Practicing Surgeons' Perception of Barriers to Palliative Care Delivery in British Columbia.

BACKGROUND: Utilization of palliative care remains low among surgical patients. We aim to characterize general surgeons' perceptions of barriers to access palliative care in British Columbia (BC). METHODS: Semi-structured interviews were carried out with a total of 11 surgeons in BC. Interviews were transcribed for thematic analysis via interpretive description. Dominant themes were identified and agreed upon between the authors. RESULTS: Several barriers were identified, which include system and institution, communication and surgical workflow barriers. At the system and institutional level, there were difficulties accessing patient information and continuity of care. Themes in the communication included patient misconceptions about palliative care and communication challenges with consulting services. Surgical workflow barriers influenced the overall perceived role of surgeons when caring for patients with palliative care needs. CONCLUSION: Understanding surgeons' perspectives on barriers to palliative care is an important step in changing management. This can aid in the development of strategies that ease access to palliative care.

Partial purification of linoleic acid isomerase enzyme from Lactobacillus paracasei bacteria isolated from milk

Abstract Conjugated Linoleic Acid (CLA) has attracted the attention of many researchers, especially that of microbial origin due to its biological importance to the consumer. The current study aims to extract LA Isomerase enzyme from Lactobacillus paracasei bacteria from milk and to use the enzyme in the production of CLA. Selective media, including MRS and MRS-Dagatose, were used in isolating local strains. The selected bacterial isolates were tested for their ability to produce LA-Isomerase enzyme. The isolate with high enzymatic activity was selected. After extraction and partial purification of the enzyme, the optimal conditions for the production of conjugated fatty acid were studied, and the reaction products were diagnosed using GC-MS technology. It was found that 11 isolates have the ability to produce CLA at different concentrations, H1 isolate showed the highest production of conjugated fatty acid at a concentration of 120.45 g.ml-1, this isolate was selected as the source for enzyme extraction. The enzymatic activity of the crude extract and partially purified with ammonium sulfate was estimated using color methods at wavelength of 233 nm. The effect of the optimum conditions (pH, temperature, linoleic acid concentration and enzyme concentration) on the CLA product was studied using the partially purified LA Isomerase enzyme, the optimum conditions for production were 6.5, 45 °C, 100 g.ml-1 and 0.7 ml, respectively. The GC-MS technique showed the presence of a number of reaction products that are isomers of conjugated linoleic acid (C9T11, T9T12, T10C12) with different concentrations.

Resumo O Ácido Linoleico Conjugado (CLA) tem chamado a atenção de diversos pesquisadores, principalmente aquele de origem microbiana, devido à sua importância biológica para o consumidor. O presente estudo visa extrair a enzima LA Isomerase da bactéria Lactobacillus paracasei do leite e usar essa enzima na produção de CLA. Meios seletivos, incluindo MRS e MRS-Dagatose, foram usados no isolamento de cepas locais. Os isolados bacterianos selecionados foram testados quanto à sua capacidade de produzir a enzima LA-Isomerase. Foi selecionado o isolado com alta atividade enzimática. Após a extração e purificação parcial da enzima, as condições ideais para a produção de ácido graxo conjugado foram estudadas e os produtos da reação foram identificados usando a tecnologia GC-MS. Verificou-se que 11 isolados possuem capacidade de produzir CLA em diferentes concentrações. O isolado H1 apresentou a maior produção de ácido graxo conjugado, na concentração de 120,45 g.ml-1, e este isolado foi selecionado como fonte para extração enzimática. A atividade enzimática do extrato bruto e parcialmente purificado com sulfato de amônio foi estimada por métodos de coloração em comprimento de onda de 233 nm. O efeito das condições ótimas (pH, temperatura, concentração de ácido linoleico e concentração de enzima) no produto CLA foi estudado usando a enzima LA Isomerase parcialmente purificada e as condições ótimas para produção foram 6,5, 45 °C, 100 g.ml-1 e 0,7 mL, respectivamente. A técnica de GC-MS mostrou a presença de uma série de produtos de reação que são isômeros do ácido linoleico conjugado (C9T11, T9T12, T10C12) com diferentes concentrações.

