Tuning the band gap, optical, mechanical, and electrical features of a bio-blend by Cr2O3/V2O5 nanofillers for optoelectronics and energy applications.

This work presents a facile approach for controlling the optical and electrical parameters of a biopolymeric matrix for optoelectronics. Vanadium oxide (V2O5) and chromium oxide (Cr2O3) nanoparticles (NPs) were prepared and incorporated into the carboxymethylcellulose/polyethylene glycol (CMC/PEG) blend by simple chemical techniques. Transmission electron microscopy (HR-TEM), and X-ray diffraction (XRD) data showed that V2O5 and Cr2O3 exhibited spherical shapes with sizes in the range of 40-50 nm and 10-20 nm, respectively. In addition, the blend's degree of crystallinity was sensitive to the V2O5 and Cr2O3 doping ratios. The scanning electron microscopy (FE-SEM) and the elemental chemical analysis (EDAX) used to study the filler distribution inside the blend, and confirmed the existence of both V and Cr in the matrix. Fourier transform infrared (FTIR) spectroscopy showed that the dopants significantly affected the blend reactive (C-O-C, OH, and C=O) groups. The stress-strain curves illustrated the reinforcing effect of the dopants up to 1.0 wt\% Cr2O3/V. The transmittance and absorption index spectra in the visible-IR wavelengths decreased with increasing filler content. Utilizing Tauc's relation and (optical) dielectric loss, the direct (indirect) band gap narrowed from 5.6 (4.5) eV to 4.7 (3.05) eV at 1.0   wt\% Cr2O3/V. All films have an index of refraction in the range of 1.93-2.17. AC conductivity was improved with increasing filler content and temperature. The energy density at 50 °C is in the range of 1-3 J/m3. The influence of V2O5 and Cr2O3 content on the optical conductivity, dielectric constant, loss, and dielectric modulus of CMC/PEG was reported. These enhancements in electrical and optical properties, along with the potential for band gap engineering, offer promising prospects for advanced applications in optoelectronics and energy-related fields.

Synthesis, structural, optical, and thermal properties of LaFeO3/Poly(methyl methacrylate)/Poly(vinyl acetate) nanocomposites for radiation shielding.

This work is an attempt to develop flexible radiation shielding based on a blend of polymethyl methacrylate (PMMA)/polyvinyl acetate (PVAc) and LaFeO3 nanoparticles (NPs). LaFeO3 and LaFeO3/PMMA/PVAc were made using simple chemical techniques. A high-resolution transmission electron microscope (HR-TEM) and X-ray diffraction (XRD) showed that well-crystallized LaFeO3 NPs with particles 79 nm in size and an orthorhombic shape were obtained. In addition, XRD confirmed the existence of PMMA, PVAc, and LaFeO3 in the nanocomposite films. Fourier transform infrared (FTIR) confirmed that the LaFeO3 NPs and the reactive functional groups in the blend interacted with each other. Field emission-scan electron microscope (FE-SEM) analysis showed that PMMA and PVAc form a homogenous blend and that the LaFeO3 NPs were spread out inside and on the blend surface. The samples showed transmittance in the range of 30-74% and a small extinction coefficient (≤ 0.08). The samples exhibited a dual-band gap structure, and the direct (indirect) band gap shrank from 5.1 to 4.7 eV (4.9 to 4.4 eV). The thermal analyses showed that the samples are thermally stable up to 260 °C. The Phy-X/PSD software was used to figure out the theoretical gamma-ray attenuation parameters, such as the mass attenuation coefficient, the mean free path, and the half-value layer, for different PMMA/PVAc + x% LaFeO3 composites. It is demonstrated that the PMMA/PVAc + 10 wt% LaFeO3 sample exhibits much better shielding effectiveness than PMMA/PVAc, and hence it is suitable for protecting against radiation.

Improving the structural, optical, and electrical properties of carboxymethyl cellulose/starch/selenium oxide nanocomposites for flexible electronic devices.

