Citrus sinensis (Sweet Oranges) Wastes: The Orange Wealth

The sweet oranges or Citrus sinensis (CS) fruit is a member of the family Rutaceae. It accounts for nearly 70% of the total annual production of the Citrus species. It is usually introduced in folk medicine to treat the common cold due to its high content of vitamin C that supports the immune system. The CS residues from orange juice industry are the peel and seeds that constitute about 50% of the juice industry wastes. Nevertheless, almost all the parts of the oranges can be consumed for industrial and medicinal uses. Citrus Sinensis peel (CSP) contains many nutrients and antinutrients. Nutrients in the aqueous and ethanol CSP extracts included carbohydrates, proteins, fixed oils, sugars, and amino acids. The antinutrients included saponins and tannins. Studies have documented the antioxidant properties of the CSP extract due to the phytochemical constituents, including flavonoids and phenolic compounds. These phytochemical properties encourage the usage of the CSP extract in the food industry and for medical purposes. The industrial uses of the CSP extracts involve food preservation due to their antimicrobial and antioxidant activities. The edible and industrial applications of the seed oil are among the documented uses of CS. The orange pomace powder has been found to increase the acceptability and the nutritional value of the cake when added in a percentage of 10% to the refined wheat. The residue of the CS has been identified as food supplements due to its high fiber and phenolics content. Moreover, the CS wastes are an excellent source for the production of biofuel and biodiesel. The wastes of CS represent an environmental burden. Hence, incorporating the CS residues in eco-friendly medical and industrial uses is of multiple benefits to the environment, the industry, and human health. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.

Prevention and screening during the COVID-19 pandemic: qualitative findings from the BETTER WISE project.

BACKGROUND: The COVID-19 pandemic challenged healthcare systems worldwide and disrupted primary care, particularly prevention, screening, and lifestyle counselling. BETTER WISE is a comprehensive and structured approach that proactively addresses cancer and chronic disease prevention and screening (CCDPS), including cancer survivorship and screening for poverty and lifestyle risks for patients aged 40 to 65. Patients from 13 primary care clinics (urban, rural, and remote) in Alberta, Ontario, and Newfoundland & Labrador, Canada were invited for a 1-hour visit with a prevention practitioner (PP), a member of the primary care team with specialized training in CCDPS to provide patients an overview of eligible screening and assist with lifestyle counselling. This qualitative sub-study describes how the COVID-19 pandemic impacted BETTER WISE in a constantly changing medical landscape. METHODS: We conducted 17 focus groups and 48 key informant interviews with a total of 132 primary care providers (PPs, physicians, allied health professionals, and clinic staff) over three different time points to better understand their perspectives on the BETTER WISE project. We also received 585 patient feedback forms of the 1005 patients who agreed to participate in the study. We also collected field notes and memos and employed thematic analysis using a constant comparative method focused on the impact of the pandemic on BETTER WISE. RESULTS: We identified four themes related to how the COVID-19 pandemic impacted the BETTER WISE study: 1) Switch of in-person visits to visits over the phone; 2) Lack of access to preventive care and delays of screening tests; 3) Changes in primary care providers' availability and priorities; 4) Mental health impacts of the pandemic on patients and primary care providers. CONCLUSIONS: The COVID-19 pandemic had and, at the time of writing, continues to have an impact on primary care, particularly on prevention, screening, and lifestyle counselling. Despite structural, procedural, and personal challenges throughout different waves of the pandemic, the primary care clinics participating in BETTER WISE were able to complete the study. Our results underscore the importance of the role of primary care providers in adapting to changing circumstances and support of patients in these challenging times. TRIAL REGISTRATION: This qualitative study is a sub-component of the BETTER WISE pragmatic, cRCT, trial registration ISRCTN21333761 (date of registration 19/12/2016).

Introducing ROTAVAC® to the occupied Palestinian Territories: Impact on diarrhea incidence, rotavirus prevalence and genotype composition.

