Meta-analysis and trial sequential analysis of pancreatic stump closure using a hand-sewn or stapler technique in distal pancreatectomy.

This study aimed to compare outcomes of hand-sewn and stapler closure techniques of pancreatic stump in patients undergoing distal pancreatectomy (DP). Impact of stapler closure reinforcement using mesh on outcomes was also evaluated. Literature search was carried out using multiple data sources to identify studies that compared hand-sewn and stapler closure techniques in management of pancreatic stump following DP. Odds ratio (OR) was determined for clinically relevant postoperative pancreatic fistula (POPF) via random-effects modelling. Subsequently, trial sequential analysis was performed. Thirty-two studies with a total of 4,022 patients undergoing DP with hand-sewn (n = 1,184) or stapler (n = 2,838) closure technique of pancreatic stump were analyzed. Hand-sewn closure significantly increased the risk of clinically relevant POPF compared to stapler closure (OR: 1.56, p = 0.02). When stapler closure was considered, staple line reinforcement significantly reduced formation of such POPF (OR: 0.54, p = 0.002). When only randomized controlled trials were considered, there was no significant difference in clinically relevant POPF between hand-sewn and stapler closure techniques (OR: 1.20, p = 0.64) or between reinforced and standard stapler closure techniques (OR: 0.50, p = 0.08). When observational studies were considered, hand-sewn closure was associated with a significantly higher rate of clinically relevant POPF compared to stapler closure (OR: 1.59, p = 0.03). Moreover, when stapler closure was considered, staple line reinforcement significantly reduced formation of such POPF (OR: 0.55, p = 0.02). Trial sequential analysis detected risk of type 2 error. In conclusion, reinforced stapler closure in DP may reduce risk of clinically relevant POPF compared to hand-sewn closure or stapler closure without reinforcement. Future randomized research is needed to provide stronger evidence.

Effect of experimental boundary conditions and treatment-time on the electro-desalination of soils.

This study investigates the effect of boundary conditions and treatment-time on the electro-desalination of artificially-contaminated soil. The effect of ion exchange membranes (IEM), calcium chloride (CaCl2), and ethylenediaminetetraacetic acid (EDTA) on the removal of salt (i.e., Na+, Cl-, and Ca2+) and metal (i.e., Co2+ and Fe2+) ions from the soil by electrokinetic (EK) was studied. The outcomes demonstrate that an increase in treatment-time decreases the electroosmosis and ion removal rate, which might be attributed to the formation of acid-base fronts in soil, except in the IEM case. Because a high pH jump and electroosmotic flow (EOF) of water were not observed within the soil specimen due to the IEM, the removal of ions was only by diffusion and electromigration. The collision of acid-base fronts produced a large voltage gradient in a narrow soil region with a reduced electric field (EF) in its remaining parts, causing a decrease in EOF and ion transport by electromigration. The results showed that higher electroosmosis was observed by using CaCl2 and EDTA; thus, the removal rate of Co2+, Na+, and Ca2+ was greater than Cl- due to higher EOF. However, for relatively low EOF, the removal of Cl- exceeded that of Co2+, Na+, and Ca2+, possibly due to a lack of EOF. In addition, the adsorption of Fe2+ in soil increased with treatment-time due to the corrosion of the anode during all EK experiments except in the case of IEM, where an anion exchange membrane (AEM) was introduced at the anode-soil interface.

Prevalence of celiac-related antibodies and its impact on metabolic control in Egyptian children with type 1 diabetes mellitus.

