Search

Dr Adnan al-Bursh was head of orthopaedics at al-Shifa Hospital, the largest medical facility in the Gaza Strip. Some have anecdotally called him the best orthopaedic surgeon in the land. When hostilities knocked the front door of al-Shifa hospital, instead of heading south as ‘requested’ by the Israeli Occupation Force (IOF), he went north to continue serving his people until his arrest in December 2023. On 19 April 2024, news reached the world that Dr al-Bursh died in prison, likely from torture

Nasser M Alorfi,1 Mansour M Alourfi,2,3 Ghfran Abdulrahman Bokhari,3 Abdullah Alkhattabi,3 Nihal Abdalla Ibrahim,4 Abdulmalik Mohammed Alsabban,5 Mohammad J Almatrafi,5 Yaser Abdulaziz Zakri,5 Abdullah Jasem Almahmoud,6 Khalid Mohammed A Al-ghamdi,6 Saeed Nasser Alsharif7 1Department of Pharmacology and Toxicology, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia; 2Internal Medicine Department, King Faisal Medical City for Southern Region, Abha, Saudi Arabia; 3Department of Gastroenterology, East Jeddah Hospital, Jeddah, Saudi Arabia; 4College of Pharmacy, Ajman University, Ajman, United Arab Emirates; 5Gastroenterology Section, Department of Medicine, King Abdulaziz Medical City, Jeddah, Saudi Arabia; 6Gastroenterology Section, Internal Medicine Department, King Fahad Hospital, Jeddah, Saudi Arabia; 7Gastroenterology Department, Armed Force Hospital of Southern Region, Khamis Mushait, Saudi ArabiaCorrespondence: Nasser M Alorfi, Department of Pharmacology and Toxicology, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia, Email Nmorfi@uqu.edu.saBackground: Inflammatory bowel diseases (IBD), including Crohn’s disease and ulcerative colitis, are chronic inflammatory conditions affecting the gastrointestinal tract. To achieve and sustain remission, effective treatment strategies are necessary. Ustekinumab, a biologic agent targeting interleukin-12 and interleukin-23, has emerged as a significant therapeutic option for moderate to severe IBD.Aim: To gain insights into the utilization of Ustekinumab for IBD, we conducted a comprehensive review of the ClinicalTrials.gov registry.Methods: A comprehensive search of the ClinicalTrials.gov was conducted to find all clinical trials involving the use of Ustekinumab in IBD patients. As of December 30th, 2022, 69 clinical trials were identified that included IBD and Ustekinumab. The study list was saved, and those clinical trials that fitted the definition of targeted therapy were included in the review.Results: The results showed that Ustekinumab was associated with significant improvements in the clinical response and remission rates, in both Crohn’s disease and ulcerative colitis patients. Additionally, the safety profile of Ustekinumab was generally favourable, with low rates of adverse events reported. In terms of study design, most of the relevant studies found in the database were interventional studies. The investigation focused on completed studies and found that there were a limited number of clinical trials with interventional measures.Conclusion: Ustekinumab appears to be a promising treatment option for patients with IBD, with the potential to provide significant clinical benefits and a favourable safety profile. Further research is warranted to confirm these findings and explore optimal dosing and treatment regimens.Keywords: ustekinumab, pharmacology, biologics, IBD, clinical trials, gastroenterology

Waleed H Mahallawi,1 Wael A Alharbi,1 Sultan A Aloufi,1 Nadir A Ibrahim,1 Muntasir M Abdelrahman,2 Bader A Alhomayeed,2 Moutasem S Aboonq,3 Saeed Awad M Alqahtani,3 Emad S Rajih,4 Abdulaziz M Bakhsh,4 Ibrahim Sandokji5 1Medical Laboratory Technology Department, College of Applied Medical Sciences, Taibah University, Madinah, Saudi Arabia; 2King Fahad Hospital, Ministry of Health, Madinah, Saudi Arabia; 3Department of Physiology, College of Medicine, Taibah University, Madinah, Saudi Arabia; 4Urology Department, College of Medicine, Taibah University, Madinah, Saudi Arabia; 5Department of Pediatrics, College of Medicine, Taibah University, Madinah, Saudi ArabiaCorrespondence: Waleed H Mahallawi, Medical Laboratory Technology Department, College of Applied Medical Sciences, Taibah University, Madinah, Saudi Arabia, Email wmahallawi@gmail.comBackground: Kidney transplant recipients (KTRs) commonly suffer from impaired immunity. KTRs’ compromised immune response to COVID-19 vaccines indicates urgent revision of immunisation policies.Methods: A cross-sectional study was conducted in Madinah, Saudi Arabia of 84 KTRs who had received at least one dose of a COVID-19 vaccine. ELISA was used to evaluate anti-spike SARS-CoV-2 IgG and IgM antibody levels in blood samples obtained one month and seven months after vaccination. Univariate and multivariate analyses were performed to identify associations between seropositive status and factors such as the number of vaccine doses, transplant age, and immunosuppressive therapies.Results: The mean age of KTRs was 44.3 ± 14.7 years. The IgG antibody seropositivity rate (n=66, 78.5%) was significantly higher than the seronegativity rate (n=18, 21.4%) in the whole cohort (p< 0.001). In KTRs seroconverting after one month (n=66), anti-SARS-CoV-2 IgG levels declined significantly between one month (median [IQR]:3 [3– 3]) and seven months (2.4 [1.7– 2.6]) after vaccination (p< 0.01). In KTRs with hypertension, IgG levels significantly decreased between one and seven months after vaccination (p< 0.01). IgG levels also decreased significantly in KTRs with a transplant of > 10 years (p=0.02). Maintenance immunosuppressive regimens (triple immunosuppressive therapy and steroid-based and antimetabolite-based regimens) led to a significant decrease in IgG levels between the first and second sample (p< 0.01). KTRs receiving three vaccine doses showed higher antibody levels than those receiving a single dose or two doses, but the levels decreased significantly between one (median [IQR]: 3 [3– 3]) and seven months (2.4 [1.9– 2.6]) after vaccination (p< 0.01).Conclusion: KTRs’ humoral response after SARS-CoV-2 vaccination is dramatically inhibited and wanes. Antibody levels show a significant decline over time in KTRs with hypertension; receiving triple immunosuppressive therapy or steroid-based or antimetabolite-based regimens; receiving mixed mRNA and viral vector vaccines; and with a transplant of > 10 years.Keywords: SARS-CoV-2, kidney transplant recipients, booster, immunosuppression, COVID-19 vaccines, humoral immune response

