Enhanced methylene blue adsorption using single-walled carbon nanotubes/chitosan-graft-gelatin nanocomposite hydrogels.

In the present study, single-walled carbon nanotubes (SWCNTs) incorporating chitosan-graft-gelatin (CS-g-GEL/SWCNTs) hydrogels were fabricated with multiple advantages, including cost-effectiveness, high efficiency, biodegradability, and ease of separation for methylene blue (MB) dye from aqueous solution. To verify the successful formulation of the prepared hydrogels, various characterization methods such as NMR, FTIR, XRD, FE-SEM, TGA, BET, and EDX were employed. The removal efficiency of CS-g-GEL/SWCNTs nanocomposite hydrogel increased significantly to 98.87% when the SWCNTs percentage was increased to 20%. The highest adsorption was observed for pH = 9, an adsorbent dose = 1.5 g L-1, a temperature = 25 °C, a contact time = 60 min, and a contaminant concentration = 20 mg L-1. Based on the thermodynamic results, spontaneous adsorption occurred from a negative Gibbs free energy (ΔG°). In addition, the thermodynamic analysis of the adsorption process revealed an average enthalpy of - 21.869 kJ mol-1 for the adsorption process at a temperature range of 25-45 °C, which indicates its spontaneous and exothermic behavior. The Langmuir isotherm model was successfully used to describe the equilibrium behavior of adsorption. The pseudo-first-order model better described adsorption kinetics compared to the pseudo-second-order, intra-particle, and Elovich models. CS-g-GEL/SWCNTs hydrogels have improved reusability for five consecutive cycles, suggesting that they may be effective for removing anionic dyes from aquatic environments.

Hydrogel Encapsulation Techniques and Its Clinical Applications in Drug Delivery and Regenerative Medicine: A Systematic Review.

Hydrogel encapsulation is a promising carrier for cell and drug delivery due to its ability to protect the encapsulated entities from harsh physiological conditions and enhance their therapeutic efficacy and bioavailability. However, there is not yet consensus on the optimal hydrogel type, encapsulation method, and clinical application. Therefore, a systematic review of hydrogel encapsulation techniques and their potential for clinical application is needed to provide a comprehensive and up-to-date overview. In this systematic review, we searched electronic databases for articles published between 2008 and 2023 that described the encapsulation of cells or drug molecules within hydrogels. Herein, we identified 9 relevant studies that met the inclusion and exclusion criteria of our study. Our analysis revealed that the physicochemical properties of the hydrogel, such as its porosity, swelling behavior, and degradation rate, play a critical role in the encapsulation of cells or drug molecules. Furthermore, the encapsulation method, including physical, chemical, or biological methods, can affect the encapsulated entities' stability, bioavailability, and therapeutic efficacy. Challenges of hydrogel encapsulation include poor control over the release of encapsulated entities, limited shelf life, and potential immune responses. Future directions of hydrogel encapsulation include the development of novel hydrogel and encapsulation methods and the integration of hydrogel encapsulation with other technologies, such as 3D printing and gene editing. In conclusion, this review is useful for researchers, clinicians, and policymakers who are interested in this field of drug delivery and regenerative medicine that can serve as a guide for the future development of novel technologies that can be applied into clinical practice.

Effect of Dual Glucagon-Like Peptide 1/Glucose-Dependent Insulinotropic Polypeptide Receptor Agonist (Tirzepatide) versus Bariatric Surgery on Weight Loss and Nonalcoholic Fatty Liver Disease.

