Efficient photoanode with a MoS2/TiO2/Au nanoparticle heterostructure for ultraviolet-visible photoelectrocatalysis.

Green energy technology is generally becoming one of hot issues that need to be solved due to the adverse effects on the environment of fossil fuels. One of the strategies being studied and developed by theorists and experimentalists is the use of photoelectrochemical (PEC) cells, which are emerging as a candidate to produce hydrogen from water splitting. However, creating photoelectrodes that meet the requirements for PEC water splitting has emerged as the primary obstacle in bringing this technology to commercial fruition. Here, we construct a heterostructure, which consists of MoS2/TiO2/Au nanoparticles (NPs) to overcome the drawbacks of the photoanode. Owing to the dependence on charge transfer, the bandgap of MoS2/TiO2and the utilization the Au NPs as a stimulant for charges separation of TiO2by localized surface plasmon resonances effect as well as the increase of hot electron injection to cathode, leading to photocatalytic activities are improved. The results have recorded a significant increase in the photocurrent density from 2.3µAcm-2of TiO2to approximately 16.3µAcm-2of MoS2/TiO2/Au NPs. This work unveils a promising route to enhance the visible light adsorption and charge transfer in photo-electrode of the PEC cells by combining two-dimensional materials with metal NPs.

Iron Sulfide Microspheres Supported on Cellulose-Carbon Nanotube Conductive Flexible Film as an Electrode Material for Aqueous-Based Symmetric Supercapacitors with High Voltage.

Nanostructured iron disulfide (FeS2) was uniformly deposited on regenerated cellulose (RC) and oxidized carbon nanotube (CNT)-based composite films using a simple chemical bath deposition method to form RC/CNT/FeS2 composite films. The RC/CNT composite film served as an ideal substrate for the homogeneous deposition of FeS2 microspheres due to its unique porous architecture, large specific surface area, and high conductivity. Polypyrrole (PPy), a conductive polymer, was coated on the RC/CNT/FeS2 composite to improve its conductivity and cycling stability. Due to the synergistic effect of FeS2 with high redox activity and PPy with high stability and conductivity, the RC/CNT/FeS2/PPy composite electrode exhibited excellent electrochemical performance. The RC/CNT/0.3FeS2/PPy-60 composite electrode tested with Na2SO4 aqueous electrolyte could achieve an excellent areal capacitance of 6543.8 mF cm-2 at a current density of 1 mA cm-2. The electrode retained 91.1% of its original capacitance after 10,000 charge/discharge cycles. Scanning electron microscopy (SEM) images showed that the ion transfer channels with a pore diameter of 5-30 µm were formed in the RC/CNT/0.3FeS2/PPy-60 film after a 10,000 cycle test. A symmetrical supercapacitor device composed of two identical pieces of RC/CNT/0.3FeS2/PPy-60 composite electrodes provided a high areal capacitance of 1280 mF cm-2, a maximum energy density of 329 µWh cm-2, a maximum power density of 24.9 mW cm-2, and 86.2% of capacitance retention after 10,000 cycles at 40 mA cm-2 when tested at a wide voltage window of 1.4 V. These results demonstrate the greatest potential of RC/CNT/FeS2/PPy composite electrodes for the fabrication of high-performance symmetric supercapacitors with high operating voltages.

Covalent-Organic-Framework-Modified Quartz Crystal Microbalance Sensor for Selective Detection of Hazardous Formic Acid.

Covalent organic frameworks (COFs) are a novel family of porous crystalline materials utilized in various advanced applications. However, applying COFs as a hazardous organic acid gas sensor is substantial but still challenging. Herein, a phenylenediamine-based covalent organic framework (TPDA-TPB COF) featuring excellent crystallinity, ultrastable thermal stability, and high surface area was successfully constructed. Then, the TPDA-TPB COF-modified quartz crystal microbalance (QCM) sensor is fabricated by immobilizing the TPDA-TPB COF thin film on the gold-QCM chip. The fabricated TPDA-TPB COF-modified QCM sensor demonstrates a rapid response, excellent reproducibility, high selectivity, and sensitivity to formic gas, arising from hydrogen-bonding interactions between formic acid and the outermost layer of the TPDA-TPB COF, as determined by extensive analysis and density functional theory calculations. The basic sites of the TPDA-TPB COF, which are numerous due to its high nitrogen content, and the carboxylic acid groups present in formic acid exhibit efficient interactions. The sensitivity of the TPDA-TPB COF-modified QCM sensor was found to be 7.75 Hz ppm-1 at standard room temperature and pressure conditions, with a limit of detection (LOD) of formic acid down to 1.18 ppm, which is significantly below the workplace olfactory threshold limit of 5.0 ppm established by the Occupational Safety and Health Administration. The TPDA-TPB COF-modified QCM sensor exhibits remarkable detecting capabilities, making it highly attractive for detecting organic acid vapors in diverse applications that require superior performance.