Abera Bedasa Alemu,1 Neil Abdurashid Ibrahim,2 Kiber Wolde Argaw3 1Curative and Rehabilitative Core Process Section, Dire-Dawa City Administration Health Bureau, Dire Dawa, Ethiopia; 2Department of Midwifery, College of Medicine and Health Science, Dire-Dawa University, Dire Dawa, Ethiopia; 3Public Health Department, College of Medicine and Health Science, Dire-Dawa University, Dire Dawa, EthiopiaCorrespondence: Neil Abdurashid Ibrahim, Email firdowsayuzarsif@gmail.comBackground: World Health Organization refers medication waste as expired, unused, spilled, and contaminated pharmaceutical items, medications, vaccines, and sera. Budget constraints in financing the health care system together with huge amount of wastage and disposal costs of unused medications at LMIC create a serious risk to the economy, health care system and environment. Thus, the aim of this study was to assess the rate of medication waste and to identify contributing factors in public health facilities in Dire-Dawa city.Methods: An institution-based retrospective, cross-sectional study was supplemented by a qualitative study design from May 10 to June 10, 2021, at 2 public hospitals and 14 health centers. Qualitative data were collected by self-administered questionnaires and 2 years record review. In-depth interviews were used to obtain qualitative data. Excel sheets and SPSS version 20 and thematic analysis were used to analyze quantitative and qualitative data.Results: An average medicine wastage rate was 3.07% between 2010 and 2012 EFY, in Dire-Dawa public health facilities that worth 4,048,594.0 ETB. The most wasted class of medication was anti-infectives, accounting for 2,360,330 ETB (58.3%), while tablets 2,615,391 ETB (64.6%). Medical waste has been linked to several issues, including pushing nearly expired medications to healthcare institutions, lack of clinician involvement in medication selection and quantification, rapid changes in treatment regimens, and the existence of overstocked medication shelves.Conclusion: The average rate of medication waste was higher than the allowed level of 2%. The only medications that should be accepted by medical facilities are those that can be used before they expire. All prescribers should receive lists of the drugs that are readily available from the pharmacy department, and clinicians should be involved in the quantification and drug selection processes to increase the effectiveness of the use of medications.Keywords: medicine wastage, contributing factors

Sari T Alhoufie,1 Nadir A Ibrahim,1 Areej A Alhazmi,1 Hatim M Makhdoom,1 Hamza M Ali,1 Hassan A Hemeg,1 Yahya A Almutawif,1 Waleed H Mahallawi,1 Khalid O Alfarouk2,3 1Medical Laboratories Technology Department, College of Applied Medical Sciences, Taibah University, Al- Madinah Al-Munwarah, Saudi Arabia; 2Zamzam Research Center, Zamzam Medical College, Khartoum, Sudan; 3Alfarouk Biomedical Research LLC, Temple Terrace, FL, 33617, USACorrespondence: Sari T Alhoufie, Medical Laboratories Technology Department, College of Applied Medical Sciences, Taibah University, Al- Madinah Al-Munwarah, Saudi Arabia, Email shoufie@taibahu.edu.saBackground: Helicobacter pylori (H. pylori) infection is relevant to several chronic human diseases, from digestive diseases to renal, metabolic, and cancer diseases. H. pylori infections and chronic kidney diseases are in increasing, global records; if not well controlled in a specific population, these diseases might lead to more clinical complications.Methods: In this retrospective study, we investigated the prevalence of acute H. pylori infections among 127 dialysis patients via subjecting their serums to the enzyme-linked immunosorbent assay (ELISA) to detect the human Immunoglobulin M (IgM) against H. pylori infections. Samples were from dialysis patients in a single hemodialysis center in Medina, Saudi Arabia, from January to August 2021.Results: Our results indicated the significant prevalence of H. pylori acute infections among 33.1% of renal failure patients recruited in this study, chi-squared: 14.559, p-value: 0.0001. In addition, no significant occurrence of acute H. pylori infection among males and females, chi-squared: 1.823, p-value: 0.177. Furthermore, the prevalence of acute H. pylori infection was not significant in different age groups of renal failure patients. Chi-squared: 6.803, p-value: 0.147, despite H. pylori-infected cases predominantly represented in patients above 51 years. Moreover, we noticed that hypertension, followed by diabetes, was the most prevalent underlying medical condition among acute infected H. pylori and renal failure patients.Conclusion: We documented the significant prevalence of acute H. pylori infection among renal failure patients. We also highlighted and discussed the possible potential roles of H. pylori in renal failure and other chronic diseases. Routine screening and treatment for acute H. pylori infection for chronic kidney diseases, hypertension, and diabetes patients would positively reduce the bacterium’s progressive effects on them. They might even improve the control of these diseases.Keywords: Helicobacter pylori, acute infection, chronic kidney disease, renal failure, hypertension, diabetes mellitus

Waleed H Mahallawi,1 Nadir A Ibrahim,1 Walaa A Mumena2 1Medical Laboratory Technology Department, College of Applied Medical Sciences, Taibah University, Madinah, Saudi Arabia; 2Department of Clinical Nutrition, College of Applied Medical Sciences, Taibah University, Madinah, Saudi ArabiaCorrespondence: Waleed H MahallawiMedical Laboratory Technology Department, College of Applied Medical Sciences, Taibah University, Madinah, Saudi ArabiaEmail wmahallawi@taibahu.edu.saBackground: Several published data on the dialysis population showed that antibody levels decreased after COVID-19 vaccinations in comparison to the overall population. We aimed to illustrate the persistence of humoral response after receiving second dose of the Pfizer or AstraZeneca vaccines in patients under maintenance hemodialysis (HD).Methods: A total of 119 adult patients on HD who were recruited from a single hemodialysis center in Madinah, Saudi Arabia. An enzyme-linked immunosorbent assay (ELISA) was utilized to measure the specific antibody response to the spike protein in the serum samples.Results: Mean age of patients was 48.5 ± 13.5 years, while mean time since starting the renal dialysis was 5.09 ± 5.29 years. Blood samples were collected after 89.2 ± 25.7 days of receiving the second dose of the vaccines. A very high positive correlation between anti-S IgG antibodies in pre- and post-dialysis was found (rs= 0.93, p < 0.001). Additionally, there was a high positive correlation between anti-S IgG antibody collected at baseline and follow-up blood samples (30 days apart) (rs= 0.82, p < 0.001). Moreover, patients who received Pfizer had significantly higher mean change in anti-S IgG antibodies compared to patients who received AstraZeneca (0.41 ± 0.94 vs 0.03 ± 0.30, respectively, p = 0.026).Conclusion: The majority of the patients included in this study were able to yield an immune response to the vaccine after receiving the two doses. Persistence of IgG antibodies in the majority of the patients on HD in response to COVID-19 vaccines is encouraging in terms of continuing to vaccinate this category of patients in addition to monitoring them.Keywords: SARS-CoV-2, maintenance hemodialysis, COVID-19 vaccines, chronic kidney disease

Badriyah Shadid Alotaibi,1 Manal Buabeid,2,3 Nihal Abdalla Ibrahim,2,3 Zelal Jaber Kharaba,4 Munazza Ijaz,5 Sobia Noreen,6 Ghulam Murtaza7 1Department of Pharmaceutical Sciences, College of Pharmacy, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia; 2Medical and Bio-allied Health Sciences Research Centre, Ajman University, Ajman, United Arab Emirates; 3Department of Clinical Sciences, Ajman University, Ajman, 346, United Arab Emirates; 4Department of Clinical Sciences, College of Pharmacy, Al-Ain University of Science and Technology, Abu Dhabi, United Arab Emirates; 5Institute of Molecular Biology and Biotechnology, the University of Lahore, Lahore, Pakistan; 6Department of Pharmaceutics, Faculty of Pharmacy, The Islamia University of Bahawalpur, Bahawalpur, Pakistan; 7Department of Pharmacy, COMSATS University Islamabad, Lahore Campus, Lahore, 54000, PakistanCorrespondence: Ghulam Murtaza Tel +92 3215129950Fax +92 992-383441Email gmdogar356@gmail.comAbstract: The advent of nanotechnologies such as nanocarriers and nanotherapeutics has changed the treatment strategy and developed a more efficacious novel drug delivery system. Various drug delivery systems are focused on drug-targeting of brain cells. However, the manifestation of the brain barrier is the main hurdle for the effective delivery of chemotherapeutics, ultimately causing treatment failure of various drugs. To solve this problem, various nanocarrier-based drug delivery system has been developed for brain targeting. This review outlines nanocarrier-based composites for different brain diseases and highlights nanocarriers for drug targeting towards brain cells. It also summarizes the latest developments in nanocarrier-based delivery systems containing liposomal systems, dendrimers, polymeric micelles, polymeric nanocarriers, quantum dots (QDs), and gold nanoparticles. Besides, the optimal properties of nanocarriers and therapeutic implications for brain targeting have been extensively studied. Finally, the potential applications and research opportunities for nanocarriers in brain targeting are discussed.Keywords: brain targeting, nanocarriers, blood–brain barrier, nanotherapeutics, in-vivo

