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The direct anterior approach (DAA) for total hip arthroplasty (THA) is a muscle-sparing approach thought to have less post-operative pain and quicker recovery, with similar functional outcomes to other approaches. However, it is technically challenging and transitioning surgeons may experience increased complication rates. The purpose of this systematic review is to identify reported learning curves associated with the DAA.

Three databases (MEDLINE, Embase, and Web of Science) were searched using terms including "total hip arthroplasty," "direct anterior approach," and "learning curve." Study characteristics, patient demographics, learning curve analyses, and complications were abstracted.

Twenty-one studies met inclusion criteria, with a total of 9738 patients (60% female), an average age of 63.7 years (range 13-94), body mass index of 27.0 kg/m

(range 16.8-58.9), and follow-up of 19 months (range 1.5-100). There were five retrospective cohort studies and 13 case series representing fair methodological quality. Six studies depicted a true learning curve, with mean operative time of 156.59 ± 41.71 minutes for the first case, 93.18 ± 14.68 minutes by case 30, and 80.45 ± 12.28 minutes by case 100. Mean complication rate was 20.8 ± 12.7% in early groups and decreased to 7.6 ± 7.1% in late groups.

This review demonstrated a substantial learning curve associated with the DAA to THA. Operative time plateaued after approximately 100 cases. Complication rates decreased substantially from early to late groups.

This review demonstrated a substantial learning curve associated with the DAA to THA. Operative time plateaued after approximately 100 cases. Complication rates decreased substantially from early to late groups.

Transhiatal esophagectomy (THE) was popularized to reduce the morbidity of esophagectomy. Thoracoscopy-assisted esophagectomy (TAE) offers esophageal dissection under magnified vision. This study compares the short-term morbidity and oncological outcome following TAE and THE for esophageal carcinoma.

This is a prospective comparative (January 2017-May 2018) study between TAE and THE for >cT1bN1 esophageal carcinoma. After neoadjuvant chemoradiotherapy (NACRT), responders and patients with stable diseases were subjected to surgery. Thoracoscopy in esophagectomy was performed in prone position. Follow-up duration was at least 4weeks post-discharge.

Thirty-three patients of esophageal carcinoma undergoing TAE (n = 18) or THE (n = 15) were included. Common locations of tumor were lower third of esophagus (72.7%) and esophagogastric junction (18.2%). Majority (73.3%) had squamous cell carcinoma. Median interval between NACRT and surgery was 13weeks. The mean operating time was significantly more with TAE than THE (292.5 vs 207.33min, p = 0.005). R0 resection rate in TAE was 83.3% compared with 66.7% in THE. There was no difference in the lymph node yield. There was non-significant trend towards lower incidence of major pulmonary complication (66.7% vs 80.0%), cardiac complications (27.8% vs 46.7%), anastomotic leak (27.8% vs 46.7%), recurrent laryngeal nerve palsy (16.7% vs 20.0%), and overall major morbidity (Clavien-Dindo ≥ III) (44.4% vs 66.7%) in TAE than THE. The chyle leak was observed more in TAE (16.7%) than THE (6.7%).

TAE achieved higher R0 resection rate and better short-term morbidity than THE. Enrollment of small number of cases in the study precluded statistical significance.

This study was registered in Clinical Trial Registry-India (CTRI registration no CTRI/2018/05/013880) in 14-05-2018.