Room-Temperature Synthesis of Covalent Organic Frameworks using Gamma-Irradiation in Open-Air Conditions.

Covalent organic frameworks (COFs), which have layered stacking structures, extended π-conjugation, and periodic frameworks have become a promising class of materials for a wide range of applications. However, their synthetic pathways frequently need high temperatures, enclosed systems under high pressures, an inert atmosphere, and extended reaction time, which restrict their practicality in real-world applications. Herein, the use of gamma irradiation is presented to synthesize highly crystalline COFs at room temperature under an open-air condition within a short time. This is demonstrated that there is no significant difference in crystallinity of COFs by gamma irradiation under air, N2 or Ar atmosphere conditions. Moreover, this approach can successfully fabricate COFs in the vessel with different degrees of transparency or even in a plastic container. Importantly, this strategy is applicable not only to imine linkage of COFs but also effective to the imide linkages of COFs. Most importantly, these COFs demonstrate improved crystallinity, surface area, and thermal stability in comparison to the corresponding materials synthesized via the solvothermal method. Finally, a COF synthesized through gamma irradiation exhibits remarkable photocatalytic activity in promoting the sacrificial hydrogen evolution from water, displaying a more catalytic efficiency compared with that of its solvothermal analogue.

Evaluation of novel synthesized thiazole derivatives as potential aromatase inhibitors against breast cancer.

Background: 4-Methylacetophenone is used in the preparation of starting materials, 4-methylphenacyle bromide (2) and 4-methylacetophenone thiosemicarbazole (3). Results: Several novel 2,4-disubstituted-1,3-thiazole analogues were obtained via the treatment of starting materials with 4-methylphenacyl bromide, acetyl chloride, aromatic aldehydes and bromination providing thiazole derivatives 5-8 respectively. Conclusion: Compounds 5-8 were investigated for their cytotoxic activity on MCF-7 and normal breast cells. Active compounds were found and in contrast to staurosporine, compound 8 displayed the most potent cytotoxic action that showed a strong inhibitory effect (aromatase) and (protein tyrosine kinase) enzymes, proving that the novel thiazole derivatives promoted the effective anticancer drug candidates.

Exploring Clinical Trajectories and the Continuum of Care for Patients With Acute Coronary Syndrome in the United Kingdom: A Thorough Cross-Sectional Analysis.

The United Kingdom (UK) has a sustainable healthcare system. Nonetheless, the burden of acute coronary syndrome (ACS) is still a significant challenge. A scarcity of literature primarily focuses on the continuum of care for ACS patients in the UK. Moreover, limited research studies highlight the clinical trajectories of ACS patients across the UK. Therefore, the current study was designed to explore clinical trajectories and the continuum of care for patients with ACS in the UK. Secondary data was obtained from the Myocardial Ischaemia National Audit Project (MINAP) database. The latest data available in the MINAP database was used. As our objective was to explore clinical trajectories and the continuum of care for patients, we retrieved data regarding the care received by ACS patients admitted to hospitals across the UK.  The data of 85574 ACS patients was retrieved. A large number (n=47035) of patients were estimated to be eligible for the angiogram; however, an angiogram was performed for 87.15% (n=40995) of eligible patients. Angioplasty within 72 hours of admission was required for most (n=26313) ACS patients. Nonetheless, angioplasty within 72 hours of admission was performed for 59.7% (n=15703) of the eligible patients. There was a significant difference (P<0.05) between different regions of the UK and the percentage of patients for whom angioplasty was performed within 72 hours of admission. Primary percutaneous coronary intervention (PCI) was performed for 23923 ACS patients, of which the door-to-balloon interval for 17590 (73.5%) patients was ≤60 minutes while the door-to-balloon interval for 3086 (12.9%) patients was ≤90 minutes. Out of the total 85574 ACS patients, 65959 (77.08%) patients were discharged on appropriate medications, while 19615 (22.92%) were transferred to another hospital or died there. A total of 75361 were eligible to be referred to cardiac rehabilitation settings. Nonetheless, 64518 (85.61%) were referred to cardiac rehabilitation. About 85000 patients were reported in the UK (England, Northern Ireland, Wales). Optimal care was provided to most patients in the UK. However, some patients received sub-optimal care, highlighting the disparity in the healthcare system. There is a need to explore further the factors that might be responsible for the sub-optimal care to the patients.