Alotaibi BS, Buabeid M, Ibrahim NA, et al. Int J Nanomedicine. 2021;16:7517–7533. The authors have advised Correspondence section on page 7517 should be: Correspondence: Ghulam Murtaza Tel +92 3215129950 Fax +92 992-383441Email gmdogar356@gmail.com Manal Buabeid Tel +97 1503602776 Email m.buabeid@ajman.ac.ae Read the original article

Nadir Ahmed Ibrahim,1,2 Fathelrahman M Hassan,3 Mahmoud Mohamed Elgari,2 Sana Eltahir Abdalla4 1Department of Hematology and Immunohematology, College of Medical Laboratory Science, Sudan University of Science and Technology, Khartoum, Sudan; 2Department of Clinical Laboratory Sciences, Faculty of Applied Medical Sciences, Taibah University, Medina, Saudi Arabia; 3Department of Clinical Laboratory Science, College of Applied Medical Science, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; 4Neelain Medical Research Centre, Al Neelain University, Khartoum, Sudan Aim: In this study, we aimed to analyze the genetic and acquired risk factors for deep vein thrombosis (DVT) of the lower extremities among Sudanese women. Methods: A total of 136 women were enrolled in the study, including 75 DVT patients and 61 healthy controls. Demographic and clinical data were collected using a specific questionnaire. Citrated blood samples of patients and controls were used for coagulation assays, and DNAs isolated from EDTA-blood samples were used for the detection of Factor V Leiden and prothrombin G20210A mutations using multiplex polymerase chain reaction-restriction fragment length polymorphism analysis. Results: Both gene mutations were found to be absent from all 136 subjects, and therefore did not account for the incidence of DVT in Sudanese women. Of the 75 DVTs, 70 (93.3%) were localized in the left leg and 5 (6.7%) in the right leg. Additionally, 84% of the DVTs were proximal and 16% were distal. Among the 75 patients, 22 (29.33%) were postpartum, 7 (9.33%) were pregnant, and 46 (61.33%) were nonpregnant. Levels of prothrombin fragment 1+2, prothrombin time, activated partial thromboplastin time, and D-dimer were significantly higher in DVT patients than in healthy controls (P

Susan Azizi,1 Mansor Bin Ahmad,1 Mohd Zobir Hussein,1 Nor Azowa Ibrahim,1 Farideh Namvar2,31Department of Chemistry, Faculty of Science, 2Institute of Tropical Forestry and Forest Products, University Putra Malaysia, Selangor, Malaysia; 3Mashhad Branch, Islamic Azad University, Mashhad, IranAbstract: A series of novel bionanocomposites were cast using different contents of zinc oxide-silver nanoparticles (ZnO-AgNPs) stabilized by cellulose nanocrystals (CNC) as multifunctional nanosized fillers in poly(vinyl alcohol)/chitosan (PVA/Cs) matrices. The morphological structure, mechanical properties, ultraviolet-visible absorption, and antimicrobial properties of the prepared films were investigated as a function of their CNC/ZnO-AgNP content and compared with PVA/chitosan/CNC bionanocomposite films. X-ray diffraction and field emission scanning electron microscopic analyses showed that the CNC/ZnO-AgNPs were homogeneously dispersed in the PVA/Cs matrix and the crystallinity increased with increasing nanosized filler content. Compared with pure PVA/Cs, the tensile strength and modulus in the films increased from 0.055 to 0.205 GPa and from 0.395 to 1.20 GPa, respectively. Ultraviolet and visible light can be efficiently absorbed by incorporating ZnO-AgNPs into a PVA/Cs matrix, suggesting that these bionanocomposite films show good visibility and ultraviolet-shielding effects. The bionanocomposite films had excellent antimicrobial properties, killing both Gram-negative Salmonella choleraesuis and Gram-positive Staphylococcus aureus. The enhanced physical properties achieved by incorporating CNC/ZnO-AgNPs could be beneficial in various applications.Keywords: multifunctional nanofiller, bionanocomposite, cellulose nanocrystals, antimicrobial properties, poly(vinyl alcohol)/chitosan blend

Muhammad Sani Usman,1 Mohamed Ezzat El Zowalaty,2,5 Kamyar Shameli,1,3 Norhazlin Zainuddin,1 Mohamed Salama,4 Nor Azowa Ibrahim1 1Department of Chemistry, Faculty of Science, 2Laboratory of Vaccines and Immunotherapeutics, Institute of Bioscience, Universiti Putra Malaysia, Selangor, Malaysia; 3Materials and Energy, Research Center, Karaj, Iran; 4Faculty of Pharmacy, UiTM, Puncak Alam, Selangor, Malaysia; 5Department of Environmental Health, Faculty of Public Health and Tropical Medicine, Jazan University, Jazan, Kingdom of Saudi Arabia Abstract: Copper nanoparticle synthesis has been gaining attention due to its availability. However, factors such as agglomeration and rapid oxidation have made it a difficult research area. In the present work, pure copper nanoparticles were prepared in the presence of a chitosan stabilizer through chemical means. The purity of the nanoparticles was authenticated using different characterization techniques, including ultraviolet visible spectroscopy, transmission electron microscopy, X-ray diffraction, Fourier transform infrared spectroscopy, and field emission scanning electron microscopy. The antibacterial as well as antifungal activity of the nanoparticles were investigated using several microorganisms of interest, including methicillin-resistant Staphylococcus aureus, Bacillus subtilis, Pseudomonas aeruginosa, Salmonella choleraesuis, and Candida albicans. The effect of a chitosan medium on growth of the microorganism was studied, and this was found to influence growth rate. The size of the copper nanoparticles obtained was in the range of 2–350 nm, depending on the concentration of the chitosan stabilizer. Keywords: chitosan, copper nanoparticles, antimicrobial activity, chemical synthesis, aqueous medium

Majid Darroudi1,2, Mansor Bin Ahmad3, Reza Zamiri4, AK Zak5, Abdul Halim Abdullah1,3, Nor Azowa Ibrahim31Advanced Materials and Nanotechnology Laboratory, Institute of Advanced Technology (ITMA), Universiti Putra Malaysia, Selangor, Malaysia; 2Department of Chemistry, Faculty of Science, Ferdowsi University of Mashhad, Mashhad, Iran; 3Department of Chemistry, 4Department of Physics, Faculty of Science, Universiti Putra Malaysia, Selangor, Malaysia; 5Low Dimensional Materials Research Center, Department of Physics, Faculty of Science, University of Malaya, Kuala Lumpur, MalaysiaAbstract: The application of “green” chemistry rules to nanoscience and nanotechnology is very important in the preparation of various nanomaterials. In this work, we successfully developed an eco-friendly chemistry method for preparing silver nanoparticles (Ag-NPs) in natural polymeric media. The colloidal Ag-NPs were synthesized in an aqueous solution using silver nitrate, gelatin, and glucose as a silver precursor, stabilizer, and reducing agent, respectively. The properties of synthesized colloidal Ag-NPs were studied at different reaction times. The ultraviolet-visible (UV-vis) spectra were in excellent agreement with the obtained nanostructure studies performed by transmission electron microscopy (TEM) and their size distributions. The prepared samples were also characterized by X-ray diffraction (XRD) and atomic force microscopy (AFM). The use of eco-friendly reagents, such as gelatin and glucose, provides green and economic attributes to this work.Keywords: silver nanoparticles, gelatin, green chemistry, time-dependent effect, ultraviolet-visible spectra

