Correction and removal of expression of concern: Palladium supported on mixed-metal-organic framework (Co-Mn-MOF-74) for efficient catalytic oxidation of CO.

[This corrects the article DOI: 10.1039/D0RA09970H.].

Expression of concern: Palladium supported on mixed-metal-organic framework (Co-Mn-MOF-74) for efficient catalytic oxidation of CO.

Expression of Concern for 'Palladium supported on mixed-metal-organic framework (Co-Mn-MOF-74) for efficient catalytic oxidation of CO' by Reda S. Salama et al., RSC Adv., 2021, 11, 4318-4326, https://doi.org/10.1039/D0RA09970H.

Mycotic Aortic Aneurysm Secondary to Salmonella enterica Infection: A Case Report and Treatment Approach.

Mycotic (infected) aortic aneurysm is a severe clinical condition with high morbidity and mortality. Salmonella spp. is a Gram-negative, rod-shaped bacteria that is typically limited to the gastrointestinal tract and resolves spontaneously but can progress to invasive infections such as bacteremia. Serious complications may arise, particularly in debilitated, elderly, and neonatal patients. We describe the case of a 74-year-old female with a history of diabetes and hypertension who presented with shortness of breath, fever, chills, abdominal pain, vomiting, and diarrhea. The patient's blood culture tested positive for Salmonella enterica, and she was given ceftriaxone based on the results, but he remained symptomatic. A computed tomography scan of the chest with contrast revealed a mycotic aneurysm of the thoracic aorta. The patient was urgently transferred to a higher level of care and underwent emergency thoracic endovascular aortic repair with stenting and intravenous antibiotics. The presence of an infected aneurysm and associated abscess formation in such high-risk patients makes the endovascular approach more suitable than other options such as open surgery, aneurysmal excision and ligation without arterial reconstruction, excision with immediate reconstruction, and excision with interval reconstruction.

A comparative study of α-Ni(OH)2 and Ni nanoparticle supported ZIF-8@reduced graphene oxide-derived nitrogen doped carbon for electrocatalytic ethanol oxidation.

Ethanol electrooxidation is an important reaction for fuel cells, however, the major obstacle to ethanol electrocatalysis is the splitting of the carbon-carbon bond to CO2 at lower overpotentials. Herein, a ZIF-8@graphene oxide-derived highly porous nitrogen-doped carbonaceous platform containing zinc oxide was attained for supporting a non-precious Ni-based catalyst. The support was doped with the disordered α-phase Ni(OH)2 NPs and Ni NPs that are converted to Ni(OH)2 through potential cycling in alkaline media. The Ni-based catalysts exhibit high electroactivity owing to the formation of the NiOOH species which has more unpaired d electrons that can bond with the adsorbed species. From CV curves, the EOR onset potential of the α-Ni(OH)2/ZNC@rGO electrode is strongly shifted to negative potential (Eonset = 0.34 V) with a high current density of 8.3 mA cm-2 relative to Ni/ZNC@rGO. The high catalytic activity is related to the large interlayer spacing of α-Ni(OH)2 which facilitates the ion-solvent intercalation. Besides, the porous structure of the NC and the high conductivity of rGO facilitate the kinetic transport of the reactants and electrons. Finally, the catalyst displays a high stability of 92% after 900 cycles relative to the Ni/ZNC@rGO and commercial Pt/C catalysts. Hence, the fabricated α-Ni(OH)2/ZNC@rGO catalyst could be regarded as a potential catalyst for direct EOR in fuel cells.

Selective Reduction of Multivariate Metal-Organic Frameworks for Advanced Electrocatalytic Cathodes in High Areal Capacity and Long-Life Lithium-Sulfur Batteries.