OBJECTIVES: Bariatric surgery is a well-established treatment for obesity and type 2 diabetes. Tirzepatide, a dual GIP/GLP-1 receptor agonist, has emerged as a promising therapy for type 2 diabetes. This study aimed to compare the effects of bariatric surgery, semaglutide (a GLP-1 receptor agonist), and tirzepatide in Sprague-Dawley rats fed a high-fat diet. METHODS: Rats were divided into surgery, semaglutide, and tirzepatide treatment groups, along with a control group (sham). Weight, oral glucose tolerance, and levels of metabolic markers were assessed, along with adipose and liver tissue analysis. RESULTS: Surgery led to a 15.5% weight reduction, while rats treated with semaglutide exhibited a 10.7% reduction. Tirzepatide treatment at various concentrations (10, 50, and 100 nmol/kg) resulted in weight reductions of 5.0%, 14.9%, and 17.7%, respectively, compared to the sham group. Metabolic analyte levels decreased in intervention groups compared to the sham group, indicating improved metabolic health and glucose tolerance. Adipose tissue weight and hepatic liver fat droplets decreased in the intervention groups. CONCLUSION: Bariatric surgery and tirzepatide treatment significantly improved metabolic parameters in obese rats. Tirzepatide, particularly at higher concentrations, showed pronounced improvements compared to surgery and semaglutide. These findings suggest that high doses of tirzepatide could be explored as an alternative to bariatric surgery for the treatment of obesity.

Paths to improve voluntary blood donation in mixed public/private blood donation systems such as in Lebanon?

BACKGROUND: The World Health Organization advocates for the achievement of 100% voluntary non-remunerated blood donation (VNRD) globally by the year 2020. However, until today, little was known in Lebanon regarding its actual rate or influencing factors, particularly donor motivations and behaviors. Therefore, the aim of this study was to assess the knowledge, attitudes, and practices of blood donors in Lebanon. The ultimate goals were to retain first-time donors, encourage them to become regular ones, and facilitate the transition from replacement donation to VNRD. MATERIALS AND METHODS: A multi-centric cross-sectional study was carried across the five governorates in Lebanon. A self-administered and structured questionnaire was used in this survey. Results were presented in terms of odds ratios, with statistical significance defined at a P value of 0.05 and a 95% confidence interval. Additionally, a benchmarking analysis of the situation of blood donation in Lebanon was also conducted, identifying several areas for improvement. RESULTS: A total of 620 blood donors participated in this study, with 21.3% being first-time donors and 78.7% repeat donors. While the latter were primarily motivated by self-esteem, solidarity or returning a favor (89%, 77.9% and 78.1%), the main obstacle for becoming regular donors was a lack of initiative (34.6%). Female donors (9.9% of the total) exhibited better knowledge (OR = 2.20, p = 0.011) and were more inclined to donate voluntarily (OR = 1.52, p = 0.048). Conversely, male donors were more likely to be repeat donors, often through replacement donation (OR = 2.95, p = 0.001). CONCLUSION: There is a significant disparity between the low rate of voluntary donation in Lebanon (22.2%) and the relatively high proportion of donors with adequate knowledge of the donation process (60.5%). Therefore, urgent action by public authorities, based on the evidence based strategies outlined in this article, is crucial to enhancing the voluntary donation rate in Lebanon.

One-pot synthesis of quinazolinone heterocyclic compounds using functionalized SBA-15 with natural material ellagic acid as a novel nanocatalyst.

The nanoporous compound SBA-15 was functionalized using (3-aminopropyl)trimethoxysilane (APTES). Then the obtained product was modified with ellagic acid (ELA), a bioactive polyphenolic compound. The structure of the prepared nanoporous composition SBA-15@ELA was extensively characterized and confirmed by various techniques, such as Fourier-transform infrared (FT-IR) spectroscopy, Energy dispersive X-ray (EDX) elemental analysis, scanning electron microscopy (SEM), thermogravimetric analysis (TGA), X-ray diffraction (XRD), transmission electron microscopy (TEM) and N2 adsorption-desorption isotherms (BET). The novel, recoverable, heterogenous SBA-15@ELA nanoporous compound was used to investigate its catalytic effect in the synthesis of 4-oxo-quinazoline derivatives (19 examples) with high yields (78-96%), as an important class of nitrogen-containing heterocyclic compounds. The use of an inexpensive mesoporous catalyst with a high surface area, along with easy recovery by simple filtration are among the advantages of this catalysis research work. The catalyst has been used in at least 6 consecutive runs without a significant loss of its activity.