Agrobiological evaluations of newly introduced grapes varieties under climatic conditions of the south of Kazakhstan

Abstract Variety assortment enhancement is a normal task that involves enhancing the assortment's quality and upgrading varieties. The findings of a research of imported grape varieties in the southeast of Kazakhstan, namely in the Almaty region's bottom-mountain zone, are presented in this article. The onset and conclusion of the main phenological phases of a grape plant throughout the vegetative period were directly influenced by the climatic and meteorological conditions of this district. In comparison to the recognized variety Almaty early-maturing, it has been proven that types Priusadebny, Iyulsky, and Kuibyshevsk early-maturing have a high degree of eyes wintering buds and may provide a high-quality crop in this location.

Resumo O aprimoramento da variedade é uma tarefa normal que envolve o aprimoramento da qualidade da variedade e o aprimoramento das variedades. As descobertas de uma pesquisa de variedades de uvas importadas no sudeste do Cazaquistão, ou seja, na zona de base da montanha da região de Almaty, são apresentadas neste artigo. O início e a conclusão das principais fases fenológicas de uma videira ao longo do período vegetativo foram diretamente influenciados pelas condições climáticas e meteorológicas deste distrito. Em comparação com a variedade reconhecida Almaty de maturação precoce, foi comprovado que os tipos Priusadebny, Iyulsky e Kuibyshevsk de maturação precoce têm um alto grau de gomos de inverno de olhos e podem fornecer uma safra de alta qualidade neste local.

Partial purification of linoleic acid isomerase enzyme from Lactobacillus paracasei bacteria isolated from milk / Purificação parcial da enzima isomerase do ácido linoleico da bactéria Lactobacillus paracasei isolada do leite

Conjugated Linoleic Acid (CLA) has attracted the attention of many researchers, especially that of microbial origin due to its biological importance to the consumer. The current study aims to extract LA Isomerase enzyme from Lactobacillus paracasei bacteria from milk and to use the enzyme in the production of CLA. Selective media, including MRS and MRS-Dagatose, were used in isolating local strains. The selected bacterial isolates were tested for their ability to produce LA-Isomerase enzyme. The isolate with high enzymatic activity was selected. After extraction and partial purification of the enzyme, the optimal conditions for the production of conjugated fatty acid were studied, and the reaction products were diagnosed using GC-MS technology. It was found that 11 isolates have the ability to produce CLA at different concentrations, H1 isolate showed the highest production of conjugated fatty acid at a concentration of 120.45 g.ml-1, this isolate was selected as the source for enzyme extraction. The enzymatic activity of the crude extract and partially purified with ammonium sulfate was estimated using color methods at wavelength of 233 nm. The effect of the optimum conditions (pH, temperature, linoleic acid concentration and enzyme concentration) on the CLA product was studied using the partially purified LA Isomerase enzyme, the optimum conditions for production were 6.5, 45 °C, 100 µg.ml-1 and 0.7 ml, respectively. The GC-MS technique showed the presence of a number of reaction products that are isomers of conjugated linoleic acid (C9T11, T9T12, T10C12) with different concentrations.

O Ácido Linoleico Conjugado (CLA) tem chamado a atenção de diversos pesquisadores, principalmente aquele de origem microbiana, devido à sua importância biológica para o consumidor. O presente estudo visa extrair a enzima LA Isomerase da bactéria Lactobacillus paracasei do leite e usar essa enzima na produção de CLA. Meios seletivos, incluindo MRS e MRS-Dagatose, foram usados no isolamento de cepas locais. Os isolados bacterianos selecionados foram testados quanto à sua capacidade de produzir a enzima LA-Isomerase. Foi selecionado o isolado com alta atividade enzimática. Após a extração e purificação parcial da enzima, as condições ideais para a produção de ácido graxo conjugado foram estudadas e os produtos da reação foram identificados usando a tecnologia GC-MS. Verificou-se que 11 isolados possuem capacidade de produzir CLA em diferentes concentrações. O isolado H1 apresentou a maior produção de ácido graxo conjugado, na concentração de 120,45 g.ml-1, e este isolado foi selecionado como fonte para extração enzimática. A atividade enzimática do extrato bruto e parcialmente purificado com sulfato de amônio foi estimada por métodos de coloração em comprimento de onda de 233 nm. O efeito das condições ótimas (pH, temperatura, concentração de ácido linoleico e concentração de enzima) no produto CLA foi estudado usando a enzima LA Isomerase parcialmente purificada e as condições ótimas para produção foram 6,5, 45 °C, 100 µg.ml-1 e 0,7 mL, respectivamente. A técnica de GC-MS mostrou a presença de uma série de produtos de reação que são isômeros do ácido linoleico conjugado (C9T11, T9T12, T10C12) com diferentes concentrações.