Lithium-sulfur batteries hold great promise as next-generation high-energy-density batteries. However, their performance has been limited by the low cycling stability and sulfur utilization. Herein, we demonstrate that a selective reduction of the multivariate metal-organic framework, MTV-MOF-74 (Co, Ni, Fe), transforms the framework into a porous carbon decorated with bimetallic CoNi alloy and Fe3O4 nanoparticles capable of entrapping soluble lithium polysulfides while synergistically facilitating their rapid conversion into Li2S. Electrochemical studies on coin cells containing 89 wt % sulfur loading revealed a reversible capacity of 1439.8 mA h g-1 at 0.05 C and prolonged cycling stability for 1000 cycles at 1 C/1060.2 mA h g-1 with a decay rate of 0.018% per cycle. At a high areal sulfur loading of 6.9 mg cm-2 and lean electrolyte/sulfur ratio (4.5 µL:1.0 mg), the battery based on the 89S@CoNiFe3O4/PC cathode provides a high areal capacity of 6.7 mA h cm-2. The battery exhibits an outstanding power density of 849 W kg-1 at 5 C and delivers a specific energy of 216 W h kg-1 at 2 C, corresponding to a specific power of 433 W kg-1. Density functional theory shows that the observed results are due to the strong interaction between the CoNi alloy and Fe3O4, facilitated by charge transfer between the polysulfides and the substrate.

Petroleum wastewater: Environmental protection, treatment, and safe reuse: An overview.

Oil petroleum production consumes about 1.0-7.2 bbl. The needed water for such production ranges between 0.47 and 7.2 L water to 1.0 L crude. Between 80 and 90% of the consumed water is disposed of as wasted effluents. Consequently, there is an important connection between petroleum production and the contamination of the environment and surface water in addition to their ecotoxicological effects. The objective of the present review is to through light on the hazardous impact of petroleum wastewater on the environment and water ways. The present study presents several wastewater treatment technologies in handling the petroleum produced water (PPW) and reducing the hazardous impact to the environment. Safe reuse is also presented including simple, advanced, and environmentally friendly techniques. The reported treatment technologies are divided into five main categories: membrane technologies, biological treatment processes, electro-chemical coagulation, physical/chemical treatment processes (dissolved air flotation (DAF)/air flotation (IAF), adsorption, and chemical flocculation), and catalytic oxidation including chemicals such as advanced and Fenton oxidation processes (AOPs). The analysis and observation of each treatment process are also presented. Implementing of these processes in sequential and/or in combined to avoid the drawbacks of any poor treatment are discussed. The present review discusses; also, in detail each of these treatment technologies and their efficiency including the observation and conclusions of each one. The study shows; also; how the final treated effluent can be reused for non-potable purposes as an additional water resource according to the degree of decontamination. An additional advantage of treatment is protection of both the environment and the water ways by avoiding any discharge of such hazardous wastewater.

Stable polyethylene glycol/biochar composite as a cost-effective photothermal absorber for 24 hours of steam and electricity cogeneration.

Seawater desalination powered by solar energy is the most environmentally and economical solution in responding to the global water and energy crisis. However, solar desalination has been negatively impacted by intermittent sun radiation that alternates between day and night. In this study, sugarcane bagasse (SCB) was recycled via the pyrolysis process to biochar as a cost-effective solar absorber. Besides, polyethylene glycol (PEG) as a phase change material was encapsulated in the abundant pore structure of biochar to store the thermal energy for 24 hours of continuous steam generation. The BDB/1.5 PEG evaporator exhibited an evaporation rate of 2.11 kg m-2 h-1 (98.1% efficiency) under 1 sun irradiation. Additionally, the BDB/1.5 PEG evaporator incorporated by the TEC1-12706 module for continuous steam and electricity generation with a power density of 320.41 mW m-2. Moreover, 10 continuous hours of evaporation were applied to the composite demonstrating outstanding stability. The composite exhibited high water purification efficiency through solar desalination due to the abundant functional groups on the biochar surface. Finally, the resulting low-cost and highly efficient PCM-based absorber can be used on a wide scale to produce fresh water and energy.

Construction of thickness-controllable bimetallic sulfides/reduced graphene oxide as a binder-free positive electrode for hybrid supercapacitors.