Outcome and toxicity of ifosfamide, carboplatin, and etoposide versus gemcitabine and vinorelbine regimen for pediatric patients with relapsed or refractory Hodgkin's lymphoma.

Background: Pediatric classical Hodgkin lymphoma (CHL) is a curable disease; however, the optimal salvage regimen is unclear for relapsed/refractory (R/R) disease. This study aimed to compare response rates, toxicity, event-free survival (EFS), and overall survival (OS) of ifosfamide, carboplatin, and etoposide (ICE) with gemcitabine and vinorelbine (GV) regimen after first-line doxorubicin, bleomycin, vinblastine, dacarbazine (ABVD) in pediatric patients with R/R CHL. Methods: This is a retrospective cohort study of 132 pediatric patients with R/R CHL treated from July 2012 to December 2020 with ICE (n = 82) or GV (n = 50). Results: The median age at relapse was 13.9 years, and 68.2% were men. Rates of complete response, partial response, and progressive disease before consolidation were 50.6%, 3.7%, and 45.7% for ICE and 28.5%, 0%, and 71.5% for GV (P = 0.011). By multivariate analysis, regimen (P = 0.002), time to relapse (P = 0.0001), and B-symptoms (P = 0.002) were independent factors to lower response rates. Hematological toxicity, electrolyte disturbance, hemorrhagic cystitis, infectious complications, and hospital admission for fever neutropenia were statistically significant higher for the ICE regimen. Treatment-related mortalities were 2.4% for ICE and 2% for GV (P = 0.86). The 3-year EFS was 39.3% ± 11.4% for ICE and 24.9% ± 12.5% for GV (P = 0.0001), while 3-year OS was 69.3% ± 10.6% and 74% ± 12.9% (P = 0.3), respectively. By multivariate analysis, regimen (P = 0.0001), time to relapse (P = 0.011), B-symptoms (P = 0.001), and leukocytosis (P = 0.007) were significant for EFS, while anemia (P = 0.008), and progressive disease on early response evaluation (P = 0.022) were significant for OS. Conclusions: The ICE regimen had a better overall response rate and EFS, but higher toxicity, than GV; however, OS and mortality were similar.

π-Electron-Extended Triazine-Based Covalent Organic Framework as Photocatalyst for Organic Pollution Degradation and H2 Production from Water.

Herein, we report the efficient preparation of π-electron-extended triazine-based covalent organic framework (TFP-TPTPh COF) for photocatalysis and adsorption of the rhodamine B (RhB) dye molecule, as well as for photocatalytic hydrogen generation from water. The resultant TFP-TPTPh COF exhibited remarkable porosity, excellent crystallinity, high surface area of 724 m2 g-1, and massive thermal stability with a char yield of 63.41%. The TFP-TPTPh COF demonstrated an excellent removal efficiency of RhB from water in 60 min when used as an adsorbent, and its maximum adsorption capacity (Qm) of 480 mg g-1 is among the highest Qm values for porous polymers ever to be recorded. In addition, the TFP-TPTPh COF showed a remarkable photocatalytic degradation of RhB dye molecules with a reaction rate constant of 4.1 × 10-2 min-1 and an efficiency of 97.02% under ultraviolet-visible light irradiation. Furthermore, without additional co-catalysts, the TFP-TPTPh COF displayed an excellent photocatalytic capacity for reducing water to generate H2 with a hydrogen evolution rate (HER) of 2712 µmol g-1 h-1. This highly active COF-based photocatalyst appears to be a useful material for dye removal from water, as well as solar energy processing and conversion.