Agrobiological evaluations of newly introduced grapes varieties under climatic conditions of the south of Kazakhstan / Avaliações agrobiológicas de variedades de uvas recém-introduzidas sob as condições climáticas do sul do Cazaquistão

Variety assortment enhancement is a normal task that involves enhancing the assortment's quality and upgrading varieties. The findings of a research of imported grape varieties in the southeast of Kazakhstan, namely in the Almaty region's bottom-mountain zone, are presented in this article. The onset and conclusion of the main phenological phases of a grape plant throughout the vegetative period were directly influenced by the climatic and meteorological conditions of this district. In comparison to the recognized variety Almaty early-maturing, it has been proven that types Priusadebny, Iyulsky, and Kuibyshevsk early-maturing have a high degree of eyes wintering buds and may provide a high-quality crop in this location.

O aprimoramento da variedade é uma tarefa normal que envolve o aprimoramento da qualidade da variedade e o aprimoramento das variedades. As descobertas de uma pesquisa de variedades de uvas importadas no sudeste do Cazaquistão, ou seja, na zona de base da montanha da região de Almaty, são apresentadas neste artigo. O início e a conclusão das principais fases fenológicas de uma videira ao longo do período vegetativo foram diretamente influenciados pelas condições climáticas e meteorológicas deste distrito. Em comparação com a variedade reconhecida Almaty de maturação precoce, foi comprovado que os tipos Priusadebny, Iyulsky e Kuibyshevsk de maturação precoce têm um alto grau de gomos de inverno de olhos e podem fornecer uma safra de alta qualidade neste local.

The Impact of Berberine Loaded Selenium Nanoparticles on K. pneumoniae and Candida albicans Antibiotics Resistance Isolates.

This study aimed to investigate the antibacterial and antifungal activities of selenium nanoparticles (SeNPs) and berberine (BBR) despite antibiotic resistance against Klebsiella pneumoniae and Candida albicans. Cells of K. pneumoniae and C. albicans were treated with solutions of different concentrations of each bare SeNPs, BBR, and BBR-loaded SeNPs (BLS) using the disk diffusion method. The results indicated that the activities of SeNPs, BBR, and BLS were statistically significant (P<0.05) when the concentration of all agents increased. Moreover, it was found that BLS had a statistically significant effect against K. pneumoniae and C. albicans, compared to SeNPs and BBR alone (P<0.05). The largest zones of inhibition of SeNPs were 14 and 16 mm toward K. pneumoniae and C. albicans, respectively, at the concentration of 20 Mml, compared to the concentrations of 10 and 15 Mml. Furthermore, BBR showed a maximum zone of inhibition at the concentration of 1,200 mg (15 mm for K. pneumoniae and 18 mm for C. albicans) and it was statistically significant in comparison with other concentrations of 400 and 800 mg. In addition, the BLS underwent a statistically significant increase (P<0.05) when the concentration increased and it registered a large zone of inhibition of 22 and 25 mm against K. pneumoniae and C. albicans, respectively, at 20 Mml of SeNPs: 1,200 mg BBR, compared to 10 Mml of SeNPs: 400 mg BBR and 15 Mml of SeNPs: 800 mg BBR. Based on the results of the current study, there was a statistically synergistic effect of BBR-loaded SeNPs, compared to that of BBR and Se nanoparticles, only in the case of both K. pneumoniae and C. albicans. This study is promising as a blueprint for the enhancement of weak antimicrobial agents and their return to their previous role as antibiotics.

Evaluation of Phosphorus Storage and Performance of Broilers Using Phytase Synthetic Enzyme.