Nanocomposites based on biopolymers are interesting materials owing to their multifunctionality and ease of preparation. In this study, the solution casting method was used to mix selenium oxide nanoparticles (SeO2 NP) made by a solvothermal method into a bio-blend of carboxymethyl cellulose and starch (CMC/St). XRD analysis showed that SeO2 NP increased the amorphous portion inside the blend. HR-TEM revealed the spherical morphology of these NP with an average diameter of 16.88 nm. The FE-SEM indicated a satisfactory uniform distribution and homogeneity in the surface morphology of the films. FTIR confirmed the interaction between SeO2 and the blend functional groups. The films preserved good transmission after doping, and their direct and indirect band gaps decreased. The refractive index, absorption index, optical conductivity, and other dispersion parameters were improved after SeO2 loading. The DC conductivity of the blend is in the range of 3.8 × 10-7 to 5.6 × 10-4 S/m and improved after loading SeO2 NP. The IV characteristic curves in the temperature range of 300-415 K were studied to figure out the conduction mechanism in the CMC/St/SeO2 composites. Because the optical and electrical properties improved, these nanocomposites could be used for coatings and other things like waveguides, photovoltaic cells, and light-emitting diodes.

Design of high-sensitivity La-doped ZnO sensors for CO2 gas detection at room temperature.

For the sake of people's health and the safety of the environment, more efforts should be directed towards the fabrication of gas sensors that can operate effectively at room temperature (RT). In this context, increased attention has been paid to developing gas sensors based on rare-earth (RE)-doped transparent conducting oxides (TCO). In this report, lanthanum-doped zinc oxide (La-doped ZnO) films were fabricated by sol-gel and spin-coating techniques. XRD analysis revealed the hexagonal structure of the ZnO films, with preferred growth along the (002) direction. The crystallite size was decreased from 33.21 to 26.41 nm with increasing La content to 4.0 at.%. The UV-vis-NIR indicating that the films are highly transparent (˃ 80%), La-doping increased the UV blocking ability of the films and narrowed the optical band gap (Eg) from 3.275 to 3.125 eV. Additionally, La-doping has influenced the refractive index of the samples. Gas sensing measurements were performed at ambient temperature (30 °C) and a relative humidity (RH) of 30%, employing different flow rates of carbon dioxide (CO2) gas used synthetically with air. Among the evaluated sensors, the ZnO: 4.0 at.% La sensor exhibited the most significant gas response, with a value of 114.22%. This response was observed when the sensor was subjected to a flow rate of 200 SCCM of CO2 gas. Additionally, the sensor revealed a response time of 24.4 s and a recovery time of 44 s. The exceptional performance exhibited by the sensor makes it very appropriate for a wide range of industrial applications. Additionally, we assessed the effect of humidity, selectivity, reusability, repeatability, detection limit, and limit of quantification.

Influence of α-Fe2O3, CuO and GO 2D nano-fillers on the structure, physical properties and antifungal activity of Na-CMC-PAAm blend.

The present work aims to improve the uses of the carboxymethyl cellulose-polyacrylamide (Na-CMC-PAAm) blend for energy storage, optoelectronic applications, biological control, and plant disease management. Nano-sized materials (α-Fe2O3 nanoplates (NP), CuO NP, and GO nanosheets (NS), were synthesized and incorporated into the blend. The phase purity and morphologies of the used fillers were studied by XRD and HR-TEM. The interactions and complexation between the nano-fillers and the blend chains were investigated using XRD and FTIR spectra. The chemical composition and surface morphology of the nanocomposites were studied using EDS and FE-SEM analysis. UV-vis-NIR spectra revealed that the blend shows about 95% transmittance, reduced by 10-30% after doping. The absorption and refractive indices, as well as the optical gaps of the blend, were greatly affected by the doping. The dielectric constant and loss depend on the type of filler and the applied frequency. The maximum ac conductivity of the blend at 303 K and 4.0 MHz is 21.5 × 10-4 S/m and increased to 23.5 × 10-4 S/m after doping with CuO NP. The thermal stability, activation energy, stress-strain curves, and tensile strength are dependent on the filler type. All nanocomposite solutions except the blend exhibited a wide range of antifungal properties against pre- and post-harvest phytopathogenic fungi. Aspergillus niger among the examined fungi showed high sensitivity to the tested nanocomposite solutions. Furthermore, the CuO/blend nanocomposite had the highest antifungal activity against all tested fungi. Based on that, we suggest the use of CuO/blend and GO/blend nanocomposites to control and combat pre- and post-harvest fungal plant diseases.