BACKGROUND: Rotavirus infection remains an important cause of morbidity and mortality in children. The introduction of vaccination programs in more than 100 countries has contributed to a decrease in hospitalizations and mortality. This study investigates the epidemiological impact of the rotavirus vaccine ROTAVAC® in the Palestinian Territories, the first country to switch from ROTARIX® to this new vaccine. METHODS: Clinical surveillance data was collected fromchildren younger than 5attendingoutpatient clinics throughout Gaza withdiarrhea between 2015 and 2020. The incidence of all-cause diarrhea was assessed using an interrupted time-series approach. Rotavirus prevalence was determined at the Caritas Baby Hospital in the West Bank usingELISA on stool specimen of children younger than 5with diarrhea. Genotyping was performed on 325 randomly selected rotavirus-positive samples from January 2015 through December 2020 using multiplex PCR analysis. RESULTS: Average monthly diarrhea casesdropped by 16.7% annually fromintroduction of rotavirus vaccination in May 2016 to the beginning of the SARS-CoV-2 epidemic in March 2020 for a total of 53%. Case count declines were maintained afterthe switchto ROTAVAC® in October 2018. Rotavirus positivity in stool samples declined by 67.1% over the same period without change followingthe switch to ROTAVAC®. The distribution of predominant genotypes in rotavirus-positive stool samples changed from a pre-vaccination G1P [8] to G9P[8] and G12P[8] during the ROTARIX® period and G2P[4] after the introduction of ROTAVAC®. CONCLUSION: ROTAVAC® has shown epidemiological impact on par with ROTARIX® after its introduction to the national immunization schedule in the Palestinian Territories. A molecular genotype shift from a pre-vaccination predominance of G1P[8] to a current predominance of G2P[4] requires more long-term surveillance.

Evaluation of inhaled nitric oxide (iNO) treatment for moderate-to-severe ARDS in critically ill patients with COVID-19: a multicenter cohort study.

BACKGROUND: Inhaled nitric oxide (iNO) is used as rescue therapy in patients with refractory hypoxemia due to severe COVID-19 acute respiratory distress syndrome (ARDS) despite the recommendation against the use of this treatment. To date, the effect of iNO on the clinical outcomes of critically ill COVID-19 patients with moderate-to-severe ARDS remains arguable. Therefore, this study aimed to evaluate the use of iNO in critically ill COVID-19 patients with moderate-to-severe ARDS. METHODS: This multicenter, retrospective cohort study included critically ill adult patients with confirmed COVID-19 treated from March 01, 2020, until July 31, 2021. Eligible patients with moderate-to-severe ARDS were subsequently categorized into two groups based on inhaled nitric oxide (iNO) use throughout their ICU stay. The primary endpoint was the improvement in oxygenation parameters 24 h after iNO use. Other outcomes were considered secondary. Propensity score matching (1:2) was used based on the predefined criteria. RESULTS: A total of 1598 patients were screened, and 815 were included based on the eligibility criteria. Among them, 210 patients were matched based on predefined criteria. Oxygenation parameters (PaO2, FiO2 requirement, P/F ratio, oxygenation index) were significantly improved 24 h after iNO administration within a median of six days of ICU admission. However, the risk of 30-day and in-hospital mortality were found to be similar between the two groups (HR: 1.18; 95% CI: 0.77, 1.82; p = 0.45 and HR: 1.40; 95% CI: 0.94, 2.11; p= 0.10, respectively). On the other hand, ventilator-free days (VFDs) were significantly fewer, and  ICU and hospital LOS were significantly longer in the iNO group. In addition, patients who received iNO had higher odds of acute kidney injury (AKI) (OR (95% CI): 2.35 (1.30, 4.26), p value = 0.005) and hospital/ventilator-acquired pneumonia (OR (95% CI): 3.2 (1.76, 5.83), p value = 0.001). CONCLUSION: In critically ill COVID-19 patients with moderate-to-severe ARDS, iNO rescue therapy is associated with improved oxygenation parameters but no mortality benefits. Moreover, iNO use is associated with higher odds of AKI, pneumonia, longer LOS, and fewer VFDs.