Effective remediation of Pb2+ polluted environment by adsorption onto recyclable hydroxyl bearing covalent organic framework.

The removal of heavy metal ions from wastewater has attracted considerable interest because of their toxicity. Adsorption is one of the most promising methods for the removal of heavy metal ions due to its simplicity and effectiveness. Recently, covalent organic frameworks (COFs) have become promising adsorbents for effective wastewater remediation. However, many building blocks have been developed, and the design of COFs with high adsorption efficiency remains a challenge. Here, a covalent organic framework (DHTP-TPB COF) decorated with hydroxyl groups was developed for the efficient removal of Pb2+ ions. The DHTP-TPB COF showed excellent performance in adsorbing Pb2+ from aqueous solution. More importantly, DHTP-TPB COF exhibited high selectivity for Pb2+ compared to other competing ions, capturing Pb2+ ions with a removal efficiency of over 96% at pH 4. The results show that the DHTP-TPB COF exhibits excellent adsorption capacity at pH 4 of up to 154.3 mg/g for Pb2+ ions; the value is comparable to many previously reported COFs. Moreover, the adsorbed Pb2+ ions could be easily eluted with a 0.1 M EDTA solution, and the DHTP-TPB COF can be reused for more than five adsorption-desorption cycles without significant loss of adsorption capacity. Moreover, the adsorption mechanism was revealed using XPS analysis, indicating the formation of strong coordination-bonding interactions between hydroxyl and Pb2+ ions. Therefore, the DHTP-TPB COF prepared herein has high potential for the treatment of Pb2+-contaminated wastewater and is promising for the adsorption of Pb2+ ions in practical applications.

Design and synthesis of metal-free ethene-based covalent organic framework photocatalysts for efficient, selective, and long-term stable CO2 conversion into methane.

The efficient and selective photocatalytic CO2 conversion into higher-valued hydrocarbon products (e.g., methane and ethane) over covalent organic frameworks (COFs) remains a challenge, with all previously reported attempts producing carbon monoxide as the dominant product. Herein, we report a new ethene-based COF, through polycondensation of electron-rich (E)-1,2­diphenylethene and 1,3,6,8­tetraphenylpyrene units. The synthesized ethene-based COF functioned as an efficient metal-free photocatalyst for the conversion of CO2 into methane under visible light irradiation, with a selectivity of 100 %, a production rate of 14.7 µmol g-1h-1, and an apparent quantum yield of c.a. 0.99 % at 489.5 nm, which are the most promising values reported for CO2 conversion by a metal-free COF photocatalyst, without any support from a co-catalyst. The carbon origin of CH4 product is confirmed by isotope tracer 13CO2 experiment. Moreover, the photocatalytic system consistently produces methane for > 14 h with recyclability.

Systematic Review and Meta-Analysis of Randomized Controlled Trials (RCTs) Revealing the Future of Airway Management: Video Laryngoscopy vs. Macintosh Laryngoscopy for Enhanced Clinical Outcomes.

Since the 1940s, Macintosh laryngoscopy (Mac laryngoscopy) has been the gold standard for tracheal intubation, offering visualization of the glottis entrance. However, recent years have witnessed the emergence of various video laryngoscopy (VL) techniques. This systematic review and meta-analysis aims to assess the clinical outcomes of VL versus Mac laryngoscopy in an elective setting. We comprehensively searched five medical databases - PubMed, EMBASE, Medline, Cochrane Library, and Web of Science. All the databases were last searched in January 2023. We only included studies with full texts comparing VL to Mac laryngoscopy clinical outcomes. Studies were excluded if they were non-full text or non-randomized controlled trials (RCTs) and did not compare VL to Mac laryngoscopy. We extracted data comprising author names, publication year, key study outcomes (first-attempt intubation success rate, Cormack and Lehane grade, hypoxia incidence, and glottis view quality), video laryngoscope types, and sample sizes of both VL and Mac laryngoscopy groups. The Cochrane risk of bias tool was used to assess the risk of bias in the included studies. Statistical analysis was performed using Review Manager (RevMan, version 5.4; Cochrane Collaboration, London, UK), presenting results as odds ratio (OR) and risk ratios (RR) at a 95% confidence interval (CI). This facilitated the identification of relevant and appropriate studies of our analysis. The search produced 19 studies that were included in this review. The evaluated sample size ranges from 40 to 802, with 3,238 participants. The rate of success at the first attempt in the use of VL was 1,558/1,890 (82.43%), while the success rate for Mac laryngoscopy was 982/1,348 (72.85%; OR: 1.98 (1.25, 3.12)) at a 95% confidence interval. Pooled analysis indicated no significant difference for hypoxia concerning the type of device used RR (random effects: 1.02; 95% CI: 0.80-1.29). A video laryngoscope had a higher likelihood of visualizing the vocal cords categorized as category 1 in the Cormack-Lehane system of classification (RR: 2.45; 95% CI: 1.43-4.21). Additionally, considerably better glottis views were attained during VL than Mac laryngoscopy (OR: 1.77; 95% CI: 1.19-2.62). In elective tracheal intubation, VL demonstrates superior first-attempt success rates, offers improved glottis visualization, and reduces instances where the glottis cannot be viewed compared to Mac laryngoscopy.