Devices for electrochemical energy storage with exceptional capacitance and rate performance, outstanding energy density, simple fabrication, long-term stability, and remarkable reversibility have always been in high demand. Herein, a high-performance binder-free electrode (3D NiCuS/rGO) was fabricated as a supercapacitor by a simple electrodeposition process on a Ni foam (NF) surface. The thickness of the deposited materials on the NF surface was adjusted by applying a low cycle number of cyclic voltammetry (5 cycles) which produced a thin layer and thus enabled the easier penetration of electrolytes to promote electron and charge transfer. The NiCuS was anchored by graphene layers producing nicely integrated materials leading to a higher electroconductivity and a larger surface area electrode. The as-fabricated electrode displayed a high specific capacitance (2211.029 F g-1 at 5 mV s-1). The NiCuS/rGO/NF//active carbon device can achieve a stable voltage window of 1.5 V with a highly specific capacitance of 84.3 F g-1 at a current density of 1 A g-1. At a power density of 749 W kg-1, a satisfactory energy density of 26.3 W h kg-1 was achieved, with outstanding coulombic efficiency of 100% and an admirable life span of 96.2% after 10 000 GCD cycles suggesting the significant potential of the as-prepared materials for practical supercapacitors.

Biliary fistula and late recurrence of liver hydatid cyst: Role of cysto-biliary communication: A prospective multicenter study.

BACKGROUND: Hydatid cyst disease (HCD) is common in certain locations. Surgery is associated with postoperative biliary fistula (POBF) and recurrence. The primary aim of this study was to identify whether occult cysto-biliary communication (CBC) can predict recurrent HCD. The secondary aim was to assess the role of cystic fluid bilirubin and alkaline phosphatase (ALP) levels in predicting POBF and recurrent HCD. AIM: To identify whether occult CBC can predict recurrent HCD. The secondary aim was to assess the role of cystic fluid bilirubin and ALP levels in predicting POBF and recurrent HCD. METHODS: From September 2010 to September 2016, a prospective multicenter study was undertaken involving 244 patients with solitary primary superficial stage cystic echinococcosis 2 and cystic echinococcosis 3b HCD who underwent laparoscopic partial cystectomy with omentoplasty. Univariable logistic regression analysis assessed independent factors determining biliary complications and recurrence. RESULTS: There was a highly statistically significant association (P ≤ 0.001) between cystic fluid biochemical indices and the development of biliary complications (of 16 patients with POBF, 15 patients had high cyst fluid bilirubin and ALP levels), where patients with high bilirubin-ALP levels were 3405 times more likely to have biliary complications. There was a highly statistically significant association (P ≤ 0.001) between biliary complications, biochemical indices, and the occurrence of recurrent HCD (of 30 patients with recurrent HCD, 15 patients had high cyst fluid bilirubin and ALP; all 16 patients who had POBF later developed recurrent HCD), where patients who developed biliary complications and high bilirubin-ALP were 244.6 and 214 times more likely to have recurrent hydatid cysts, respectively. CONCLUSION: Occult CBC can predict recurrent HCD. Elevated cyst fluid bilirubin and ALP levels predicted POBF and recurrent HCD.

Solar-driven seawater desalination via plasmonic hybrid MOF/polymer and its antibacterial activity.

In recent years, solar seawater desalination has been considered to be a promising and cost-effective technique to produce clean sources for water treatment and water deficiency. In addition, this technique shows high photothermal conversion efficiency by solar collectors to transfer solar energy into heat and the transformation of molecules in the capillaries of solar evaporators. In this study, we report the preparation of graphene-supported MIL-125 with polyurethane foam (MGPU) for solar steam generation. We modified MGPU by using the plasmonic nanoparticles of Ag and a polymer of polyaniline to increase the evaporation rate. Polyurethane foam can float on the surface of water and self-pump water by its hydrophilic porous structure, superior thermal insulation capabilities, and easy fabrication. MIL-125 has a high salt rejection and higher water permeability. It can reduce the affinity between water molecules and the pore surface of membrane, making it simple for water molecules to move through the pores. GO is a great alternative for steam generation applications since it exhibits broad-band light. The strong solar absorption, photothermal conversion efficiency, and photoreaction efficiency are enhanced by the use of silver nanoparticles in the photoreaction. The salt resistance capability is enhanced in saline water in the presence of polyaniline in a composite. Under one solar irradiation, the Ag/PANI/GO@MIL-125 (Ag-PMG) nanocomposite demonstrates an average 1.26 kg m2 h-1 rate of evaporation and an efficiency as high as 90%. The composite exhibits remarkable stability and durability after more than 10 cycles of use without a noticeable decrease in activity. In addition, the composite exhibits excellent organic dye removal from contaminated water and generates pure condensed freshwater. The antibacterial photoactivity of the photocatalysts was examined against B. subtilis and E. coli. The results demonstrate that Ag-PMG shows higher antibacterial activity than MIL-125 and PMG. It was shown that the presence of rGO, PANI, and Ag in the sample enhances the antimicrobial activity.

