The Mambaka watershed is extends between latitudes 1 3°45'E and 14°15'E and longitudes 7°16'N and 6°45'N. The geology, various tectonic and structural events that have affected the Adamawa Plateau in Cameroon make it rich in multi-substance mining. The objective of this study is to map rare earth (REE) geochemical anomalies in the sediments of the watershed streams west of Mambaka, and to trace their origins and geochemical processes. Predictive maps from inverse distance interpolations (IDW), factor analysis (F1) or principal component analysis (PCA) and hierarchical bottom-up classification maps provided a better understanding of the central tendency, distribution and dispersion of REE in the samples and in the study area, based on standard deviation and variance values that generated two factors F1 (Ho-Tm-Er-Yb-Lu-Dy-Tb-Gd-Eu-Sm) and F2 (Pr-Nd-Ce-La-Sm) representing 92.44% of the total cumulative variance. The ratios Ce/Ce* > 0.78 and Eu/Eu* > 1 demonstrate positive anomalies in Ce and Eu, and clear differentiation. The normalized concentrations used to calculate fractionation ratios show that the values for LaN/YbN (0.58 to 1.34), LaN/SmN (0.61 to 0.88) and LaN/LuN (0.62 to 1.43) suggest higher fractionation in SS09 and lower fractionation in SS01. Similarly, the ratios La/Lu (61.71 to 143.46), La/Yb (9.00 to 20.72), La/Sm (4.02 to 5.83) and La/ Lu (61.71 to 143.46) confirm these higher ratios in SS09 and lower in SS01. The REE in the study area comes from hydrothermal processes based on high lineament densities at sampling points in igneous rocks with a mean ∑REE value of between 174-219 ppm.

Background: Maternity leave, whether paid or unpaid, is a critical resource that can significantly impact maternal well-being and newborn outcomes. However, its availability and utilization among mothers living in poverty remain understudied. Education is widely recognized as a key factor that increases access to both paid and unpaid leave. However, the theory of Minorities’ Diminished Returns (MDRs) posits that structural racism, segregation, and labor market discrimination limit the benefits of socioeconomic resources, such as education, for Black and Latino individuals. This suggests that the effects of education on maternity leave may not be uniform across racial and ethnic groups. Objective: This study aimed to examine the MDRs of education on access to unpaid and paid maternity leave among Black and Latino mothers compared to White mothers giving birth while living in poverty. Methods: We utilized baseline data from the Baby’s First Years Study (BFY), a longitudinal investigation of the effects of poverty on child development. The sample consisted of 1,050 mothers living in poverty who had recently given birth. Maternity leave (paid and unpaid) was assessed via self-report, and educational attainment was measured in years of schooling. Structural equation modeling (SEM) and interaction terms were employed to analyze racial and ethnic differences in the relationship between education and access to maternity leave. Results: Educational attainment was positively associated with access to unpaid maternity leave for the overall sample of mothers giving birth in poverty, but this association was weaker for Black and Latino mothers compared to non-Latino White mothers. Education did not significantly increase the likelihood of paid maternity leave, and there were no group differences for this association. Conclusion: This study highlights the urgent needs to address structural racism, labor market discrimination, and residential segregation that diminish the impact of education on living conditions for Black and Latino mothers, compared to non-Latino White mothers, even for those living under poverty. Policymakers and practitioners should develop targeted interventions to reduce racial and ethnic disparities in access to paid and unpaid maternity leave and other critical resources, particularly for new mothers living in poverty. Addressing these inequities is essential for improving maternal and newborn health outcomes and promoting social justice.

