reduced; further to that, the omental content was also reduced and the hernia was repaired. The patient tolerated the procedure with no complications. This case highlights the use of robotics to treat a rare clinical entity. Robotics was used for this case as it provided exceptional ergonomics, three-dimensional visualization, and wristed movements. A femorocele is a rare form of a femoral hernia that requires accurate diagnosis and proper management. In this case, we demonstrated the possibility of using robotics as a viable option for treatment of a femorocele. • Although femorocele is a very rare entity it is still clinically significant. • The most reliable diagnostic technique for a femorocele is a CT scan. • Once a femorocele is diagnosed surgical treatment is usually curative. • Robotics may be used as a viable treatment option for femorocele. [ABSTRACT FROM AUTHOR]

Meckel's diverticulum (MD) is a common congenital anomaly of the digestive tract that affects around 4 % of the population. Although it is relatively common, diagnosis still remains very challenging; it requires an astute clinician with a high clinical index of suspicion to achieve the diagnosis. Once a diagnosis is reached, treatment is almost always surgical. This case report provides evidence of the effectiveness of a new robotic surgical system for resection of MD in the elderly. 61 year old male presented to the emergency room with recurrent hematochezia. After multiple diagnostic techniques, he was finally diagnosed with MD using Meckel's scan. After diagnosis, surgical resection using the Cambridge Medical Robotics (CMR) Versius robotic system was performed, which yielded good results. This case highlights the use of a new robotic system for the treatment of Meckel's Diverticulum. Our initial experience with the CMR Versius surgical system in small bowel resection was successful; however, further studies are needed to demonstrate the safety and efficacy of such a system. • Meckel's diverticulum can persist in the elderly, thus ruling out the disease based on age is not reasonable. • Many diagnostic techniques can be used to investigate Meckel's diverticulum, however the most reliable is the Meckel's scan. • Once Meckel's is diagnosed surgical treatment is usually curative. • Small bowel resection can be done with this new robotic platform. [ABSTRACT FROM AUTHOR]

Introduction and Importance: Cecal volvulus is an uncommon cause of large bowel obstruction that typically presents in older adults with a history of chronic constipation or prior abdominal surgery. However, this report documents a rare and atypical case of cecal volvulus presenting in a middle-aged female with no significant past medical or surgical history. This case also highlights the benefits of adopting a synergistic approach between a physician's clinical judgment and the patient's presentation when making a diagnosis to ensure timely interventions and prevent life-threatening complications., Case Presentation: A 40-year-old female with no significant medical or surgical history presented to the emergency department with acute onset of severe abdominal pain radiating to the lower back, associated with nausea, vomiting, and constipation. CT imaging revealed a markedly distended cecum with evidence of volvulus. Despite the absence of common predisposing factors of cecal volvulus, the patient was correctly diagnosed. She underwent an urgent right hemicolectomy with primary anastomosis, which was uneventful. The patient had a complete recovery and was discharged home on postoperative day 5., Clinical Discussion: This case is particularly noteworthy due to the patient's atypical demographic profile and the absence of common risk factors associated with cecal volvulus. The timely recognition and surgical intervention were critical in preventing severe complications such as bowel ischemia or perforation. Furthermore, this case underscores the importance of considering cecal volvulus in the differential diagnosis of acute abdominal pain, even in patients who do not exhibit conventional risk factors., Conclusion: This case report highlights a rare presentation of cecal volvulus in a previously healthy middle-aged woman, emphasizing the importance of prompt diagnosis and intervention. The favorable outcome in this patient demonstrates the critical role of timely surgical management in such high risk cases., Competing Interests: Conflict of interest statement HM is a proctor for Intuitive Surgical and CMR surgical. MA, MH, and KK have no competing interests to declare., (Copyright © 2024. Published by Elsevier Ltd.)

Background: There is increasing evidence on the exponential use of technology-based social media in medical field that has led to a proliferation of unprofessional behaviors in digital realm. Educating, training, and changing the behaviors of healthcare professionals are essential elements to restrain the rising unprofessional incidents. Therefore, this research was designed to determine the impact of an interventional workshop on the medical and dental students in improving their professional behaviors in the digital world using the newly developed medical Education e-Professionalism (MEeP) framework., Methods: We adopted the Theory of Planned Behavior (TPB) as a benchmark reference which explores constructs intertwined with the mission-based MEeP framework; values (whistleblowing-raising concerns), behaviors (being responsible in the digital world) and identity (reflective practice in the digital world). A multicentre 3-phased mixed-method study was conducted using a pre-workshop survey, an online interventional workshop, and a post-workshop survey. SPSS and NVivo were the tools used for the data analysis., Results: A total of 130 students registered for workshop out of which 120 completed the pre-workshop survey, 62 joined the workshop and 59 completed the workshop and post-workshop survey. From the whistleblowing - raising concern perspective, we found that attitudes and perceived behavioral control had a significant relationship. While for responsible in digital world category, attitude and perceived behavioral control had a significant bearing on the intentions. Third, for reflective practice , attitude and subjective norms significantly enhanced the intention of participants. A multi layered thematic analysis yielded four overarching themes of attitudes, subjective norms, perceived behavioral control and intentions. Most students showed positive attitudes of being reflective, self-directed, and humane . Students realized the subjective norms had made them conscientious, self-aware and conformative . While perceived behavioural control manifested as identity and Intentions were heavily reliant on self-actualization ., Conclusion: Our mixed method study found that the interventional workshop using MEeP framework significantly improved attitudes, subjective norms, perceived behavioral control, and intentions. This study provides valuable evidence of MEeP framework evaluation using the theoretical underpinning of TPB by reporting positive changes in professional values, behaviors, and identities of undergraduate medical and dental students., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Guraya, Yusoff, Rashid-Doubell, Harkin, Al-Amad, Fredericks, Halabi, Abdullah, Moussa, Mallah, Sefen, AlKoheji, Althawadi, Alabbasi, Nor, Reguig and Guraya.)