This study was registered in Clinical Trial Registry-India (CTRI registration no CTRI/2018/05/013880) in 14-05-2018.Gut microbiota have long attracted the interest of scientists due to their profound impact on the well-being of animals. A non-random pattern of microbial assembly that results in a parallelism between host phylogeny and microbial similarity is described as phylosymbiosis. Phylosymbiosis has been consistently observed in different clades of animal hosts, but there have been no studies on crustaceans. In this study, we investigated whether host phylogeny has an impact on the gut microbiota assemblages in decapod shrimps. We examined the gut microbial communities in 20 shrimp species from three families inhabiting distinct environments, using metabarcoding analyses of the V1-V3 hypervariable region of the 16S rRNA gene. Gut microbial communities varied within each shrimp group but were generally dominated by Proteobacteria. A prevalent phylosymbiotic pattern in shrimps was evidenced for the first time by the observations of (1) the distinguishability of microbial communities among species within each group, (2)or all shrimp groups examined and in the predicted functions for the penaeid shrimps indicate a tight host-microbial relationship during evolution.An innovative label-free DNA genosensing assay based on a direct hybridization followed by DPASV in the presence of [Fe(CN)6]4-/3- was developed for recognizing the H. influenza genome in human plasma samples. To attain this objective, Zn-based MOF was synthesized and combined with carboxymethyl cellulose (CMC), which were immobilized on the surface of Au electrode and AuNPs were immobilized on the Zn-based MOF/CMC/Au-modified electrode surface. The genosensing bio-assay provides high specificity, sensitivity, and good performance for the determination of L-fuculokinase gene from the Haemophilus influenza genome. Various characterization techniques were applied including Fe-SEM, EDS, FT-IR, and XRD for investigation of morphological features and particle size. Under optimal conditions LOD and LOQ were 1.48 fM and 3.23 fM, respectively. Moreover, a wide linear range was obtained ranging from 0.1 pM-10 nM for t-DNA. The recoveries and RSDs were 98.4-103% and 2.2-3.2, respectively. The fabricated biosensing assay presented high selective ability of one, two, and three-base mismatched sequences. In addition, negative control of the genosensing assay for investigation of the selectivity was performed by the t-DNAs of Salmonella typhimurium and Shigella flexneri bacteria. Likewise, reproducibility and repeatability of the related bio-assay were investigated. It is to be noted that the organized genosensing bio-assay can be straightforwardly reused and regenerated to assess the hybridization process.Graphene oxide sheets (GO) were coupled with carbon nanotubes (CNTs) to enhance the photoactivity of anatase under visible and solar irradiation. The carbon nanotube surface was functionalized in the acidic reflux condition before coupling with GO and decoration of anatase by the sol-gel method. A modified kinetic model was appropriately applied to predict the breakthrough in the methylene blue degradation yield and determine the constant rate which was clearly affected by coupling architecture. The nanocomposite fabricated by the same proportions of GO and CNTs, 3.33%, exhibited the maximal degradation yield, 96.5%, in the dye solution with the initial concentration of 3.0 mg l-1. The characterizations based on X-ray diffraction (XRD), Fourier-transform infrared spectroscopy (FTIR), Raman spectroscopy, and field emission scanning electron microscopy (FESEM) revealed that the functionalized CNTs could create the appropriate space between the graphene sheets for uniformly interconnection of anatase via oxygen-containing groups onto the material surfaces. This enhancement in the degradation efficiency could be ascribed to the unique architecture, leading to a decrease in bandgap energy, 2.2 eV, which facilitated the electron-hole separation. Besides of breakthrough in the photoreaction rate, the adequate architecture led to an efficient reduction in the content of carbon-based materials. Also, the performance of mentioned nanocomposite under sunlight photons was effectively higher than that under UV irradiation. The hybrid nanocomposite provided a large number of active sites for photoreactions to facilitate the treatment of wastewater under solar irradiation.Water leakage in the urban water cycle involves relevant economic, social, and environmental negative impacts. Thus, reducing water leakage is a key challenge for both water regulators and water companies. This study estimated the evolution (2007-2015) of the marginal cost of improving the quality of service in terms of water leakage in the Chilean water industry, which involves full private, concessionary, and public water companies. In water companies, management skills and efforts play an important role in meeting water leakage targets. Thus, this study employed a cost frontier model where it was assumed that unobserved management ability interacts with output and water leakage factors. The results reveal high levels of cost efficiency for the average water company. Management increases outputs and reduces water leakage and, thus, has a positive impact on costs and efficiency. read more The marginal cost of reducing water leakage is higher for the public water company than for private and concessionary water companies. The average estimated marginal cost of reducing water leakage was 0.349 €/m3, which means that a water company has to spend an extra 0.349 € in operating costs to avoid a cubic meter of water leakage. Some policy implications were discussed based on the results of this study.Many researchers are seeking simple and successful solutions to increase the output from the solar distiller. In this research work, reflective mirrors and reflective aluminium foil sheet were fixed on inner surfaces of the single-slope solar distiller, leading to more water production. The presence of reflective mirrors and reflective aluminium foil sheet on inner surfaces of the solar distillate permits the reflection of solar radiation falling inside the basin. Experiments were carried out on three stills the first distiller is conventional solar still with black painted walls (CSS-BPW); the second distiller is conventional solar still with reflective aluminium foil sheet walls (CSS-RAFW); and the third distiller is conventional solar still with reflective glass mirror walls (CSS-RGMW). The maximum total drinking water productions from the CSS, CSS-RAFW and the CSS-RGMW are 3.41, 5.1 and 5.54 kg/m2, respectively. Compared to the CSS-BPW, the production of drinking water was increased by 68.57% when using the reflective glass mirrors and 48.57% when using the reflective aluminium foil sheet.The present study aimed at investigating (1) the seasonal concentrations of heavy metals in different organs of Vossia cuspidata (Roxb.) Griff. in its main natural habitats in the River Nile ecosystem in Cairo, Egypt, (2) the bioaccumulation and translocation of heavy metals in the organs of V. cuspidata and its potentials as a phytostabilizer, and (3) the seasonal changes in the dry matter (DM) biomass of the organs. Two river islands were selected for seasonal sampling of water, sediment, and plant organs in eighteen randomly distributed quadrates (0.5 × 0.5 m each) during the period from February 2018 to January 2019. The total annual mean DM biomass was ≈ 18.7 ton ha-1. The aboveground organs had significant seasonal variations in DM biomass (p less then 0.05). The belowground DM biomass represents 23% of the aboveground DM biomass. Belowground organs had the highest DM biomass values in winter for the roots (23.85 g DM m-2, 4.75% from the total DM) and spring for the rhizomes (108.96 g DM m-2, 37.3% from the total DM).