OBJECTIVE: The simultaneous presence of celiac disease and type 1 diabetes (T1DM) is coupled with more hazards of comorbidities and complications. This current study aimed to screen for celiac disease in Egyptian children with type 1 diabetes and evaluate its impact on glycemic control. METHODS: A cross-sectional study was verified with 200 Egyptian children diagnosed with T1DM and having a diabetic duration of less than five years. Testing for anti-tissue transglutaminase IgA (tTG-IgA), anti-tissue transglutaminase IgG (tTG-IgG), anti-Endomysial IgA (EMA), and Hb A1c levels were done. RESULTS: The serological screening revealed that 11 cases (5.5%) tested positive; 8 children with T1DM (4.0%) showed tTG-IgA antibodies ≥ 10 times the upper limit of normal (ULN) with at least one symptom; and 3 cases (1.5%) had levels between 20 and 50 IU/ml (considering a cut-off point of 10 U/ML for positive results). Intestinal biopsy was performed for these three cases, with one case detected to have subtotal villous atrophy, resulting in an overall prevalence of celiac disease in T1DM as 4.5%. Children with positive screening exhibited a higher insulin dose, a higher HbA1c, an increased frequency of hypoglycemic attacks, and recurrent DKA compared to negative cases. A negative correlation was detected between tTG-IgA antibodies with height Z score and hemoglobin level, while a positive correlation was found between tTG-IgA antibodies and HbA1c level. CONCLUSION: Undiagnosed celiac disease in children with T1DM negatively impacted metabolic control and affected their general health.

Strategies and sustainability in fast charging station deployment for electric vehicles.

This comprehensive review investigates the growing adoption of electric vehicles (EVs) as a practical solution for environmental concerns associated with fossil fuel usage in mobility. The increasing demand for EVs underscores the critical importance of establishing efficient, fast-charging infrastructure, especially from the standpoint of the electrical power grid. The review systematically examines the planning strategies and considerations for deploying electric vehicle fast charging stations. It emphasizes their unique dual role as loads and storage units, intricately linked to diverse road and user constraints. Furthermore, the review underscores the significant opportunity surrounding these stations for the integration of distributed renewable energy sources. It thoroughly explores the challenges and opportunities intrinsic to the planning and localization process, providing insights into the complexities associated with these multifaceted stations. Renewable resources, including wind and solar energy, are investigated for their potential in powering these charging stations, with a simultaneous exploration of energy storage systems to minimize environmental impact and boost sustainability. In addition to analyzing planning approaches, the review evaluates existing simulation models and optimization tools employed in designing and operating fast charging stations. The review consolidates key findings and offers recommendations to researchers and grid authorities, addressing critical research gaps arising from the escalating demand for electric vehicle fast-charging infrastructure. This synthesis is a valuable resource for advancing understanding and implementing robust strategies in integrating EVs with the electrical power grid.

Health risks assessment and source admeasurement of potentially dangerous heavy metals (Cu, Fe, and Ni) in rapidly growing urban settlement.

Environmental contamination is a global challenge that impacts every aspect of ecosystem. The contaminants from anthropogenic or industrial trash continually recirculate into the environment, agricultural land, plants, livestock, and ultimately into humans by way of the food chain. After an increase in human and farmland animal deaths from illnesses due to contaminated drinking water, toxic metal water poisoning has remained a global concern. Diverse environmental and enforcement organisations have attempted to regulate the activities that serve as precursors to these heavy metals which have been proven ineffective. These unnecessary metals have severely hampered most biological processes. The presence of hazardous metals, which are harmful at extremely high levels and have a negative effect on the health of living bodies generally degrades the nutritional value of water. In order to evaluate the heavy metals (Cu, Ni, and Fe) toxicity of groundwater in pri-urban areas, the current study was conducted that have been considered as advance solution to tackle climate change which influence coastal ecosystem. Additionally, the impacts of soil and plant (spinach and brassica) contamination from groundwater were evaluated. The heavy metals were examined in the soil and groundwater samples (Pb, Fe and Ni). While Fe concentrations in water samples were found to be high as 1.978 mg/L as compared to Ni and Cu values low. According to WHO guidelines, the mean value of Fe exceeds the limit value. Similarly, Cu had a higher mean value (0.7 mg/L) in soil samples than other metals (Ni and Fe). In comparison to Ni and Cu, the Fe concentrations in spinach and brassica plants samples are greater, at 17.2 mg/L and 3.22 mg/L, respectively. The possible effects of metal poisoning of groundwater and plants on human health have been assessed using the Hazard Quotient (HQ), Evaluated Daily Intake (EDI), and Incremental Life Time Cancer Risk formulas (ILTCR). When drinking Ni-contaminated water, humans are more at risk of developing cancer (0.0031) than Fe and Cu. Metal concentrations in water and brassica showed substantially more scattered behaviour on the plot and no meaningful relationship, although PCA and masked matrix correlation showed a fair association between Ni and Cu in brassica (r2: 0.46) and Fe and Ni in spinach (r2: 0.31). According to the study's findings, it is anticipated that special management and groundwater monitoring will be needed in the examined area to reduce the health risks related to drinking water that has been contaminated with metals.