The potential role of Hypericum perforatum in wound healing: A literature review on the phytochemicals, pharmacological approaches, and mechanistic perspectives.

St. John's Wort, commonly known as Hypericum perforatum L., is a flowering plant in the Clusiaceae family that traditionally been employed for treating anxiety, depression, wounds, burns, sunburn, irritation, and stomach ailments. This review provides a synopsis of H. perforatum L. phytoconstituents and their biological effects, highlighting its beneficial therapeutic properties for dermatological indications, as well as its antioxidant, antimicrobial, anti-inflammatory, and anti-angiogenic activity in various applications including wound healing and skin conditions such as eczema, sun burn and minor burns also spastic paralysis, stiff neck and mood disorders as anti-depressant and nerve pains such as neuralgia. The data were collected from several databases as Web of Science PubMed, ScienceDirect, Scopus and Google Scholar using the terms: "H. perforatum L.", "H. perforatum L. /phytochemistry," and "H. perforatum extracts/wound healing" collected from 1994 to 2023. The findings suggest H. perforatum L. acts through various mechanisms and plays a role in each phase of the wound healing process, including re-epithelialization, angiogenesis, wound contraction, and connective tissue regeneration. H. perforatum L. enhances collagen deposition, decreases inflammation, inhibits fibroblast migration, and promotes epithelialization by increasing the number of fibroblasts with polygonal shape and the number of collagen fibers within fibroblasts. H. Perforatum L. extracts modulate the immune response and reduce inflammation were found to accelerate the wound healing process via inhibition of inflammatory mediators' production like interleukin-6, tumor necrosis factor-α, cyclooxygenase-2 gene expression, and inducible nitric oxide synthase. Thus, H. perforatum L. represents a potential remedy for a wide range of dermatological problems, owing to its constituents with beneficial therapeutic properties. H. perforatum L. could be utilized in the development of novel wound healing therapies.

Enhanced antibacterial activity of porous chitosan-based hydrogels crosslinked with gelatin and metal ions.

Addressing the increasing drug resistance in pathogenic microbes, a significant threat to public health, calls for the development of innovative antibacterial agents with versatile capabilities. To enhance the antimicrobial activity of non-toxic biomaterials in this regard, this study focuses on novel, cost-effective chitosan (CS)-based hydrogels, crosslinked using gelatin (GEL), formaldehyde, and metallic salts (Ag+, Cu2+, and Zn2+). These hydrogels are formed by mixing CS and GEL with formaldehyde, creating iminium ion crosslinks with metallic salts without hazardous crosslinkers. Characterization techniques like FTIR, XRD, FESEM, EDX, and rheological tests were employed. FTIR analysis showed metal ions binding to amino and hydroxyl groups on CS, enhancing hydrogelation. FESEM revealed that freeze-dried hydrogels possess a crosslinked, porous structure influenced by various metal ions. Antibacterial testing against gram-negative and gram-positive bacteria demonstrated significant bacterial growth inhibition. CS-based hydrogels containing metal ions showed reduced MIC and MBC values against Staphylococcus aureus (0.5, 8, 16 µg/mL) and Escherichia coli (1, 16, 8 µg/mL) for CS-g-GEL-Ag+, CS-g-GEL-Cu2+, and CS-g-GEL-Zn2+. MTT assay results confirmed high biocompatibility (84.27%, 85.24%, 84.96% viability at 10 µg/mL) for CS-based hydrogels towards HFF-1 cells over 48 h. Therefore, due to their non-toxic nature, these CS hydrogels are promising for antibacterial applications.

Semaglutide and Tirzepatide for the Management of Weight Recurrence After Sleeve Gastrectomy: A Retrospective Cohort Study.

