Assessment of groundwater quality in arid regions utilizing principal component analysis, GIS, and machine learning techniques.

Assessing water quality in arid regions is vital due to scarce resources, impacting health and sustainable management.This study examines groundwater quality in Assuit Governorate, Egypt, using Principal Component Analysis, GIS, and Machine Learning Techniques. Data from 217 wells across 12 parameters were analyzed, including TDS, EC, Cl-, Fe++, Ca++, Mg++, Na+, SO4--, Mn++, HCO3-, K+, and pH. The Water Quality Index (WQI) was calculated, and ArcGIS mapped its spatial distribution. Machine learning algorithms, including Ridge Regression, XGBoost, Decision Tree, Random Forest, and K-Nearest Neighbors, were used for predictive analysis. Higher concentrations of Na, K, Ca, Mg, Mn, and Fe were correlated with industrial and densely populated areas. Most samples exhibited excellent or good quality, with a small percentage unsuitable for consumption. Ridge Regression showed the lowest MAPE rates (0.22 % training, 0.26 % in testing). This research highlights the importance of advanced machine learning for sustainable groundwater management in arid regions. Thus, our results could provide valuable assistance to both national and local authorities involved in water management decisions, particularly for water resource managers and decision-makers. This information can aid in the development of regulations aimed at safeguarding and sustainably managing groundwater resources, which are essential for the overall prosperity of the country.

Regional analgesia using ultrasound-guided intermediate cervical plexus block versus cervical erector spinae block for anterior cervical spine surgery: a randomized trial.

BACKGROUND: Regional analgesia techniques are crucial for pain management after cervical spine surgeries. Anesthesiologists strive to select the most effective and least hazardous regional analgesia technique for the cervical region. Our hypothesis is that an intermediate cervical plexus (IC) block can provide adequate postoperative analgesia compared to a cervical erector spinae (ES) block in patients undergoing anterior cervical spine surgery. METHODS: In this double-blind prospective trial, 58 patients were randomly assigned into two equal groups prior to the administration of general anesthesia. Patients in the IC group (n = 29) underwent ultrasound-guided bilateral intermediate cervical plexus block with 15 ml of bupivacaine 0.25% administered to each side. The ES group (n = 29) underwent ultrasound-guided bilateral cervical erector spinae plane blocks with 15 ml of 0.25% bupivacaine administered to each side at the C6 level. The primary outcome was to record the time to the first call for rescue analgesia (nalbuphine), and the secondary outcomes were to measure the performance time, the onset of the sensory block, the intraoperative fentanyl consumption, postoperative pain intensity using VAS, the postoperative total nalbuphine consumption, and postoperative complications such as nausea, vomiting, hypotension, and bradycardia. RESULTS: The performance and onset of sensory block times were significantly shorter in the IC group compared to the ES group. The time to first call for nalbuphine was significantly shorter in the IC group (7.31 ± 1.34 h) compared to the ES group (11.10 ± 1.82 h). The mean postoperative VAS scores were comparable between the two groups at the measured time points, except at 8 h, where it was significantly higher in the IC group, and at 12 h, where it was significantly higher in the ES group. The total nalbuphine consumption was significantly higher in the IC group (33.1 ± 10.13 mg) compared to the ES group (22.76 ± 8.62 mg). CONCLUSIONS: For patients undergoing anterior cervical spine surgery, the intermediate cervical plexus block does not provide better postoperative regional analgesia compared to the cervical erector spinae block. Performance time and onset time were shorter in the IC group, whereas nalbuphine consumption was lower in the ES group. TRIAL REGISTRATION: The trial was registered at clinicaltrials.gov. (NCT05577559, and the date of registration: 13-10-2022).

The Analgesic Effects of Preemptive Ultrasound-Guided Pericapsular Nerve Group Block in Comparison with Erector Spinae Plane Block in Elderly Undergoing Hip Arthroplasty: A Randomized Controlled Trial.