Background: Proper umbilical cord care prevents neonatal infections and reduces neonatal mortality. Despite global recommendations for evidence-based cord care practices, traditional beliefs, and inadequate maternal knowledge often lead to unsafe practices, particularly in low-resource settings like Bangladesh. This study aimed to assess the understanding of umbilical cord care among mothers of neonates in Sherpur District, Bangladesh, and identify factors associated with knowledge levels. Methods: A descriptive cross-sectional study was conducted from July to October 2020 at Sherpur Sadar Hospital. A total of 193 mothers of neonates were recruited using a non-randomized purposive sampling method. Data was collected through a pre-tested, semi-structured, interviewer-administered questionnaire. Knowledge levels were categorized as "Good" (>6) or "Poor" (≤6) based on responses to 10 structured questions. Statistical analyses, including chi-square tests and crude odds ratios (COR), were performed to identify socio-demographic factors associated with knowledge levels. Results: Of the 193 participants, 48.7% demonstrated "Good" knowledge, while 51.3% had "Poor" knowledge. Education level (p = 0.01), occupation (p = 0.02), family type (p < 0.001), and family size (p = 0.04) were significantly associated with knowledge levels. Mothers with higher education and those from joint families exhibited better knowledge. However, 28.5% of respondents were unaware of the typical umbilical cord-shedding timeframe, and 44% could not identify signs of infection. Unsafe practices, such as using medications (14.5%) or hot compression (7.2%) for drying the cord, were reported. Conclusion: The study reveals significant gaps in maternal knowledge regarding umbilical cord care in Sherpur District, driven by socio-demographic disparities and cultural practices. Targeted health education programs, emphasizing evidence-based cord care practices and leveraging local social structures, are urgently needed to improve neonatal health outcomes in similar resource-limited settings. Future research should evaluate the effectiveness of these interventions to inform policy and practice.

Background: Nursing students are exposed to significant stress due to academic and clinical demands, which can adversely affect their mental health, academic performance, and future clinical competence. Despite the global acknowledgment of this issue, limited research has been conducted to explore the prevalence and determinants of stress among nursing students in Bangladesh. Methods: This cross-sectional study was conducted from December 2023 to February 2024 among 372 nursing students enrolled in selected nursing colleges in Bangladesh. A purposive sampling technique was used, and data was collected using a semi-structured questionnaire. The questionnaire assessed socio-demographic characteristics, academic challenges, and psychological symptoms, with mental health stress measured using a Likert scale. Descriptive statistics and Chi-square tests were used to analyze the data, with a 95% confidence interval applied to all analyses. Results: The findings revealed that 31.7% of nursing students experienced severe stress, 23.9% reported moderate stress, and 16.7% had mild stress. Age, academic semester, and course load difficulties were significantly associated with stress levels (p < 0.05). Psychological symptoms such as anxiety, difficulty concentrating, and loss of interest in activities were also significantly linked to higher stress levels. Notably, students in their first semester and those reporting harder course loads were more likely to experience stress. However, gender was not significantly associated with stress levels. Conclusions: This study underscores the high prevalence of stress among nursing students in Bangladesh, driven by academic and clinical challenges and psychological symptoms. The findings highlight the need for targeted interventions, such as stress management training, enhanced mental health support, and policies to alleviate academic pressures. Future research should explore longitudinal trends in stress and evaluate the effectiveness of interventions to support a resilient nursing workforce.

This study aimed to assess the knowledge level of street food vendors on hygiene in the Tamale metropolis in the Northern Region of Ghana. The study employed the health belief model as the theoretical basis. Quantitatively, the study employed a descriptive cross-sectional study design to examine the microbial load of street-cut fruits and assess the knowledge and practice of vendors of cut fruits on personal and food hygiene in the study setting. The population consists of cut and vented pawpaw, watermelon, and street fruit vendors registered with the health directorate in the Tamale Metropolis. A convenient sampling technique was used to select 113 respondents for the study. The Yamane formula was used to determine the sample size to select one hundred and thirteen participants (113) out of one hundred and fifty-eight street fruit vendors in the Tamale Metropolis. The main instrument for data collection was a questionnaire. A questionnaire had close-ended questions which were developed using a 'Yes' and 'No' response, and a four-point Likert-type scale ranging from 1=Strongly Disagree (SD), 2=Disagree (D), 3=Agree (A) and 4= Strongly Agree (SA). The data were analysed using descriptive statistics (frequency, percentages, means and standard deviation). The findings revealed that the overall knowledge level of respondents is low. The findings also indicate that vendors do not control the rate at which their customers touch their vended fruits. It is recommended that Street fruit vendors and handlers be educated on fruit hygiene practices through engagement by the Health Directorate Unit of Tamale Metropolis and the Ministry of Health. To keep consumers safe, the Tamale Metropolitan Assembly must strictly enforce compliance with regulations on operation permits and health clearance certificates. Metropolitan sanitation officers must regularly monitor fruit vendors to ensure compliance with goods.