BACKGROUND: Metabolic and bariatric surgery (MBS) is the most effective treatment for obesity and improvement of obesity-associated comorbidities. However, a proportion of these patients may suffer from weight recurrence and recurrence of obesity-associated comorbidities. METHOD: A retrospective cohort study of patients who underwent SG between January 2008 and August 2022 and sought treatment for weight recurrence with semaglutide or tirzepetide from January 2022 onwards. RESULT: A total of 115 patients were included, of which 70 had SG and treated for weight recurrence with semaglutide and 45 had SG and treated with tirzepatide. The mean age of patients was 38.8 (10.4) and 80.9% of patients were female. The mean pre-treatment weight and BMI was 94.0 (23.8) kg and 35.1 (6.0) kg/m2. Following treatment with semaglutide and tirzepatide, the mean post-treatment weight at 6 months was 81.0 (19.0) kg from 90.1 (19.6) kg and 87.6 (28.3) kg from 100.2 (28.5) kg respectively, corresponding to a clinically significant mean weight loss from baseline to 6 months of 10.3 (5.9)% (p < 0.05) and 15.5 (6.3)% (p < 0.05). Weight loss in tirzepatide patients was significantly greater than the semaglutide patients at 6 months (p < 0.02). There were no reported severe adverse events to the treatment. CONCLUSION: Short-term outcomes show that semaglutide and tirzepatide can be an effective treatment for managing weight recurrence after SG. Studies with longer follow-up are needed to determine the durability, as weight regain after discontinuation of the medication is highly likely, and the high cost of these medications can limit their use.

Phase tunable nickel doped Mn3O4 nanoparticle synthesis by chemical precipitation: kinetic study on dye degradation.

Nickel (Ni) doped Mn3O4 nanoparticles (NPs) were synthesized by a quick and facile chemical precipitation technique to investigate their performance in the degradation of methylene blue (MB) in the absence of light. XRD, FESEM, TEM, AAS, XPS, and FT-IR were used for the investigation of the structural, surface morphological, and elemental composition of Ni doped Mn3O4 NPs. XRD confirms the formation of a tetragonal phase structure of pure Mn3O4 and 1% and 3% Ni doped Mn3O4 NPs. However, mixed phases were found in the case of 5 to 10% Ni doped Mn3O4 NPs. Well-defined spherical-shaped morphology was presented through FESEM. Particle sizes decreased linearly (58.50 to 23.68 nm) upon increasing the doping concentration from 0% (pure Mn3O4) to 7% respectively, and then increased (48.62 nm) in the case of 10% doping concentration. TEM further confirmed spherical shaped 32 nm nanoparticles for 7% Ni doped Mn3O4. The elemental composition and oxidation state of the prepared NPs were confirmed by using XPS spectra. Mixed valence Mn2+ and Mn4+ states were found in pure Mn3O4 and 1% and 3% Ni doped Mn3O4 NPs in the ratio of 2MnO-MnO2. In addition, three different oxidation states Mn2+, Mn3+, and Mn4+ were found in 5 to 10% Ni doped Mn3O4 NPs. Moreover, as a dopant Ni exists as Ni2+ and Ni3+ states in all Ni doped Mn3O4 NPs. The synthesized NPs were then applied as potent oxidants for the degradation of MB at pH 3. With the increase of doping concentration to 7%, the degree of degradation was increased to 79% in the first 10 min and finally, it became about 98%. The degradation of MB follows the pseudo-first-order linear kinetics with a degradation rate of 0.0342 min-1.

Effectiveness and tolerability of liraglutide for the management of weight regain following sleeve gastrectomy.

Background: There is currently very little research evidence on the benefits and safety of liraglutide in the management of weight regain or inadequate weight loss following metabolic and bariatric surgery. This study aimed to determine the clinical effectiveness and tolerability of liraglutide as an adjunct therapy for managing weight regain and inadequate weight loss following sleeve gastrectomy (SG). Methods: This was a retrospective analysis of medical records conducted at a private clinic in Kuwait. Results: Data of 57 post-SG patients were included in the analysis. The mean (±SD) pre-treatment weight was 96.12 (29.26) kg. Following a median liraglutide treatment duration of approximately 3 months, the mean post-treatment weight was 90.19 (26.82) kg. This represents a statistically significant mean weight loss of 5.94 (6.31) kg (p < 0.001), corresponding to a loss of 6.20% of pre-treatment weight. Patients aged 31-40 years achieved a greater post-treatment weight loss of 7.63 (7.41) kg, a loss of 7.80%, relative to age groups after treatment (p = 0.047). Patients who tolerated ≥2.4 mg of liraglutide recorded a higher mean weight loss of 8.42 (7.63) kg, a loss of 8.10% (p = 0.010). Conclusion: The use of liraglutide may be an effective adjunct treatment for weight optimization following SG. Maximizing the tolerable dose may yield greater weight reduction.

