Microplastics and Co-pollutants in soil and marine environments: Sorption and desorption dynamics in unveiling invisible danger and key to ecotoxicological risk assessment.

Microplastics (MPs) and their co-pollutants pose significant threats to soil and marine environments, necessitating understanding of their colonization processes to combat the plastic pandemic and protect ecosystems. MPs can act as invisible carriers, concentrating and transporting pollutants, leading to a more widespread and potentially toxic impact than the presence of either MPs or the pollutants alone. Analyzing the sorption and desorption dynamics of MPs is crucial for understanding pollutants amplification and predicting the fate and transport of pollutants in soil and marine environments. This review provides an in-depth analysis of the sorption and desorption dynamics of MPs, highlighting the importance of considering these dynamics in ecotoxicological risk assessment of MPs pollution. The review identifies limitations of current frameworks that neglect these interactions and proposes incorporating sorption and desorption data into robust frameworks to improve the ability to predict ecological risks posed by MPs and co-pollutants in soil and marine environments. However, failure to address the interplay between sorption and desorption can result in underestimation of the true impact of MPs and co-pollutants, affecting livelihoods and agro-employments, and exacerbate poverty and community disputes (SDGs 1, 2, 3, 8, 9, and 16). It can also affect food production and security (SDG 2), life below water and life on land (DSGs 14 and 15), cultural practices, and natural heritage (SDG 11.4). Hence, it is necessary to develop new approaches to ecotoxicological risk assessment that consider sorption and desorption processes in the interactions between the components in the framework to address the identified limitations.

Isolated pancreatic tuberculosis with splenic tuberculosis mimicking lymphoma malignum: A case report.

Tuberculosis is an endemic disease in certain parts of the world. This disease typically presents in the lungs, but it may also appear within the abdomen, such as in the pancreas. There can be challenges in diagnosing isolated pancreatic tuberculosis as it may mimic other diseases radiologically. We present a 33-year-old female with intermittent abdominal pain and weight loss. Chest x-rays showed normal findings while noncontrast abdominal computed tomography (CT) showed a solid cystic mass in the pancreas and in the spleen. Contrast-enhanced CT showed an inhomogeneous cystic mass in the body and tail of the pancreas with peripheral rim enhancement. A laparotomy procedure was performed, and tuberculosis was confirmed histopathologically. In this case report, we highlight the challenging nature of diagnosing isolated pancreatic and splenic tuberculosis due to its presentation, which is similar to other neoplastic processes.

Prevalence of Aortic Root Dilation and Correlates of Aortic Root Dimensions in Treatment Naïve Hypertensive Patients in North-Eastern Nigeria.

Background: Systemic arterial hypertension is an independent predictor of cardiovascular diseases including aortic root dilation. Aortic root dilation is a hypertension-mediated organ damage entity regardless of age, gender, and body size. This study aims at determining the prevalence and associations of aortic root dilatation among treatment naïve hypertensive patients. Methodology: The study was a cross-sectional study conducted at the University of Maiduguri Teaching Hospital from June 2019 to June 2021. Study participants were treatment naïve hypertensive patients recruited consecutively from the outpatient clinic of the hospital and normotensive sex- and age-matched controls. End diastolic aortic root diameter was measured using 2D transthoracic echocardiography at the annulus, sinuses of Valsalva, and Sinotubular junction by leading-edge to a leading-edge convention as recommended by the American Society of Echocardiography in parasternal long-axis view. Results: Three hundred treatment naïve hypertensive patients (39.0% females) and 300 health normotensive age-and sex-matched controls (38.3% females) were enrolled. The mean ages of the patients and controls were 46.4±12.5 years and 46.4 ± 12.4 years respectively. The mean aortic root diameter (in mm) was significantly higher in the treatment naïve hypertensive arm of the study at the levels [AoA (24.7 ± 3.9mm versus 22.5 ± 2.0mm, p = 0.002), SoV (33.1 ± 3.4mm versus 31.4 ± 3.4mm, p = 0.023), and STJ (27.8 ± 3.5mm versus 25.9 ± 2.2mm, p = 0.002)]. Males had larger absolute aortic root diameters than females, however, after indexing aortic root diameters for BSA, there was no significant difference. The prevalence of aortic root dilatation amongst the treatment naïve hypertensive patients was 1.3% at all considered levels. Conclusion: The aortic root dimensions in the treatment naïve hypertensive patients were larger than in normotensive adults. The prevalence of aortic root dilation at all levels amongst treatment naïve hypertensive patients is 1.3%.