Assessing the risk of venous thromboembolism in patients with haematological cancers using three prediction models.

PURPOSE: Assessment of individual VTE risk in cancer patients prior to chemotherapy is critical for determining necessity of interventions. Risk assessment models (RAM) are available but have not been validated for haematological malignancy. We aimed to assess the validity of the Vienna Cancer and Thrombosis Study (V-CATS) score in prediction of VTE in a variety of haematological malignancies. METHODS: This is a prospective cohort study conducted on 81 newly diagnosed cancer patients undergoing chemotherapy. Demographic, clinical and cancer related data were collected, patients were followed up for 6 months, and VTE events were recorded. Khorana score (KS) was calculated. Plasma D-dimer and sP-selectin were measured, and then, V-CATS score was calculated. Receiver operator curve (ROC) was used to assess the sensitivity and specificity of RAMs. A modified V-CATS was generated and subsequently assessed by using new cut-off levels of d-dimer and sP-selectin based on ROC curve of the patients' results and compared the probability of VTE occurrence using all three RAMs. RESULTS: Among the 81 patients included in this study, a total of 2.7% were diagnosed with advanced metastatic cancer. The most frequent cancer was non-Hodgkin lymphoma (39.5%), and 8 patients (9.8%) developed VTE events. The calculated probability of VTE occurrence using KS, V-CATS and modified V-CATS scores at cut-off levels ≥ 3 was 87.5%, 87.5% and 100%, respectively. The AUC in ROC curve of modified Vienna CATS score showed significant difference when compared to that of V-CATS and KS (P = 0.047 and 0.029, respectively). CONCLUSION: The findings of our study highlight the value of three VTE risk assessment models in haematological malignancies. The modified V-CATS score demonstrated higher specificity compared to both V-CATS and KS, while all three scores exhibited similar sensitivity. We encourage the implementation of RAMs in haematological cancers for an appropriate use of thromboprophylaxis.

Elevation of D-dimer levels are associated with early need for mechanical ventilation support in patients with COVID-19.

BACKGROUND: Severe COVID-19 disease is typically associated with an urgent need for supplemental oxygen therapy that may be successfully delivered through conventional methods or require invasive mechanical ventilation. Early prediction of the need for invasive mechanical ventilation could significantly improve outcomes of COVID-19 patients. Plasma levels of D-dimer and a number of inflammatory markers as well as values of complete blood counts, all measured in the first two days of hospital admission of COVID-19 patients, were evaluated for their significance as predictors of the eventual need for invasive mechanical ventilation support as well as their values as predictors of post-ventilation morbidly and mortality. METHODS: This retrospective cohort study was conducted at a single center and included data pertaining to 200 patients with previously confirmed moderate to severe COVID-19 disease in the period between May 2021 and the end of December 2022. Data were retrieved from medical records for further analysis. RESULTS: The mean (SD) age of patients stood at 59 (14) years of age, and with a majority of patients being male (77%). About 18% of cases, all of significantly older age, had been connected to invasive mechanical ventilation (IMV). Total leucocytic count (TLC), as well as levels of urea, creatinine, D-dimer, ferritin, and CRP in IMV patients were significantly higher than non-ventilated patients (p < 0.01 for all). In contrast, lymphocytic count, hemoglobin level, and platelet count were significantly lower in IMV patients (p < 0.001, 0.04, and 0.002, respectively). The mortality rate was significantly higher in IMV patients (p < 0.001). D-dimer independently predicted IMV demand (OR = 1, p = 0.001 in adjusted and unadjusted models). The utility of D-dimer was excellent; and the cutoff level of above 1415 µ/L showed sensitivity and specificity of about 92% and 76%, respectively. Also, the D-dimer level was very effective in predicting post-IMV survival; the AUC = 0.86, p = 0.02, and a cutoff value below 4558 µ/L was associated with 100% and 66% sensitivity and specificity, respectively. CONCLUSIONS: High D-dimer levels independently correlated with the need for invasive mechanical ventilation. Low levels of this marker could evidently predict post-IMV survival of mechanically ventilated COVID-19 patients. Measuring D-dimer levels during routine follow up of those patients would thus be useful in predicting patient outcomes.

