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A split-thickness skin graft (STSG) is one of the main tools used in the reconstruction of skin defects. Negative-pressure wound therapy (NPWT) has been widely used as adjunct therapy for wound healing for decades. Few studies have conducted the outcomes of NPWT use as a postoperative dressing for STSGs. This study aimed to compare the outcomes of the application of NPWT versus conventional dressing on STSGs after soft-tissue reconstruction. A prospective observational study was performed at the King Abdullah Medical City. A total of 18 patients with STSGs for acute or chronic skin defects were recruited. Patients from the two groups—10 patients in the NPWT group and 8 in the No-NPWT group—were postoperatively evaluated for three weeks. Assessment included the STSG take rate, wound healing, pain, infection, hematoma formation, and the need to re-graft the same recipient area. Our data demonstrated a higher mean skin graft take rate in the second and third weeks of the No-NPWT group compared to the NPWT group, but it was not statistically significant (p > 0.05). No significant differences between the two groups in terms of wound healing, pain, infection, hematoma formation, and the need to re-graft (p > 0.05) were found. Our study showed that the conventional dressing of STSGs is not inferior to NPWT. In addition, conventional dressing was shown to be easier to use and less expensive to apply, as well as having a higher skin graft take rate and lower infection rate.

Introduction Syria’s protracted conflict has devastated the health system reversing progress made on maternal health preconflict. Our aim is to understand the state of maternal health in Syria focused on underage pregnancy and caesarean sections using a scoping review and quantitative analysis; the latter draws on data from the Syrian American Medical Society’s (SAMS) maternal health facilities in northwest Syria.Methods We performed a scoping review of academic and grey literature on the state of maternal health across Syria since the onset of conflict (taken as March 2011). Identified articles were screened using pre-established criteria and themes identified. We also performed a retrospective quantitative analysis of maternal health data from SAMS’ facilities in a microcontext in north-west Syria between March 2017 and July 2020, analysing the trends in the proportion of births by caesarean section and age at pregnancy.Results Scoping review: of 2824 articles, 21 remained after screening. Main themes related to maternal mortality rates, caesarean sections, maternal age and perinatal care. 12 studies reported caesarean section rates; these varied from 16% to 64% of all births: northern Syria (19%–45%,) Damascus (16%–54%,) Lattakia (64%) and Tartous (59%.) Quantitative analysis: Of 77 746 births across 17 facilities, trend data for caesarean sections showed a decrease from 35% in March 2017 to 23% in July 2020 across SAMS facilities. Girls under 18 years accounted for 10% of births and had a lower proportion of caesarean section births. There was notable geographical and interfacility variation in the findings.Conclusion The quality of available literature was poor with country-level generalisations. Research which explores microcontexts in Syria is important given the different effects of conflict across the country and the fragmented health system. Our quantitative analysis provides some evidence around the changes to caesarean section rates in northwest Syria. Despite limitations, this study adds to sparse literature on this important topic.

Introduction: Syria has the largest number of internally displaced people (IDPs) globally with 6.7 million forced from their homes since the uprising erupted in 2011. Most face multiple intersecting vulnerabilities with adverse health impacts. We explore the key health concerns among IDPs, how the various health systems in Syria have responded to the dynamic health needs of IDPs and what modalities have been used by humanitarian actors to address these needs. Methods: We undertook a scoping review of academic and grey literature for available evidence regarding the health of IDPs in Syria. We then organised an online workshop in November 2021 with around 30 participants who represent local, regional, and international organisations and who have relevant expertise. The discussion focused on how the health systems in Syria's various territories have responded to the health needs of IDPs, what this means to the structure and dynamics of these health systems and their intended outcomes and responsiveness. Findings: These emphasised the weak evidence base around IDP health in Syria, particularly in certain geographical areas. Workshop participants explored the applicability of the term IDP in the Syrian context given the fragmented health system and its impact on IDPs, the importance of considering co-determinants (beyond forced displacement) on the health of IDPs and taking a transectoral, community led approach to identify and respond to needs. Conclusion: This manuscript presents some of the current issues with regards to IDP health in Syria, however, there remain numerous unknowns, both for the health of IDP as well as non-IDP populations. We hope that it will be the foundation for further discussions on practical steps relating to research, analysis and interventions which can support health system responses for IDPs in Syria.