Fabrications, Classifications, and Environmental Impact of PCM-Incorporated Textiles: Current State and Future Outlook.

Phase change materials (PCMs) are an extraordinary family of compounds that can store and release thermal energy during phase changes. In recent years, the incorporation of PCMs into textiles has attracted considerable interest, since it represents a unique way to improve the comfort and usefulness of textiles. This article examines the advancements achieved in the preparation, classifications, and environmental effects of PCM-integrated textiles, along with a roadmap for the future. Progress of different PCM has been reported including its pros and cons. In addition, fabrications of the PCM on the apparel have been highlighted. Moreover, this Review analyzed the positive environmental impact of PCM-integrated textiles including improved insulation, extended product lifespan, and energy savings along with negative effects like higher energy consumption in the manufacturing process, added chemical additives tending to have a negative impact on the environment, less disposal features textiles and many more with recent references. Moreover, the future outlook also reports more research on nanoencapsulation, making it energy efficient, ensuring affordability, and more applications in smart PCM textiles. It seeks to stimulate additional research, encourage innovation, and contribute to the creation of high-performance, energy-efficient textiles by investigating the possibilities of PCM-enhanced textiles. The future of PCM in textiles is hopeful, with continuous research and technological advances resolving the aforementioned difficulties.

Revolutionizing Drug Targeting Strategies: Integrating Artificial Intelligence and Structure-Based Methods in PROTAC Development.

PROteolysis TArgeting Chimera (PROTAC) is an emerging technology in chemical biology and drug discovery. This technique facilitates the complete removal of the target proteins that are "undruggable" or challenging to target through chemical molecules via the Ubiquitin-Proteasome System (UPS). PROTACs have been widely explored and outperformed not only in cancer but also in other diseases. During the past few decades, several academic institutes and pharma companies have poured more efforts into PROTAC-related technologies, setting the stage for several major degrader trial readouts in clinical phases. Despite their promising results, the formation of robust ternary orientation, off-target activity, poor permeability, and binding affinity are some of the limitations that hinder their development. Recent advancements in computational technologies have facilitated progress in the development of PROTACs. Researchers have been able to utilize these technologies to explore a wider range of E3 ligases and optimize linkers, thereby gaining a better understanding of the effectiveness and safety of PROTACs in clinical settings. In this review, we briefly explore the computational strategies reported to date for the formation of PROTAC components and discuss the key challenges and opportunities for further research in this area.

Development of new magnetic nanocomposite designed by reduced graphene oxide aerogel and HKUST-1, and its catalytic application in the synthesis of polyhydroquinoline and 1,8-dioxo-decahydroacridine derivatives.

In this study, new magnetic reduced graphene oxide aerogel/HKUST-1 nanocomposite was designed and synthesized given the transformation of graphene oxide sheets to three-dimensional reduced graphene oxide aerogel, the in-situ magnetization of aerogel substrate, and the in-situ formation of HKUST-1 particles. Apart from characterizing the chemistry and structure of the designed magnetic nanocomposite (FT-IR, EDX, ICP, FE-SEM, DLS, XRD, VSM, and TG analyses), its catalytic performance was evaluated in the one-pot synthesis of biologically active 1,8-dioxo-decahydroacridine and polyhydroquinoline derivatives. The combination of magnetized reduced graphene oxide aerogel and HKUST-1 in the form of a new heterogeneous magnetic nanocatalyst was accompanied by a high synergetic catalytic effect in the symmetric and unsymmetrical Hantzsch condensation reactions. Compared to previous research studies, the pharmaceutical 1,8-dioxo-decahydroacridine and polyhydroquinoline derivatives can be synthesized using a partial amount of this nanocatalyst with a high percentage of yields in a short reaction time.