Prognostic roles and survival benefits of endoscopic resection versus surgical resection in the management of malignant colon polyps

Background: Due to few sufficient data regarding the comparison between endoscopic and surgical resection of malignant colorectal polyps regarding outcomes and survival benefits, there are no clear guidelines of management strategies of malignant colorectal polyps. The aims of the present study were to compare endoscopic resection alone and surgical resection in patients with malignant polyps in the colon (T1N0M0) readings advantages, disadvantages, recurrence risks, survival benefits, and long-term prognosis to detect how management strategy affects outcome. Patients and methods: we included 350 patients. All included patients were divided into 2 groups; the first group included 100 patients who underwent only endoscopic polypectomy and the second group included 250 patients who underwent endoscopic polypectomy followed by definitive surgical resection after histopathological diagnosis. We followed all patients for about 5 years, ranging from 18 to 55 months. The primarily evaluated parameters are surgical consequences and patients' morbidity. The secondary evaluated parameters are recurrence risks, recurrence free survival, and overall survival rates. Results: The age of patients who underwent polypectomy is usually younger than the surgical group, males have more liability to polypectomy in comparison with females. Patients with tumors in the left colon have more liability to polypectomy in comparison with the right colon (p< 0.0001). Tumor factors associated with more liability to surgical resection are presence of lymphovascular invasion, high grade, and poor tumor differentiation (p< 0.0001). The management strategy was the most significant predictor of overall and recurrence free survival rates in patients with malignant colon polyps (p< 0.001). Conclusions: We found that survival benefits and lower incidence of recurrence are detected in the surgical resection group more than in the polypectomy group. (AU)

Risk factors and outcomes of occurrence of anastomotic leakage and reoperations for its management after colorectal surgery

Background: Anastomotic leakage (AL) is still the most annoying postsurgery complication after colorectal resection due to its serious complications up to death. Limited data were available regarding differences in AL incidence, management, and consequences for different types of colorectal resection. The aim of the present work was to evaluate differences in incidence of AL, incidence of postoperative complications, and length of hospital stay in a large number of patients who underwent elective colorectal resection for management of colorectal lesions. In addition to detect when and what type of reoperation for management of AL occur after colorectal resection. Patients: All 250 included patients underwent elective surgeries for colorectal resection with performance of primary anastomosis for management of colorectal neoplastic and non-neoplastic diseases in the period between May 2016 and July 31, 2021. We followed the patients for 90 days; we registered the follow-up findings. Results: the rates of AL occurrence were variable after the different procedures. The lowest rate of AL occurrence was found in patients who underwent right hemicolectomy, then in patients who underwent sigmoidectomy, left hemicolectomy, transversectomy and anterior resection (p= 0.004). A stoma was frequently performed during reoperation (79.5%) which was significantly different between different procedures: 65.5% in right hemicolectomy, 75.0% in transversectomy, 85.7% in left hemicolectomy, and 93.0% in sigmoid resection (p< 0.001). Conclusion Rates, types, time of occurrence and severity of AL vary according to the type of colectomy performed and selective construction of stoma during AL reoperation is currently safely applied with comparable mortality rates for patients who did and who did not have a stoma after reoperation. (AU)

Cesium salt of tungstophosphoric acid/mesoporous (zirconia-silica) composite for highly efficient synthesis of 7-hydroxy-4-methyl coumarin and removal of methylene blue.

