Sodium-glucose cotransporter-2 inhibitors improve cardiovascular outcomes post-acute coronary syndrome complicated by acute heart failure.

Background: Acute coronary syndrome (ACS) remains a risk factor for heart failure (HF). Therefore, we aimed to assess the cardioprotective role of sodium-glucose cotransporter-2 (SGLT2) inhibitors post-ACS in patients with acute HF (AHF) and diabetes. Methods: We conducted a retrospective observational cohort study employing propensity score matching. This study involved patients with diabetes admitted with ACS complicated by AHF, defined as either new clinical HF requiring diuretics during the index admission or having an ejection fraction (EF) of <40%. The study population was divided into two groups; (1) SGLT2 inhibitor users and (2) SGLT2 inhibitor non-users. The Cox proportional hazard regression analysis was used to evaluate the outcomes. Results: A total of 465 patients (93% male; mean age, 55 ± 10 years) were included in this study. Using a 1 : 1 propensity score matching, 78 patients were included per arm with an absolute standardized difference of <0.1 for all baseline characteristics. The use of SGLT2 inhibitors resulted in lower composite outcomes of ACS, HF hospitalization, and all-cause mortality at 1 month and 12 months [1 month: 2.6% vs. 11.5%, HR = 0.20 (0.04-0.94), p = 0.041; 12 months: 14.1% vs. 23.1%, HR = 0.46 (0.22-0.99), p = 0.046]. Conclusion: The findings suggest that SGLT2 inhibitors may confer cardioprotective effects in ACS-induced AHF, thereby widening the spectrum for indications of SGLT2 inhibitors.

New photocatalytic materials based on alumina with reduced band gap: A DFT approach to study the band structure and optical properties.

In this study, first-principles calculations using Density Functional Theory (DFT) have been conducted, which were carried out using the Vienna Ab initio Simulation Package (VASP) to examine the effect of Tl insertion on electronic and optical properties of the α-Al2O3. Alumina materials are abundant and the main shortcoming of alumina for photocatalyst applications is their large energy band gap and little absorption in the visible region of electromagnetic (EM) radiation. Insertion of transition metals (TM) into semiconductor or insulating materials is a hot approach to improve the absorption behavior of these materials using DFT assessment. In the current work an analysis of the band structure (BS) and the density of states (DOS); comprising both the total density of states (TDOS) as well as the partial density of states (PDOS) were carried out. The BS diagram revealed that various concentrations of Tl insertion into the α-Al2O3 reduced the band gap to 2.38 eV. In the density of state diagram, the band gap energy shifted to lower photon energies with increasing Tl concentrations which supports the BS results. The band gap obtained from the first peak in the imaginary part of dielectric function is close enough to those established from the BS diagram. Distinguished shifting of absorption coefficient to lower photon energy (2.27 eV) reveals the suitability of the doped α-Al2O3 for various applications. The increase of refractive index (n) with increasing of Tl into the α-Al2O3 structure is evidence for the increase of charge, which is a source for polarization and attenuates the velocity of light in a medium. The increase of optical conductivity with photon energy started after band gap values. The reflectance, absorbance and transmittance results indicate that the doped α-Al2O3 is responsive to the visible region of EM radiation while in pure state almost transparent.

Pulmonary Enteric Adenocarcinoma: A Very Rare Case Report from Qatar.

A 78-year-old male patient presented with dyspnea, loss of appetite, and weight loss. Workup and imaging showed suspected malignant lung lesion. Biopsy was done and showed features of pulmonary enteric adenocarcinoma (PEAC). This is a very rare disease and its diagnosis is challenging.

Endomyocardial Fibrosis With Bilateral Ventricular Thrombus: A Case Report and Literature Review.