Kamyar Shameli1, Mansor Bin Ahmad1, Mohsen Zargar2, Wan Md Zin Wan Yunus1, Abdolhossein Rustaiyan3, Nor Azowa Ibrahim11Department of Chemistry, Faculty of Science, Universiti Putra Malaysia, Serdang, Selangor, Malaysia; 2Department of Biology, Faculty of Science, Islamic Azad University, Qom Branch, Qom, Iran; 3Department of Chemistry, Science and Research Branch, Islamic Azad University, Tehran, IranAbstract: Silver nanoparticles (Ag NPs) were synthesized by the chemical reducing method in the external and interlamellar space of montmorillonite (MMT) as a solid support at room temperature. AgNO3 and NaBH4 were used as a silver precursor and reducing agent, respectively. The most favorable experimental conditions for synthesizing Ag NPs in the MMT are described in terms of the initial concentration of AgNO3. The interlamellar space limits changed little (d-spacing = 1.24–1.47 nm); therefore, Ag NPs formed on the MMT suspension with d-average = 4.19–8.53 nm diameter. The Ag/MMT nanocomposites (NCs), formed from AgNO3/MMT suspension, were characterizations with different instruments, for example UV-visible, PXRD, TEM, SEM, EDXRF, FT-IR, and ICP-OES analyzer. The antibacterial activity of different sizes of Ag NPs in MMT were investigated against Gram-positive, ie, Staphylococcus aureus and methicillin-resistant S. aureus (MRSA) and Gram-negative bacteria, ie, Escherichia coli, Escherichia coli O157:H7, and Klebsiella pneumoniae, by the disk diffusion method using Mueller-Hinton agar (MHA). The smaller Ag NPs were found to have significantly higher antibacterial activity. These results showed that Ag NPs can be used as effective growth inhibitors in different biological systems, making them applicable to medical applications.Keywords: silver nanoparticles, nanoparticles, montmorillonite, antibacterial activity, Mueller-Hinton agar

Abstract Background Pregnancy-related anxiety significantly impacts maternal and fetal health in low- and middle-income countries (LMICs), including those within Sub-Saharan Africa (SSA). Most studies conducted to evaluate pregnancy-related anxiety in LMICs have utilized scales developed in high-income countries, despite significant variations in pregnancy-related anxiety due to socioeconomic and cultural contexts. This review surveyed existing literature in order to identify which scales have been used to measure pregnancy-related anxiety in SSA. Methods A systematic search was conducted in PubMed, Health and Psychosocial Instruments, and APA PsycNet for relevant studies published in the English language up to March 22, 2023. Eligible studies focused on anxiety in pregnant populations within SSA, using validated scales or tools. Screening followed PRIMSA guidelines, with blinded review at the abstract/title level and subsequent full-text review. Data was extracted and analyzed to identify trends and characteristics of the screening tools used. Results From 271 articles, 37 met inclusion criteria, identifying 24 different tools used to measure anxiety in pregnant women in SSA. The most common tools were the Generalized Anxiety Disorder 7-item scale (seven uses), State-Trait Anxiety Inventory (five uses), and the Self-Reporting Questionnaire 20 (five uses). Seven tools were pregnancy-specific, with only two designed specifically for SSA: the Risk Factor Assessment (RFA), and the 4-Item Screening Tool. Studies were most frequently conducted in South Africa, followed by Tanzania, Ethiopia, Nigeria, and Ghana. Conclusions This scoping review illustrates that only two tools (the RFA and 4-item Screening Tool) were created to assess pregnancy-related anxiety specifically in SSA. This highlights the need for more culturally sensitive tools tailored to the specific contexts of pregnant populations in SSA.

Saat ini pemerintah terus mendorong masyarakat untuk memanfaatkan EBT di Indonesia untuk mencapai target bauran sebanyak 23 % di tahun 2025. Pada penelitian ini dilakukan perancangan PLTS atap on-grid pada salah satu industri yang bergerak di bidang pengolahan bahan pangan hewani. PLTS digunakan untuk melayani beban penerangan dengan standar kelayakan mengikuti panduan EBTKE ESDM (SNI 8395:2017) dan sistem instalasi pemasangan berdasarkan PUIL 2011. Berdasarkan hasil perancangan digunakanlah modul surya jenis monocrystalline 410 Wp sebanyak 108 unit dan satu unit inverter 40 kW yang menghasilkan energi sebesar 63.032,58 kWh/tahun dan pengurangan emisi gas karbon dioksida (CO2) sebanyak 78.790,725 ton/tahun. Hasil kelayakan ekonomi dengan investasi awal Rp. 548.890.000, menghasilkan NPV Rp. 72.019.012, BCR 1,11, dan payback period pada tahun ke-18. Hasil tersebut menunjukkan bahwa PLTS dapat melayani beban penerangan dan melakukan penghematan energi listrik sebesar penggunaan beban penerangan harian di industri.

Disiplinler arası çalışmaların önemi son yıllarda giderek artmaktadır. Sosyal bilimler özelinde ise disiplinler arası geçişler ve etkileşimler güncel çalışmalarda daha fazla yer almaktadır. Modern dışı toplulukları inceleyen antropoloji ile modern toplumları inceleyen sosyolojinin kesişim alanları en çok kent araştırmalarında kendisini göstermektedir. Sosyoloji açısından kent demografik, ekonomik, siyasi vb. yapısal açıdan ele alınırken, antropolojinin metoduyla kente yaklaşmak daha mikro alanların keşfedilmesine yol açmıştır. Günümüz kentleri üzerine yapılan sosyolojik çalışmalar, sosyal problemler ve kamusal politikalar ekseninde şekillenmektedir. Fakat kentler arası kültürel farklılıklar ve yerel dinamikleri keşfedici analizler ortaya çıkmamaktadır. Bu makalenin amacı kent araştırmalarında antropolojik eğilimlerin yeni araştırma konuları (meseleler) ortaya çıkardığını böylece özgün yaklaşımlar sunulduğunu göstermektedir. Çağdaş kent toplumunu antropolojik yöntemlerle araştırmak, kente özgü keşfedilmemiş yeni alt kültür gruplarını veya insan ölçeğini merkeze alan gündelik rutinlerin keşfedilmesini sağlamıştır.

The experimental research was carried out to study the tribological behaviour of materials used in the manufacture of rotary dryer blades (based on abrasive/abrasive-erosive wear analysis of the blades) using the Baroid tester. The test program included 2 series of tests consisting of subjecting the specimens to a wear process, generated by friction between their test surface and a rotating granite roller. Each set of tests was by specific parameters characterized: test medium, rotational speed of the granite roller, pressing force of the roller on the specimen surface, test time, number of test cycles. The test results highlight the erosion phenomenon (abrasive erosion) responsible for the damage of the rotary dryer blades and the conditions of accentuation of specific wear phenomena.