Silver nanoparticles (Ag⁺NPs) contamination in the environment is a serious concern. This study investigated selected heavy metal (Ag⁺, Cd^2+, Cr²⁺ and Pb²⁺) concentrations at different sampling points to assess the risk to human health (infants, children, and adults). To do this, an enclosed area (laboratory) of 12.6 m X 8.5 m (107.1 m²) was clearly marked at different coded distances of S1, S2, S3, and S4 representing 2, 4, 6, and 8 m, while unpolluted atmosphere at 50 m away without Ag⁺NPs served as the control (S5). The silver fireworks were allowed to burn for an approximate 00h03m30s at each sampling points using a high-volume air sampler mounted at the Environmental Engineering Departmental Laboratory, Rivers State University, with windows and doors closed to simulate indoor conditions. Samples were digested using a mixture of analytical-grade nitric acid, analytical-grade hydrochloric acid and analyzed to evaluate the levels of heavy metals by atomic absorption spectrophotometry. The Ag⁺ result at S1 shows 30,000 µg/cm³, S2 was 29,000 µg/cm³, while S3 was 28000 µg/cm³ and then S4 was 13,000 µg/cm³. These results exceeded the permissible values of the United States National Ambient Air Concentration for rural, urban and industrial areas (0.0005, 0.004 and 0.6 µg/cm³, respectively). The result for the control (S5) (0.037 µg/cm³) was within the maximum allowable value. Results from other heavy metals such as Cd were 1000, 743, 401, 153, 0.001 µg/cm³, Cr was 5000, 4000, 3729, 2960, 0.002 µg/cm³, Pb was 0.048, 0.041, 0.035, 0.034 and 0.01, µg/cm³, respectively. However, higher values of Ag⁺, Cd, and Cr indicated a higher propensity for the metals to be toxic (bioavailable). In addition, the assessment of the potential health risk posed by these metals proved contaminated and harmful. Visitors recorded high values in exposure concentration (EC) and low values in average daily dose (ADD).

The Chinese film Wolf Warrior II floats all the way at the domestic box office, and jumps into the top 100 of the world's film box office rankings. It has achieved great economic success and ratings are overwhelmingly positive in China. Nevertheless, in stark contrast to this, Wolf Warrior II is cold at the box office abroad, and the word of mouth is not satisfactory. Transcreation is the re-creation or adaptation of content for a group of specific target audience. As an inter-related process of translation, a successful and holistic transcreation can arouse the same emotions as well as connotations produced in the target language as the source language. There are different perspectives to detailed translation analysis of China’s identity as a prominent character of contemporary society. Insofar as this research probes into the branding and in subtitle translation, it also constructs a binary theoretical model based on triadic signs of intersemiotic translation and metafunctional framework of multimodal analysis to testify China’s core values in this film and beyond.

