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Chlorogenic acid (CGA) is a well-known natural antioxidant in human diet. To understand the effects of CGA on wound healing by enhancing antioxidant defense in the body, the present study sought to investigate the potential role of systemic CGA therapy on wound healing and oxidative stress markers of the skin. We also aimed to understand whether chronic CGA treatment has side effects on pivotal organs or rat bone marrow during therapy. Full-thickness experimental wounds were created on the backs of rats. CGA (25, 50, 100, 200 mg/kg) or vehicle was administered intraperitoneally for 15 days. All rats were sacrificed on the 16th day. Biochemical, histopathological, and immunohistochemical examinations were performed. Possible side effects were also investigated. The results suggested that CGA accelerated wound healing in a dose-dependent manner. CGA enhanced hydroxyproline content, decreased malondialdehyde and nitric oxide levels. and elevated reduced glutathione, superoxide dismutase, and catalase levels in wound tissues. Epithelialization, angiogenesis, fibroblast proliferation, and collagen formation increased by CGA while polymorph nuclear leukocytes infiltration decreased. CGA modulated matrix metalloproteinase-9 and tissue inhibitor-2 expression in biopsies. Otherwise, high dose of CGA increased lipid peroxidation of liver and kidney without affecting the heart and muscle samples. Chronic CGA increased micronuclei formation and induced cytotoxicity in the bone marrow. In conclusion, systemic CGA has beneficial effects in improving wound repair. Antioxidant, free radical scavenger, angiogenesis, and anti-inflammatory effects of CGA may ameliorate wound healing. High dose of CGA may induce side effects. In light of these observations, CGA supplementation or dietary CGA may have benefit on wound healing.

In this study the clinical and histopathological effects of topically applied tripeptide-copper complex (TCC) and zinc oxide on open-wound healing in rabbits was evaluated. Eighteen New Zealand rabbits were divided into three groups: TCC, zinc oxide and no treatment. One full thickness wound was created on each side of the dorsal midline in each rabbit. Wound margins were traced on days 0, 7, 14, and 21 and topical TCC and zinc oxide were applied daily for 21 days to each rabbit in the respective treatment groups. The mean unhealed wound area was significantly smaller in the TCC than in the zinc oxide group on day 7, but it was significantly smaller in the TCC group than in to the control group on days 7, 14 and 21. The mean percentage of wound contraction on day 7 was significantly higher in the TCC than in the zinc oxide group; however, it was significantly higher in the TCC group than in the control group on days 7, 14 and 21. Median time for the coverage of the wound bed with granulation tissue was significantly shorter in the TCC group than in the other groups. Filling of the open wound with granulation tissue to skin level was significantly slower in the control group than in the other two groups. Neutrophil counts decreased regardless of the group in parallel with healing, while neovascularization was best observed in the TCC group. The results suggest that TCC is a better choice in the treatment protocols of open wounds in rabbits than zinc oxide.

The aim of this study was to compare the clinical and histopathological effects of tripeptide copper complex (TCC) and two different doses of laser application (helium-neon laser, 1 and 3 J cm(-2)) on wound healing with untreated control wounds. Experimental wounds were created on a total of 24 New Zealand white rabbits and topical TCC or laser was applied for 28 days. The wounds were observed daily, and planimetry was performed on days 7, 14, 21 and 28 to measure the unhealed wound area and percentage of total wound healing. Biopsies were taken weekly to evaluate the inflammatory response and the level of neovascularization. The median time for the first observable granulation tissue was shorter (P < 0.05) in the low and high dose laser groups than in the control group (3 and 2.66 vs. 4.5 days), but was not different between the TCC and control groups (4.16 vs. 4.5 days). Filling of the open wound to skin level with granulation tissue was faster (P < 0.05) in the TCC and high dose laser groups than in the control group (14 and 16 vs. 25 days), but was not different between the low dose laser and control groups (23 vs. 25 days). The average time for healing was shorter (P < 0.05) in the TCC and high dose laser groups (29.8 and 30.2 vs. 34.6 days), but was not different between the low dose laser and control groups (33.8 vs. 34.6 days). Histopathologically, wound healing was characterized by a decrease in the neutrophil counts and an increase in neovascularization. The TCC and high dose laser groups had greater neutrophil and vessel counts than in the control group, suggesting a more beneficial effect for wound healing.