Potential of montmorillonite modified by an organosulfur surfactant for reducing aflatoxin B1 toxicity and ruminal methanogenesis in vitro.

BACKGROUND: Montmorillonite clay modified by organosulfur surfactants possesses high cation exchange capacity (CEC) and adsorption capacity than their unmodified form (UM), therefore they may elevate the adverse impact of aflatoxin B1 (AFB1) on ruminal fermentation and methanogenesis. Chemical and mechanical modifications were used to innovate the organically modified nano montmorillonite (MNM). The UM was modified using sodium dodecyl sulfate (SDS) and grounded to obtain the nanoscale particle size form. The dose-response effects of the MNM supplementation to a basal diet contaminated or not with AFB1 (20 ppb) were evaluated in vitro using the gas production (GP) system. The following treatments were tested: control (basal diet without supplementations), UM diet [UM supplemented at 5000 mg /kg dry matter (DM)], and MNM diets at low (500 mg/ kg DM) and high doses (1000 mg/ kg DM). RESULTS: Results of the Fourier Transform Infra-Red Spectroscopy analysis showed shifts of bands of the OH-group occurred from lower frequencies to higher frequencies in MNM, also an extra band at the lower frequency range only appeared in MNM compared to UM. Increasing the dose of the MNM resulted in linear and quadratic decreasing effects (P < 0.05) on GP and pH values. Diets supplemented with the low dose of MNM either with or without AFB1 supplementation resulted in lower (P = 0.015) methane (CH4) production, ruminal pH (P = 0.002), and ammonia concentration (P = 0.002) compared to the control with AFB1. Neither the treatments nor the AFB1 addition affected the organic matter or natural detergent fiber degradability. Contamination of AFB1 reduced (P = 0.032) CH4 production, while increased (P < 0.05) the ruminal pH and ammonia concentrations. Quadratic increases (P = 0.012) in total short-chain fatty acids and propionate by MNM supplementations were observed. CONCLUSION: These results highlighted the positive effects of MNM on reducing the adverse effects of AFB1 contaminated diets with a recommended dose of 500 mg/ kg DM under the conditions of this study.

Morphometric measurements and the relationship with body weight in the Sudanese Dorcas Gazelle and Bohor Reedbuck.

The objectives were to describe the morphometric measurements and determine the best model for estimating the relationship between body weight and morphometric measurements of the two Sudanese antelopes, Dorcas Gazelle (Gazella dorcas) and Bohor Reedbuck (Redunca redunca). Twenty-four animals belonging to two Sudanese antelope species, six males and six females from each species were used. Data on body weight and body measurements were recorded from each species. Averages of body weight and morphometric traits of Bohor Reedbuck were larger than the corresponding values of Dorcas Gazelle, while the opposite was true in the case of horn thickness, which was larger in the later. Stepwise regression analysis indicated that, the best model for Dorcas Gazelle had the variables neck length, belly girth and chest height, while Bohor Reedbuck had body length, head length, neck length, tail length, chest girth and pelvic height. These variables explained 82% of the total variation in body weight of Dorcas Gazelle, and 92% of the variation of Bohor Reedbuck. These results are discussed in relation to morphometric measurements reported for antelopes elsewhere.

High Thermal Resistance of Epoxy/Cyanate Ester Hybrids Incorporating an Inorganic Double-Decker-Shaped Polyhedral Silsesquioxane Nanomaterial.