Design and fabrication of a magnetic nanobiocomposite based on flaxseed mucilage hydrogel and silk fibroin for biomedical and in-vitro hyperthermia applications.

In this research work, a magnetic nanobiocomposite is designed and presented based on the extraction of flaxseed mucilage hydrogel, silk fibroin (SF), and Fe3O4 magnetic nanoparticles (Fe3O4 MNPs). The physiochemical features of magnetic flaxseed mucilage hydrogel/SF nanobiocomposite are evaluated by FT-IR, EDX, FE-SEM, TEM, XRD, VSM, and TG technical analyses. In addition to chemical characterization, given its natural-based composition, the in-vitro cytotoxicity and hemolysis assays are studied and the results are considerable. Following the use of highest concentration of magnetic flaxseed mucilage hydrogel/SF nanobiocomposite (1.75 mg/mL) and the cell viability percentage of two different cell lines including normal HEK293T cells (95.73%, 96.19%) and breast cancer BT549 cells (87.32%, 86.9%) in 2 and 3 days, it can be inferred that this magnetic nanobiocomposite is biocompatible with HEK293T cells and can inhibit the growth of BT549 cell lines. Besides, observing less than 5% of hemolytic effect can confirm its hemocompatibility. Furthermore, the high specific absorption rate value (107.8 W/g) at 200 kHz is generated by a determined concentration of this nanobiocomposite (1 mg/mL). According to these biological assays, this magnetic responsive cytocompatible composite can be contemplated as a high-potent substrate for further biomedical applications like magnetic hyperthermia treatment and tissue engineering.

Effect of Reaction Parameters on CO2 Absorption from Biogas Using CaO Sorbent Prepared from Waste Chicken Eggshell.

This study provides an efficient and straightforward approach to eliminate carbon dioxide (CO2) by absorption using a calcium oxide (CaO) sorbent derived from chicken eggshells. The sorbent concentration, stirring speed, and contact time were varied. The optimal condition for CO2 removal was a 10% calcium hydroxide (Ca(OH)2) suspension at 600 rpm with 20 min interaction. This optimum condition conferred the ever-highest absorption (98.71%) of CO2 through Ca(OH)2 suspensions from eggshell-derived CaO. X-ray diffraction was used to identify crystallographic phases and optimum conditions revealed calcium carbonate (CaCO3) formation with the highest intensity, Fourier transform infrared spectroscopy revealed peaks for the carbonate (CO32-) group, field emission scanning electron microscopy was used to investigate the morphological and structural properties of the sorbent before and after CO2 absorption, and thermogravimetric analysis was performed to understand the reaction mechanism. According to the kinetic analysis, the sorbent can be fully decomposed with a minimum activation energy (Ea) of 89.09 kJ/mol.

Natural defense against multi-drug resistant Pseudomonas aeruginosa: Cassia occidentalis L. in vitro and in silico antibacterial activity.