Background: Perioperative pain management strategies in the elderly undergoing hip arthroplasty need special and safe preemptive care. Objectives: The primary aim of this study was to compare the analgesic effects of preemptive ultrasound-guided pericapsular nerve group (PENG) block and lumbar erector spinae plane block (L-ESPB) in the elderly undergoing hip arthroplasty. The time to the first postoperative rescue analgesia was measured. The secondary aim was to assess the ease of spinal positioning (EOSP), onset of sensory block, block performance time, and patient satisfaction. Methods: Before positioning for spinal anesthesia, 69 elderly patients undergoing hip arthroplasty were randomized into three groups (n = 23 per group). The first intervention group received ultrasound-guided PENG block with 20 mL bupivacaine 0.25%; the second intervention group received ultrasound-guided L-ESPB using the same dose of bupivacaine. In the control group, patients received spinal anesthesia without any block. Results: The time to first postoperative rescue analgesic (morphine) was significantly prolonged in the PENG group (13.3 ± 3.5 h) compared to the L-ESPB (9.5 ± 2.3 h) and control (2.6 ± 0.4 h) groups. The EOSP score was significantly higher in the PENG group compared to the L-ESPB and control groups (P < 0.001). The block performance time and oneset of the sensory block were significantly shorter in the PENG group compared to the L-ESPB group. The highest patient satisfaction scores were observed in the PENG group. Conclusions: Preemptive pericapsular nerve group block postponed the need for postoperative analgesia and eased spinal positioning compared to L-ESPB in the elderly undergoing hip arthroplasty.

Effective loading of incompatible drugs into nanosized vesicles: a strategy to allow concurrent administration of furosemide and midazolam in simulated clinical settings.

The current study aims to assess the use of nanocarriers to limit drug incompatibilities in clinical settings, and thus eliminating serious clinical consequences (e.g., catheter obstruction and embolism), and enhancing in vivo bioavailability and efficacy. As a proof-of-concept, the impact of loading well-documented physically incompatible drugs (i.e., furosemide and midazolam) into nanosized vesicles on in vitro stability and in vivo bioavailability of the two drugs was investigated. Furosemide and midazolam were loaded into nanosized spherical vesicles at high entrapment efficiency (ca. 62-69%). The drug-loaded vesicles demonstrated a sustained drug release patterns, high physical stability and negligible hemolytic activity. Physical incompatibility was assessed by exploiting microscopic technique coupled with image processing and analysis, dynamic light scattering and laser Doppler anemometry. Incorporation of drugs separately inside the nanosized vesicles dramatically decreased size and number of the precipitated particles. In vivo, the niosomal drug mixture demonstrated a significant improvement in pharmacokinetic profiles of furosemide and midazolam compared to the mixed free drug solutions, as evidenced by their longer circulation half-lives and higher area under the plasma-concentration time curves of both drugs. Nanocarriers could provide an auspicious strategy for circumventing drug incompatibilities, thus reducing adverse reactions, hospitalization period and improving therapeutic outcomes.

Methods for preparation of nanostructured lipid carriers.

Construction of nanocarriers of different structures and properties have shown great promise as delivery systems for a wide range of drugs to improve therapeutic effects and reduce side effects. Nanostructured lipid carriers (NLCs) have been introduced as a new generation of solid lipid nanoparticles (SLNs) to overcome several of the limitations associated with the SLNs. NLCs consist of a blend of solid and liquid lipids which result in a partially crystallized lipid system that enables higher drug loading efficiency compared to SLNs. Owing to their biocompatibility, low toxicity, ease of preparation and scaling-up, and high stability, NLCs have been exploited in numerous pharmaceutical applications. Different methods for fabrication of NLCs have been described in the literature. In this article, procedures involved in emulsification-solvent evaporation method, one of the commonly utilized methods for preparation of NLCs, are described in detail. Critical aspects that should be considered throughout preparation process are also highlighted to allow for consistent and reproducible construction of NLCs.