FRAMEWORK OF MEASURES FOR COVID-19 PANDEMIC IN MALAYSIA: THREATS, INITIATIVES AND OPPORTUNITIES

Globally, COVID-19 has infected over millions of people worldwide. The first COVID-19 case in Malaysia was imported from Singapore on 24th January 2020. Since then, many more local cases had been reported with the basic reproduction value reaching 3.5. The government has thus implemented the Movement Control Order (MCO) from 18th March to 12th May, and Conditional MCO from 13th May to 9th June, as preventive measures to lower the R-nought (Ro) value to about 1. In hindsight, this pandemic has exposed our limitations, unpreparedness and imprudent resource allocations in coping with the consequences, besides posing a monumental challenge to recovery. This article describes the COVID-19 scenario in Malaysia and explores its preemptive framework for socio-economic mitigation measures to maintain economic health and recovery, as well as strengthening the nation’s healthcare system. Several opportunities (research grants for COVID-19 and the Internet of Things) and issues (prediction of COVID-19 cases without MCO and global superpower shifts) that emerged due to the crisis that may directly or indirectly affect the country are also highlighted. © 2022

Bridging gaps in distance learning during a pandemic: exploratory questionnaire based analysis in Jordan during COVID-19 lockdown

During the second semester of the 2019/2020 academic year, universities and schools around the world switched to distance learning to comply with the strict lock-down conditions and assure the safety of staff and students. Thus a structured self-administered questionnaire was used on an undergraduate sample of students (n = 573) enrolled in the Faculty of Pharmacy at one of the top private universities in Jordan. It aimed to measure the student's general attitudes, perceptions and obstacles witnessed during that period. The results indicate the need for implementation of a sustainability plan to assure the levels of quality in the program, by offering more proactive strategies that ensure the fairness of online assessments, and online students' affairs office, which will provide positive reinforcement to junior students and allow online academic counselling sessions that are focused on problem solving and emotional health which will in-turn stimulate quality distance learning practices.

D-Dimer May be a Prognostic Hematological Marker for COVID-19: A Retrospective Case Analysis

Cross linked fibrin as D-Dimer fragments formed by fibrinolysis and mainly detected in the blood sample. High D-Dimer level is associated with liver disease, malignancy, chronic kidney disease, cardio vascular disease, lung disease, pregnancy, inflammation and vacuities. The normal serum D-Dimer level considered upto 0.50mg/L in serological immunochromatography which is indicated to exclude the risk of thrombus formation related to life threatening deep vein thrombosis (DVT), disseminated intravascular coagulation (DIC), pulmonary embolism (PE), and critical cardiovascular events. Anticoagulant therapy by Low molecular weight heparin (LMWH) is the choice of treatment. These case report represent increased D-Dimer might be considered as a strong biomarker to distinguish the moribund of COVID-19 positive patients in hospital.

Positive and negative effects of COVID-19 pandemic on aquatic environment: A review

In December 2019, a novel coronavirus called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak was reported for the first time in Wuhan, Hubei province, China. This coronavirus has been referred as Coronavirus Disease 2019 or COVID-19 by World Health Organization (WHO). The spread of COVID-19 has become unstoppable, infecting around 93.5 million people worldwide, with the infections and deaths still increasing. Today, the entire planet has changed due to the greatest threat on the planet since the introduction of this lethal disease. This pandemic has left the world in turmoil and various measures have been taken by many countries including movement control order or lockdown, to slow down or mitigate the infection. Since the lockdown has been implemented almost in all affected countries, there has been a significant reduction in anthropogenic activity, including a reduction in industrial operations, vehicle numbers, and marine-related activities. All of these changes have also led to some unexpected environmental consequences. As a result of this lockdown, it had a positive and negative impact on the environment including the aquatic environment. Hence this review will therefore focus on the good and bad perspectives of the lockdown toward the aquatic environment. © 2021 Penerbit Universiti Kebangsaan Malaysia. All rights reserved.