The current research aimed to evaluate the supplemental effects of iron oxide nanoparticles (IONPs) on production performance, viscera development, blood metabolites, redox status, meat quality, and jejunal histology in broilers. A total of 300 day-old broilers were randomly divided into six groups with five replicates per group. Birds were fed on a corn soybean-based diet supplemented with 0, 20, 40, 60, or 80 mg/kg IONPs or 80 mg/kg of FeSO4 for 35 days. The feed conversion ratio (FCR) was improved in birds supplemented with 60 mg/kg IONPs. The pH24h was lower in birds supplemented with 40 mg/kg IONPs compared to that of the bulk group. Pectoral muscle fascicle diameter and fiber density were significantly increased in 20 mg/kg IONP-supplemented birds compared to those of the bulk group, respectively. The muscle fiber diameter was higher in 40 mg/kg IONP-supplemented birds compared with the bulk group. The jejunal villus height, crypt depth, and villus surface area were significantly increased with 60 mg/kg IONP supplementation, whereas villus width was decreased in birds supplemented with 40 mg/kg IONPs. The villus-height-to-crypt-depth ratio was lower in IONP-supplemented birds compared to the bulk group. IONP supplementation improved the FCR, jejunal, and pectoral muscle morphology without affecting the carcass characteristics and redox status of broilers.

The aim of the present work is to eradicate Congo red (CR) dye from aqueous solutions since the dye compounds are harmful to human life and the environment leading to detrimental results. For this purpose, Holarrhena antidysenterica (HA) and Citrullus colocynthis (CC) adsorbents were used for the adsorptive removal of Congo red dye from wastewaters. The unmodified adsorbents (U-HA and U-CC) were chemically modified using tartaric acid (TA). Morphological structures were examined by FTIR and SEM. Batch adsorption studies were tested at a variety of pH, time exposure, temperatures, and adsorbent dosages. Thermodynamic parameters such as Gibbs free energy (∆G°), enthalpy (∆H°), entropy changes (∆S°), and energy of activation (Ea) were also calculated. The results revealed that tartaric acid-Citrullus colocynthis (TA-CC) gave optimum conditions of time of contact (35 min), temperature conditions (40°C), pH (3), and dosage of adsorbent (1.6 g) for maximum dye removal. Tartaric acid-Holarrhena antidysenterica (TA-HA) gave equilibrium time of contact (30 min), temperature (40°C), and pH optimum (2) along with a 1.6 g dosage of adsorbent. Mechanistic understanding of adsorption isotherm provided that the Langmuir model was followed by raw and modified adsorbents. Maximum adsorption capacities Qmax attained were 60.61 (mg g-1), 128.21 (mg g-1), 87.71 (mg g-1), and 131.57 (mg g-1), respectively, for U-HA, TA-HA, U-CC, and TA-CC. The results of kinetic modeling displayed a high value of R2 (0.99) along with minimal error (RMSE) for dye removal showing that the pseudo-second-order kinetic model has acceptable accuracy. Fourier transform infrared proposed the electrostatic, pi-pi interactions, and hydrogen bonding as dominant adsorption mechanisms at acidic pH, respectively. Rate-determining steps comprise both surface and intraparticle diffusions. Thermodynamics indicated that the dye adsorption of CR is spontaneous, exothermic, and favorable in nature. These agricultural wastes due to specific points such as low cost, availability, and high removal rates of adsorption are highly competent for the expulsion of anionic dye like CR from wastewaters.