Binary spinel-type metal oxides (AB 2 O 4 ) related materials, including ferrites (AFe 2 O 4 ), are attractive photocatalysts thanks to their excellent visible light response for the photodegradation of organic pollutants. Currently, these materials are synthesized via conventional chemical routes suffering from long preparation duration and multistep. Moreover, the photocatalysts are obtained as nano-powders from conventional chemical routes would introduce another drawback for their recycling and reuse. From an industrial perspective, it is desirable to develop an efficient and facile synthesis process to produce photocatalysts in a non-dispersible form. Herein, we demonstrate that the solution precursor plasma spray (SPPS) process is a single-step method for depositing photocatalytically active zinc ferrite-based films within several minutes. The influence of the precursor ratio on the microstructures and phase compositions of the ZnFe 2 O 4 films was investigated by XRD and Raman analyses. In addition, two optimized ZnFe 2 O 4 films were prepared by increasing the ZnO loading and tailoring injection pattern of the precursor solution. The surface morphologies and optical bandgap were also determined by SEM and UV-visible spectroscopy. The photocatalytic activities of the ZnFe 2 O 4 films were evaluated through the degradation of the Orange II dye and of tetracycline hydrochloride under UV or visible light irradiation. The results show that compositional ratios and composition distribution of the ZnFe 2 O 4 films prepared via SPPS played a key role on the photocatalytic activity. The SPPS route was demonstrated to be a promising method for the synthesis and the deposition of metal oxide (i.e. perovskite type and spinel type) films within a single-step for functional applications.

CdSe nanorods (NRs) with an average length of ≈120 nm were prepared by a solvothermal process and associated to TiO 2 nanoparticles (Aeroxide ® P25) by annealing at 300 °C for 1 h. The content of CdSe NRs in CdSe/TiO 2 composites was varied from 0.5 to 5 wt %. The CdSe/TiO 2 heterostructured materials were characterized by XRD, TEM, SEM, XPS, UV-visible spectroscopy and Raman spectroscopy. TEM images and XRD patterns show that CdSe NRs with wurtzite structure are associated to TiO 2 particles. The UV-visible spectra demonstrate that the narrow bandgap of CdSe NRs serves to increase the photoresponse of CdSe/TiO 2 composites until ≈725 nm. The CdSe (2 wt %)/TiO 2 composite exhibits the highest photocatalytic activity for the degradation of rhodamine B in aqueous solution under simulated sunlight or visible light irradiation. The enhancement in photocatalytic activity likely originates from CdSe sensitization of TiO 2 and the heterojunction between these materials which facilitates electron transfer from CdSe to TiO 2 . Due to its high stability (up to ten reuses without any significant loss in activity), the CdSe/TiO 2 heterostructured catalysts show high potential for real water decontamination.

Background: Obstructive sleep apnea (OSA) syndrome is frequent, and misdiagnosed., The Aim: Of this study is to assess the prevalence of OSA syndrome in a Tunisian population of obese (body mass index > or = 30 Kg/m2) and to determine its predictive factors., Methods: It's a transversal study. One hundred patients (63 females, 37 males) were inculded. All patients underwent nocturnal polysomnography or respiratory polygraphy., Results: Sixty-five patients had an OSA syndrome: mild (24.6%), moderate (30.7%) and severe (44.6%). We compared, by a statistical analysis, the group with OSA syndrome and the group without OSA syndrome. There was a predominance of men (81% of men vs 55.5 of women had OSA). Age was higher in the group with OSA syndrome (56.8 years +/- 10 vs 48.1 +/- 12, P = 0.04). Clinical symptoms such as snoring, daytime sleepiness, nocturnal awakening and respiratory pauses were more frequent in the group with OSA syndrome. Morphological abnormalities such as retrognathy and/or short neck were significantly more frequent in the group with OSA syndrome (p = 0.05 and 0.02 respectively). Cardiopathies and diabetes were more frequent in obese with OSA syndrome., Conclusion: In obese persons, male gender, comorbidities and /or clinical symptoms such as snoring, daytime sleepiness, nocturnal awakening and respiratory pauses, retrognathy and/or short neck are predictive of OSA syndrome. So, we propose a nocturnal recording in obese presenting at least one of these predictive factors.