Effectiveness of Triple Benefit Health Education Intervention on Knowledge, Attitude and Food Security towards Malnutrition among Adolescent Girls in Borno State, Nigeria.

Knowledge and attitude are essential components of food security as malnutrition remains a critical public health concern among adolescents. The study evaluates the effectiveness of a Triple Benefit Health Education Intervention on knowledge, attitude and food security towards malnutrition among adolescent girls. This was a cluster randomized controlled trial among 417 randomly selected adolescent girls aged 10 to 19 years old in Maiduguri, Borno state, Nigeria from October 2019 to March 2020. About 208 respondents were assigned to experimental while 209 to control group, respectively, using an opaque sealed envelope. A structured questionnaire using KoBo Collect Toolbox was used for the collection of data at baseline, three and six-months post intervention while the data collected were analyzed using generalized estimating equation (GEE). The outcome of the baseline shows no statistically significant difference in sociodemographic characteristics, knowledge, attitude and food security between experimental and control groups. The study reveals a statistically significant difference between experimental and control groups for knowledge (p < 0.001; p < 0.001), attitude (p < 0.001; p < 0.001) and food security (p = 0.026; p = 0.001) at three and six-months post intervention, respectively. The triple benefit health education intervention package employed in this study can serve as an intervention tool to combat malnutrition among adolescent girls in Nigeria at large.

Effects of Particle Size on the Dielectric, Mechanical, and Thermal Properties of Recycled Borosilicate Glass-Filled PTFE Microwave Substrates.

Low dielectric loss and low-cost recycled borosilicate (BRS) glass-reinforced polytetrafluoroethylene (PTFE) composites were fabricated for microwave substrate applications. The composites were prepared through a dry powder processing technique by dispersing different micron sizes (25 µm, 45 µm, 63 µm, 90 µm, and 106 µm) of the recycled BRS filler in the PTFE matrix. The effect of the filler sizes on the composites' thermal, mechanical, and dielectric properties was studied. The dielectric properties of the composites were characterised in the frequency range of 1-12 GHz using an open-ended coaxial probe (OCP) connected to a vector network analyser (VNA). XRD patterns confirmed the phase formation of PTFE and recycled BRS glass. The scanning electron microscope also showed good filler dispersion at larger filler particle sizes. In addition, the composites' coefficient of thermal expansion and tensile strength decreased from 12.93 MPa and 64.86 ppm/°C to 7.12 MPa and 55.77 ppm/°C when the filler size is reduced from 106 µm to 25 µm. However, moisture absorption and density of the composites increased from 0.01% and 2.17 g/cm3 to 0.04% and 2.21 g/cm3. The decrement in filler size from 106 µm to 25 µm also increased the mean dielectric constant and loss tangent of the composites from 2.07 and 0.0010 to 2.18 and 0.0011, respectively, while it reduced the mean signal transmission speed from 2.088 × 108 m/s to 2.031 × 108 m/s. The presented results showed that PTFE/recycled BRS composite exhibited comparable characteristics with commercial high-frequency laminates.

Effects of Recycled Fe2O3 Nanofiller on the Structural, Thermal, Mechanical, Dielectric, and Magnetic Properties of PTFE Matrix.