Endomyocardial fibrosis (EMF) is a rare restrictive cardiomyopathy in non-tropical areas. It is seen in most of the patients living in or coming from tropical areas, and is rarely seen in patients who have never visited these areas. It is characterized by fibrotic thickening of the endocardium, predominantly affecting the ventricular apices and inflow tracts. Although thrombus formation is a known complication in various cardiac conditions such as atrial fibrillation, atrial flutter, ventricular heart disease, and patent foramen ovale, the occurrence of bilateral thrombus in EMF is exceptionally rare. We present a case report describing a unique finding of bilateral ventricular thrombus in a patient diagnosed with EMF, highlighting the clinical presentation, diagnostic approach, and management challenges associated with this rare phenomenon.

A Challenging Case of Adult-Onset Still's Disease Complicated by Macrophage Activation Syndrome With Multiorgan Failure.

Adult-onset Still's disease (AOSD) is a rare systemic inflammatory disease that involves the excessive production of proinflammatory cytokines. Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening immune-mediated disorder that can be primary or secondary to malignancy, infections, and autoimmune diseases. We present an interesting case of a young female with adult-onset Still's disease that commenced during pregnancy. Whole-body fluorodeoxyglucose (FDG)-positron emission tomography (PET)/computed tomography (CT) scan showed diffuse uptake in the spleen and bone marrow with widespread lymphadenopathy. During the delayed diagnostic process to exclude lymphoproliferative malignancy, she developed severe HLH/macrophage activation syndrome (MAS) with multiorgan failure. In this case report, we described the challenges faced during the diagnosis of AOSD. We also highlighted the importance of using clinical criteria to aid in the early diagnosis and management of AOSD patients and the role of FDG-PET/CT scans in patients with AOSD. Additionally, we discussed the management aspects for patients with macrophage activation syndrome.

A Subacute Presentation of Isolated Tuberculous Septic Hip Arthritis.

Tuberculous septic arthritis is a rare type of septic arthritis that is caused by Mycobacterium tuberculosis. However, it can lead to devastating complications if not diagnosed and treated correctly. We hereby report a 41-year-old female with no medical history who presented with a three-week history of right hip pain and inability to bear weight, found to have moderate to severe tenderness at the right anterior hip and gluteal area and limitation of joint movement. Magnetic resonance imaging (MRI) of the hip showed features of right hip septic arthritis with synovitis and anteromedial and posteromedial small collections. She was diagnosed with tuberculosis (TB) after joint fluid aspiration, and she was started on anti-TB treatment including isoniazid, rifampicin, ethambutol, and pyrazinamide directly after. Considering the case and the subacute presentation that can mimic bacterial septic arthritis, clinicians should always consider TB infection in their differential diagnosis upon assessing a suspected patient with septic arthritis even with a subacute presentation to achieve the correct diagnosis and start appropriate treatment to avoid its harmful complications.

Recurrence of acute chest syndrome post stopping Crizanlizumab, the dilemma of stopping vs continuation in patient with sickle cell disease: case report.

Sickle cell disease (SCD) is one of the most common hematological diseases, which results in variable complications. The treatment of SCD is evolving but limited options are available for now. Acute chest syndrome (ACS) is one of the serious complications observed in SCD and a challenging one in prevention. Crizanlizumab is a monoclonal antibody that binds to P-selectin and improves blood flow by preventing sickle cell adhesion to endothelium, resulting in improvement of vaso-oclusive crises (VOC). It is not well evaluated in terms of ACS prevention. Here we report a 23-year-old patient with SCD and recurrent ACS; she was started on Crizanlizumab and she had no more ACS, but once she was off Crizanlizumab she developed ACS again, later Crizanlizumab was re-started, and the patient has improved significantly.

A Challenging Case of a Patient With Immune Thrombocytopenic Purpura on Eltrombopag Who Developed Atrial Fibrillation: An Anticoagulation Dilemma.

A 61-year-old female, who was a known case of immune thrombocytopenic purpura (ITP) on eltrombopag, was admitted for atrial fibrillation (AF). Labs showed a platelet count of 116 × 103/µL. AF reverted to sinus rhythm by cardioversion. Therapeutic enoxaparin was started for two days. She was discharged on dabigatran for four weeks. The choice of anticoagulation in these cases (ITP and AF) is not straightforward and needs further research.

Radioactive Iodine-Induced Chronic Myeloid Leukemia in a Patient With Graves' Disease: A Case Report.