Phytic acid is a stored form of phosphorus in cereals, 65 to 70% of phosphorus in plant sources is phytate, and broilers are only able to use part of the phosphorus in plant sources. To meet the needs of chickens, it is necessary to use other artificial resources, which not only impose part of the cost of the breeding period because of its presence in the manure but is one of the factors polluting the environment. This study aimed to use different levels of phytase enzyme to reduce dietary phosphorus levels. 600 Ross 308 broilers were used in this experiment with five treatments and six replications, and in each replication, 20 chickens were used in a completely randomized design (CRD). Experimental treatments include 1) basal diet (control) 2) basal diet with 15% less phosphorus 3) basal diet with 15% less phosphorus + 1250 (FTU) phytase enzyme 4) basal diet with 15% less phosphorus + 2500 (FTU) phytase enzyme 5) basal diet with 15% less phosphorus + 5000 (FTU) phytase enzyme. The evaluated traits included weekly feed intake, weekly weight gain, feed conversion ratio, carcass characteristics, ash, calcium, and bone phosphorus. The use of phytase enzyme in different diets had no significant effect on food intake, weight gain, and feed conversion ratio (P>0.05). However, the use of phytase in different diets significantly affected the percentage of Gizzard, Heart, Liver, Proventriculus, and Spleen (P<0.05). The most changes were the increase in the ratio of feed intake and weight gain in the fourth week compared to the third week so that the changes in the ratio of feed intake ranged from 1.85 to 1.91, and this ratio for weight gain also ranged from 3.12 to 3.86 was recorded, and the lowest feed conversion ratio was obtained at the same age. The percentage of raw ash in broiler chickens was significantly increased by adding dietary phytase. The lowest amount of ash, calcium, and phosphorus belonged to the second group (diets with low phosphorus and no enzyme). The difference between the other groups and the control was not significant. Feed intake, weight gain, and feed conversion ratio with the addition of phytase enzyme were not affected by phosphorus reduction and had no significant effect on carcass characteristics. Environmental pollution can be prevented by reducing the level of dietary phosphorus and reducing excreted phosphorus.

The Role of Selenium on the Status of Mineral Elements and Some Blood Parameters of Blood Serum of Lambs.

Selenium is one of the compounds belonging to the trace minerals group, which needs less than 100 mg/day. This element is one of the main constituents of selenoproteins, and the function of selenoproteins is to help make DNA and protect cells from damage and infection. This experiment aimed to evaluate the effect of different sources of selenium on some mineral elements in the blood serum of lambs. This experiment was conducted using twenty 4-month-old lambs with an average weight of 37±2.2 kg, 4 treatments, and 5 replications in a completely randomized design (CRD). The treatments tested included control, sodium selenite, nano selenium, and VitEsel. The experiment duration was 30 days, and blood sampling of lambs was performed at the beginning of the experiment (zero), 15, and 30 days. Different sources of selenium significantly affected the concentrations of iron, copper, and zinc (P<0.05). Different sources of selenium in this experiment decreased the concentration of iron and copper and increased the concentration of zinc and plasma selenium in different periods (P<0.05). Using different sources of selenium changed the concentration of the studied elements and showed the difference in their bioavailability.

The Relation between Increasing Anxiety and Prolactin-Releasing Peptide in Rats.

PrRP, also known as prolactoliberin, is a bovine hypothalamic extract neurohormone that stimulates prolactin synthesis in a rat pituitary adenoma cell line and lactating rat pituitary cells. PrRP has been shown to control the intake of food and energy expenditure, but it may also have a role in stress sensitivity, reproduction, cardia productivity, secretion of endocrine components, and lately, neuroprotective characteristics, among others. The current study was performed to identify if prolactin-releasing peptide (PrRP) had any effect in increasing anxiety clinical features in rats as an animal model. The study included 114 Wistar handling-acclimated male rats (160 gm, 2 months old); divided randomly into three major groups. The rats were divided randomly into three major groups (38-control animals (38C), and 38-PrRP animals (38P), both were examined using the EPM test to test for stress-related signs, such as fear of height (5 mins duration for each rat). The maze was cleaned with water to eliminate the previous rat odor after the experiment for each rat was completed. The tests were performed between 13:00 to 17:00 of the day. Then, a week later, 38 (19-PrRP animals (19P) and 19-control animals (19C)) were examined using the SP test conducted between 13:00 to 16:00 of the day. Fifteen minutes before EPM, the 38C received intranasal 0.9%-10µl NaCl (per nostril), and 38P received intranasal 10-10mol/l-10 µl PrRP (per nostril), and the anxiety-related signs, such as time spent in open arms (less time means more anxious), during the EPM test were recorded. The 19P and 19C received 10-10mol/l-10µl PrRP and 0.9%-10µl NaCl, respectively, (intranasal, per nostril, and 15 minutes before the SP test, where a stranger rat was placed in a specific cage in front of each of the 19P and 19C animals in a separate cage, in which both cages provided visual and olfactory but no confrontational contact). The results showed that PrRP significantly (P<0.05) decreased the time spent by the treated rats on the open arms. In addition, PrRP revealed significant (P<0.05) decreases in the time spent close to the stranger rat, which means increased anxiety levels. The current findings revealed that prolactin-releasing peptide increases anxiety and decreases sociality in the studied male rats.