The purpose of this study was to improve the dielectric, magnetic, and thermal properties of polytetrafluoroethylene (PTFE) composites using recycled Fe2O3 (rFe2O3) nanofiller. Hematite (Fe2O3) was recycled from mill scale waste and the particle size was reduced to 11.3 nm after 6 h of high-energy ball milling. Different compositions (5-25 wt %) of rFe2O3 nanoparticles were incorporated as a filler in the PTFE matrix through a hydraulic pressing and sintering method in order to fabricate rFe2O3-PTFE nanocomposites. The microstructure properties of rFe2O3 nanoparticles and the nanocomposites were characterized through X-ray diffraction (XRD), field emission scanning electron microscopy (FESEM), and high-resolution transmission electron microscopy (HRTEM). The thermal expansion coefficients (CTEs) of the PTFE matrix and nanocomposites were determined using a dilatometer apparatus. The complex permittivity and permeability were measured using rectangular waveguide connected to vector network analyzer (VNA) in the frequency range 8.2-12.4 GHz. The CTE of PTFE matrix decreased from 65.28×10-6/°C to 39.84×10-6/°C when the filler loading increased to 25 wt %. The real (ε') and imaginary (ε″) parts of permittivity increased with the rFe2O3 loading and reached maximum values of 3.1 and 0.23 at 8 GHz when the filler loading was increased from 5 to 25 wt %. A maximum complex permeability of 1.1-j0.07 was also achieved by 25 wt % nanocomposite at 10 GHz.

Ethnicity and COVID-19 outcomes among healthcare workers in the United Kingdom: UK-REACH ethico-legal research, qualitative research on healthcare workers' experiences, and stakeholder engagement protocol

IntroductionAs the world continues to grapple with the COVID-19 pandemic, emerging evidence suggests that individuals from ethnic minority backgrounds may be disproportionately affected. The UK-REACH project has been initiated to understand ethnic differentials in COVID-19 outcomes among healthcare workers (HCWs) in the United Kingdom (UK) through five inter-linked work packages. The ethico-legal work package (Work Package 3) aims to understand and address legal, ethical and acceptability issues around big data research; the healthcare workers experiences work package (Work Package 4) is a qualitative study exploring healthcare workers experiences during COVID-19 and; the stakeholder engagement work package (Work Package 5) aims to provide feedback and support with the formulation and dissemination of the project recommendations. Methods and AnalysisWork Package 3 has two different research strands: (a) desk-based doctrinal research; and (b) empirical qualitative research with key opinion leaders. For the empirical research, in-depth interviews will be conducted digitally and recorded with participants permission. Recordings will be transcribed, coded and analysed using thematic analysis. In Work Package 4, online in-depth interviews and focus groups will be conducted with approximately 150 HCWs, from across the UK, and these will be recorded with participants consent. The recordings will be transcribed, coded and data will be analysed using thematic analysis. Work Package 5 will achieve its objectives through regular group meetings and in-group discussions. Ethics and DisseminationEthical approval has been received from the London - Brighton & Sussex Research Ethics Committee of the Health Research Authority (Ref No. 20/HRA/4718). Results of the study will be published in open access journals, and disseminated through conference presentations, project website, stakeholder organisations, media and scientific advisory groups. Registration DetailsRegistered with the International Standard Randomised Controlled Trial Number registry (ISRCTN11811602). STRENGTHS AND LIMITATIONS OF THIS STUDYO_LIThe dual approach of doctrinal and empirical research (Work Package 3) on the use of personal data by UK-REACH will give a comprehensive understanding of the ethical and legal implications of the study, and perceptions about its use of data. C_LIO_LIQualitative research with healthcare workers in the UK on their experiences during the COVID-19 pandemic (Work Package 4) will provide insight into personal behaviour, perceptions of risk and coping mechanisms adopted both inside and outside of the work environment. C_LIO_LIStakeholder engagement (Work Package 5) from professional regulatory bodies and staff groups is embedded within the UK-REACH study to provide feedback on project activities and support with project recommendations. C_LIO_LIThe target participants (key opinion leaders) for Work Package 3 empirical study will likely come from predominantly White backgrounds which may limit the breadth of views obtained in interviews. This limitation will be mitigated by active recruitment of opinion leaders from a wide variety of ethnic backgrounds and active interaction with Work Package 5. C_LIO_LIDue to the pandemic restrictions, interviews and focus group discussions will be conducted via online methods as a substitute for face-to-face meetings, posing practical and technological challenges for dynamic interaction with participants. C_LI