Optical and radiation shielding properties of PVC/BiVO4 nanocomposite.

This study investigates the physical and optical properties as well as the radiation shielding capacity of polyvinyl chloride (PVC) loaded with x% of bismuth vanadate (BiVO4) (x = 0, 1, 3, and 6 wt%). As a non-toxic nanofiller, the designed materials are low-cost, flexible, and lightweight plastic to replace traditional lead, which is toxic and dense. XRD patterns and FTIR spectra demonstrated a successful fabrication and complexation of nanocomposite films. In addition, the particle size, morphology, and elemental composition of the BiVO4 nanofiller were demonstrated through the utilization of TEM, SEM, and EDX spectra. The MCNP5 simulation code assessed the gamma-ray shielding effectiveness of four PVC + x% BiVO4 nanocomposites. The obtained mass attenuation coefficient data of the developed nanocomposites were comparable to the theoretical calculation performed with Phy-X/PSD software. Moreover, the initial stage in the computation of various shielding parameters, such as half-value layer, tenth value layer, and mean free path, besides the simulation of linear attenuation coefficient. The transmission factor declines while radiation protection efficiency increases with an increase in the proportion of BiVO4 nanofiller. Further, the current investigation seeks to evaluate the thickness equivalent (Xeq), effective atomic number (Zeff), and effective electron density (Neff) values as a function of the concentration of BiVO4 in a PVC matrix. The results obtained from the parameters indicate that incorporating BiVO4 into PVC can be an effective strategy for developing sustainable and lead-free polymer nanocomposites, with potential uses in radiation shielding applications.

SCAPS simulation of novel inorganic ZrS2/CuO heterojunction solar cells.

ZrS2 is transition metal dichalcogenides (TMDCs) which is believed one of the most talented applicants to fabricate photovoltaics. Therefore, we present here for the first-time numerical simulation of novel inorganic ZrS2/CuO heterojunction solar cells employing SCAPS-1D. The influence of the thickness, carrier concentration, and bandgap for both the window and absorber layers on the solar cell fundamental parameters was explored intensely. Our results reveal that the solar cell devices performance is mainly affected by many parameters such as the depletion width (Wd), built-in voltage (Vbi), collection length of charge carrier, the minority carrier lifetime, photogenerated current, and recombination rate. The η of 23.8% was achieved as the highest value for our simulated devices with the Voc value of 0.96 V, the Jsc value of 34.2 mA/cm2, and the FF value of 72.2%. Such efficiency was obtained when the CuO band gap, thickness, and carrier concentration were 1.35 eV, 5.5 µm, and above 1018 cm-3, respectively, and for the ZrS2 were 1.4 eV, 1 µm, and less than 1020 cm-3, respectively. Our simulated results indicate that the inorganic ZrS2/CuO heterojunction solar cells are promising to fabricate low-cost, large-scale, and high-efficiency photovoltaic devices.

The Impact of Co Doping and Annealing Temperature on the Electrochemical Performance and Structural Characteristics of SnO2 Nanoparticulate Photoanodes.

Obtaining H2 energy from H2O using the most abundant solar radiation is an outstanding approach to zero pollution. This work focuses on studying the effect of Co doping and calcination on the structure, morphology, and optical properties of spin-coated SnO2 films as well as their photoelectrochemical (PEC) efficiency. The structures and morphologies of the films were investigated by XRD, AFM, and Raman spectra. The results confirmed the preparation of SnO2 of the rutile phase, with crystallite sizes in the range of 18.4-29.2 nm. AFM showed the granular structure and smooth surfaces having limited roughness. UV-Vis spectroscopy showed that the absorption spectra depend on the calcination temperature and the Co content, and the films have optical bandgap (Eg) in the range of 3.67-3.93 eV. The prepared samples were applied for the PEC hydrogen generation after optimizing the sample doping ratio, using electrolyte (HCl, Na2SO4, NaOH), electrode reusability, applied temperature, and monochromatic illumination. Additionally, the electrode stability, thermodynamic parameters, conversion efficiency, number of hydrogen moles, and PEC impedance were evaluated and discussed, while the SnO2 films were used as working electrodes and platinum sheet as an auxiliary or counter electrode (2-electrode system) and both were dipped in the electrolyte. The highest photocurrent (21.25 mA/cm2), number of hydrogen moles (20.4 mmol/h.cm2), incident photon-to-current change efficiency (6.892%@307 nm and +1 V), and the absorbed photon-to-current conversion efficiency (4.61% at ~500 nm and +1 V) were recorded for the 2.5% Co-doped SnO2 photoanode that annealed at 673 K.

