Background: There is ongoing debate regarding the usefulness of laparoscopic pancreaticoduodenectomy. This study aimed to analyze all the randomized control trials published including the most recent one. Material and methods: The study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and MOOSE guidelines. Heterogeneity was measured using Q tests and I2. The random-effects models were used to summarise the relative risks, odds ratios, and mean differences as appropriate.Results:4 RCTs were included consisting of 818 patients. 411 patients were in the laparoscopic group and 407 in the open pancreaticoduodenectomy group. Weighted baseline patient characteristics were similar except more patients with pancreatic adenocarcinoma and more males were there in the open pancreaticoduodenectomy group. There was no difference in-hospital stay,90 days complications rate, 90 days mortality, R1 resection, postoperative pancreatic fistula, delayed gastric emptying, post pancreatectomy hemorrhage, bile leak between the two groups. Operative time was more in the laparoscopic group. Blood loss [mean difference -132.12 ml (-172.60,-91.65)] and surgical site infection [Risk ratio 0.41 ( 0.17-1.0)] were significantly lesser in laparoscopic group.Conclusion:There was no benefit in-hospital stay or clinical outcomes after laparoscopic pancreaticoduodenectomy. Blood loss and surgical site infection were lesser in laparoscopic pancreaticoduodenectomy.

Peri-implant diseases are defined as pathological inflammatory reactions in the tissue surrounding the osseointegrated implants. They are classified into two categories: mucositis - defined as peri-implant soft tissue inflammation and peri-implantitis - bone loss in the peri-implant region. A clinical case of a 61-years-old woman with an implant in the 46 anatomical position and a 5-year follow-up is presented. A probe depth of 5mm and a bone defect length of 35% was observed. The Implacure® Protocol was applied, with the main objective of eliminating the biofilm present on the exposed implant surface. There are multiple approaches to treat peri-implant diseases. While non-surgical treatment is essential for mucositis control, the treatment of peri-implantitis surgical treatment should be considered. Regenerative bone reconstruction promotes bone repair in the defect area and reduces bleeding during probing. To achieve that, autologous fibrin combined with Cerasorb M® was used. The proposed approach in the exposed clinical case involves the application of Implacure® Protocol, whose combination of the physical decontamination technique, together with the use of chlorhexidine and orthophosphoric acid, added with the combination Piperacillin + Tazobactam together with hyaluronic acid, provide a base that allows to regenerate bone using platelet-rich fibrin with Cerasorb M® and increase the survival time of the implant.

Background: Early postoperative airway management after laryngo-tracheal surgery is crucial. Acute respiratory failure due to glottis’ oedema may occur, requiring reintubation. This can prolong ventilatory assistance, jeopardizing the anastomosis. To date, only judicious steroid administration and fluid management are available to avoid more invasive procedures. High-Flow-Oxygen-Therapy(HFOT) is a noninvasive O2 support method providing humidification, warmed air, Positive-End-Expiratory-Pressure(AIRVO2). No data exist about HFOT use to prevent early complications after laryngo-tracheal surgery. Methods: Between Sept.2020-Sept.2022, 107 consecutive patients underwent laryngo-tracheal surgery received HFOT(Group A). Data and long-term results were compared with those of 80 patients operated between Sept.2018-Aug.2020(Group B), when HFOT was not available. All patients were operated in a single center. No pre- or post-operative settings changed, except for HFOT introduction. We analyzed and compared the risk for “delayed” reintubation (unexpected reintubation within the first 24-48 hours after extubating/laryngeal mask removal) in the two groups. Results: No patients reported HFOT-related adverse events. Control group(B) presented “delayed” reintubation in 37% (p= 0.027), Intensive Care Unit admission in 67%(p=0.005) and longer hospital stay(p=0.001) compared to HFOT group(A). Minor complications rate was 3% in both group and overall mortality was 0%. Re-stenosis was described in 4.6% of HFOT group, without a statistically significant difference (p=0.7006). Conclusions: Our study is the first to investigate HFOT use in patients undergoing laryngo-tracheal surgery, potentially representing a consistent innovation in the peri-operative management of these patients. With the limit of a retrospective series, we would suggest HFOT use for preventing post-operative reintubation rate, possibly reducing ICU admission and hospital stay.