Electrospun vancomycin-loaded nanofibers for management of methicillin-resistant Staphylococcus aureus-induced skin infections.

Skin damage exposes the underlying layers to bacterial invasion, leading to skin and soft tissue infections. Several pathogens have developed resistance against conventional topical antimicrobial treatments and rendered them less effective. Recently, several nanomedical strategies have emerged as a potential approach to improve therapeutic outcomes of treating bacterial skin infections. In the current study, nanofibers were utilized for topical delivery of the antimicrobial drug vancomycin and evaluated as a promising tool for treatment of topical skin infections. Vancomycin-loaded nanofibers were prepared via electrospinning technique, and vancomycin-loaded nanofibers of the optimal composition exhibited nanosized uniform smooth fibers (ca. 200 nm diameter), high drug entrapment efficiency and sustained drug release patterns over 48 h. In vitro cytotoxicity assays, using several cell lines, revealed the biocompatibility of the drug-loaded nanofibers. In vitro antibacterial studies showed sustained antibacterial activity of the vancomycin-loaded nanofibers against methicillin-resistant Staphylococcus aureus (MRSA), in comparison to the free drug. The nanofibers were then tested in animal model of superficial MRSA skin infection and demonstrated a superior antibacterial efficiency, as compared to animals treated with the free vancomycin solution. Hence, nanofibers might provide an efficient nanodevice to overcome MRSA-induced skin infections and a promising topical delivery vehicle for antimicrobial drugs.

Nanomedicine: a new paradigm to overcome drug incompatibilities.

OBJECTIVES: Drug incompatibilities may compromise the safety and effectiveness of combined drugs and result in mild-to-serious clinical complications, such as catheter obstruction, loss of drug efficacy, formation of toxic derivatives and embolism. Various preventive strategies have been implemented to overcome drug incompatibilities with limited success. This review presents an innovative approach to prevent drug incompatibilities via isolating the incompatible drugs into nanostructures. KEY FINDINGS: Several examples of incompatible drugs may be loaded separately into nanostructures of various types. Physicochemical characteristics and biocompatibility of the nanomaterials that are being utilized to prevent physicochemical incompatibilities should be carefully considered. CONCLUSIONS: There is a new era of exploiting nanomaterials in overcoming various types of physicochemical incompatibilities, with additional benefits of further improvements in pharmacokinetic profiles and pharmacological actions of the administered drugs.

Integration of remote sensing data and in situ measurements to monitor the water quality of the Ismailia Canal, Nile Delta, Egypt.

The Ismailia Canal is one of the most important tributaries of the River Nile in Egypt. It is threatened by extinction from several sources of pollution, in addition to the intersection and nearness of the canal path with the Bilbayes drain and the effluent from the two largest conventional wastewater treatment plants in Greater Cairo. In this study, the integration of remote sensing and geospatial information system techniques is carried out to enhance the contribution of satellite data in water quality management in the Ismailia Canal. A Landsat-8 operational land imager image dated 2018 was used to detect the land use and land cover changes in the area of study, in addition to retrieving various spectral band ratios. Statistical correlations were applied among the extracted band ratios and the measured in situ water quality parameters. The most appropriate spectral band ratios were extracted from the NIR band (near infrared/blue), which showed a significant correlation with eight water quality metrics (CO3, BOD5, COD, TSS, TDS, Cl, NH4, and fecal coliform bacteria). A linear regression model was then established to predict information about these important water quality parameters along Ismailia Canal. The developed models, using linear regression equations for this study, give a set of powerful decision support frameworks with statistical tools to provide comprehensive, integrated views of surface water quality information under similar circumstances.

Nanostructured lipid carriers for improved oral delivery and prolonged antihyperlipidemic effect of simvastatin.