In this study, we prepared a difunctionalized cyanate ester double-decker silsesquioxane (DDSQ-OCN) cage with a char yield and thermal decomposition temperature (Td) which were both much higher than those of a typical bisphenol A dicyanate ester (BADCy, without the DDSQ cage) after thermal polymerization. Here, the inorganic DDSQ nanomaterial improved the thermal behavior through a nano-reinforcement effect. Blending the inorganic DDSQ-OCN cage into the epoxy resin improved its thermal and mechanical stabilities after the ring-opening polymerization of the epoxy units during thermal polymerization. The enhancement in the physical properties arose from the copolymerization of the epoxy and OCN units to form the organic/inorganic covalently bonded network structure, as well as the hydrogen bonding of the OH groups of the epoxy with the SiOSi moieties of the DDSQ units. For example, the epoxy/DDSQ-OCN = 1/1 hybrid, prepared without Cu(II)-acac as a catalyst, exhibited a glass transition temperature, thermal decomposition temperature (Td), and char yield (166 °C, 427 °C, and 51.0 wt%, respectively) that were significantly higher than those obtained when applying typical organic curing agents in the epoxy resin. The addition of Cu(II)-acac into the epoxy/BADCy and epoxy/DDSQ-OCN hybrids decreased the thermal stability (as characterized by the values of Td and the char yields) because the crosslinking density and post-hardening also decreased during thermal polymerization; nevertheless, it accelerated the thermal polymerization to a lower curing peak temperature, which is potentially useful for real applications as epoxy molding compounds.

Hydroxyl-Functionalized Covalent Organic Frameworks as High-Performance Supercapacitors.

Covalent organic frameworks (COFs) have attracted significant interest because of their heteroatom-containing architectures, high porous networks, large surface areas, and capacity to include redox-active units, which can provide good electrochemical efficiency in energy applications. In this research, we synthesized two novel hydroxy-functionalized COFs-TAPT-2,3-NA(OH)2, TAPT-2,6-NA(OH)2 COFs-through Schiff-base [3 + 2] polycondensations of 1,3,5-tris-(4-aminophenyl)triazine (TAPT-3NH2) with 2,3-dihydroxynaphthalene-1,4-dicarbaldehyde (2,3-NADC) and 2,6-dihydroxynaphthalene-1,5-dicarbaldehyde (2,6-NADC), respectively. The resultant hydroxy-functionalized COFs featured high BET-specific surface areas up to 1089 m2 g-1, excellent crystallinity, and superior thermal stability up to 60.44% char yield. When used as supercapacitor electrodes, the hydroxy-functionalized COFs exhibited electrochemical redox activity due to the presence of redox-active 2,3-dihydroxynaphthalene and 2,6-dihydroxynaphthalene in their COF skeletons. The hydroxy-functionalized COFs showed specific capacitance of 271 F g-1 at a current density of 0.5 A g-1 with excellent stability after 2000 cycles of 86.5% capacitance retention. Well-known pore features and high surface areas of such COFs, together with their superior supercapacitor performance, make them suitable electrode materials for use in practical applications.

The impact of milk suckling protocol and schedule on body weight and some morphometric measurements of Holstein heifers.

Having a successful heifer raising operation is not only relevant financially, but also influential for the future of the dairy herds. Milk feeding has a significant role on the health and growth of calves before weaning, in addition to the direct progressive effects on future performance post-weaning. Therefore, the aim of this study was to compare the effects of constants amount of milk (CMS) versus step-up/step-down (SUSD) on calf performance in two different suckling schedules of suckling milk gradually till 9th weeks of calf age, then decreasing it till weaning. For this study, forty Holstein heifers calves utilized between birth and 8 months of age were randomly divided into four groups of 10 calves each. Grouping was performed according to suckling protocol (constant versus variable) and suckling schedule (2 versus 3 times/day). Each calf suckled 600 kg of milk in a suckling period of 120 days. Body weight (BW), in addition to five body measurements: chest girth (CG), height at wither (HW), height at rump (HR), body length (BL), and diagonal length (DL), were recorded weekly. The heaviest BW was observed on SUSD calves suckling twice/day which had also the highest HW at weaning. Similarly, were BW, HW, and CG at 6 months of age. Also, the same group achieved the largest daily BW (0.902 kg/day), BL (0.246 cm), and CG (0.338 cm/day) gains during the pre-weaning phase. However, CMS suckled 3 times/day calves had the largest daily BW gain between birth and 6 or 8 months of age. CMS twice/day calves had the largest daily gain in CG from weaning to 6 months and from weaning to 8 months of age followed by SUSD suckling 3 times/day calves. Also, CMS twice/day calves had the largest daily gain in rump height from birth to 8 months of age compared to other groups. It can be concluded that when equal amounts of milk were fed during the suckling period, suckling protocol affected growth rate before weaning but that effect diminished as calf age increased after weaning.