Modern anesthesia continues to be impacted in new and unforeseen ways by digital technology. Combining portability and versatility, mobile applications or “apps” provide a multitude of ways to enhance anesthetic and peri-operative care. Research suggests that uptake of apps into anesthetic practice is becoming increasingly routine, especially amongst younger anesthetists brought up in the digital age. Despite this enthusiasm, there remains no consensus in how apps are safely and efficiently integrated into anesthetic practice. This review summarizes the most popular forms of app usage in anesthesia currently and explores the challenges and opportunities inherent in implementing app use in anesthesia, with an emphasis on a practical approach for the modern anesthetist.

Surface chemistry evaluation plays a crucial role in assessing the efficacy of chemical decontamination products for titanium implants. This study aimed to investigate the effectiveness of chemical decontamination solutions in cleaning a contaminated dental implant surface and to evaluate the potential of combining Pluronic gel with hydrogen peroxide (NuBone®Clean) by evaluating pellicle disruption and re-formation on implant surfaces. In addition, ensuring safety with in- vitro and human testing protocols. X-ray Photoelectron Spectroscopy (XPS) was utilized for surface analysis. All the tested gels had some effect on the surface cleanness except for PrefGel®. Among the tested chemical decontamination candidates, NuBone®Clean demonstrated effectiveness in providing a cleaner titanium surface. Furthermore, none of the tested chemical agents exhibited any cytotoxic effects, and the safety assessment showed no adverse events. The results of this study highlight the significance of conducting comprehensive evaluations, encompassing safety and efficacy, before introducing new chemical agents for dental treatments. The findings suggest that NuBone®Clean shows potential as a chemical decontamination solution for implant surfaces. However, further investigation through randomized clinical trials is necessary. By adhering to rigorous testing protocols, the development of safe and efficient chemical decontamination strategies can be advanced, benefiting patients and promoting progress in the field of implant dentistry.

Peri-urban forests often have extensive networks of greenways that allow for outdoor recreation. However, information associated with these greenways often does not include their degree of naturalness, which is usually reduced to descriptions of flora and fauna and often overlook the factors that reduce naturalness. Therefore, in some cases, the naturalness of these greenways is not as high as expected. Having a quantification of their naturalness would be useful, especially for hikers interested in appreciating and enjoying nature. Additionally, this information would help outdoor recreation managers to design trails or decide which ones to promote as "greenways". The objectives of this study are (1) to design a method to calculate and map the naturalness of greenways using two approaches, one based on perceptual fieldwork and the other on Geographic Information Systems (GIS); (2) to apply the designed method to a specific greenway; and (3) to compare both methodological approaches. The results show that, for the greenway studied, the naturalness scores obtained are low in all three types of analyses used. Around 70% of the greenway sections in the GIS visibility analysis and 80% in the GIS proximity analysis have a low naturalness index, while this value is reduced to 40% with the fieldwork analysis. Although the results of the GIS approach (proximity and visibility) generate naturalness indices and spatial patterns that are very similar, they differ significantly from those derived from the fieldwork analysis. The discussion of the results suggests that the three methodologies used are valid for analysing the degree of naturalness of the trails, but if used together, it would be possible to add flexibility to the type of variables incorporated in the analysis.

Background: this RCT assesses the 18 months clinical outcomes after regenerative therapy of periimplantitis lesions using either an electrolytic method (EC) to remove biofilms or a combination of powder spray and electrolytic method (PEC). Materials and Methods: Twenty-four patients (24 implants) suffering from periimplantitis were randomly treated by EC or PEC followed by augmentation and submerged healing. Probing pocket depth (PPD), Bleeding on Probing (BoP), suppuration and standardized radiographs were assessed before surgery (T0), 6 months after augmentation (T1), 6 (T2) and 12 (T3) months after replacement of the restoration. Results: Mean of PPD changed from 5.8 ± 1.6 mm (T0) to 3.1 ± 1.4 mm (T3). While BoP and suppuration at T0 was 100 % BoP decreased at T2 to 36.8 % and at T3 to 35.3 %. Suppuration could be found 10.6% at T2 and 11.8% at T3. Radiologic bone level measured from the implant shoulder to the first visible bone to implant contact was 4.9 ± 1.9 mm at me-sial and 4.4 ± 2.2 mm at distal sites (T0) and 1.7 ± 1.7 mm and 1.5 ± 17 mm at T3. Conclusions: Significant radiographic bone fill and improvement of clinical parameters were demonstrated 18 months after therapy.