The Influence of Electrode Thickness on the Structure and Water Splitting Performance of Iridium Oxide Nanostructured Films.

For a safe environment, humanity should be oriented towards renewable energy technology. Water splitting (WS), utilizing a photoelectrode with suitable thickness, morphology, and conductivity, is essential for efficient hydrogen production. In this report, iridium oxide (IrOx) films of high conductivity were spin-cast on glass substrates. FE-SEM showed that the films are of nanorod morphology and different thicknesses. UV-Vis spectra indicated that the absorption and reflectance of the films depend on their thickness. The optical band gap (Eg) was increased from 2.925 eV to 3.07 eV by varying the spin speed (SS) of the substrates in a range of 1.5 × 103-4.5 × 103 rpm. It was clear from the micro-Raman spectra that the films were amorphous. The Eg vibrational mode of Ir-O stretching was red-shifted from 563 cm-1 (for the rutile IrO2 single crystal) to 553 cm-1. The IrOx films were used to develop photoelectrochemical (PEC) hydrogen production catalysts in 0.5M of sodium sulfite heptahydrate Na2SO3·7H2O (2-electrode system), which exhibits higher hydrogen evaluation (HE) reaction activity, which is proportional to the thickness and absorbance of the used IrOx photocathode, as it showed an incident photon-to-current efficiency (IPCE%) of 7.069% at 390 nm and -1 V. Photocurrent density (Jph = 2.38 mA/cm2 at -1 V vs. platinum) and PEC hydrogen generation rate (83.68 mmol/ h cm2 at 1 V) are the best characteristics of the best electrode (the thickest and most absorbent IrOx photocathode). At -1 V and 500 nm, the absorbed photon-to-current conversion efficiency (APCE%) was 7.84%. Electrode stability, thermodynamic factors, solar-to-hydrogen conversion efficiency (STH), and electrochemical impedance spectroscopies (EISs) were also studied.

Psychosis as Initial Presentation of Small Cell Lung Cancer: A Case Report.

Paraneoplastic neurological syndromes (PNS) are a group of symptoms and physical findings that can reflect various neurological conditions, which may uncommonly include acute psychosis. In this report, we present the case of a 62-year-old African American male with a medical history significant for sarcoidosis and adrenal insufficiency who presented with several months of altered mentation and aggressive behavior of unknown etiology. Extensive laboratory workup, including lumbar puncture and cerebrospinal fluid antibodies, did not reveal any significant findings. Imaging studies, including computed tomography of the chest, showed mediastinal adenopathy and densities suggestive of metastatic small cell carcinoma, which was later confirmed following bronchoscopy and lymph node biopsy. A PNS was suspected as the explanation for the patient's psychiatric symptoms. Treatment with steroids and intravenous immunoglobulins was started, but there was no improvement. Surgery and systemic therapy were not recommended, and the family elected to pursue a palliative care option for the remainder of the patient's treatment. Our goal in this report is to provide basic information on PNS and highlight the need for a multidisciplinary approach to the diagnosis and treatment of these rare, albeit interesting, presentations.

Design of SnO2:Ni,Ir Nanoparticulate Photoelectrodes for Efficient Photoelectrochemical Water Splitting.