Therapy-related leukemia is an increasing concern in hematology. One of these substances that showed to increase the incidence of leukemia is radioactive iodine (RAI). We report here a case of radioactive iodine-induced chronic myeloid leukemia (CML) in a patient with Graves' disease, although most cases in the literature were for thyroid cancer. Also, our patient received a very low dose, which is unique compared to previous case reports in the literature.

Solar-driven desalination using salt-rejecting plasmonic cellulose nanofiber membrane.

Solar-driven steam generation is a promising, renewable, effective, and environment-friendly technology for desalination and water purification. However, steam generation from seawater causes severe salt formation on the photothermal material, which hinders long-term and large-scale practical applications. In this study, we develop salt-rejecting plasmonic cellulose-based membranes (CMNF-NP) composed of an optimized ratio of Au/Ag nanoparticles, cellulose micro/nanofibers, and polyethyleneimine for efficient solar-driven desalination. The CMNF-NP exhibits a water evaporation rate of 1.31 kg m-2h-1 (82.1% of solar-to-vapor conversion efficiency) for distilled water under 1-sun. The CMNF-NP shows a comparable evaporation rate for 3.5 wt% brine, which has been maintained for 10 h; the evaporation rate of the filter paper-based counterpart severely decreases because of salt-scaling. The efficient salt-rejecting capability of the CMNF-NP membrane is attributed to the compact structure and electrostatic repulsion of cationic ions of salt that originate from cellulose nanofibers and the amine-functionalized polymer, polyethyleneimine, as a structural binder. This simple fabrication method of casting the CMNF-NP solution on the substrate followed by drying allows a facile coating of a highly efficient and salt-rejecting photothermal membrane on various practical substrates.

Optimization of soluble phosphate and IAA production using response surface methodology and ANN approach.

Phosphorus (P) is often found inaccessible to plants, as it forms precipitates with cations and can be converted to accessible forms by using Phosphate solubilizing bacteria (PSB). In the present study, isolation and characterization of PSB from rhizospheric soil of coffee plants were performed. The influence of four independent variables (incubation temperature, incubation time, pH, and inoculum size) was investigated and optimized using an artificial neural network and response surface methodology on the solubility of phosphate and indole acetic acid production. The bacterium that can dissolve phosphate were isolated in Pikovskaya's agar containing insoluble tricalcium phosphate. Total, six Phosphate Solubilizing Bacteria were isolated and three of them (PSB1, PSB3, and PSB4) were found to be effectively solubilizing phosphate. Based on phosphate solubilizing index results Pseudomonas bacteria (PSB1) was selected for modeling. The results showed that both models performed reasonably well, but properly trained artificial neural networks have the more powerful modeling capability compared to the response surface method. The optimum conditions were found to be incubation temperature of 37.5 °C, incubation time of 9 days, pH of 7.2, and inoculum size of 1.89 OD. Under these conditions, the model predicted solubility of phosphate of 260.69 µg/ml and production of IAA of 80.00 µg/ml with a desirability value of 0.947. In general, the isolated Pseudomonas is expected to have phosphorus-degrading ability that promotes plant growth, and further field experimental work is required to use this bacterial strain as biofertilizer, as an alternative to synthetic fertilizer.

Bovine schistosomiasis in some selected areas of South Wollo and Oromia Zones of Amhara Region, North-East Ethiopia.