Men are perceived as significant barriers to the uptake of contraception in some communities, and lack of spousal communication regarding contraception is evident in some studies conducted in South-West and Northern Nigeria. The objective is to identify and discuss how husband consent to family planning (FP) and spousal communication influence family planning use among peri-urban dwellers in Nigeria. The study was limited to the primary dataset collected among young mothers that resides in peri-urban between the age of 15-30 years in South West, Nigeria. The result showed that the use of family planning was high among the respondents whose husband give consent to the use of family planning, and respondents who had appropriate spousal communication. Similarly, respondents whose spouse asks questions or whose husband advises on communication are likely to use FP. On the other hand, respondents whose husband didn’t give consent, respondents with inappropriate communication with the spouse, respondents whose spouses didn’t give advice, and those whose spouses didn’t ask questions are less likely to use FP.

Worldwide, oral lesions and cancers are still being significant public health conditions. Thus, an introduction of new oral healthcare protocols is becoming essential. Oral diseases are related to many causative factors, manly dental plaque/biofilm due to poor hygiene. New anti-biofilm therapies are needed to develop. The strategies of anti-biofilm therapies should help to control biofilm formation and microbial attachment to dental surfaces. The present review aimed to provide a comprehensive over-view on evidence related to the potential utility of topical oxygen therapy (BlueM formula) as novel oral care therapies in clinical practice.

Analgesic products for piglet castration are critically needed. This requires extensive animal experimentation such as to meet regulatory-required proof of efficacy. At present, there are no validated methods of assessing pain in neonatal piglets. This poses challenges for investigators to optimize trial design and to meet ethical obligations to minimize the number of animals needed. Pain in neonatal piglets may be subtle, transient and / or variably expressed and, in the absence of validated methods, investigators must rely on using a range of biochemical, physiological and behavioural variables, many of which appear to have very low (or unknown) sensitivity or specificity for documenting pain, or pain-relieving effects. A previous systematic review of this subject was hampered by the high degree of variability in the literature base both in terms of methods used to assess pain and pain mitigation, as well as in outcomes reported. In this setting we provide a narrative review, to assist in determining the optimal methods currently available to detect piglet pain during castration and methods to mitigate castration-induced pain. In overview, the optimal outcome variables identified are nociceptive motor and vocal response scores during castration, and quantitative sensory-threshold response testing and pain-associated behaviour scores following castration.

Food and nutrition insecurity, affecting 30% of the global population in 2020, poses a significant challenge to achieving Sustainable Development Goal (SDG) 2 - Zero Hunger. Urbanization, particularly in sub-Saharan African cities e.g. Lagos, Nigeria, exacerbates these issues, impacting resources and contributing to informal settlements. There is emphasis on innovative solutions in urban farming, with Recirculating Aquaculture Systems (RAS) emerging as one of the promising approach due to its efficiency in space and capital utilization. However, maintaining optimal conditions in RAS, crucial for SDG 2 and 11, requires robust water quality monitoring. This study explores the availability of digital tools for water quality monitoring in small-scale urban RAS, evaluating handheld devices and IoT sensors' reliability through t-test statistical method. The results aim to guide practitioners in selecting effective monitoring tools, contributing valuable insights for sustainable aquaculture in urban areas, particularly in sub-Saharan Africa, where access to affordable digital solutions is pivotal for success and can attract youth to agri-food technologies.

Rapid peri-urbanization has resulted in increasing demand for and pressure on peri-urban lands at the expense of agricultural lands. Households’ decision to convert from agricultural land uses to residential and commercial land uses is driven by a myriad of factors, ranging from social to economic, in the Asante-Akim South district of the Asante region, Ghana. The paper examined the effects of agricultural land use trade-off on food production in the district. Using a triangulation of qualitative and quantitative methods, 115 household respondents were proportionately sampled from three selected communities in the district, for the collection of data through the administration of questionnaires. The data were subjected to the Pearson’s chi-square, embedded in the SPSS V.16, to test for association among the variables. We report that the increasing rate of agricultural land uses conversions was as a result of increasing demand for residential and commercial land usage at the expense of agricultural land uses. Converting prime agricultural lands into other land uses was seen as profitable to agricultural expansion. A re-examination of the district land use plans by the Ghanaian Physical (Town and Country) Planning Department in tandem with the Lands Commission is therefore recommended.