Identifying and Characterizing COVID-19 Themed Malicious Domain Campaigns

Ever since the beginning of the outbreak of the COVID-19 pandemic, attackers acted quickly to exploit the confusion, uncertainty and anxiety caused by the pandemic and launched various attacks through COVID-19 themed malicious domains. Malicious domains are rarely deployed independently, but rather almost always belong to much bigger and coordinated attack campaigns. Thus, analyzing COVID-themed malicious domains from the angle of attack campaigns would help us gain a deeper understanding of the scale, scope and sophistication of the threats imposed by such malicious domains. In this paper, we collect data from multiple sources, and identify and characterize COVID-themed malicious domain campaigns, including the evolution of such campaigns, their underlying infrastructures and the different strategies taken by attackers behind these campaigns. Our exploration suggests that some malicious domains have strong correlations, which can guide us to identify new malicious domains and raise alarms at the early stage of their deployment. The results shed light on the emergency for detecting and mitigating public event related cyber attacks. © 2021 ACM.

Attention-Based LSTM Network for COVID-19 Clinical Trial Parsing

COVID-19 clinical trial design is a critical task in developing therapeutics for the prevention and treatment of COVID-19. In this study, we apply a deep learning approach to extract eligibility criteria variables from COVID-19 trials to enable quantitative analysis of trial design and optimization. Specifically, we train attention-based bidirectional Long Short-Term Memory (Att-BiLSTM) models and use the optimal model to extract entities (i.e., variables) from the eligibility criteria of COVID-19 trials. We compare the performance of Att-BiLSTM with traditional ontology-based method. The result on a benchmark dataset shows that Att-BiLSTM outperforms the ontology model. Att-BiLSTM achieves a precision of 0.942, recall of 0.810, and F1 of 0.871, while the ontology model only achieves a precision of 0.715, recall of 0.659, and F1 of 0.686. The extracted variables can help characterize patient populations eligible for COVID-19 trials. Our analyses demonstrate that Att-BiLSTM is an effective approach for eligibility criteria parsing. © 2020 IEEE.

Public Knowledge, Attitudes, and Practice towards COVID-19 Pandemic in Saudi Arabia: A Web-Based Cross-Sectional Survey.

(1) Background: COVID-19 has become a worldwide public health problem. No previous study has investigated factors associated with COVID-19 knowledge, attitude, and practice (KAP) after completely lifting the curfew in all Saudi Arabia regions and cities. Therefore, adequate knowledge, a positive attitude, and correct control of COVID-19 are essential to eradicate the disease. Hence, this study aims to assess factors associated with KAP of COVID-19; (2) Methods: This cross-sectional web-based survey was performed with the participation of 4305 individuals aged over 15 years living in Saudi Arabia from 11 to 19 August 2020. They were included using the snowball sampling method; (3) Results: Of the 4305 participants, 94.9% were Saudis, 60% females, and 45.4% were in the age group of 20-34 years, 61.7% married, and 49.3% from the Eastern Province of Saudi Arabia. Most of the participants demonstrated good KAP levels (89.6%, 87.2%, and 87.2%) towards the COVID-19 pandemic, respectively. In addition, most of the participants (85.8%) used the internet and social media as a source for COVID-19 information (4) Conclusions: The finding showed that most of the participants demonstrated good knowledge of COVID-19, positive attitudes, and demonstrated good practices for preventing the spread of disease infection.

Sub-continental Atmosphere and Inherent Immune System may have Impact on Novel Corona Virus' 2019 (nCovid-19) Prevalence in South East Asia.

Pandemic enveloped RNA Novel Corona Virus' 2019 (SARS-CoV-2) appears as a beating reed which induce overwhelming outbreak all over the world since November 2019 to till date. Inherent Immunity developed by traditional food habit, exposure to various antigens and vitamin D induced sunlight exposure. Meteorological parameters are the important factors which influencing the severe acute respiratory syndrome (SARS) like infectious disease. Aim of this review to enhance our knowledge and explore the association among build up immunity, weather parameters and Corona virus disease (COVID-19) death. In this review we emphasize role of meteorological factor included degree of sun exposure and effect of temperature on enveloped lipid bi-layer structure of Novel corona virus. These meteorological factors and inherent immunity may have impact on SARS-CoV-2 incidence among South East Asian including Bangladeshi. In summary, this study suggests that temperature-humidity variation, inherent immunity and lower life expectancy of South East Asia may be important.