FOS-Like Antigen 1 Expression Was Associated With Survival of Hepatocellular Carcinoma Patients.

Background: Early diagnosis and proper management of hepatocellular carcinoma (HCC) improve patient prognosis. Several studies attempted to discover new genes to understand the pathogenesis and identify the prognostic and predictive factors in HCC patients, to improve patient's overall survival (OS) and maintain their physical and social activity. The transcription factor FOS-like antigen 1 (FOSL1) acts as one of the important prognostic factors in different tumors, and its overexpression correlates with tumors' progression and worse patient survival. However, its expression and molecular mechanisms underlying its dysregulation in human HCC remain poorly understood. Our study was conducted to evaluate the expression of FOSL1 in HCC tissues and its relationship with various clinicopathological parameters besides OS. Methods: This study is a retrospective cohort study conducted among 113 patients with a proven diagnosis of HCC, who underwent tumor resection and received treatment at South Egypt Cancer Institute. Immunohistochemistry for FOSL1 expression and survival curves were conducted followed by statistical analysis. Results: HCC occurred at older age group and affected males more than females. There was a statistically significant correlation between combined cytoplasmic and nuclear expression of FOSL1 and worse prognosis in HCC patients. There was a statistically significant correlation of FOSL1 expression with histological grade, lymphovascular embolization, and tumor budding where high expression indicated potential deterioration of HCC patients. There was statistically significant correlation between tumor size, tumor grade and FOSL1 expression with the cumulative OS. Conclusions: Combined cytoplasmic and nuclear FOSL1 expression has significant prognostic association with HCC and diagnostic importance, as it can identify cirrhosis and premalignant lesions that can progress to HCC. Furthermore, Kaplan-Meier survival analysis found that overexpressed FOSL1 was correlated with poor OS.

Noncytotoxic Dy3+ -activated glass emits cool white light for near ultraviolet-based white light-emitting diodes, visible lasers, and biomedical applications.

Using the melt quenching technique, a lithium zinc borate glass (LZB) system with trivalent dysprosium ions (Dy3+ ) was synthesized, and the luminescence and lasing properties of these materials were examined for the generation of white light. Structural investigation through X-ray diffraction revealed that the prepared glass had an amorphous nature. The optimized glass containing 0.5 Dy3+ had a direct optical band gap of 2.782 eV and an indirect optical band gap of 3.110 eV. A strong excitation band at 386 nm (6 H15/2 →4 I13/2 ) was recognized in the ultraviolet (UV) light region of its excitation spectrum. Emission bands could be seen in the photoluminescence spectrum at 659, 573, and 480 nm under the 386 nm excitation. These transitions of emission resembled electronic transitions such as (4 F9/2 →6 H11/2 ), (4 F9/2 →6 H13/2 ), and (4 F9/2 →6 H15/2 ). In a pristine glass matrix, the higher intensity ratio of yellow to blue can result in the production of white light. The optimized Dy3+ ion concentration was observed to be 0.5 mol%. In addition, an analysis of lifetime decay was conducted for all synthesized glasses, and their decay trends were systematically investigated. Noticeably, we assessed the photometric parameters and found that they were close to the white light standard. Furthermore, a cytotoxicity study was carried out using lung fibroblast (WI-38) cell lines for the optimized 0.5Dy3+ -doped LZB glass and it appeared to be noncytotoxic. It is clear from the results that the noncytotoxic LZB glass doped with 0.5 Dy3+ ions could be a suggestive choice for the manufacture of white light-emitting diodes and lasers using near-UVs.

Silica quantum dots; an optical nanosensing approach for trace detection of pesticides in environmental and biological samples.