Teff (Eragrostis tef) is a staple crop and holds the biggest share of grains cultivated area in Ethiopia, consequently, a large quantity of Teff straw is produced. The Teff straw was pretreated for the first time with Chromium-based Metal-Organic Framework, MIL-101(Cr), assisted hydrothermal method at temperatures ranging from 160 to 240 °C for 1/2, 1, or 2 h time independently. With an increase of pretreatment severity, the yield of total reducing sugar (TRS) was increased until reaching maximum (185 mg g−1). The identified optimum hydrothermal pretreatment condition, (180 °C and 1 h), had a feature of higher TRS yield and lower furfural concentration. The morphological analysis showed that treated Teff straw had degraded structure, higher surface area, and distorted bundles than native Teff straws. This study insight into MOFs’ application in lignocellulose biomass processing, and optimizing the pretreatment condition of Teff straw biomass.

Abstract The present study synthesized magnetite-pectin-chitosan (MPC), which is a nanocomposite adsorbent through partial reduction co-precipitation method. Its structure and morphology were characterized by Scanning Electron Spectroscopy (SEM), X-ray diffraction (XRD), Fourier Transform Infrared Spectrometry (FT-IR) and Vibrating Sample Magnetometry (VSM). One studied the adsorption of Lanthanum and Cerium ions onto MPC in a batch system as a function of initial pH of solution, contact time, initial concentration and temperature. When the initial pH of the solution increased, the La(III)/Ce(III) ions augmented as well. The optimum pH for La/Ce adsorption was 5 and the maximum adsorption achieved within 30 min. The thermodynamics parameters such as enthalpy ( $$\Delta {\text{H}}^\circ$$ Δ H ∘ ), entropy ( $$\Delta {\text{S}}^\circ$$ Δ S ∘ ) and Gibbs free energy changes ( $$\Delta {\text{G}}^\circ$$ Δ G ∘ ) were calculated with the results suggesting that the adsorption was exothermic and spontaneous. To determine the adsorption characteristics, models of Langmuir, Dubinin-Radushkevich, Freundlich, Temkin and Flory–Huggins adsorption isotherms were performed. Langmuir isotherm model enabled the data of adsorption to be described very well. The adsorption capacity was seen to be 8.17 mg/g and 9.72 mg/g for lanthanum and cerium, respectively. The adsorption kinetics of MPC indicated that the adsorption process fit the Pseudosecond-order (PSO) model. Based on these data, it is concluded that short operating time, eco-friendly technology, and easy to apply MPC can be used for La(III)/Ce(III) ions removal.

This paper investigates the pivotal role of logistics performance in shaping economic growth in selected West African nations. Employing a rigorous fixed effects methodology over the period 2007–2022, the study unveils compelling insights. Logistics performance emerges as a critical driver of economic growth, emphasizing the need for infrastructure investments. Similarly, industrialization and trade openness have significant positive impacts on economic growth, endorsing pro-manufacturing and trade facilitation policies. Surprisingly, inflation exhibits no direct influence on growth, although prudent monetary management remains vital. These findings carry profound policy implications, advocating for holistic strategies to unlock West Africa's economic potential.

Hospitality services play a crucial role in shaping tourist satisfaction and revisiting intention toward destinations. Traditional feedback methods like surveys often fail to capture the nuanced and real-time experiences of tourists. Digital platforms such as TripAdvisor, Yelp, and Google Reviews provide a rich source of user-generated content, but the sheer volume of reviews makes manual analysis impractical. This study proposes integrating aspect-based sentiment analysis with zero-shot learning to analyze online tourist reviews effectively without requiring extensive annotated datasets. Using pretrained models like RoBERTa, the research framework involves keyword extraction, sentence segment detection, aspect construction, and sentiment polarity measurement. The dataset, sourced from TripAdvisor reviews of attractions, hotels, and restaurants in Central Java, Indonesia, underwent preprocessing to ensure suitability for analysis. The results highlight the importance of aspects such as food, accommodation, and cultural experiences in tourist satisfaction. The findings indicate a need for continuous service improvement to meet evolving tourist expectations, demonstrating the potential of advanced natural language processing techniques in enhancing hospitality services and customer satisfaction.

INTRODUCTION: End-of-life (EOL) care has become an important topic of discussion in those with chronic illness, especially in End Stage Renal Disease (ESRD) patients on dialysis. This study explored attitudes towards the EOL care among haemodialysis patients and compared them with the patients' family members. MATERIALS AND METHODS: The study was a cross-sectional descriptive study conducted in two tertiary hospitals in Malaysia. The data was collected by using a survey questionnaire from 164 participants which consisted of 82 pairs of patients and their relatives. RESULTS: 'Patient' and 'family' groups demonstrated differences in their preferences regarding EOL care options. Family members group favoured cardiopulmonary resuscitation (81.7% vs 41.4%) (p <0.001), endotracheal intubation (80.5% vs 43.9%) (p = 0.989) and nasogastric tube feeding (87.8% vs 67%) (p = 0.001) more than patients themselves. The physician was the most nominated surrogate decision -maker by the patient (91.5%). Majority of the patients (57.3%) felt uncomfortable discussing EOL care options. There was significant correlation between duration of dialysis and patients' EOL preferences where patients less than 5 years on haemodialysis favoured CPR (55.9% vs 31.3%; p = 0.026), intubation (55.9% vs 35.4%) and nasogastric tube feeding (82.3% vs 56.3%; p = 0.013) compared to patients who had been on haemodialysis for 5 years or longer. CONCLUSION: This study demonstrated significant differences between the attitudes of the patients and their relatives regarding EOL care preferences. [ABSTRACT FROM AUTHOR]

Drug abuse is a rising psychological concept in many countries, and its use among individuals is increasing. Therefore, this study aimed to assess the Knowledge and demographic factors associated with drug abuse among male pharmacy and nursing students at King Saud University, Riyadh, Saudi Arabia. This study used a cross-sectional design targeting male entry-level pharmacy and nursing students in their first and second years of Bachelor of Nursing and Doctor of Pharmacy courses. Of them, 85.3 % of the pharmacy and 75.3 % of nursing students thought that cocaine causes drug addiction, followed by heroin (pharmacy 80.7 %; nursing students 71 %), and morphine (pharmacy 75.2 %; nursing students 59.1 %). In this study, 52 % (n = 105) claimed low awareness, whereas 48 % (n = 97) indicated good understanding regarding drug addictions. Furthermore, the mean knowledge score among pharmacy students was higher (7.073 ± 2.570) in comparison to nursing (5.806 ± 2.494) (t = 3.540; p = 0. 0001). In addition, the father’s occupation was found to be significantly associated with the mean knowledge score of drug addiction (F = 2.667; p = 0.034). According to the findings, 52 % of male students had insufficient knowledge about drugs that cause addiction. Age, course of study, and father's occupation all had a substantial impact on knowledge scores. The knowledge score on the complications of addictive substances was not significantly associated with the characteristics of the students (p = 0.05). As a result, we advocate for the introduction of educational initiatives that educate students about the harmful consequences of drug addiction and how to avoid issues.

Summary: The latissimus dorsi (LD) muscle is a workhorse flap in reconstructive surgery (e.g., breast reconstruction, chest wall defects, and lower limb trauma). The thoracodorsal artery and its venae comitantes supply this muscle. Recipient vessel options for microsurgical free flap reconstruction of the posterior thorax and lower back are limited. The thoracodorsal vessels are an excellent option due to their reliable anatomy and ease of access. In circumstances when the patient is best positioned prone, the posterior approach to access the thoracodorsal vessels is advantageous. We describe the technique to identify and isolate these vessels via a posterior approach.