The removal of harmful organic dyes from aqueous solutions has drawn the attention of scientists because of the substantial threat they pose to society's worldwide health. Hence, it is crucial to design an adsorbent that is both very effective in removing dyes and has the benefit of being inexpensive. In the present work, Cs salts of tungstophosphoric acid (CPW) supported mesoporous Zr-mSiO2 (mZS) with varying extents of Cs ions have been prepared by a two-step impregnation technique. Accordingly, a lowering in the surface acidity modes was observed after Cs exchanged protons of H3W12O40 and formed salts immobilized on the mZS support. After exchanging the protons with Cs ions, the characterization results revealed that the primary Keggin structure was unaltered. Moreover, the Cs exchanged catalysts had higher surface area than the parent H3W12O40/mZS, suggesting that Cs reacts with H3W12O40 molecules to create new primary particles with smaller sizes possessing inter-crystallite centers with a higher dispersion degree. With an increase in Cs content and thus a decrease in the acid strength and surface acid density, the methylene blue (MB) monolayer adsorption capacities on CPW/mZS catalysts were increased and reached an uptake capacity of 359.9 mg g-1 for Cs3PW12O40/mZS (3.0CPW/mZS). The catalytic formation of 7-hydroxy-4-methyl coumarin was also studied at optimum conditions and it is found that the catalytic activity is influenced by the amount of exchangeable Cs with PW on the mZrS support, which is in turn influenced by the catalyst acidity. The catalyst kept approximately the initial catalytic activity even after the fifth cycle.

Identification and characterization of a recombinant cysteine peptidase (AsCathL) from leaf-cutting ant Atta sexdens Linnaeus, 1758 (Hymenoptera, Formicidae).

Cysteine peptidases are involved in physiological processes of insect development and have been considered as potential targets for the development of insect control strategies. In this study, we obtained a recombinant cysteine cathepsin L (AsCathL) from leaf-cutting ant (Atta sexdens), a species from the order Hymenoptera who causes enormous damage to crops, natural forests and reforested areas. RT-qPCR showed AsCathL expression throughout insect development and in all body parts of the adult insect analysed, suggesting its role as a lysosomal cathepsin. AsCathL encodes a protein of 320 amino acid residues consisting of a pro-peptide and the mature with amino acids sequence over 67% similarity with lysosomal cathepsin L of species from Lepidoptera and Diptera. Phylogenetic tree revealed that AsCathL is very similar to predicted cathepsins found in other ants. Recombinant AsCathL was expressed in insoluble form by Escherichia coli Arctic Express (DE3) RIL, purified under denaturing conditions and refolded. The enzyme showed hydrolytic activity in vitro towards synthetic substrate Z-Phe-Arg-AMC at acidic pH. Synthetic inhibitor E-64 acted against peptidase activity and a study regarding the interaction between E-64 and AsCathL using nuclear magnetic resonance (NMR) revealed that 83.18% from all E-64 molecules are irreversibly bound to AsCathL. In addition, the proteolytic activity of AsCathL was strongly inhibited by recombinant sugarcane cystatins with Ki ranging from 0.6 nM to 2.95 nM. To the best of our knowledge this is the first report characterizing a cysteine peptidase from leaf-cutting ants, which may contribute to future studies of ants' cathepsins.

Silver sulfide decorated carbonaceous sawdust/ES-PANI composites as salt-resistant solar steam generator.

Solar steam generation (SSG) is a potential approach for resolving the global water and energy crisis while causing the least amount of environmental damage. However, using adaptable photothermal absorbers with salt resistance through a simple, scalable, and cost-effective production approach is difficult. Herein, taking advantage of the ultra-fast water transportation in capillaries, and the large seawater storage capacity of wood, we develop a highly efficient natural evaporator. The wood wastes (sawdust) were carbonized at low temperatures to fabricate a green and low-cost carbonaceous porous material (CW). To enhance the salt resistance in high saline water, this evaporator was coated with polyaniline emeraldine salt (ES-PANI) which was synthesized through facile and cost-effective one-step oxidation of aniline. Furthermore, the composite was decorated with silver sulfide to increase the evaporation rate which reached up to 1.1 kg m-2 h-1 under 1 sun irradiation with 91.5% efficiency. Besides, the evaporator performs exceptionally well over 10 cycles due to the salt resistance capability of ES-PANI which generates a "Donnan exclusion" effect against cations in saline water. The Ag2S@PANI/CW evaporator may be a viable large-scale generator of drinking water due to its high efficiency for energy conversion, simple and low-cost fabrication approach, salt-resistance, and durability.