Foods rich in phytochemicals are well recognized for their role in the prevention of chronic disease development, in addition to fulfilling the nutrient requirements. However, different processing methods employed during preparation may affect their levels and functionality as they are sensitive to different processing parameters such as temperature and light. This study aimed to evaluate the effects of three common processing methods; boiling, fermentation, and drying (sun and solar drying, with and without blanching), on total phenolic content and total flavonoid content in cassava (Manhot esculenta Crantz), black jack (Bidens pilosa) and bitter lettuce leaves (Launaea cornuta) grown in Mkuranga District in the Eastern part of Tanzania. Total phenolic content and total flavonoid content were analyzed by using the spectrophotometric method with the use of Folin-Ciocalteu and Aluminum Chloride reagents, respectively. Total phenolic content ranged from 0.9±0.14 to 85.7 ± 0.56 mg Gallic Acid Equivalent (GAE)/100g and flavonoids ranged from 0.03±0.00 to 3.9±0.03 mg/100g across the treatments. Both parameters were adversely affected by fermentation and boiling, while solar and sun drying only reduced the flavonoid content. Results showed that direct solar and sun drying appear to be effective processing methods, for the retention and maintenance of total phenolic content in all samples while, none proved to be effective for flavonoid content.

The Douala-Edea National Park is a coastal protected area that opens to the Atlantic Ocean, and contains an abundant wildlife which finds a privilege habitat there, and certain taxa such as epiphytes, which are of particular interest for conservation. In many tropical forests, vascular epiphytes are one of the richest taxa, with major impacts on the nutrient and hydrological cycles. The aim of this research was to study the effect of the disturbance of habitat on the floristic composition of vascular epiphytes in the Douala-Edea National Park. This study was carried out between January - April 2021 in three types of disturbed habitats at the northern part of the park. Three plots of 100 m × 100 m dimensions were laid out across three ecosystems along the Sanaga river. The sampling method consisted in the direct observation of five adjacent transects of 100 m x 20 m dimensions inside each plot. Epiphytes species were evaluated on all trees of DBH ≥10 cm. Epiphytes' life-forms and the position on the host trees occupied by the epiphytes were also recorded. A total of 18 species belonging to 16 genera and 13 families were identified. Culcasia sp. was the most common species with a relative frequency of 30.27%. Biological indicators were represented by Ferns, with four species, and Orchidaceae, with one species. The epiphytes species richness was highest in the low disturbed habitat (13 species), and lowest in the highly disturbed habitat (8 species). Strict epiphytes were highly recorded in the low disturbed habitat (6 species), and were absent in the highly disturbed habitat. Hemi-epiphytes were the commonest life-form (12 species) in the highly disturbed habitat, and have been defined as indicators of the perturbation of the habitat. Canopy was mostly sollicitated by epiphytes in the low disturbed habitat (66.25%) than the moderate disturbed habitat (49.85%), and highly disturbed habitat (30.66%). It has been found that the different forest sites have an influence on the typology of epiphytic species, and therefore, epiphytic flora should be managed for the conservation of the biodiversity in tropical forests.

Background: Vitamin D plays an important role in the development of bone health and possibly non-communicable diseases. Arab countries had made their own national studies to assess serum vitamin D level among women, yet in Egypt there is no national survey done. The aim of the current study was to identify risk factors affecting vitamin D level among Egyptian females during the child-bearing period. Subjects and methods: A total of 100 healthy adult females in their childbearing period who were attending a Family Medicine Center were included in our study. The age of the included women ranged from 19 to 49 years old with a mean age of 34 (SD 8.47) years. The majority of participants had deficiency (43%) and insufficiency (13%) of vitamin D level. Results: Unemployed women were more likely to have vitamin D deficiency than employed women (P<0.05). Participants who were exposed to sun ˃30 minutes/day were more likely to have sufficient vitamin D level (P<0.05). All participants who consume fish ≥3 times/week had sufficient vitamin D level. Therefore, there was a statistically significance association between a number of consuming fish/week and vitamin D3 level groups. Also, there was statistically significant association between number of consumed milk cups/day and vitamin D3 level groups. All participants who drink 2 cups of milk have sufficient vitamin D level. No statistically significance association was found between using multivitamins and vitamin D3 level groups. Conclusion: Unemployment, low fish consumption and infrequent sun exposure were significant risk factors for vitamin D deficiency. Future research on the role of multivitamins supplements in improving vitamin D nutrition is warranted.