A cross-sectional coprological and pathological study was conducted in five districts of South Wollo and Oromia Administrative Zones, Amhara regional state, Ethiopia from November 2020 to June 2021 to determine the prevalence and associated risk factors of Bovine Schistosomiasis and to characterize pathological lesions induced by the adult worm of Schistosoma bovis. For coprological examination, a total of 768 fecal samples were collected both from the field (384) and the abattoirs (384). An abattoir survey was carried out on 384 cattle to evaluate the performance of the sedimentation method. The risk factors were identified using multivariable mixed-effect logistic regression analyses. The diagnostic efficacy of the sedimentation technique was determined by calculating sensitivity and specificity considering postmortem examination as a reference test. The overall prevalence of bovine shistosomiasis using coprological examination was found to be 16.7% (95% CI = 14.10-19.49). The prevalence of shistosomiasis based on post-mortem examination was found to be 17.19% (95% CI = 13.55-21.34). Local cattle breed (OR = 2.44, 95%CI = 1.34-4.43), poor body condition (OR = 4.09, 95% CI = 2.45-6.83) and adult (OR = 1.78, 95% CI = 1.21-3.28) cattle are more likely to acquire shistosomiasis than crossbreed, good body condition, and young cattle. The sensitivity and specificity of sedimentation techniques, keeping postmortem examination as a reference test were 74.24% (95%CI = 61.99-84.22) and 98.11% (95%CI = 95.94-99.30), respectively. The major gross lesions were observed in the liver and intestinal tracts. In conclusion, adult local cattle with medium and poor body conditions should be prioritized for deworming and future surveillance.

COVID-19-related anxiety and knowledge toward its preventive measures among patients with chronic medical illness on follow-up in public hospitals of Bale, East Bale, and West Arsi zones, Ethiopia.

BACKGROUND: Coronavirus disease 2019, also known as 2019-nCoV cluster of acute respiratory illness with unknown causes, which occurred in Wuhan, Hubei Province, in China, was first reported to World Health Organization country office as of December 30, 2019. People with medical illness are at a higher risk for coronavirus disease, and the pandemic influences mental health and causes psychological problems, particularly in those with chronic medical illness. Hence, this study aimed to assess coronavirus disease 2019-related anxiety and the knowledge on its preventive measures among patients with medical illness on follow-up in public hospitals of Bale, East Bale, and Arsi zones. OBJECTIVE: To assess coronavirus disease 2019-related anxiety and knowledge toward coronavirus disease 2019 preventive measures among patients with chronic medical illness on follow-up in public hospitals of Bale, East Bale, and West Arsi zones. METHODS: A hospital-based cross-sectional study was conducted in selected hospitals of Bale and West Arsi zones, Southeast Ethiopia. A total of 633 study participants were included in this study, and data were collected through an interviewer-administered questionnaire. A descriptive summary was computed. Bivariable and multivariable logistic regression analyses were carried out to identify the associated factors. RESULTS: Overall, the prevalence of anxiety among chronic patients in this study was 6.3% (95% confidence interval: 4.6%-8.5%) and 420 (66.35%) had good knowledge on the preventive measures of coronavirus disease 2019. Factors significantly associated with anxiety among chronic patients were being educated (95% confidence interval: adjusted odds ratio = 0.26 (0.09-0.74)), being male (95% confidence interval: 2.69 (1.11-6.53)), and use of mask (95% confidence interval: 0.11 (0.05-0.26)). CONCLUSION: The prevalence of coronavirus disease 2019-related anxiety among chronic patients was high and being males, uneducated, and not using face mask was significantly associated with coronavirus disease 2019-related anxiety.

Rainwater-driven microbial fuel cells for power generation in remote areas.

The possibility of using rainwater as a sustainable anolyte in an air-cathode microbial fuel cell (MFC) is investigated in this study. The results indicate that the proposed MFC can work within a wide temperature range (from 0 to 30°C) and under aerobic or anaerobic conditions. However, the rainwater season has a distinct impact. Under anaerobic conditions, the summer rainwater achieves a promised open circuit potential (OCP) of 553 ± 2 mV without addition of nutrients at the ambient temperature, while addition of nutrients leads to an increase in the cell voltage to 763 ± 3 and 588 ± 2 mV at 30°C and ambient temperature, respectively. The maximum OCP for the winter rainwater (492 ± 1.5 mV) is obtained when the reactor is exposed to the air (aerobic conditions) at ambient temperature. Furthermore, the winter rainwater MFC generates a maximum power output of 7 ± 0.1 mWm-2 at a corresponding current density value of 44 ± 0.7 mAm-2 at 30°C. While, at the ambient temperature, the maximum output power is obtained with the summer rainwater (7.2 ± 0.1 mWm-2 at 26 ± 0.5 mAm-2). Moreover, investigation of the bacterial diversity indicates that Lactobacillus spp. is the dominant electroactive genus in the summer rainwater, while in the winter rainwater, Staphylococcus spp. is the main electroactive bacteria. The cyclic voltammetry analysis confirms that the electrons are delivered directly from the bacterial biofilm to the anode surface and without mediators. Overall, this study opens a new avenue for using a novel sustainable type of MFC derived from rainwater.