Both the environment and human health have suffered as a result of excessive and irrational pesticide use. The human body is vulnerable to a wide range of illnesses brought on by prolonged exposure to or intake of food contaminated with pesticide residues, including immunological and hormonal abnormalities and the development of certain tumors. Sensors based on nanoparticles stand out from more conventional spectrophotometry analytical methods due to their low detection limits, high sensitivity, and ease of use; that is why the demand for simple, fast, and less expensive sensing methods increases daily and presents myriad uses. Such demands are fulfilled by employing paper-based analytical devices having intrinsic properties. The presented work reports an on-site, easy-to-handle, and disposable paper-based sensing device for performing fast screening along with readout from a smartphone. The fabricated device utilizes luminescent silica quantum dots, immobilized into a paper cellulose matrix, and the resonance energy transfer phenomenon is employed. The silica quantum dots probes were fabricated from citric acid and, by undergoing physical adsorption, were confined on the nitrocellulose substrate in small wax-traced spots. The silica quantum dots were excited by smartphone ultraviolet LED, acting as an energy source and for capturing the image. The obtained LOD is 0.054 µM, and the coefficient of variation is less than 6.1%, comparable to the result obtained by UV-Visible and fluorometric analysis under similar experimental conditions. In addition, high reproducibility (≥9.8%) and high recovery ≥90% were obtained in spiked blood samples. The fabricated sensor sensitively detected pesticides giving a LOD of 2.5 ppm along with the development of yellow color within a short period of 5 min. The sensor functions well when sophisticated instrumentation is not accessible. The presented work shows the potential of the paper strip for the on-site detection of pesticides in biological and environmental samples.

Excellent photocatalytic and antibacterial activities of bio-activated carbon decorated magnesium oxide nanoparticles.

Green production of nanomaterials are restrict toxic substances and motivated the noxious free environment. Photocatalysis and antibacterial resistance are more promising and efficient fields for their chemical reductants and clean environment. Herein, we adopted a green and simple method for the biosynthesis of MgO NPs using Manilkara zapota as a bio source. Recently, the green synthesis of magnesium oxide nanoparticles has been a keen interest amongst researchers and scientists due to its simplicity eco-friendliness, non-toxic, inexpensive and potential to perform as an antibacterial agent. Activated carbon/Magnesium oxide (AC/MgO) photocatalyst was blended through a simple solution evaporation method. The surface electron microscopy (SEM) study reviles that AC/MgO had smooth and aggregated particles. The Fourier transform infrared (FT-IR) and x-ray diffraction (XRD) study confirms the structural formation and incorporation of nanoparticles into the AC matrix. Results confirmed the flourishing integration of MgO NPs over the activated carbon matrix. The electron movement and valency of AC/MgO photocatalyst reduced the bandgap and their findings were characterized by ultra visible diffuse reflectance spectroscopy (UV-DRS) and x-ray photoelectron spectroscopy (XPS). The blended AC/MgO photocatalyst was analyzed for photodegradation of Rhodamine- B (Rh-B) dye using a UV-visible spectrophotometer. The degradation study projects that the AC/MgO photocatalyst degrades (Rh-B) dye with 99% efficiency under simulated solar irradiation. This efficient degradation of (Rh-B) dye by AC/MgO photocatalyst is ascribed to the synergetic AC as catalytic support and adsorbent and MgO as photocatalyst. Finally, the photocatalytic material shows a better bactericidal effect in both gram-positive bacteria Escherichia coli-745 and gram-negative bacteria Staphylococcus aureus-9779. The AC/MgO photocatalyst is effectively used in bacteriocidal and photocatalytic removal of dyes and can be used for further development of water reuse and bio-medical fields. In addition, this research shows a viable method for synthesizing a cheap and effective AC/MgO for the photocatalytic destruction of organic pollutants.

Green synthesized Ag decorated CeO2 nanoparticles: Efficient photocatalysts and potential antibacterial agents.