This study investigates the impact of the COVID-19 pandemic on the relationship between income diversification and bank stability among Jordanian commercial banks listed on the Amman Stock Exchange (ASE), using a panel Autoregressive Distributed-Lagged Model (panel-ARDL) and quarterly data from 2015 to 2021. The findings demonstrate that during the COVID-19 period, a higher proportion of non-interest income, resulting from income diversification, enhances bank stability. However, considering the entire sample period, the results suggest a potential deterioration in bank stability when banks diversify towards non-interest income, aligning with the negative effect observed in the literature. Additionally, the study identifies factors such as bank size, liquidity, loan loss provisions, cost efficiency, and the deposit ratio, which influence bank stability. These findings hold significant implications for policymakers and banks in developing countries concerned about the impact of income diversification on bank stability. They also offer valuable insights to understanding the dynamics of income diversification and its implications for bank stability in the context of the COVID-19 pandemic.

Senna didymobotrya is one of the emerging invasive weeds in East and South Africa. One of the solutions for weed management involves isolating cellulose and converting it into valuable materials. In this research, the isolation of cellulose was optimized by the Plackett-Burman design (PBD) and response surface methodology using Box-Behnken design (BBD), both of which are statistical empirical models. The maximum isolated cellulose yield was 37.5% (w/w) using sulfuric acid 1.75% (w/v), sodium chlorite 3% (w/v) at pH of 3.5, and potassium hydroxide 6% (w/v) treatment. Each chemical treatment was done by heating the mixture at 90°C for 2 hrs. The cellulose yield obtained (37.5% (w/w)) was higher than the preoptimized value of 35.5% (w/w). The dewaxed powder of the weed, isolated cellulose, and commercial cellulose was characterized side by side for comparison using FTIR, XRD, SEM, and TGA/DTA. All the characterizing methods indicated that the isolated material was cellulose. Even though the intensity of FTIR and XRD graphs of the isolated cellulose was higher than the commercial cellulose, the crystallinity index calculated from XRD analysis showed that the commercial cellulose (83%) was higher than the isolated cellulose (78%). The TGA/DTA indicates that the isolated cellulose and commercial cellulose had comparable thermal stability, both stable at up to 360°C. Therefore, using this optimized method, cellulose isolation from S. didymobotrya opens avenues for converting cellulose into valuable materials like carboxymethyl cellulose, cellulose hydrogel, and cellulose nanocrystals.

AbstractThis study investigates the impact of board composition and gender diversity on capital structure using a dataset comprising 30 publicly traded Ghanaian firms from 2008 to 2018. By employing the system generalized method of moments (GMM) as the analytical technique and controlling for firm size and profitability, the study unveils several noteworthy findings. Firstly, the presence of inside directors demonstrates a significant negative influence on leverage, aligning with the principles of agency theory, suggesting that inside directors with privileged access to internal information adopt a cautious approach to debt financing to minimize conflicts between managers and shareholders. Secondly, the positive and significant effect of independent or outside directors on leverage syncs with resource dependency theory, implying that these directors bring valuable expertise and perspectives to firms’ capital structure decisions. Surprisingly, the study reveals that gender diversity on boards exerts a significant positive impact on leverage, supporting resource dependency theory, as gender-diverse boards enhance a firm’s reputation and attractiveness to lenders. Moreover, firm size demonstrates a negative and significant effect on leverage, indicating that larger firms possess greater access to internal financing sources, reducing reliance on external debt. Overall, the study underscores the importance of carefully considering board composition for optimal capital structure decisions, highlighting the benefits of maintaining a balance between inside and outside directors and promoting gender diversity on boards for improved decision-making and enhanced firm value.

The study aimed to discover the role of vitamin D in improving the respiratory function in sickle cell disease patients. In this prospective study, 188 adults were enrolled, drawn from the out-patients unit of Thalassemia Cente The collected data were categorized into three groups: group 1 included the data of 100 healthy individuals of age range of 18-50 years as control; group 2 included the data of 88 (40 males and 48 females) sickle cell disease patients in steady state before supplementation of vitamin D; group 3 represented the data of the same 88 sickle cell disease patients as measured and recorded after 6 weeks of vitamin D supplementation. Laboratory measurements including pulmonary function tests and hematological parameters, while vitamin D levels were estimated for all groups to compare the data before and after supplementation of vitamin We found significant differences in the pulmonary function tests when comparing groups. Mean value of FEV1 revealed significant differences between group 1 and 2 (p >0.05), while vitamin D supplement created a significant difference between group 2 and 3 (p >0.05). The improvement in FEV1 did not reach to that of healthy (group 1), as referred by the significant variation between group 1 and group 3 (p>0.05). The same findings were indicative within most pulmonary function tests, and the percentages of combined cases (restrictive and obstructive) were also deceased in group 3. Conclusion: supplement of vitamin D in SCD patients could result in relative improvement in lung function.

Abstract Cataract surgery is among the most common medical procedures, and accurate ocular biometry measurements are key for successful visual outcome. The current study evaluated data obtained by the Eyestar 900, Anterion, IOLMaster700 biometers and the Pentacam corneal topographer. Compared values were axial length (AL), anterior chamber depth (ACD), steep- and flat-K, cylinder and axis. Clinical impact was assessed by calculating intraocular lens (IOL) power using the mean values of every parameter and the Barrett and Kane formulas, stratified by device and amount of cylinder. IOL was re-calculated for each device substituting Pentacam K-values. This study included 196 eyes (98 participants) of cataract surgery candidates. When comparing the IOLMaster to the Eyestar (157 eyes), no difference was found in mean AL or ACD measurements (P > 0.05). Steep-K measurements differed between these devices and the Pentacam (P = 0.01). AL and ACD measurements differed between the IOLMaster and Anterion (38 eyes; P

Abstract Zinc-Imidazole coordination polymer (ZnImCP) was simply synthesized hydrothermally at relatively low temperature (70 °C) from zinc acetate and imidazole. ZnImCP was treated by sulfide solution to produce sulfur-doped samples (S-ZnImCPs). Structures of the synthesized ZnImCP and S-ZnImCPs were characterized through FTIR, PXRD, and, Raman, SEM/EDX, N2-BET, UV–VIS DRS, and pHpzc analyses. The photocatalytic performances of pristine CP and sulfur modified CPs under visible and ultra-violet irradiations for degrading the cationic methylene blue (MB) and the anionic methyl orange (MO) were investigated considering different initial pH values 4, 7 and 10. Under visible light, the results indicate that these CPs display considerable photocatalytic degradation towards the cationic MB for the initial pH 4 and 7 where degradation increases with sulfur content. While under ultra-violet, results indicate considerable photocatalytic degradation towards both dyes for the initial pH 7 and 10 where degradation increases with sulfur content which indicates the gainful of non-metal dopping. The buffering nature of CPs and the type of radiation considering determined band-gap values effectively influence the degradation mechanisms.

Abstract Background Dysarthria is a common and persisting sequela to stroke. It can have a negative influence on psychological wellbeing, and quality of life. This systematic review aimed to describe and identify the neuroanatomical regions associated with non-progressive dysarthria following stroke. Methods A systematic search of PubMed, Ovid Medline, CINAHL, Cochrane, Scopus, and ScienceDirect was conducted to identify all relevant articles published in peer-reviewed journals up to December 2021. Following data extraction, the National Institutes of Health (NIH) quality assessment tools were used to evaluate the methodological quality of the included studies. Results Out of 2186 papers found in the literature related to dysarthria post-stroke, 24 met the inclusion criteria. Eligible articles assessed 1150 post-stroke subjects. Out of them, 420 subjects had dysarthria from isolated lesions. Regarding dysarthric subjects with ischemic strokes, 153 sustained supratentorial infarctions, while 267 had infratentorial infarctions. The majority had pontine infarctions (n = 142), followed by infarctions in the corona radiata (n = 104), and the cerebellum (n = 64). Conclusion This systematic review is the first step toward establishing a neuroanatomical model of dysarthria throughout the whole brain. Our findings have many implications for clinical practice and provide a framework for implementing guidelines for early detection and management of dysarthria post-stroke.