Currently, hydrogen generation via photocatalytic water splitting using semiconductors is regarded as a simple environmental solution to energy challenges. This paper discusses the effects of the doping of noble metals, Ir (3.0 at.%) and Ni (1.5-4.5 at.%), on the structure, morphology, optical properties, and photoelectrochemical performance of sol-gel-produced SnO2 thin films. The incorporation of Ir and Ni influences the position of the peaks and the lattice characteristics of the tetragonal polycrystalline SnO2 films. The films have a homogeneous, compact, and crack-free nanoparticulate morphology. As the doping level is increased, the grain size shrinks, and the films have a high proclivity for forming Sn-OH bonds. The optical bandgap of the un-doped film is 3.5 eV, which fluctuates depending on the doping elements and their ratios to 2.7 eV for the 3.0% Ni-doped SnO2:Ir Photoelectrochemical (PEC) electrode. This electrode produces the highest photocurrent density (Jph = 46.38 mA/cm2) and PEC hydrogen production rate (52.22 mmol h-1cm-2 at -1V), with an Incident-Photon-to-Current Efficiency (IPCE% )of 17.43% at 307 nm. The applied bias photon-to-current efficiency (ABPE) of this electrode is 1.038% at -0.839 V, with an offset of 0.391% at 0 V and 307 nm. These are the highest reported values for SnO2-based PEC catalysts. The electrolyte type influences the Jph values of photoelectrodes in the order Jph(HCl) > Jph(NaOH) > Jph(Na2SO4). After 12 runs of reusability at -1 V, the optimized photoelectrode shows high stability and retains about 94.95% of its initial PEC performance, with a corrosion rate of 5.46 nm/year. This research provides a novel doping technique for the development of a highly active SnO2-based photoelectrocatalyst for solar light-driven hydrogen fuel generation.

Diabetes and Ramadan: Practical guidelines 2021.

Fasting during Ramadan is one of the five pillars of Islam and is obligatory for all healthy Muslims from the age of puberty. Though individuals with some illness and serious medical conditions, including some people with diabetes, can be exempted from fasting, many will fast anyway. It is of paramount importance that people with diabetes that fast are given the appropriate guidance and receive proper care. The International Diabetes Federation (IDF) and Diabetes and Ramadan (DaR) International Alliance have come together to provide a substantial update to the previous guidelines. This update includes key information on fasting during Ramadan with type 1 diabetes, the management of diabetes in people of elderly ages and pregnant women, the effects of Ramadan on one's mental wellbeing, changes to the risk of macrovascular and microvascular complications, and areas of future research. The IDF-DAR Diabetes and Ramadan Practical Guidelines 2021 seek to improve upon the awareness, knowledge and management of diabetes during Ramadan, and to provide real-world recommendations to health professionals and the people with diabetes who choose to fast.

Coupling effects of phosphorus fertilization source and rate on growth and ion accumulation of common bean under salinity stress.

Many agricultural regions in arid and semiarid climate zone need to deal with increased soil salinity. Legumes are classified as salt-sensitive crops. A field experiment was performed to examine the application of phosphorus (P) fertilizer source and rate on growth, chlorophylls and carotenoid content, DNA and RNA content and ion accumulation in common bean (Phaseolus vulgaris L.) cultivated under salinity stress. An experimental design was split-plot with three replicates. The main plots included two P sources, namely single superphosphate (SP) and urea phosphate (UP). The sub-plots covered four P rates, i.e., 0.0, 17.5, 35.0, and 52.5 kg P ha-1. All applied P fertilization rates, in both forms, increased plant height, leaf area, dry weight of shoots and roots per plant, and total dry weight (TDW) in t ha-1. The highest accumulation of N, P, K+, Mg2+, Mn2+, Zn2+, and Cu2+ was determined in the shoot and root of common bean, while 35 kg of P per ha-1 was used compared to the other levels of P fertilizer. The highest P rate (52.5 kg ha-1) resulted in a significant reduction in Na+ in shoot and root of common bean. The response curve of TDW (t ha-1) to different rates of P (kg ha-1) proved that the quadratic model fit better than the linear model for both P sources. Under SP, the expected TDW was 1.675 t ha-1 if P was applied at 51.5 kg ha-1, while under UP, the maximum expected TDW was 1.875 t ha-1 if P was supplied at 42.5 kg ha-1. In conclusion, the 35.0 kg P ha-1 could be considered the best effective P level imposed. The application of P fertilizer as urea phosphate is generally more effective than single superphosphate in enhancing plant growth and alleviating common bean plants against salinity stress.