Effect of Licorice Essential Oil (Glycyrrhizaglabraglabra) on Performance and Some Biochemical Parameters of Broiler Chickens.

Due to its beneficial components, such as glycyrrhizin, licorice is regarded a medicinal and fragrant plant. This research was designed to investigate the efficacy of licorice essential oil as an alternative to chemical antibiotics on broiler production, carcass features, cellular and humoral safety, and numerous biochemical variables in broiler blood serum. A total of 160 day-old broiler chicks were assigned to four treatment groups using a totally randomized approach. Each treatment consisted of 4 replicates, with 10 chicks in each replication. The experimental treatments included a control group, a group receiving an elemental diet containing 0.1% licorice essential oil, a group receiving an elemental diet containing 0.2% licorice essential oil, and a group receiving an elemental diet containing 0.3% licorice essential oil. Broilers had ad libitum access to feed and water in accordance with a three-phase feeding schedule consisting of a starter, grower, and finisher diet. There was no statistically significant difference (P>0.05) in body weight, feed intake, or feed conversion ratio between birds given the control or essential oil licorice at various stages of the experiment. However, birds receiving 0.1% licorice essential oil had a lower gallbladder relative weight and 0.3% licorice essential oil had less abdominal fat than the control group (P<0.05). Blood glucose, cholesterol, and LDL concentrations all fell considerably in licorice essential oil-treated birds relative to controls (P<0.05). The cellular immune response of birds fed licorice-containing diets did not differ from that of control birds (P>0.05), however there was a significant difference in the humoral immune response at 0.1% licorice essential oil compared to the control group (P<0.05). In overall, the results of this experiment demonstrated that incorporating licorice essential oil into a bird's diet improves its health and safety.

Electrospun Polycaprolactone/Chitosan Nanofibers Containing Cordia myxa Fruit Extract as Potential Biocompatible Antibacterial Wound Dressings.

The goal of the current work was to create an antibacterial agent by using polycaprolactone/chitosan (PCL/CH) nanofibers loaded with Cordia myxa fruit extract (CMFE) as an antimicrobial agent for wound dressing. Several characteristics, including morphological, physicomechanical, and mechanical characteristics, surface wettability, antibacterial activity, cell viability, and in vitro drug release, were investigated. The inclusion of CMFE in PCL/CH led to increased swelling capability and maximum weight loss. The SEM images of the PCL/CH/CMFE mat showed a uniform topology free of beads and an average fiber diameter of 195.378 nm. Excellent antimicrobial activity was shown towards Escherichia coli (31.34 ± 0.42 mm), Salmonella enterica (30.27 ± 0.57 mm), Staphylococcus aureus (21.31 ± 0.17 mm), Bacillus subtilis (27.53 ± 1.53 mm), and Pseudomonas aeruginosa (22.17 ± 0.12 mm) based on the inhibition zone assay. The sample containing 5 wt% CMFE had a lower water contact angle (47 ± 3.7°), high porosity, and high swelling compared to the neat mat. The release of the 5% CMFE-loaded mat was proven to be based on anomalous non-Fickian diffusion using the Korsmeyer-Peppas model. Compared to the pure PCL membrane, the PCL-CH/CMFE membrane exhibited suitable cytocompatibility on L929 cells. In conclusion, the fabricated antimicrobial nanofibrous films demonstrated high bioavailability, with suitable properties that can be used in wound dressings.

In vitro study of antioxidant, antibacterial, and cytotoxicity properties of Cordia myxa fruit extract.