We propose a within-host mathematical model for the dynamics of Usutu virus infection, incorporating Crowley–Martin functional response. The basic reproduction number R0 is found by applying the next-generation matrix approach. Depending on this threshold, parameter, global asymptotic stability of one of the two possible equilibria is also established via constructing appropriate Lyapunov functions and using LaSalle’s invariance principle. We present numerical simulations to illustrate the results and a sensitivity analysis of R0 was also completed. Finally, we fit the model to actual data on Usutu virus titers. Our study provides new insights into the dynamics of Usutu virus infection.

Background: Low cardiorespiratory fitness is an established risk predictor for chronic non-communicable diseases. We aimed to investigate the prognostic significance of fitness level on the risk of major adverse cardiac events (MACE, the composite of myocardial infarction, stroke, or all-cause death), in a contemporary cohort of middle-aged subjects without cardiovascular disease. Methods: Retrospective analysis of patients aged 40–60 years without a history of cardiovascular disease. Degree of fitness was determined according to a graded, maximal treadmill exercise stress testing (EST) time achieved, classified into age- and sex-specific quintiles (Q), and categorized as low (Q1), moderate (Q2–Q4) or high (Q5) fitness groups. A multivariable Cox proportional hazard regression model was used to assess the association of fitness level with the risk of MACE. Results: A total of 6836 patients were included, of which 44.5% were women, and the mean age was 52 years. Overall, 289 MACE events occurred during a median follow-up of 7 years. Level of fitness was inversely associated with the presence of cardiovascular risk factors. The multivariable adjusted hazard ratio (95% confidence interval) for MACE was 1.65 (1.12–2.44) and 2.17 (1.40–3.38) in those at moderate and low fitness levels, compared to the high-fitness group (reference), respectively. For each decrease of one metabolic equivalent (MET) unit achieved at peak exercise, the relative risk for MACE increased by 18%. The association between low fitness and MACE was not modified by other risk factors (P-for-interaction non-significant). Conclusions: Low fitness level, as captured by a maximal treadmill EST, is an independent risk predictor for MACE among middle-age individuals without known cardiovascular disease. The association of low fitness with high burden of cardiometabolic risk factors highlight the importance of lifestyle intervention in this patient population.

Abstract Background Lenvatinib is a multitargeted tyrosine kinase inhibitor that is being tested in combination with immune checkpoint inhibitors to treat advanced gastric cancer; however, little data exists regarding the efficacy of lenvatinib monotherapy. Patient-derived xenografts (PDX) are established by engrafting human tumors into immunodeficient mice. The generation of PDXs may be hampered by growth of lymphomas. In this study, we compared the use of mice with different degrees of immunodeficiency to establish PDXs from a diverse cohort of Western gastric cancer patients. We then tested the efficacy of lenvatinib in this system. Methods PDXs were established by implanting gastric cancer tissue into NOD.Cg-Prkdc scid Il2rg tm1Wjl /SzJ (NSG) or Foxn1 nu (nude) mice. Tumors from multiple passages from each PDX line were compared histologically and transcriptomically. PDX-bearing mice were randomized to receive the drug delivery vehicle or lenvatinib. After 21 days, the percent tumor volume change (%Δvtumor) was calculated. Results 23 PDX models were established from Black, non-Hispanic White, Hispanic, and Asian gastric cancer patients. The engraftment rate was 17% (23/139). Tumors implanted into NSG (16%; 18/115) and nude (21%; 5/24) mice had a similar engraftment rate. The rate of lymphoma formation in nude mice (0%; 0/24) was lower than in NSG mice (20%; 23/115; p

Background: Gallbladder carcinoma (GBC) is a rare, aggressive malignancy comprising 0.5% of gastrointestinal cancers. It has poor survival outcomes due to its insidious onset, lack of standardized screening, and limited therapies. Advanced-stage diagnosis with liver, lymph node, and peritoneal metastasis is common, while bone metastasis is rare. The knowledge on bone metastasis in GBC is limited to case reports and small series, and its clinical significance is largely unexplored. Methods: The study extracted the demographic and clinical variables of patients with metastatic (M1) gallbladder adenocarcinoma from the Surveillance, Epidemiology, and End Results (SEER) database between 2011 and 2020. Descriptive statistics were used to analyze the demographic characteristics. The multivariate Cox regression analysis was used to calculate the hazard ratio. The overall survival (OS) was assessed using the Kaplan–Meier method, and the log-rank test was utilized to compare the survival between the groups. Results: A total of 2724 patients were included in the study. A total of 69% of the patients were female, and the median age was 68 (range 24–90+). A total of 7.4% of the patients had bone metastasis on diagnosis. The multivariate Cox analysis identified bone metastasis as an independent mortality risk factor in metastatic GBC (HR 1.50, p < 0.001). The patients were divided into two age groups: a younger age group (18–74 years) and an older age group (75+ years). In the younger group, the median OS with and without bone metastasis was 3 and 5 months, respectively (p < 0.0001). In the older age group, there was no significant difference in the OS between the patients with and without bone metastasis (p = 0.35). In the younger group who were treated with chemotherapy, the patients with bone metastasis had a significantly worse OS (median OS 5 months vs. 8 months, p < 0.0001). In the untreated group, the patients with bone metastasis in the younger age group had a significantly worse OS (median OS 1 month vs. 2 months, p = 0.014). In the patients with bone metastasis, those who did not receive chemotherapy had a significantly worse OS than those who were treated with chemotherapy in both age groups (younger age group: median OS 1 month vs. 5 months, p < 0.0001 and older age group: median OS 1 month vs. 5 months, p = 0.041). Conclusions: Our findings suggest that the presence of bone metastasis in gallbladder adenocarcinoma is an independent prognostic factor associated with unfavorable survival outcomes in the younger age group (18–74 years). However, in the older age group (75+ years), the presence of bone metastasis did not impact the survival. Treatment with chemotherapy was associated with extended survival in all patients. Thus, early detection and aggressive management of bone metastasis, including the consideration of chemotherapy, may be crucial in improving the OS and quality of life for individuals with gallbladder adenocarcinoma.

Over the last two decades, there have been many reported advances in the clinical management of pancreatic ductal adenocarcinoma (PDAC). We sought to evaluate changes in survival for patients diagnosed with PDAC between 2004 and 2017. The National Cancer Database was queried for patients diagnosed with PDAC between 2004 and 2017. There were 55,401 patients who underwent surgery and 109,477 patients who underwent non-surgical treatment for PDAC between 2004 and 2017. Patients were categorized into four groups by year of diagnosis. Median survival improved from 15.5 months to 25.3 months for patients treated with surgery between the years 2016 and 2017 compared with between 2004 and 2007 (p < 0.001). Median survival improved from 7.2 months to 10.1 months for patients treated without surgery during the same years (p < 0.001). On multivariable analysis, the hazard ratio for death was estimated to multiply by 0.975 per year for patients treated with surgery and 0.959 per year for patients treated without surgery (p < 0.001). This increase in survival in the setting of evolving care validates continued efforts aimed at improving survival for patients with this devastating disease.