Digoxin and Symptomatic Bradyarrhythmia: the 'demon' or a 'red herring'.

Digoxin toxicity has been implicated in all forms of cardiac arrhythmias with the notable exception of Mobitz II atrioventricular block, which is very rare. The manifestation is quite variable, ranging from being asymptomatic to gastrointestinal, cardiac, and neurologic symptoms. The manifestations can be protean in the elderly, the most vulnerable group, where degenerative cardiac conduction system diseases add another layer of intrigue by providing an intrinsic substrate for cardiac dysrhythmia. This is in addition to age-related alteration of digoxin pharmacokinetics, use of multiple medications, chronic conditions, and electrolyte derangement, all of which increase the propensity for digoxin toxicity. We present a case of various atrioventricular conduction blocks in a septuagenarian following the use of digoxin.

Development and immunogenic potentials of chitosan-saponin encapsulated DNA vaccine against avian infectious bronchitis coronavirus.

Infectious Bronchitis (IB) is an economically important avian disease that considerably threatens the global poultry industry. This is partly, as a result of its negative consequences on egg production, weight gain as well as mortality rate.The disease is caused by a constantly evolving avian infectious bronchitis virus whose isolates are classified into several serotypes and genotypes that demonstrate little or no cross protection. In order to curb the menace of the disease therefore, broad based vaccines are urgently needed. The aim of this study was to develop a recombinant DNA vaccine candidate for improved protection of avian infectious bronchitis in poultry. Using bioinformatics and molecular cloning procedures, sets of monovalent and bivalent DNA vaccine constructs were developed based on the S1 glycoprotein from classical and variants IBV strains namely, M41 and CR88 respectively. The candidate vaccine was then encapsulated with a chitosan and saponin formulated nanoparticle for enhanced immunogenicity and protective capacity. RT-PCR assay and IFAT were used to confirm the transcriptional and translational expression of the encoded proteins respectively, while ELISA and Flow-cytometry were used to evaluate the immunogenicity of the candidate vaccine following immunization of various SPF chicken groups (A-F). Furthermore, histopathological changes and virus shedding were determined by quantitative realtime PCR assay and lesion scoring procedure respectively following challenge of various subgroups with respective wild-type IBV viruses. Results obtained from this study showed that, groups vaccinated with a bivalent DNA vaccine construct (pBudCR88-S1/M41-S1) had a significant increase in anti-IBV antibodies, CD3+ and CD8+ T-cells responses as compared to non-vaccinated groups. Likewise, the bivalent vaccine candidate significantly decreased the oropharyngeal and cloacal virus shedding (p < 0.05) compared to non-vaccinated control. Chickens immunized with the bivalent vaccine also exhibited milder clinical signs as well as low tracheal and kidney lesion scores following virus challenge when compared to control groups. Collectively, the present study demonstrated that bivalent DNA vaccine co-expressing dual S1 glycoprotein induced strong immune responses capable of protecting chickens against infection with both M41 and CR88 IBV strains. Moreso, it was evident that encapsulation of the vaccine with chitosan-saponin nanoparticle further enhanced immune responses and abrogates the need for multiple booster administration of vaccine. Therefore, the bivalent DNA vaccine could serve as efficient and effective alternative strategy for the control of IB in poultry.