Background and Objectives: Medicinal plants have recently received much interest because of the low production costs and fewer side effects associated with remedies made from them compared with chemical therapies. The current study investigated the antioxidant, antibacterial, and cytotoxicity properties of an ethanol extract of Cordiamyxa fruit (CMF) extract. Materials and Methods: The antioxidant activity of CMF was determined by measuring electron-donating ability with a 1,1-diphenyl-2picrylhydrazyl (DPPH) assay. The phenolic content was calculated as Gallic acid equivalents using the Folin- Ciocalteu assay. To evaluate the efficiency of CMF, five multidrug-resistant bacterial strains (Salmonella enterica, Escherichia coli, Bacillus subtilis, Staphylococcus aureus, and Pseudomonas aeruginosa) were tested using the agar diffusion method. Furthermore, the cytotoxic activity of CMF was determined using 3-(4,5-dimethylthiazol-2-yl)-2,5-dipheltetrazolium (MTT) assay against a healthy fibroblast (L929) cell line. Results: The CMF ethanol extract was revealed to have substantial phenol and flavonoid content (113.71± 0.04 mg gallic acid/g dried extract and 68.9 ± 0.002 mg quercetin/g dried extract, respectively) that showed the highest percentage of DPPH inhibition (86.45%), which was achieved by ethanol extract at the concentration of 60 µg/ml, with excellent antibacterial activity against S. aureus, E. coli, S. enterica, B. subtilis, and P. aeruginosa (17.5 ± 1.0, 14.9 ± 1.0, 13.3 ± 1.5, 15.7 ± 1.0, and 13.8 ± 1.5 mm IZ, respectively). In addition, no expressive antiproliferative effect was recorded in the assessment of cytotoxicity on L929 cells. Conclusion: According to the current findings, CMF exhibits low cytotoxicity, antibacterial activity, and antioxidant properties in vitro and can be developed for pharmaceutical and medical uses in the future.

Agrobiological evaluations of newly introduced grapes varieties under climatic conditions of the south of Kazakhstan.

Variety assortment enhancement is a normal task that involves enhancing the assortment's quality and upgrading varieties. The findings of a research of imported grape varieties in the southeast of Kazakhstan, namely in the Almaty region's bottom-mountain zone, are presented in this article. The onset and conclusion of the main phenological phases of a grape plant throughout the vegetative period were directly influenced by the climatic and meteorological conditions of this district. In comparison to the recognized variety Almaty early-maturing, it has been proven that types Priusadebny, Iyulsky, and Kuibyshevsk early-maturing have a high degree of eyes wintering buds and may provide a high-quality crop in this location.

Partial purification of linoleic acid isomerase enzyme from Lactobacillus paracasei bacteria isolated from milk.

Conjugated Linoleic Acid (CLA) has attracted the attention of many researchers, especially that of microbial origin due to its biological importance to the consumer. The current study aims to extract LA Isomerase enzyme from Lactobacillus paracasei bacteria from milk and to use the enzyme in the production of CLA. Selective media, including MRS and MRS-Dagatose, were used in isolating local strains. The selected bacterial isolates were tested for their ability to produce LA-Isomerase enzyme. The isolate with high enzymatic activity was selected. After extraction and partial purification of the enzyme, the optimal conditions for the production of conjugated fatty acid were studied, and the reaction products were diagnosed using GC-MS technology. It was found that 11 isolates have the ability to produce CLA at different concentrations, H1 isolate showed the highest production of conjugated fatty acid at a concentration of 120.45 g.ml-1, this isolate was selected as the source for enzyme extraction. The enzymatic activity of the crude extract and partially purified with ammonium sulfate was estimated using color methods at wavelength of 233 nm. The effect of the optimum conditions (pH, temperature, linoleic acid concentration and enzyme concentration) on the CLA product was studied using the partially purified LA Isomerase enzyme, the optimum conditions for production were 6.5, 45 °C, 100 µg.ml-1 and 0.7 ml, respectively. The GC-MS technique showed the presence of a number of reaction products that are isomers of conjugated linoleic acid (C9T11, T9T12, T10C12) with different concentrations.

Clinicopathological Features and Outcomes of Gastrointestinal Stromal Tumours in Oman: A multi-centre study.