Cassia occidentalis L. is widely used in indigenous and traditional medicine, but its impact on multi-drug resistant (MDR) bacterial infections mostly remains unknown. Therefore, this study aimed to evaluate the in vitro antibacterial efficiency of methanol and ethyl acetate extracts of C. occidentalis L. leaves (MECOL and EAECOL) against multi-drug resistant Pseudomonas aeruginosa and to identify potential antibacterial agents through computational studies targeting the LasR protein. Initially, 82 compounds were identified using GC-MS analysis, and the functional groups were determined through FT-IR analysis. Both extracts of the plant exhibited dose-dependent antibacterial activity, with MICs of 104.16 ± 36.08 µg mL-1 for MECOL and 83.33 ± 36.08 µg mL-1 for EAECOL, and an MBC of 125 µg mL-1. Among the 82 compounds, 12 potential compounds were identified based on binding scores using molecular docking with the LasR protein and MM-GBSA analysis. Furthermore, screening for ADME properties, including physicochemical features, water solubility, lipophilicity, RO5 compliance, and toxicity, identified the top three compounds: methyl dihydrojasmonate, methyl benzoate, and 4a-methyl-4,4a,5,6,7,8-hexahydro-2(3H)-naphthalenone, which also demonstrated binding affinity with the active site residues of the LpxC protein of the bacteria. Additionally, molecular dynamics (MD) simulations confirmed the binding reliability of these three phytochemicals to LasR's active pocket, comparable to the protein native inhibitory ligands (C12-HSL). The study offers scientific support for the traditional use of C. occidentalis in treating bacterial infections, highlighting the potential of the three compounds as leads for developing LasR inhibitors to combat multi-drug resistant P. aeruginosa.

Gatekeepers in the health financing scheme: Assessment of knowledge, attitude, practices, and participation of Malaysian private general practitioners in the PeKa B40 scheme.

This is cross-sectional research done to assess the readiness of the private Malaysian general practitioners (GPs) for the implementation of the national health financing scheme. The study focused on their levels of knowledge and attitudes towards the types of health financing scheme, gatekeeper roles in the health financing scheme, and their participation in the PeKa B40 scheme. Their acceptance and level of participation in the national health financing scheme (NHFS) were also assessed. A set of self-designed and pre-tested questionnaires focusing on the aforementioned objectives were mailed to the respondents. The selection of respondents was done by stratified random sampling of the GPs in all 14 Malaysian states at both urban and rural levels. Out of a calculated number of 362 GPs targeted, 296 responses were received which represented a response rate of 81.7%. The respondents had a mean age of 50.7 years 165 (55.75%) were males and 131 (44.3%) were females. The rural respondents totalled 158 (53.4%) as compared to those from urban 138 (46.6%) areas. The outcomes observed were that GPs with PeKa B40 provider status, positive attitude towards health financing schemes, gatekeeper roles, and PeKa B40, were strongly associated with their acceptance and level of participation in the NHFS. The GPs possessed a positive attitude and were generally ready to participate in the NHFS, but the lower scores in knowledge levels would require definite education and training plans to further enhance their readiness. More incentives should be given to GPs to enrol as PeKa B40 providers. The results of this study should be strongly considered by the government in the efforts to engage the Malaysian private GPs in the forthcoming NHFS. Most importantly, the role of GPs as gatekeepers needed to be implemented, and the PeKa B40 scheme be greatly improved.

Anterior Nutcracker syndrome in a young male patient: a case report and review of literature.

Introduction and importance: The left renal vein (LRV) is affected by a venous compression syndrome called Nutcracker syndrome (NCS). This syndrome is characterized by extrinsic compression of the LRV, which usually occurs between aorta and superior mesenteric artery. It is a rare and under-diagnosed condition, more prevalent in females and that, if left untreated, can lead to severe problems. There are no clear guidelines regarding management. Therefore, the authors report this rare case and its symptoms in male patient and they display current management options. Case presentation: NCS was observed during computer tomography in a male patient presented with persistent left flank pain and associated haematuria. Ultrasound for left scrotum demonstrated left moderate-sized varicocele. The left varicocele testis unit was 1.6 mm and during the Valsalva manoeuvre in the supine position the testis unit was 2 mm. LRV compression between abdominal aorta and superior mesenteric artery was identified by computer tomography imaging and therefore, diagnosis of NCS was confirmed. Clinical discussion: The actual prevalence is unclear, and incidence rates have been observed to fluctuate among age group and more prevalent in women. Main symptoms include haematuria, left flank discomfort, varicocele in men, proteinuria and anaemia. Depending on severity of symptoms, management might range from conservative care to surgery. Conclusion: This treatment strategy was effective in reducing the symptoms of the patients. In young patients, conservative treatment is advised for a fair amount of time. However, more studies on how much the authors should wait before considering surgery is important.