Development and validation of the 4C Deterioration model for adults hospitalised with COVID-19

Prognostic models to predict the risk of clinical deterioration in acute COVID-19 are required to inform clinical management decisions. Among 75,016 consecutive adults across England, Scotland and Wales prospectively recruited to the ISARIC Coronavirus Clinical Characterisation Consortium (ISARIC4C) study, we developed and validated a multivariable logistic regression model for in-hospital clinical deterioration (defined as any requirement of ventilatory support or critical care, or death) using 11 routinely measured variables. We used internal-external cross-validation to show consistent measures of discrimination, calibration and clinical utility across eight geographical regions. We further validated the final model in held-out data from 8,252 individuals in London, with similarly consistent performance (C-statistic 0.77 (95% CI 0.75 to 0.78); calibration-in-the-large 0.01 (-0.04 to 0.06); calibration slope 0.96 (0.90 to 1.02)). Importantly, this model demonstrated higher net benefit than using other candidate scores to inform decision-making. Our 4C Deterioration model thus demonstrates unprecedented clinical utility and generalisability to predict clinical deterioration among adults hospitalised with COVID-19.

Systematic evaluation and external validation of 22 prognostic models among hospitalised adults with COVID-19: An observational cohort study

BackgroundThe number of proposed prognostic models for COVID-19, which aim to predict disease outcomes, is growing rapidly. It is not known whether any are suitable for widespread clinical implementation. We addressed this question by independent and systematic evaluation of their performance among hospitalised COVID-19 cases. MethodsWe conducted an observational cohort study to assess candidate prognostic models, identified through a living systematic review. We included consecutive adults admitted to a secondary care hospital with PCR-confirmed or clinically diagnosed community-acquired COVID-19 (1st February to 30th April 2020). We reconstructed candidate models as per their original descriptions and evaluated performance for their original intended outcomes (clinical deterioration or mortality) and time horizons. We assessed discrimination using the area under the receiver operating characteristic curve (AUROC), and calibration using calibration plots, slopes and calibration-in-the-large. We calculated net benefit compared to the default strategies of treating all and no patients, and against the most discriminating predictor in univariable analyses, based on a limited subset of a priori candidates. ResultsWe tested 22 candidate prognostic models among a cohort of 411 participants, of whom 180 (43.8%) and 115 (28.0%) met the endpoints of clinical deterioration and mortality, respectively. The highest AUROCs were achieved by the NEWS2 score for prediction of deterioration over 24 hours (0.78; 95% CI 0.73-0.83), and a novel model for prediction of deterioration <14 days from admission (0.78; 0.74-0.82). Calibration appeared generally poor for models that used probability outcomes. In univariable analyses, admission oxygen saturation on room air was the strongest predictor of in-hospital deterioration (AUROC 0.76; 0.71-0.81), while age was the strongest predictor of in-hospital mortality (AUROC 0.76; 0.71-0.81). No prognostic model demonstrated consistently higher net benefit than using the most discriminating univariable predictors to stratify treatment, across a range of threshold probabilities. ConclusionsOxygen saturation on room air and patient age are strong predictors of deterioration and mortality among hospitalised adults with COVID-19, respectively. None of the prognostic models evaluated offer incremental value for patient stratification to these univariable predictors.

Effective governance for management of invasive alien plants: evidence from the perspective of forest and wildlife officers in Sri Lanka.

Invasive alien plants (IAPs) are a significant cause of socio-ecological change in Sri Lanka. Many studies have focused on the ecological dimensions of this problem, but few have addressed sociological factors such as the knowledge and perceptions of individuals and groups tasked with addressing IAPs. This study investigates how IAP issues are understood and perceived by professional forest and wildlife officers in Sri Lanka. The data analyzed were gathered using a questionnaire that covered three themes: the respondents' ability to identify IAPs, the impacts of IAPs and the threats they pose, and knowledge regarding control and mitigation. The questionnaire was completed by 186 field officers, and the resulting descriptive statistics and a probit regression analysis were used to analyze the data. The results show that almost all of the participating forest and wildlife officers were aware of the problems associated with IAPs but more than 75% of them lacked an accurate understanding of scientific means for controlling them and control policies established by the government of Sri Lanka. Generally, wildlife officers had a better understanding than forest officers. In addition, the analysis shows that officers' knowledge and perceptions of IAPs were positively correlated with their level of education and position within the organization. The analysis points to several recommendations for Sri Lankan officials when designing and implementing comprehensive policies and professional programs, particularly for lower-level field officers.