Implication of natural resources for manufacturing of nanoparticles is sustainable, economical and contaminant free approach towards ecological and medical applications. Herein, CeO2 and Ag/CeO2 nanoparticles are green synthesized from Morinda tinctoria plant extract. The phase structure, surface morphology, optical identity, Ce(III) and Ce(IV) valency of the synthesized CeO2 and Ag/CeO2 nanoparticles are explored. The X-ray diffraction analysis indicated the formation of cubic phase CeO2 and cubic silver decorated CeO2 nanoparticles. Fourier transform infrared (FTIR) spectroscopy revealed the metal decoration of CeO2 nanoparticles, metal-oxygen stretching, indicating the plant molecules reduction and stabilization. UV-visible spectroscopy shown the decreased band gap owing to silver modification. Scanning electron microscopy (SEM) and transmission electron microscopy (TEM) micrographs displayed spherical morphology of the nanoparticles. Elemental composition and sample purity is assessed by energy dispersive spectroscopy (EDS). Double oxidation of Ce, double splitting energy of Ag and lattice oxygen are observed from X-ray photoelectron spectroscopy (XPS). Photocatalytic activity of Ag/CeO2 exposed the enhanced photocatalytic activity up to 94% where CeO2 nanoparticles gave 60% degradation of bromophenol blue (BB). The plasmonic decoration of silver on the ceria surface induced the charge separations and free radical reactions. Moreover, Ag/CeO2 nanoparticles are seen as superior antibacterial agents than CeO2 towards both E.coli and S.aureus. Hence, the silver decorated metal oxide photocatalyst successfully degraded the BB dye and inactivated the bacterial strains. This report established a future research in green synthesis of multipurpose metal nanoparticles.

Development and optimization of amphiphilic self-assembly into nanostructured liquid crystals for transdermal delivery of an antidiabetic SGLT2 inhibitor.

The anti-hyperglycemic sodium glucose co-transporter 2 inhibitor Canagliflozin (CFZ) represents a recent antihyperglycemic modality, yet it suffers from low oral bioavailability. The current work aims to formulate CFZ-loaded transdermal nanostructured liquid crystal gel matrix (NLCG) to improve its therapeutic efficiency. Pre-formulation study included the construction of pseudoternary phase diagrams to explore the effect of two conventional amphiphiles against amphiphilic tri-block copolymer in the formulation of NLCG. The influence of different co-solvents was also investigated with the use of monooleine as the oil. Physical characterization, morphological examination and skin permeation were performed for the optimized formulations. The formula of choice was further investigated for skin irritation and chemical stability. Pharmacodynamic evaluation of the successful formula was conducted on hyperglycemic as well as normoglycemic mice. In addition, oral glucose tolerance test was conducted. Results revealed the supremacy of Poloxamer for stabilizing and maximizing liquid crystal gel (LCG) area percentage that reached up to 12.6%. CFZ-NLCG2 isotropic formula showed the highest permeation parameters; maximum flux value of 7460 µg/cm2 h and Q24 of 5327 µg/cm2. Pharmacodynamic evaluation revealed the superiority of the antihyperglycemic activity of CFZ-NLCG2 in fasting mice and its equivalence in the oral glucose tolerance test (OGTT) compared to the oral one. The obtained results confirmed the success of CFZ-NLCG2 in the transdermal delivery of CFZ in therapeutically effective concentration compared to the oral route, bypassing first pass effect; in addition, eliminates the possible gastrointestinal side effects related to the inhibition of intestinal sodium glucose co-transporter (SGLT) and maximizes its selectivity to the desired inhibition of renal SGLT.

Prevalence of Intestinal Parasitic Infections and Associated Risk Factors Among Schoolchildren in Ibb Governorate, Southwest Yemen: A Cross-Sectional Study.

Introduction: Intestinal parasitic infections (IPIs) among schoolchildren are important public health problem, especially in developing countries, and monitoring of such infections and associated risk factors are necessary for intervention strategies. In line with this view, the aim of this study was to determine the prevalence of IPIs and associated risk factors among schoolchildren in Ibb governorate, southwest Yemen. Methods: A cross-sectional study was carried out during February to April 2020 on 600 schoolchildren selected from 6 districts of Ibb governorate. Fecal specimens were examined using saline and iodine wet mount and formal-ether concentration techniques. Socio-demographic data were collected using pre-designed, structured questionnaires. The results were analyzed using SPSS for Windows version 25 (SPSS Inc., Chicago, IL, USA). Results: Out of 600 participants, the overall prevalence of IPIs was 66.3% (398/600). The prevalence rate of protozoan infections (56.3%, 338/600) was largely higher than helminthic infections (10%, 60/600). The most common intestinal parasite was E. histolytica/dispar (28.5%, 171/600). S. mansoni infection showed higher infection rate in males (5.3%) than in females (0.4%), with statistically significant difference (P = 0.001). Univariate analysis showed that the age was only significantly associated with protozoan infections, with statistically significant differences (P = 0.002). Regarding to clinical symptoms, the presence of IPIs was significantly associated with diarrhea, dysentery, and abdominal pain. Conclusion: The present study revealed that there was a relatively high prevalence of IPIs, especially protozoan parasites, in schoolchildren of the study area, with E. histolytica/dispar being the most prevalent parasite. The results showed that age was only significantly associated with IPIs. According to the results of this study, IPIs are still among the main public health problems in the study area. Thus, effective prevention and control strategies are important to reduce the incidence of IPIs in this area of the country.