Background. Recently, human life expectancy, aging, and age-related health disorders, especially neurodegenerative diseases such as Alzheimer’s disease (AD), have increased. The increasing number of AD patients causes a heavy social and economic burden on society. Since there is no treatment for AD, utilization of natural products is currently accepted as an alternative or integrative treatment agent against AD. Methods. Selection of protein databases related to synaptic plasticity was obtained from a gene bank. The protein-protein interaction (PPI) analysis was performed using Cytoscape 3.9.1. Prediction of Centella asiatica target constituents and their relationship with target synaptic plasticity was performed using STITCH, followed by GO and KEGG pathway enrichment analysis and molecular binding of ligands to presynaptic and postsynaptic receptors afterwards. Results. From the protein database, 446 protein coding genes related to synaptic plasticity were found. PPI and KEGG pathway analysis showed potentiality to inhibit AKT and mTORC1 pathways. The targeted proteins were TSC1, Rheb, and FMRP. Conclusion. This study showed potentiality of Centella asiatica in AD through its binding to several proteins such as TSC1, Rheb, and FMRP. This compound in Centella asiatica was able to bind to the AKT1 and mTOR signaling pathways. Centella asiatica may behold greater potency in AD therapy.

BackgroundCoronavirus disease 2019 (COVID-19) has emerged as an important cause of morbidity and mortality worldwide. The aim of this study is to identify the clinical predictors of mortality among patients with COVID-19 pneumonia during first and second waves in a treatment center in northwestern Nigeria.MethodsThis was a retrospective cohort study of 195 patients hospitalized with COVID-19 between April 2020 to March 2021 at a designated COVID-19 isolation center in Kano State, Northwest Nigeria. Data were summarized using frequencies and percentages. Unadjusted odds ratios and 95% confidence intervals and p-values were obtained. To determine independent determinants of mortality, we performed a stepwise multivariate logistic regression model.ResultsOf 195 patients studied, 21(10.77%) patients died. Males comprised 158 (81.03%) of the study population. In the adjusted stepwise logistic regression analysis, age>64 years (OR = 9.476, 95% CI: 2.181-41.165), second wave of the pandemic (OR = 49.340, 95% CI:6.222-391.247), cardiac complications (OR = 24.984, 95% CI: 3.618-172.508), hypertension (OR = 5.831, 95% CI:1.413-24.065) and lowest systolic blood pressure while on admission greater than or equal to 90mmHg were independent predictors of mortality (OR = 0.111, 95%CI: 0.021-0.581).ConclusionStrategies targeted to prioritize needed care to patients with identified factors that predict mortality might improve patient outcome.

The objective of this study was to investigate the influence of polyethylene glycol (PEG) incorporated chitosan scaffolds on osteoblasts proliferation and differentiation. The chitosan polymer was initially modified by the predetermined concentration of the photoreactive azido group for UV-crosslinking and with RGD peptides (N-acetyl-GRGDSPGYG-amide). The PEG was mixed at different ratios (0, 10, and 20 wt%) with modified chitosan in 96-well tissue culture polystyrene plates to prepare CHI-100, CHI-90, and CHI-80 scaffolds. PEG-containing scaffolds exhibited bigger pore size and higher water content compared to unmodified chitosan scaffolds. After 10 days of incubation, the cell number of CHI-90 (1.1 × 106 cells/scaffold) surpasses that of CHI-100 (9.2 × 105 cells/scaffold) and the cell number of CHI-80 (7.6 × 105 cells/scaffold) were significantly lower. The ALP activity of CHI-90 was the highest on the fifth day indicating the favored osteoblasts' early-stage differentiation. Moreover, after 14 days of osteogenic culture, calcium deposition in the CHI-90 scaffolds (2.7 μmol Ca/scaffold) was significantly higher than the control (2.2 μmol Ca/scaffold) whereas on CHI-80 was 1.9 μmol/scaffold. The results demonstrate that PEG-incorporated chitosan scaffolds favored osteoblasts proliferation and differentiation; however, mixing relatively excess PEG (≥20% wt.) had a negative impact on osteoblasts proliferation and differentiation.

Background: Crataegus aronia (C. aronia) extracts have been used medicinally since ancient times and are often utilized in traditional Arab medicine. An extensive study has revealed that Crataegus species have antioxidant, antibacterial, anti-inflammatory, and hypotensive properties. Objectives: This work was performed to explore the phytochemical contents of C. aronia extract, as well as its antioxidant and antibacterial properties, and to assess the lipid peroxidation level as an oxidative stress biomarker in erythrocytes. Methods: Chemical constituents in the methanolic extract of C. aronia were identified by gas chromatography-mass spectrometry and their relative concentrations were determined. The antioxidant activity of C. aronia extract was determined using the 2,2-diphenyl-1-picrylhydrazyl (DPPH) and ferric reducing antioxidant power (FRAP) assays. The effect of C. aronia on the concentration of malondialdehyde (MDA) in the erythrocyte hemolysates was studied. Also, the crude extract was assessed for its antimicrobial activity through agar diffusion and microbroth dilution assays. Key findings: The DPPH IC50 value of the extract showed that the antioxidants activity was equal to (14.3 μg/mL) and according to FRAP assay, the antioxidant activity was in the range of 33.9 μmol–82.86 μmol Fe+2/g dw. The extract exerts a protective effect against oxidative stress in RBCs and shows a 50% inhibition of malonyldialdehyde (MDA) at 39.48 μg/mL extract. Minimum inhibitory concentrations were found in the range of 800–1000 μg/mL of leave extracts. The phytochemical analysis showed that the total phenols, flavonoids, and flavonols content were 494.071 mg GAE/g extract, 155.251 mg RE/g extract, and 103.2049 mg RE/g extract). C. aronia extract contains alkaloids, flavonoids, terpenoids, and steroids. Crude extract of C. aronia was more potent in inhibiting the growth of B. subtilis, S. aureus and M. luteus with MIC and MBC values of 800,800 and 1000 μg/mL, respectively. According to GC-MS, 20 compounds were identified: dihydro-3-methylene-5-methyl-2-furanone (14.71%), hexanoic acid (6.57%), ethyl 3,5-ditert-butyl-4-hydroxybenzoate (6.4%), N, N-dimethylheptadecan-1-amine (4.91%), methyl 2-oxobutanoate (4.14%), glyceraldehyde (3.98%), and 2-methoxy-1-(2-nitroethenyl)-3-phenylmethoxybenzene (3.16%), were the major constituents. Conclusion: This study may open a window of hope for children with Glucose-6-phosphate dehydrogenase disorder by possible utilization of the active ingredients of C. aronia to minimize both oxidative stress and infection which negatively impact the disease sequelae.According to these in vitro experiments, this plant extract has a significant amount of natural antioxidants, which may aid in the protection of various oxidative stresses. As a result, employing the active components of C. aronia to minimize oxidative stress and infection, both of which have a detrimental impact on disease sequelae, may bring hope to children with Glucose-6-phosphate dehydrogenase disorder.

This paper discusses to what degree did civil society organisations (CSOs) felt threatened during COVID-19 in Scotland, Wales and Ireland. The authors explore how civil society organisations handled lockdowns. The authors invited three CSOs from Scotland, Wales and Ireland to describe the variations between cultural and political contexts and the influence of social and environmental dynamics on their work during COVID-19. These three countries have been challenged to a great extent by a high level of uncertainty owing to the full lockdowns during COVID-19. Hitherto, the people of Scotland, Wales and Ireland have been living relaxed and operating smoothly. Lockdowns have created challenges for successful CSOs. This paper focuses on the political reactions and social dynamics of CSOs focused on active grassroots participatory democracy and the philosophy that comes with it as a democratic decision-making mechanism where people have the power to vote on progress in the area of public participation and social change. The central finding in our investigation is that CSOs power to influence their politicians or society and become engaged in changes within their society is minimised during the pandemic.