The purpose of the current study is to develop nanostructured lipid carriers (NLCs) for the delivery of the antihyperlipidemic drug simvastatin (SIM) to increase its extremely low oral bioavailability (<5%) and prolong its antihyperlipidemic effect. NLCs were prepared via emulsification-solvent evaporation technique followed by ultrasonication, and the effect of composition of the nanocarriers on the particle size, size distribution, surface charge, entrapment efficiency, drug release kinetics and physical stability was extensively studied. NLCs exhibited nanosized (<200nm) spherical morphologies with narrow size distribution and high drug entrapment efficiency (>75%), sustained drug release pattern, and negative surface charge (zeta potential of -35-40mV) that imparts sufficient electrostatic physical stability. When tested in vivo, SIM-NLCs of the optimal composition demonstrated improved and prolonged reduction in the total cholesterol and non-high density lipoprotein cholesterol levels, as compared to the drug suspension. After oral administration of a single dose of SIM-NLC, 4-fold increase in bioavailability was observed, as compared to the SIM suspension. Hence, NLCs might provide efficient nanodevices for the management of hyperlipidemia and promising drug delivery systems to enhance SIM oral bioavailability.

Polyphosphoester nanoparticles as biodegradable platform for delivery of multiple drugs and siRNA.

Delivery of multiple therapeutics and/or diagnostic agents to diseased tissues is challenging and necessitates the development of multifunctional platforms. Among the various strategies for design of multifunctional nanocarriers, biodegradable polyphosphoester (PPE) polymers have been recently synthesized via a rapid and simple synthetic strategy. In addition, the chemical structure of the polymer could be tuned to form nanoparticles with varying surface chemistries and charges, which have shown exceptional safety and biocompatibility as compared to several commercial agents. The purpose of this study was to exploit a mixture of PPE nanoparticles of cationic and neutral surface charges for multiple delivery of anticancer drugs (ie, sorafenib and paclitaxel) and nucleic acids (ie, siRNA). Cationic PPE polymers could efficiently complex siRNA, and the stability of the nanoparticles could be maintained in physiological solutions and upon freeze-drying and were able to deliver siRNA in vivo when injected intravenously in mice. Commercially available cationic polyethylenimine polymer had LD50 of ca. 61.7 mg/kg in mice, whereas no animal died after injection of the cationic PPE polymer at a dose of >130 mg/kg. Neutral PPE nanoparticles were able to encapsulate two hydrophobic drugs, namely, sorafenib and paclitaxel, which are commonly used for the treatment of hepatocellular carcinoma. Mixing the neutral and cationic PPE nanoparticles did not result in any precipitation, and the size characteristics of both types of nanoparticles were maintained. Hence, PPE polymers might have potential for the delivery of multiple drugs and diagnostic agents to diseased tissues via simple synthesis of the individual polymers and assembly into nanoparticles that can host several drugs while being mixed in the same administration set, which is of importance for industrial and clinical development.

Lifetime prevalence of alcohol and substance use in Egypt: a community survey.

OBJECTIVE: The aim of this study was to determine the prevalence of substance use and addiction in Egypt and study its sociodemographic correlates. METHOD: A total of 44,000 subjects were interviewed from 8 governorates by stratified sampling. A questionnaire derived from the Addiction Severity Index (ASI) was individually administered. RESULTS: The lifetime prevalence of any substance use varies between 7.25% and 14.5%. One-month prevalence varies between 5.4% and 11.5% when adjusted to different population parameters. A total of 4832 subjects were identified as using illicit substances at least once in their life (9.6%), including 1329 experimental and social use (3.3%), 1860 regular use (4.64%), and 629 substance dependence (1.6%). The prevalence of substance use in males is 13.2% and 1.1% in females. Prevalence increases significantly in males of Bedouin origin, in seaside governorates, with lesser levels of education, and in certain occupations. The 15-19 age group showed the highest onset of substance use. Cannabis is the drug mostly misused in Egypt; alcohol is a distant second. CONCLUSIONS: The prevalence of substance use is lower than Western countries and higher compared with a 1996 survey. The true population prevalence is probably higher due to underreporting. The demographic pattern reflects availability and accessibility to drugs.