Tobacco plants expressing the maize nitrate transporter ZmNrt2.1 exhibit altered responses of growth and gene expression to nitrate and calcium.

BACKGROUND: Nitrate uptake is a highly regulated process. Understanding the intricate interactions between nitrate availability and genetically-controlled nitrate acquisition and metabolism is essential for improving nitrogen use efficiency and increasing nitrate uptake capacity for plants grown in both nitrate-poor and nitrate-enriched environments. In this report, we introduced into tobacco (Nicotiana tabacum) the constitutively expressed maize high-affinity transporter ZmNrt2.1 gene that would bypass the tight control for the endogenous nitrate-responsive genes. By using calcium inhibitors and varying levels of NO3-, Ca2+ and K+, we probed how the host plants were affected in their nitrate response. RESULTS: We found that the ZmNrt2.1-expressing plants had better root growth than the wild type plants when Ca2+ was deficient regardless of the nitrate levels. The growth restriction associated with Ca2+-deficiency can be alleviated with a high level of K+. Furthermore, the transgenic plants exhibited altered expression patterns of several endogenous, nitrate-responsive genes, including the high- and low-affinity nitrate transporters, the Bric-a-Brac/Tramtrack/Broad protein BT2 and the transcription factor TGA-binding protein TGA1, in responding to treatments of NO3-, K+ or inhibitors for the calcium channel and the cytosolic Ca2+-regulating phospholipase C, as compared to the wild type plants under the same treatments. Their expression was not only responsive to nitrate, but also affected by Ca2+. There were also different patterns of gene expression between roots and shoots. CONCLUSION: Our results demonstrate the ectopic effect of the maize nitrate transporter on the host plant's overall gene expression of nitrate sensing system, and further highlight the involvement of calcium in nitrate sensing in tobacco plants.

The Provider Cost of Treating Tuberculosis in Bauchi State; Nigeria

The study was aimed at assessing the economic cost shouldered by government; as providers; in the provision of free tuberculosis (TB) diagnosis and treatment services in Bauchi State; northern Nigeria. A cost analysis study was designed and questionnaires administered by the principal investigators to officers in charge of 27 randomly sampled government TB services providers across the State of Bauchi. Seventeen of these centers were primary care centers; 9 secondary care providers and one was a tertiary care provider. Data was also collected from personnel and projects records in the State Ministry of Health; of Works as well as the Ministry of Budget and Planning. The cost of buildings; staff and equipment replacement; laboratory; radiology and drugs in facilities were assessed and costs attributable tuberculosis inpatient; outpatient and directly observed therapy (DOT) services were estimated from the total cost based on the proportion of TB cases in the total patient pool accessing those services. The average proportion of TB patients in facilities was 3.4in overall; 3.3among inpatients and 3.1in the outpatient population. The average cost spent to treat a patient with TB was estimated at US $227.14. The cost of inpatient care averaged $16.95/patient; DOT and outpatient services was $133.34/patient; while the overhead cost per patient was $30.89. The overall cost and all computed cost elements; except for DOT services; were highest in the tertiary center and least expensive in the infectious diseases hospital partly due to the higher administrative and other overhead recurrent spending in the tertiary health facility while the lower overhead cost observed in the infectious diseases hospital could be due to the economy of scale as a result of the relative higher number of TB cases seen in the facility operating with relatively same level of resources as other facilities in the state