A risk of ischemic stroke increases exponentially after menopause. Even a mild-ischemic stroke can result in increased frailty. Frailty is a state of increased vulnerability to adverse outcomes, which subsequently increases risk of cerebrovascular events and severe cognitive decline, particularly after menopause. Several interventions to reduce frailty and subsequent risk of stroke and cognitive decline have been proposed in laboratory animals and patients. One of them is whole body vibration (WBV). WBV recuperates cerebral function and cognitive ability that deteriorates with increased frailty. The goal of the current study is to test the efficacy of WBV in reducing post-ischemic stroke frailty and brain damage in reproductively senescent female rats. Reproductively senescent Sprague–Dawley female rats were exposed to transient middle cerebral artery occlusion (tMCAO) and randomly assigned to either WBV or control groups. Animals placed in the WBV group underwent 30 days of WBV (40 Hz) treatment performed twice daily for 15 min each session, 5 days each week. The motor functions of animals belonging to both groups were tested intermittently and at the end of treatment period. Brains were then harvested for inflammatory markers and histopathological analysis. The results demonstrate a significant reduction in inflammatory markers and infarct volume with significant increases in brain-derived neurotrophic factor and improvement in functional activity after tMCAO in middle-aged female rats that were treated with WBV as compared to the control group. Our results may facilitate a faster translation of the WBV intervention for improved outcome after stroke, particularly among frail women.

This study was aim to assess the spatial-temporal trends of urban expansion with land use/land cover change dynamics over a period of 30 years in Addis Ababa. The source of data were Land sat satellite imagery freely available by the United States Geological Survey, Addis Ababa City plan map obtained from Addis Ababa city governance planning and development commission, and Ethiopia Space Science and Geospatial Agency. The data obtained were analysed by using QGIS, and ERDAS software. The finding showed that over the last thirty years Addis Ababa city was highly spreads with (Urban Expansion Intensity Index(UEII)=1.524%); building-up land increased faster (dynamic degree (K) = -6.22 and Annual Urban Expansion Rate(AUER) is 3.56. From the finding, Addis Ababa is spreading speedily.

Chlorhexidine digluconate (CHX) has shown the ability to significantly reduce inflammation and marginal bone loss (MBL) at 1-year follow-up but limited data exists regarding its long-term efficacy in peri implant stability. The objective was to compare the long-term effects of a placebo gel (16 patients in Group A) or a 0.20% CHX gel (15 patients in Group B) used at each previous surgical and prosthetic stage. Follow-ups were conducted in 2022, investigating by biological, radiological, clinical, mechanical evaluation the long-term effects. Data were statistically analyzed. The research achieved a 96.7% implant success rate over five years, but 41.9% of patients didn't attend annual oral hygiene check-ups. The average MBL was 1.04 ± 0.39 mm, with no significant differences between the two groups. Notably, patients who attended regular periodontal check-ups experienced significantly less MBL than those who didn't (p <0.05). At five years, the effects of CHX were reduced, with both groups showing moderate bone loss. The results suggest early disinfection could enhance both short and long-term outcomes. In fact, patient with initial minor MBL preserve this advantage also at 5 years of follow-up. Additionally, the data underscore the importance of annual check-ups in early detection and management of biological and mechanical complications.

This article aims at investigating the complex relationship between the local population and its natural and urban environment. The study of area which, is previously dominated by cereal cultivation, facing profitability challenges due to climate change, water scarcity Rapid urban expansion and overexploitation of aquifers, influenced by changes in agricultural practices, are disrupting the local ecosystem. The study relies on three interconnected indicators: population growth, climate change effects on agriculture, and the NDVI (Normalized Difference Vegetation Index) reveal the impact of these factors on agricultural practices. Google Earth Engine was employed to determine urbanization and greenness indices using scripts. Key findings include a shift towards intensive and protected agriculture, driven by individual and collective choices of official and unofficial actors, deviating from government directives. Additionally, the study highlights the unsustainability of this new agricultural direction, as the available water re-sources cannot meet the demands, potentially leading to recurrent agricultural shortages. The study underscores the importance of incorporating agricultural production into future urban planning and development programs to maintain a renewed balance between built environ-ments and agriculture on the outskirts of cities.