Baloxavir marboxil (BXM) is a novel anti-influenza agent that developed in Japan and inhibit the cap endonuclease specifically, and suggested the more clinical effectiveness in influenza. BXM reduces viral shedding more than do neuraminidase inhibitors (NAIs), and its clinical efficacy is equivalent to that of NAIs but is superior to that of NAIs in the case of type B influenza. BXM does not demonstrate any issues with safety, and treatment with BXM reduces the incidences of complicating sinusitis and bronchitis. Prophylactic administration of BXM inhibits intrafamilial transmission of influenza although low susceptible viruses with a PA/I38X substitution are isolated with a certain frequency following administration of BXM. Finally, In influenza treatment for patients aged 12−19 years and for adult outpatients, BXM can be used with the same recommendation level as oseltamivir.

The Internationalization of higher education has plummeted since the 2010 tightening of migration policies. This study aims to examine the retention and graduation rates of international students at Northern Arizona University (NAU). Using a quantitative analysis approach, the study utilized secondary data from the Center for International Admission and Recruitment Office at NAU to examine the university’s recruitment, graduation, and retention strategies. The aim was to evaluate the impact of internationalization strategies on application and enrolment numbers. The study sample consisted over 2000 international students from fourteen countries, including China, India, Vietnam, Kuwait, Nepal, Ghana, Nigeria, United Kingdom, Spain, Germany, Canada, Mexico, France, and Iran in four cultural groups (Asia, Europe, Africa, and North America). A random sampling technique was used to select these countries partly because of their highest applications, enrolment numbers, as well as their adoption of recruitment strategies like those used by higher education institutions in the United States. A descriptive graphic representation, focusing on full-time undergraduate students during fall semesters, specifically freshmen international students, is illustrated. To facilitate a cross-country comparison of international students, this study presents an analysis of retention and graduation data across different countries spanning the past five years, from 2016 to 2020.

The banana (Musa spp.) is a tropical fruit with excellent sensory characteristics in terms of aroma, flavor and texture, consumed worldwide and exploited in most tropical countries. Green banana flour is rich in flavonoids, which protect the gastric mucosa, has a high content of resistant starch, which acts in the body as a dietary fiber and thus has health benefits, and is an alternative option for bakery products, reducing waste of both the peel and the pulp. The aim of this study was to develop bread formulations with partial substitution of wheat flour with green banana flour (FBV), thus increasing the nutritional, technological and sensory value. 4 formulations, (A), standard sample; (B), bread with 10% FBV; (C), bread with 15% FBV and (D), bread with 20% FBV. Physico-chemical quality was assessed in terms of moisture content by drying at 105ºC, ash by incineration, fat by the Soxhlet method, protein by the biuret method, carbohydrates by difference calculation and calorific value by sum calculation and sensory analysis by affective methods. The data was evaluated using the RStudio 4.2.1 DCC statistical package. There were no significant differences in moisture content, lipids and calorific value. Differences were evident in the ash and protein content. Sensory acceptance of the standard formulation was 82.22%. The results obtained show that green banana flour can be used as a partial substitute for wheat flour to produce breads with functional properties.