OBJECTIVES: This study aimed to report the clinicopathological features, management and long-term outcomes of patients with gastrointestinal stromal tumours (GISTs) in Oman. METHODS: This retrospective study was conducted on patients treated for GIST between January 2003 and December 2017 at three tertiary referral centres in Muscat, Oman. All patients with confirmed histopathological diagnoses of GIST and followed-up at the centres during this period were included. Relevant information was retrieved from hospital records until April 2019. RESULTS: A total of 44 patients were included in the study. The median age was 55.5 years and 56.8% were female. The most common primary site of disease was the stomach (63.6%) followed by the jejunum/ileum (18.2%). Two patients (4.5%) had c-Kit-negative, discovered on GIST-1-positive disease. A total of 24 patients (54.5%) presented with localised disease and eight (33.3%) were classified as being at high risk of relapse. Patients with metastatic disease received imatinib in a palliative setting, whereas those with completely resected disease in the intermediate and high-risk groups were treated with adjuvant imatinib. Of the six patients (13.6%) with progressive metastatic disease, of which four had mutations on exon 11 and one on exon 9, while one had wild-type disease. Overall, rates of progression-free survival and overall survival (OS) at 100 months were 77.4% and 80.4%, respectively. Rates of OS for patients with localised and metastatic disease were 89.9% and 80.2%, respectively. CONCLUSION: The presenting features and outcomes of patients with GISTs in Oman were comparable to those reported in the regional and international literature.

Photocatalytic activity and photoelectrochemical properties of Ag/ZnO core/shell nanorods under low-intensity white light irradiation.

Zinc oxide (ZnO) nanorod thin films were prepared by CBD onto glass and FTO/glass substrates. Silver (Ag) nanoparticles were synthesized on the surface of the prepared ZnO nanorod thin films using electrochemical methods. The scanning electron microscopy images of the Ag/ZnO/glass core/shell nanostructure confirmed that the average particles size is 20 nm while it was 41 nm for Ag NPs that synthesized onto ZnO/FTO NRs. The photocatalytic activity of the prepared Ag/ZnO core/shell nanostructure was studied by analyzing the degradation of methylene blue (MB) dye under visible light. Various pH values (6 and 10) and exposure time (30-240) min were controlled to investigate the photocatalytic activity of as-prepared Ag/ZnO core/shell nanostructure and that annealed at 200 °C and 300 °C for 1 h. It was observed that when the pH was 6, the degradation rate increased with the annealing temperature and irradiation time reaching 51% at the annealing temperature of 300 °C and exposure time of 240 min. In other hands, when the pH was 10, and the sample was annealed at 200 °C, it showed a good degradation rate of 100% at the irradiation time of 90 min. By contrast, the sample annealed at 300 °C required 180 min to degrade the MB dye completely. The photoelectrochemical cell measurement based on photocurrent density revealed a slight response to light. Cycle voltammetry (CV) measurement was conducted, and the CV curves of the Ag/ZnO core/shell electrodes indicated nonfaradaic and pseudocapacitance behavior. The electrodes showed nearly rectangular CV curves, which indicated the dominance of the nonfaradaic capacitance behavior. The specific capacitance of the electrodes remained at approximately 99%. Mott-Schottky analysis revealed that the semiconductor was an n-type with dependence on flat band potential V FB deviation in the negative direction.

Current status of scoliosis school screening: targeted screening of underserved populations may be the solution.

OBJECTIVES: The growing body of evidence documenting the effectiveness of brace treatment for scoliosis has renewed interest in potential benefits of early detection through school screening. We aimed to assess the prevalence and identify barriers of screening. We hypothesized that school screening is more frequent in schools that have a nurse on staff compared to schools without nurse on staff. STUDY DESIGN: A questionnaire survey. METHODS: All schools located in four counties in Louisiana, United States of America comprising the New Orleans metropolitan area between September 2015 and January 2016 were contacted by phone to assess rates of scoliosis screening, report the availability of a school nurse, and specify barriers if screening was not performed. RESULTS: Two hundred and ninety-one schools responded to the survey including 152 public, 30 charter, and 109 private schools (101 had religious affiliation). A staff nurse was available in 180 schools (61.8%). Only 21 schools (7.2%) performed scoliosis screening. The majority were charter schools (11 schools), while six were private and four were public (P < 0.0001). Of these 21 schools, 16 (76.2%) had a nurse on staff while five schools did not (P = 0.16). Lack of a referral pathway in the event of a positive screen was the most common barrier to performing scoliosis screening. CONCLUSION: Scoliosis screening is infrequent in the examined school districts. Efforts to support school screening can facilitate clear referral pathways for schools in the event of a positive screen. These findings suggest a potential need for different pathway of scoliosis screening. Pediatricians and family physicians can assist with scoliosis screening during the annual visit. While universal screening is overburdensome and likely unnecessary, targeted screening of underserved populations may prove to be beneficial. Further investigation should include assessment of the economic viability of targeted screening programs. LEVEL OF EVIDENCE: IV.