Expression of epithelial-mesenchymal transition biomarkers: Discoidin domain receptor 2, Snail-1, and Ovol-2 as predictors of clinical outcome in patients with epithelial ovarian carcinoma.

Context: Discoidin domain receptor 2 (DDR-2), which belongs to the receptor tyrosine kinase family, Snail-1, which is a member of zinc-finger transcription factor family, and Ovol-2, which is a member of Ovol family, are incriminated in epithelial-mesenchymal transition (EMT) during cancer progression. Aim: In the current study, we aim to clarify the extent to which EMT biomarkers, DDR-2, Snail-1, and Ovol-2 expression, are involved in the progression of EOC aiming at identification of novel markers for predicting the prognosis of EOC patients. Settings and Design: This was a prospective cohort that was performed in the Faculty of Medicine, Zagazig University. Materials and Methods: We evaluated DDR-2, Snail-1, and Ovol-2 expression in 60 patients of EOC using immunohistochemistry. We followed our patients for about 36 months and analyzed the relationship between markers expression and the prognosis of patients. Statistical Analysis Used: SPSS program (Statistical Package for the Social Sciences). Results: High expression of both DDR-2 and Snail-1 was related to higher grade (P = 0.006) and advanced FIGO stage of the tumor (P < 0.001). Ovol-2 high expression was associated with lower grade of the tumor (P = 0.002) and early stage of the tumor (P < 0.001). High Ovol-2 and low DDR2 and Snail-1 expression were strongly correlated with better response to therapy (P = 0.003 and 0.005, respectively) and increased 3-year survival rates (P < 0.001). Conclusion: DDR-2 and Snail-1 are markers of poor prognosis in EOC while Ovol-2 is a marker of good prognosis.

Development and implementation of the AIDA International Registry for patients with Periodic Fever, Aphthous stomatitis, Pharyngitis, and cervical Adenitis syndrome.

Objective: Aim of this paper is to illustrate the methodology, design, and development of the AutoInflammatory Disease Alliance (AIDA) International Registry dedicated to patients with the Periodic Fever, Aphthous stomatitis, Pharyngitis, and cervical Adenitis (PFAPA) syndrome. Methods: This is a physician-driven, non-population- and electronic-based registry proposed to gather real-world demographics, clinical, laboratory, instrumental and socioeconomic data from PFAPA patients. Data recruitment is realized through the on-line Research Electronic Data Capture (REDCap) tool. This registry is thought to collect standardized information for clinical research leading to solid real-life evidence. The international scope and the flexibility of the registry will facilitate the realization of cutting-edge study projects through the constant updating of variables and the possible merging and transfer of data between current and future PFAPA registries. Results: A total of 112 centers have already been involved from 23 countries and 4 continents starting from August 24th, 2021, to April 6th, 2022. In total 56/112 have already obtained the formal approval from their local Ethics Committees. The platform counts 321 users (113 principal investigators, 203 site investigators, two lead investigators, and three data managers). The registry collects retrospective and prospective data using 3,856 fields organized into 25 instruments, including PFAPA patient's demographics, medical histories, symptoms, triggers/risk factors, therapies, and impact on the healthcare systems. Conclusions: The development of the AIDA International Registry for PFAPA patients will enable the on-line collection of standardized data prompting real-life studies through the connection of worldwide groups of physicians and researchers. This project can be found on https://clinicaltrials.gov NCT05200715.

High-Efficacy Hierarchical Dy2O3/TiO2 Nanoflower toward Wastewater Reclamation: A Combined Photoelectrochemical and Photocatalytic Strategy.

Developing a sustainable photocatalyst is crucial to mitigate the foreseeable energy shortage and environmental pollution caused by the rapid advancement of global industry. We developed Dy2O3/TiO2 nanoflower (TNF) with a hierarchical nanoflower structure and a near-ideal anatase crystallite morphology to degrade aqueous rhodamine B solution under simulated solar light irradiation. The prepared photocatalyst was well-characterized using powder X-ray diffraction, Fourier transform infrared spectroscopy, transmission electron microscopy, energy-dispersive spectroscopy, scanning electron microscopy, Brunauer-Emmett-Teller, diffuse reflectance UV-vis spectra, and X-ray photoelectron spectroscopy. Further analysis was performed to highlight the photoelectrochemical activity of the prepared photocatalysts such as electrochemical impedance spectroscopy, linear sweep voltammetry, photocurrent response, and a Mott-Schottky study. The crystalline Dy2O3/TNF exhibits superb photocatalytic activity attributed to the improved charge transfer, reduced recombination rate of the electron-hole pairs, and a remarkable red-shift in light absorption.