Diabetes and Ramadan: Practical guidelines.

Ramadan fasting is one of the five pillars of Islam and is compulsory for all healthy Muslims from puberty onwards. Exemptions exist for people with serious medical conditions, including many with diabetes, but a large number will participate, often against medical advice. Ensuring the optimal care of these patients during Ramadan is crucial. The International Diabetes Federation (IDF) and Diabetes and Ramadan (DAR) International Alliance have come together to deliver comprehensive guidelines on this subject. The key areas covered include epidemiology, the physiology of fasting, risk stratification, nutrition advice and medication adjustment. The IDF-DAR Practical Guidelines should enhance knowledge surrounding the issue of diabetes and Ramadan fasting, thereby empowering healthcare professionals to give the most up-to-date advice and the best possible support to their patients during Ramadan.

Enhanced Gas Sensing Properties of Spin-coated Na-doped ZnO Nanostructured Films.

In this report, the structures, morphologies, optical, electrical and gas sensing properties of ZnO and ZnO: Na spin-coated films are studied. X-ray diffraction (XRD) results reveal that the films are of a single phase wurtzite ZnO with a preferential orientation along (002) direction parallel to c-axis. Na doping reduces the crystalline quality of the films. The plane surface of ZnO film turned to be wrinkle net-work structure after doping. The reflectance and the optical band gap of the ZnO film decreased after Na doping. The wrinkle net-work nanostructured Na-doped film shows an unusually sensitivity, 81.9% @ 50 sccm, for CO2 gas at room temperature compared to 1.0% for the pure ZnO film. The signals to noise ratio (SNR) and detection limit of Na-doped ZnO sensor are 0.24 and 0.42 sccm, respectively. These enhanced sensing properties are ascribed to high surface-to-volume ratio, hoping effect, and the increase of O- vacancies density according to Kroger VinK effect. The response time increased from 179 to 240 s by the incorporation of Na atoms @50 sccm. This response time increased as the CO2 concentration increased. The recovery time is increased from 122 to 472 s by the incorporation of Na atoms @50 sccm.

Assessment of Hair Aluminum, Lead, and Mercury in a Sample of Autistic Egyptian Children: Environmental Risk Factors of Heavy Metals in Autism.

BACKGROUND AND AIMS: The etiological factors involved in the etiology of autism remain elusive and controversial, but both genetic and environmental factors have been implicated. The aim of this study was to assess the levels and possible environmental risk factors and sources of exposure to mercury, lead, and aluminum in children with autism spectrum disorder (ASD) as compared to their matched controls. METHODS: One hundred ASD children were studied in comparison to 100 controls. All participants were subjected to clinical evaluation and measurement of mercury, lead, and aluminum through hair analysis which reflects past exposure. RESULTS: The mean Levels of mercury, lead, and aluminum in hair of the autistic patients were significantly higher than controls. Mercury, lead, and aluminum levels were positively correlated with maternal fish consumptions, living nearby gasoline stations, and the usage of aluminum pans, respectively. CONCLUSION: Levels of mercury, lead, and aluminum in the hair of autistic children are higher than controls. Environmental exposure to these toxic heavy metals, at key times in development, may play a causal role in autism.

Fasting Ramadan in diabetic patients: When is fasting not advisable in a person with diabetes?

Ramadan Fasting is one of the five pillars of Islam, but there is a clear exemption in holy Qur'an for those who are temporarily or permanently ill. Diabetes Mellitus is one of the most prevalent chronic illnesses globally; it is associated with metabolic risks that might be augmented with fasting. In spite of this risk many Muslims prefer to fast considering not fasting is a great sin and shameful. Defining the situations when fasting is not advisable in a diabetic patient is an important issue which has to be clearly determined on bases of solid evidence whenever possible. The recommendations have to be agreed between experts of physicians and Islamic Religion scientists. The advances in diabetes management necessitate continuous updating of the recommendations to match with Islamic legitimacy. The role of healthcare providers is neither recommending nor preventing a patient from fasting, their role is just to explore risks and provide medical advice for safe fasting. This review summarizes previous trials for risk stratifications and recommendations for fasting in diabetic patients.