This work evaluated the bioremediation potential of Jatropha tanjorensis leaf extract at different masses (250g, 500g and 750g) over a 40-day period. To achieve this, crude oil contamination of sandy loam soil was stimulated in twelve plastic reactors containing fixed masses of soil (4kg each) of topsoil homogenized with 500g of Bonny light crude oil. The Jatropha tanjorensis leaves were cultivated, rinsed with distilled water, blended, and purified by filtration. The leaf extract was applied at the stated concentrations including a control reactor (without leaf extract). The plastics reactors were kept in an open air shielded away from rainfall. The physicochemical characteristics determined were particle size distribution (PSD), potential of hydrogen (pH), electrical conductivity (EC), organic matter (OM), organic carbon (OC), selected heavy metals (Cr, Cd, Zn, Pb) and sample management were all in line with standard procedure. After 40 days of treatment, results obtained showed that plastic reactor with 750g of leaf extract produced the highest amount of cadmium reduction of 97% (from an initial of and there was significant difference among treatment (P < 0.05). The sequence of reduction among treatment was 750g > 500g > 250g of the leaf extract. Chromium, Lead and zinc followed similar trend. Thus, the Jatropha tanjorensis leaf extract has the potential to ameliorate crude oil-contaminated soil.

The price of grains like maize and sorghum is subject to significant fluctuations, which can have a significant impact on a country's economy and food security. The aim of the study is to model sorghum and maize price volatility in Nigeria. The data utilized in the study was extracted from World Bank Commodity Price Data (WBCPD), 2022. The data consists of monthly prices in nominal US dollars for maize and sorghum from January 1960 – August 2022. The Autoregressive Conditional Heteroskedasticity (ARCH) and Generalized Autoregressive Conditional Heteroskedasticity (GARCH) models were utilized for capturing the two-grain price volatility. Two types of conditional heteroscedastic models exist, the first group uses exact functions to control the evolution of , while the second group describes with stochastic equations. It is inferred from the result that inherent uncertainties and fluctuations existed in the prices of maize and sorghum in Nigeria which implies that the price volatility is positive and statistically significant suggesting that historical information and past shocks play a crucial role in determining the volatility observed in the grains. It is recommended that the ARCH, GARCH, EGARCH, TGARCH, PARCH, CGARCH, and IGARCH models should be employed for modeling and managing the volatility of maize and sorghum prices in Nigeria. These models have shown effectiveness in capturing different aspects of volatility, including the impact of past shocks, conditional volatility, asymmetry, and other relevant factors.

The quality of communication between healthcare providers and pregnant women is a topic of paramount importance within the realm of maternal healthcare. It is not merely an aspect of medical interaction; rather, it is the prerequisite that influences various critical dimensions of maternal care, including maternal satisfaction, health outcomes, and shared decision-making. Effective communication between healthcare providers and pregnant women is essential for optimal maternal care during pregnancy and childbirth. Maternal satisfaction is a fundamental metric of patient-centered care, and improved communication, characterized by empathy, information sharing, and active listening, cultivates trust and enhances women's contentment with their care experiences. Positive provider-patient interactions are associated with improved emotional well-being, reduced stress levels, and increased adherence to prenatal recommendations, contributing to positive health outcomes for both mother and fetus. Shared decision-making is impacted by open and transparent dialogue between healthcare providers and pregnant women. Inclusive discussions about available interventions, risks, and benefits empower women to make informed choices aligned with their preferences and values. This shared decision-making promotes autonomy, self-efficacy, and a collaborative care partnership, potentially influencing the birthing experience and postpartum adaptation. However, challenges persist in communication quality, such as variability in healthcare provider communication styles, cultural considerations, and system-level factors. Addressing these challenges through targeted interventions, training, and policy implementation can further enhance the overall maternal care experience. Further research is needed to explore innovative strategies that optimize communication and promote positive outcomes throughout the continuum of maternal care.