Efficiency Enhancement of Electro-Adsorption Desalination Using Iron Oxide Nanoparticle-Incorporated Activated Carbon Nanocomposite.

Capacitive deionization (CDI) technology is currently considered a potential candidate for brackish water desalination. In this study, we designed iron oxide nanoparticle-incorporated activated carbon (AC/Fe2O3) via a facile and cost-effective hydrothermal process. The as-synthesized material was characterized using several techniques and tested as electrodes in CDI applications. We found that the distinctive properties of the AC/Fe2O3 electrode, i.e., high wettability, high surface area, unique structural morphology, and high conductivity, resulted in promising CDI performance. The electrosorptive capacity of the AC/Fe2O3 nanocomposite reached 6.76 mg g-1 in the CDI process, with a high specific capacitance of 1157.5 F g-1 at 10 mV s-1 in a 1 M NaCl electrolyte. This study confirms the potential use of AC/Fe2O3 nanocomposites as viable electrode materials in CDI and other electrochemical applications.

Cheap, facile, and upscalable activated carbon-based photothermal layers for solar steam generation.

Solar-to-steam generation characterized by nanostructured photothermal materials and interfacial heating is developed based on various carbon nanostructures such as graphene, reduced graphene oxide, CNT, or their combinations. However, multiple and sophisticated synthetic steps are required to generate macroscopic porosity in photothermal devices for the efficient mass transport of water and generated steam. Additionally, the fabrication of photothermal layers on a practical scale constitutes the main hurdle for real applications toward solar-driven desalination. Herein, we report on the development of highly efficient photothermal layers with a commercially available low-cost material, activated carbon (AC), by using facile filtration and spray coating methods, which lead to the generation of intraparticle porous structure without any additional processing. The AC-based photothermal layers generated 1.17 kg m-2 h-1 of steam under 1 sun, and 4.7 wt% of polyethyleneimine coating on AC enhanced steam generation by 8.5% under 1 sun, corresponding to 1.27 kg m-2 h-1 of the water evaporation rate and 85.66% of the photothermal conversion efficiency. This was due to improvements in light absorption and water uptake properties with the additional advantage of mechanical robustness. The outdoor solar-to-steam generation test with the spray-coated A4-sized photothermal layer in conjunction with the desalination test demonstrated the potential for practical desalination application with upscalability.

Facile synthesis of TiO2/ZrO2 nanofibers/nitrogen co-doped activated carbon to enhance the desalination and bacterial inactivation via capacitive deionization.

Capacitive deionization, as a second generation electrosorption technique to obtain water, is one of the most promising water desalination technologies. Yet; in order to achieve high CDI performance, a well-designed structure of the electrode materials is needed, and is in high demand. Here, a novel composite nitrogen-TiO2/ZrO2 nanofibers incorporated activated carbon (NACTZ) is synthesized for the first time with enhanced desalination efficiency as well as disinfection performance towards brackish water. Nitrogen and TiO2/ZrO2 nanofibers are used as the support of activated carbon to improve its low capacitance and hydrophobicity, which had dramatically limited its adequacy during the CDI process. Importantly, the as-fabricated NACTZ nanocomposite demonstrates enhanced electrochemical performance with significant specific capacitance of 691.78 F g-1, low internal resistance and good cycling stability. In addition, it offers a high capacitive deionization performance of NACTZ yield with electrosorptive capacity of 3.98 mg g-1, and, good antibacterial effects as well. This work will provide an effective solution for developing highly performance and low-cost design for CDI electrode materials.