Diabetes in the Middle-East and North Africa: an update.

In recent decades, the prevalence of diabetes has risen dramatically in many countries of the International Diabetes Federation's (IDF) Middle-East and North Africa (MENA) Region. This increase has been driven by a range of factors that include rapid economic development and urbanisation; changes in lifestyle that have led to reduced levels of physical activity, increased intake of refined carbohydrates, and a rise in obesity. These changes have resulted in the countries of MENA Region now having among the highest rates of diabetes prevalence in the world. The current prevalence of diabetes in adults in the Region is estimated to be around 9.2%. Of the 34 million people affected by diabetes, nearly 17 million were undiagnosed and therefore at considerable risk of diabetes complications and poor health outcomes. Enhanced research on the epidemiology of diabetes in the MENA Region needs to be combined with more effective primary prevention of diabetes; and early detection and improved management of patients with established diabetes, including an increased focus on self-management and management in primary care and community settings.

Predictive factors of worsening of esophageal varices after balloon-occluded retrograde transvenous obliteration in patients with gastric varices.

OBJECTIVES: Although balloon-occluded retrograde transvenous obliteration (B-RTO) is useful for management of gastric varices, worsening of esophageal varices (EV) is the most important complication of B-RTO. The predictive factors of worsening of EV have not been evaluated in detail. This study was designed to evaluate the role of endoscopic color Doppler ultrasonography (ECDUS) in the detection of possible risk factors for worsening of EV after B-RTO. METHODS: A total of 39 cirrhotic patients with high-risk gastric varices successfully treated by B-RTO were included in this study. All patients underwent ECDUS before B-RTO to measure hemodynamic parameters of gastric varices and regular endoscopic follow-up after B-RTO to detect worsening of EV. The risk factors were analyzed by Cox's proportional hazards regression. RESULTS: Worsening of EV was found in 24 (61.5%) patients. The presence of esophageal varices before B-RTO and a lower degree of liver dysfunction (Child-Pugh class B) were statistically independent risk factors for worsening of EV after B-RTO (hazard ratio, HR, 5.81, 95% confidence interval, CI, 1.71-19.77 and HR 2.92, 95% CI: 1.21-7, respectively). High resistance index (> or =0.24), measured by ECDUS, is also an independent risk factor for worsening of EV after B-RTO (HR 4.06, 95% CI: 1.14-14.38) and increase in resistance index is associated with worsening of EV (P for trend=0.028). CONCLUSIONS: The presence of EV, higher Child-Pugh class, and higher resistance index assessed by ECDUS before B-RTO were significant risk factors for worsening of EV after B-RTO.

Annexin A2 expression and phosphorylation are up-regulated in hepatocellular carcinoma.

Annexins (ANXs) constitute a family of Ca2+-dependent membrane-binding proteins; at least 20 of them have been described to date. Among these, Annexin A2 (ANXA2) has been revealed as a multi-functional protein in vitro. Its actual role in vivo, however, requires further investigation. We already reported that ANX-I (ANXA1) was up-regulated in hepatocellular carcinoma (HCC). The role of ANXA2 in various liver diseases including HCC remains obscure. In the present study, the protein and mRNA levels of ANXA2, as well as its localization, were determined for the normal human liver, chronic hepatitis liver, and non-tumorous and tumorous portions of HCC tissues. ANXA2 was rarely detected in either normal or chronic hepatitis liver tissues, whereas it was overexpressed at both the transcriptional and translational levels in tumorous and non-tumorous regions of HCC. In addition, in many cases, more ANXA2 was expressed in the tumorous portion than in the non-tumorous portion of HCC. The expression of ANXA2 was mainly localized in cancer cells, especially in poorly differentiated HCC. Furthermore, ANXA2 was tyrosine-phosphorylated in HCC. These data suggest that overexpression and tyrosine phosphorylation of ANXA2 play important roles in the malignant transformation process leading to HCC and are related to the histological grade of HCC.