Biochemical Reactions and Their Biological Contributions in Honey.

Honey is known for its content of biomolecules, such as enzymes. The enzymes of honey originate from bees, plant nectars, secretions or excretions of plant-sucking insects, or from microorganisms such as yeasts. Honey can be characterized by enzyme-catalyzed and non-enzymatic reactions. Notable examples of enzyme-catalyzed reactions are the production of hydrogen peroxide through glucose oxidase activity and the conversion of hydrogen peroxide to water and oxygen by catalase enzymes. Production of hydroxymethylfurfural (HMF) from glucose or fructose is an example of non-enzymatic reactions in honey.

A comparative study of chiral separation of proton pump inhibitors by supercritical fluid chromatography and high-performance liquid chromatography.

A comparative study of chiral separation of pantoprazole and rabeprazole is carried out using supercritical fluid chromatography and high-performance liquid chromatography. The columns used were Chiralpak IA and Chiralpak IE. The best mobile phase in supercritical fluid chromatography was carbon dioxide-0.2% triethylamine in methanol (60:40) and 0.1% triethylamine in n-hexane-ethanol (50:50) in high-performance liquid chromatography. For supercritical fluid chromatography, values of the retention factor of pantoprazole enantiomers were 3.97 and 4.88. These values for rabeprazole enantiomers were 6.10 and 7.52. The values of separation and resolution factor for pantoprazole and rabeprazole were 1.23 and 1.23 and 2.20 and 3.36, respectively. Similarly, for high-performance liquid chromatography, the values of retention factor for enantiomers of pantoprazole were 4.02 and 7.32. These values for rabeprazole enantiomers were 5.32 and 7.88, respectively. The values of separation and resolution factor for pantoprazole and rabeprazole were 1.82 and 1.48 and 9.22 and 6.58, respectively. A comparison was carried out, which confirmed supercritical fluid chromatography as the best method due to its fastness, eco-friendly, and inexpensiveness. The reported methods are effective, efficient, and reproducible and may be used to separate and identify pantoprazole and rabeprazole in any unknown samples.

Earliest Olduvai hominins exploited unstable environments ~ 2 million years ago.

Rapid environmental change is a catalyst for human evolution, driving dietary innovations, habitat diversification, and dispersal. However, there is a dearth of information to assess hominin adaptions to changing physiography during key evolutionary stages such as the early Pleistocene. Here we report a multiproxy dataset from Ewass Oldupa, in the Western Plio-Pleistocene rift basin of Olduvai Gorge (now Oldupai), Tanzania, to address this lacuna and offer an ecological perspective on human adaptability two million years ago. Oldupai's earliest hominins sequentially inhabited the floodplains of sinuous channels, then river-influenced contexts, which now comprises the oldest palaeolake setting documented regionally. Early Oldowan tools reveal a homogenous technology to utilise diverse, rapidly changing environments that ranged from fern meadows to woodland mosaics, naturally burned landscapes, to lakeside woodland/palm groves as well as hyper-xeric steppes. Hominins periodically used emerging landscapes and disturbance biomes multiple times over 235,000 years, thus predating by more than 180,000 years the earliest known hominins and Oldowan industries from the Eastern side of the basin.

Adding a Preoperative Dose of LMWH may Decrease VTE Following Bariatric Surgery.