This study aimed to evaluate the impact of Candida albicans on subgingival biofilm formation on dental implant surfaces. Scanning electron microscopy (SEM) and confocal laser scanning microscopy (CLSM) were used to compare biofilm structure and microbial biomass in the presence and absence of the fungus after periods of 24, 48, and 72 h. Quantitative polymerase chain reaction (qPCR) was used to quantify the number of viable and total micro-organisms for each of the biofilm-forming strains. A general linear model was applied to compare CLSM and qPCR results between control and test conditions. The biofilm developed with C. albicans at 72 h had a higher bacterial biomass, with a significantly higher cell viability (p < 0.05). After both 48 and 72 h of incubation, in the presence of C. albicans, there was a significant increase in counts of Fusobacterium nucleatum and Porphyromonas gingivalis and in the cell viability of Streptococcus oralis, Aggregatibacter actinomycetemcomitans, F. nucleatum, and P. gingivalis. Using a dynamic in vitro multispecies biofilm model, C. albicans exacerbated the development of the biofilm grown on dental implant surfaces, significantly increasing the number and cell viability of periodontal bacteria.

The objective of this study was to evaluate the pain and inflammatory response in soft tissues using healing and prosthetic abutments of different diameters and lengths. Methods: The study population was rehabilitated with Astra tech EV single implants (Dentsply Sirona, Atlantis, Dentsply Sirona S.A., Barcelona, Spain), 4.2 and 4.8 millimetres in diameter in upper and lower maxilla and loaded with custom abutments digitally designed with the software of the company Dentsply Sirona (Atlantis WebOrder, Dentsply Sirona S.A., Barcelona, Spain), version 4.6.5, with a larger diameter than the healing abutment, to account for biomarkers through ELISA. Results: Rehabilitations in mandible and with healing abutments below 4.29 millimetres and rehabilitators below 2.18 millimetres elicited higher pain and inflammatory responses, and in turn higher interleukin 1β values. Conclusions: Greater inflammation was evident in cases in which healing abutments with reduced diameter were used in relation to the same subsequent rehabilitation with prosthetic abutments of larger diameter.

Objective To analyze the influence of HIV in penitentiary institutions through an exhaustive lexiconmetric and sentiment analysis of news in the Spanish written press related to HIV and prison. Material an method observational, descriptive, and retrospective design based on news published in Spanish newspapers from 1981 to 2020, linking HIV infection with penitentiary institutions. Natural language processing and lexiconmetry techniques were used, using the Python programming language and ATLAS Ti v.9 software. Result: 318 articles were analyzed, with 10,502 distinct words. The sentiment of news was evaluated in three different periods: the discovery of HIV, and the periods before and after the existence of antiretroviral treatments. N-gram analysis and word cloud creation were carried out for each period. In the initial phase, ignorance predominated, and prominent terms such as "homosexual," "isolate," "test," "trial," or "confirm" were observed. In the period before antiretroviral treatments, news reflected negative feelings and criticism of prison policy, with keywords such as "give birth," "drug," "carrier," or "disease." With the arrival of treatments, news showed an evolution towards a more positive tone, highlighting terms such as "treatment," "release," or "syringes”.Conclusions: The presence of HIV in Spanish prisons has experienced a significant evolution from an alarming situation to an improvement in the care of inmates, driven by institutional adaptation and advances in antiretroviral treatments.

This research experiments with a sustainability assessment based on the Sustainable Development Goals (SDGs) of Agenda 2030 through a process of their territorialisation and implementation. This process enables the development of a Spatial Decision Support System (SDSS) that can be integrated with strategic environmental assessments in urban planning. The assessment takes place on the transversality of the sustainability concept by trying to consider together the three dimensions (environmental, social and economic) into a single assessment through the Spatial Sustainability Assessment Model (SSAM) by integrating Geographic Information Systems (GIS) and multi-criteria analyses. Economic development, social equity, and ecological integrity represent three common visions for rethinking peri-urban edges.