Delayed Diagnosis of Ureteral Injury Following Penetrating Abdominal Trauma: A Case Report and Review of the Literature.

BACKGROUND Ureteral injuries are considered to be uncommon in cases of trauma. The possibility of damage to the ureters may not be considered in the setting of acute trauma when life-threatening injuries take clinical management priority. A case of acute ureteral injury is described in a patient with acute penetrating gunshot abdominal injury that had a delay in diagnosis, with a review of the literature. CASE REPORT A 29-year-old woman presented to our hospital with a missed ureteral injury following a self-inflicted gunshot injury to the abdomen. She underwent abdominal computed tomography (CT) imaging and a retrograde pyelogram, which showed complete transection of the left upper ureter with contrast extravasation and the formation of a large urinoma. She underwent a percutaneous nephrostomy and drainage of the urinoma. An end-to-end ureteric anastomosis with excision of the intervening injured ureter, or ureteroureterostomy, was performed three weeks following the diagnosis. CONCLUSIONS Ureteral injuries following trauma are rare, but a delay in diagnosis can be associated with clinical morbidity. A high index of clinical suspicion is important for early identification of ureteral injury in cases of acute abdominal trauma.

Distribution of Trauma Care Facilities in Oman in Relation to High-Incidence Road Traffic Injury Sites: Pilot study.

OBJECTIVES: Road traffic injuries (RTIs) are considered a major public health problem worldwide. In Oman, high numbers of RTIs and RTI-related deaths are frequently registered. This study aimed to evaluate the distribution of trauma care facilities in Oman with regards to their proximity to RTI-prevalent areas. METHODS: This descriptive pilot study analysed RTI data recorded in the national Royal Oman Police registry from January to December 2014. The distribution of trauma care facilities was analysed by calculating distances between areas of peak RTI incidence and the closest trauma centre using Google Earth and Google Maps software (Google Inc., Googleplex, Mountain View, California, USA). RESULTS: A total of 32 trauma care facilities were identified. Four facilities (12.5%) were categorised as class V trauma centres. Of the facilities in Muscat, 42.9% were ranked as class IV or V. There were no class IV or V facilities in Musandam, Al-Wusta or Al-Buraimi. General surgery, orthopaedic surgery and neurosurgery services were available in 68.8%, 59.3% and 12.5% of the centres, respectively. Emergency services were available in 75.0% of the facilities. Intensive care units were available in 11 facilities, with four located in Muscat. The mean distance between a RTI hotspot and the nearest trauma care facility was 34.7 km; however, the mean distance to the nearest class IV or V facility was 83.3 km. CONCLUSION: The distribution and quality of trauma care facilities in Oman needs modification. It is recommended that certain centres upgrade their levels of trauma care in order to reduce RTI-associated morbidity and mortality in Oman.

Comparison of Postoperative Drain Insertion versus No Drain Insertion in Thyroidectomies: Retrospective case-control study from the Sultan Qaboos University Hospital, Muscat, Oman.

OBJECTIVES: A thyroidectomy is a frequently performed surgical procedure which can result in life-threatening complications. The insertion of a drain after a thyroidectomy has been suggested to prevent such complications. This study aimed to evaluate the use of surgical drains following thyroidectomies in relation to postoperative complications and mass sizes. METHODS: This retrospective case-control study included all thyroidectomies conducted at the Sultan Qaboos University Hospital, Muscat, Oman, from January 2011 to December 2013. Length of hospital stay, readmission, postoperative complications and mass size were evaluated. RESULTS: During the study period, 250 surgeries were carried out on 241 patients. The majority of patients were female (87.2%). Drains were inserted postoperatively after 202 surgeries (80.8%) compared to 48 surgeries (19.2%) without drains. A total of 32 surgeries (12.8%) were conducted on patients with thyroid masses <1 cm, 138 (55.2%) on those with masses between 1-4 cm and 80 (32.0%) on those with masses >4 cm. The association between drain use and mass size was not significant (P = 0.439). Although postoperative complications were more prevalent in patients with drains, the relationship between these factors was not significant (P >0.050). Length of hospital stay was significantly longer among patients with postoperative drains (P <0.010). CONCLUSION: The routine insertion of drains after thyroid surgeries was found to result in longer hospital stays and did not reduce rates of post-thyroidectomy complications. Thyroid mass size should not be used as an indicator for the insertion of a drain after thyroidectomy.