Synthesis and characterization of chitosan/collagen/polycaprolactone hydrogel films with enhanced biocompatibility and hydrophilicity for artificial tendon applications.

Regenerative medicine confronts various obstacles, such as creating and advancing biomaterials. Besides being safe, such materials should promote cellular activity. Polycaprolactone (PCL) has numerous medical applications as an engineering material. However, these polymers lack hydrophilicity. Herein, chitosan (CS)/collagen (COL)/polycaprolactone hydrogel films (CSCPs) were synthesized with different weight ratios of PCL; specifically, CS/COL (CSC): PCL content of 1:3, 1:6, and 1:9. For this purpose, novel COL immobilization on CS was performed via covalent attachment. Following the addition of PCL to CSC hydrogel, the resulting CSCP hydrogel films were characterized using tensile measurements, TGA, XRD, FTIR, and FE-SEM. A greater PCL content increases the elongation at break from 134.8 to 369.5 % and the tensile strength of the hydrogel films from 4.8 to 18.4 MPa. The hydrophobicity of prepared specimens was assessed through water absorption and contact-angle tests. For CSCP3 to CSCP9, the water contact angle increased from 61.03° to 70.82°. After 48 days, CSCP6 and CSCP9 hydrogel films demonstrated a slow rate of degradation, losing <15 % of their weight. Moreover, all three types of hydrogel films exhibited high biocompatibility (higher than 95 % after three days), as confirmed by the MTT assay. The hemolysis rates of CSCP hydrogel films were <2 %, which could be deemed safe for contact with a blood environment. The presence of no costly and bio-based crosslinking agents and desired characteristics for tissue engineering applications suggest that CSCP hydrogel films may be promising candidates for use in artificial tendons.

Integrated gene expression profiling and functional enrichment analyses to discover biomarkers and pathways associated with Guillain-Barré syndrome and autism spectrum disorder to identify new therapeutic targets.

Guillain-Barré syndrome (GBS) is one of the most prominent and acute immune-mediated peripheral neuropathy, while autism spectrum disorders (ASD) are a group of heterogeneous neurodevelopmental disorders. The complete mechanism regarding the neuropathophysiology of these disorders is still ambiguous. Even after recent breakthroughs in molecular biology, the link between GBS and ASD remains a mystery. Therefore, we have implemented well-established bioinformatic techniques to identify potential biomarkers and drug candidates for GBS and ASD. 17 common differentially expressed genes (DEGs) were identified for these two disorders, which later guided the rest of the research. Common genes identified the protein-protein interaction (PPI) network and pathways associated with both disorders. Based on the PPI network, the constructed hub gene and module analysis network determined two common DEGs, namely CXCL9 and CXCL10, which are vital in predicting the top drug candidates. Furthermore, coregulatory networks of TF-gene and TF-miRNA were built to detect the regulatory biomolecules. Among drug candidates, imatinib had the highest docking and MM-GBSA score with the well-known chemokine receptor CXCR3 and remained stable during the 100 ns molecular dynamics simulation validated by the principal component analysis and the dynamic cross-correlation map. This study predicted the gene-based disease network for GBS and ASD and suggested prospective drug candidates. However, more in-depth research is required for clinical validation.Communicated by Ramaswamy H. Sarma.

17 common differentially expressed genes (DEGs) were identified from 693 DEGs of the GBS dataset (GSE72748) and 365 DEGs of the ASD dataset (GSE113834), which is the preliminary part of this investigation.From the PPI network analysis, a total of 10 hub genes were identified and two common DEGs named CXCL9 and CXCL10 were found in both the hub gene and essential module analysis.The identified leading pathways and GO pathways, TF-gene interaction, and TF-miRNAs network has made the process more relevant and appropriate for suggesting probable drug candidates.Among the drug candidates, imatinib was suggested as the main drug candidate due to its interaction with the hub gene CXCL9 and CXCL10 and lower p value than the other candidates. It showed the highest binding affinity score and remained stable with the CXCR3 chemokine receptor.