The efficacy and adverse effects of favipiravir on patients with COVID-19: A systematic review and meta-analysis of published clinical trials and observational studies.

OBJECTIVES: This study aimed to evaluate the efficacy and adverse events of favipiravir in patients with COVID-19. METHODS: Our protocol was registered on PROSPERO (CRD42020206305). Fourteen databases were searched until February 8th, 2021. An update search for new RCTs was done on March 2nd, 2022. Meta-analysis was done for randomized controlled trials (RCTs) and non-RCTs. RESULTS: Overall, 157 studies (24 RCTs, 1 non-RCT, 21 observational studies, 2 case series, and 106 case reports) were included. On hospitalized patients, in comparison to standard of care, favipiravir showed a higher rate of viral clearance at day 5 (RR = 1.60, p = 0.02), defervescence at day 3-4 (RR = 1.99, p <0.01), chest radiological improvement (RR = 1.33, p <0.01), hospital discharge at day 10-11 (RR = 1.19, p <0.01), and shorter clinical improvement time (MD = -1.18, p = 0.05). Regarding adverse events, favipiravir groups had higher rates of hyperuricemia (RR = 9.42, p <0.01), increased alanine aminotransferase (RR = 1.35, p <0.01) but lower rates of nausea (RR = 0.42, p <0.01) and vomiting (R R= 0.19, p=0.02). There were no differences regarding mortality (RR=1.19, p=0.32), and increased aspartate aminotransferase (RR = 1.11, p = 0.25). On nonhospitalized patients, no significant differences were reported. CONCLUSIONS: Adding favipiravir to the standard of care provides better outcomes for hospitalized patients with COVID-19. Pregnant, lactating women, and patients with a history of hyperuricemia should avoid using favipiravir.

Effect of docosahexaenoic acid as a chemopreventive agent on experimentally induced hamster buccal pouch carcinogenesis.

PURPOSE: The current study was directed to investigate the effectiveness of docosahexaenoic acid (DHA) as a chemopreventive agent on experimentally induced hamster buccal pouch (HBP) carcinogenesis. MATERIAL AND METHODS: In this study we used 40 Syrian male hamsters, five weeks old, were divided into 4 groups (GI, GII, GIII, and GIV) of 10 animals in each as follows, GI: Topical application of liquid paraffin alone (thrice a week for 14 weeks), GII: Topical application of 7, 12 dimethyl benz[a]anthracene (DMBA) alone (0.5% in liquid paraffin, thrice a week for 14 weeks), GIII: Topical application of DMBA (0.5% in liquid paraffin, thrice a week for 14 weeks) + Oral administration of DHA (125 mg/kg b.w. in 1 ml distilled water by oral gavage, thrice a week for 14 weeks on alternative days of DMBA application), GIV: Oral administration of DHA alone (125 mg/kg b.w. in 1 ml distilled water by oral gavage, thrice a week for 14 weeks). RESULTS: Gross observations and histopathological findings revealed that, in GI: normal stratified squamous epithelium, in GII: well and moderately differentiated squamous cell carcinoma (SCC), in GIII: variable results ranges from hyperkeratosis, hyperkeratosis and focal hyperplasia, mild dysplasia, and well differentiated SCC with superficial invasion of tumor cells not extended to deeper areas, while in GIV: normal similar to GI. Immunohistochemical results indicated that oral DHA treatment to DMBA treated hamsters restored the normal expression of bcl-2. CONCLUSION: Our results indicated that DHA has the potential to be a dietary chemopreventive agent due to its capacity to improve carcinogen detoxification and to block/suppress the initiation and promotion stages of experimentally produced HBP carcinogenesis.