BACKGROUND: Bariatric procedures are the most effective management for obesity. There is no standard venous thromboembolism (VTE) prophylaxis for both dosing and duration of anticoagulation following laparoscopic sleeve gastrectomy. Our purpose was to assess the optimum regimen for VTE prophylaxis in bariatric procedures and to reduce the incidence of perioperative bleeding. METHODS AND MATERIALS: This is a prospective randomized study which involved 100 morbidly obese patients, subdivided into two groups; group A received postoperative low molecular weight heparin (LMWH) prophylaxis alone starting from day 1 to day 15 in dose 1 mg/kg/day in a maximum dose 120 mg/day, and group B received both pre- and postoperative LMWH; at night of surgery 12 h preoperatively and postoperative starting from day 1 to day 15 with the same dose. All patients underwent mesenteric and bilateral lower limbs duplex 15 days postoperative using Philips iU machine and linear (L9-3), convex (C5-1) and sector (S5-1) probes. RESULTS: Regarding postoperative VTE, we found statistically significant increase in postoperative VTE in patients of group A (four cases) without any case complicated with VTE in patients of group B (P value = 0.041). Regarding postoperative bleeding, we found statistically insignificant percent of cases complicated with postoperative bleeding in group B compared to group A (P value 0.315). CONCLUSION: Preoperative as well as a postoperative prophylactic anticoagulant as LMWH is recommended to prevent perioperative VTE. There was an insignificant increase in postoperative bleeding in patients who received preoperative prophylactic anticoagulants.

Impact of the coronavirus disease 2019 (COVID-19) pandemic on pediatric oncology care in the Middle East, North Africa, and West Asia region: A report from the Pediatric Oncology East and Mediterranean (POEM) group.

BACKGROUND: Childhood cancer is a highly curable disease when timely diagnosis and appropriate therapy are provided. A negative impact of the coronavirus disease 2019 (COVID-19) pandemic on access to care for children with cancer is likely but has not been evaluated. METHODS: A 34-item survey focusing on barriers to pediatric oncology management during the COVID-19 pandemic was distributed to heads of pediatric oncology units within the Pediatric Oncology East and Mediterranean (POEM) collaborative group, from the Middle East, North Africa, and West Asia. Responses were collected on April 11 through 22, 2020. Corresponding rates of proven COVID-19 cases and deaths were retrieved from the World Health Organization database. RESULTS: In total, 34 centers from 19 countries participated. Almost all centers applied guidelines to optimize resource utilization and safety, including delaying off-treatment visits, rotating and reducing staff, and implementing social distancing, hand hygiene measures, and personal protective equipment use. Essential treatments, including chemotherapy, surgery, and radiation therapy, were delayed in 29% to 44% of centers, and 24% of centers restricted acceptance of new patients. Clinical care delivery was reported as negatively affected in 28% of centers. Greater than 70% of centers reported shortages in blood products, and 47% to 62% reported interruptions in surgery and radiation as well as medication shortages. However, bed availability was affected in <30% of centers, reflecting the low rates of COVID-19 hospitalizations in the corresponding countries at the time of the survey. CONCLUSIONS: Mechanisms to approach childhood cancer treatment delivery during crises need to be re-evaluated, because treatment interruptions and delays are expected to affect patient outcomes in this otherwise largely curable disease.

Awareness of carpal tunnel syndrome among adult population of Al Majmaah city, Saudi Arabia, 2018-2019.

BACKGROUND: Due to the lack of data and studies concerning about measurement of population awareness about carpal tunnel syndrome (CTS) in Al Majmaah city, this study aims at determining the level of population awareness among Al Majmaah adult population in Saudi Arabia. AIMS: To study the awareness of CTS among adult population in Al Majmaah city, Saudi Arabia, and to estimate the overall prevalence of CTS. In addition, to look for the relationship between CTS and chronic disease. MATERIALS AND METHODS: In this cross-sectional study, 386 individuals were covered, both males and females in the targeted areas. A standardized questionnaire was used to cover 11 different aspects concerning CTS. SPSS package was used to analyze the data collected from the sample. RESULTS: The result of scoring system shows that 54 of participants (14.0%) have CTS. Approximately, 30% of them are thought that the main symptom is pain in wrist. However, 26.7% think that tingling and numbness in fingers is the main manifestation. The most causes that population think that leads to the CTS are trauma, repeated hand physical activities such as using computer, taping, and wrist fracture or dislocation by 33.8%, 29.1%, and 21.4% respectively. There is relationship between patients who had chronic diseases and CTS [sig = 0.000]. CTS cause a strong effect on social life by 79.01% of participant though that CTS could affect patient sleep and job performance. CONCLUSION: The awareness of community was sufficient among adult population in Al Majmaah city, and the prevalence of CTS is 14%.