A Multifunctional Zinc Oxide/Poly(Lactic Acid) Nanocomposite Layer Coated on Magnesium Alloys for Controlled Degradation and Antibacterial Function.

In the present work, magnesium (Mg) AZ31 alloy was coated with a multifunctional membrane layer composed of ZnO nanoparticles (NPs) embedded in a poly(lactic acid) (PLA) matrix. We aimed to produce a stable coating that would be used to control the degradation rate of the Mg alloy and promote a local antibacterial activity. ZnO NPs were dispersed at 5 and 10 wt % in a PLA solution and dip-coated onto the AZ31 substrate. Surface topography, chemical composition, thickness, electrochemical corrosion performance, mass variation, antibacterial activity, adhesion performance, and cytotoxicity of an uncoated control and coated alloys were investigated. The results indicated that the incorporation of ZnO NPs at various concentrations affords a dramatic control over surface topography and degradation rates under in vitro and in vivo environmental conditions when compared to the uncoated Mg alloy control. In addition, the results confirmed that the coated layer exerts antibacterial properties and supports cell growth, indicating this system may have utility for bone tissue engineering applications.

Under-oil superhydrophilic wetted PVDF electrospun modified membrane for continuous gravitational oil/water separation with outstanding flux.

Water in the world is becoming an increasingly scarce commodity and the membrane technology is a most effective strategy to address this issue. However, the fouling and low flux of the polymeric membrane remains the big challenges. Novel modified Polyvinylidene fluoride (PVDF) membrane was introduced, in this work, using a novel treatment technique for an electrospun polymeric PVDF membrane to be used in oil/water separation systems. The Characterizations of the modified and pristine membranes showed distinct changes in the phase and crystal structure of the membrane material as well as the wettability. The modification process altered the surface morphology and structure of the membrane by forming hydrophilic microspheres on the membrane surface. Therefore, the proposed treatment converts the membrane from highly hydrophobic to be a superhydrophilic under-oil when wetted with water. Accordingly, in the separation of oil/water mixtures, the modified membrane can achieve an outstanding flux of 20664 L/m2. hr under gravity, which is higher than the pristine membrane by infinite times. Moreover, in the separation of the emulsion, a high flux of 2727 L/m2. h was achieved. The results exhibited that the modified membrane can treat a huge amount of oily water with a minimal energy consumption. The corresponding separation efficiencies of both of oil/water mixtures and emulsion are more than 99%. The achieved characteristics for the modified and pristine membranes could be exploited to design a novel continuous system for oil/water separation with an excellent efficiency.

Facile synthesis of GO@SnO2/TiO2 nanofibers and their behavior in photovoltaics.

Chemical doping is a widely-used strategy to improve the performance of TiO2 for the dye-sensitized solar cells (DSCs). However, the effect of two efficient dopants has been rarely investigated. We present the synthesis of GO@SnO2/TiO2 nanofibers (NFs) by a facile method using electrospinning and hydrothermal processes. The synthesized NFs are described in terms of morphology, crystallinity and chemistry through FESEM, TEM, HR-TEM, XRD, EDX, XPS, FT-IR and Raman spectra. As the results, the axial ratio and the average diameter of NFs decreased after the hydrothermal treatment and calcination process, respectively. The prepared Titania-based nanofibers have 81.82% anatase and 18.18% rutile-structure. The developed materials are applied as working electrodes of DSCs. The photovoltaic performances showed that the efficiency of the device employed GO@SnO2/TiO2 photoanode gave 5.41%, which was higher than those of cells fabricated with SnO2/TiO2 NFs (3.41%) and GO@TiO2 NFs (4.52%) photoanodes. The photovoltaic parameters such as Jsc, Voc, FF and Rct are calculated and found to be 11.19mAcm-2, 0.72V, 0.67 and 9.26Ω, respectively. The high photovoltaic response of DSC based of GO@SnO2/TiO2 NFs may be attributed to the large surface area of the NFs, and the low electron recombination. Furthermore, the start-stop switches of the cell devices with the developed photoanode affirmed the stability and photovoltaic performance of the cell.