Effects of adding low-dose ketamine to etomidate on serum cortisol levels in critically ill cardiac patients: a randomized clinical trial.

BACKGROUND: Etomidate was associated with an inhibition of adrenal steroid synthesis. This study aimed to evaluate the effects of adding low-dose ketamine to etomidate to minimize the decrease in serum cortisol level in critically ill cardiac patients. METHODS: Sixty adult cardiac patients, ≥ 18 years, who underwent upper endoscopy and Colonoscopy to manage acute anemia in the cardiac intensive care units were enrolled. Patients were randomly divided into two groups: (group (E): n = 30) received etomidate 0.2 mg/kg IV followed by etomidate 0.05 mg/kg IV, and (group (KE): n = 30) received ketamine 0.5 mg/kg IV, then etomidate 0.1 mg/kg IV, followed by etomidate 0.05 mg/kg IV. The primary outcome was Serum cortisol level at 6 h after the procedure. RESULTS: The mean postoperative cortisol level was significantly lower in group E (295.60 ± 49.218 nmol/L) versus group KE (461.00 ± 67.946 nmol/L), with 95% CI = 351.94 to 404.66; p = 0.000. In addition, the estimated serum cortisol reduction level was also significant between groups; In group E, the estimated cortisol level decreased nearly 53% from 632.40 ± 35.066 nmol/L to 295.60 ± 49.218 nmol/L 6 hours postoperative. While in group KE, the estimated cortisol level decreased only 27% from 639.13 ± 43.035 nmol/L to 461.00 ± 67.946 nmol/L. CONCLUSIONS: Single-dose ketamine (0.5 mg/kg) was helpful to decrease the total dose of etomidate and hence decreased the percentage of serum cortisol level in such critically ill patients with preservation of patient satisfaction. TRIAL REGISTRATION: This study is registered on ClinicalTrials.gov ( NCT04857450 ; principal investigator: Mostafa Mohammed Elsaid Elhamamsy; registration date: 23/04/ 2021).

The Analgesic Efficacy of Ultrasound-Guided Bilateral Transversus Thoracic Muscle Plane Block After Open-Heart Surgeries: A Randomized Controlled Study.

Background: We aimed to evaluate the analgesic efficacy of ultrasound-guided bilateral transversus thoracic muscle plane block after open-heart surgeries. Methods: Seventy patients aged above 18 years and scheduled for valve replacement or adult congenital via median sternotomy were enrolled in this study. Patients were divided into two groups, randomized by computer-generated random numbers: the block group, which had the ultrasound-guided bilateral transversus thoracic muscle plane block, and the control group, which had a sham block. The primary outcome was total fentanyl consumption in the first 24-hours. The secondary outcomes were pain score, time to the first analgesic request, time to extubation, ICU stays, and hospital stay. Results: The total fentanyl consumption in the first 24 hours was significantly lower in the block group, with a mean difference of -158.286 (95% CI = (-179.271 to -137.300; p =<0.0001)). The time to the first analgesic request was statistically significantly shorter in the non-block group (median 3 hours) than the block group (median 14 hours). During the postoperative period (0.5-24 hours), at-rest pain scores were 1.86 units lower in the block group (the estimate was -1.80, 95% CI = -2.14 to -1.45, t = -10.323 with p < 0.0001). Likewise, pain scores with cough were 3.29 units lower in the block group (the estimate was -3.29, 95% CI = -3.80 to -2.77, t = -12.703, p < 0.0001). Conclusion: Bilateral transversus thoracic muscle plane block is a promising and effective technique in reducing opioid consumption and controlling post-sternotomy pain after open-heart surgery via median sternotomy.