The effects of halothane, isoflurane and sevoflurane anaesthesia on hepatic function and hepatocellular damage were investigated in dogs, comparing the activity of hepatic enzymes and bilirubin concentration in serum. An experimental study was designed. Twenty-one clinically normal mongrel dogs were divided into three groups and accordingly anaesthetized with halothane (n = 7), isoflurane (n = 7) and sevoflurane (n = 7). The dogs were 1-4 years old, and weighed between 13.5 and 27 kg (18.4 +/- 3.9). Xylazine HCI (1-2 mg/kg) i.m. was used as pre-anaesthetic medication. Anaesthesia was induced with propofol 2 mg/kg i.v. The trachea was intubated and anaesthesia maintained with halothane, isoflurane or sevoflurane in oxygen at concentrations of 1.35, 2 and 3%, respectively. Intermittent positive pressure ventilation (tidal volume, 15 ml/kg; respiration rate, 12-14/min) was started immediately after intubation and the anaesthesia lasted for 60 min. Venous blood samples were collected before pre-medication, 24 and 48 h, and 7 and 14 days after anaesthesia. Serum level of aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP) and gamma-glutamyltransferase (GGT), lactate dehydrogenase (LDH GGT) activities and bilirubin concentration were measured. Serum AST, ALT and GGT activities increased after anaesthesia in all groups. In the halothane group, serum AST and ALT activities significantly increased all the time after anaesthesia compared with baseline activities. But in the isoflurane group AST and ALT activities increased only between 2 and 7 days, and in the sevoflurane group 7 days after anaesthesia. GGT activity was increased in the halothane group between 2 and 7 days, and in the isoflurane and sevoflurane groups 7 days after anaesthesia. All dogs recovered from anaesthesia without complications and none developed clinical signs of hepatic damage within 14 days. The results suggest that the use of halothane anaesthesia induces an elevation of serum activities of liver enzymes more frequently than isoflurane or sevoflurane from 2 to 14 days after anaesthesia in dogs. The effects of isoflurane or sevoflurane anaesthesia on the liver in dogs is safer than halothane anaesthesia in dogs.

Higher education institutions (HEI) have realized the advantages of implementing a blended learning environment by using learning management systems (LMSs) to provide effective ways of learning and teaching. However, recent literature has revealed that developing countries' educational institutions fail when they adopt LMS technologies because they ignore the human factors related to these technologies. This study investigated the impact of human factors on the effectiveness of LMS in a blended learning environment at Kuwait's HEIs (KHEIs). In this paper, a pragmatic approach consisting of quantitative and qualitative methods is used. User characteristics traits from the literature review were organized into three main indicators of human impact on the effectiveness of LMS: technological characteristics, psychological characteristics, and student-instructor interaction characteristics. After these indicators were identified, a conceptual model was developed to study the characteristics. A deductive approach was used, and the model was tested for significance through receiving feedback from the universities' students and faculty members. In addition, an inductive approach was implemented through conducting interviews to explore more factors related to the effectiveness of LMS. The inductive approach's results revealed the relevant factors for the usage of the LMS, such as training, needs, expectations, and branding. The human factors that positively affect the success and effectiveness of LMS included attitude, enjoyment, experience, self-efficacy, and promptness, which had the most substantial impacts on user satisfaction. The modified conceptual model that this paper presents includes these impacting factors and provides an acceptable fit to the data. This research has developed an updated framework for demonstrating the effectiveness of LMS as it pertains to human factors, and its findings can be used to enhance user experience in a blended learning environment, thus improving the quality of Kuwaiti education. INDEX TERMS Learning management systems (LMSs), blended learning, human factors, effectiveness of LMS, Kuwait's higher education institutions.

Warehouses link suppliers and customers throughout the entire supply chain. The location of the warehouse has a significant impact on the logistics process. Even though all other warehouse activities are successful, if the product dispatched from the warehouse fails to meet the customer needs in time, the company may face with the risk of losing customers. This affects the performance of the whole supply chain therefore the choice of warehouse location is an important decision problem. This problem is a multi-criteria decision-making (MCDM) problem since it involves many criteria and alternatives in the selection process. This study proposes an integrated grey MCDM model including grey preference selection index (GPSI) and grey proximity indexed value (GPIV) to determine the most appropriate warehouse location for a supermarket. This study aims to make three contributions to the literature. PSI and PIV methods combined with grey theory will be introduced for the first time in the literature. In addition, GPSI and GPIV methods will be combined and used to select the best warehouse location. In this study, the performances of five warehouse location alternatives were assessed with twelve criteria. Location 4 is found as the best alternative in GPIV. The GPIV results were compared with other grey MCDM methods, and it was found that GPIV method is reliable. It has been determined from the sensitivity analysis that the change in criteria weights causes a change in the ranking of the locations therefore GPIV method was found to be sensitive to the change in criteria weights.