High-definition video surveys of remotely-operated vehicle (ROV) dives from the NOAA’s Mountains in the Deep 2017 expedition (EX1705) along volcanic ridges and seamounts of the Manihiki Plateau coupled with multibeam bathymetry data and water column profiles, reveal no or minimal sediment cover on the basaltic edifice, but variable amounts of cold-water corals on ferromanganese-encrusted basaltic rocks. Coarse sediment, however, accumulates in crevasses and sedimentary ripples testify the existence of currents in the area. Collectively, these observations illustrate the strong influence of deep currents on the surficial geology and cold-water coral distribution at ∼2,000 m water depths. Dive transects along two basaltic seamounts show stark differences of sedimentary features and cold-water coral distribution. On the ridges of “Te Kawhiti” (water depth: 2,089–2,220 m), basaltic slabs, and cold-water corals are far more abundant in comparison to the slope of a mesa in “Te Tuku” (water depth: 2,440–2,495 m). The increased abundance on “Te Kawhiti” is due to the exposure of “Te Kawhiti” to Lower Circumpolar Deep Water that sweeps the summit of the ridges as indicated by frequent ripples observed in between the basaltic rocks. The currents are strong enough to sweep fine-grained sediments away, leaving coarse-grained sediments behind, inducing the formation of ferromanganese crust on the basaltic rocks. Both dive sites are below the high-Mg calcite saturation horizon, and as a result, the cold-water coral community is dominated by Isididae, which can build a high-Mg calcite skeleton in water undersaturated in regards to high-Mg calcite.

Introduction: Appendicitis is the most common emergency surgical admission regardless of the age group. In case of delay in diagnosis, serious complications may occur, needing immediate actions. Complications of acute appendicitis like perforation, peritonitis, and sepsis are to justify massive negative appendectomies. In this study, it has been tried to collect data about negative appendectomy during last 5 years in Modarres hospital, Shahid Beheshti University of Medical sciences, Tehran, Iran, based on demographics and correlation with diagnostic studies before operation. This study is important in terms of economy and health care aspects. Methods: Data were collected about all patients appendectomized during 5 years between 2012 and 2017 at Modarres hospital. There were 1454 records, of which 108 records were excluded from the study due to the lack of enough data, interval appendectomy, and clean appendectomy. Finally, end 1346 appendectomies were assessed. Results: There were 275 (20.4%) and 1071 (79.6%) negative appendectomy and suppurative appendicitis, respectively. Preoperative ultrasonography (US) was performed on 753 (56.0%) patients, of which 472 (62.7%) and 281 (37.3%) cases were coordinated with and different from pathologic records, respectively. Preoperative computed tomography (CT) scan was performed for 316 (23.5%) patients, which matched and differed pathologic records in 280 (88.6%) and 36 (11.4%) cases, respectively. Conclusion: Diagnosis of appendicitis should still mainly be based on history, and clinical and laboratory data.

Two novel adsorbents Holarrhena antidysenterica (HA) and Citrullus colocynthis (CC) were collected from native Pakistan and treated with tartaric acid. The adsorbents were characterized by Fourier-transform infrared spectroscopy (FT-IR) and scanning electron microscopy, and their adsorptive behavior was studied against model cationic dye crystal violet (CV). Role of biosorbent dose, time of contact, temperature studies, agitation rates, and solution pH was investigated. Optimum conditions obtained for the removal of CV dye for H. antidysenterica-tartaric acid modified (HA-TA) were as follows: 0.8 g adsorbent dose, 35 minutes contact time, 5.0 pH, 40°C temperature, and 150 rpm agitation rates as compared to H. antidysenterica that gave 1.4 g adsorbent dose, 40 minutes time of contact, 6.0 pH, 50°C temperature, and 150 rpm agitation speed. C. colocynthis-tartaric acid modified (CC-TA) removed CV dye at 0.6 g adsorbent dose, 30 minutes contact interval, 4.0 pH, 40°C temperature, and 125 rpm agitation speed in contrast to C. colocynthis which gave 0.8 g adsorbent dose, 40 minutes time of contact, 6.0 pH, 50°C temperature, and 125 rpm agitation speed, respectively. Isothermal studies for both raw and modified biosorbents were compliant with the Langmuir model indicating monolayer, chemisorption. The maximum Langmuir capacities were up to 128.20 mg/g, 136.98 mg/g, 144.92 mg/g, and 166.66 mg/g for HA, CC, HA-TA, and CC-TA. Pseudo-second-order kinetic model well fitted the dye removal data. The rate-determining steps involved both surface and intraparticle diffusion mechanisms. Adsorption of dye molecules on active surfaces was governed by electrostatic attractions and chelating abilities. Thermodynamics research revealed the spontaneous and exothermic nature of the reaction. The adsorbents serve promising candidates for the effective removal of hazardous dyes from aqueous solutions.