Background: Recently specific interactions and crosslinks between the gut microbiota and the lungs have been recognized, particularly with regard to respiratory immune and anti-microbial reactions. This is often known as the “gut-lung axis” or “a common mucosal immunological system”. Objective: The aim of the current systematic review was to evaluate evidence, from published clinical trials and cohort studies, if probiotics may have an effect in improving and managing COVID-19 symptoms. Materials and methods: The available studies were searched through a comprehensive search of electronic databases that included PubMed, Science Direct, Scirus, ISI Web of Knowledge, Google Scholar and CENTRAL (Cochrane Central Register of Controlled Trials), using a combination of the following keywords: “COVID-19" OR "SARS-CoV-2" AND "Microbiota" OR "Probiotics” OR “Gut Lung Axis”. The literature was reviewed until August 31, 2022. Results: Only 3 studies were included. One of them evaluated the efficacy of probiotics in COVID-19 patients to obtain complete remission of all signs and symptoms. The clinical trial proves that probiotics have a significant effect on complete remission of all signs and symptoms of COVID-19 patients with statistical significant difference. Only one clinical trial out of the 3 included studies had evaluated the need for O2 therapy during the study between the probiotics and control groups, but without statistical significant difference. No statistical significant difference between the probiotics group and placebo group was observed regarding fatal prognosis during the only clinical trial that measured death as an outcome. Conclusion: We couldn’t judge on these results as they are insufficient data for pooling and meta-analysis. However, what we can say is “Most probably Probiotics have no role in treatment of COVID-19 infection”.

Background: Coronavirus disease 2019 (COVID-19) is a newly emerging human disease caused by a novel coronavirus, causing a global pandemic crisis. Probiotics and/or colchicine may be considered as options for treatment since they have anti-viral, anti-inflammatory, and immunomodulatory effects. The aim of the current review was to assess the effectiveness of probiotic supplements and colchicine on symptoms, duration, and progression of mild and moderate cases of COVID-19 infection. Review: A randomized, double-blind, placebo-controlled trial in the United States with 182 participants who were randomly assigned to receive daily oral probiotic (Lactobacillus rhamnosus) LGG or placebo for 28 days. The study indicated that LGG is well-tolerated and is associated with a delay in the onset of COVID-19 infection, a reduction in the incidence of symptoms, and alterations in the structure of the gut microbiome when administered as post-exposure prophylaxis within seven days of exposure. Colchicine may lessen mortality and the need for mechanical ventilation in mild-to-moderate COVID-19 patients, according to a systematic review and meta-analysis. Conclusion: Probiotics and/or colchicine may be viable treatment options for COVID-19 patients. To examine the efficacy of probiotics and colchicine in the treatment of COVID-19, it is necessary to conduct additional clinical trials and provide clinicians with evidence, as there are currently insufficient studies to support this conclusion.

Objective: aortic root enlargement (ARE) and descending thoracic aorta dilatation (DTAD) in combined aortic valve and ascending aorta replacement surgery (AV+AAR) are postoperative concerning issues. This retrospective observational analysis studies surgical factors which could determine those complications. Methods: 236 patients underwent AV+AAR. Mean-time follow-up by trans-thoracic echocardiography (TTE) and computer tomography (CT) was 44.7 ± 21.2 and 38.2 ± 18.4 months respectively. In long-term follow-up, outcome variables are: ARE equal/more than 10% of the preoperative TTE data and DTAD equal more than 5% of preoperative CT measurement at the same thoracic vertebrae axial slice. Results: ARE and DTAD appear strictly related to the discrepancy between prosthetic valve and straight vascular prosthesis diameters (p = 0.024), while there is not significant difference (log-rank = 0.917) related to aortic valve surgery type (replacement or repair). Considering diameter difference (DD) between vascular and aortic valve prosthesis, patients were subsequently grouped into two sections: L5 group, in which DD was less/equal than 5 mm, and M5, in which DD was more/equal than 5 mm. ARE was found in 30.8 % of L5 patients and only in 14.7 % among M5 patients (log-rank = 0.026). We have also observed descending thoracic aorta dilatation in 34.2 % of L5 and in 12.1 % of M5 (log-rank = 0.023). Conclusions: According with our data, difference between vascular prosthesis and aortic valve prosthesis equal/more than 5 mm is a protective factor against ARE and DATD.